By Lauri Berger de Brito
Co-Director, Agency For Surrogacy Solutions

No matter where you are going for your fertility or IVF treatment there`s no avoiding the simple fact that it will cost you money. Often times, travelling abroad will save you money, but for many, it will mean spending even more. Either way there are some things you should consider before taking out your checkbook. Remember, an informed patient is often a happy patient (and hopefully a pregnant one too.)

  1. Shop around. Not all Reproductive Endocrinologists (RE) or fertility clinics are created equal. Some doctors and their support staff have better bedside manners, ones who will keep your spirits up even if your beta numbers are dropping; some clinics have staff who speak more than one language and doctors who are accessible via email or cell phone; some clinics cost less; and others have better statistics. So, before locking into one clinic or RE you should prioritize what is most important to you – cost, experience, bedside manner, location, etc. Also, don`t fall into the trap of going where your friend or an acquaintance got pregnant since this may not be the best choice for you. Your fertility issues may not be the same. Your best path is to set up consults with more than one doctor/clinic and asking lots of questions. Doing your homework upfront and being patient (even though you want to be pregnant yesterday) can save you time, money and heartache in the end.
  2. Don`t be afraid to ask questions. Go beyond the clinic or doctor`s website and Google his or her name on the web. See if others like their experience or if there are chronic problems. You should also determine how many cycles they perform a year. The more they do often increases their expertise and success rate. Check to make sure the laboratory is headed by a full-time, experienced andrologist or embryologist. Again, in many cases the more procedures a clinic perform, the greater the skill level. Find out the cost of the treatment(s) you want. Costs can vary greatly in the same country even between clinics in the same city. And remember, a high price tag does not always guarantee the best treatment. Make sure the physicians, nurses and or coordinators answer all of your questions adequately, don`t; rush you and return you phone calls and emails in a timely manner. Better yet, if you find an RE who is willing to directly communicate with you via email (and not just through their staff), this can be a big plus in helping to alleviate stress during the IVF/DE/GS process.
  3. Ask for discounts. Sometimes clinics are conducting a study or studies that are underwritten by pharmaceutical or research companies and are not heavily promoted. You might qualify for one of them and this can lead to small or even big savings. Some clinics will discount if you pay for procedures and medications in advance. Some clinics offer things like shared cycles on egg donors, or discounts for purchasing multiple cycles in advance. The later (which can be called a `shared risk` cycle) is very much like purchasing an insurance policy – if you need more than one or even two cycles you end up getting a deal or in some cases, a significant monetary refund. If it just takes one try to get pregnant, then you usually have paid more than you needed to — that`s what makes it a `shared risk.` The bottom line is that with the way the economy is right now many clinics are offering discounts, if you just ask. So don`t be shy, speak up! — because if you don`t, most clinics aren`t going to volunteer the information.
  4. Don`t overlook using your health insurance to help offset some costs. First off, get a copy of your policy from your carrier or employer. Unless a procedure is specifically excluded, you might be able to get some reimbursement for your expenses in your home country. If you are leaving the country for treatment, see if they might cover those expenses. It doesn`t hurt to ask, you may be surprised at what they will cover. Also, you may be able to get some medications fully or partially paid for – even if there is fertility exclusion since some drugs are used for multiple purposes. Your policy could include blood work and ultrasounds. Make sure your RE`s office uses the correct codes for billing so you don`t have to spend hours on the phone trying to get coverage. Also, even though a procedure or related expense has been rejected, if you have the time and dedication, you can often call your insurance company and fight for them to cover some of the expenses. Your determination often determines what the insurance company pays for in the end. Take a look at the RESOLVE website (www.resolve.org) for assistance and ideas on approaching your company regarding fertility coverage.
  5. Shop around for your medications. The price of medications can vary between pharmacies and countries. When shopping abroad remember that the name of the medication on the package may be different than the one you are familiar with, but the content is the same. Your RE or the pharmacy will be able to tell you if the drug goes by a different name in other countries. There are also pharmacies that specialize in fertility medications and even though they are smaller independent companies, they may be cheaper than the large chains. You can always ask your clinic`s nurse if she has any recommendations. Also, sometimes your clinic may have meds that other people have not used and donated back to the clinic. So, (and I can`t say this enough) if money is an issue for you (and who doesn`t have money issues when it comes to IVF) then don`t be afraid to open up your mouth and ask about ways you can save money.
  6. Get expert advice. Once again, don`t be afraid to ask for help. Sometimes spending a little more money in the beginning can save you money in the end. There are international fertility consultants whose job it is to help clients make good fertility choices – from sifting through the countries and their laws to finding clinics with good statistics and happy patients. These fertility consulting companies can also help in reviewing your insurance options and helping you ask the right questions.
  7. Take your time. Infertility and treatment is a highly emotional time for most people. It`s common to want to take control and try to fix things fast. But this is a big decision – and probably one of the more important decisions in your lifetime…so take time to research, and talk with your partner (if you have one) about your options and preferences. Don`t race in because you are desperate to have a baby. If you take an extra month or two to make a decision – even though it feels like an eternity – it could very well save you more than time in the long run and bring a baby home to you faster, perhaps less expensively and certainly with less frustration.

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