Are you considering IVF but feeling overwhelmed by the financial aspect? In this session, Dr Alan Thornhill, Fertility Expert & Coach, Founder of The Fertility Guy guided IVF expenses and funding options. He gave some tips that can be useful before you make the final decision.
The reality is that IVF is all about the money. Unfortunately, it has become a bit of a business, it’s crucial to understand the costs, think of ways that you might be able to fund your treatment and find ways to save money. Whether you’re just starting, haven’t had any treatment yet, or have already spent quite a lot of money, you might find the provided tips useful.
There are some bad and some good news to start with. More than half of all IVF cycles are unsuccessful on average. This is largely because, in women, fertility declines dramatically with age. Over time, we see more women starting their families later, which naturally means that more IVF cycles are needed, and more cycles are unsuccessful. Most people require several cycles. While some are successful on the first cycle, others might need multiple cycles or might be unsuccessful altogether. This can make the process very expensive.
The truth is that clinics are getting busier and more business-like. Most of the time, patients usually spend a lot more money than they thought they would, whether they think the add-ons are useful or not.
On the other hand, success rates are improving as we get more treatment options, and that means fewer cycles will be needed ultimately for the average patient. There are more clinics, and there are more overseas options. This can sometimes mean reduced prices for IVF in different countries where wages and other costs of living might be lower, so you can get good deals by travelling overseas.
Before starting fertility treatment, you should consider several tips that might be useful for you:
A costed treatment plan is a way, after one or more consultations with a doctor, to outline what you are likely to need from the list of treatments, add it all together, and provide a likely cost, including a minimum, maximum, and average range. This gives you an idea of the funds needed to cover the treatment.
Many people have overspent, sold their homes, or taken extreme measures to fund their treatment. It’s wise to draw a line and make a budget to avoid overspending.
Here are some possible pros and cons:
Public centres might have longer waiting lists due to funded patients and may have exclusions based on funding criteria. Age limits and other factors can vary between centres. It’s crucial to ask these questions directly when considering a centre for treatment.
Private IVF treatments are generally considerably more expensive. On the plus side, they typically have shorter waiting lists, potentially fewer patient exclusions, and possibly better customer service, though this can be variable. Private clinics typically offer more treatment options, which is almost certainly true. It’s not just a matter of whether public or private is better; it’s about what you particularly need and want.
A multicycle package involves paying for multiple cycles upfront. You get money off your treatment, and it benefits the clinic by providing guaranteed income. Money-back offers or refunds, sometimes called money-back guarantees, are another option. This is a shared risk model where the company offers partial or full refunds if you do not get pregnant. They are prepared to take a financial hit if you don’t succeed, hoping to optimize the chances of early success in the first cycles.
Low-cost IVF programs offer basic, no-frills IVF without many extra treatments or add-ons. This approach is intended to meet routine needs effectively. It’s a good sign if you are eligible for such a program, but be cautious. If unsuccessful, you might end up staying with that clinic and potentially facing more complex and costly IVF treatments.
When considering these options, always read the small print. Some important questions to ask include:
Some clinics offer buy now, pay later, interest-free loans, which make IVF more accessible. However, remember that these deals are calculated so that the clinic and company offering them do not lose money. Despite this, such options can help make treatment more accessible.
When you’re undertaking the treatment, there are some other aspects you should be looking out for, those include:
As defined by the HFEA, an add-on is an optional, non-essential treatment offered in addition to proven or basic fertility treatments. There is a very long list of add-ons, and a recent paper by ESHRE listed between 50 and 100, possibly more. They were comprehensive, including anything that wasn’t routine. Here are a few examples: time-lapse incubation (common in the UK), PGT-A (testing embryos to identify chromosomally normal ones), and EmbryoGlue (which has the most evidence among these). These add-ons have associated costs, and very few clinics include them in the standard treatment package.
For example, in the UK, time-lapse incubation ranges from £250 to nearly £1,000 extra per cycle. PGTA ranges from approximately £1,750 to £3,500, which could be equivalent to the cost of a whole IVF cycle. Embryo glue costs between £250 and £500. Some clinics include these in the total package cost, but this gives a sense of what an add-on might cost. When considering add-ons, focus on the following questions:
It’s essential to get clear answers. If the response is “we don’t know” or there’s little evidence, this is still useful information to help you decide. A bad answer would be ignoring your questions or providing unsatisfactory responses.
Routine standard medications, such as gonadotropins to stimulate the ovaries, HCG to mature the egg, and progesterone to support pregnancy, are essential. Consider these strategies:
Non-standard medications, like growth hormone, require careful consideration. Ask the same questions as for standard meds, with the addition of:
If you receive vague answers about side effects, and you’re not comfortable with the information provided, you might consider switching clinics or doctors.
Hidden costs are unexpected expenses that were not apparent when choosing a treatment option. These are different from misleading price quotes. Examples include:
These examples illustrate the importance of thoroughly understanding and asking about potential hidden costs before committing to treatment. Educate yourself about the basic process, assume that nothing is free, read the small print, and ask questions. At the end, I have a slide that will address this in more detail.
After fertility treatment, it’s really important to review your cycle, possibly with a coach or certainly with the clinic. This will help you review and potentially reset your boundaries. Consider refunds and potentially negotiate. Clinics value retaining customers because acquiring new ones is costly.
Review not just the cycle and the medical aspects, but also your financial boundaries and budget. When it comes to saying no or complaining, be clear, concise, and precise. Be persistent and put things in writing. It helps to have an email trail rather than relying on verbal conversations, which can become a “he said, she said” situation. Consider going with a friend or family member for support. Clinics should have a complaints process, but try to resolve issues amicably first, as this can lead to quicker and better responses. Be friendly and firm.
To conclude, regarding overseas treatment: remember that there are specific treatment costs and additional costs involved. People often focus on the cost of the treatment itself, but this doesn’t include repeat treatments or the cost of exporting eggs, sperm, or embryos. This is not to discourage overseas treatment, as many clients have found success there, but be aware of potential extra costs: travel, including flights, taxis, and other expenses; passports and visas; accommodation; meals; time away from work; costs for childcare or pet care; and possible legal costs due to different rules in various countries.
Final thoughts on costs and funding IVF: choose the right clinic, as this is likely the most critical cost factor. Compare money-back guarantees, packages, and fee-for-service options. Read the fine print carefully. Consider overseas treatment but be mindful of the extra costs. Always ask questions and review the small print. If the small print is missing, you have a good case if you later dispute unexpected costs. Avoid simply accepting the costs presented by the clinic. You have choices and rights to say no or opt for different treatments. Prepare thoroughly to avoid unexpected expenses and ensure you don’t spend more money than anticipated.
I’m aware there are a few of these calculators available. I would say to try them, but they vary enough that I can’t give a generic answer about what they all include. During my presentation, I mentioned the costed treatment plan, which is specific to the UK. This is something you should receive after your first or second consultation, once they have a good idea of what your treatment will involve. That plan should include everything you’ve outlined—medications, procedures, and additional fees.
These calculators are available online. I’ve seen some, but I’m not familiar with them, so I can’t say they all include the same things. I will look into them more because I’m interested in seeing how much they vary. It’s great that you’ve done your homework on this.
If I’m correct, a good calculator shouldn’t just give you a final number. What you should look for is a breakdown of where the money is going: how much is for medications, how much is for treatments, and so on. In some countries, personnel fees, like those for physicians and anaesthetists, are listed separately. In the UK, I believe we still have more consolidated fees for the IVF process, with add-ons and medications being separate.
I know that’s not a perfect answer, but understanding what you need in a cycle and then matching that against the calculated cost is probably the best approach. I don’t think it’s useful to just receive a final number without understanding how it was calculated. It’s like doing your tax return and getting a number at the end without knowing how it was derived—you just have to trust it. I wouldn’t be comfortable with that; I’d want a breakdown that makes sense.
First, there are quite a lot of components to getting a good quality embryo. One key factor is starting with a good egg. If you have a poor-quality egg, it’s difficult to get a good-quality embryo. Interestingly, you can have a very good-quality egg and not such good sperm and still get a good-quality embryo, which shows how crucial the egg is in this process.
Regarding your question about standard IVF versus ICSI, the relatively few studies that have compared them show that the quality of embryos from standard IVF has been marginally better, if I recall correctly. However, in a good quality lab with decent skill in doing ICSI, they can also get good quality embryos.
There is a slight risk with ICSI—it’s tiny, but it’s there. You’re sticking a glass needle into an egg, and I’ve met patients who say, “If I don’t need ICSI, I don’t want it,” because it feels like there’s a sort of guarantee of fertilization, which is why some countries use it a lot. They don’t like the idea of injecting a glass needle into their egg. There is a small risk of the egg being damaged, and while it’s very small, it’s there, which might contribute to potentially slightly lower quality embryos when using ICSI. But in reality, very similar-quality embryos can be obtained from both IVF and ICSI when ICSI is done in a good laboratory.
If your question is about whether you should do ICSI to get better-quality embryos, I would say no. You should only do ICSI if you have a good reason, particularly in the UK, where they’re very strong on this. A good reason would be if you’re worried about fertilization failure or if the sperm parameters are such that the lab would be extremely uncomfortable doing IVF because of the risk of failed fertilization.
I hope this answers your question, but getting a good-quality embryo is a vast subject.
The simple answer is that I think treatment in London would be more expensive, but that’s on average. You’re talking about regions, and we’re talking about average clinics. Of course, there could be a clinic in the north that’s more expensive than one in the south or in London because people adjust their pricing.
In reality, prices aren’t fixed, but clinics are always looking at each other’s pricing. So, if you’re working in the Southeast or London, you’d need a very strong reason to undercut everyone by a huge amount to be the cheapest clinic in town. In reality, prices sort of equilibrate in regions, but on average, prices in the South and specifically London will almost certainly be more expensive than in the North. It makes sense, unfortunately, but that’s how it is.
That’s a great question with a lot of layers. It links to that story I told you about someone saying, “This is the cheapest clinic in the whole country.” You need to read the small print carefully. Are you just paying for the IVF procedure itself—egg collection, embryo culture, and so on—or does it include other things? For example, is embryo glue included? Is storage for frozen embryos included?
You need to get that costed treatment plan or do it yourself. Say, “This is what I would expect to get, this is what I’ve been told I might get,”—maybe five embryos, transferring one and freezing three. What’s my likely cost? That’s what a costed treatment plan does, so you want to compare apples to apples.
The other thing to consider is if you’re talking about a clinic that offers the whole package for considerably less, they may be doing that only for people who are eligible for that treatment. It’s a good sign if they choose you because you meet specific criteria, like being under 30, having male factor infertility, and normal hormone levels. They might say, “There’s not much point in doing extra things, so let’s do basic IVF or maybe with ICSI, and we can afford to give it to you at this price.”
The cynical part is that if you fail with that treatment, they might say you need something extra now, but they’ve already got you as a customer. You went in with a good chance of success with basic treatment, but you came out needing additional things. So, I wouldn’t say “beware,” but just have your eyes open about that.
There are several options here, though this is not an exhaustive list since I don’t have all the information at hand. There are opportunities for loans and “buy now, pay later” plans. I realize that if you’re on a low income, it might be difficult to pay for it all, but I’m just mentioning these as examples for someone who can’t pay upfront.
It’s always worth asking—don’t be afraid to reach out. You could even approach a clinic and explain your situation, saying, “I can’t afford this, and I’m not eligible for NHS support.” Some clinics might be willing to work with you, perhaps in exchange for being featured in a newsletter or marketing piece, though that might not be something you’re comfortable with. If you’re in a desperate situation, there are always ways to explore.
Not just for medications, but other aspects of your treatment might be covered by a research study. I would ask the clinic you’re interested in if they have any research opportunities that could subsidize your treatment. Clinics are often looking for participants for marketing or research, and while it might sound a bit mercenary, we’re dealing with reality here. If your only option for treatment involves being part of a study or a marketing campaign, and you’re fully informed and comfortable with it, why not take advantage of that?
Yes, I do expect people to be on a longer journey. It’s not just about a week or so—these journeys can take quite a long time. So yes, definitely, you can contact me, and we can have a chat to see how I can help. Maybe I can help, maybe I can’t, but I’ll be very honest with you.
Great question. I haven’t got a simple answer. The simple answer would be, if you’re okay with it, to book a free call, and we can talk about how many supplements you’re on, what they’re doing, or what they’re not doing.
I’ll give you an example—this may not be you, so I’m not pointing this at you—but I’ve spoken to some men who were using supplements and taking three times the recommended dose. Now, I’m not saying you’re doing that, but supplements can get very expensive, very quickly, with questionable value. And, certainly, questionable value if you’re not taking the right dose.
Let’s discuss that because the main thing is to make sure you’re getting the right thing, what you need, at the right time, and not just throwing everything at it and hoping something sticks.
