Shady Grove Fertility Helps Expand Maryland Mandate Coverage of Donor Sperm Treatment

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Maryland’s Insurance Mandate is now expanded to allow couples with male factor infertility, which comprises up to 50 percent of infertility cases, to use donor sperm.

donor sperm treatment at Shady Grove Fertility
By expanding the Maryland Insurance Mandate for fertility coverage, this will create an opportunity for many couples who would otherwise not be able to afford the care they need to have a child. Now we can help them make their dreams come true.”

Maryland's Insurance Mandate has been expanded to allow couples with male factor infertility to use donor sperm. Thanks in part to Shady Grove Fertility physician, Stephanie Beall, M.D., Ph.D., who shared testimony with the Maryland Senate and House of Delegates in January 2016 on behalf of the Shady Grove Fertility patients who would benefit from and would need assistance of donor sperm to have a baby, as well as the fervent advocacy work of organizations like Resolve, the National Infertility Association, a Shady Grove Fertility partner. The Fertility Parity Bill was signed by Maryland Governor Larry Hogan on May 10th.

“It was an honor to work with Senator Kagan and Delegate Hill and give testimony on behalf of the many couples who need to use donor sperm to have a baby in the state of Maryland. By expanding the Maryland Insurance Mandate for fertility coverage, this will create an opportunity for many couples who would otherwise not be able to afford the care they need to have a child. Now we can help them make their dreams come true," said Stephanie Beall, M.D., Ph.D.

Why This Change Is Important
This amendment to the existing Maryland Mandate creates access to fertility coverage for more patients. An estimated 120,000 couples who live in Maryland will experience infertility—half of whom have contributing male fertility issues. This change provide coverage for donor sperm, enabling families who would otherwise be ineligible to use the Maryland Mandate and ultimately struggle to continue with treatment due to the financial barriers.

Maryland is one of just 15 states that have an infertility insurance mandate that requires health insurance plans to offer or provide coverage for in vitro fertilization (IVF) procedures. While this is benefit is advantageous to patients who are employed through the state of Maryland, there are some limitations. For example, employers with 50 or fewer employees, or religious organizations whose beliefs conflict with fertility treatment, are exempt from offering this coverage.

There have been progressive changes to the original law created in 1985. In 2015, the Maryland legislature updated the infertility insurance mandate to allow same-sex couples to use donor sperm, creating an inequality for heterosexual couples needing donor sperm to conceive.

According to Shady Grove Fertility’s Donor Program Director, Michele Purcell, M.H.A., R.N., “This is a huge step forward. In the past, many insurance companies excluded infertility coverage in the event an egg or sperm donor was needed; not allowing for reasons or causes behind the need for donor services. As a result of this exclusion, many patients were forced to stop treatment, or pay 100% out of pocket.”

Paul R. Shin, M.D., a Shady Grove Fertility reproductive urologist and male fertility specialist, also explains why this change is so important, “The prospect of helping couples to achieve their dreams of family building can take many different paths. For the majority of male factor infertility patients that seek their care here at Shady Grove Fertility, those dreams end with a happy healthy baby conceived from the sperm and egg of the male and female partners. However, some men have no sperm and some men with very poor sperm quality can go through an entire IVF cycle and have suboptimal fertilization and embryo development. Without this mandate, the use of donor sperm and the costs associated with uncovered cycles were a significant enough barrier that couples were forced to make a decision based solely on finances, cutting short their dreams of building a family.”

Why People Need Donor Sperm
The use of donor sperm spans more than LGBT couples. Of the one in eight couples who experience infertility, up to 10 percent of the patients with male factor infertility may be candidates for using donor sperm. For men with male factor infertility, there are a number of contributing factors that result in low quantity or poor quality sperm. Some men are simply born without the cells in the testicle that are needed for sperm manufacturing; while others have genetic problems that leave them with no sperm or very little sperm. Of men that do have sperm, there are cases when the sperm simply do not fertilize or promote good embryo development. In addition, men with cancer who have received chemotherapy often lose the ability to make sperm.

About Shady Grove Fertility
Shady Grove Fertility is a leading fertility and IVF center of excellence offering patients individualized care, innovative financial options, and pregnancy rates among the highest of all national centers. 2016 commemorates 25 years of Shady Grove Fertility providing medical and service excellence to patients from all 50 states and 35 countries around the world, and celebrates over 40,000 babies born—more than any other center in the nation. Today, 34 reproductive endocrinologists, supported by a highly specialized team of 600 urologists, Ph.D. scientists, geneticists, and staff care for patients in 18 full-service offices and five satellite sites throughout Maryland, Pennsylvania, Virginia, and Washington, D.C. Shady Grove Fertility physicians actively train residents and reproductive endocrinology fellows and invest in continuous clinical research and education to advance the field of reproductive medicine through numerous academic appointments and partnerships such as Georgetown Medical School, Walter Reed National Military Medical Center, the University of Maryland, and the National Institutes of Health. More than 1,700 physicians refer their patients to Shady Grove Fertility each year. For more information, call 1-888-761-1967 or visit ShadyGroveFertility.com.

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Courtney Flantzer

Kasey Murphy
@SGFertility
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