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Financial decision analysis based on “willingness to pay” for surgical sperm retrieval approaches among men with non‐obstructive azoospermia in the United States

Financial decision analysis based on “willingness to pay” for surgical sperm retrieval approaches... INTRODUCTIONTesticular sperm extraction (TESE) remains the only viable option for men with non‐obstructive azoospermia (NOA) to conceive a biological child. However, there are several ancillary decisions pertaining to the surgical approach that affected couples must make in order to conceive. Microsurgical TESE (micro‐TESE) is considered the gold standard for the management of NOA as it has a superior surgical sperm retrieval rate when compared to conventional TESE (c‐TESE).1 However, micro‐TESE is relatively more time intensive, costly, requires microsurgical expertise, and ready access to a surgical microscope. Given such limitations, c‐TESE remains a viable, albeit less favorable, surgical option. Couples must also choose between fresh TESE—performed in conjunction with programmed ovulation induction and oocyte retrieval—or frozen TESE which is performed electively with a plan to use thawed testicular sperm for use with intracytoplasmic sperm injection (ICSI) at a future date.In the absence of insurance coverage for fertility procedures, these decisions may have significant financial implications for couples. Presently, only 13 states mandate insurance coverage for in‐vitro fertilization (IVF).2 Even with insurance coverage for IVF, couples are subject to variable insurance deductibles which may impact their decision‐making calculus.3 Other patients without insurance coverage for IVF are left to navigate out‐of‐pocket (OOP) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Andrology Wiley

Financial decision analysis based on “willingness to pay” for surgical sperm retrieval approaches among men with non‐obstructive azoospermia in the United States

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References (14)

Publisher
Wiley
Copyright
© 2023 American Society of Andrology and European Academy of Andrology.
ISSN
2047-2919
eISSN
2047-2927
DOI
10.1111/andr.13488
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONTesticular sperm extraction (TESE) remains the only viable option for men with non‐obstructive azoospermia (NOA) to conceive a biological child. However, there are several ancillary decisions pertaining to the surgical approach that affected couples must make in order to conceive. Microsurgical TESE (micro‐TESE) is considered the gold standard for the management of NOA as it has a superior surgical sperm retrieval rate when compared to conventional TESE (c‐TESE).1 However, micro‐TESE is relatively more time intensive, costly, requires microsurgical expertise, and ready access to a surgical microscope. Given such limitations, c‐TESE remains a viable, albeit less favorable, surgical option. Couples must also choose between fresh TESE—performed in conjunction with programmed ovulation induction and oocyte retrieval—or frozen TESE which is performed electively with a plan to use thawed testicular sperm for use with intracytoplasmic sperm injection (ICSI) at a future date.In the absence of insurance coverage for fertility procedures, these decisions may have significant financial implications for couples. Presently, only 13 states mandate insurance coverage for in‐vitro fertilization (IVF).2 Even with insurance coverage for IVF, couples are subject to variable insurance deductibles which may impact their decision‐making calculus.3 Other patients without insurance coverage for IVF are left to navigate out‐of‐pocket (OOP)

Journal

Andrology – Wiley

Published: Jun 28, 2023

Keywords: azoospermia; cost‐effective; micro‐TESE; testicular sperm extraction

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