IVF and Infertility should it be covered by your health care provider ?

Kellie - posted on 12/03/2011

l don't think you can just say she must have waited to long. l know a person that was 23 and needed ivf. l know a women who had her first child naturally at 46. What if you don't marry in your early 20's. Fertility seems to be luck of the draw. l was 28 when l startd ivf. This was the same year l got married. Life in general is not that black and white. 30% of couples that have fertiliy problem, are unexplained. Like I have said before. Intil you need ivf you have no idea.

Rebecca - posted on 12/03/2011

Centain, I don't think you really have a good grasp of fertility (or infertility for that matter). Declining fertility (meaning the odds of getting pregnant in one month) isn't the same as infertility. Having a lower monthly likelihood of conceiving isn't the same as being infertile. All infertility is due to medical reasons. You also don't seem to really understand the supposed "health risks" of conceiving in your 30s vs. your 20s (or your teens as in your case). Even at age 40, the risk of having a baby with Downs' Syndrome (or any other chromosonal abnormality) is about 1%. Hardly a earth-shatteringly-high risk. And that's what prenatal testing is for anyway. I only know one person who conceived in her late teens and one who conceived in her early twenties. The remainder of the women I know conceived in their mid to late 30s and had little to no problems getting pregnant (myself excluded) and all of them had healthy kids.

Sylvia - posted on 12/03/2011

So basically you're saying that anyone who's not married and ready to start having kids by age 25 is just being short-sighted and selfish? WOW. I don't even know what to say to that. Except, I know people who got married really young (

Sherri - posted on 12/02/2011

Not maybe more ideal but definitely people are getting married later in life now and so maternal age is therefore higher when many are now having children. You can't say just because you didn't meet the right person and didn't get married till you were 30-35 that you shouldn't have children.

Heck I was married at 25 had my first two kids at 25 and 26 and then didn't have my 3rd till I was 34 and I am now 39 pregnant with #4. It is no more risky or less ideal at my age now then it was when I had my first almost 15yrs ago. Oh and it is the same marriage the same dad for all my kids.

Centain - posted on 12/02/2011

Maybe so, but there are also alot of situations where the woman has alot of trouble conveiving at age 35, whereas perhaps at age 25 or even 30, there would be no problem.
There are also many health risks to the baby with increasing maternal age, for example downs syndrome. So many people are under the impression that 30 plus is the normal and healthiest biological age to bear children and take in for granted that it will happen for them when they are ready. Its just not true. I know thats not a politically correct thing to say, but thats the reality. Why is 35 so much more ideal than 25 anyway? I dont see why it would be.

Sherri - posted on 12/02/2011

35 is 100% reasonably healthy age to conceive and give birth. Also biologically it is also. So I disagree with you that just because they decided to wait a few years that automatically makes them unsuitable for gov't paid for IVF. That is simply a ludacris way of looking at it and honestly quite selfish as well.

Centain - posted on 12/02/2011

Yes it happened to my parents. I am adopted because the IVF wasnt a sucess.
Im sure 35 sounds like a reasonably healthy age to conceive and give birth, and im not saying it isnt. But purely biologically speaking, it is not. Women's most fertile years are between 16 and 25, although I realise it may not be a great age to become a parent for alot of women due to many other factors.
I think if you know having a family is important to you, you wouldnt be waiting until you were 30, to start thinking about it. Alot of young women just think they'll be right and will be able to have a baby later on, but unfortunately not everyones that lucky.

Sylvia - posted on 12/02/2011

Centain, not to be rude, but are you seriously saying that someone who met her husband/partner at 30, got married at 32, started trying to conceive at 33, and is still not pregnant at 35 is SOL because her infertility is her own fault? I'm guessing you don't actually know anyone that this has happened to?

(That's not me, btw: I was married at 23 and TTC at 24, and my infertility is strictly medical. But lots and lots of women need help getting pregnant for reasons other than "Meh, I'm having too much fun making money right now, I'll have kids when I'm 40!" and it irritates me when people assume that infertile women fall into just 2 categories: those who deserve help and those who don't because "it's their own fault".)

Centain - posted on 12/02/2011

Alot of the time I would not say infertility is a medical problem, if the reason for the infertility is simply waiting too long to start a family. In that case, there is nothing medically wrong with you, its that you chose to wait, and missed the boat.
Also, for those who save parenting for later, most of them are doing so for a reason, primarily financial security. So you would assume that these parents would have saved and planned for these costs, so In that case I do not think it should be government funded.
However, if the treatment is needed for a medical reason that is preventing you from conceiving naturally, such as polycystic ovarian syndrome, then yes you should be subsidised.

Kellie - posted on 11/29/2011

All of ivf should be covered 100 %. Intil you need something like ivf. You just don't understand. People that say it should not be covered are sitting in there house and have there children. That makes me angry. When all you have ever wanted is a child and you need ivf. You would wish it was covered. You ask any person that has had to go through it. They all would wish it was covered. l know that is is like. l am on my 9th cycle. Also putting a limit on the amount of trys is hard. l took 7 cycles to have my twins. Yet a friend of mine got pregnant on her first cycle. How would you feel if you were in a room with say 20 other women. All had no children. Someone walked in and picked out 7 women and said you lot can have children and the other 13 can't. You would feel angry and not except it. That is how people that have to go through ivf feel. People that have children easy don;t get it.

Leyla - posted on 11/29/2011

i don't think the procedures should be covered but the process to discover the problems should be!!! infertility issues can also have lasting whole body and health effects.

Rosie - posted on 11/29/2011

i think that it should be covered, up to a certain number of tries. how many, i don't know...

Angela - posted on 11/16/2011

only funny Kellie because how many think so little that one must just save like they would for a car or even a home.
I too was lucky or better said treated with equality to a medical problem... 100% covered.

Kellie - posted on 11/16/2011

l don't understand, saying just cut back and save the money if you want it. The point that is being over looked by some is, just doing ivf does not meet you are going to have a baby. A few years ago it was a public hoilday and l was due for a ivf related blood test. So l had to drive a 1 1/2 to get to. When l was waiting l was talking to a lady that had been doing ivf for over 10 years. She had to sell her home , had old cars and no money in the bank and still no children. She was on her last cycle. l still think of her often. People that have children easy just don't understand. l would not have a home loan if it was'nt for ivf. But l am one of the lucky ones. ivf should be 100% covered.

Angela - posted on 11/16/2011

@ Susanne, I am not sure what post you are referencing to cost but I looked up those cost via the NHS. In addition it was well spelled out on various post what the NHS does and does not cover. It does vary. If you or anyone cares to look it up. Google,, IVF NHS, NICE. In some parts of the UK you are on extensive wait list to boot. Not everyone has that kind of time and some are left to lotteries. However I am happy the NHS does cover treatment for infertility equally amongst it's citizens as best as it can afford to.

I also want to point out we are not just talking about the NHS, IVF but all infertility treatments to be covered by all health care providers due to a medical problem.

I am very happy for you that you can save up for a home and baby via infertility treatments but it is not reality for most. I find it very outstanding you could pay full cash for your home and not have to take a loan for a home. I can say most people not to matter where they live if they buy a home, they pay a down payment and then must carry a loan. You obviously are not most...

In fact I would like to poll how many on here reading this paid cash for their home in full, with out any help but to just save.

Many point were made on many post.

One was that why should a person have to give up a home, auto, etc to have a child because of a medical problem.

Susanne - posted on 11/16/2011

Angela IVF in the UK does not cost £20,000 also the NHS only pays for one treatment after that you pay for it yourself. Also even if it was £20,000 yes i could afford to do it, because if i wanted a baby that desperately I would save until i had enough cut back on everything I could. We did this when we wanted to buy a house and paid for our house cash so im not talking through my arse we have done it before and could again if we didnt have children who spend all our money lol.

Angela - posted on 11/14/2011

Sharlene what about if a person is covered under a health care provider such as the NHS, where taxes fun the most of it?

Sharlene - posted on 11/13/2011

I thinlk it should if your paying ex - mount of dollars for private health insurance .Ours do but we never used IVF or treatment

Angela - posted on 11/13/2011

@Marina I call it Mama brain!....
Sorry I have been busy.... Claire turned 3, on 11 11! So exciting! AND THANK YOU IVF!

Lacieann - posted on 11/11/2011

I think if the fertility issue is a medical problem then it should be covered.



Infertile single men and gay men would be covered to help with sperm production but not donor eggs or surrogacy(sp) and and infertile single women and lesbians would be given treatments to help with egg production or a donor egg, or surrogacy(sp) but not the cost of the sperm.



If both halves of a same sex couple or a single women/man are fertile then they would be responsible for finding a way to make a baby. Though insurance should cover some testing to find out if they are fertile.



An elective c-section should not be covered.



Many hospitals will not do a vaginal delivery if the mom has had a previous c-section, so in that case it wouldn't be elective, it would be necessary.

~♥Little Miss - posted on 11/11/2011

Brittany, I know....that is what I said. Having and elective c section for non medical reasons is different than having a c section on your second child because your first was a c section.

~♥Little Miss - posted on 11/11/2011

LOL Angela, we ARE indeed saying the same thing then...but somehow we both missed that...doi!

Angela - posted on 11/10/2011

Yep that is true Brittany and happen to a friend of mine! It was utter BS but yes insurance in the USA is so varied that the bottom line for me is their is not equality in coverage at all. Access is limited to what the insurance companies will do. Thus why I am FOR UHC.
Same goes with life saving heart surgeries for children, they too can be told pre existing condition.... sicking really.

Angela - posted on 11/10/2011

Marina we are saying the same thing I think! I said if gay or single for example have a infertility issues IE bad sperm, or other medical condition that would make them infertile it should be covered for the condition.
I completely agree when you say for example being gay with fertile sperm but no female egg is NOT a medical condition and thus should NOT be covered.
Not sure how I missed communicated here or do you think it should be covered??? I am confused ha ha

Brittany - posted on 11/10/2011

There are some insurances here that consider pregeancy a "pre-exisitng condition".

Let us say, for example, your husband gets a new job and insurance. You find out a week later that you are preggers. The insurance company will pry until they finid out if you were prego before the insurance or after the new insurance. If you were before the insurance then, it will be listed as a pre-exisitng condition and will not be covered.

This is why I dislike insurance.

Mary - posted on 11/10/2011

Not only does it vary with insurance providers, but it does vary from state to state.

Maryland (where I live) passed legislation in 2000 that mandated that all insurance packages that offered maternity coverage also must cover IVF. There were some restrictions - the couple had to have exhausted all other (less expensive) treatment options first, it is limited to 3 attempts, and there is a lifetime cap of $100,000.00. Companies with under 50 employees are exempt from this law.

Rebecca - posted on 11/10/2011

If your insurance doesn't cover pregnancy-related services it won't cover a c-section. ;-(

Janice - posted on 11/10/2011

Brittany, everything in the US depends on what insurance you have. Mine didnt cover IVF but some do. I personally, have never heard of a c-section not being covered but I'm sure it happens.

Brittany - posted on 11/10/2011

Marina,

I do not believe in the USA IVF is covered but, C-Sections, depending on your insurance, have to have a medical reason or at least mine did.

Rebecca - posted on 11/10/2011

@Sherri -- lots of plans don't cover pregnancy. It all depends on your insurer and insurance.

Sherri - posted on 11/10/2011

@Angela what providers do not cover pregnancy care in the US?? That information can not be true because doctors visits are covered under every plan and an OB appt. is not different.

~♥Little Miss - posted on 11/10/2011

Being gay with fertile sperm but no female egg is not a medical condition. It is an inconvenience.

~♥Little Miss - posted on 11/10/2011

Angela, being infertile is not the same as being fertile without an egg/sperm being AVAILABLE. If you are a single women, and fertile...you go to a sperm bank and have the process done out of pocket. If you are gay, and fertile, the same thing. You have a surrogate that you pay, and have a donor egg. If you are gay, infertile, have a donor egg and a surrogate, you would think insurance would or SHOULD cover the cost of the sperm. Not everything else. That would be my opinion on the matter. Just because someone is gay or single with good fertility does not mean they cannot have children. Nor does it mean the insurance companies should foot the bill simply because you want a child but don't have a partner.

Angela - posted on 11/10/2011

Marina, but being fertile and single and fertile and gay is not a medical issue. I have a gay son, and we talked about this actually because he wants children. If he has poor sperm sure he should be covered for help medically. But if his sperm is good he does not have an infertility problem due to medical issue. So I think he would have to pay for an egg donor, and surrogate if he could not find one to do it for free. But in fact his sisters both (not blood related) offered to surrogate when the time comes, but he needs a donor egg.

In a perfect world all would be covered but their has to be limits and priories due to cost. If a UHC plan is financially healthy enough to offer treatment to all fine I am for it.

Same goes with a single female or male who is fertile.... they do not have a medical problem, they need sperm.

I hope I am making sense... sorry to ramble Claire is climbing all over me at the moment ha ha



ETA if you look at the NHS Cathy explained it well in on of her last post, it is not always fair but it is the best that the NHS can offer. But, at least it is covered.

When you look at most USA insurance providers it is not covered well heck on some insurance pregnancy is not covered.

This is why I am pro UHC that is regulated to cover all equally. In this situation I think Infertility should be covered. But the USA is still very different than most health care in the world. So it is hard to say when all insurance is different etc. in the States. Bottom line their is not any equality in in health care coverage in teh USA.



I want to add the NHS is just one form of UHC, not all have long wait list, in my country their is not any wait list for fertility treatments. But yes you must have tried to conceive for at least one year before seeking medical advice.

~♥Little Miss - posted on 11/09/2011

@ Angela "Personally I feel if one is having a problem with fertility but not due to life style IE single and or gay they have the right to treatment covered. "

I just really read this comment on your op. If IVF is to be covered as a medical condition, it should be covered for everyone that is having fertility issues. Fertility issues are not a side effect of homosexuality or being single. Also, being gay should not be discriminated against in a circumstance like this. If IVF would be offered fully covered under all health insurances, it should be available to ANYONE with fertility issues.

~♥Little Miss - posted on 11/09/2011

Yes Janice, and there is a very loose definition of medically necessary sometimes. I was personally offered a c section for a repeat on my second. It was not medically necessary, but since I had one on my first, it was offered. And, if I chose to, I feel it would have been elective. VBACS are becoming less frequent....and instead of it being elective now, it is becoming forced in many hospitals as rule...you have a c section 1 time, you will ONLY have c sections from there on out.

Janice - posted on 11/09/2011

Just need to note that the comparison of C-sections to IVF earlier was in reference to a thread about covering c-section by choice with zero medical reason. Obviously, any c-section that is medically necessary should be covered.

Sylvia - posted on 11/09/2011

@Brittany -- I think it's important to note that what you're citing are not the costs of the procedures, they're the fees that clinics are able to charge for those procedures because of the way they're paid for in the US. I promise you, the NHS in the UK, the provincial plan in Quebec, etc., are not paying that much per procedure -- clinics only charge that much in the US because the insurance landscape is fundamentally wackadoo, and in Canada because desperate people are paying out of pocket. Even so, though, costs are appreciably lower here. DH and I have done a total of 4 IVF cycles, 3 of them with ICSI; the total cost of each of them was under $10K including egg-donor compensation (3 different donors; cycle #4 was an FET, so the costs were much much lower), and because I have a good drug plan through work, we were reimbursed for about $2K worth of medications each time.

Donor compensation is a whole 'nother thing. Standard compensation for an ovum donor in Canada is, I would say, around 20% of the amounts you're quoting. Might be somewhat higher now, but our last 2 cycles were not much more than a year ago, and for a shared cycle (i.e., we paid half the donor compensation) we paid $3K. Not $30K -- $3K.

I should add that even if our provincial health plan covered IVF, which I wish it would because not doing so is both socially mean and fiscally stupid, I would not expect donor compensation to be covered; that's between donor and recipient. The vast majority of IVF procedures don't involve donors, so those costs shouldn't drive policy decisions on coverage for IVF.

~♥Little Miss - posted on 11/09/2011

But like I said earlier, the company my husband used to work for also help cover 2-3 rounds if you were under their insurance plan.

~♥Little Miss - posted on 11/09/2011

Exactly Sherri...it is not outright covered the way c sections are. You have to jump through so many hoops, and many people do not get approved. I have known 5 people that have gone through IVF, and every one of them had to pay out of pocket.....Oops wait...one of them was covered for her first 2 attempts. They never took, so she attempted a third time on her own. No luck. Ended up adopting.

Sherri - posted on 11/09/2011

Actually most private and big insurance companies will cover a good portion of IVF Marina. However, it is a process to get it approved, just as a breast reduction, surgery etc.

~♥Little Miss - posted on 11/09/2011

I am not really sold on the comparison of IVF and c sections. C sections ARE covered by insurance......I suppose it can all depend on YOUR specific insurance coverage, but I believe for the most part it is covered. As far as IVF goes, it is very rare for insurance coverage....for the most part it is NOT covered.

Brittany - posted on 11/09/2011

If you want to have IVF as a choice and an option then why having an elective c-section not be a choice or an option?

It was said that adoption can be a lenghty, expensive process.....so is IVF.

I am going to use prices from America. To have IFV without any additional assistance you are looking at around $12,000. For ISCS treatment you are looking at an additional $1,000 to $3,000. If you want to add on a PGD Treatment that can be $3,000 or more. Should you choose to use an egg donor you are looking at $25,000 to $30,000. To use a sperm donor you are looking at $13,000 to $17,000. Then you have the embryo donation which is $3,000 to $7,000. These numbers are PER IVF CYCLE.

To adopt a child, depending on what country you adopt from and other factors, you are looking at $3,000 to $30,000. This number includes adoption fees and travling expense.

I am not trying to discourage anyone from doing IVF or adopting. I am just trying to say that if a woman wants to try IVF and it be covered by her insurance, then a C-Section should be covered by her insurance.

In America, even though our insurance is awful here, the doctor has to list a reason as to why a C-Section was performed. Then he has to show documentation of why.

Example:
I was in labor with Caoleb and all was going fine. We lost his heart beat then it came back, we lost it again, and this went on for about 30 mins. Caoleb flat lined and while we were running to the operating room they were getting me prepared for the C-Section. He had to report to my insurance company that Caoleb would have died if one was not performed.

Caoliann was another emergency C-Section. She was supposed to be a VBAC but, there were underlying circumstances.

Rauri was a "planned" C-Section but, he also was a high risk one.

I have not met a doctor that will allow a "planned" C-Section without some kind of medical reason.

I know things in Europe are different.

Rebecca - posted on 11/08/2011

I actually didn't conceive either set of twins using Clomid, Mary.

Janice - posted on 11/08/2011

Mary, yes off topic, I was just trying to make sure I understood.

Mary - posted on 11/08/2011

Sorry - in that previous post I miss-typed - I did mean to say 21 eggs. Egg production was never my issue, I did that just fine on my own. With clomid, it was outrageous, and the ensuing peritonitis and inpatient admission for hyperstim rather unpleasant. I did much better with injectables. As for for what LPD is...your understanding of it is a little off - or perhaps, incomplete - although not really relevant to this debate.

I'm also not sure why this became a debate about the merits of clomid. My goal was merely to point out that treatment options other than IVF are not always the best way to go; it depends on the individual issues. As well, to bring up the fact that other fertility treatments can have a much higher risk of multiples, since the number of eggs that can be fertilized is left up to chance. No, anecdotal accounts are not representative of the whole (but thank you so much for the definition of what they are, I was unsure until you spelled it out for me!) - although it does not change the reality of their life. I have nothing against it's use, but I do not think it is the benign treatment that so many women believe it to be. But, hey - if it worked for you, and gave you your 2 sets of twins - great.

Sal - posted on 11/08/2011

I struggle with this too..... On one hand it is a huge expense for a struggling couple, and I relaize most couples are just unlucky in the fertility stakes and wound have a couple of bubs and be happy but then there are the extreams where mum just waited too long and expects the govt to foot the bill for something that has no medical reason but nature.... Or the couple who isn't content with a couple of babies and wants to govt to foot the bill for 6 or more so where to draw the line is where I would have a prob.....

Janice - posted on 11/08/2011

Rebecca, If I had waited a few minutes, my post would be unnecessary! :) Thank you for clarifying what I thought I remembered from 3 years ago. I still don't like the drug though.

Rebecca - posted on 11/08/2011

@Mary -- those numbers are the nationwide numbers for Clomid, regardless of the ovulatory status of the woman. Clomid doesn’t increase the numbers of follicles produced during the recruitment phase (the first week of your cycle) – 21 follicles is actually normal. Your doctor shouldn’t have cancelled a cycle based on those counts because they aren’t really indicative of much of anything other than that your ovaries were working. Between 15 and 26 follicles is a normal antral follicle count for a woman who is NOT taking any medications to enhance fertility. Clomid merely increases the likelihood that more than one antral follicle will develop into a “mature follicle” (i.e., a follicle with a greater than 14 mm measurement). I had more than 30 antral follicles without Clomid, about the same number with Clomid and about the same number with fertility drugs. Clomid does not have a high risk of hyperstimulation – it CAN occur, but it’s actually quite rare. It does cause ovarian enlargement in about 15% of cases, but that’s not the same as OHHS.
The overwhelming majority of high order multiples are the result of IUI combined with injectible fertility drugs, NOT IUI and Clomid. Just because you happen to know two people who produced higher than twins with Clomid doesn’t change the overall statistics for Clomid – you are merely offering anecdotal evidence (e.g., I won’t get lung cancer because my grandma smoked for 60 years and didn’t get cancer). This page from a local fertility clinic gives a good analysis of the differences in success rates/higher order multiples based on the different treatment types: http://www.advancedfertility.com/revmult...
A luteal phase defect doesn’t affect the maturity of eggs – the problem is a fertilized egg doesn’t have a chance to implant if the luteal phase is too short.
None of this changes the fact that the Gosselins did not use Clomid, of course – Kate Gosselin has specifically stated that they used injectible fertility drugs (FSH, etc.).

Janice - posted on 11/08/2011

Okay this is reference to discussions of Clomid.



When I was on clomid and being monitered for egg release I was told by my OBGYN that all women produce multiple follicles during each cycle but only one develops and releases an egg. When I went on the drug the doctors weren't really sure if I was ovulating or not because my blood work said I was, everything was fine (sperm, tubes, only 25, ect) yet I wasn't conceiving. I was told my chances of having twins would jump from 3% to 10% because more than 1 follicle may mature and release an egg but this was unlikely. Based on Mary's info, considering my infertility issue I would think I wouldn't have been a good clomid candidate or I would have been given more warning. I only did 2 cycles because I ended up with large ovarian cysts which meant I had to wait for them to go away before being on clomid again which I nixed anyways.



In general after my own experience and what I've heard from others I'm surprised that Clomid still is the #1 go to at the beginning of infertility treatment.