Out-of-pocket expense during fertility care

This study evaluated out-of-pocket costs incurred by couples seeking fertility care.

Many treatments are currently offered to couples attempting to overcome infertility problems. Medications to induce ovulation, in-vitro fertilization (IVF) and intrauterine insemination (IUI) are just some of the methods commonly used to help couples conceive. Couples undergoing infertility treatments bare a heavy financial burden, since treatments are both expensive, and multiple treatment cycles are often required. While numerous studies have evaluated the costs of the various infertility treatments, direct patient out-of-pocket costs have not yet been investigated.

This study included 437 couples seeking fertility care, followed for an average of 18 months during treatments. Participants were asked to keep a cost diary, including all out-of-pocket expenses, whether be it for treatments, clinic visits, medications, travel or any other treatment related expense.

On average, overall out-of-pocket expense for couples seeking fertility care was $5,338. Out-of-pocket expenses varied significantly depending on the treatment received. Out-of-pocket costs were highest for couples undergoing in-vitro fertilization. Couples treated with in-vitro fertilization spent an average of $19,234, compared to an average of $2,623 for intrauterine insemination. Couples receiving only ovulation induction drugs spent an average of $912. For couples undergoing IVF, out-of-pocket expense rose significantly for each additional treatment cycle received, a trend not observed among couples receiving multiple IUI treatments. Couples undergoing a single IVF cycle reported an average out-of-pocket expense of $16,069, while couples undergoing more than 4 treatment cycles reported an average expense of $31,742. Couples with male factor infertility were noticed to have paid on average $9,404 more than those with female factor infertility only. Couples with medical insurance did report slightly lower out-of-pocket expenses, but differences were not great enough to be considered statistically significant. After adjusting for multiple variables, out-of-pocket expense was not found to associated with the chance of achieving a successful pregnancy.