Madelin Lopez, a 40-year old woman from New Jersey was told by her gynecologist that in vitro fertilization (IVF) was the only way she would be able to conceive. But Lopez is on the government’s public health insurance, so she and her husband had to cover the IVF procedure out of pocket. The cost of their dream to conceive would lead to heavy credit card debt, various loans and emotional toll.
According to the CDC Infertility rates have risen to 13.4% affecting approximately 9.7 million women of childbearing age in the U.S. leading to a rise in fertility services like in vitro fertilization, a costly option with no guarantees.
IVF costs can vary but are anywhere between $10,000-$20,000 a cycle. Yet it does not necessarily guarantee pregnancy, with 65.3% of patients achieving pregnancy after 6 or more cycles. Meaning that on average it can cost approximately $60,000 or more.
When the Alabama supreme court threatened IVF by claiming that embryos were people, President elect Trump spoke in support of IVF access. During Trump’s campaign trail he stated that once elected he would have the U.S government or mandate that insurance companies pay for all costs associated with IVF. A nationwide policy would alleviate the significant burden IVF has on the average American struggling with infertility, but nothing is known yet about Trump’s plan.
There are already some states that have acknowledged the financial toll of IVF and have mandates in place. State mandated IVF coverage requires large group employers to offer fertility benefits, but employers who are self-insured, have less than 50 employees or are religiously affiliated can be exempt. Currently 13 states such as: Arkansas, Maryland, New York, Rhode Island, Massachusetts and so on offer IVF coverage.
“There's certain states that are currently mandated, which is amazing, but it's hard to make it a federal rule. Policies like these are hard to say at a national level. I would love for it to be at the national level, but I don't think it’ll be anytime soon.” says Dr. Roohi Jeelani, a fertility doctor at the Kindbody Chicago fertility clinic.
Although one doesn’t plan for infertility, taking some preemptive steps like investing in insurance, making sure you have an employer with fertility benefits, taking fertility preserving measures, and starting family planning early can ensure a smoother pregnancy journey.
IVF without insurance coverage can add up quickly
Lopez’s IVF journey started in 2020 at a fertility clinic in downtown New Jersey, where they offered her a package of 3 cycles for $25,000.
An IVF cycle involves retrieving eggs from the ovaries and manually fertilizing them in a lab, after which the fertilized egg is implanted inside the uterus.
Lopez and her husband decided it was worth it to start their family, so they got a loan, used their savings and borrowed money from family to cover their costs.
“I thought the $25,000 package included everything.” says Madelin Lopez “But It was just the medications that were killing me, just one injection cost $1800.”
In the first stage of an IVF cycle there are a series of injections that a person must undergo in order to stimulate the production of multiple eggs. During Lopez’s first cycle she wasted $8,000 on injections and an additional $5,000 on lab testing.
As of 2024, Lopez has undergone 3 IVF cycles and has not been able to get pregnant. She still has a $12,000 loan to repay, a $5,000 debt on a credit card, $8,000 on another, and owes $10,000 to her mother in law.
Private Insurance coverage can pay off long term
Lakia Holmes, an IVF patient and advocate was told at 38 years old, that she had a blocked fallopian tube and the probability of conceiving naturally was 2%. Leaving her with no choice but to do IVF if she wished to have a biological child.
“I had just heard of all of the horror stories about how much it would cost, and the tens and thousands of dollars, and people having to take out loans and stuff to pay for the cost.” said Holmes.
Holmes works full time at Warner Bros. Discovery and found out she had IVF coverage through Progyny, a third-party insurance company that offers fertility benefits.
For Holmes second and third egg retrievals, her insurance covered a large part of the procedures and she was only responsible for her deductible of $4,000.
“I was very fortunate that I didn't have to go through multiple rounds before getting pregnant. Because I know a family that went through like 11 rounds before they got pregnant. And that comes at a cost too.” says Holmes
Your job’s benefits can help ease the financial burden
Jasmin J. a Floridian woman in a same sex relationship knew that IVF was the route they would take, so finding a job with good fertility coverage was essential in her search.
If you have a job with no fertility benefits, consider switching to a job that does offer fertility benefits, or consider investing in a higher premium with better fertility benefits that will pay off in the long term. Look into your insurance policy, find out your deductibles, the co-pay costs, doctors in network and more.
Figure out if you can use other employer benefits like an HSA (health savings account) or FSA (flexible spending account) to alleviate the cost. Additionally consider relocating to a state that does have IVF mandated coverage.
Starting young can lead to a higher success rate
A big factor of IVF success rates is age, the younger you start, the higher your chances of getting pregnant. Dr. Jeemani says “As soon as we hear the magic number 35, it's the magic cliff where things fall. It's not necessarily the quantity of eggs that drops, but it's the quality.”
Egg quality can influence miscarriage and live birth rates. Alternative fertility preserving procedures like egg freezing can also extend time for decision making. Originally Holmes had been looking into egg freezing, but her insurance did not fully cover it. The insurance covered lab tests, medication and the doctor’s visits, but Holmes had to pay $8600 for the egg retrieval procedure itself.
There are 11 states that in addition to IVF coverage also have preserving fertility coverage states like Connecticut, Delaware, Maryland and more.
Certain IVF clinics also have a an age limit cutoff of 42-45 extensive research has shown that advanced maternal age can significantly increase the risk of preterm delivery, preeclampsia and even mortality.