When you realise that you might be one of the many people annually who may need to undergo in-vitro fertilization, or IVF, as a way to create a family, the emotional toll is immense.
Unravelling the seemingly foreign language of clinical terminology and insurance verbiage can be a heavy added stress on a patient struggling with infertility; Below is as an introduction to anyone beginning this process. Here are four financial factors to bear in mind when starting this journey.
- How Much IVF Actually Costs
On average, nationally, a “fresh” IVF cycle costs between R 40 000.00 – R 60 000.00. In a “fresh” IVF cycle, eggs are harvested trans vaginally after a closely monitored period of ovulation-inducing medications and then “mixed” with fresh sperm. One or two of the best-looking of the resulting embryos are then transferred to the uterus via a thin catheter.
The ICSI step of the process means looking at another R 15 000.00 – R 20 000.00. Altogether, conservatively speaking, IVF can cost about R 70,000, for each attempt to have a healthy child. Coupled to this is the fact that it is utilizing a procedure that is successful (most optimistically) about 30% of the time, and dependant, of course, upon factors such as maternal age and the specific medical circumstances of the parents.
One of the most complex aspects of an infertility diagnosis is that for a patient to have her best chances for conception with IVF, she needs to act as quickly (to ensure that her eggs are as young and thus as viable as possible) as she can upon diagnosis. This biological urgency doesn’t exactly complement the equally pragmatic need to invest in the time to budget and save for treatment.
For some individuals undergoing IVF, if a fresh cycle doesn’t result in a pregnancy, and the remaining embryos from this fresh cycle can subsequently be used during a “frozen” cycle. “Frozen” cycles, often abbreviated as FET or Frozen Embryo Transfer, are much more economical, as they use “frozen” (technically, vitrified) embryos stored for future use. FET averages anywhere from R 20 000 – R 40 000 per cycle and annual storage fees for frozen embryos are typically an additional fee for each year.
- The Various Payment Options
Funding the costs of infertility treatments or adoption are for the most part short-term financial goals. In thinking about how to finance your treatments, remember that diverting money out of your retirement fund comes with penalties and translates into money that will not be available—and not accruing interest—when it comes time for you to retire. That does not mean that choosing to borrow or divert funds meant for other goals is unwise; it simply means that you need to prioritize your goals and know the consequences of your choices.
Using your credit cards as a quick loan will force you into a situation with high-penalty fees and interest, not to mention a swift hit to your credit score. Credit cards also normally carry higher interest rates and with interest rates rising, repayment amounts will also increase and must be factored into the household budget.
There are also Finance Companies, which provide you with loans for procedures not covered by your medical aid. These Companies provide reasonable underwriting, interest rates, and repayment times.
Infertility care is medical, and you may also deduct medical expenses not paid by your medical aid, from your tax return each year. Many parts of your infertility treatment will qualify for this kind of deduction, as preventive care, treatment, surgeries and prescription medications are all deductible.
- How To Manage Debt
You know how it happens — one swipe at a time — those credit card balances build up quickly. Each with its own interest rate, credit limit, and payment terms.
Paula Ryan, a financial advisor, relays some of her tips for aggressively managing the debt that is so often part of the infertility experience and a part, for that matter, of modern financial life.
- If you do not have a budget, put one together. Decide how much of your budget can go to paying down debt. Couples should decide before beginning infertility treatment how much they want or can afford to spend, and, how far they are willing to go.
- Make a list of debts by name, adding columns for balances, minimum payments, and interest rates.
- Smallest-to-Largest Strategy: Total up the minimum monthly payments on all debts, and subtract this from the budgeted amount for paying down debt. Use all of the excess to pay into one credit card — the one with the smallest balance. Pay off this first debt until it is gone, and maintain minimum payments on other debts. After this, use all excess funds to pay off the next smallest balance, and so on, until you have brought the debt under control. The “smallest-to-largest strategy” means that you must put successfully larger payments into remaining debts as you knock out the smaller balances.
- When faced with two roughly equal-sized debts, pay off the one with the higher interest rate or the highest minimum payment.
- Generally, pay off credit cards/higher interest debt before student loans, and pay off student loans before home equity loans.
- If you are having trouble making all minimum payments, call your lender to negotiate a lower minimum payment.
- Try to consolidate your debt – Confirm what the minimum payment will be and the interest rare before agreeing to the consolidation.
It is quite possible to plan for medical and/or adoption expenses, according to Fowles. “Work these expenses into your budget, designating a monthly amount for the adoption or medical expense fund. Transfer the money to a savings account each month as if you were paying a creditor. Keep a schedule of the amounts in your savings account that are earmarked for various goals.
- How to Work With Your Practice’s Financial Services Department
Trying to find the costs associated with infertility treatment can be frustrating. Couples should ask their doctor how many treatment cycles they should plan for financially, and get information up front about all their family building options. Speak to the accounting department of the clinic once you have a protocol and ask for the costs of all the procedures and medications required.
You may be able to find cheaper drugs from different pharmacies as opposed to straight from the clinics.
Some questions that will help you obtain the full cost:
- Are medications, tests, lab work and consultations included in the cost of treatment?
- Does the clinic provide financial counselling and psychological counselling? If so, are there fees for these services?
- Since most patients do not have insurance coverage for infertility treatment, knowing the costs up front makes good financial sense.
Some medical aids, may have a “preferred” lab to which they send routine lab work. If your practice sends the lab work to the lab that your medical aid recognizes, they mayl pay for it (if the lab tests are covered by your plan). If those same tests are sent to a lab that is not in-network for your plan, the plan will not pay. Make sure both you and your providers know the ins and outs of your plan.
Not all clinics charge the same for the same procedures and protocols. If financing is an important consideration consider obtaining costs from different clinics. Travelling to another province is also an option and could be financially beneficial.
The bottom line: Talk with your partner about your financial feelings, establish a workable plan of action, create a budget and follow it. And most important, seek help, assistance and guidance during your family building journey.
- Debby Fowles’ financial planning tips, including budgeting guidelines and sample budgets.
- Robin Roberts, PhD, LCSW, practices in Los Angeles, CA.
- Olivia Mellan, Money Harmony: Resolving Money Conflicts inYour Life and Your Relationships (1994) Walker & Company.
- Paula Ryan, financial, raymondjames.com.
- Jennifer Gerson Uffalussy – The Cost of IVF: 4 things I learned while battling Infertility