WHAT IS THE ‘IMPLANTATION WINDOW’ IN FERTILITY TREATMENT AND HOW TO IMPROVE IT?
SIGN UP AND GET ANSWERS LIVE >

IVF pregnancy guarantee – refund based programs in Europe – costs, restrictions and qualification

Maria Arqué, MD
Specialist in obstetrics and gynecology & reproductive medicine

Category:
IVF Abroad

IVF Guarantee Programs - Refund Based Scheme
From this video you will find out:
  • What is the IVF refund program or Money Back Guarantee Program? How do they work?
  • What are the different types of programs?
  • Why some program names may be misleading?
  • Is such a program for me?
  • What are the pros and cons?
  • What are the qualification criteria?
  • Is a patient’s age or BMI a crucial factor when qualifying for such a program?
  • What is the cost in European clinics?

 

 

Do I qualify for an IVF pregnancy guarantee program?

In this webinar, Dr Maria Arque is discussing IVF pregnancy guarantee – refund-based programs in Europe. She was talking about costs, restrictions, and qualification criteria.

IVF Refund Programme is a term used for financial IVF programs. They give the patient access to two or three IVF cycles for a single payment. Usually, fresh embryo transfer and extra frozen embryo transfers are included in the prize. The cost of IVF Refund programmes in Europe ranges from €10, 000 to €20,000 depending on the type of programme and the country.

A multi-cycle IVF refund program means that the treatment continues until the desired result. It may refer to either a clinical pregnancy or a live birth- or until all the program’s cycles are completed. If the IVF program ends successfully, the clinic will not return your money. However, if you don’t achieve your goal, you can count on a partial or full refund of the costs.

In general, the cost of an average IVF warranty program in Europe is around €17,000 including around three cycles with expected success rates between 85%- 99%.

Some of those refund programs have some restrictions in terms of medical conditions and other criteria that have to be fulfilled by the couples. The amount refunded usually is 100% depending on the programme.

IVF refund or IVF money-back guarantee programs

It is mentioned that programs with a “guarantee” are becoming more common. The terms and conditions attached to such programs can sometimes be complicated and confusing. As there are “no guarantees” in medicine, the only guarantee possible is financial, that is, a refund guarantee in case the IVF program does not end with the desired result.

There are different types of IVF refunding programs:

  • IVF Guarantee
  • IVF Refund
  • IVF Money-Back Guarantee
  • IVF shared RISK/ Shared IVF Success Programme

Why are IVF refund programs increasing in popularity? There are many reasons why IVF refund programs are becoming increasingly popular. Reasons include:

  • The possibility of detailed treatment cost planning on the part of the patient.
  • Possibility or “guarantee” of receiving a full or partial refund in case of failure.

Both are valid reasons to consider an IVF Refund program. Besides, the most important thing to consider when couples are undergoing fertility treatments is that the economic burden of having to undergo several fertility treatments is a major cause of stress.

IVF refund and IVF Money-Back Guarantee programs can be divided into programs that aim to achieve a clinical pregnancy, usually defined as reaching the 6th, 7th, or 12th week of pregnancy. Programs in which the main goal is the live birth of a child. IVF Refund Programmes in which the patient does not receive a refund if the treatment is successful, and IVF Refund Programs in which the patient receives a partial refund if the treatment is successful. It is important to note that refund programs for IVF treatment are available both for treatment using the patient’s own eggs, as well as donor eggs.

IVF Refund program – is it for me?

Remember that no matter what the program offers, what the clinic offers is a refund “guarantee” in case the treatment does not conclude with satisfactory results. Should you then use such a program? Finances are one of the most important aspects for most patients from their own treatment, and it is something to consider in case you can afford it. In cases where several cycles are required, sometimes the overall cost of the treatment is more expensive than the refund. On the other hand, in patients with good prognoses and outcomes in the very first cycle, if they are under a warranty program, they would end up paying more money for only one cycle.

IVF Refund program – pros & cons

The main pros of IVF Refund programs are full or partial refunds in case of an unsuccessful IVF treatment, which can be put towards the treatments. The clinic is much more motivated to achieve success as quickly as possible, after all, a money refund is on the line.
If you use all of the IVF cycles within the program, the overall cost becomes cheaper than if you were receiving the same number of cycles outside the program. Sometimes the “IVF guarantee” turns out to be cheaper. You can focus on your treatment instead of your finances – because you’ve been covered by a program and have more cycles available. Every cycle assigned to your program will be performed in the same clinic. Patients often switch clinics after a failed attempt. That is not always the smartest choice, as sticking with one clinic allows staff to gain more insight into your medical history. Financial planning of your treatment is easier: since it is easiest to estimate the total cost of the programme.

If we take a look at the cons of such programs, you must be aware that if you achieve your desired result during the first cycle, you will end up paying more than you would when paying for a single cycle outside of any program (that’s why we are talking here about “IVF” shared risk finance programs). Another thing is that not every patient qualifies for an IVF Refund Programme. When it comes to treatments using donor eggs, the qualifications for the patients are relatively lax. If you are set on using your own eggs, it becomes much harder to qualify, as the financial risk for the clinic becomes higher. Age would be one of the main limitations, as well as ovarian reserve criteria. There are also higher entry costs for such programs.

IVF Refund program – qualification

Patients considering signing up for an IVF Refund program will need to pass a medical test to qualify for treatment. Also, couples where a man has low-quality sperm, for instance, are disqualified from partaking in such programs, although some fertility tests might be required to confirm that would not have a detrimental effect on the outcome of the cycle.

Additionally, different clinics have their own criteria for judging sperm quality. Some use the latest WHO (World Health Organization) directives while others have their own standards dictated by their own experience. Moreover, some clinics also require a karyotype test but it only needs to be performed once during a patient’s lifetime.

Is the patient’s age and BMI a factor when qualifying for an IVF Refund Program? It is mentioned that in the case of IVF treatments using donor eggs, your age does not play a role. However, many countries have different legislative and statutory guidelines limiting treatment based on a patient’s age. In the case of treatment using your own eggs, your eggs will be the basic qualifying factor. Usually, the maximum age is 39 years old. It also needs to be noted that patients aged 37 to 39 receive smaller refunds. Sometimes as low as 50%. When compared to younger patients using IVF Guarantee programs.

An important requirement for an IVF Refund program is an appropriate BMI (Body Mass Index). In IVF with donor eggs programs, the maximum acceptable BMI is 35. In cases of higher BMI values, around 35 for instance, the clinic may recommend performing additional tests.

Sample terms and conditions for an average donor egg IVF program in Spain:

  • Hormone tests
  • Endometrium quality test (transvaginal ultrasound scan)
  • Male partner: Semen analysis and karyotype
  • Maximum patient age: 50 (due to Spanish law)

Furthermore, tests are performed at the clinic. The qualifying tests are not free of charge. Their cost may be deducted from the total cost of the program if you qualify.

IVF Refund program – cost

The total costs of an IVF Refund guarantee program can range from €10, 000 to €25, 000. It does not fall within the Definition of affordable fertility treatment. When compared with the price of a single donor egg IVF treatment, it is much more expensive.

What drives the price of such a program?

  • The type of treatment – IVF using your own or donor eggs.
  • The desired result – clinical pregnancy or live birth: programs aimed at achieving a live birth are more expensive since the success rates are not as high
  • The number of IVF cycles, frozen embryo transfers, and additional IVF Laboratory techniques covered by the program
  • Additionally, the IVF Refund Programme cost is affected by the same elements that dictate the price of a one-off IVF treatment.
  • The cost of medications for the patient is sometimes not included in the program’s costs.
  • Another additional cost would occur if you use donor sperm which can cost between €1,200 and €1,500 on average
  • PGT-A is often not included in program prices either.
  • The total cost of the IVF Refund program is also influenced by the country.

Conclusions

It is known that IVF refund programs are often offered by external companies that work directly with IVF clinics. The external company offers financing for IVF costs, while the clinic provides the treatment. When we look at the IVF Refund Programme cost using donor eggs, as shown in the chart from the Egg Donation Friends website, the costs are known to vary depending on the country

  • Spain – €18,000
  • Czech Republic – €16, 000
  • Greece- €16, 000
  • Georgia- €12, 000
- Questions and Answers

I’ve heard that if someone had failed cycles, they might not be accepted for a guarantee program? Is there a limit? And what if it was egg donation?

This is true, probably if you have had several cycles that did not work that also depends on the causa, the clinic will have to analyze what was the cause, why this treatment didn’t work for you before. That might make it a little bit more difficult for you to be accepted for a baby guarantee program. Usually, the limit of cycles is two or three egg donation cycles. If it’s more than 3 egg donation cycles that did not work most likely, it will be difficult to be accepted in a baby guarantee program unless the cause is very clear and it’s already solved, or there is a way to solve it.

What if you have a successful live birth and have a number of embryos left. Are any other transfers covered or just the original transfer is covered?

Usually, everything is covered until you have a live birth. If you have a live birth and you have embryos frozen, probably you will have to pay for the frozen transfer because you have already fulfilled what was included in the baby guarantee program with one live birth.

Do you provide pictures and profiles for donors in Spain?

Egg donation is anonymous in Spain, which means we cannot provide any information that might disclose the identity of the donor, so we do not provide pictures. In Spain, what we can disclose, is the age of the donor, the blood group and then general phenotype characteristics like hair colour, eye colour, the colour of skin, weight, height, all these general information regarding the phenotype, but nothing else that could disclose the identity.

What is the required min endometrium for the guaranteed program?

In general, there is no required minimum. What we would be aiming for is an endometrium that is 7 millimetres, so and that would be ideal. Patients that have problems with the endometrium or the endometrium did not respond to the medication, it’s called a refractory endometrium, have a history of recurrent implantation failures, that might be a reason why a patient might not be accepted for a baby guarantee program. It also depends on the clinic and the cost unless there is a solution found and we can try to solve that problem.

Is it possible to have more than 1 embryo transferred? Is it covered in overall costs?

Yes, it is possible to have more than one embryo transfer, even though generally in most fertility clinics what we tend to do a single embryo transfer. We know that twin pregnancies are much riskier than singleton pregnancies, so that’s the main reason why we recommend it. If you don’t have any medical contraindications for having a double transfer that could result in twins, that should be okay, and this will be covered.

Someone with problems in the uterus, cyst, fibroids are they allowed in the programme?

That really depends, it has to be evaluated, what kind of problems are there in the uterus and what kind of cysts and fibroids. If there are problems like these, they will need to be solved before undergoing the cycle. For example, if there are fibroids that are located in the inner part of the uterus, and they can interfere in the implantation of the embryo, this will need to be addressed. We will need to remove those fibroids by hysteroscopy or with laparoscopy and myomectomy. This is something to take in consideration, and after solving those problems the patient might be accepted on the baby guarantee program, but regardless of the fact if you do a baby guarantee program or not, these things need to be addressed, before you have an embryo transfer, if that’s the case.

Would the IVF clinics normally help with any potential underlying conditions like recurrent miscarriages?

Absolutely, the clinics always want to help with any potential underlying conditions, but it is very difficult to answer all these questions regarding if someone with these general problems would be accepted on a baby guarantee program because someone with recurrent miscarriages can have a lot of different problems, so there might a lot of different reasons why this person is having recurrent miscarriages. We need to identify the cause, and we decide which is the best treatment option. If someone is having recurrent miscarriages because there is a problem with the quality of the embryos, or there is low egg quality because of age, or there is any other reason, and this patient decides to undergo the treatment with the egg donor, in that case, most likely there will be no problem at all for that patient to be accepted for the baby guarantee program. If we’re talking about someone who has had recurrent miscarriages with eggs of the egg donor and that the factors might be other reasons, we’re speaking about a completely different scenario.

Do you ship frozen donor eggs to Canada or the treatment has to be done in Spain?

We don’t ship frozen donor eggs to Canada. What we can ship is an embryo. If you want to undergo the treatment in our clinic and then you’re living in Canada, and you want to do the embryo transfer in your clinic in Canada if we have a legal agreement with a clinic there and with their lab, once we have your embryos we can ship those embryos to the clinic in Canada, but we cannot ship only the eggs from the donor.

What do you do if you have eggs from an egg donor and there are remaining embryos, do you offer to freeze these to be used by the patient at a later date?

Absolutely, we always do that. When we undergo a cycle with the egg donor, and we get several good quality embryos, what we’re going to do as we are obviously not capable of having a few kids at the same time, so we will transfer the best embryo, then the remaining surplus good quality embryos will be frozen and left in storage for your future use, as long as you want to use them before you reach the legal age in which we can treat patients in Spain which is 50 years old.
Understanding the Importance of Carrier Genetic Testing
Hysteroscopy before IVF:  can it improve outcomes?
Recurrent Pregnancy Loss challenges: causes and solutions
How to prepare for an embryo transfer to improve your chances: There’s more to consider than just the endometrium
Endometrial factor and recurrent failures in IVF: diagnosis and treatment
How old is too old for my IVF treatment?
Authors
Maria Arqué, MD

Maria Arqué, MD

Dr Maria Arquè is a specialist in obstetrics and gynaecology and reproductive medicine. She has worked in a few renowned IVF clinics in Europe. Dr Maria Arquè’s professional interests include preserving fertility for men and women, IVF and reproductive health research, fertility education for patients and the impact of lifestyle/diet on IVF with ICSI success rates. She has studied and worked in Ireland, did some of her training in reproductive medicine in the USA. She was formerly the International Medical Director at Reproclinic (Fertty International) in Barcelona, Spain. Currently, she's founded a clinic in Barcelona, Gynnergy. Dr Maria is proficient in a few European languages: English, Italian, Spanish and Catalan. "All patients inspire me. Each of the patients I meet every day has a different background and a different approach towards their infertility diagnosis. I learn from all of them every day, and I’m grateful for it. The biggest lesson I have learned from my patients is that resilience and perseverance are key if you want to succeed."
Event Moderator
Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.
Have questions about what factors will affect your IVF success?
Join our live event to directly ask your questions to three IVF experts.