How much does IVF cost in New Jersey?
Cost can be thought of as the expenditure (effort or sacrifice) made to obtain something.
The cost of IVF in New Jersey for any patient is complex since there are
1. financial (monetary) costs,
2. emotional (stress) costs,
3. physical (risks to your health) costs,
4. spiritual (religious and other moral) costs,
5. relationship (partner and family) costs, and
6. time (away from what you would rather be doing) costs.
Additional variables that also influence a couple’s out of pocket cost for IVF specifically in New Jersey include:
1. access to medical insurance that covers the cost of IVF in New Jersey,
2. access to short term disability insurance to reduce some of the cost of IVF in New Jersey, and
3. New Jersey and Federal tax laws governing the personal medical expenses and the cost of IVF.
(1) What are the financial costs of IVF?
The monetary cost of a cycle of IVF in New Jersey for a specific couple primarily depends on
1. the patient’s needs and desires and
2. the IVF center’s charges for a cycle of IVF.
Most IVF centers in New Jersey and the USA in general only offer “conventional IVF,” which uses very large amounts of medications to maximize the number of eggs that are developed, at tremendous additional cost to patients. IVF centers (such as our own IVF center) that offer milder forms of IVF, such as mini IVF, may offer quality IVF at a much lower cost to couples. This may make all of the difference for couples that need IVF in New Jersey but cannot afford the cost of conventional IVF.
In New Jersey, the cost of
1. the IVF egg retrieval procedure,
2. anesthesia for the egg retrieval,
3. basic embryology with fertilization of the egg(s) and tissue culture of the embryos (fertilized eggs) in the laboratory, and
4. embryo transfer of normal appearing fresh embryos
is often bundled together by IVF programs as “the cost of IVF.”
The cost of these charges (fees) for this basic bundle of required procedures usually start at about 5,000-6,000 dollars and can reach costs in excess of 12,000 dollars at some of the New Jersey IVF centers.
It is important to realize that this cost is for only the most basic IVF requirements and often the total cost of completing an IVF cycle (beginning to end) at a conventional IVF center is more than double this cost.
The total cost of completing a cycle of IVF also includes
1. the pre-treatment evaluation (which can cost thousands of dollars at IVF centers in New Jersey),
2. the cost of monitoring the cycle prior to the egg retrieval and following the embryo transfer (each office visit can cost a few hundred dollars at an IVF center in New Jersey),
3. the additional embryology procedures that are suggested but are not included in the bundled “cost of IVF” that is quoted (for example ICSI can cost several thousand dollars at IVF centers in New Jersey),
4. the anesthesia cost (if not specifically stated as included in the bundled “cost of IVF” quote),
5. the medication cost (which alone can cost 5,000-7,000 dollars at the pharmacy when undergoing a conventional IVF cycle), and
6. the cost of freezing any supernumerary (extra) embryos.
Additionally, many IVF centers do not offer refunds to couples that have paid for a bundled “cycle of IVF” and for some reason cannot complete the cycle. This can be for personal reasons or because they did not make enough eggs, the fertilized eggs did not grow normally, or all of the embryos were frozen.
For much more information on the financial cost of IVF in New Jersey as well as a detailed description of our mild IVF center’s discounted rates for couples without insurance coverage for IVF and our central New Jersey mild IVF center’s refund policies for these patients please click here. You should look for similarly detailed descriptions when comparing prices and cost for IVF at other IVF centers.
(2) What are the emotional (stress) costs of IVF?
Raising children is often considered to be the single most important activity of a family. When this opportunity is limited or eliminated, whether by reduced fertility or other circumstances, then tremendous tension and emotional stress can develop. In addition, undergoing medical procedures that are very expensive, involve several weeks of daily injections and frequent office visits, and are poorly understood due to their inherent complexity can increase this stress. The emotional and stress related costs of IVF can be very significant and should not be ignored. Of note, conventional IVF protocols are highly aggressive, very expensive, and require more frequent office visits for monitoring when compared to mild IVF protocols.
The American Society of Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) have prepared a very helpful paper entitled: “Preparing for IVF: Emotional Considerations”
In this SART paper, the authors note that patients often rate the level of stress associated with undergoing a cycle of IVF as similar or greater than other major life events such as the death of a family member or divorce. For more information from this SART paper on the aspects of IVF that patients found to be stressful, the phase of IVF that was perceived as the most stressful, and some really good tips for coping with the stress of IVF, please click here.
At our central New Jersey mild IVF center we do understand that IVF can be very stressful and we try to help you recognize and deal effectively with this. If the emotional costs of IVF are a major concern for you, you should know that mild IVF, including mini IVF and modified natural cycle IVF, is reportedly very significantly less stressful than the highly aggressive conventional IVF cycles and mild IVF allows access to IVF for a large number of couples who could not afford the high financial and emotional costs of conventional IVF.
Ultimately, you should feel some comfort knowing that regardless of the final outcome of your treatments, you have succeeded in doing everything within your power to optimize your chances to have a child.
(3) What are the physical costs of IVF (health risks to yourself or your pregnancy)?
The American Society for Reproductive Medicine (ASRM) has an informative fact sheet entitled “In vitro fertilization (IVF): What are the risks?”
The IVF related health risks discussed in this ASRM fact sheet include side effects and complications of the medication(s) that are used; surgical or anesthesia complications from the egg retrieval process; risks of the embryo transfer procedure; increased exposure to the risk of birth defects for the child conceived with IVF; and increased risk of complications of pregnancy when IVF is used to conceive. It is noted that serious complications are uncommon with IVF but many minor complications and side effects do exist and are fairly common.
Most of the health risks that are associated with the medication used for ovulation induction, the surgical and anesthesia procedures used to remove the eggs from the ovaries, and the pregnancy risks associated with IVF are significantly reduced when undergoing a cycle of mild (mini) IVF as compared to a cycle of conventional IVF.
For more detailed information on these specific physical costs (health risks) of IVF, and which ones are reduced when undergoing mild IVF compared to conventional IVF, please click here.
(4) What are the spiritual (religious and other moral) costs of IVF?
Personal, moral, religious and cultural belief systems all play an important role in defining what different people think of as “right or wrong,” “good or bad,” “better or worse,” and “moral or immoral.” In our mild IVF program, we understand that patients often make decisions that differ from what we might personally make for ourselves, but we offer the same level of professional medical care to all of our patients regardless of their belief systems.
We do suggest that patients carefully consider the implications of their decisions regarding IVF, since there are often deep moral and religious feelings with regard to artificial forms of conception, the destiny of frozen embryos, and the use of third party eggs and/or sperm. The spiritual cost of IVF is often overlooked at IVF centers in New Jersey.
The potential cost of completing a cycle of IVF, including possibly freezing fertilized eggs (embryos), without thoroughly considering your own personal and/or religious feelings can be significant. You should discuss all of these decisions with your significant other(s) and/or religious leaders (if applicable).
(5) What are the costs of IVF to your most significant relationships?
The financial, emotional, physical, and spiritual costs of IVF can add up quickly and they can have a significant toll on your most valuable relationships, those involving your partner and your family.
At our mild IVF program, the overall cost of IVF is usually far less than at a conventional IVF program. The overall impact that is felt by a couple undergoing mild IVF is often stated to be tolerable, whereas the overall impact felt by a couple undergoing conventional IVF is often described as “similar or greater than other major life events such as the death of a family member or divorce.”
At our mild IVF program, we suggest that you gather together your “best support team” possible and you discuss and share your honest concerns about IVF for about 15-30 minutes on a regular basis (daily if possible) during the treatment cycle. This may allow you to allocate a reasonable and finite amount of time to review these concerns on an almost daily basis, and it will also make available conversation and discussion if/when unexpected events occur during your treatment cycle. Most couples that share their concerns, and develop other helpful coping strategies, during an IVF cycle appear to end up with even stronger and deeper relationships (since you have helped each other through a rough time). Without good communication throughout your IVF cycle, and an honest discussion of each other’s IVF-related concerns, the cost (damage) to a valued relationship can be devastating.
(6) What is the cost of IVF in terms of time commitments?
Juggling your schedule to fit in all of your commitments is often a real challenge.
When you are actively undergoing in an IVF cycle, a lot of the office visits (for ultrasound exams and blood work), phone calls from the IVF center (to provide your lab results and modify your medication dosages), egg retrieval and embryo transfer procedures, and other obligations are scheduled “on the fly” according to your ovary’s ongoing response to treatment and their timing is usually relatively inflexible (need to be completed at certain specific times). This means that you need to have a very flexible schedule that can accommodate frequent changes in your monitoring and treatment.Job obligations, child care responsibilities, and other important commitments in your schedule often need to be fit around the IVF schedule. Time commitment costs of IVF are often underestimated by a couple undergoing their initial cycle of conventional IVF.
The time commitment costs of IVF for monitoring and treatment is far greater, less flexible, and more intense when you are undergoing conventional IVF with daily injections of large amounts of medication than it is with mild IVF (modified natural cycle IVF or mini IVF). When undergoing a mild IVF cycle, monitoring and timing of procedures are more predictable (giving you more time to adjust your schedule) and can sometimes be scheduled to accommodate your existing schedule.
The cost of missing job, child care, or other responsibilities is best known to the individual undergoing the IVF cycle. If this cost of IVF is anticipated to be especially high, additional consideration of mild IVF may be helpful.
(7) What medical insurance covers IVF costs in New Jersey?
The New Jersey Infertility Insurance Mandate, referred to as the New Jersey Family Building Act, was signed into effect in 2001. New Jersey is one of only 15 states with an infertility insurance mandate that covers the cost of IVF. To compare the different insurance benefits and coverage for the cost of infertility testing and treatment (including the cost of IVF), the specific definitions of infertility and patient requirements by state, and the exceptions to the mandates in these 15 states please click here.
The New Jersey Infertility Insurance Mandate (aka the New Jersey Family Building Act) “mandates that all New Jersey health insurers insuring groups of 50 or more persons and providing hospital or medical benefits, including pregnancy related benefits, provide coverage for medically necessary expenses incurred in the diagnosis and treatment of infertility”. Under the treatment of infertility the cost of up to 4 cycles of IVF are covered. Click here to learn more.
The New Jersey Family Building Act specifically defines infertility as a disease or condition that results in abnormal function of the reproductive system such that (1) a male is unable to impregnate a female; (2) a female under 35 years of age is unable to conceive after 2 years of unprotected sexual intercourse; (3) a female 35 years of age and over is unable to conceive after 1 year of unprotected sexual intercourse, (4) the male or female is medically sterile; and (5) the female is unable to carry a pregnancy to live birth.
In New Jersey, four women are challenging the legality of the New Jersey Family Building Act definition of infertility, since the definition of sexual intercourse excludes couples in same sex relationships. These same sex couples would like to have access to insurance coverage for the cost of IVF and other infertility treatments in New Jersey. For more information on this issue, click here.
This New Jersey Family Building Act has been taken to exclude couples who were voluntarily sterilized in the past (either tubal ligation or vasectomy); couples not engaging in sexual intercourse that is specifically defined as involving a male and female (excluding same sex couples); patients who have achieved an age of 46 or greater; patients who are employees of employers having fewer than 50 employees on insurance plans; patients who are employed by religious employers that chose not to offer infertility benefits due to their religious beliefs; patients who have employers that have self insured medical plans (and therefore are only obligated to comply with Federal, not State, mandates).
If you qualify for coverage under the New Jersey Family Building Act, then coverage includes: diagnostic testing, IVF with up to 4 completed egg retrievals per lifetime, medications, ovulation induction, surgery including microscopic sperm aspiration, and artificial insemination (IUI or intrauterine insemination). Procedures that are specifically excluded from coverage by the New Jersey Family Building Act include cryopreservation (freezing of eggs, sperm, or embryos), nonmedical costs of an egg or sperm donor, infertility treatments that are experimental or investigational, and procedures that are performed at facilities that do not conform with ACOG and ASRM guidelines.
(8) Does New Jersey provide short-term disability that limits the out of pocket cost of IVF?
A lot of time is generally spent at office visits for monitoring, as well as at the IVF center for egg retrieval and embryo transfer procedures, when a couple undergoes IVF in New Jersey. A patient can lose a lot of time from work, which quickly and significantly adds to the overall cost of IVF. If the couple has short-term disability insurance through the State of New Jersey or as private insurance, then the overall cost of an IVF cycle could be lower.
Most employers in New Jersey do not provide paid personal time for IVF treatments or maternity leave (at the end of pregnancy). The New Jersey Department of Labor and Workforce Development does provide for maternity leave, as long as you qualify, but it is uncommon for patients to qualify for disability during the actual IVF treatment cycle and immediately thereafter. Private disability insurance may also cover time lost from work during IVF treatment cycles and/or maternity leave if you qualify.
To qualify for disability benefits, either at the New Jersey state level or for private disability insurance, you need to be disabled AND you need to be disabled for a certain length of time (the elimination period). Disability generally requires that you are (1) unable to perform all of the duties of your regular full time job, (2) not working in any other job at the time of the disability, and (3) under the professional care of a physician. The elimination period is the number of days that you are continuously disabled before disability benefits begin, which is usually at least one week and can be a few (or even several) months.
Most couples actively undergoing IVF treatments in New Jersey are not working at another job and are under the care of a physician, however, they are generally NOT unable to perform their usual job obligations and therefore they generally do not qualify for disability insurance benefits. When a patient undergoing IVF treatment in New Jersey is also unable to perform their usual work responsibilities, possibly due to anesthesia used during an egg retrieval procedure,the disability usually does not last for the time required to meet the elimination period requirements (a week to several months). An exception may be if the patient develops moderate to severe ovarian hyperstimulation syndrome and may be disabled for a few weeks.
In New Jersey, having maternity benefits can reduce the cost of IVF and the subsequent pregnancy. In New Jersey, for a normal pregnancy benefits are usually payable for 4 weeks prior to expected delivery and 6 weeks after the actual delivery date (or 8 weeks if you delivered by Cesarean Section). Additionally, a physician can certify that you are disabled for a longer time than this if you have pregnancy related complications, another coincidental disability, or your are physically unable to perform your regular job responsibilities.
(9) What New Jersey tax laws relate to the cost of IVF medical expenses?
All of the information herein should be reviewed and validated with your accountant for accuracy and current applicability. This information is used as an example of how tax breaks can affect the cost of IVF in New Jersey.
New Jersey tax breaks for non-reimbursed medical expenses, including the cost of IVF, can significantly impact a couple’s overall out of pocket cost of IVF treatment. In the State of New Jersey certain medical expenses (generally, those allowed for Federal income tax purposes are also allowed in New Jersey) in excess of 2% of your gross income may be deducted. Your medical insurance or similar provider must not reimburse these expenses. You can also deduct transportation costs associated with IVF on the New Jersey State taxes when they are allowable on your Federal return.
In New Jersey, state income tax is based on which state the income is earned. For example, marginal tax rates can be much different in the Tri State area and the higher the marginal tax rates the greater the cost benefit of a tax break for couples undergoing IVF. For example, New Jersey has six tax brackets and a top marginal rate of 8.97% while Pennsylvania has a flat tax rate of 3.07% across all income ranges. Also, in New Jersey there may be no threshold to the qualified medical expenses that can be deducted.
You should consider a consultation with your accountant to see how the current New Jersey and Federal tax laws apply to the cost of your IVF cycle.