Navigating Fertility Treatment Costs

Infertility affects approximately 20% of couples, but only 10% will ever see a doctor.

At SCCRM we appreciate that fertility treatments are not only emotionally and physically exhausting, but for many couples may seem unaffordable. This is true in part because insurances often don’t cover such treatments; and because most people think of fertility treatments as involving only the highest technologies, such as in-vitro fertilization (IVF) ‘“ the rarest used but most costly treatment. The truth is that fewer than 5% of all fertility treatments in the United States use assisted reproductive technologies (ART).

Reassuringly, among couples who do see a Reproductive Endocrinologist and Infertility Specialist, approximately 70% will have success within one-year of treatment ‘“ assuming they stick with it ‘“ most using treatments that are considered ‘œlow-tech’ (e.g., not involving ART/IVF). In fact, since a woman’s age is a major predictor of success (see Age and Fertility) delaying treatment can lead to the need for more intensive and costly treatments, limit family size options, and, ultimately, impede a potentially successful outcome.

The following steps may help you navigate fertility treatment costs:

First, get educated!

Learn about what tests are needed to diagnose your condition and what treatments are available, as well as their costs and your insurance coverage. Check your health insurance policy and speak with a representative to clarify what is and what is not covered by your plan. Sometimes patients are surprised to learn that though fertility treatment may not be covered (i.e., in-vitro fertilization), many plans do cover tests that are needed to determine the cause of a couple’s infertility (i.e., hormone tests, x-ray, etc.).

Most couples require only simple interventions, such as help with ovulation (i.e., clomid, gonadotropins, etc.) or intrauterine insemination (IUI). This type of treatment typically costs a few hundred to a couple thousand dollars per cycle. The most advanced technique, IVF, costs several thousand dollars per cycle depending upon the specific procedures used and the amount of medication needed. Sometimes a minor procedure (i.e., hysteroscopy) or surgery (i.e., laparoscopy) is needed to correct a specific problem (i.e., polyp, blocked tubes, endometriosis, etc.), and this may be covered by your insurance plan.

Second, develop a plan.

Set pragmatic goals, expectations, and budgets. Fertility treatment is a process. Set a realistic time frame (1-2 years) to achieve your objective and commit to treatment during that time. If you succeed sooner, then celebrate!

Not only is it crucial to know what treatments are available and how much they cost, but it is equally important to understand what you are getting for what you are paying. In other words, what is the value of the treatment for your particular situation? For instance, in young women (<35 years old) starting with a simple treatment such as clomid and IUI is reasonable. The risk of multiples is low, there is a fair chance of success (5-10% per cycle), and the cost is relatively affordable (few hundred dollars per cycle). However, if unsuccessful after a few cycles that same couple may choose to avoid the risks and costs of gonadotropins with IUI by investing in a higher yield strategy, such as IVF. With IVF the risk of multiples can be controlled by replacing fewer embryos in the uterus, the chance for pregnancy is high in young women (usually >50% per cycle), and the chance for having excess embryos for future use is likely. On the other hand, an older woman (>40 years old) who has a small risk for multiple gestation pregnancy and lower success rates using clomid (<5% per cycle) may choose to start with a more aggressive plan, such as gonadotropins with IUI or IVF.

Third, be flexible.

In an ideal world, we’d know ahead of time which treatment is going to result in a pregnancy. Since that is impossible, invest wisely by not wasting time, money, and fertility on low yield therapies. Most pregnancies will occur in the first three months of a particular treatment (i.e., clomid with IUI) and the chances decrease thereafter. It’s important that you are evaluated during your treatments with ultrasounds and/or blood tests in order to determine whether or not a treatment is effective and to guide future treatment decisions. You may choose to change strategies before completing a predetermined number of cycles. It may make sense to invest in a higher yield treatment that costs more, but has a much higher chance of getting you pregnant.

Contact our Billing Department

Our Billing department is available to answer your questions related to insurance coverage and treatments, as well as answer questions regarding Financing Options with Prosper Healthcare Lending:

To apply, please click on the link below:

Prosper HealthCare Lending is the premier financing company in the fertility industry. With over $5 Billion funded and over 300,000 loans inquiries serviced through their lenders, this is a name and a program you can trust.
Here are some of the benefits you’ll receive with a loan from Prosper HealthCare Lending:

  • Immediate decisions for loans under $35,000
  • Term options out to 84 months (affordable monthly payments)
  • No collateral required
  • No prepayment penalties
  • Fast & easy loan inquiry process
  • 100% Confidential

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