Japanese Health Insurance Coverage of Fertility Treatment in 2022: Does Coverage Change Patient Perspectives?

Area of Science:

• Reproductive Medicine
• Health Economics
• Patient Attitudes

Background:

• Infertility affects a significant portion of the population, necessitating effective treatment strategies.
• Patient perceptions and attitudes towards infertility and its treatment are crucial for successful outcomes.
• The initiation of insurance coverage for fertility treatments can influence patient decision-making and expectations.

Purpose of the Study:

• To assess changes in patient background and attitudes towards infertility treatment following the introduction of insurance coverage.
• To explore patients' perspectives on future challenges and considerations related to fertility care.

Main Methods:

• A cross-sectional survey was conducted in a Japanese fertility clinic between February and June 2022.
• Two groups of new patients were surveyed: those before insurance coverage began and those after.
• An original questionnaire assessed patient demographics, attitudes, and treatment preferences.

Main Results:

• Patients who received insurance coverage were more likely to perceive infertility as a "disease" (OR: 5.03) and prefer in vitro fertilization (IVF) as an initial treatment (OR: 2.54).
• A significant proportion of patients recommended oocyte freezing for their children (OR: 3.88), irrespective of insurance status.
• The anticipated financial burden associated with infertility treatment did not significantly differ between the groups.

Conclusions:

• Insurance coverage positively influenced patient perception of infertility as a "disease" and preference for IVF.
• Patient desire to recommend oocyte freezing for offspring suggests a growing acceptance of fertility preservation.
• The unchanged anticipated economic burden indicates a persistent challenge in communicating treatment costs effectively to patients.