Researchers assess direct out-of-pocket costs for couples undergoing fertility treatment

Published on December 9, 2013 at 2:18 AM · No Comments

From drug therapy to IVF, out-of pocket costs can range from $900 to $19,000 per treatment cycle, report researchers in The Journal of Urology®

Although the demand for infertility treatment is rising, the high cost may deter some couples from seeking care. Researchers from the University of California-San Francisco assessed direct out-of-pocket costs for couples undergoing fertility treatment. Those using medication only had the lowest out-of-pocket expenses at $912, while those using in vitro fertilization (IVF) had the highest at $19,234. The results, published in The Journal of Urology®, will help inform couples who seek infertility care and the physicians who counsel them.

"Urologists are on the front lines of counseling male and female partners about fertility options and almost all patients want to know the cost. To our knowledge no previous group has measured the actual out-of-pocket costs of reproductive care in prospective fashion," explains James F. Smith, MD, MS, Assistant Professor and Director, Male Reproductive Health, at the University of California-San Francisco.

Up to 24% of couples have difficulty conceiving a child, with estimates of the prevalence of infertility varying from 6% to 24%. Between 8% and 18% of men and 12% of women seek infertility care at some point in life. However, many couples who seek infertility care have only partial or no insurance coverage, and the costs may be too burdensome for their household. Even for couples who are receiving fertility care, socioeconomic status may influence the success of fertility treatment. These problems are compounded by the lack of comprehensive infertility insurance coverage in the United States.

Data from the Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technologies indicate that the use of fertility treatments in the United States is increasing each year. However, the United States has one of the lowest rates of IVF use compared to other developed countries, while Australia has the highest IVF use, according to an earlier study. The average cost of an IVF cycle was 6% of annual disposable income in Australia compared to 44% in the United States.

In this study couples were recruited from eight reproductive endocrinology clinics. They were followed for 18 months from the start of treatment and were asked to maintain monthly cost diaries of out-of-pocket expenses, including clinic visits, medication, and miscellaneous expenses such as travel, parking, food, and other expenses related to fertility care. A total of 332 couples completed cost diaries and had data available on treatment and outcomes.

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