According to RESOLVE: The National Infertility Association, only 16 states mandate infertility insurance coverage. And with IVF averaging $23,000 per cycle, the decision about whether or not to move forward often comes down to money.
There are ways, however, to both reduce the IVF cost and present it in a way that patients can understand.
IVF Cost #1: Fertility Testing
Fertility clinic patients are a mix of first-timers and those who are switching providers. While many reproductive endocrinologists like to start from scratch when it comes to fertility testing, regardless of the situation, patients have a hard time justifying this cost.
Doctors should explain the purpose behind — and cost of — any test they order, leaving room for two-way dialogue.
IVF Cost #2: Consultation(s)
During an IVF consultation, it's important to explain the IVF process in detail, including the patient's protocol, what to expect, the risks associated with conceiving multiples, the American Society for Reproductive Medicine's embryo transfer guidelines and, of course, all associated costs.
This appointment can be quite lengthy, however, and many reproductive endocrinologists end up scheduling more than one consultation as a result, ultimately costing patients more money.
Doctors can limit this cost and improve patient satisfaction by creating both written and video content — each containing the same information but appealing to different learning styles — about every aspect (except the patient's unique protocol) and sharing it with patients at least a week in advance of the consultation.
IVF Cost #3: Additional Assisted Reproductive Technologies
From intracytoplasmic sperm injection to preimplantation genetic testing and everything in between, there are many possible additional costs during an IVF cycle. Again, only informed patients can make good decisions about which ones to pursue.
If possible, reproductive endocrinologists should discuss these options and their associated costs during the initial consultation, even though patients may not make final decisions until later.
IVF Cost #4: Mock Embryo Transfer
While potentially helpful, not all patients can justify the cost of a mock embryo transfer. Nevertheless, doctors should again explain the purpose of this procedure and how much it will cost, ultimately allowing the patient to choose whether or not to move forward.
IVF Cost #5: Fertility Medications
Depending on the protocol, drugs can add an average of $5,000 to the overall price tag of IVF. Several approaches make the conversation around medication more palatable.
First, reproductive endocrinologists should explain how each medication impacts the patient's hormones. Then, if the patient is a good candidate, discuss the pros and cons of a low-stimulation IVF cycle. If the clinic has any leftover drugs donated by former patients, offer them. Finally, have someone on staff keep up to date on the latest prices at specialty pharmacies and any coupons offered by drug manufacturers.
IVF Cost #6: Ultrasound Monitoring and Blood Work
The importance of monitoring a patient's response to stimulation during an IVF cycle should be clearly explained during the initial consultation. In an attempt to reduce patient costs, and because ultrasound technology has become so accurate, many clinics skip the ultrasound on day three of stims and only draw blood.
Although it's impossible to know exactly how many ultrasounds and blood draws a patient will need during an IVF cycle, reproductive endocrinologists should strive to include this monitoring in the overall IVF package rather than itemize it.
IVF Cost #7: Egg Retrieval
Because egg retrievals are almost always performed under anesthesia in a surgical setting, this step is one of the most expensive, and once again, ultrasound plays an important role.
While there aren't many opportunities, if any, to reduce the cost of an egg retrieval, reproductive endocrinologists should explain each aspect of the process. It's easier for patients to justify an expense once they have a basic understanding of everything involved.
IVF Cost #8: Embryology
Few patients know what happens after their egg retrieval, but the importance of the clinic's embryology department cannot be overstated. Again, written and video content can educate patients on each step and allow them to comprehend the cost.
IVF Cost #9: Cryopreservation and Storage
The discussion here should be around long-term family building. Approximately how many transfers over what period of time might it take to achieve their goal? It's important that patients understand that this is an annual cost.
IVF Cost #10: Embryo Transfer
Again, many patients are unaware about what happens behind the scenes on transfer day. Reproductive endocrinologists should walk them through each step, including how an abdominal ultrasound guides proper embryo placement.
Doctors need to be understanding about the fact that IVF is a huge financial decision for patients. Being considerate and informative when explaining IVF costs to paitents will ensure that patients feel empowered to make these kinds of choices.
