Going through fertility treatments can be a daunting process. Here’s what to expect before starting IVF.
Learning that you’ll have to use IVF to start a family can be an overwhelming feeling. In our last installment, I went over a few basics about starting the process. In part 2, I’ll go over a little bit more of what I wish I knew before starting IVF.
Your insurance may cover some (or all) of the costs
One of my biggest concerns about having to go through IVF was the expense. I’d heard estimates that a single round could cost as much as $25,000-$30,000, and I definitely didn’t have that kind of money just laying around.
Fortunately, New York state has a specific mandate in place regarding fertility treatments and insurance coverage (at the time of this writing, anyway). All large group health plans are required to cover up to three cycles of IVF and medically necessary fertility procedures including egg freezing. If you’ve got health insurance through an employer, chances are you won’t have to foot your entire IVF bill.
Some insurances offer even better coverage that what’s mandated. Checking into your policy may reveal that you’re entitled to more than 3 rounds, or in some cases, unlimited coverage.
That being said, you’ll still probably have to pay out of pocket for certain things. Any medication I needed was covered, but the co-pays ran us around $250 per round. My insurance didn’t cover anesthesia for the egg retrievals, so that cost us $600 each time. And usually, elective procedures like preimplantation genetic testing (or PGT for short — a process that tests your embryos for genetic abnormalities) isn’t covered, so you’ll have to cover that entire expense. PGT cost us between $1200-$2800 per round, depending on how many embryos we had. Still, $3650 is a much easier bill to pay than $30,000.
For more information about New York State’s mandated fertility coverage, click here.
IVF is a waiting game
In part one, I highlighted the fact that both you and your partner will have to go through some testing before you can even begin injections. Those tests can take anywhere from a few weeks to a few months, depending on certain factors.
Preparing for a round can take some time too, and that’s because everything is based on your cycle. You’ll begin ovarian stimulation somewhere around the start of your cycle, usually a few days into your period. So if you’ve been given the green light but your next period is two weeks away, you’ll have to wait until then. In some cases, you may have to wait until the next period after that — many reproductive endocrinologists will want to regulate your hormones with a birth control or other medications first.
If you have to go through multiple rounds of IVF, you’ll have some time to wait in between. Most doctors recommend waiting at least one full cycle before starting any medications again.
I mentioned PGT above, and I’ll get into more details about it below. But if you decide to do any genetic testing on your embryos, that will eat up even more time — it takes around 2 weeks or so to get the results back.
Timing is everything with IVF, so expect that you’ll be sitting back and waiting for that time to be right.
You can genetically test your embryos…
Yep — that’s the PGT I mentioned. There’s several different kinds of PGT:
- PGT-A (or preimplantation genetic testing for aneuploidy) screens your embryos for abnormal numbers of chromosomes, which could result in conditions like Down Syndrome or Turner Syndrome. PGT-A is generally recommended for those who are advanced in maternal age, couples who’ve had recurrent miscarriages, or couples who’ve had previous unsuccessful IVF attempts.
- PGT-M (or preimplantation genetic testing for monogenetic disorders) tests embryos for specific inherited genetic conditions, like cystic fibrosis or sickle cell anemia. PGT-M is recommended for couples where both partners are carriers for the same condition, or have a family history of a genetic disorder.
- PGT-SR (or preimplantation genetic testing for structural rearrangements) tests embryos for translocations or inversions in chromosomes. PGT-SR is recommended for couples who have a known structural rearrangement in their chromosomes and may pass it on to their offspring.
There are some minor risks to the procedure, which includes damage to the embryo and misdiagnosis. All in all, PGT is considered very safe.
Some clinics will require patients to genetically test their embryos, and some won’t. It’s completely up to you what route you go, so keep that in mind as you search for a fertility clinic.
If you decide to undergo PGT, your embryos will be frozen until you’re ready to transfer them.
…but that doesn’t guarantee success
Even though I tested all of my embryos, I still had three failed IVF attempts that didn’t end in a pregnancy. PGT won’t pick up every single chromosomal abnormality, so there’s a chance that an unknown genetic issue caused those attempts to fail. There’s other potential reasons too, some of which we’ll probably never know. But regardless — testing your embryos won’t guarantee a pregnancy (but it will definitely help your chances).
There’s still plenty more to cover, so stay tuned for Part 3 of this series.