Trying to conceive a child isn’t just emotionally draining. It can also be a financial burden, especially for low-income families.
With the average initial in vitro fertilization (IVF) treatment priced at about $12,000, many assisted reproductive technologies are out of financial reach even for people with moderate incomes.
However, a growing number of programs and initiatives are making parenthood more accessible to women of all economic backgrounds.
By providing funding for infertility treatments and adoption services, as well as offering much-needed emotional support to those who might otherwise not have those resources, these organizations are changing the notion that fertility services are only for the wealthy.
A Place of Empathy
Many fertility financing programs exist because of people who understand the physical and psychological toll that infertility takes on women. Those who have experienced the pain firsthand are especially committed to helping others who face challenges conceiving.
Dr. Camille T.C. Hammond, MPH, tried to get pregnant for five years with no success. Then she received life-changing help from her own mother. Tinina Q. Cade carried and delivered Hammond’s three triplets at age 55, in the first delivery of its kind. The birth itself garnered international attention, but for Hammond it brought another major issue to light
“There were a lot of other people who were struggling with infertility who were encouraged by our story,” Hammond said. “Many of my friends came out to us and disclosed that they were struggling with infertility treatments and adoption.”
This realization led to the creation of the Tinina Q. Cade Foundation to cover the costs of fertility treatments and adoption services. The organization also takes part in a number of fundraisers.
This summer, the Cade Foundation will partner with local fertility treatment centers across the country for fundraisers that include the chance to receive free IVF cycles.
Watching a loved one cope with infertility can be equally painful, a fact that Pamela Hirsch knows well. Her daughter struggled for years to conceive before hiring a surrogate. Hirsch was fortunate enough to be able to provide her daughter with financial assistance, but she understands this isn’t possible for many low-income women.
Her daughter’s experience, Hirsch said, “opened my eyes to the reality that whether it be — in vitro fertilization, artificial insemination, or surrogacy — it’s a very expensive process that’s ... very often not affordable to the general population.”
It was this realization that inspired Hirsch to co-found the Baby Quest Foundation, which provides grants to those in need of a range of infertility services.
Why Are Infertility Treatments So Expensive?
A number of factors make infertility treatments generally expensive procedures.
Many of these treatments, such as IVF and intrauterine insemination (IUI), aren’t always completed in a single round. It may take multiple treatment cycles for a woman to become pregnant, with each one costing more money. The fresh cycle in which eggs are first harvested is usually the most expensive, with costs often decreasing for each subsequent attempt.
There are also the indirect costs associated with fertility treatments, from medication to lab visits to transportation to and from clinics. It all quickly adds up.
“Sometimes when they come to us they’ve spent so much money on so many different treatments,” Hirsch said.
Some people may also opt for several cycles of a relatively more affordable treatment option such as artificial insemination, Hirsch explained, only to find that after multiple failed attempts, a single round of a pricier treatment such as IVF would have more likely resulted in pregnancy.
“It’s so hard to convince them that you do need to be aggressive and move forward, and even though it’s more money upfront, it’s going to be worth it in the end because you’re going to reach your goal,” said Dr. Carol Wheeler of the Center for Reproduction and Infertility at Women & Infants Hospital of Rhode Island.
Choosing the Right Treatment
Besides providing financial assistance, these programs can also serve as valuable sources of information regarding the best options for assisted reproduction. Just as there are myriad causes of infertility, there is no one-size-fits all solution to the problem.
That’s why it’s crucial for women to have counseling to determine the most effective course of treatment for their own infertility issues.
“Once we know what the issue is, we can counsel them better,” Wheeler said.
And not everyone requires the most intensive medical intervention. Depending on age, health status, and other factors, a noninvasive, relatively low-cost treatment such as fertility drugs may suffice. The most expensive option doesn’t always deliver the best results. A wide range of assisted reproductive technologies can be explored with a fertility specialist.
“There’s a whole lot of stuff we can do besides IVF that can be a lot of more affordable,” Wheeler said.
This knowledge can be a relief to low-income families who may go into the process assuming there’s no hope of conceiving without the most advanced technologies.
Finding Emotional Support
There is a phrase about the frustrations of infertility that’s stuck with Lori Moscato for years.
“The emotions run out before the money runs out,” she said.
Financial strain makes for a significant source of stress throughout the process, but the anguish alone is distressing enough.
As founder of the Pay It Forward Fertility Foundation, Moscato understands how emotionally costly infertility can be. She likens the experience to applying for a job month after month and getting rejected for no reason.
The goal of Pay It Forward grants, Moscato says, is to offset some of the financial burden and therefore offset some stress, making the overall process a little more manageable. It’s one less thing to worry about during a trying time.
That emotional well-being can make a true difference in fertility success.
Nancy Hemenway, executive director of the International Council on Infertility Information Dissemination (INCIID), tried to have a baby for seven years with four miscarriages. She found encouragement and medical advice from other people online, and she eventually was able to carry a baby to term.
Hemenway’s interactions with others seeking fertility advice online prompted the creation of INCIID, deemed the first infertility site on the web.
Now she and the experts at INCIID are helping others achieve parenthood with the organization’s scholarship and wealth of resources, many of which focus on mental health.
The organization recently held a webinar about recognizing the mind-body connection in relation to infertility, a concept that Hemenway believes is often overlooked.
“It’s surprising how many people don’t think about that,” Hemenway said. “When couples are in the midst of this, it’s so stressful that they don’t take time to breathe, literally.”
Making Fertility Access Political
Advocates for access to affordable infertility treatments are bringing the conversation into the public sphere with calls for changes in insurance policy.
Most insurance plans won’t cover infertility care. If insurance is available for treatment, there may be restrictions on what’s covered. Currently, 15 states have laws mandating coverage for infertility treatment, with different patient requirements for each one.
But, as Hammond explains, certain loopholes can exempt some employers from providing coverage for fertility-related support. For example, if a business is associated with a national organization, it might be able to bypass the state mandate.
It’s one issue that the National Infertility Association’s Resolve initiative is tackling, a measure that some fertility experts, including Hammond, support.
“This is a disease, and it deserves the same support from our medical community and our policy community as other diseases,” she said.
Making a Plan
Undergoing fertility treatment as a low-income woman or couple can be intimidating, but the fertility experts agree that with the right plan, care can be affordable and effective. It’s often just a matter of knowing what resources are out there, including grants for fertility treatment.
“The knowledge gap to me has been most noticeable in underprivileged communities,” Hammond said. “Whether they are communities of color, communities in urban locations or in rural locations, these are communities where people are less likely to know about some of the different options.”
Without the knowledge of fertility financing options, people could be missing out on easily accessible means of care and support. It’s another issue fertility financing programs are working to address.
“A large part of what we do is talk about the financial planning so that people don’t just walk away thinking that it’s just not available, it’s not something they can pursue,” Hammond said.
And there are always options, whether reaching out to a support network, talking to insurance providers about treatment coverage, or applying for grants and scholarships.
“It’s really important before you get into treatment to plan ahead,” Hemenway said. “What are your long- and short-term goals? How far will you take treatment? It doesn’t mean that you can’t go back and tweak your plan if you can’t do three IVF cycles.”