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Is health insurance coverage of infertility treatments an essential benefit to help people manage a medical disorder? Or is it a life-enhancing benefit, nice to have perhaps but not essential because it doesn't sustain a person's life?

A panel of experts convened by the Institute of Medicine is wrestling with this and other issues raised by the new health-care law. Members are trying to determine what essential health benefits should be included in polices available through the state-based insurance exchanges where individuals and small businesses may buy coverage starting in 2014. The IOM recommendations will go to the Department of Health and Human Services.

Infertility coverage today is generally pretty skimpy. Only about 20 percent of employers cover assisted reproductive therapies such as in vitro fertilization, according to a 2006 survey of 931 employers conducted for Resolve: The National Infertility Association. A majority of employers that didn't offer coverage cited cost concerns, but 91 percent of those that did offer it said it hadn't significantly increased their costs.

About one in eight couples of childbearing age is infertile, according to...