Bringing Up Baby

The costs and benefits of IVF and fertility technology make prospective mothers’ choices an ever-changing concern
Dawn figured it might take a few months to get pregnant when she began trying to start a family with her husband a few years ago at the age of 30. But after three years without success, including a year taking a drug to stimulate egg production and five rounds of artificial insemination, the couple began to consider in-vitro fertilization—and the staggering costs that would come with it.

IVF technology, which brings egg and sperm together in a lab, then transfers resulting embryos into the mother’s womb, resulted in the birth of America’s first “test-tube baby” in 1981. In 2012, IVF produced more than 61,000 babies—about 1.5 percent of all U.S. births. With today’s best techniques, women under 35 who are generally healthy have about a 47 percent chance of getting pregnant and a 40 percent chance of giving birth with IVF (the numbers drop precipitously with increased age).

Fifteen states require health-insurance companies to cover many infertility treatments, but Minnesota isn’t one of them. A single round of IVF costs about $12,000, along with up to $8,000 for related medications. Because the first try often doesn’t work, costs can quickly multiply. As a result, many Minnesotans face tough financial decisions that send them searching for creative solutions. “I even looked into companies based in states that require IVF to be covered by insurance, to see if I could possibly work for them to get that coverage,” says Dawn, a manager at a local retail company. She eventually was accepted into a clinical trial for a new IVF drug regimen in New York that cost her $7,000 in travel, local clinic appointments, and medications. Her son, Arthur, was born in January.

As science advances, the balance of costs and benefits for prospective parents is changing—in complicated ways. Additional procedures that have become available in recent years increase odds of conception but also add to the total bill: Screening embryos for genetic defects runs $3,000 to $5,000. Injecting sperm directly into eggs adds about $1,500. Using an egg donor can cost thousands more. And freezing extra embryos for future use is about $1,000. (By comparison, it costs, on average, about $25,000 to adopt a child).

One of the latest developments in IVF is pre-implantation genetic screening, which scans embryos for extra or missing chromosomes. In a group of women with particularly good prognoses, a study last year found that the embryo-analysis technique increased the rate of successful pregnancies from 70 percent to nearly 85 percent. Success rates were just as good for women up to age 42—suggesting that chromosomal factors account for a significant portion of IVF failures at older ages.

The initial screening costs $2,500 on average but could reduce overall costs by helping couples have babies more quickly. “Instead of going through two or three cycles to get that baby, they have to go through one,” says Dr. Phoebe Leonard, a reproductive endocrinology and infertility specialist at the University of Minnesota’s Reproductive Medicine Center.

Deciding whether fertility treatments are worth the price will always be a matter of personal circumstances, and many clinics offer financial counseling to help navigate the stress and emotional turmoil that often accompany the process. Several fertility clinics in Minnesota also offer risk-sharing plans that ask for more money up front but give patients several tries and return most of their money if they’re unsuccessful.

Jenni, a 39-year-old from Bloomington, saved for years to afford the $26,000 required to become pregnant with her second baby, due in September and conceived with IVF after a third try from a single cycle of frozen eggs. “We knew if we were unable to come up with the money, we were going to be unable to have another child,” Jenni says. “If you want a child that bad, you kind of do what you have to do.”