1 Infertility Treatment, ART and IUI Procedures and Delivery

Abstract: High infertility levels are of great concern in the American society and in the recent years there has been a surge in the use of Assisted Reproductive Technologies (ART) and other infertility procedures such as Intrauterine Insemination (IUI). Women that use these treatments come from a different health risk pool compared to women who are able to conceive naturally, thus creating a selection problem as it is unclear that maternal and neonatal outcomes stem from infertility treatment type or preexisting health condition. Using a database on medical claims made by people working mostly in large firms, we first demonstrate that state mandates that require firms to offer health plans with coverage for infertility treatment are associated with increased ART/IUI usage. Once we use this information to treat the selection problem in ART treatment type, mother’s pre-existing health condition is a better predictor of the likelihood of poor outcomes such as complications during pregnancy, miscarriage, abortion and ectopic pregnancy rate and neo-natal health, while infertility treatments such as ART and IUI are at best only weakly associated