Dealing with infertility is difficult enough, but when it comes time to look at the costs of fertility treatment, it can feel really unfair. After trying to get pregnant without success, many patients turn to artificial insemination or intrauterine insemination (IUI) before they attempt the bigger stuff, like in vitro fertilization (IVF). But how much does artificial insemination or IUI cost? The costs aren't exactly low.
In the U.S., artificial insemination or IUI can run you between $300 and $1000, reported Advanced Fertility, and sometimes much higher, depending on the state, medications you take, and the fertility clinic. You're especially likely to shell out more if you need to use donor sperm, and unfortunately, IUI has only a 10 to 20 percent success rate, as Today's Parent reported. It gets worse — Alice Crisci, founder of Fertile Action, tells Romper that for some women, their insurance dictates that they may be required to undergo six unnecessary IUI procedures before insurance will agree to cover the costs of the IVF they actually need. That means that many women and couples who begin with IUI will wind up paying for far costlier courses of IVF.
Couples who undergo an IVF procedure spent on average $15,435 more than those who underwent IUI, according to a study by The American Urological Association. For many patients — especially those whose fertility was impacted by cancer, endometriosis, or polycystic ovarian syndrome — the healthcare bills fly in like an endless stream of paper airplanes. Never stopping, and never going away.
Crisci, who also founded the app MedAnswers, explains her problem with the state of IUI and IVF coverage this way:
"My biggest complaint about IUI is that most of the time, it’s not clinically indicated. If couples know they’re fertile, there’s no reason not to go that route. But if you’re infertile, and your insurance dictates you have to endure six IUIs in order to access any IVF coverage, then you’re simply wasting time. For the states that have those mandates, I think it's an unethical law."
Welcome to Fertility Coverage Nightmares, 101.
"As an advocate, there’s just so many antiquated laws on the books currently with insurance," says Crisci. When I ask if she sees positive change ahead, she sighs. "Not with the law."
In fact, she doesn't see the public sector solving the problem of the high costs of fertility treatment anytime soon. However, she does see an opportunity for companies — especially large ones — to roll fertility procedures into their normal coverage without bumping up premiums.
"There have been ample economic models that have proven that if you cover IVF, people choose single embryo transfers more often, which leads to fewer multiples, which leads to better neonatal and maternal health outcomes, which reduces overall cost," Crisci explains.
For these larger companies, covering fertility procedures will actually save them money in the long run.
For mid-tier companies, however, simply covering infertility is generally cost-prohibitive. Instead, Crisci advocates for a cash benefit. "A lot of [mid-tier] companies provide an adoption credit — a cash amount to offset the cost of adoption. So for fertility treatments, they simply could offer a $20,000 cash reimbursement when you go through IVF, even going as high as $40,000 so people can afford more than one cycle," she explains.
What every parent struggling to conceive should know is that the thousands you spend on IVF treatments in no way guarantees you a baby. What it guarantees is a chance at a baby — and many couples go through multiple cycles to get pregnant.
Crisci doesn't think we'll have fertility coverage on a state-by-state basis anytime soon. Rather, she sees the problem being solved through the private sector, which she hopes will put pressure on the military and government employers to follow suit.
Whatever the cost of fertility treatments in your state, artificial insemination and IUI may be required — though for many infertile couples, they're simply not a viable path to parenthood. For couples who need only a little boost, however, a few thousand dollars spent for intrauterine insemination might well lead to the miracle they're hoping for. If not, there's IVF. When it comes to covering those heavy costs, Crisci encourages couples to start a Go Fund Me and look into non-profit aid.
MedAnswers.com, designed for "patients tired ... of sifting through iffy answers on patient forums," connects infertility patients with experts on demand. It's a quick and easy way to get answers to pressing questions. If you're struggling with infertility, you're not alone. And don't be afraid to ask for help.