IVF Refund Program

The financial requirements of IVF treatment rank highly among the concerns of couples contemplating fertility therapy. The IVF Refund Financial Program has been developed to reduce a couple’s financial anxieties by fixing the cost involved in undergoing multiple IVF treatments and limiting the amount of money at risk should IVF fail to produce a live birth. In the case of such failure, the specified monies to be refunded preserve the couple’s resources for other family-building options.

The IVF Refund Program is an alternative to traditional fee-for-service payment and is exclusively designed for couples who have no insurance coverage for IVF. While couples must also meet certain eligibility requirements, we project that at least two thirds of couples who seek IVF treatment at our center will qualify for this financial program after they have completed their required pre-cycle testing. Couples who choose this option and conceive in their first treatment cycle will end up paying much higher costs than in the fee-for-service payment option, but couples who require more than one fresh IVF cycle to conceive will save money, in addition to having the indemnity against failure of the treatment. It is important to understand that we are not guaranteeing the success of the treatment but we are limiting the financial risk for couples for whom a live birth is not achieved.

How it works

Qualified couples receive up to three fresh IVF treatment cycles and up to three cryopreservation IVF (frozen embryo) cycles over a 24 month period for a global fee that varies slightly according to the age of the female partner (see Table I). This “contract” is fulfilled when a live birth occurs or when the time period ends.

Table 1:  The IVF Refund Program Fee provides for up to 3 fresh cycles with ICSI, Assisted Hatching, embryo cryopreservation and up to 3 frozen IVF cycles

Table 2.  Standard Fee-for-Service Pricing

Advantages of this IVF Refund Program

• Costs are set at the time the contract is purchased for the duration of the payment contract
• Limiting the amount of money at risk should IVF ultimately fail
• Retaining some of your financial resources for other family building options (such as adoption)
• Conditional cancellation option is offered in this plan (see “Cancellation”)

Disadvantages of this IVF Refund Program

• Patients who succeed after the first treatment cycle or first frozen embryo cycle will have paid more than the standard fee for service
• Certain costs still must be paid ( see “services not included”) for each fresh or frozen treatment cycle
• Requires a personal commitment/determination to complete all of the fresh and frozen IVF treatments within the 24 month contract period
• Some women will not produce an adequate number of quality fresh embryos for both a fresh IVF cycle and a cryopreservation IVF cycle; therefore, they will not have as many opportunities to conceive under the plan. The refund is still given if three fresh cycles fail to produce a live birth

Who Qualifies?

Women must not have reached their 38th birthday before beginning the first stimulation cycle and must be reasonably able to complete the program in the 24 month time limit. Women must complete the medically appropriate pre-cycle testing and be proven to have normal ovarian reserve, a normal uterus and uterine cavity, no hydrosalpinx, and must not have previously begun more than two IVF cycles prior to enrollment in the IVF Refund Program at NHCRM. Women with chronic illness (such as diabetes, autoimmune diseases, etc.) must have medical clearance for becoming pregnant from their physician prior to enrollment. Men must at least be able to produce adequate sperm for ICSI , even if surgical sperm retrieval is necessary. While not every fresh IVF cycle can be expected to result in surplus embryos of adequate quality for cryopreservation, couples in this program must agree to have their surplus eligible embryos from their fresh IVF cycles cryopreserved for future use. Couples must also agree to transfer at least two embryos per cycle. IVF cycles in which PGD is planned are not eligible for this financial program. All pre-cycle testing must have been completed no earlier than 6 months prior to enrollment.

*women over age 37 or women with abnormal ovarian reserve may still be eligible if they are planning to use an egg donor under the age of 35 with normal ovarian reserve: all other qualification criteria still applies.

1. must have never had a day three FSH level over 9.9 mIU/ml, or a failed clomiphene challenge test
2. patients diagnosed with hydrosalpinges must have them surgically removed prior to determining eligibility
3. complete medical records of all prior IVF treatments must be received and reviewed prior to determining eligibility
4. men diagnosed with sperm production deficiency qualify only if they agree to use donor sperm in the event of failure to collect adequate sperm on the day of egg retrieval

IVF Services Included in the IVF Refund Program

1. Monitoring of IVF Ovarian Stimulation (all ultrasounds , estradiol and progesterone blood tests, and physician services for monitoring)
2. Oocyte retrieval and embryo transfer procedures
3. IVF facility fees for oocyte retrievals and embryo transfers
4. IVF laboratory services including

• identification of eggs
• semen processing for insemination of the eggs
• fertilization of the eggs
• ICSI, when needed
• culture of embryos for up to 6 days after egg retrieval
• embryo cryopreservation and storage until a live birth occurs (after a live birth occurs, standard fees for cryo-storage and future use of frozen embryos are applied)
• assisted hatching (AH) when needed
• embryo transfer laboratory services for fresh or cryopreserved embryos

5. Two quantitative HCG blood tests to diagnose pregnancy at the end of the treatment cycle.

Services NOT included in the IVF Refund Program

1. IVF pre-cycle screening tests and office visits
2. Medications and their administration (injections)
3. Nursing visits for teaching of the administration of medications for IVF
4. All non-IVF surgical procedures (laparoscopy, myomectomy, surgical procedures on fallopian tubes and ovaries, hysteroscopy, D&C, etc. ( These procedures are frequently of a general gynecologic or obstetric nature, and are often covered by your existing health insurance)
5. Costs related to the use of a known or anonymous egg donor such as recruitment, all required donor screening fees (medical, legal, and psychological), and donor compensation fees or donor agency fees
6. Costs of obtaining donor sperm, or costs for the surgical sperm retrieval when necessary.
7. Ultrasound monitoring of early pregnancy
8. Any medical services provided for obstetrical care, or for complications related to the IVF process such as treatment of ovarian hyperstimulation syndrome, ectopic pregnancy, miscarriage, or other pregnancy complications
9. Storage of cryopreserved embryos that may still remain after a live birth occurs. Standard storage fees and IVF treatment fees for future attempts at conceiving will be assessed for cryopreserved embryos once a birth has occurred.
10. CBC/UA required pre-op for anesthesia
11. Anesthesia Services

Cancellation of the IVF Refund financial program may be initiated by the couple or by NHCRM at any time without cause. If cancellation is initiated by NHCRM at any time, a refund according to age (see Table I) is paid. Cancellations initiated by the patient will result in reverting to a fee for service payment schedule for treatment services already rendered; only any unused balance remaining at the time of cancellation will be refunded. No balance will be due, however, if the ‘fee for service equivalent’ amount for services already received is greater than that already paid in the contract.

Patients are expected to

• closely follow all of the physician’s instructions and to tightly adhere to their medication protocols both during IVF treatment and during their pregnancy until medically released from our care
• have proper medical obstetrical care with their physician immediately after being released from our care and throughout their IVF pregnancy.

Failure to do so may disqualify a patient from the financial discounts/refunds in this plan.