Counting the cost of ART

There are a number of prime considerations about the decision to undertake ART treatments and how many IVF cycles to attempt. Apart from the ever increasing overlay of emotional and physical factors, there are practical issues as well. Arranging treatment around work schedules; allowing for travel time; and the extent of the waiting list to see the fertility specialist of choice.

We consider ourselves to be fortunate to be seeing our third specialist. Dr Loverley is young and keen and largely undiscovered. Our ability to see him for a consultation at short notice is almost unimpeded.

Beyond the practical, emotional and physical factors there is one almighty consideration that needs revisiting with the dawn of each new cycle; the financial cost.

Despite much financial burden, it seems the average couple or single undergoing ART is unwilling to complain over the costs, preferring to view the ultimate success of a baby as priceless and well worth going into debt where necessary to achieve. Lifeslurper might complain about many aspects of IVF, but remains grateful to have such innovation readily available to her. There is an intricate guilt involved with the devoting of so much money to making a baby. Wobbles and I are mostly able to afford the costs, and are particularly aware of living in a country with a health system that is supportive of fertility treatments. I have read plenty of horror stories as to the cost of IVF cycles in other countries to be very pleased to be living in Australia. However, that does not prevent me from seeing flaws in the way some of our clinics handle the payment process, and the lack of understanding that sometimes goes with that.

After the sudden failure of our second IVF cycle (we received word our sole embryo’s “arrest” as we waited in the clinic’s waiting room before transfer) we were able to get an immediate appointment with our then fertility specialist, Dr Dream. We were not to know that Dr Dream would suddenly announce his early retirement due to health reasons before the end of our third cycle. We planned to continue on with him, and after the shock of our near transfer we wanted to speak to him sooner rather than later. Okay, this meant returning to the city only two days after the cycle end. This meant I had a completed a record four visits to the city in just on seven days. No wonder we weren’t thinking straight when after the appointment with Dr Dream where a shiny new protocol was drawn up, we were given the chance to go straight over to the other side of the hospital location of the clinic and speak to our nurse. This meant saving another lengthy and costly trip back to the clinic to get signed up when we were ready to resume our treatments.

We realised a bit too late that we were actually signing up for a cycle and were expected to pay up on the day. I looked at Wobbles and thought he might be having a stroke. When he regained his composure he asked a gentle; “do we need to pay today?” Which received a rather severe “If you don’t pay today you will have to come back here again to complete the forms!” a statement we later found to be untrue, but like so much of this IVF process we didn’t know any better and certainly didn’t question those in authority.

Having only completed cycle #2 days earlier meant the claims process of receiving a large wad of refunds on the required upfront payment to the clinic had not yet begun. Paying for cycle #3 meant having over $8500 in upfront payments sitting in the clinics’ coffers all at the one time. That was not including the associated other costs for additional medication, specialist consultations, extra ultrasounds and pathology, day hospital, anaesthetic, travel, accommodation and more. Moments later at the accounts department, we enquired as to whether the refund process on cycle #2 had begun, which was met with a slight lecture on the fact that what with government refunds we had to pay very little. That wasn’t the issue. We had just been wondering how long the refund process was likely to take.

Just before Wobbles and I first signed up in the long lead in to starting IVF treatment, the group of clinics we belong to was sold for a massive amount of money. So we know they make huge profits out of the business of infertility. What is somewhat difficult to understand is why complete upfront payments are required; what happens to funds that can take many weeks after treatment ends to be partially refunded; why subsequent cycles have to be paid for outright when payments for previous cycles awaiting refund are already ‘in system’ and so on.

It seems so often with infertility we are so grateful for the assistance we receive we are willing accept conditions that perhaps we would not allow elsewhere in our lives.