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Infertility Services – Commercial Coverage Determination ...

Infertility Services Page 1 of 5 UnitedHealthcare Commercial Coverage Determination Guideline Effective 01/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services , Inc. UnitedHealthcare Commercial Cover a ge Deter mina tion Guideline Infertility Services Guideline Number: Effective Date: January 1, 2022 Instructions for Use Table of Contents Page Coverage Rationale .. 1 Documentation Requirements .. 3 Definitions .. 4 References .. 4 Guideline History/Revision Information.

Female Infertility: Infertility caused by a problem that results in the inability to produce an egg, if an embryo is unable to travel to the womb, or there is a process that prevents use of the womb for reproduction. Male Infertility: Infertility caused by problems due to inability to ejaculate or insufficient number or motility of sperm.

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