Out of pocket costs become very important when medical insurance does not cover the expenses.
IVF is expensive, partially because:
- the physicians that develop and monitor your IVF cycle are highly trained medical sub-specialists (in Reproductive Endocrinology and Infertility),
- the medications that are used to stimulate the ovaries are extremely expensive (in a conventional IVF protocol the cost of medication alone can exceed 8,000 dollars),
- monitoring the development of ovarian follicles (cysts in the ovaries that contain the eggs) can be labor intensive (ultrasound exams and blood work may be required every day or two during conventional IVF cycles since lots of medication is used and changes can occur quickly),
- the embryology laboratory requires very expensive cutting edge equipment that is capable of successfully simulating the natural environment in which human eggs become fertilized and the resulting embryos (fertilized eggs) grow normally
- the embryology laboratory may suggest some “experimental” or other genetic testing and/or tissue culture procedures that are not covered expenses by your insurance plan so you end up receiving the bill (some of these genetic tests and other lab procedures can cost several thousands of dollars)
- complications associated with conventional (high dose medication) IVF protocols include ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy (both of which can be very expensive to manage)
A treatment cycle of “mild IVF” can be much less expensive than a treatment cycle of “conventional IVF” since
- far fewer medications are used during ovarian stimulation since the goal is to develop a few high quality eggs rather than as many eggs as possible
- less monitoring of the cycle is required since the cycles are often much more predictable
- experimental or other genetic testing and/or tissue culture procedures are rarely suggested
- much fewer complications such as OHSS and multiple pregnancies are encountered
Cost comparisons between “mild IVF” and “conventional IVF” would ideally focus on the average cost per pregnancy or the average cost per live birth. The available research comparing these costs is fairly scanty. One of the best comparisons is discussed (Soft ovarian stimulation IVF (Mini-IVF) vs conventional IVF: an economic perspective Zhang, J et al., Fertil Steril 2008).
In 2008, Dr. Zhang et al published research findings comparing the cost per pregnancy in NYC for minimal stimulation IVF (mild IVF or mini-IVF) versus conventional IVF, comparing his IVF center for the cost of mini IVF (New Hope Fertility, NY, NY) and two conventional IVF centers located within NYC. The cost of IVF complications such as ovarian hyperstimulation syndrome (OHSS, primarily associated with conventional IVF cycles), preterm and premature birth (primarily associated with higher order multiple pregnancies that are associated with conventional IVF), and cycle cancellation (primarily associated with mini-IVF due to premature LH surge and ovulation) were not considered.
In this study, Dr. Zhang et al. found that the conventional IVF programs had higher pregnancy rates per IVF cycle than mild IVF: (a) conventional IVF program 1 had a clinical pregnancy rate of 46%, twin rate of 31%, higher order multiple pregnancy rate of 6%; (b) conventional IVF program 2 had a clinical pregnancy rate of 54%, twin rate of 41%, higher order multiple pregnancy rate of 3%; and (c) the mini IVF program had a clinical pregnancy rate of 37%, twin rate of 4%, higher order multiple pregnancy rate of 0%. However, and more importantly, the cost per pregnancy was found to be significantly greater for the conventional IVF programs when compared to the mini-IVF program. The average cost per pregnancy in conventional IVF program 1 was $129,318. The average cost per pregnancy in conventional IVF program 2 was 110,742 dollars. The average cost per pregnancy in the mini-IVF program was 44, 378 dollars. (Note: At the time of this research, the mini-IVF program was charging 8,300 dollars per cycle, which included the medications, anesthetic services, and embryo vitrification for repeated single embryo transfer cycles).