Affordable IVF?

August 5, 2010Carole 3 Comments »

Paying for infertility services, especially high tech options like IVF is a big deal for most patients. How can IVF be made more affordable? The infertility support group Resolve has put together some useful links on its page Making Treatment Affordable. Under The Costs of  Infertility Clinics, they report the results of their survey of prices charged for various fertility procedures from IUI to IVF. Interestingly, they found that in areas with fewer clinics, prices tended to be higher, suggesting that competition may drive costs down. Resolve also publishes a list of Fertility Financing Programs that are offered by other agencies.

Some US clinics are providing IVF at substantially lower costs according to this Newsweek article Why is IVF so expensive in the US?. For instance, Elan Simckes of Fertility Partnership offers full IVF for  around $7500, which includes both ICSI and Assisted Hatching. But I was disappointed when I reviewed their website and couldn’t find any self-reported pregnancy rates. (As of 2015, still no self-reported success rates on their site and I could not locate them in the list of reporting clinics in Missouri on the SART webpage.)  I appreciate their efforts to reduce the price but patients need to know what their success rates are. Fertility Partnership is no longer a new clinic and should report their rates unless they have closed.

Other clinics have been able to shave thousands of dollars off the price for their patients by establishing labs in free-standing office complexes, instead of hospitals and outpatient surgery centers, thus bypassing the expensive overhead associated with hospitals and surgery centers.  A cautionary note: IVF labs require a controlled air flow environment which means that instead of a typical office ceiling, a solid drywall ceiling (like in an OR) is required with HEPA filtration and net positive air flow so that air flows out of lab, instead of into the lab to keep dirty air out. I would ask about this feature if I was considering using a free-standing office-based clinic. A  dropped-ceiling tile ceiling that is common in most office buildings is not sufficient to control air flow in an IVF lab. Although life threatening complications are rare from egg retrieval, patients should ask free standing clinics what emergency procedures are in place to get them to an ER if needed.

Some patients, frustrated by the high cost of IVF in the US, travel overseas in search of less expensive IVF as reported in this article “US women crossing globe for fertility help”. Patient Shauna Anderson traveled to Cape Town South Africa, and paid $6400 total for both travel and IVF expenses. The actual IVF costs were only $3600 and included drugs, procedures, and lab and hospital fees. The average cost for IVF in the states in $12,000. Another example of how US citizens have used overseas IVF  programs is through  IVFvacation.com, a program started by an Ohio couple to arrange IVF “vacations” for couples to do IVF in the Czech Republic. Amazingly, there is actually a website created to compare medical tourism options for all kinds of medical problems at AllMedicalTourism.com. If you are considering going this route, you really need to carefully study what is promised and who, if anyone, is monitoring the quality of the program.

Although good clinics do exist around the world, the type of regulations and oversight vary widely so the US consumer needs to carefully review program information.  If a program reports pregnancy rates, find out whether there is an authority that audits reported rates. Canada and the European Union are similar to the US in that they have a strong system of IVF regulation. But how IVF is regulated varies. For instance, the European Union has the Human Embryology and Fertility Authority which provides oversight and licenses for IVF clinics. The requirement for licensing of ART clinics and greater national standardization of care could arguably provide even stronger oversight of IVF clinics than is practiced in the US.

Medical tourism comes to the US too. For instance, because egg and sperm donors are more scarce in Canada and the UK (due to restricting or prohibiting paying donors), patients from these countries travel to the US for donors. Overall live birth rates for clinics are published on-line by the Canadian Fertility and Andrology Society, the Canadian professional society for reproductive medicine, similar to our ASRM.  A list of Canadian clinics can be found here.

I would be thrilled if physicians, nurses and lab directors could brain storm and share cost-cutting measures they have employed successfully without affecting pregnancy rates. Making IVF more affordable for patients is an area where the IVF community really could do more to establish best practices. ASRM- are you listening?

© 2010 – 2015, Carole. All rights reserved.

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