Humboldt-Universität zu Berlin - Department of Social Sciences - Berlin Graduate School of Social Science

Mio Tamakoshi

Mio Tamakoshi

BGSS Generation 2022



The (Un)Equal Impact of Public Insurance Coverage for Infertility Treatment



Dr. Hannah Zagel



My dissertation investigates the impact of public insurance coverage for infertility treatment on patterns of reproduction among different socioeconomic groups. Infertility, defined as not being able to conceive after 12 months of regular unprotected sexual intercourse, is prevalent worldwide along with the societal change, including postponement of childbearing. One of the policy strategies to enhance fertility care is to publicly subsidize infertility treatment through health insurance coverage. While provision of public funding improves individual access to medically assisted reproductive technologies (MRTs), the impact of state subsidies should also be discussed from the perspective of equality and equity. Although the public insurance coverage may have an egalitarian effect to a certain extent, it might have a stratified impact on utilization of such medical care and, more broadly, on patterns of reproduction among different socioeconomic groups. The reproductive patterns I aim to address in my research are not limited to the use of MRTs and resultant childbirths, but also conceived more broadly, including the formation of pregnancy desire and the choice of one’s life course. Furthermore, by investigating the policy-outcome relations and comparing them across different countries, I hope to attend to the normative implications such policies bring to a society, such as family norms expressed in the insurance eligibility criteria, or high value on biological kinship. The research combines quantitative and qualitative approaches to examine the interaction between structural and institutional settings surrounding infertility treatment, on one hand, and the decisions and actions of individuals who face (in)fertility, on the other.