For couples struggling with infertility, in-vitro fertilization (IVF) can seem miraculous, but a bundle of joy conceived using this specialized technique can end up costing a bundle.
After Heather had two unsuccessful intrauterine inseminations (IUI), she decided to try conceiving a child via IVF. Before she started taking medications to begin the process, however, she owed approximately $15,000 to the fertility center—upfront.
“That’s a large sum of money, even for people who are financially stable,” recalls Heather, of Alexandria, Va., who asked not to be identified by her last name. She is now nearly two months pregnant with twins after one round of IVF.
Couples who choose this option know it's expensive and that it can take a few rounds to be successful—if it works at all. And even the best insurance policies do not always provide coverage.
Heather and her husband were fortunate because her parents lent them $10,000 to help offset the costs. Though she never wanted to accept the loan, she said putting out the money for the procedure would have left her and her husband without much of a financial safety net. They accepted the offer and have begun paying her parents back.
Fran Meadows of New Fairfield, Conn., underwent three rounds of IVF before conceiving her son a few years ago. Insurance covered most of her treatments, except for anesthesia, embryo and sperm cryopreservation, and some co-payments. With several doctor visits a week over the span of a few years, the bills added up despite “exceptional” coverage, but she says she's paid them off.
The High Costs of IVF
According to the American Society for Reproductive Medicine, an average IVF cycle costs $12,400. A U.S. Centers for Disease Control and Prevention report states that 163,039 assisted reproductive technology (ART) cycles occurred in 451 American clinics during 2011. The use of such procedures has doubled over the past decade, and more than one percent of all infants born each year are conceived using ART.
Though the National Infertility Association and the World Health Organization recognize infertility as a disease of the reproductive system, other organizations do not. This is why some organizations and individuals like Meadows are pushing insurers to cover costs associated with treatments.
“[Insurance companies] kind of think of [fertility treatments] as a luxury,” Meadows said. “They don’t recognize it as a medical diagnosis.”
Financial Aid for Infertility?
Dr. Serena H. Chen, who heads up the reproductive endocrinology division at Saint Barnabas Medical Center in Livingston, N.J., said her group has staffers that can calculate IVF costs, secure loans, and acquire medicine discounts for patients.
“On an individual level, it can really be quite complicated for the patient,” Chen said.
Univfy, a company that works to provide predictions for fertility treatment success, now offers an advanced IVF cost calculator that allows patients to do some of this leg work at home.
New Jersey is one of 15 states that require insurance companies to provide infertility coverage. Women must qualify for fertility treatments, including IVF, and even the best policies may not cover all expenses.
Chen says insurance companies do not always consider the risks to the patient along with costs when choosing what to cover, and may only cover less expensive treatments, such as IUI. Although IVF may be more costly up front, it can cost an insurer and patient more in the long term in the event that a woman has multiple children—not to mention the medical risk of a multiple pregnancy.
“Some of the frustration with these insurance companies is that they’re not necessarily looking at evidence-based medicine or the whole picture,” Chen said.
Advancements in genetic testing and single-embryo transfers are on the horizon for IVF, which may reduce costs and medical risks.
“The better we get at selecting the best embryo the more we can do single-embryo transfers,” Chen said. “More is not better.”
Reducing IVF Costs
What can be done to make IVF more accessible—and affordable? There aren’t too many ways to lower costs because IVF is a detailed process that requires state-of-the-art technology and attentive patient care, said Dr. Shahin Ghadir, a reproductive endocrinologist at the Southern California Reproductive Center in Beverly Hills, Calif.
He recommends conducting preliminary testing at an obstetrician’s office to offset the initial costs. Women need to have lab work and ultrasounds done at the fertility clinic, however, in order to maintain the strict timeline needed for IVF success.
“Unfortunately, there are not many other things that can be done in order to decrease the costs, and patients must be aware that there are significant behind-the-scenes expenses and laboratory costs that cause fertility treatments to be costly,” Ghadir said.
When asked if healthcare reform will offer more options for infertility treatment coverage, Ghadir and Chen said they aren’t counting on it.
Meadows is involved with organizations that promote insurance coverage for fertility treatments, including IVF. She hopes each state will someday have a coverage mandate.
“Unfortunately, I think that’s a while down the way,” Meadows said.