It is more expensive to be infertile in America than any other developed nation. Today, the costs of an IVF cycle have surpassed $23,000 per patient, dramatically higher than $12,400 figure often quoted to patients by clinics and the industry societies. The reality, according to our data, is that the average IVF patient will cycle multiple times (2.3 - 2.7x), which brings the actual cost closer to $50,000. One article published in JAMA in 2015 estimated successful IVF patients spent on average $60,000 or more across three cycles.
There are multiple cost components to an IVF cycle and they add up quickly. The basic monitoring and procedures themselves often run around $10,000 - $12,000. The cost of medications typically range from $5,000 - $7,000, though deals can be found by purchasing medication abroad. The decision to do PGS carries a $5,000 price tag, and there is healthy debate when that test is most appropriate. Even procedures like ICSI cost $1,000 - $3,000 and, for the majority of patients, its use probably isn't necessary.
Women who elect to do egg freezing deal with the same reality. Their per-cycle treatment will typically cost around $16,000 and, as with IVF patients, they'll often come back for a second cycle, bringing the real costs closer to $30,000. And that's not including years of paying storage fees.
To be certain, the costs are not equal in every part of America. Cities like Chicago and San Francisco are conspicuously more expensive because a single clinic holds 30 - 50% market share and patients have less choice. Conversely, costs are lower in Boston where multiple large hospitals (MGH, Brigham & Womens, etc.) compete with a number of aggressive private practices (Boston IVF, IVF New Engalnd) to offer patients more choice.
For gay couples pursuing surrogacy, the costs typically fall between $75,000 - $200,000. That's because the line items include the cost of an egg donor, a surrogate, medical and insurance expenses, plus agency costs, and that of an attorney. Not surprisingly, many gay couples hope to have twins in the process to help complete their family in a single cycle.
As for lesbian couples, and single mothers, the costs can vary tremendously. While the costs of donor sperm are typically $1,000 - $5,000, the major variable deals in whether one progresses from IUI ($500 - $2,500 per cycle) to IVF ($23,000 per cycle). Many people enter this process thinking it should be reasonably quick and simple, only to discover they are not as fertile as they presumed, making things more complex and more costly.
According to our FertilityIQ employment report, less than 27% of Americans have their fertility treatment paid for by insurance, so consumers need to educate themselves on the value of different treatment options (is ICSI worth the extra $1,000 - $3,000?) and where money can be reasonably saved (e.g. applying to the New York Demonstration Fund if you are a state resident).
Today nearly 50% of U.S. clinics offer patients the chance to buy cycles in-bulk for a discount (known as a package) or with a refund feature (known as "shared risk"). We have mixed opinions on these programs but typically believe they are offered to patients who are otherwise good candidates, succeed early in treatment (2/3 of refund patients succeed in the first cycle, see below) and thus these customers dramatically overpay for results they would have gotten anyhow. What's more, the list of medical exclusions is enormous (medication, PGS, pre-treatment testing) and as a result most patients spend 25 - 50% beyond the quoted "sticker price".
That said, patient levels of satisfaction with these programs are high, though we personally believe irrationally so. If you are being offered access to such a program, consider why, the success rates (at which cycle) others like you in the program enjoyed, and the real cash outlay you're likely to incur.