IVF process and cost: What HR leaders need to know

In the U.S., approximately 9% of men and 11% of women of reproductive age will experience fertility issues. Facing difficulty conceiving without treatment, many heterosexual partners look to fertility treatment to help them realize their dreams of becoming parents. In addition, growing numbers of LGBTQ+ couples and single parents are using intrauterine insemination (IUI) and in vitro fertilization (IVF) to have children.

Overall, four in ten American adults say they have used or know someone who has used fertility treatments to expand their families. IVF accounts for more than 99% of assisted reproductive technology (ART) procedures performed in the U.S. and is an important reproductive health treatment option for those who cannot conceive via other methods or wish to preserve their fertility so that they can try for children in the future.

With 2.5% of all births in the U.S. a result of IVF treatment, it's likely that there are employees within your business navigating the emotional, financial, and logistical impact of IVF procedures. For HR leaders, understanding the IVF process and associated costs is pivotal to supporting your workforce with empathy, flexibility, and inclusivity, and empowering your employees to pursue their personal goals while still being able to thrive at work too.

Supporting employees through their IVF journey has business benefits too. 72% of employees would stay at a company longer should they provide fertility benefits and 96% of employees who have received Maven fertility benefits said they felt more loyal and committed to their employer. This translates to increased engagement, with research showing that companies with high engagement are 21% more profitable.

The IVF process explained

In vitro fertilization (IVF) is a medical process that helps couples facing infertility to conceive a child. This involves fertilizing an egg with sperm outside the body before implanting the embryo into the uterus. An IVF cycle includes several stages, each crucial for increasing the chances of a successful pregnancy.

Initial consultation and evaluation

The IVF process usually begins with researching and reviewing fertility clinics before reaching out for an appointment. During the initial consultation, a fertility specialist will review the patient's medical history and discuss any fertility issues.

Initial tests, including blood tests and ultrasounds, are conducted to assess hormone levels and reproductive health. This evaluation helps create a tailored treatment plan for each person or couple's IVF journey.

Ovarian stimulation

The ovarian stimulation phase involves self-administering hormone injections to encourage the ovaries to produce a higher number of mature eggs than in a normal menstrual cycle in preparation for egg retrieval. Fertility medications are injected daily for 8-14 days and the response of the ovaries is monitored through regular blood tests and ultrasounds to track egg development. Once the follicles in the ovaries reach the right size, a ‘trigger shot’ is administered at a precise time. This hormone triggers the final maturation of the eggs.

Egg retrieval

Egg retrieval is a minor surgical procedure lasting around 20 minutes. It is performed under sedation and usually occurs 36 hours after the trigger shot is done. Using a thin, ultrasound-guided needle, eggs are carefully removed from each follicle.

Risks are minimal and typical of any medical procedure. Most individuals recover quickly, experiencing only mild discomfort for a short time afterwards. However, there are a few more serious risks. Ovarian hyperstimulation syndrome can be caused by the fertility medications used to produce eggs. In addition, pelvic inflammation and puncturing of the bladder, bowel, or blood vessels can occur as a result of the egg retrieval procedure.

Sperm collection

The sperm collection process varies. If using a partner's sperm, a sample can be provided on the same day as egg collection or may have been retrieved via surgical extraction at a prior point. If using a known sperm donor, they too can provide a sample on the day. If using donor sperm from a bank, frozen sperm will be held by the fertility clinic in readiness for egg fertilization.

The sperm is then prepared and tested for quality. This ensures that the healthiest and most motile sperm are used for fertilization, increasing the chances of successful embryo development.

Fertilization

Fertilization occurs in a laboratory and is carried out by an embryologist. With traditional IVF, the sperm and eggs are mixed so that sperm can naturally penetrate the eggs, With intracytoplasmic sperm injection (ICSI), a single sperm is injected directly into each egg. Embryo creation is carefully monitored over the next few days using a microscope or embryoscope.

Embryo transfer

An embryo transfer usually occurs 3-5 days after fertilization. The procedure is quick and painless, where a fertilized egg is placed into the uterus using a thin catheter. A single embryo transfer is recommended by the American Society for Reproductive Medicine and Society for Assisted Reproductive Technology for patients with favorable prognosis, usually women aged 35 years or younger and with eggs or embryos of good quality.

Post-transfer guidelines include resting for a short period and avoiding strenuous activities but most people resume their usual activities soon afterwards. There may be some symptoms such as cramping, bloating, spotting, fatigue, and nausea. However, 10-15% of people experience no symptoms following their embryo transfer. Any embryos not used in this IVF cycle can be cryopreserved and used for a frozen embryo transfer in the future.

Pregnancy test

A pregnancy test is typically conducted about two weeks after the embryo transfer. If the test is positive, follow-up appointments will confirm the pregnancy and ensure it is progressing well. If negative, a specialist will discuss the next steps and potential adjustments to the treatment plan for a subsequent IVF cycle.

Factors affecting IVF success rates

The success of in vitro fertilization can be influenced by many factors, making it a highly individualized process. Understanding these factors can help employees set realistic expectations and optimize their chances for a successful outcome.

Age of the birthing parent

The age of the birthing parent is one of the most significant factors affecting the success of an IVF cycle. As age increases, egg quality and quantity decline, reducing the likelihood of fertilization and healthy embryo development. One study found that the clinical pregnancy rate for women under 30 who’d undergone an embryo transfer was 69%, while for women aged 40 to 43, it was 9%.

Quality of eggs and sperm

The quality of both eggs and sperm is also crucial for successful IVF as higher quality is more likely to result in viable embryos. Poor egg or sperm quality can lead to failed fertilization or embryos that do not develop properly, reducing the chances of a successful pregnancy.

Fertility clinic’s success rates

The success rates of fertility clinics can vary widely. Choosing a clinic with high success rates and experienced staff can significantly improve the chances of a positive outcome. It’s important to research and consider a clinic’s track record when deciding where to undergo IVF treatment.

Underlying medical conditions

Certain medical conditions, such as endometriosis or uterine abnormalities, can impact IVF success. Managing these conditions effectively and addressing any underlying health issues is crucial to improving the likelihood of a successful pregnancy.

Lifestyle factors

Lifestyle factors, including diet, exercise, smoking, alcohol consumption, and exposure to environmental toxins play a significant role in IVF success. Maintaining a healthy weight, eating a balanced diet, and avoiding harmful substances can enhance fertility and increase the chances of a successful IVF cycle.

IVF treatment costs

Only 15 states require health insurance to cover fertility treatment. However, even with insurance coverage, undergoing IVF treatment can place a significant financial burden on individuals and families.

How much does IVF cost? A breakdown of typical costs

The cost of IVF is significant with the average cost of one IVF cycle reaching $15,000. Each stage of an IVF cycle contributes to the overall expense and fees are usually incurred even if a cycle is abandoned part way through or unsuccessful.

Initial consultation fees: The initial consultation with a fertility specialist typically costs between $250 and $500. This includes a review of medical history, fertility assessment, and creating a tailored treatment plan.

Ovarian stimulation medications: Medication costs for ovarian stimulation are essential and can cost between $3,000 and $6,000 per cycle.

Monitoring and tests: The base cost of IVF typically includes monitoring appointments.

Egg retrieval procedure: The egg collection procedure is also normally included within the base IVF cost.

Fertilization and embryo culture: Fertilization and embryo culture, where the eggs and sperm are combined in the lab is usually factored into the base cost of IVF. However, additional fees for intracytoplasmic sperm injection (ICSI) are not uncommon.

Embryo transfer: An embryo transfer using fresh eggs is typically covered within the fees of a single IVF cycle. Subsequent transfers of frozen eggs average $3,000 - $5,000.

Pregnancy tests: Pregnancy tests, conducted approximately two weeks after the embryo transfer, can vary in cost. A store-bought urine test can be a few dollars, whereas a lab blood test averages $50. These tests confirm whether the IVF cycle was successful.

Additional costs to consider

In addition to the price of standard fertility treatments, there are extra costs that prospective parents can incur. These are for optional or recommended services and procedures which can further increase medical expenses but may also enhance the chances of a successful pregnancy.

Genetic testing: Genetic testing, such as preimplantation genetic testing for aneuploidy (PGT-A) or monogenic disorders (PGT-M), can cost between $1,800 and $6,000. These tests help ensure the embryos are genetically healthy and reduce the risk of genetic disorders.

Donor eggs or sperm: Using donor eggs or sperm adds significant costs, ranging from $5,000 to $15,000. This includes the donor's compensation, medical procedures, and legal fees, ensuring a safe and ethical process.

Cryopreservation: Freezing embryos for future use, costs around $1,000 to $2,000 initially, with additional annual embryo storage fees ranging from $350 to $600. This option allows for future IVF cycles without repeating ovarian stimulation and another egg retrieval process.

Additional IVF cycles: Each additional IVF cycle can cost up to $15,000. This includes all procedures and medications for another attempt, including egg collection, which might be necessary if the initial cycle is unsuccessful and results in no embryos being frozen.

Insurance coverage and financial assistance

Navigating the financial aspects of IVF can be challenging, but understanding insurance policies and exploring various financial assistance options can help. Some private insurance plans will cover diagnostic testing but insurance which covers IVF and other fertility treatments is uncommon. Only a small number of states require private insurance plans to cover infertility treatment and only two states, New York and Illinois, offer limited coverage for fertility services under Medicaid. This leaves the majority with no choice but to pay out of pocket, which is unattainable for many people.

Various financial assistance programs and grants are available to help offset the costs of IVF. Organizations such as the Baby Quest Foundation and the Cade Foundation offer IVF grants to eligible couples. These programs can provide substantial financial relief and make treatment more accessible.

31% of employers offer some form of fertility benefits as part of their health insurance packages yet coverage for assisted reproductive technology can vary drastically between companies. The most comprehensive fertility benefits cover reproductive health in its entirety, giving employees access to preconception fertility specialists and actually reducing the need for fertility treatments. For example, 30% of Maven fertility members achieve pregnancy without IVF or IUI.

Comparing IVF costs globally

The cost of in vitro fertilization (IVF) varies widely worldwide, influenced by factors such as healthcare systems, regulatory environments, and the cost of living. Comparing these costs globally helps prospective parents make informed decisions about where to undergo treatment based on affordability and accessibility. It has also led to a growing number of people traveling out of state or country to access more affordable treatment.

Cost variations by region

The cost of IVF abroad can be significantly lower than in the U.S. but it does depend on location:

North America: In Canada, the average cost of IVF is $10,000 - $15,000 whereas prices for treatment in Mexico start at $4,000.

Europe: There is a broad range of treatment costs across Europe. For example, an IVF cycle can start at £5,000 in the UK, €2,800 in Turkey and €3,600 in Greece.

Asia: A single IVF cycle in Thailand costs between $3,000 and $7,000. In comparison, treatment in India starts at around $2,200.

Australia: The cost of IVF in Australia is impacted by coverage and the clinic but ranges from $4,200 to $12,000.

Reasons for cost differences

The regulatory environment in each country impacts IVF costs significantly. Countries with stringent regulations often have higher costs due to compliance requirements, licensing fees, and mandatory procedures. In contrast, countries with less regulation may offer lower-cost treatments but might lack certain safety and quality assurances.

In addition, the level of technology and expertise available at fertility clinics also affects IVF costs. Clinics in countries with advanced medical technology and highly skilled specialists may charge more due to the superior quality of care and higher success rates. Conversely, clinics in regions with less advanced technology and fewer specialists might offer lower prices but could have varying success rates.

The availability of medical resources, including medications, laboratory facilities, and donor materials, also plays a crucial role in determining IVF costs. In countries where these resources are readily available and less expensive, IVF treatments tend to be more affordable. However, in regions where resources are scarce or need to be imported, the costs can be higher.

The emotional and psychological impact of IVF

The financial cost of IVF cannot be overlooked. However, fertility treatment also comes with emotional and psychological costs which can have a significant impact on employees. It is crucial to acknowledge these challenges so that you can effectively support your workforce.

Balancing work and IVF treatment can be stressful. Frequent medical appointments, hormone treatments, and the uncertainty of outcomes can create emotional strain. Those going through IVF have ranked it as stressful as major life events including the death of a loved one and divorce.

It's important to create an environment where employees feel comfortable talking about their situation, seeking flexible work arrangements, and practicing stress management techniques such as taking breaks when needed. Building a colleague or third-party support network can also be incredibly beneficial.

The emotional rollercoaster of hope, disappointment, and anxiety can take a toll on overall well-being. That's why fertility benefits that offer mental health support for IVF are critical. 33% of Maven members, for instance, report being better able to manage their mental health.

Family building with Maven

The IVF process involves understanding its multiple stages and associated costs, from initial consultations and ovarian stimulation to retrieval, fertilization, and embryo transfer.

Costs vary widely based on age, medical conditions, and geographic location. Making informed decisions about treatment options and financial planning is crucial for the prospective parents amongst your employees.

HR leaders play a pivotal role in supporting employees by offering comprehensive fertility benefits, which can alleviate financial stress and enhance emotional well-being, ultimately fostering a more supportive and inclusive workplace.

Maven enables businesses to deliver exceptional care at scale, empowering employees with their reproductive choices and positioning companies as family-forward workplaces. Employers who invest in Maven see 2-4x clinical business savings while their employees benefit from accessible, end-to-end reproductive care and improved fertility outcomes. To find out more, book a demo today.