RESUMO
BACKGROUND: Though insurance coverage is evolving for male infertility services, most patients continue to pay out of pocket. These costs such as semen analysis and intracytoplasmic sperm injection preparation may affect the utilization of those services. We sought to determine online price transparency specifically for male infertility services on the websites of in-vitro fertilization (IVF) clinics in the US. METHODS: In this cross-sectional analysis, pricing data was acquired from each clinic on the Society for Assisted Reproductive Technology (SART) website as of July 2019. Each website was examined for availability and cost of services. Pricing data that required applying for a quote or a phone call was excluded. Mean price was calculated for each service. Additionally, practice location in an insurance coverage mandated state (ICMS) was also analyzed to evaluate for any effect on price transparency. RESULTS: Only 24.7% (89/361) of SART clinic websites included any pricing information. Of clinics with websites (361/383), 16.3% (59/361) had ≥2 prices reported and only 5.0% (18/361) had ≥6 prices reported. Only 3.6% (13/361) reported prices for male-related infertility services. Average semen analysis price was $161 of 10 reporting clinics. Four clinics reported sperm cryopreservation or annual sperm storage price, $388 and $555, respectively. Sperm retrieval cost $244 at the two reporting clinics. ICMS did not affect male price transparency, ICMS 3.1% (6/194) vs. non-ICMS 4.2% (7/167) (P=0.576). CONCLUSIONS: Price transparency of SART clinics on websites is relatively poor with only about one-quarter of clinics providing any cost information at all. Male infertility related pricing information is even more rarely reported compared to other IVF services potentially causing a stronger barrier for males to pursue infertility treatment.
RESUMO
Endometriosis is a leading cause of pelvic pain and infertility. It is defined by the presence of endometrial tissue in extrauterine locations. The development of novel therapies and diagnostic tools for endometriosis has been limited due in part to challenges in studying the disease. Outside of primates, few mammals menstruate, and none develop spontaneous endometriosis. Rodent models are popular but require artificial induction of endometriosis, with many utilizing either immunocompromised mice or surgically induced disease. Recently, more attention has been given to models involving intraperitoneal injection. We present a murine model of endometriosis that integrates several features of existing endometriosis models into a novel, simplified system that relies on microscopic quantification in lieu of subjective grading. In this model, we perform hormonal stimulation of donor mice, intraperitoneal injection, systematic abdominal survey and tissue harvest, and histologic quantification that can be performed and verified at any time after necropsy. This model requires minimal resources and training; does not require expertise by lab technicians in murine survival surgery or in the identification of gross endometriotic lesions; can be used in immunocompromised, immunocompetent, and/or mutant mice; and reliably creates endometriotic lesions that are histologically consistent with human endometriotic disease.