Willingness to pay for in vitro fertilization: results from a national sample of reproductive-aged adults in the US.

Purpose: To assess United States (US) reproductive-aged adults' willingness to pay for in vitro fertilization (IVF) and determine socio-demographic factors associated with their willingness to pay.

Methods: We conducted a cross-sectional survey of reproductive-aged adults (18-50 years old) to ask respondents demographic and reproductive health questions, including the US dollar amount they would be willing to pay out-of-pocket for IVF over a 12-month period. We used linear regression models to determine associations between socio-demographic factors and respondents' willingness to pay for IVF.

Results: There were 2,035 survey respondents from 49 states and the District of Columbia. 43.6% were female assigned at birth, 81.7% were heterosexual, 42.6% were married, and 7.2% of respondents reported having infertility. 66% (n = 1,353) of respondents were willing to pay a non-zero amount for IVF, with a median willingness to pay of $5,000. Annual household incomes between $121,000 and $199,000 (p = 0.003) and greater than $200,000 (p = 0.005) and familiarity with IVF treatment (p < 0.001) were associated with a higher willingness to pay. Among infertile respondents (n = 133), the median willingness to pay was also $5,000 and familiarity with IVF (p = 0.04) was associated with a higher willingness to pay.

Conclusion: We found a median willingness to pay for IVF of $5,000 among respondents, which is one-third of the average out-of-pocket cost of one IVF cycle in the US (~ $15,000). These findings highlight the need for policymakers and clinicians to advocate for expanded health insurance coverage for IVF to align with reproductive-aged adults' willingness to pay and address barriers accessing infertility services.