More health providers are covering fertility treatments

When Kathryn Francisco was a senior in college, she found out the man she called Dad was not actually her biological father. She and her brother had been conceived through a sperm donor.

“It felt like a punch in the gut, in the deepest part of my soul,” she said.

Francisco realized she probably had an unknown number of biological half-siblings. “You don’t really matter, there’s so many of you,” she said. “But then there’s this overwhelming feeling of, ‘I have to get to know these people.’”

Ten years later, with the help of DNA testing technology, the 32-year-old and her full brother Matt have discovered they have five half siblings, all of whom were conceived through the same sperm donor. Together, they’ve become a strange sort of family, she said, made up of people she didn’t grow up with and yet who share her genes and personality quirks.

Francisco now has a relationship with her biological father, but she said that navigating life as a product of a third-party sperm donation left her deeply unhappy with the fertility treatments her parents used to conceive her.

The number of artificial insemination treatments like those that brought Francisco into the world will likely grow as more employers and insurance providers agree to cover the costs for employees. Earlier this year, the U.S. government announced it would start requiring its insurance providers to cover artificial insemination as well as drugs related to in vitro fertilization. Come Nov. 13—the start of open season for federal health insurance—thousands of Americans covered by federal health insurance, including single women and lesbians, will see new changes to their fertility coverage.

Currently, 19 states require insurance to offer or cover some level of fertility treatment, according to Resolve: The National Infertility Association, but the specifics vary by state. In the District of Columbia, for example, a law that passed in June requires the city’s insurance providers and Medicaid to cover multiple rounds of IVF for its residents. Providers just a few miles away in Virginia aren’t required to cover any fertility treatment.

Dr. Jeff Barrows, an obstetrician-gynecologist and senior vice president of bioethics and public policy for the Christian Medical and Dental Associations, said in some cases, artificial insemination poses no moral problems. Barrows would not have any qualms recommending artificial insemination to a married man and woman using the husband’s sperm or semen. But he said that’s not common. In those rare cases, a man is often physically disabled or has a sexual dysfunction.

More often than not, requests for artificial insemination will involve a third-party donor, which Barrows said is morally problematic. Involving a sperm donor in reproduction means introducing a child to the world without the child’s biological father in the picture—such as in Kathryn Francisco’s case.

“I cannot come up with any morally acceptable clinical scenario, especially when you look at it from the perspective of the child,” Barrows said. “I think that is one of the major pieces that’s missing from the conversation. Certainly, it’s a major piece missing from these new government regulations.”

According to Resolve, 1 in 8 U.S. couples struggle with fertility. The federal employee health benefits program has two definitions of infertility. The first is the failure to conceive after six to 12 months of unprotected sex between a man and woman. Everyone I spoke with agreed on that terminology.

The second definition states that for “women without male partners or exposure to sperm,” the federal government defines infertility as “the inability to conceive after six cycles of artificial insemination or intrauterine insemination performed by a qualified specialist using normal-quality donor sperm.”

Barrows said those women are not infertile by medical standards, and he did not see any scientific basis for the government’s second definition.

LGBTQ advocates want to expand the meaning even further. Last month, 32 lawmakers signed a letter appealing to the Office of Personnel Management to model its definition of infertility on that of the state of Illinois, which includes, “a person’s inability to reproduce either as a single individual or with a partner without medical intervention.”

Katy Faust, founder and president of children’s advocacy group Them Before Us, said gay couples have the legal right to marry, but the right to create a family does not necessarily follow.

“It is true that the UN Declaration on Human Rights does talk about the right to marry and found a family,” she said. “But that doesn’t mean you have a right to somebody else’s child.”

Last week, the Institute for Family Studies published new findings further confirming that children benefit from stable, two-parent families. Faust goes further, saying it’s best when those two parents are a child’s biological father and mother—something that could never be achieved using third-party donor sperm.

Francisco, the woman conceived by donor sperm, thinks health insurance providers are ignoring a child’s welfare when they cover some fertility treatments. “This is not healing a broken body part,” she said.

Instead, she turned to restorative reproductive methods, which she said involves doctors developing natural strategies to restore fertility, to help her and her husband build their family. They now have a son and she is pregnant with their second child.

“My son knows both of his parents, and there’s no question,” she said. “I’m sure he’ll have other conflicts with us, but they’re going to be more natural questions dealing with the world, not questions of his identity.”