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What makes fertility treatment procedures so expensive?


The cost of standard in-vitro fertilisation (IVF) comprises of a range of factors, namely: medication, laboratory, procedure room and professional fees.

Medication: controlled ovarian stimulation requires a combination of medication to promote egg follicle development, to prevent premature release of the oocytes, to induce final oocyte maturation and luteal-phase progesterone support. These medications all required research & development by pharmaceutical companies, who then set a profit margin.

Laboratory: high-tech (read expensive) lab equipment is required to facilitate the fertilisation of oocytes and the growth of embryos. This includes high-magnification microscopes, with sophisticated manipulators to hold & inject oocytes (for intra-cytoplasmic sperm injection – ICSI). Incubators that maintain embryos at the correct temperature and pH for growth. Gas supply to the incubators, providing the constant supply of nitrogen, oxygen & carbon dioxide. Air filtration systems that keep the ambient room clean, exhausting volatile gasses and air particles that can negatively affect embryo growth. Monitoring and alarm systems that alert clinicians if a change in the key parameters occurs. There are also disposable items required for each treatment cycle, which may include media for sperm and oocyte prep & embryo growth, pipettes, petri dishes, micro-manipulators etc.

Procedure room: the egg retrieval is performed under anaesthetic in a minor-procedure room, with appropriate life-support systems in place, including oxygen & air supply to an anaesthetic machine that can support ventilation while the patient is anaesthetised. There are minimum standards required by the Department of Health to set-up a procedure room/minor theatre.

Professional fees: professionals involved in an IVF stimulation cycle include fertility specialist, embryologist, cycle co-ordinator, nursing sister and anaesthetist. All have been through extensive training in order to provide a skilled service to the patients undergoing treatment.

Pathology lab: variable blood tests may be required during assisted reproduction treatment to monitor response to treatment.

Perhaps the question to be asked is why medical aids don’t reimburse members for fertility treatment!