May 19, 1999
Web posted at: 11:17 AM EDT (1517 GMT)
By Roxanne Nelson
|BREAKDOWN OF THE AVERAGE COST OF IVF|
|Screening lab: $300 (3%)|
|Ultrasound/lab work: $3,000 (30%)|
|Egg recovery: $1,500 (15%)|
|Fertilization lab: $2,000 (20%)|
|Embryo transfer: $1,000 (10%)|
|Ovulation drugs: $2,190 (22%)|
|Total: $9,990 (100%)|
(WebMD) -- Approximately 2 million American women undergo some type of fertility treatment every year. Contrary to the intensive media coverage of fertility issues, infertility has not reached epidemic proportions. According to the National Center for Health Statistics, the number of infertile married couples was actually lower in 1995 (2.1 million) than in 1982 (2.4 million).
Infertility rates have not increased in the past three decades, but treatment protocols were forever changed the moment Louise Brown entered the world in 1978. As the first baby born via in-vitro fertilization (IVF), she opened a whole new arena of hope to infertile couples, in addition to aggravating a hotbed of moral and ethical debate. Brown's birth also raised the financial stakes. The hefty price tag attached to ever advancing technology has become one of the more controversial and emotional issues of infertility.
Health plans and infertility
"About 25 percent of employer-sponsored plans have infertility benefits," says Sean Tipton, director of government and media affairs at the American Society of Reproductive Medicine. "And even with that, coverage can vary. Some may not pay for IVF, others may ask for a 50 percent co-pay or they may only cover certain drugs."
While 13 states have mandated some form of infertility care, more than 65 percent of all employees are in plans that are exempt from state mandates under federal law. The reality for the majority seeking help is that they must somehow figure out how to pay for it.
Most people begin with low-tech treatment, usually fertility drugs. But even these can get pricey. A single dose of the drug Fertinex costs about $60, but most doctors monitor the treatment process with ultrasound scans and blood tests, which can jack up the price to around $1,500 a cycle. Using more powerful drugs like Pergonal can double that cost.
If drug therapy fails, a couple must decide if they want to proceed with Assisted Reproduction Therapy (ART). The most common of these is IVF, which on average costs $10,000. And because success with IVF increases with the number of cycles attempted (up to four attempts), women often try it more than once. When IVF is unsuccessful, more complex -- and more costly -- procedures are attempted. The tab can be staggering.
"People do very creative things to get money," says Tipton, "like selling or mortgaging their house."
Fertility clinics are getting creative as well. Many don't offer payment plans. As Dr. Richard Sherbahn of the Chicago-based Advanced Fertility Center points out, clinics have experienced low collection rates when people were billed for uncovered infertility services after the fact -- especially if they didn't end up with a live birth. To help offset high costs, some clinics are offering more options. The Advanced Fertility Center, for example, offers a special guarantee program: For a flat rate of $16,000, couples meeting the eligibility requirements receive one complete IVF cycle and as many transfers of thawed embryos as needed to achieve a birth. Couples receive a 100 percent refund if they don't become pregnant from the initial or frozen-thawed cycles.
Dr. Deborah S. Simmons, a Minnesota-based marriage and family therapist who specializes in fertility issues, is surprised at how many of her clients are low-income couples who need to scrimp and scrape to afford an IVF. "I often find myself talking with couples about how much they are willing to gamble," says Simmons. "How much of their future are they willing to sacrifice -- for example, college education for a child, should they conceive -- in order to have a baby. They often have not thought about their future other than hoping there's a baby in it."
Light on the horizon
Whether or not insurance coverage for infertility will increase remains to be seen. Several court rulings, in cases specific to infertility insurance coverage, have produced mixed results. Consumer advocates are hopeful that a recent Supreme Court ruling, which stated that reproduction is a major life activity, will strengthen the case for better insurance coverage.
It is estimated that the cost of adding IVF treatments to a standard healthcare benefits package would be less than $3 per member per year.
Copyright 1999 by WebMD, Inc. All rights reserved.
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