Recently I have been out of my comfort zone again, learning how to ski. My partner is a snowboarder and is keen to take the family for a skiing holiday, so I thought I should learn how to ski so I can participate. To get the ski trip underway though I had to make some key investments, the first and most important one was Bionic Braces for my knees. Basketball injuries and 2 knee surgeries, including an ACL reconstruction, means this is the most vital purchase for our holiday. To get started I had to do a little research into the best braces for supporting my knees. I found a local website with the braces advertised for $720 – yikes – because I was buying 2 braces. However after a little further research and some emails backwards and forwards with the company, I discovered the same company selling the braces on eBay for $448 for 2 braces!
Perfect, so I ordered them through eBay and saved myself $272, which is a significant sum when you are going on a skiing holiday. I arrived at the Korean owned Lotte Arai ski resort in Japan, to start my skiing lessons with the best support possible for my knees … within the first day they had proved their value by perfectly protecting my knees when I tumbled in the snow!
During my conversations with clients over the years, it is apparent that Finances are a considerable area of concern for most people when they require fertility treatment. Next to relationship problems and breakdown, finances are a significant reason that prevent people from seeking further treatment.
In Australia the average cost of an IVF cycle is approximately $10,000, however in that cost you must also consider the extras and the hidden costs that you may not have budgeted for when embarking on your treatment.
So let’s discuss the extras that you may not have considered when signing up to your clinic.
Some clinics will charge you for the Trigger injection $100 to get your body ready to releasing the mature oocytes – you are taken to theatre for oocyte collection prior to the oocytes being released from the follicles.
Embryo storage is another cost that is added on after the first 6 months of ‘free’ storage included at most clinics, this will range from$252 to $550 per annum on average.
PGD or PGS testing, genetic testing can add a further $5000 to your expected costs. These charges are per embryo up until a certain number and then capped at a specific amount $4000 – $8640.
Doctors’ fees (specialists) can sometimes be charged separately to the clinic quote – this is a question that you should ask – the addition of their fees for a standard stimulated cycle oocyte pick up and embryo transfer can add a further $1500 to your cycle costs.
Medication cost for some patients can see this figure sky rocket by another $1500-$5000 if you are not covered by Medicare or need extra medications for other health conditions.
Donor Sperm charges vary considerably between clinics, with some charging $1200 for USA/overseas sperm and other $10,000 which is payable directly to the overseas donor sperm company. One new client I spoke to had just started her fertility journey and was shocked by the price difference between clinics.
Donor Management Fees for the arrangement of your Donor Sperm can add another $2000 to your fertility costs.
Donor oocytes, if using a known donor in Australia will cost the same as a stimulated cycle approximately $10,000 for the cycle, with all the extras you will require, plus the Frozen Embryo Transfer at a later time.
Using Donor Oocytes from overseas companies is quite popular due to the waiting lists in Australia, however you will need to add $20,000 – $30,000AUD to your costs for the oocytes only.
Some clinics offer payment plans, afterpay options, which are helpful for many people, however there should be an estimate in mind when considering all these options – statistically speaking, it is most likely that you are not going to take home a baby after your first cycle. On average you are looking at 3 cycles to achieve a pregnancy. So it is vital that you calculate this cost when choosing your clinic – obtain the costs/extra charges/doctors’ fees/medication and then multiply by this figure by 3. I do hope that everything works for you in the first stimulated cycle, however experience in the fertility space and statistics show that sadly this is not common place!
In amongst the 3 cycles on average to achieve a pregnancy, there may be additional Frozen Embryo Transfer costs. These are expected standardly when you are undergoing genetic testing and will add a further $3000-$5000 cost per cycle in the interim.
Remembering that is these aforementioned cases we are discussing fertility treatment in Australia and whether or not you are eligible for the Medicare rebate, will make little difference to your budget. For the most part you are expected to pay the full cost of the treatment upfront and receive your Medicare rebate sometime after your cycle is complete.
Some clinics may offer gap only payments and may require the rebate amount to be paid to the clinic prior to commencing your cycle. It all gets very confusing and it completely at the discretion of the individual clinics, so ask as many questions as you can to get the best options for your situation.
Budget clinics are a recent newcomer to the fertility scene offering flat rate $1500 cycles for eligible patients. This will depend on your Medicare eligibility and your individual fertility needs/requirements. Donor sperm/oocytes, genetic testing, choosing your own specialist and other optional treatment extras are not available at the budget clinics generally. I speak to many clients weekly who are moving from these budget clinics back to private clinics, for their specific treatment needs.
When considering a specialist and clinic interstate, travel and accommodation costs also should be factored into your budget for both you and your partner. Again whilst the option of seeing your desired specialist is a high priority for you achieving pregnancy, it is realistic to multiply this cost by 3 also.
One client who lived in Perth WA travelled to the Gold Coast in QLD for treatment on multiple occasions, each time she was adding not only the extra costs of travel and accommodation to her rising treatment costs, the other consideration was the time involved, 5-6 hour flights from the West to East coast of Australia. Naturally when you look at the real time involved of getting to and from the airport, entire days are lost in travel alone.
Theatre and Anaesthetic costs are another important question to ask your fertility clinic. Some clinics will perform these procedure ‘in house’ at the same facility and thereby offer a reduced price. However additional $1625 for some theatre/day surgery costs and up to $800 for an attending Anaesthetist – you are now getting a more accurate picture of just how expensive 1 stimulate cycle may cost you.
We have not got the serious competition that is seen in USA/Canada with the expensive health care costs, no coverage with private health insurance and no government assistance with rebates. In these countries some clinics will offer set fees and take home baby promises – this will be a matter for another blog though, as I would like to take the time to comprehensively cover the real cost of IVF overseas.
Surgery costs prior to IVF are another consideration when planning for the financial aspect of fertility treatment. Gynaecology procedures of Laparoscopy and Hysteroscopy, Dye Studies, Fibroid removal etc. will add another $2000 – $3000 on average to your budget, this is just for the specialist fees btw, and you will need to add hospital and anaesthetist fees on top of this cost.
I speak to some clients who will have a cycle and then save up for a whole year for the next one, although this is admirable, for many clients, age is a determining factor with urgency and treatment must be a quicker process.
Male factor charges to consider are the exploratory PESA, TESA costs, it is important to ask about the storage fees whether or not they are included. If another procedure is performed on the day of oocyte collection, what is the cost? Are there any theatre/day surgery costs/anaesthetist charges? Although these procedures are routinely performed under a local anaesthetic. Confirmation of all these costs is required to get your budget accurate.
Counselling sessions for some clients are mandatory if they are using donor gametes (sperm or eggs), so it is important that you know how many sessions are required and the estimated costs.
Other tests to add to your extras budget –
Endometrial Scratch a process offered to women who have had no pregnancy success after a a few transfers of good quality embryos, it is a biopsy of sorts of the endometrial lining and it is thought that the repair function of the uterine lining may assist the next embryo transferred to have a better chance of implantation.
Embryo Glue a media with a higher concentration of Hyaluronan which is thought to increase the stickiness and chance of implantation at the time of transfer, this can add a further $350-$500 to your costs.
Embryoscope is the latest incubator technology, where you can see the video of your developing embryos, this can be sent to apps and used to pick the best embryos for transfer. It can add a further $500 to your fertility costs and not every clinic has this equipment to offer patients.
PICSI stands for, Physiological Intra-Cytoplasmic Sperm Injection, specialised dishes containing Hyaluronic Acid droplets are used to determine the sperms maturity, by its ability to bind to these droplets. The mature sperm is then chosen for injection and thought more likely to fertilise the oocyte.
Embryo freezing, whilst most clinics will include this is in the cycle cost, others may charge up to $750 for embryo freezing. If you have more than 10 embryos some clinics will charge a further $300 to freeze larger numbers of embryos.
Looking at the cost of IVF treatment around the world, there is a vast discrepancy in pricing. I should highlight that not all countries offer a subsidy for treatment through government and national health bodies. We are extremely fortunate in Australia. Without subsidy and private health cover for some clients, the full costs of the cycle would apply.
So my recommendations when considering your Finances is to do your research, ask many questions, please see my list of questions below … factor in all the extras and then budget for 3 times that amount per cycle.
My top questions to ask your clinic –
- What is the cost of IVF/ICSI cycle and what does that include?
- Extra charges for PGD/PGS? Capped amount?
- Medication costs expected? Trigger injection included?
- Hospital and Anaesthetist costs?
- Specialist fees included in the cycle costs?
- Other tests required, Endometrial Scratch, Embryo Glue, Extra Storage, Embryoscope, PICSI?
- PESA/TESA exploratory and on the day cycle costs?
- Is there a discount for a second cycle/third cycle per calendar year?
- Counselling available, cost of these sessions?
- Payment options, investigate all that the clinic offers
- When are payments required, this varies clinic to clinic?
Fertility Coach and Reproductive Scientist