Not all fertility benefits are created equal: Q&A with Dr. Brian Levine

44% of large companies provide reimbursement benefits for in vitro fertilization (IVF), according to Mercer. While providing financial support to employees is critical, there are many aspects of fertility testing and decision-making, treatment processes and experiences, emotional support, and more that are critical for anyone navigating a fertility journey—whether IVF, intrauterine insemination (IUI), egg freezing, or other treatments—that are shrouded in secrecy for many HR and benefits leaders.

We know there are many questions you have when considering what to include in a fertility benefits program to best support your employees and how to design benefits that drive outcomes for your employees and lower your costs.

To understand the basics and answer some of your questions, we turned to one of the foremost experts in the fertility space, Dr. Brian Levine, Reproductive Endocrinologist and founding partner of leading fertility clinic CCRM New York. We spoke with Dr. Levine about how to design fertility benefits to include guidance and steerage to the best clinics, and why it impacts your bottom line.

Maven: We’re seeing more and more employers support their employees with fertility benefits and support. What do you think of this trend?

Dr. Brian Levine: I think it’s incredible! One in eight couples suffer from infertility. And I say suffer because it’s tough and it’s uncomfortable—an uncomfortable conversation or an uncomfortable treatment plan. The fact that something that seems so natural becomes so distant, so quickly, is tough. But to know that you’re supported by your employer is unbelievable. Because the truth is you will spend more time at your employer than you will with your significant other on a weekly basis. To know that your employer cares about what you go home to and where you come to work from, sends a huge message of support. If you can give your employees better access to care, they can typically identify issues before they become problems and think about solutions before they think about costly, alternate pathways. So, to me, fertility benefits are part of being a responsible employer but, more importantly, reproductive benefits give couples and women and men the ability to plan their lives and to plan their careers—which ultimately benefits everyone.

Q: What is the foundation for your personalized approach to working with patients, and why is it important to drive outcomes?

Dr. Levine: One of the underpinnings of our philosophy here at CCRM is that from the moment a patient walks through the door of our clinic, we’d rather treat that patient like gold than dig for gold. At most clinics, quite often, patients are getting the million-dollar workup. That’s why they’re spending through fertility benefits from their employers so quickly. Or they’re jumping to intervention when they need diagnostics. Instead of figuring out what’s wrong by doing a costly procedure, we’d much rather here use the philosophy of let’s learn who this patient is, let’s evaluate them. What this means is that our patient cadence is a little bit slower than some clinics.

But because we don’t rush to treatment, our ultimate time-to-conception for those patients is much shorter. And we utilize less drugs, less hormones, and less interventions. Which is good for conservation of healthcare dollars; which is good for limiting not just the financial risks but the medical risks for patients; and which, ultimately, in my opinion, leads to better outcomes for all parties involved.

Q: Could you talk a little more broadly about why a fertility clinic’s success rates are so important for consideration for a patient or an individual when they’re navigating or beginning their journey?

Dr. Levine: I think that quite often, patients come to a fertility clinic with an expectation that’s not recognized by their doctor. And it doesn’t matter what that expectation is—it might be that they imagine that they’re going to come in and get 30 eggs through egg freezing. It may be that they imagine they’re going to do IVF once and get 12 embryos.

So it all starts with a very simple question all my partners ask, which is, ‘Why are you here and what can we do to help you?’ From the very beginning, we have an open conversation and we understand expectations. And what happens, we find, is that we are able to provide care to the patient, rather than put the patient into a bucket. The process is so much better for our patients because we don’t have a script that we’re following. We do what the patient needs now and treat the patient and not just their number (number being their age or their AMH, which doctors use to estimate the number of follicles inside the ovaries).

“We’d rather treat a patient like gold than dig for gold. At most clinics, patients are getting the million-dollar workup. That’s why they’re spending through fertility benefits from their employers so quickly.”

Q: Why is holistic care important to individuals going through a fertility treatment, and how do you embed transparency in your process?

Dr. Levine: I’ll talk specifically about egg freezing because a lot of people don’t think about it this way, but egg freezing is really challenging for an individual. Here you are going to a doctor when you’re totally healthy and fine, and preparing for a disaster—preparing to have the worst fertility ever. That’s really a loaded experience. When someone goes through egg freezing, every injection reminds someone that they’re single. Every injection reminds them that they don’t have a partner or that their partner isn’t ready to become a parent with them. And injections are painful—they’re needles. So the entire process can be a truly painful reminder that they haven’t met that right partner in their life or that things haven’t gone according to their plans.

As we go through this process, that’s why I think it’s so important to support patients and to set them up for success. To be open with them and to level their expectations so they understand what’s going on, how things are going, how they’re developing. We give them transparency into how they’re responding to the medicine. We give them transparency into how things look, how they should feel. And what we find is that people tend to be much happier when there’s transparency, when their doctor talks them through the steps and the outcomes.

Open communication, honesty, being frank with patients, helping engage patients in the process, asking them what they see, what they want, what they hope for—that’s a core part of our plan from day one.

Maven: What inspired you to become a Reproductive Endocrinologist and why are you passionate about fertility?

Dr. Levine: My career path has been dictated completely by my second day in Medical School at NYU. That day, I learned about the genetic testing of embryos which blew my mind. We learned about what is a relatively happy field of medicine, which is reproductive endocrinology and infertility. You’re helping people achieve what they’ve always thought to be their dream and helping them to navigate a challenging time when they start to have trouble. You also get to use incredible technology. That really interested me at an early stage—the engineering, the biotechnology, the technology, and the happiness. And that’s what drove me to it.

Maven: Any final takeaways for employers or individuals?

Dr. Levine: Two last thoughts. The first: not all fertility clinics are created equal. Employers should know that Maven has done an incredible job of identifying only the best clinics to build partnerships with and guide members to, and that’s really important.

And the second is a tip for everyone: it’s not scary to go to a doctor. Going to a fertility doctor doesn’t mean you’re going to get diagnosed with a problem, which I think a lot of people are scared of.

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