Infertility
care is most cost effective when delivered by an infertility
specialist. Misconceptions about the cost of infertility
treatment include: 1) insurance never covers infertility
related treatments 2) specialist care is always more
expensive 3) reproductive endocrinologists usually
recommend high tech, expensive treatments as "first
line" therapies.
The
mass media often focuses on infertility treatments
such as in vitro fertilization, intracytoplasmic sperm
injection, preimplantation genetic diagnosis, and
other "high tech" approaches. It is rarely
noted that the majority of patients seeing a reproductive
endocrinologist will become pregnant with other less
expensive treatments.
In
general, approximately, 30% of patients who consult
a specialist will eventually require IVF to achieve
pregnancy. Those who have male factor infertility,
tubal disease, infertility of unknown causes, or who
are older are more likely to require IVF, donor egg,
and associated procedures.
The
most expensive therapies are those that do not work.
A complete evaluation of the male and female is critical
to prescribing the most appropriate treatment. Women
often receive months of Clomid therapy even though
studies clearly demonstrate that pregnancy is most
likely to occur within the first 3 ovulatory cycles.
If male factor is present, and not diagnosed and treated,
treatment of the female will not be successful.
Women
often see a reproductive endocrinologist after having
one or more laparoscopic procedures.The
laparoscopy is a valuable diagnostic tool; however,
an infertility trained microsurgeon can often administer
treatments during the diagnostic laparoscopy, such
as removal of endometrial tissue.
If infertility is the primary consideration, the laparoscopy
is best performed by a reproductive surgeon. This avoids
the necessity of a repeat laparoscopy to treat a previously
diagnosed condition thus reducing cost and patient stress.
Insurance
will often cover diagnostic tests and laparoscopic procedures.
This is highly dependent upon the individual policy
and the state of residence (some states mandate infertility
coverage). The majority of infertility centers have
staff that help patients determine exactly what their
plans will cover before treatment begins. A copy of
the actual policy is always helpful as specific exclusions
are defined.
When
more expensive therapies, such as IVF, are required
many centers offer programs to help with financing.
Some also offer "Shared Risk Programs". These
programs vary among different centers and the details
should be carefully reviewed.
