In vitro fertilization (IVF) treatment is expensive and virtually no one contemplates undergoing treatment without first considering this. But with IVF there are really two components to this cost.  The first is financial and the second (usually the most burdensome) is emotional.

The Financial Cost of IVF

“Perception is reality.” Nothing could be truer when it comes to comparing and interpreting IVF fees presented to patients seeking such services.  But here I offer a few words of caution: Beware of comparing one program’s quoted cost of IVF directly to another’s at face value.  As with the purchase of any product or service, it is always important to first look at the base cost and then to evaluate the fees for additional services (“add-ons”).  IVF Program A might include the cost for add-ons such as intracytoplasmic sperm injection (ICSI), assisted hatching and initial freezing and storage of embryos in their “base price” while Program B  might quote a lower IVF fee that does not include the cost of some/all such add-ons. Unless this is taken into consideration, it is possible to erroneously consider the cost of IVF at Program B as being lower than at Program A.

An analysis conducted on base fees sampled from more than 400 IVF programs in the US(for a single cycle of IVF, exclusive of cost of anesthesia and fertility medications) reported an average cost of about $10,500.  To this, the inevitable additional cost of anesthesia and fertility drugs (which can vary from patient to patient) must be added.  Then comes the cost of add-ons such as ICSI, assisted hatching, embryo biopsy, PGD, embryo freezing/storage, etc.

It follows that when comparing IVF costs at different IVF programs, it is important to always compare “apples with apples”. First, examine the base fee per cycle, add the inevitable cost of anesthesia and fertility drugs and then ask about the extra cost of any “add-ons”.

At SIRM-Las Vegas, my base fee for a cycle of IVF is currently around $10,000. The additional cost of medications will, of course, vary depending on the amount of fertility drugs that patient needs. Anesthesia costs (for egg retrieval) are usually around $400. I do not charge for ICSI (because it is routinely performed on virtually all patients’ eggs) and I do not charge for assisted hatching (AH).  Embryo freezing (vitrification) and storage of supernumerary (left-over) embryos cost extra unless the patient is enrolled in one of our multi-cycle, discounted IVF packages (involving up to 3 attempts at IVF).

Patients must view the cost of an IVF procedure as the cost of having a baby and not the cost of each individual cycle of treatment. Thus, another important consideration issue is the experience, quality and expertise of the doctor and lab, as this inevitably impacts the likelihood of a successful outcome (live birth).

The aforementioned factors all ultimately influence the number of attempts, and thus the overall cost.  If one or more of these factors are sub-standard, it could take much longer (more IVF cycles) to achieve a pregnancy in that setting.  Thus,  even if the cost per IVF treatment cycle were lower in that clinic, the overall expenditure before getting a baby could be much higher (if it happens at all).

The average IVF patient is relatively young (<36 years), has normal ovarian reserve, and the underlying cause of infertility is mechanical (tubal/pelvic adhesions, or male factor infertility). These patients fall within the “bell” of the bell-shaped distribution curve, and are probably likely to achieve success in most competent IVF settings.

In contrast, approximately 30% of IVF candidates (many of whom have often had repeated prior IVF failures) are of a more advanced age, have diminished ovarian reserve and/or have complex implantation problems (often due to immunologic implantation dysfunction). Such patients usually are much less likely to be successful with IVF and as such, their chance of having an IVF baby might very much be influenced by the experience and expertise of the treating RE and his/her team.  For reason of enlightened self interest, such candidates should seek services at those centers that are best equipped to address such issues.

Undoubtedly, it would be very helpful to have access to reliable information regarding comparative IVF success rates in the US.  As I have previously reported on this site, this is currently not possible because of the fact that currently SART/CDC reports on IVF success rates are self-generated by each IVF center and are usually published as-is.  They are not audited, and are thus unreliable, even potentially subject to manipulation.

Moreover, SART/CDC only report success rates by age and by the type of procedure performed (fresh IVF, frozen embryo transfers and egg donor-IVF) They do not take into consideration other important variables that can impact IVF success.  That is we at SIRM have developed our Outcome Based Reporting System (OBRS) where we report our annual IVF outcome statistics (See our IVF success rate stats HERE).

So, what it boils down to is that when it comes to comparing IVF success rates in the US, consumers are still left to fend for themselves.  My advice is that the best way to acquire such information is to affiliate with a consumer advocacy group such as INCIID (www.inciid.org) or Resolve (www.resolve.org), talk to patients that have been through IVF at a number of programs, and do the necessary footwork by visiting several IVF programs before making a final decision.

The emotional cost of IVF
To describe the effects of preparing for, participating in, and post IVF anticipation as a “roller coaster ride” is a gross understatement.  Anyone who has been through the process, whether successfully or unsuccessfully will attest to the fact that in the final analysis the emotional price turned out to be far greater than the financial.

Unquestionably, the majority of US women/couples going through IVF find the financial burden to be overwhelming. They have to massage every dollar available to afford a single cycle of treatment. As such they view the financial challenge as great. For them the knowledge that if they do not succeed the first time around, they might not be able to afford a second attempt, only serves to deepen their emotional stress. Here, it becomes even more important to seek out the best possible available venue for IVF services, in their area or out-of-town.

More than 80% of my IVF patients travel from out of town, state or country to Las Vegas for treatment. I do try to soften the financial blow by giving them a significant rebate on our services.  However, I fully recognize that for some, traveling away from home for IVF could deny them access to their built-in support systems and, as such, might represent a hardship and a sacrifice.  However, for others, traveling out of town for IVF treatment can present an opportunity for a welcome break from the pressure and stress that is often associated with questions and inquiries from concerned friends and family.

In conclusion, I urge those seeking IVF services to assess the cost of IVF in terms of both the financial and emotional component rather than the cost per cycle of treatment.  Also, consider how the underlying medical cause of the problem might influence where to best seek treatment.  Finally, patients should always shop around and do their homework before making a final decision.