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Affording IVF in a Tough Economy
a blog by David Kreiner, M.D., F.A.C.O.G., Feb. 3, 2010
Most people don’t have insurance coverage for IVF services, which means infertility treatment is out of reach for most in need. To those affected, it’s hard to understand why insurance provides coverage for other chronic illnesses or conditions, but not for a medical condition which prevents individuals from having children and building their families.
The current economy has forced many to resort to less expensive treatments including taking ovulation inducing hormones that stimulate multiple eggs and result in high-risk, costly multiple pregnancies. It’s ironic that insurers are concerned that covering IVF treatment will lead to greater expenses when affordable IVF would actually save insurers money.
Covering IVF would reduce costs resulting from high risk pregnancies, premature deliveries, neonatal intensive care and long term care for those babies born with disabilities, because IVF limits the number of embryos transferred. There’d be less need for hospital beds, NICU beds and disability care. Covering IVF would eliminate suffering from infertility, from risky pregnancies and unnecessary complications from the resulting multiple pregnancies including the children born with disabilities.
While efforts are being made to push government and insurance companies to do the right thing -- ethically and financially -- and include coverage for IVF, some clinics are offering IVF programs with options that go a long way in helping to make treatment affordable:
A Single Embryo Transfer program, designed to incentivize transferring one embryo at a time by offering the embryo cryopreservation and storage, and unlimited free frozen embryo transfers, allows a patient to pay only for the initial fresh cycle. This eliminates the financial need for the patient to put all her eggs in one basket.
Another option is minimal stimulation IVF or MicroIVF. IVF using limited stimulation such as clomid and minimal low dose gonadotropins requires less monitoring, shorter retrieval time, less anesthesia and less lab time. It also lets you avoid the high cost of medication, making it significantly less expensive than a full stim IVF. In addition to being more affordable, MicroIVF also eliminates the risk of hyperstimulation syndrome and minimizes the risk of a multiple pregnancy. MicroIVF can be offered essentially at the cost of IUI with ovulation inducing medications, but without IUI's risk and double its success.
Income-based, sliding scale grant programs can make IVF more affordable to patients in need. They are available in many regions of the country, either promoted by the state (such as the New York State Department of Health grant) or offered by individual clinics themselves.
For other patients with a limited budget, a money back refund such as a guaranteed or shared risk program is ideal. Typically, in the absence of the birth of a live baby, the IVF fee minus the cost for medication and anesthesia is refunded.
As an IVF program director, my wish is to assist all patients in need with creating that healthy family of their dreams without adding unnecessary risk. The programs I’ve mentioned above can help them in their quest. Until the government and insurance companies step up with coverage, it's up to the IVF programs themselves to help patients get the IVF that they need to help build their families.