IVF Cost

Are you trying to get pregnant but have been told you need IVF? Do you have to bear the IVF cost yourselves? Have you been searching for a quick resource that compares the IVF cost around the world? Well now it’s here! Finding a list of the IVF costs worldwide for informed decisions on where you can get cost effective treatment is very difficult – I know I’ve been trying and failed! So I decided to compile one for you. Here are the results – the only up-to-date list of worldwide IVF costs on the internet. This article addresses three areas:

1. The costs that are incurred for any one IVF cycle
2. A comparison of the basic IVF treatment cost across the globe.
3. An estimate of the total basic IVF cost to get pregnant according to age and country based on average success rates.

The first thing you need to understand is how the total cost of an IVF cycle is made up. During any particular cycle the costs will include:

• Initial consultation (can be 6% to 10% of the basic IVF treatment cost).

• Basic IVF Treatment (varies by country as outlined in Table 1) Usually includes doctor’s fees for egg collection and embryo transfer, embryologist’s fees for intro fertilisation, anaesthetics, ultrasound scans, theatre charges.

• Intracytoplasmic sperm injection (can be 28% to 40% of the basic IVF treatment cost) Creation of embryos by direct injection of sperm into egg, procedure used for male infertility but increasingly common in standard IVF.

• Hormonal drugs (can be 20% to 80% of the basic IVF treatment cost) Precise cost will depend on which drugs are prescribed for stimulating the ovaries. A Times Body & Soul survey also found high variation in prices charged by pharmacists.

• Embryo freezing Sometimes included in the basic IVF cost. Other clinics can charge up to 20% of the basic IVF treatment cost, plus around 10% of the basic IVF cost per year for storage and between 20% and 100% of the basic IVF treatment cost for later thawing and transfer.

• Other investigations Immunological therapies: can be upto 50% of the basic IVF treatment cost. Preimplantation genetic screening, to pick the best embryos: can be 55% to 120% of the basic IVF treatment cost. Both procedures are offered by a few clinics, though there is little published evidence that they are effective.

• Regulatory fee (dependant on the country) can be 4% to 5% of the basic IVF treatment cost. Charged separately by some clinics and rolled into the general cost by others.

This IVF cost information was according to The Times, January 10, 2008 – to give an indication of how these will affect the total IVF cost around the world the figures, which originally were for UK clinics, have been converted into percentages of the basic IVF treatment cost, and it has been assumed that the percentages will be similar across the globe. Please note that if you, for example, purchase your homonal drugs in a different country to where you have your IVF treatment then the percentage will not be an accurate reflection of costs. The major extra cost on top of the basic IVF treatment cost that everybody has to bear is the hormonal drugs. The amount of hormonal drugs that are required depend upon your:

• age;
• length of infertility, and
• physical condition of your uterus and endometrium (uterine lining)

Understanding what makes up the IVF cost is important, and a great resource for this, and how to select a clinic can be found here. Bearing in mind what makes up the IVF cost we can now look at the basic IVF treatment cost across the world. It was very difficult to find comparative IVF cost figures from around the world. After much searching I realised that such a resource did not exist. As a start I took some figures from an article in Human Reproductive Update, Vol.8 No.3, 2002, An international survey of the health economics of IVF and ICSI by John A. Collins. The article had determined IVF costs for 26 countries for 2002. Taking an average inflation rate in healthcare expenditure of 3.5% I have used their figures to project these IVF costs forward and give estimates for 2008 and 2009 – these can be seen in Table 1 – all costs have been converted to US$. I then searched the internet and made some personal enquiries to find actual IVF costs now – August 2008. It was not possible to find costs for all 26 countries (although I am still trying!) on the original list from John A. Collins, however I did find the costs for countries that were not on the list. All these costs can be seen on Table 1 – all costs have been converted to US$. To understand the costs that I found there are a few notes that you should bear in mind:

• Some of the costs include medication (hormonal drugs) whilst others do not. If the comments column does not indicate whether medication is included or not then I was unable to ascertain if it was included – I will need to make more enquiries.
• If there is no figure in the “upper cost” column then the results are only based on one clinic. I had no way of knowing if this would be a cheap or an expensive clinic for that country, but it is a cost that can be achieved there.
• If both an upper and lower cost is given then prices for at least two clinics were obtained – again this does not reflect the cheapest and most expensive clinic for that country but the lowest and highest IVF cost that I found.
• Even when the cost of medication is given in the comment column, or included in the cost, it must be noted that this can vary according to age and the infertility problem that you have.

Although currently there are still a lot of gaps in the table please keep checking my IVF cost blog as I intend to continue with this research.

Having found the basic IVF cost you have to realise that this will not be the total cost that you will pay in order to have a successful pregnancy through IVF. IVF success rates depend on a number of factors including:

• age;
• number of embryos replaced, and
• cause of infertility.

The HFEA (Human Fertilisation & Embryology Authority) gives the average success rates from 2005 for each age group as:

• 29.6% for women under 35 years old;
• 23.6% for women aged 35 – 37 years old;
• 18.2% for women aged 38 – 39 years old;
• 10.0% for women aged 40 – 42 years old;
• 3.2% for women aged 43 – 44 years old;
• 0.8% for women aged over 44 years.

Using these figures I have calculated the average total IVF cost for each age group in each country. These can be seen in Table 2.

The chance of a pregnancy through IVF is increased if more embryos are replaced. The more embryos that are replaced the greater the chances of a multiple birth, since each embryo has a chance of developing to full term. Since multiple births is the single greatest risk to health in IVF the HFEA in the UK have imposed restrictions on the number of embryos that can be transferred in IVF to a maximum of two for women under the age of 40 and a maximum of three for women aged 40 or over who are using their own eggs (if you are using donated eggs the maximum is two). In India, however, these restrictions do not apply and six or seven embryos can be replaced at any one cycle, hence increasing the chances of pregnancy but also increasing the risks. To date I do not have details of the legal limits in all of the countries, however if you keep checking my IVF Cost blog I do intend to continue with this research. The cause of infertility is very specific to you. It is not an area which I will address at the moment. Having an estimate of the total IVF cost in each country now puts you in a position to be able to make an informed decision on the best country to focus on for your IVF treatment. India clearly comes out as the cheapest country on IVF cost. India also has the benefit of a vast amount of experience – they were the second country in the world to have a successful pregnancy with IVF, only a couple of month after the UK in 1978. In India many of the doctors have been trained and have practised in the West and are fluent in English. However, if you are from Europe and want to stay closer to home, Hungary (a beautiful country, and so clean. I have had personal contact with one of the clinics there and their communication was excellent) and Latvia (I have never been so I cannot comment) appear very good options. For a truely excellent, must-read book for helping you with the issue of infertility click here.