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It contains information about Infertility Solutions, the science behind various infertility issues (sperm problems, ICSI, assisted hatching, IUIs, tubal occlusion, ovulation induction, etc.) and information about how Dr. Rose approaches infertility and IVF. There frequently is more than one correct way to do things in infertility. Dr. Rose's approaches are based on his understanding of reproductive physiology together with his personal experiences with infertility. These web pages try to show the kind of thinking that goes into helping patients decide on their most appropriate next directions.

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The High Cost of IVF

by Bruce Rose

Usually when people think about the cost of IVF, they focus on the specific IVF procedures such as taking eggs out, fertilizing eggs, and growing embryos in the laboratory. However, research in the medical literature shows that about half the cost of an IVF cycle is the cost of injectible medications and associated monitoring. In some counties were IVF costs are controlled, medications may constitute a higher proportion of the total costs. Injectible medications used in IVF cycles include, Lupron, Antegon, Ganirelex, Follistim, Braville, Menopur, and Gonal F.

We looked closely at 20 IVF patients from 2012 to see exactly how much medication was taken during the course of their IVF cycle. This may differ from what was prescribed because some medications may have not been used or some may have been obtained by the patients from other sources (such as left over medications from friends). Our assessment did not include the cost of medications that was purchased and not used.

We then priced the cost of these medications in two ways. We called the primary retail pharmacies in the United States (CVS, Walgreens, Rite Aid) to determine their charges for the above medications. We also called seven on-line fertility pharmacies that we either recommended to patients or were aware that our patients were using. Note that medication prices change frequently and the lowest prices we obtained from these dispensers of fertility medications may be different today.

The median cost (using the middle charge for each medication) for an IVF cycle for patients who purchased their medications from the above retail pharmacies was $5747. The median charge for the same medications from on-line fertility pharmacies was $3292- a saving of about $1500.

If a patient broke up her medication order (for example purchased Follistim from one mail-order pharmacy, hCG from another pharmacy, and Lupron from a third pharmacy), she could reduce her bill to $2747; that is, she could save another $500.

The most disturbing issue that arose from this study was the cost incurred by patients with a poor or unexpected response to gonadotropins. Their cost of medications was much higher than the cost incurred by the patients with an average medication requirement. For example, using the higher retail pharmacy median charges, the three most expensive medication users (out of 20) would have paid $15,974, $12,758, and $9,972 for their medications.

This is one of the reasons that we focus on Mini-stim IVF and IVM. Our ovulation inductions for these procedures are less variable than for IVF. The medication charges are 80 to 90% less and the variation in cost between different patients is neglible.