Most studies have shown that cost is a major factor in whether or not couples choose to pursue infertility treatment. The irony is that most infertility treatment compared to other medical treatments are not comparatively expensive. However, in most cases these costs are not covered by insurance. In many states, insurance companies consider this treatment to be elective and not a covered expense. There are many progressive states that require coverage of all or at least some fertility treatment. At present, 15 states require some coverage including Illinois, New York and New Jersey.
Finding out if you have insurance coverage for treatment in your particular case requires a call to your carrier to make inquiries. If you do have coverage, there are likely limits and inquiring as to these limits can be helpful.
In many cases, you will not have coverage and you will be left wondering how you can get the best value. Some programs may be expensive and others less expensive. Some programs may be higher quality and others lower quality. That leads to a lot of confusion as to how to select a program which is good quality at a reasonable cost.
There is little doubt that should be your starting point. You are unlikely to do well with a poor quality program which is low cost. Quality is really about the doctors, nurses and lab staff. The billing staff can also make a huge difference for you in getting as much covered by insurance as allowed. Begin by looking at the web site and the credentials of the doctors. How many doctors are there? Are they all board certified in reproductive endocrinology and infertility? Will the doctor usually see you? These are all factors that affect cost and quality. What about the lab director? Is he or she a full time PhD or an out of town director? A full time director is there all the time. An out of town director is typically there one day per month. If you can ask to stop by and talk with one of the IVF nurses. They are a true reflection of the program. Also you can look at the office and see if you can fit in. In most cases the entire staff is a mirror of the doctors and the program.
The reason we say cautiously is as Mark Twain said: “There are lies, damned lies and statistics!” No matter what system is used to track statistics clinics have used techniques to distort them. For example taking on only easier cases will make your statistics better. Also taking all tough cases out of your fresh statistics by “testing your embryos and freezing them for later transfer” is a good way to take out all the tough cases from your initial fresh transfer group. No one looks quite as closely at the frozen data. Some very large clinics have used this to improve their data. Take a look at www.sart.org. This web site lists the statistics of the best clinics. Look first at the number of cycles performed both fresh and frozen. IVF programs tend to be like open heart programs. It is tough to find a small really good program for open heart surgery. Also a large program cannot “cherry pick” cases as much as a smaller program. Look at the fresh, frozen and donor pregnancy rates.
This is where meeting with a financial counselor is a huge help. They should thoroughly explain to you the total cost of a cycle. They will usually give you an information sheet to look at. Ask for the full cost of an IVF cycle and any pretesting that you will need. In the US the average cost of an ivf cycle is $12,000. Our program is considerably less than this. Ask about pretesting, medication costs, procedure costs. Some case will require ICSI where the sperm is directly injected into an egg. That can be an additional charge. Also some case will produce extra embryos which can be frozen for later use. That can be an extra charge also. Freezing in most cases is very cost effective because the cost of a frozen cycle is typically 30-40% of the cost of a fresh cycle. Ask the financial coordinator about whether the program accepts credit cards or financing options.
These programs are well worth looking at. These type of programs for a single larger fee will allow patients to continue treatment for a group of cycles. The end point is either a live born baby or a percentage back of the package fee paid. Many couples like these programs because they believe they will not keep paying for nothing. In our program (IRH Money Back Guarantee) most patients under 38 years of age will qualify and our most recent data shows an 85% birth rate and 15% refund rate. Not all patients will qualify for this, your chart will need to be reviewed by one of the doctors. Some blood work such as AMH to measure ovarian reserve will need to be done.
Medication accounts for about 20% of an IVF cycle cost. There are now several companies that allow you to apply for medication discounts that can be as much as 25-75% of the total cost. That can be a huge help. Typically this requires you to fill out an application disclosing your yearly income information. The program staff can help to direct you to these resources but you may have to ask.
An example of such a program: Compassionate care.
Reputation is difficult to earn and easy to destroy! What is the reputation of the program in the community? What does your ob/Gyn or urologist think of this program? What do the ob/gyn nurses think of this program? What do your friends think? Visit to the program and talk to them. What do you think? Does this appear to be a good medical clinic or is it a crazy place? With a modest amount of research you can usually find a program in your community or near you of good quality. Best of luck in your search.
View Investigating Your Fertility Benefits on our Informational Videos Page.
Here are the facts: at IRH, the clinical pregnancy rates per fresh IVF cycle now exceed 50% for the best candidates. Clinical pregnancy rates for frozen embryo transfers, which offer the patients a low cost second chance, are now 30 – 40% in our program. The costs in our program have all been held down due to distribution of fixed costs over a high number of cycles. The costs for IVF are much less than the national average. Typical approximate costs after discounts, can start as low as $8400.