FET and me: An Information resource for IVF

Each bullet below can have multiple costs associated with it (for example, multiple medications are required during an egg retrieval cycle and each one has an associated cost). This is not an exhaustive list and some costs may be missing. This is also to show the numerous costs that come with IVF. This is what I have put together in my journey in the US so far. Bills, bills, bills goes over logistics around costs.

Some Tips:

If your clinic has a financial counselor, ask them questions. But also learn the ins and outs of the billing process to make sure you are charged the correct amounts.

Labs

• Your insurance may only cover specific lab facilities. Ask your clinic prior to starting which lab they use, and then ask your insurance if that’s in network.
• You will likely have labs (and an ultrasound) done at EVERY monitoring visit. These will have a cost associated every time they are done.
• Each lab test will have an associated cost.

Medications

• Some medications are inexpensive, and some are very expensive. This will depend on insurance coverage, the type of drug, and if generics are available. Information on coverage can be found with your insurance formulary, which is searchable online or you can request the formulary PDF from your insurance company.
• Ask if you can use generic medications (which may be cheaper), if available.
• Each medication will have a co-pay, and they may be different amounts. Your pharmacy should tell you each copay when you order. It will likely depend on what is included on your insurance formulary.
• There are different types of pharmacies that fill fertility medications, e.g., large pharmacies like CVS Specialty Pharmacy or smaller local specialty pharmacies. Co-pays and costs may be different at both. If using insurance, your insurance may require you to get your medications at specific pharmacies, so ask them before ordering. Also ask if there are any exceptions for emergency scenarios (e.g., a weekend medication need when a large pharmacy may not deliver).
• Look at the expiry date of each medication on the packaging when it arrives.
• Look at the storage requirements for each medication (should be on the box or package insert). This will help for delivery and travel. The package insert will also describe side effects of medications.
• Keep an inventory of all your medications; some may be leftover from a previous cycle and can be used for a later cycle if not expired.
• Sharps containers, alcohols swabs, and other supplies may come for free with your order – ask your pharmacy.

Egg + Sperm = Embryo costs

• Your fertility clinic may have specific companies they use for biopsy, testing and storage; ask if there are options so you can compare cost. Some only use one company.
• Egg freezing and sperm freezing if you are freezing them separately.
• Sperm analysis may or may not be covered by insurance.
• Embryo freezing and thawing may have separate costs.
• Assisted Hatching of the embryo may have an additional cost
• PGT-A and PGT-M are different tests and will most likely have separate costs
• Some egg biopsy companies may offer plans (e.g., unlimited biopsies for 5 years). This may seem great, but you may have cycles that have no embryos, few embryos, or many embryos. Some companies may offer plans per embryo biopsy.
• PGA-T and PGT-M companies may include free genetic counseling consults, which are very helpful.
• Storage: your eggs, sperm, or embryos will need a home to live in if you are freezing them. This will have a monthly cost.

Insurance

• Learn how to read your insurance bill.
• Cross check your insurance bill (sometimes called an Explanation of Benefits) with your clinic bill.
• ALWAYS ask for an itemized bill from your clinic. ALWAYS.
• Double and triple check all charges. Ask questions if you don’t know what a charge is.

Procedures

• One procedure may have several costs associated: facilities, physician cost, and anesthesia costs (medications plus anesthesiologist cost)
• You can ask your clinic for a rough estimate prior to the procedure.

Therapy/Counseling

• Some insurance plans may offer therapy coverage.
• This is an important component of IVF, and I highly recommend anyone to explore options.

Acupuncture

• Some insurance plans may offer therapy coverage.
• There is mixed data on the benefit of acupuncture on IVF, and I recommend for you to discuss acupuncture with your REI (some clinics will have their own providers) and do your own research as well.
• Acupuncture is generally recommended on a regular basis in the months leading up to retrieval and transfer, so this is schedule dependent. My view is if it creates more scheduling stress, the risk of stress may not outweigh the benefit.