IVF Cost

The first thought that comes to mind when most people consider in vitro fertilization (IVF) is not about its complexity or even its success rate. It’s about cost. Undeniably, IVF costs significantly more per attempt than alternative approaches such as intrauterine insemination (IUI) or a Clomid cycle with timed intercourse. However, although it may seem like a good idea to keep expenses low, one needs to consider the cumulative cost of having to repeat a low-cost procedure multiple times due to its lower success rates compared with IVF. (See my post “IUI vs. IVF: Cost Factor Revisited.”)

The total cost of a single IVF attempt differs from one clinic to another and depends on several factors:

• Office visits
• Tests (ultrasound, blood work, genetic testing, chromosome screening)
• Medications (type and quantity)
• Doctor’s and surgical facility fees for egg retrieval and transfer
• Lab fees (if preimplantation genetic screening [PGS] of chromosomes is performed)
• Egg source (own vs. donor’s)
• Sperm source (partner’s vs. donor’s)
• Multicycle discount package 
• Insurance coverage

My insurance covers portions of an IVF treatment but only after three unsuccessful IUIs. This suggests that in the insurance provider’s estimate, the cost of an IVF attempt roughly matches the cost of three IUI procedures. Keep in mind that many women over 35 require at least three IUI attempts before they get pregnant, so an IVF might be a better option right from the start as its higher success rate might shorten the time it takes one to get pregnant. (I spent nearly a year trying IUIs unsuccessfully.)

Below is a breakdown of costs for my IVF treatment assuming I had no insurance coverage.

Office Visits

I had a total of seven office visits for monitoring my IVF cycle: five prior to egg retrieval and two prior to egg transfer. I was charged $110 for two of the more comprehensive visits, $90 for four of the follow-up visits, and $225 for a mock-up transfer of an embryo in preparation for the actual procedure. Total cost: $805.

Ultrasound

My reproductive endocrinologist used transvaginal ultrasound imaging during all but one visit. I was charged either $325 or $250 per ultrasound, depending on whether the imaging was limited or comprehensive. Total cost: $1,650.

Medications

I followed what’s called a long down-regulation protocol and took the following medications:

• Birth control pills (one month supply): free
• Leuprolide acetate (1 vial of 14 mg/2.8 ml): $200
• Dexamethasone (40 tablets of 1 mg): $22
• Menopur (30 vials of 75iu): $80 per vial (discounts may apply if purchased in bulk)
• Bravelle (36 vials of 75iu): $63 per vial (discounts may apply if purchased in bulk)
• hCG (2 vials of 10,000 ui): $110 per vial
• Doxycycline hyclate (36 tablets of 100 mg): $125
• Estradiol valerate (1 vial of 20 mg/ml): $140
• Progesterone in sesame oil (4 vials of 50 mg/ml): $45 per vial
• Methylprednisolone (4 tablets of 16 mg): $18

(To read more about what each of these medications does and how it is administered, visit my post “My IVF Medications.”) Total cost: $5,573.

Blood Work

To monitor my response to medications, my doctor tested my estradiol and progesterone levels periodically. Prior to the IVF cycle, I also had to be tested for infections diseases such as hepatitis B and C. Total cost: $574.

Doctor’s and Facility Fees

The doctor’s portion of the egg retrieval fee was $1,570. The surgical facility charged me $3,012, which included the anesthesiologist fee. The embryo transfer cost me $1,250 in doctor's fee. Total cost: $5,832.

Lab Fees (Including PGS Cost)

Because of my history of failed pregnancies, which were presumably caused by chromosomal abnormalities of the embryo or fetus (suggesting poor egg quality due to my age), I elected to screen all embryos that reached sufficient maturity on days 5 and 6 post egg retrieval. The assisted fertilization and oocyte culture cost me $3,300, of which $1,500 went for intracytoplasmic sperm injection (ICSI). The biopsy and cryopreservation cost me $3,250 (for 10 embryos). The frozen embryo transfer (FET) lab fee was $800. (Note that I would have been charged $1,300 of lab fees for FET had the embryo not been already hatched as part of the preimplantation testing.) Total cost: $7,350.

Egg Source

I used my own eggs and cannot supply first-hand information, but a quick search on the Internet revealed that the cost of an IVF cycle using donated eggs can vary significantly from one clinic to another (anywhere from $20,000 to $40,000). As an average example, the Advanced Fertility Center of Chicago currently charges $7,000 in donor’s fee, $14,150 in facility fees, $4,500 in administrative fee, and $350 for short-term medical insurance. To these, one needs to add $500–$1,000 for patient’s medications and $2,000–$4,000 for donor’s medications, for a total cost of roughly $30,000.

Sperm Source

I did not use a donor’s sperm for my IVF cycle, but the average quoted cost for this option is about $500.

UPDATE: As of January 1, 2017, California Cryobank is now charging $840 per vial of anonymous donor's sperm and $890 per vial of an open donor's sperm. 

Multicycle Discount Package

For patients without IVF insurance coverage, some fertility clinics offer discount prices for multicycle packages. The downside, of course, is that one is required to pay for multiple treatments in advance, but the savings might be significant. Some clinics also offer partial refund for unsuccessful pregnancies.

Insurance Coverage

Had I not had insurance coverage, and without taking advantage of a multicycle discount package, my IVF/FET cycle would have cost me approximately $22,000. However, I ended up paying only $6,407 (most of which went for elective chromosome screening and freezing/unfreezing of embryos) as, after meeting my deductible, my insurance covered the majority of the cost of office visits, ultrasound imaging, blood work, medications, and doctor’s and facility fees. The only elements of the IVF/FET cycle that my insurance did not at least partly cover were PGS and ICSI.

Note: Even if your insurance plan explicitly states it does not cover fertility treatments, you might still find out that some of your office visits or tests (especially blood work and ultrasound) are at least partially paid for by your insurance.

Summary

Though the cost of IVF can span a vast range depending on multiple factors (particularly insurance coverage availability, donor egg use, and PGS election), most couples can expect to pay about $13,000 per cycle, including the cost of medications. This amount is approximately equal to the cost of three IUI attempts. Keep in mind that, due to the generally poorer quality of their eggs, women older than 35 might need multiple IUIs before they get pregnant and not suffer a miscarriage. One option that could drastically amplify their chances of success is PGS, which can only be done as part of IVF. Despite the added cost, this route might be the shortest and most cost-effective path to a successful pregnancy.