Friday, July 23, 2010

Should IVF be affordable for all?

Don't know how many of you saw this recent article in Newsweek.  A friend of mine shared it with me, and I think it raises several interesting questions and that it was worth sharing here.

Although I have often thought about the high cost of IVF in relation to my own personal situation, I had never really thought of some of the other things discussed in this article.  For example, if supply exceeds demand in the field of reproductive endocrinology, as one of the physicians quoted in the article says, why does IVF continue to be so expensive?  Normal market forces would usually dictate a decrease in cost for any service where supply exceeds demand.  (At least, that is my vague recollection from the single college marketing course I took.)

Additionally, I had never thought of the idea that the cost-prohibitive nature of IVF for people with middle and lower incomes acts as a sort of "economic natural selection."  Hmm.

I also think there may be some misinformation in this article, such as when one doctor is quoted as saying that "up to 80 percent of infertility cases are caused simply by increasing maternal age."  Really?  Is the number that high?  And even when age is a factor, how can we know that it is the only factor affecting fertility and that the woman wouldn't have had trouble TTC even if she'd started earlier?  Quite a number of women in their 20s have no diagnosable reason for their infertility and are "unexplained."

I also think that the article gives short shrift to male infertility, which is a common reason why IVF is recommended.

Your thoughts?


  1. I would imagine that the high cost despite market conditions is due to the same reason that Advil in the hospital costs $12 a pill... health care is a racket.

  2. I agree. I think the statistics in this article are somewhat suspect. Maternal age seems to be the big buzzword in infertility reports lately, so reporters are glomming on to that and running with it. Many of us who are older have been dealing with medical conditions since a very young age which caused infertility, and have been trying to conceive since well before we'd have been classified as being of "advanced age."

    The economic natural selection part of that article really got me riled up!!

  3. Oh, does this ever piss me off! 80% of infertility is due to "advanced maternal age?" And then he goes on to cite statistics about TEENAGERS' rates of infertility? Come on! Talk about blaming women. Either we're too young or too old, apparently. I'm going to have to stop now or I will get incoherent.

  4. First, the RE that says it's hard to classify IF as a disease doesn't sound very empathetic to the patients he serves.

    Second, I think the costs have stayed so high because not many RE's have taken advantage of the low-cost/high-volume business model. That business model does NOT make the RE a "WalMart," and that comment pissed me off. When more REs do take that approach, I think the market will slowly even itself out. Slowly.

    Third, 93% of all statistics are made up. ;) The stuff cited in this appeared to be one doctor's opinion - nothing formal was cited. I found the context ridiculous.

    Fourth, the Darwinism approach is SO wrong.

    Fifth, I want to shoot the guy who said "Really... is a baby a want or a need?" In his balls. And I hope he's young and hasn't tried to build a family yet.

  5. Yea, it is amazing the difference in costs of IVF from country to country. I have read about ladies stationed in Japan that can do IVF for $5,000 or less.

    I hope that someday the costs even out so everyone can afford it. I can only afford it because I started planning awhile ago just in case...


  6. I didn't read the article yet, but my friend and I were discussing it this morning.
    I work at a small business. The insurance provided is not great to begin with, and every year the rates increase. Of course they do not cover infertility, although we live in a soft-mandate state (useless). One of my coworkers did was actually an IUI cycle that was going so well they recommended converting to IVF (too many follicles to continue with IUI). They are young and had good fert, good embryo growth, etc. They transferred two embryos and wound up pregnant with twins. Fast forward to those twins being born out of state at 29 weeks. So um, yeah, they've been in a NICU out of state for almost two months (although one twin did come home last week, the other is still doing poorly). Our manager mentioned that this will end up causing us to raise rates again and probably end up going with a different insurance company because of the cost to our group plan. Imagine if the IVF had just been covered in the beginning, and a single embryo transfer had been done because the pressure would not have been on to transfer two blasts to a young woman (an SET would have been recommended if REs followed guidelines but we all know there are myriad reasons they do not). At any rate, just an interesting issue all around. I'm posting this anonymously because I don't want to discuss too much information that could be linked back to me since it's about a coworker.


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