The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices: An international analysis

Chambers, GM; Hoang, VP; Sullivan, EA; Chapman, MG; Ishihara, O; Zegers-Hochschild, F; Nygren, KG; Adamson, GD

The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices: An international analysis

Chambers, GM Hoang, VP Sullivan, EA

Chapman, MG Ishihara, O Zegers-Hochschild, F Nygren, KG Adamson, GD

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Publication Type:: Journal Article
Citation:: Fertility and Sterility, 2014, 101 (1)
Issue Date:: 2014-01-01

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Field	Value	Language
dc.contributor.author	Chambers, GM	en_US
dc.contributor.author	Hoang, VP	en_US
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.contributor.author	Chapman, MG	en_US
dc.contributor.author	Ishihara, O	en_US
dc.contributor.author	Zegers-Hochschild, F	en_US
dc.contributor.author	Nygren, KG	en_US
dc.contributor.author	Adamson, GD	en_US
dc.date.available	2013-09-04	en_US
dc.date.issued	2014-01-01	en_US
dc.identifier.citation	Fertility and Sterility, 2014, 101 (1)	en_US
dc.identifier.issn	0015-0282	en_US
dc.identifier.uri	http://hdl.handle.net/10453/115385
dc.description.abstract	Objective To systematically quantify the impact of consumer cost on assisted reproduction technology (ART) utilization and numbers of embryos transferred. Design Ordinary least squared (OLS) regression models were constructed to measure the independent impact of ART affordability - measured as consumer cost relative to average disposable income - on ART utilization and embryo transfer practices. Setting Not applicable. Patient(s) Women undergoing ART treatment. Intervention(s) None. Main Outcome Measure(s) OLS regression coefficient for ART affordability, which estimates the independent effect of consumer cost relative to income on utilization and number of embryos transferred. Result(s) ART affordability was independently and positively associated with ART utilization with a mean OLS coefficient of 0.032. This indicates that, on average, a decrease in the cost of a cycle of 1 percentage point of disposable income predicts a 3.2% increase in utilization. ART affordability was independently and negatively associated with the number of embryos transferred, indicating that a decrease in the cost of a cycle of 10 percentage points of disposable income predicts a 5.1% increase in single-embryo transfer cycles. Conclusion(s) The relative cost that consumers pay for ART treatment predicts the level of access and number of embryos transferred. Policies that affect ART funding should be informed by these findings to ensure equitable access to treatment and clinically responsible embryo transfer practices. © 2014 by American Society for Reproductive Medicine.	en_US
dc.relation.ispartof	Fertility and Sterility	en_US
dc.relation.isbasedon	10.1016/j.fertnstert.2013.09.005	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Reproductive Techniques, Assisted	en_US
dc.subject.mesh	Embryo Transfer	en_US
dc.subject.mesh	Registries	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Empirical Research	en_US
dc.subject.mesh	Internationality	en_US
dc.subject.mesh	Socioeconomic Factors	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices: An international analysis	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	101	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	101	en_US

Abstract:

Objective To systematically quantify the impact of consumer cost on assisted reproduction technology (ART) utilization and numbers of embryos transferred. Design Ordinary least squared (OLS) regression models were constructed to measure the independent impact of ART affordability - measured as consumer cost relative to average disposable income - on ART utilization and embryo transfer practices. Setting Not applicable. Patient(s) Women undergoing ART treatment. Intervention(s) None. Main Outcome Measure(s) OLS regression coefficient for ART affordability, which estimates the independent effect of consumer cost relative to income on utilization and number of embryos transferred. Result(s) ART affordability was independently and positively associated with ART utilization with a mean OLS coefficient of 0.032. This indicates that, on average, a decrease in the cost of a cycle of 1 percentage point of disposable income predicts a 3.2% increase in utilization. ART affordability was independently and negatively associated with the number of embryos transferred, indicating that a decrease in the cost of a cycle of 10 percentage points of disposable income predicts a 5.1% increase in single-embryo transfer cycles. Conclusion(s) The relative cost that consumers pay for ART treatment predicts the level of access and number of embryos transferred. Policies that affect ART funding should be informed by these findings to ensure equitable access to treatment and clinically responsible embryo transfer practices. © 2014 by American Society for Reproductive Medicine.

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http://hdl.handle.net/10453/115385