LOWER YOUR INFERTILITY COSTS (Part I) Introduction; Costs; Diagnostic Evaluation; Treatment Options

PART I     LOWER YOUR INFERTILITY COSTS

(Introduction; Costs; Diagnostic Evaluation; Treatment Options)

Introduction

$          The worst thing about infertility is how helpless, frustrated and powerless you become. Often, after years of contraception, you are suddenly no longer in charge of when and if you will have children. Infertility touches all aspects of your life—physical, social, emotional and of course, financial. 

$          Determining what you can afford and/or what your insurance will cover, may influence the decisions you make and ultimately the choices of infertility treatment you choose. By educating yourself and creating a plan, you will make more informed financial choices. 

$          Research shows less emotional stress is beneficial, and may even improve some infertility treatment outcomes.

 How Much Will It Cost?

$          Compounding the issues of your infertility diagnosis are the financial obstacles.

$          With appropriate diagnosis and various infertility treatments, the vast majority of couples struggling with infertility are able to bring home a baby. Unfortunately, many couples are surprised to find that the costs of the required infertility treatments are often more expensive than they had originally planned for.

$          Some infertility treatments are not covered by insurance.

$          Cost becomes a real obstacle to treatment for many couples. In fact, surveys indicate less than half the couples in the United States who experience infertility seek help from a doctor. Treatments can range from $1000 to $3000 per cycle for medication/intrauterine insemination (IUI) cycles, with IVF averaging close to $12,000 per cycle in Illinois. 

            Finances and Your Relationship

$          Put your ideas down on paper—just having it in writing helps avoid misunderstandings.

$          Working together during your infertility journey can actually bring you closer as you work towards your common goal of having a baby.

$          For many infertility couples, depending on the woman’s age and other fertility factors, multiple attempts of a given treatment are often needed. Therefore, it may not be possible to predict the exact cost of therapy, so a level of uncertainty is inevitable.

$          You need to discuss in advance whether you are willing to take out a loan or a second mortgage? Are you willing to change to a job that offers better fertility benefits?  Are you willing to work a second job? Are you willing to modify your lifestyle and other expenses? Communication is the key for couples to get through this journey.

How Much Does the Diagnostic Fertility Evaluation  Cost?

The basic diagnostic evaluation may include:

• Semen analysis (SA) to assess male factor problems with his sperm
• Hysterosalpingogram (HSG) x-ray to investigate your uterus and tubes
• Ovulation predictor kit (OPK) measures LH surge and serum progesterone level 7 days after LH surge to assess ovulation and proper hormone production.
• A hormone evaluation measures thyroid, pituitary and ovarian function and ovarian reserve (egg supply).

• Costs for the basic evaluation will range from $1000 - $1500. (Often covered by  insurance)

            How Much Will  Different Fertility Treatments Cost?

$          How much does it cost to get pregnant? 

    It depends on many factors:

             a female’s age;

                         underlying cause(s) of infertility;

             the type of infertility treatment* (medications/IUI/IVF);

             overall prognosis;

             number of treatment cycles;

             you and your partner’s overall health and lifestyles;

             variations among fertility clinic financial charges and

                         your physician’s success rates, to name a few. (*see discussion below)

$          Educate yourself about health and fertility. You can make a difference!

Recognize that lifestyle factors can affect fertility and costs in a major way. Being unhealthy,          being overweight or smoking can also significantly reduce your fertility and increase your costs.

Fertility Treatment Options & Costs

It is helpful to understand the various fertility treatment options that are available when considering the costs, risks and pregnancy success rates.

 Primary fertility treatment options include:

1. Natural cycle (trying on your own without medications) with timed intercourse

2. Natural cycle with Intrauterine Insemination (IUI)  

3. Clomid therapy with timed intercourse

4. Clomid therapy with Intrauterine Insemination (IUI) 

5. Gonadotropin (FSH) injections with IUI

6. In Vitro Fertilization (IVF)

Clomid and timed intercourse or IUI, most pregnancies occur within the first 4 cycles. Clomid with IUI is relatively easy to do, less expensive and less risky than other options. A typical Clomid/IUI cycle (drugs/labs/US/IUI) costs from $1200-1800.

Gonadotropin (FSH) injections have some significant advantages as well as disadvantages. Some of the FSH medications include Bravelle, Follistim, Gonal-F, and/or Menopur.

For these reasons—1) more eggs, 2) better cervical mucus and 3) a better uterine lining, the pregnancy rates with FSH therapy are higher than with Clomid.

However, the disadvantages of FSH therapy include:

   1) More labor intensive monitoring of the ovaries (labs and ultrasounds) for 1-2 weeks

               2) Considerably higher costs ($2000- $2800/cycle)

               3) Higher risk of multiples

In Vitro Fertilization (IVF) is the only method that allows us to assess egg quality and on occasion, abnormal genetics of embryos.  In addition, IVF allows us to bypass any tubal disease as well as overcome most male factor infertility by placement of the best sperm directly into the egg to improve fertilization rates (ICSI). IVF treatment uses the same FSH medications, but in higher doses, since we want to get more eggs. With IVF we can control the risk of multiples better by transferring fewer embryos to the uterine cavity. IVF is certainly more labor intensive but carries the highest chance for pregnancy and also allows us to minimize the risk. It is more expensive than the FSH therapy but in many cases, it is the best choice. IVF costs vary among centers, but average $12,000

(With a $10-20,000 range) - Not including medications.

Depending on the woman’s age (and ovarian reserve), sperm function testing, a couple’s work schedule and time commitments, insurance, finances and risk tolerance, we can help most couples decide on the treatment options that may be best suited for them.