Cost of IVF – Immediate Attendance At A Fertility Clinic Can Save On Long-term Costs

The challenges of failing to conceive cannot be underestimated. For many couples it is a direct challenge to their wider purpose.  Understandably most individuals will be unsuspecting of problems because often no overt symptoms exist like in most medical conditions.  The time to acceptance of a problem may be different for many individuals as the feeling that it will happen given a little more time is strong.  Vulnerability increases as there may be a mismatch in each person’s response and feelings to the situation.  Much of the time there is a desire to avoid too much “medicalisation” and a self-imposed limit on investigations and procedures deemed acceptable to the parties.  Whilst this is understandable it may have implications for long term prognosis.

The first experience of medical services will usually be through a general practitioner or generalist in gynaecology.  By the very nature it is not often the best balance between outcomes and expenditure as fertility is a particularly specialised area.  By the time a couple reaches a fertility clinic they may have received more than one opinion and often they will have incurred quite significant costs along the way.  Oftentimes stress and anxiety will accompany the nervous anticipation of medical consultation.

In reality a lot of the above could be eliminated and certainly better managed by immediate attendance at a fertility clinic providing a logical, structured approach to the problem. After a comprehensive evaluation including examination there are three key investigations required.  They are diagnostic blood tests, a sperm test and one of a few specific tests to check anatomy (for example X-Ray or keyhole surgery).  After appropriate corrections following review of these simple, quick tests there are really only three ways to conceive.  These are natural conception, artificial insemination or In Vitro Fertilisation.  The choice of which route to follow is clearly indicated by the results of the tests or response to a treatment.  Continuing with our pattern of three, each conception route has its highest success the first three times it is applied.  This makes for easy planning and review of next steps should pregnancy not occur.

How does this all tie in with the topic at hand of cost?  Well, there is a perception that In Vitro Fertilisation is expensive when compared to the other modalities mentioned.  As an immediate cost this is true, however, research has shown that if delayed when indicated the costs spiral.  One such study compared 34 year old women to 38 year old women both needing In Vitro Fertilisation where the costs were four times higher to achieve a baby in the older group.  This is because the treatment effectiveness is directly linked to female age so waiting will cost significantly more directly and this assumes no other expenditure in the meantime.  Another study has shown that artificial insemination particularly in the over 35 year olds takes on average the cost of In Vitro Fertilisation to achieve success if indeed that is the outcome as multiple attempts are required.  The markedly lower cost per treatment of artificial insemination compared to In Vitro Fertilisation can be misleading when assessing overall success. Returning to the introduction an interesting study showed that the average couple attending a fertility clinic for the first time have already spent the cost of an In Vitro Fertilisation cycle on prior interventions.  Unlike most medical conditions where it is fine to let them establish a bit before commencing treatment, fertility has a limited window of opportunity so a wider view of cost and an efficient use of resources will ensure the best balance between the ultimate goal of having a baby and how much it cost to get there.

By:

Dr. N. Clark – Medfem

Reproductive Medicine Specialist / Director Medfem Fertility Clinic

Dr Nicholas Clark, a gynaecologist for over 15 years, joined Medfem Fertility Clinic in 2012 as a director. Nicholas qualified from University College and Middlesex School of Medicine in London in 1990. After completing his training in the United Kingdom and South Africa he was appointed as a consultant gynaecologist at Chris Hani Baragwanath Hospital, Soweto. He is originally from the UK and settled in South Africa in 1997 having worked between the two countries since 1993.