Dimitris Kavakas, PhD, MBA
CEO at Redia IVF Travel, Redia IVF Travel
Category:
Donor Eggs, IVF Abroad, Success Rates
IVF Refund Guarantee and IVF Money Back Guarantee programmes are becoming more and more popular. It’s not surprising since they seem like an ideal solution for patients looking for some peace of mind during their uncertain fertility journey. The webinar is hosted by Dimitris Kavakas, an expert in the fertility travel sector and the CEO of the Redia IVF Travel company offering refund guarantee programmes, thus helping IVF patients manage their budget.
According to Dimitris Kavakas, the first thing we should bear in mind is that despite medical advances, IVF treatment has still a significant percentage of failure. There is no guarantee of an immediate pregnancy and successful treatment for the first time. That’s why from a financial point of view, IVF is an unpredictable process: you have no guarantee whether you succeed or fail. Dimitris has met a lot of patients who have been trying to succeed for several cycles and were financially devastated.
Success rates – the evidence to believe in?
Dimitris makes an interesting point warning us against blindly believing in success rates. In fact, every patient going to a fertility clinic asks mainly about success rates and every fertility clinic likes to boast about success rates as well. Dimitris explains why we should take everything a clinic says with a grain of salt. A success rate may mean many different things: a pregnancy rate (it relates to positive results of a pregnancy test), a heartbeat, 12th week of pregnancy ( the so-called 3-month rate) or live birth. Because of that, clinics may easily manipulate their actual results and mislead their patients. Dimitris highlights that there is a long way from a positive pregnancy rate to live birth, with an average miscarriage rate ranging from 5% to 25%. Age grouping can be also manipulated to make success rates look more impressive.
In some countries, like the UK and Spain, there is a state agency that controls fertility clinics so the success rates they publish should be the real ones. But elsewhere there may be clinics putting completely false success rates as nobody checks on them. So one has to be aware of the reality and check beforehand how a clinic they choose to produce their success rates in order not to be taken in by their promises.
What factors affect success?
According to Dimitris, there are a few components of a successful IVF treatment. All IVF patients should be aware of that complexity in order to assess their chances in a realistic way. The most important is the quality of the genetic material: both egg and sperm. Another factor is age – it mostly refers to a female partner, but recent research shows that a male factor is also important as the sperm quality diminishes with age.
The lab quality and scientific expertise play a crucial role as well. Dimitris recalls the statistics showing that in IVF treatment almost 70% of success depends on the quality of the lab while only 30% refers to a doctor and his/her expertise. So it is not enough to search for a doctor with a reputation and a famous name, not considering the kind of lab and technology available in the clinic this particular doctor works for. Then there is the type of treatment applied that matters. Unfortunately, for some clinics quantity is more important than quality and they apply the same protocols to everybody without paying attention to the individual needs of a patient. So Dimitris advises patients to look for clinics with tailor-made protocols suiting their needs instead of everybody’s needs.
Finally, success is an accumulative process meaning that it is important to realise you may not succeed in the first attempt. Dimitris assures it is common to have a few transfers and a couple of cycles before you can achieve your success.
Taking all the above issues into account, it becomes clear that foreseeing the effects of one’s IVF treatment is not literally possible. In such a case, it is good to have at least one constant that would make the whole process less stressful and unpredictable. What Dimitris means by that is the overall cost of the treatment.
Dimitris explains that a refund guarantee programme will help you deal with the financial insecurity of the treatment. It is your ability to do a multi-cycle programme at the set cost.
Still not convinced?
Although money-back programmes may seem like an ideal solution, you have to remember that they do have their cons as well. During the webinar, Dimitris pays our attention to two criteria that all the patients have to take into account while considering their refund-based IVF financing plan.
First of all, it is the eligibility criteria. It means that you need to be checked beforehand. You have to remember that the company offering a refund guarantee program is not an NGO or charity. Simply it is not there to lose money. They need to check if the possibility of a risk, for them meaning a refund, is not exceptionally high in your case.
Insurance companies will check certain details to minimise the risk. For example, if it is an own egg IVF treatment, they can ask for hormonal tests, look at karyotypes or endometrium. Similarly, they will look at the male partner and check his semen analysis and karyotypes to make sure sperm is good quality. Besides, there are age limitations. IVF treatment with the use of own eggs is generally for women below 40 (or up to 37) for a full money-back guarantee. In the case of egg donation, the only case of concern is quality of endometrium. A woman is asked for a transvaginal ultrasound scan and in case of a male factor, the quality of sperm is checked. There is no age limitation in egg donation. Of course, different countries have legal age limitations – in most European countries it is the age of 50.
Secondly, the thing to consider is your chances to succeed in the first cycle. You may wonder what happens if you pay for e.g. three cycles but you succeed in the first one. Obviously, you’ve got the baby you’ve always wanted but you have paid much more. Dimitris explains that it is a part of your chances and just like in case of any insurance, you do not get anything back. However, in most proper refund guarantee programs, live birth should be guaranteed. If it is only a positive pregnancy test or heartbeat, then Dimitris suggests having a second thought about such programme.
You may be interested in reading our comprehensive guide regarding IVF Refund and Money Back Guarantee Programmes
As the number of refund guarantee programmes on the market is growing, it is good to know how to differentiate among the different options and choose the most reliable offer. According to Dimitris, you should mainly look at what is included in the programme: what services, lab methods and medications. Remember that the latter are generally very expensive. For example, the cost of a medication for a 3-cycle program can be up to 4,000 GBP so it may significantly influence your budget if it is not included in the programme.
Secondly, is the refund percentage of 50%, 70% or 100%? Dimitris suggests making it clear if the total amount is guaranteed or just a percentage. The same refers to excluded extras. For example, the medication included in the programme may not be refundable so you need to know what is refundable and what you will get back in case of a failure.
Dimitris also highlights the difference between two types of guarantees: the positive pregnancy test and live birth. Some programmes guarantee a positive pregnancy test (where there is around 25% miscarriage rate). You may, for instance, pay 15,000 GBP and you get a positive pregnancy test in the first transfer and then you miscarry. In such case, you lose all your money. In case of a positive heartbeat, there is a 15% miscarriage rate and in case of 12-week pregnancy, there is a 5% miscarriage rate. A live birth guarantee is undoubtedly the best – in this case, you are guaranteed that you either have a baby or your money back.
Last but not least is your travel costs. In this case, Dimitris advises doing one’s own calculations very precisely before making an actual decision. For example, a clinic that is an hour-flight away from your home may be much cheaper than the one that is a 5-hour flight away. So you have to decide what is affordable and acceptable for you. Sometimes you need to compare 2 or 3 countries and clinics not only in terms of their offer but also and in relation to hotels’ and flights’ prices. It is important because travel costs are not included in any refund guarantee programme.
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