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It's How We Measure Our Success

The CDC surveillance data analysis of Assisted Reproductive Technology within the US suggests that success rates improve dramatically when multiple cycles of IVF treatment are adopted as a course of treatment rather than a one time attempt. However, this might be cost prohibitive for some patient couples. Consistent with our history of commitment to our patient population, The Health Access Network Fertility Center has developed several package plans designed to make quality fertility healthcare affordable. The package plans vary and can include from one to two fresh IVF cycles and even unlimited frozen embryo transfer treatments. Special pricing has been designed to assist in accommodating your individual budget. The “multi cycle” program requires that the patient couple pre-pays for the desired package. As we have expected, patient response to these packages has been overwhelming.

Since it is well documented that multiple IVF cycles may be needed to achieve an ongoing pregnancy, the advantage of the “multi cycle package” is obvious. By making IVF treatment more affordable per cycle, we essentially encourage the use of repeat cycles to achieve pregnancy, if needed.

Our patients have peace of mind from knowing that they will receive the highest quality of fertility care at the most affordable pricing when they commit to the “multi cycle package”. Patients are more relaxed from the onset with the knowledge that they have multiple chances to achieve a pregnancy and take home a baby. This positive mind frame can certainly remove some of the stress related to infertility management.

Patient couples who consent to the “multi cycle package” will be treated for up to 12 months for the one cycle package and up to 16 months for the two cycle package. In order to increase the chances of pregnancy and to exploit the chances of each fresh IVF trial, some packages offer the use of cryopreserved (frozen) embryos. Approximately 40% of couples undergoing IVF services will have viable excess embryos and therefore, an opportunity to cryopreserve (freeze) them. For certain packages the cryopreservation of embryos will incur no additional fee, however, the embryo storage fee will be $600/year paid each quarter ($150/quarter). Both package 2 and 3 include unlimited frozen embryo transfer (FET) cycles at no additional cost. The FETs must be completed within the 12 month and 16 month treatment windows for the 1 and 2 fresh cycle packages, respectively.

Despite the use of multiple IVF attempts, it is well documented that success rates for IVF generally vary depending on a large number of factors, including but not limited to the underlying female diagnosis, the presence or absence of a male factor, the age of the female and the quality and grade of embryos transferred.

It is important to note that although the multi cycle payment option provides for performing repeat fresh IVF cycles at a substantially discounted rate, this plan however does not offer any guarantees or refund of fees if a live birth does not occur.

Advantages of this package plan compared to the traditional fee for service approach include:

  • the medical and laboratory service fees for the IVF cycles are known in advance and are discounted from the regular IVF fees,
  • treatment plan is already determined and pre-paid should the first IVF cycle be unsuccessful for some packages

Disadvantages compared to the fee for service approach include:

  • If an additional cycle is NOT required for you to achieve pregnancy, then you will have paid more than if you had chosen the standard fee for service option.
  • If you did not have embryos frozen you will have paid more per fresh cycle for packages 2 and 3 than per individual cycle cost (package 1)
  • The multiple cycle global packages have to be used within 12-16 months

Who qualifies?

Women must not have reached their 43rd birthday before beginning the first stimulation cycle. Couples must be capable of and committed to completing the program in the 12-16 month time limit. If IVF has been previously recommended based on standard infertility testing and/or treatment, any couple (with female partner under 43 years old) may purchase this payment plan. IVF cycles for which Preimplantation Genetic Diagnosis (PGD) is planned would have extra fees for the PGD procedure.

Patients are expected to:

  • Closely follow all of the physician’s instructions and to tightly adhere to their medication protocols both during IVF treatment and during their pregnancy until medically released from our care
  • Use available frozen embryos first after failing their first fresh cycle if they have purchased package 3 with the two fresh cycles.
  • Have proper medical obstetrical care with their physician immediately after being released from our care and throughout their IVF pregnancy. Failure to do so may disqualify a patient from the financial discounts in this plan.

IVF services included in multiple cycle global packages

  • Monitoring of IVF Ovarian Stimulation of the patient, (all ultrasounds , estradiol and progesterone blood tests, and physician services for monitoring)
  • Oocyte retrieval(s) and embryo transfer procedure(s)
  • IVF facility fees for oocyte retrieval(s) and embryo transfer(s)

IVF laboratory services included in multiple cycle global packages

  • Oocyte aspiration and ultrasound guidance
  • Oocyte identification, cleaning and insemination
  • Sperm preparation for the IVF cycle
  • Embryo culture and extended culture if indicated
  • Embryo transfer including ultrasound guidance
  • ICSI if indicated
  • Assisted hatching if indicated
  • Embryo freezing -Cryopreservation (if that option – packages 2 or 3 – was bought and paid for) as recommended by the program (but not storage – Cryo-embryo storage will be billed at $150 each 3 months, until all frozen embryos have been used). All future IVF treatment using those frozen embryos up till 12 months from the retrieval (for package 2) and up to 16 months (for package 3) are included. Any use of the frozen embryos after 12 or 16 months will require payment for a frozen embryo transfer. The fee is $2850/frozen embryo transfer cycle.
  • All facility charges at HAN IVF Services offices
  • Two quantitative HCG blood tests to diagnose pregnancy at the end of the treatment cycle.

Services NOT included in the multiple cycle global packages

  • IVF pre-cycle screening tests and office visits for both female and male partners. This includes the semen analysis.
  • All medications (both fertility related or unrelated) and their administration (including injections)
  • All non-IVF surgical procedures before or after the oocytes retrieval including (laparoscopy, myomectomy, surgical procedures on fallopian tubes and ovaries, hysteroscopy, D&C, etc. ( These procedures are frequently of a general gynecologic or obstetric nature, and are often covered by your existing health insurance)
  • Costs of obtaining donor sperm, or costs for the surgical sperm retrieval when necessary
  • Ultrasound monitoring of early pregnancy
  • Care or medical services provided for obstetrical care, or for complications related to the IVF process such as treatment of ovarian hyperstimulation syndrome, ectopic pregnancy, miscarriage, or other pregnancy complications.
  • Anesthesia Services (extra payment to the anesthesia department will be required before each oocyte retrieval.

Package fees

 

Multiple Fresh and frozen IVF Cycles
One cycle global IVF package and unlimited FET cycles $8,000
Two cycle global IVF package and unlimited FET cycles $13,500

Alternative fee schedule

HAN IVF services is pleased to offer an impressive price for a single IVF treatment cycle. A cycle includes the stimulation of the ovaries, collection of eggs, embryology related work, and embryo transfer. The services included and excluded for these packages are similar to the ones described above. This package includes all the necessary items to complete a treatment of IVF for most individuals. Ultrasound visits, IVF, embryology services, and an embryo transfer procedure are included. Medication costs, Anesthesia costs and the initial evaluation and testing for both female and male partners are not included in this package. Embryo cryopreservation and storage is not included and also if a frozen embryo transfer is needed, additional charges will apply.

 

Single Fresh (with ICSI and Assisted Hatching)
1 Cycle Global IVF Package $6000
Single frozen embryo transfer cycle $2850

For patients with IVF insurance coverage:

Some insurance carriers are covering IVF. Our office can assist you in determining your coverage and arranging pre authorization if needed. This will allow direct billing of your IVF expenses to your insurance carrier. This must be done before treatment can be scheduled. Be aware that if your insurance carrier does not participate with HAN IVF services, you will be responsible for the portion of the fee that they don’t cover. You will also be responsible for any deductibles or co-insurance payments.

Fertility medications:

The average cost of medications is $3,000, but can vary by about $1,500 (so usual range is from $1,500 to $4,500). The amount needed by each individual is different, and most often influenced by age. Medications are generally ordered through mail order pharmacies to obtain the best price. Payment for medications is made directly to the pharmacy. Although we cannot provide a package price for the medications you require, we had recently negotiated for you a significantly discounted price of medications if you purchase the multiple cycle packages.

Answers to questions that we heard from our previous patients:

I committed to one of the packages but I changed my mind about treatment- what is your refund policy?

If you paid for one of the packages and you did not start any treatment your payment will be refunded.

I chose the 2 IVF cycle package and started the treatment. Can I “downgrade” to a single package?

No. Once you committed to a particular package and your treatment started the “downgrade” option is not available.

I started my treatment and my ovaries are not responding at all and I would like to stop treatment what is the refund policy?

You will have a refund after we deduct fees (not discounted) for all services, procedures or treatments you obtained at the HAN IVF Services.

If I didn’t get pregnant and I would like to use the frozen embryos I have stored in your practice what are the expenses I am responsible for?

If you will use the frozen embryos within 12 months from enrollment in package 2 or within 16 months from enrollment in package 3 then you will not be responsible for any payment. (remember that storage is not free and you need to pay quarterly for it).

If you would like to use the frozen embryos after 12 or 16 months (depending on the package you purchased) then you will be responsible for $2850 frozen embryo transfer fee.

I got pregnant and have multiple frozen embryos – what are my options if I do not want to use them?

The answer to this question is addressed in the IVF consent forms. Before enrolling into one of these programs you are required to provide us with choices regarding those particular conditions (such as what happens to the embryos if the female partner dies, the male partner dies, both partners die, or both partners get divorced)

What is considered 1 IVF trial?

Any cycle that went through egg retrieval is considered 1 trial

What is considered completion of the program responsibilities?

If a fresh or frozen embryo transfer resulted in pregnancy beyond the 12th week of pregnancy (8 weeks after embryo transfer) then the responsibilities of the program (either for the 2 or 3 IVF packages) have been fulfilled.

If I had a miscarriage at 16 weeks and I have still frozen embryos that I would like to use- what are my financial responsibilities?

Since the program responsibilities were accomplished you will need to pay for a frozen embryo transfer cycle of $2850

What if I had an oocyte retrieval and had to freeze my embryos because of ovarian hyperstimulation precautions?

That would count as one cycle trial and you would need to use the frozen embryos before the expiration of your contract.

Income tax related issues

Here is some helpful information that might help your financial situation. Many of the expenses incurred in this treatment may be tax deductible and information is available in IRS Publication 17 – “Your Federal Income Tax” and IRS Publication 502 “Medical and Dental Expenses”. Certain medical expenses may be deducted if you itemize on Schedule A (Form 1040). Deductions which apply to IVF are:

  • Fees for fertility enhancement (procedures such as in vitro fertilization, including temporary storage of eggs and sperm)
  • Fees for doctors and surgeons (sonograms, egg retrieval, anesthesia)
  • Fees for hospital services, laboratory, surgical, obstetrical, nursing and x-ray services (blood tests, sperm evaluation)
  • Cost of transportation for needed medical care (air fare, mileage -22 cents/mile for 2006- or out of pocket expenses -cost of gas, oil- not including general maintenance expenses)
  • Medical and hospital insurance premiums
  • Prescribed medicine (all IVF drugs)
  • Lodging necessary for medical treatment ($50/night per person – limited to two people – the person receiving treatment and a companion)

Kathy McGoldrick is the Practice manager and can assist with financial questions and planning for IVF. She can be reached at (610)447-2949