Time for an Action Plan- IVF costs
So we made it 12 months and still no pregnancy. At this point our physician recommended in vitro fertilization (IVF). We started looking at adoption and clinics for IVF. While our physician was willing to do the IVF, we felt that since we payed cash (which we had to do because of a clause in our insurance plan that stated my wife had to be insured through me for 1 year prior to getting any infertility benefits- so please check with insurance carriers well ahead of pursuing IVF) we might as well find the best place.
How did we determine the best place?
We started to research IVF clinics by talking to friends with experience. Interestingly, 1 in 8 couples are infertile and in our group of friends it panned out that way. This maybe due to the fact that most of our friends are physicians and may be older when pursuing pregnancy.
Available data online
After much discussion, we agreed to go to a high volume center with good statistical outcomes. Luckily in the era of the Internet, statistics on IVF are now easily obtained, albeit not necessarily accurate. We ended up using www.sart.org from the Society of Assisted Reproductive Technology. This website is great and provides data (from 2011 or earlier) on the volume of IVF in a year performed at the center, success rates by age, and other important facts.
Missing data online
What is missing is the underlying cause for infertility for individuals at the clinic. Additionally, reporting is voluntary and how the clinic determines what information will be provided is also voluntary. Thus, there are some gaps in data. For instance, it is great that a center has about 50-60% success rate for someone <35 years old (to me that is spending $15,000 -$20,000 to flip a coin). However, forget about getting specific information such as what is the success rate for someone <35 years old with PCOS or a luteal phase defect or with both. That info does not exist in a public forum that I know of.
High volume centers
Instead, we looked at high volume centers (>500 cases a year in my wife’s age group) in towns with family or friends where we could crash. I was able to find one and make a phone appointment. The fact that they all had between a 50-60% success rate did not make much of a difference to us. At the end of the day we wanted a high volume center that had standardized protocols. High volume meant that everyone involved in my wife’s care had a high level of experience and followed a protocol driven plan.
Housing and travel costs
Consider both housing/travel costs if thinking about doing IVF in a city away from home. The housing issue becomes important because the woman moving forward with egg retrieval is on site for about 10 days during which they stimulate her ovaries to produce eggs for retrieval. During that time she needs almost daily ultrasounds to decide how things are going.
Additionally, after egg retrieval she needs to wait at least 5 days before implantation of an embryo. That means the stay away from home can take approximately 2 weeks. Plus this is an emotionally, hormonally, and physically stressful experience and comfort is paramount.
The costs of IVF will vary based on insurance, clinic, financial plans, and the methodology. I can only speak our experience. There are things such as intra-cytoplasmic sperm injection (ICSI), hatching, and pre-implantation genetic diagnosis testing (PGD) that can increase costs. We luckily did not need to go through these and if there is enough interest I am happy to discuss them.
Our first meeting with our physician was via telephone. At that visit the doctor described various options, he reviewed our records, and discussed what he thought we needed to do.
My wife then flew up for a mock embryo transfer where the physician measured the ovaries and looked for follicles. He also looked at the size of the cervix and the shape of the uterus. All of this was in the price of the IVF treatments. We paid for transportation (all in all travel cost us an additional $3,100 when it was done).
Shared Risk Plan
We decided to go with a “Shared Risk Plan”. This plan is a program where we paid a little more up front, but then the financial risk is shared between the patient and the clinic for those who are self-pay. It provides up to 6 IVF or donor egg cycles for a flat fee and if there is no baby in the end there is a 100% refund.
I know this seems a bit strange, but when spending over $15,000 for care, it is nice to have some guarantee and know the doctors/clinic have some skin in the game. Shady Grove Fertility Clinic, which we used, also has many other financial programs that can be found here. (this is not an endorsement for one clinic over another. I have no financial relationships with this clinic or any other fertility clinics.) It is quite costly and this is a limiting factor of IVF. Not to mention the medications.
So now it is time for more injections. This time my wife started with Follistim and added Menopur to the mix. Menopur increases the number of follicles that grow. Basically the goal is to have as many and as big of follicles as possible for the egg retrieval. It is more painful and arguably a worse injection than the Follistim. First it has 2 vials of stuff, one with sodium chloride, a liquid, and the other with the medicine, a powder. The medicine has to be reconstituted, which is not particularly difficult, but annoying. Then the medicine is injected into the subcutaneous tissue.
My wife was not prepared the first time we injected medicines. We started the injection and it hurt pretty bad. Also there can be significant nausea from the Menopur that does not exist with the Follistim. So we continued with injections and also received regular ultrasounds looking at the ovaries. The amount of medications and the combination of medications typically will change based on the ultrasound measurements. Near the end my wife was getting ultrasounds every day. Over the course of the IVF treatments we had many costs from lab work to ultrasounds, to fertility medications.
We were fortunate and the first round of IVF led to a pregnancy with some minor hiccups. Approximately nine months later we had a beautiful baby boy and the idea of this blog was born- Dads Dollars Debts.
This was our experience with IVF. It was an emotional and financial experience. We never expected it when we started on the road to parentdom and it made us take a hard look at our finances to ensure we could afford it. Fortunately we could afford it due to my profession, but there are plenty of people out there who can’t afford it and even more who undergo IVF without success. I feel grateful every day that we were able to have a child, as there are no guarantees for another.
All in all we spent over $30,000 out of pocket to have our son. Some of this was tax deductible (Anything over 10% of adjusted gross income). It was worth every dollar but I can understand people's hesitancy in pursuing it again. There is an emotional cost too. Just like parenting. I can understand how the stresses of infertility can either make couples stronger or make them fall apart. Luckily we are stronger for it and our family now feels whole.
What were other people's IVF costs (Emotional and financial)?
I am Eiman Jahangir and I am a dad, husband, and cardiologist. I grew up in the South, trained in the Northeast, moved out West, and now am happily back home in the South. My wife and I have seen our fair share of ups and downs, from the pain of dealing with infertility and losing everything in a matter of hours in the Tubb’s Wildfire, to the joys of having our son and finally finding a medical practice that is right for me. It hasn’t always been easy, but I am grateful and continue to move forward in positive steps.
I write to help people looking to improve their lives. I have written my thoughts and experiences on a wide arrange of topics from parenting to finances to mindfulness. While some of my posts are more useful for doctors and other high earners, most are for everyone.