This post was updated on May 20th, 2019
While every couple taking action against infertility have their own unique set of reproductive challenges, one problem just about anyone who is considering IVF or any other expensive assisted reproduction technology will face, is the question of how to pay for IVF.
While ideally you would determine what is the ‘best’ medical solution for your diagnosis first, then figure out the cost second, it’s an unfortunate reality that for many people the cost of various treatment options can have a significant impact on how they decide to proceed.
Whether you are figuring out how much you can afford for treatment, or how to afford IVF at all it’s always worth taking a step back away from the machinations of your daily struggle to review your plans for potential improvements – almost like a dispassionate investor might. Here are a few questions and ideas to get you started:
Make sure you’re getting the right treatment from the start
Infertility treatment starts off relatively low-cost with oral medications, and begins to escalate with each successive failure to conceive after that. If you’re young enough to afford the time, a patient might be tempted to work their way up through IUI or ovulation inductions cycles before considering IVF, but if you’re in your late thirties than the age-related decline in your fertility may make these treatments far more expensive in the long-run than their dollar amount shows.
While I’m not necessarily advocating skipping these lower cost treatments and heading straight to IVF, most experts would agree that couples with poorer prognosis should escalate their treatment far sooner than the general population seeking fertility treatment because of the time it takes to do these treatments which then makes your chances of IVF even lower and may mean even more cycles of IVF to achieve a (hopefully) successful outcome. I’m also a fan of doing a cost-benefit analysis when comparing fertility treatments of differing cost.
This can be done by determining the number of cycles both treatments need to achieve a similar probability of success. For example, you might have a 34% probability of success with one IVF cycle, and a 10% probability of success with IUI. To make a fair comparison, to have a 34% chance of success with IUI, you will need to undergo 4 cycles. So when figuring out if IUI or IVF is the better option for you, strictly from a cost perspective, you need to compare the cost of 4 IUI cycles, with 1 IVF cycle. For some couples, when the probability of success is fair between two treatment options such as IUI vs IVF, or IVF vs. ICSI, the lower cost per cycle treatment can become more expensive due to the larger number of cycles that may be needed.
Make sure you’re not paying too much
The assisted reproduction industry is saturated with suppliers providing what is increasingly becoming a commodity service. While just about every clinic reports higher than average success rates (I’m not sure how this works mathematically), the reality is that the results can largely be a function of patient prognosis rather than anything special that the clinic does. As treatment technology continues to mature, the points of difference from a technical perspective between clinics becomes increasingly small meaning that shopping on price becomes an increasingly rational strategy to use.
While I’m not advocating a dutch-auction for fertility services, getting IVF financing options from at least two clinics, may be a prudent way to save a few hundred or even a thousand dollars right off the bat. Some clinics in the US even market themselves as low-cost IVF providers, so before assuming that the treatment offered will be inferior, it might be worth checking them out. The same can be said for medications. Drug costs make up at least a third of the cost of IVF treatments and (depending on the country) you the patient may have the right to buy these from a pharmacist of your choosing. Your clinic should be able to provide you with a fairly accurate estimate of the drugs you are likely to need which you can then shop around before starting your treatment. I strongly recommend that you still get all of your drugs from one pharmacist however, as having multiple suppliers will increase administrative work for both you and your clinic.
Clarify if your health insurance benefits cover financing IVF
This is true for all countries but in the USA it can be especially difficult to navigate through the information. While 15 states in the USA have mandated that health insurance companies offer fertility treatment, the list of exclusions and constraints in many states make for a mine-field of confusion where people are often disappointed by the level of cover. Getting all the information on what is covered and what is not before starting any expensive treatment, is the best way to ensure you don’t get a nasty fright after the fact.
Exhaust all health insurance possibilities
When investigating why you haven’t fallen pregnant after repeated attempts, either partner may be diagnosed with a disorder of the reproductive system. While testicular or gynecological disorders may affect your fertility, in insurance company speak, they may not necessarily be “fertility disorders” and hence may be covered by a regular health care plan. Before paying for IVF diagnostic testing or pre-treatment prior to undertaking IVF, make sure you have exhausted all possibilities with your health insurance company for coverage outside of their “exclusion of fertility treatments”.
Paying for IVF with cash first
Unless you have a stellar investment opportunity that pays big returns, financing IVF treatment with cash is always going to be your cheapest option. It’s easy to overlook the cost of IVF financing when monthly interest rate charges represent only a small amount in comparison to the principle borrowed, but over the life of the loan, these interest expense can blow the cost of your treatment out of the water. If you can sell assets, or make some tough sacrifices to save up the funds for paying for IVF treatment rather than borrow them, you will always be better off financially in the long-run. However given that time may be of the essence for many, this advice needs to be balanced against your level of urgency.
Consider secured loans
Interest rates worldwide are at unprecedented lows, especially in the United States. While many couples will baulk at the idea of increasing the debt on their house which they have been working so hard to try and pay off, using your home as collateral can open doors to you for cheap debt. One of the things I really like about borrowing against a home-loan is that the term of the loan is really long – like 20-30 years. While of course holding debt for this long means that we pay a lot of interest expense overall, inflation in the dollar means that over-time the real value of the debt becomes less and over 20 years this can make a massive difference.
Inflation helps us as it erodes the value of money over time. Remember when you could buy a can of coke for a quarter? Well the fact that we pay a buck now for the same thing is the result of inflation. The value of the coke hasn’t changed, because we all earn more money also thanks to inflation, but the dollar value has gone up. Inflation works in reverse when borrowing money: Say I borrow $10,000 today. In 20 years time, when I need to pay that $10,000 back, $10,000 will be a much lower value of money. A can of coke might cost $10 by then! If you can’t pay cash, the next best place to get funds are from a low interest, long-term secured loan.
Avoid unsecured loans
Unsecured, “good faith” or signature loans are easy to get, and there are many reputable companies offering financial products specifically for couples doing IVF. The catch here is that the more you need an unsecured loan, the more it’s going to cost you to get one. Despite the shop-front appearance, banks are almost always behind the companies offering “fertility loans” and banks are wisely cautious. If you have good credit, a low debt to equity ratio, and have plenty of “disposable income” each month, then sure they’ll give you an acceptable interest rate, but if you don’t fit this description, then you’re potentially in for a gouging. You really need to have exhausted absolutely all other IVF financing options, and be exceptionally well prepared if you’re considering paying double-digit interest rates on a loan.
The only upside I can see with fertility loans, for people where this is the last or only option, is that they will often let a friend or family member take the loan on your behalf. If you have a family member who is in a better financial situation than you, they will be able to obtain finance at lower rates, meaning they can financially help you out, without it costing them a cent (provided you always make the repayments).
Having to spend horrendous amounts of money on fertility treatments really sucks. There’s no getting around that. Obviously it’s something well worth investing in if you want to have children, but it seems unfair that some of us have to put ourselves under so much financial stress, while so many others seem to fall pregnant by mistake. The irony!
Once we get passed the emotions, and are ready to get down to the business of planning how to pay for IVF treatment however, we can soon see the power we have in our hands. Life has dealt us the cards, but we play the hand with how we choose to obtain and spend the money needed to get us a baby. We can be smart about how we’re going to overcome the financial aspects of our fertility challenge and thinking seriously about our finances never costs us a thing.
Kym Campbell is a Health Coach and PCOS expert with a strong passion for using evidence-based lifestyle interventions to manage this disorder. Kym combines rigorous scientific analysis with the advice from leading clinicians to disseminate the most helpful PCOS patient-centric information you can find online. You can read more about Kym and her team here.