Fertility Topics Explained from the Experts at SFS
When considering IVF, cost is a major consideration. Patients tend to compare the cost of treatment at one center with that of another. While it is understandable for cost per IVF procedure to be considered, the focus should rather be on the cost of having a baby…not on the cost per procedure. Moreover, aside from financial considerations there is another cost factor to be taken into account and that is the enormous emotional cost associated with IVF. For both the reason of emotional and financial costs involved, those seeking IVF need to be good consumers and seek out an IVF team with the best record when it comes to optimizing IVF outcome for the specific reproductive problem involved and can provide services in the most supportive and congenial patient-friendly environment possible.
The average IVF patient (about 70%) is relatively young (under 35 years), has normal ovarian reserve, and the underlying cause of their infertility is mechanical (tubal/pelvic adhesions or male factor. Such patients fall within the “bell of the bell-shaped curve”, and are probably the most likely to achieve success. In contrast, approximately 30% of IVF candidates (many of whom have often had repeated prior IVF failures) are of a more advanced age, have diminished ovarian reserve and/or have complex implantation problems (often due to immunologic implantation dysfunction). Such patients usually are much less likely to be successful with IVF and as such, their chance of having an IVF baby might very much be influenced by the experience and expertise of the treating RE and his/her team. For reason of enlightened self-interest such candidates should seek services at those centers that are best equipped to address such issues.
Unfortunately, it is presently not possible to gain reliable information regarding IVF outcome statistics in the United States. Annual reports on the CDC website are self-generated by IVF providers themselves and are largely accepted and published inadequately audited, on face value. Thus it is unfortunately still a case of “consumer beware”. Now, perhaps more than ever before, the onus falls upon the consumer to research their options carefully. They should visit and interview treating physicians at those programs under consideration and should talk to patients in their situation and research the internet thoroughly.
When it comes to selecting an IVF program, it is important to always consider experience, quality and expertise as this inevitably impacts the likelihood of a successful outcome (live birth) with the least number of attempts thus impacts overall cost.
An analysis conducted on base fees quoted by more than 400 IVF programs in the US (for a single cycle of IVF, exclusive of cost of anesthesia and fertility medications) reported an average cost of about $11,000. When it comes to interpreting IVF fees, the adage, “Perception is in fact reality” absolutely applies. Consumers should beware of interpreting fees quoted by one clinic with that of another program. What is important is to first look at the base cost and then to evaluate the fees for additional services (“add-on’s”). IVF Program A might include the cost for often expensive add-ons such as intracytoplasmic sperm injection (ICSI), assisted hatching and initial embryo freezing and storage, embryo biopsy and even PGS testing of embryos in their “base price” while Program B that quotes a much a lower IVF might not include the cost of some/all such add-on’s in the base price. Unless this is taken into consideration it is possible to erroneously consider the cost of IVF at Program B as being lower than that of Program A. It follows that when comparing IVF costs at different IVF programs it is important to always compare “apples with apples”.
To describe the effects of preparing for, participating in IVF is a “roller coaster ride” is a gross understatement. Anyone who has been through the process, whether successfully or unsuccessfully will attest to the fact that in the final analysis the emotional price turned out to be far greater than the financial. Unquestionably the majority of US women/couples going through IVF find the financial burden to be overwhelming. They have to massage every dollar available to afford a single cycle of treatment. As such they view the financial challenge as great. For them the fact that if they do not succeed the first time around, they might not be able to afford a second attempt only serves to deepen their emotional stress. Here, it becomes even more important to seek out the best possible available venue for IVF services, in their area or out-of-town.
More than 70% of my IVF patients travel to me for treatment from out of town, state or country. I fully recognize that for some, traveling away from home for IVF, could deny them access to their built in support systems and as such might represent a hardship and a sacrifice. However, for others, traveling out of town for IVF treatment can present an opportunity for a welcome break from the pressure and stress that is often associated with questions and inquiries from concerned friends and family.
I urge IVF consumers and always look at the financial burden in terms of the overall cost of having a baby, rather than the cost per procedure. Also, always consider how the underlying medical cause of the problem might influence where to best seek treatment. Shop around go online, talk to others who have undergone treatment at the IVF program you are considering seeking treatment with and visit infertility support groups such as Resolve or INCIID and to do the necessary homework before making a final decision, however well intended they might be.
In conclusion, I urge those seeking IVF services to assess the cost of IVF in terms of both the financial and emotional component rather than the cost per cycle of treatment.
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