How Much Does IVF Cost? – Forbes Health

2022-09-03 01:07:55 By : Ms. Alice Lee

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A single IVF cycle—defined as ovarian stimulation, egg retrieval and embryo transfer—can range from $15,000 to $30,000, depending on the center and the patient’s individual medication needs. Medications can account for up to 35% of those charges.

At best, this price tag is daunting. For many of us, it sounds entirely out of reach, especially considering that many patients go through several cycles of IVF before conceiving or attempting other options.

But there are ways to at least reduce the out-of-pocket costs of IVF. Your insurance may cover some of the procedures or medications involved in a cycle, and there are also grants, discount programs and clinical studies that help qualified patients pay for all or part of the process. Low-dose IVF, sometimes called mini IVF, is a less expensive option to explore as well, though it’s not right for everyone.

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IVF, short for in vitro fertilization, is a common fertility treatment that involves implanting a fertilized egg into the uterus via a short, simple surgery.

If you’re a person with female reproductive organs who opts to try IVF, typically you’ll inject synthetic hormones (gonadotropins) to stimulate your ovaries to produce multiple eggs. A physician will then perform an outpatient surgery to retrieve the eggs, and an embryologist will inseminate the eggs with your partner’s sperm or donated sperm to create embryos.

The embryo transfer, the procedure in which a doctor implants an embryo (or, in some cases, multiple embryos) in the uterus, is another short, outpatient surgery that can be done as soon as three (but more often at least five) days after the embryos are made. This procedure is called fresh embryo transfer. Embryos can also be frozen for later implantation, known as frozen embryo transfer (FET). Patients freeze embryos for many reasons, including for fertility preservation, to prevent ovarian hyperstimulation syndrome and/or to allow time for a genetics lab to test the embryos for possible gene defects.

“When IVF was created in the 1980s, it was for women with tubal disease, where tubes were damaged or blocked and the sperm could not meet the egg,” says Courtney Marsh, M.D., associate professor and reproductive endocrinology and infertility division director at the University of Kansas Health System. “Now, IVF is used for many factors, and success rates have dramatically improved with advancing technology.”

Prospective parents may be good candidates for IVF if a doctor has diagnosed any of the following conditions:

IVF is also an option for anyone exploring the use of donor sperm or eggs, and/or the employment of a gestational carrier or surrogate.

If you’re pricing IVF at fertility clinics in the United States, expect to be quoted roughly $12,000 to $14,000 for one cycle. This, however, doesn’t mean you’ll pay that figure and be done. There are parts of the IVF process—some required, some optional—that most clinics treat as add-ons to the base fee. Depending on your needs, a single IVF cycle can cost $30,000 or more. More often, the total bill will fall somewhere between $15,000 and $20,000.

Often, a clinic’s base fee for IVF will cover monitoring appointments, bloodwork, egg retrieval and follow-up care. If you’re quoted below $12,000, it might mean that the base fee covers less than what’s listed above. If you’re quoted above $14,000, the base fee might cover more. Always ask for a clear list of what the base fee includes and what will be charged as additional fees.

At most clinics, the quoted price doesn’t cover the price of the injectable hormones, which can cost from $3,000 to more than $6,000, usually paid directly to the pharmacy filling the prescription.

Additional clinic fees may include intracytoplasmic sperm injection (a specialized way to create embryos), genetic testing of embryos, a trial transfer (also called mock embryo transfer) and/or cryostorage fees for embryos you wish to preserve.

When you’re budgeting, consider that you may need to go through multiple embryo transfers or multiple full cycles of IVF. Ask your clinic about the price of additional embryo transfers if the first transfer doesn’t result in a successful pregnancy and birth, as well as the price of additional gonadotropin cycles if you need to create more embryos. Many patients go through several cycles of IVF before conceiving or moving on to other options, but some clinics offer discounted pricing on the second or third cycle. There is no way to know how IVF will go for you, but your clinic may be able to give you statistics based on your age and ovarian reserve, the sperm quality of your partner or donor and any other relevant medical factors.

If you’re using a sperm donor, egg donor, gestational carrier or surrogate, that may cost anywhere from an additional few hundred dollars for a sperm donation to tens of thousands of dollars for a carrier or surrogate.

Here’s a breakdown of the fees you may be charged as you move through the IVF process. Not everything listed below will be required of every patient. And while we’ve included the procedures you’re most likely to encounter during IVF, there may be other tests or procedures required, depending on your health history. Your fertility clinic will help create a plan that’s right for you.

The figures below are all estimates. Make sure to get pricing directly from your clinic before starting the IVF process or signing paperwork.

Minimal stimulation cycle IVF, or mini IVF, is the term for an IVF cycle done with minimal medications. You may also hear it referred to as mild ovarian stimulation IVF, mild-dose IVF or low-dose IVF. Instead of injecting hormones, a mini IVF patient might take an oral medication, such as Clomid, or they might opt for injectable medication but take a lower dose than is usually prescribed for an IVF cycle.

Mini IVF is less expensive per cycle—often around $5,000 to $6,000 plus medications, which can range from $50 or less for Clomid to $1,000 to $2,000 for injectable hormones. However, in terms of total cost, it’s hard to predict whether mini IVF will save you money. The lower hormone dose will likely result in fewer eggs retrieved and thus fewer possible embryos. If a mini IVF patient needs to do several cycles of embryo creation, that can end up being more expensive and risky than doing conventional IVF.

However, a review of 31 randomized controlled trials published in Human Reproduction Update in November found good news for individuals or couples exploring low-dose IVF with injectable medication. Though fewer eggs were retrieved from the low-dose patients compared to the patients who underwent conventional IVF, the number of high-grade embryos created was similar, putting both sets of patients on more equal ground in terms of pregnancy outcomes, but reducing cost for the low-dose patients[2]Datta AK, Maheshwari A, Felix N, Campbell S, Nargund G. Mild versus conventional ovarian stimulation for IVF in poor, normal and hyper-responders: a systematic review and meta-analysis . Hum Reprod Update. 2021;27(2):229-253. .

There are also reasons to explore mini IVF that have nothing to do with price, including its reduced risk of ovarian hyperstimulation.

If you’re using donor eggs as part of your IVF cycle, the price will depend on what options a clinic offers.

Some fertility clinics have relationships with egg cryobanks and/or fresh egg donor agencies and either require or suggest that you work within their system. In that case, the clinic likely will present you with a base price that includes the cost of the eggs (typically in batches of six to eight) and some, but not all, medical expenses.

Frozen donor eggs base cycle fee: $14,000 to $20,000+

Fresh donor eggs base cycle fee: $27,000 to $47,000+

As with non-donor IVF, this fee is a starting point. Ask your clinic what is included in the price of an egg donor cycle and what additional charges to prepare for.

Other clinics allow you to work directly with a cryobank or agency to obtain frozen or fresh eggs. Depending on which bank or agency you choose, you might end up spending less than you would by going directly through a clinic, or you could end up spending more. It’s unlikely that the total price will be drastically reduced by separating the fees. You may save a few thousand dollars by finding a cryobank that sells eggs in smaller batches; however, starting the IVF process with a lower number of eggs could mean you’ll end up with fewer viable embryos.

If a clinic allows, you may be able to save money by having a friend or family member donate eggs (called a known donor or directed egg donor). Most clinics, per American Society for Reproductive Medicine guidelines, will require the known donor to undergo a medical screening and psychological evaluation, and many will require a consultation with a lawyer. Talk to your clinic about its requirements regarding known donors, and the associated costs.

Using a gestational carrier typically comes with legal fees and medical expenses. There are also agency fees if you choose to use an agency, as well as the fee paid to the person carrying the child. In all, expect to pay anywhere from $60,000 to $150,000+.

The term “traditional surrogate” is used to describe a gestational carrier who also provides the eggs. The fees involved in traditional surrogacy are similar to that of gestational surrogacy, though the medical expenses may be significantly reduced if IUI is used to inseminate the eggs. However, most states don’t allow traditional surrogacy.

There is also compassionate surrogacy, an arrangement in which the gestational carrier or surrogate does not charge a fee for carrying the child. This could save around $30,000 to $50,000.

Insurance coverage for IVF generally depends on what coverage plans your employer has elected to offer. Where you live can also play a role. Nineteen states have laws that require employers to provide fertility benefits. However, which treatments must be covered and who qualifies for coverage is different from state to state. Also, small employers (often defined companies with 50 or fewer employees) and self-insured employers (companies that pay claims out of their own funds, rather than using an insurance company) are often exempt from these laws.

The initial fertility assessment required for IVF is usually covered by insurance—including policies that don’t cover IVF specifically. Semen analysis is usually covered as well.

Resolve: The National Infertility Association, a nonprofit organization that advocates for fertility rights, offers a guide to help you navigate coverage in your state.

“I think over the next decade, we’re going to see more and more employers provide fertility treatment coverage,” says Kenan Omurtag, M.D., director of the division of reproductive endocrinology and infertility in the Department of Obstetrics and Gynecology at the Washington University School of Medicine in St. Louis. “You’re having people in their 40s and 50s ascending to positions of power, where they’ll say, ‘Yeah, I went through this, and all my friends went through this, and we know what the struggle is of covering this. We should provide this benefit.’ The dominoes will start to fall.” Zocdoc helps you find and book top-rated doctors, on demand. Visit them in their offices, or video chat with them from home. Check out doctors in your area .

There are discount programs, grants and other ways to save money on IVF, including:

Discounts or grants for active or retired military service members. Some clinics offer military discounts on IVF services and/or fertility medications. Resolve has a list of clinics that offer special rates for active military and veterans. Other clinics not on this list may offer similar discounts, so always ask.

Some pharmaceutical companies provide military discounts on medications; for example, through its Heart for Heroes program, Ferring Pharmaceuticals offers free IVF medication to qualifying veterans and their spouses.

There are also non-profit organizations that help active military and/or veterans with the cost of IVF. For example, the Bob Woodruff Foundation offers IVF grants to veterans with service-connected fertility disabilities or challenges.

Financial assistance for cancer patients and survivors. Many organizations provide financial help with IVF medication and egg or embryo freezing for patients diagnosed with cancer, and/or for cancer survivors. Some programs to check out include Livestrong Fertility, Team Maggie, Chick Mission, Heart Beat and the Samfund Family Building Grant.

Clinical trials and studies. If you’re willing to enroll in an IVF-related clinical trial or study at a university, hospital, doctor’s office or other type of clinic, the lab may pay for part of or all of your medical costs. The U.S. National Library of Medicine has a searchable database of opportunities, but it comes with the disclaimer that not all listed trials have been evaluated by the U.S. government. Talk to your doctor before signing on to any trial or study.

Outcome-based programs (also called money-back or shared-risk programs) offered by fertility clinics. Ask your fertility clinic about outcome-based pricing, and for specific terms. Typically, you will pay upfront for multiple IVF cycles with the agreement that you will get a partial refund—often around 75% to 80%, usually with no refund on medication—if the IVF doesn’t result in a viable pregnancy. However, if IVF is successful on the first cycle, you don’t get your money back for the additional cycles you’ve already paid for.

Not all clinics offer these programs, and not all patients qualify. Patients who are at a higher risk of failed IVF cycles—for example, those older than 38, or who have a low ovarian reserve—may not be eligible.

Consider the numbers carefully and ask a lot of questions before entering a shared-risk program. Because clinics more readily accept younger patients with better predicted outcomes, this type of program may put a disproportionate amount of the financial risk on the patient. An important question is how the clinic defines a viable pregnancy—does that mean delivering a baby, or does that mean a positive pregnancy test? If you miscarry, are you still eligible for the additional cycles you already paid for, or for the refund?

Medication discount programs. Some clinics, pharmacies and pharmaceutical companies offer medication discounts—sometimes up to 75%—to patients whose insurance doesn’t cover fertility medications or to patients who meet income or other eligibility requirements. Check out the ReUnite Assist Program and EMD Serono’s Compassionate Care program and GO Direct Rebate program.

Income-based grants or scholarships. Finding and applying for fertility grant programs can feel a bit like navigating the world of college scholarships. There are dozens of options offered from organizations large and small, some at the national level and others hyper-local. Most of these grants are income-based—you must demonstrate a need to qualify.

Organizations that offer IVF grant or scholarship opportunities to anyone in the United States include AGC Scholarships, the International Council on Infertility Information Dissemination, Journey to Parenthood, Gift of Parenthood, the Baby Quest Foundation and the Starfish Infertility Foundation. Men Having Babies helps same-sex partners with surrogacy fees.

On the local level, the Chicago Coalition for Family Building offers grants to residents of Illinois, Wisconsin, Indiana, Iowa or Missouri. Through the New York State Infertility Demonstration Program, the New York State government subsidizes IVF procedures for patients whose insurance programs don’t cover the treatment. The Fertility Foundation of Texas awards grants to residents of central Texas.

There are many more of these types of programs all over the country. Ask your fertility clinic about what grant or scholarship opportunities they know of locally or nationally.

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Marissa Conrad, a freelance journalist based in New York, is the former features editor at Natural Health magazine. She’s also covered health and wellness for Eating Well, Furthermore, SELF and others. Her recent work includes stories on plant-based meat, wellness-branded beverages and how to get a better night's sleep.

As a practicing physician-scientist, Dr. Grifo has extensive experience in the treatment of couples with infertility. Since August 1995, Dr. Grifo has been the director of the division of reproductive endocrinology at the NYU School of Medicine, where he also holds the faculty appointment of professor of obstetrics and gynecology. In addition, Dr. Grifo also serves as the chief executive physician of the Prelude Network. Dr. Grifo received his M.D. and Ph.D. degrees at Case Western Reserve Medical School and completed his residency at Cornell University Medical Center. After completing a fellowship in reproductive endocrinology at Yale University in 1990, he returned to Cornell and established a medical practice specializing in the treatment of infertility in the division of reproductive endocrinology. While at Cornell, in 1992 he performed the first successful U.S. embryo biopsy to prevent a genetic disease, resulting in a healthy baby. His ongoing research since that time has been in improving that technology and applying it to egg freezing. He is board certified in obstetrics and gynecology and reproductive endocrinology, as well as being certified by the Accreditation Council for Gynecologic Endoscopy. His interests include reimplantation genetic testing, egg freezing and fellowship training.