Is Sharing the Risk Right for You?

One of the most daunting aspects of getting through infertility is the expense involved with treatment. While consumer groups and others are working hard toward making insurance coverage of fertility treatment available for everyone, the fact remains that at this time, most folks are paying out of pocket.

So what's a person of average financial means to do when faced with the prospect of choosing between in vitro fertilization (IVF), non- biological parenthood through adoption, or living without children?

If you've not yet explored the various financial assistance programs that do exist, you're not at the end of your rope.

One of the possibilities that works for many is the Integramed™ Shared Risk® Refund Program. We talked with Pam Schumann, product manager for this unique program offered by IntegraMed America, about its benefits.

What is the Shared Risk Refund Program?

"Simply put, it's an alternative payment option for people who do not have insurance coverage for IVF," Pam states. "We offer the program as a way for people to maximize their chance of getting pregnant through IVF with a built-in cost control." While the program does not guarantee a successful outcome, it does guarantee a refund if treatment fails.

By maximizing efforts, Pam is referring to this fact: statistics clearly demonstrate that most people who use IVF to conceive do not get pregnant on their first IVF cycle.

Why Doesn't IVF Always Work?

There are so many components to the entire process of IVF, it's possible to point at numerous probable causes for failed attempts. From starting off with too few or poor quality eggs to fertilization failure, problems with the embryo implanting in the uterus, certain asymptomatic immune disorders left either undiagnosed or untreated... the reasons for IVF not working can be many.

Fortunately, because there are so many possibilities, reproductive experts know to use each IVF attempt as a learning opportunity. Pam Schumann has had first-hand experience that illustrates how a failed IVF cycle can lead your medical team to eventual success.

"In my first attempt with IVF," Pam reveals, "my response to the medications was not what my doctor had predicted. So we learned from that first cycle, and my second IVF was successful."

How Many IVFs Does It Take?

It helps to not only know the statistics related to IVF success and failure, but to understand the terms used. A helpful starting point is the Frequently Asked Questions section of the National Summary and Fertility Clinic Reports of the U.S. Centers for Disease Control (CDC)

According to this most recent report, there were 29,344 live births resulting from the 107,587 ART cycles (98 percent of which were IVF, the remaining 2 percent being GIFT or ZIFT cycles) started in 2001. That statement, those numbers, only demonstrates the fact that not all ART cycles end in success.

Live birth rates for the varying types of ART using fresh nondonor eggs or embryos in 2001 are as follows:

• IVF without intracytoplasmic sperm injection (ICSI), 32.6 percent
• IVF with ICSI, 30.6 percent
• GIFT, 21.8 percent
• ZIFT, 30.9 percent
• Combination of IVF (with or without ICSI) and either GIFT or ZIFT, 36.4 percent

Among women who underwent an ART procedure in 2001 using fresh nondonor eggs or embryos, 47 percent reported having gone through a previous ART procedure. Because of the type of data collected, it is not possible to spell out just how many ART cycles each woman has undergone before realizing success.

What Is the Cost of Successful Treatment?

Here, Pam explains the importance of understanding that IVF is a course of therapy, rather than a single treatment, toward conception.

"Infertility treatment is not an episode of care, it's a process, and we think it should be treated that way." That process is facilitated by a whole team of individuals, not just a reproductive physician, each of whom is highly trained and skilled in a very specific field of medicine. Adding to the expense is the cost of medications and their administration and the use of advanced, technological medical tools of the trade.

Some components of the IVF process are so patient-specific, such as medications, that it's impossible to determine a fixed cost in advance. However, there are some costs that can be controlled, and that's where the Shared Risk Refund Program applies.

The Way It Works

The IntegraMed Shared Risk Refund program provides a way for patients to maximize their chance of success with IVF and minimize their financial risk by committing to three IVF cycles for a fixed price. Additionally, if treatment is not successful, the patient receives a 70 percent refund of the Program fee, which is determined based on the woman's age, specific type of treatment, and the fertility center used. For women younger than 35, the fee for three IVF cycles via this program adds up to about the cost of two cycles.

Patients who enroll in the program are not obligated to go through all three cycles, and the Program fee covers office visits, blood tests, ultrasounds, egg retrieval, fertilization, and one fresh embryo transfer per IVF cycle. It is also possible to substitute two frozen embryo transfers for one IVF cycle.

Who Benefits?

Developed primarily for patients who have no infertility insurance coverage, the IntegraMed Shared Risk Refund Program is attractive to many patients who understand that a commitment to pursue multiple attempts with IVF if necessary will greatly increase their chances of getting what they want - a baby. It can also provide relief for those who feel they've hit a financial wall in their family-building efforts when first told they need IVF.

Pam, a former fertility patient, empathizes. "Many of our patients are in the really tough position of deciding whether to spend money on multiple IVF cycles or save it for an adoption. The IntegraMed Shared Risk Refund Program addresses this concern by allowing patients to try IVF up to three times and preserve their financial resources for adoption should IVF be unsuccessful."

She adds that when asked what they found most beneficial about the program, patients commented on the peace of mind that comes from having already taken care of their treatment's financial end and the related knowledge that they can then preserve their remaining resources for other resolutions, if necessary. "They liked knowing that, if it doesn't work the first time, the next attempt is already taken care of."

Pam Schumann summarizes, "The IntegraMed Shared Risk Refund Program in and of itself does not increase your chance of success, but committing to multiple cycles does. If patients are willing to commit to multiple cycles of IVF if necessary, this Program just makes good financial sense."

More Information

Latest ART success rates

IntegraMed Shared Risk Refund Program