Societal Benefits of Funded IVF Treatments and the Barriers to Funding in the United States Jennifer Shmerl Faculty Advisor: Dr. Linda Graf Background Methods Results Discussion Conception for some couples is not an option. Subfertility is defined as “any form of reduced fertility with prolonged time of unwanted non-conception” (Gnoth, 2005). Parenthood is a huge part of human life, and the importance of in vitro fertilization (IVF) should not be underestimated. For individuals living in countries that have a national healthcare system (NHS), IVF can be performed at little to no cost. Funding IVF treatments would allow couples, who would otherwise not be able to afford this expensive treatment, a chance at starting their own family.   The Affordable Care Act (ACA) does not currently require that infertility treatments such as IVF to be covered by health insurance in the U.S. IVF treatments are mandated by state laws, and there are currently only fifteen states that have laws regarding this practice (Norris, 2016). Research design: Integrative literature review   Literature Search Strategies: Databases: CINAHL, ProQuest Nursing & Allied Health Source, and PubMed Keywords:: in vitro fertilization, IVF, infertility, subfertility, subfertile couples, conception, national healthcare system, national health care countries, NHS, healthcare costs, and benefits A total of 10 articles were chosen for this review. Medical necessity: “IVF should be publicly funded because infertility is a medical condition” (Mladovsky et al., 2010) “Infertility can result in a medical need, because it can be a disruption of normal species function and can result in diminished opportunity, being able to reproduce at childbearing age is something they ought to be able to do in order to have the equal opportunity of living a good life” (Mladovsky et al., 2010) “IVF should be reimbursable when confronted with the knowledge that the cost of three IVF cycles was roughly equivalent to the cost of a hip replacement” (Mladovsky et al., 2010) Barriers to funding this treatment in the United States Financial restrictions: IVF treatments in the United States require patients to pay out of pocket with hopes of getting reimbursed later on “Insurers frequently will not commit to coverage in advance, and instead make decisions on a case-by-case basis which can take months” (Klitzman, 2017) “Patients face the obstacle of how much to keep spending—how much a child is worth—and must make complex risk/benefit decisions” (Klitzman, 2017) This financial burden creates stress Funding IVF treatments for subfertile couples benefits society as a whole, but this is often overlooked due to the initial cost of the IVF treatment. These benefits include (but are not limited to): Financial Family Societal Medical Limitations Results Limited access to all studies conducted in NHS funded countries-language barriers Some studies used a small number of participants-concerns for reliability with replication   Limited generalizability to the U.S. population because most of the literature was from other countries that utilize a NHS. Financial Benefits: The return of a positive net value to the State with a lifetime surplus tax payment “A two embryo transfer’ policy to increase the number of NHS-funded IVF treatment cycles at no extra cost” and a single embryo transfer’ policy to save money going towards funding IVF (Ledger et al., 2008) Increasing the census in a country with a population concern Decreased costs of live births Family benefits: Making the dream of starting a family a reality for subfertile couples Having the choice to conceive and the value IVF brings to one’s mental health The choice of starting a family for single, lesbian, and older women The cost of IVF relative to other expenses in life was dwarfed by the value attributed to having a child Mental and health benefits: Between one in six and one in seven couples are affected with infertility Unseen consequences of infertility include the impact on mental health and general wellbeing "Infertility is a disease, but it also has fallout beyond that for a significant proportion of couples, causing mental health problems, depression, stress-related illnesses” (Kent, 2016)  Health problems caused by infertility issues could be more expensive and detrimental to the NHS than funding IVF treatments Conclusion By examining these benefits, the high cost of IVF treatment can be validated and covered by insurance companies in the United States. This would allow subfertile couples the chance at starting their own family while also contributing to society. Further research needs to be conducted in order to help identify the benefits of funding IVF treatments in the United States. Purpose To identify societal benefits from funding IVF treatments and using this knowledge to fund this procedure in the U.S. Research Questions What are the societal benefits from funded IVF treatments for subfertile couples? What are the barriers to this treatment being funded in the United States?