Affording IVF

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Choosing the best fertility clinic, not the cheapest, will save you money in the long run.

Many factors go into choosing the right fertility clinic for you and your family. Cost is certainly always one of them but be aware of what’s included and not included in the price. And pay attention to the clinic’s success rates. At Overlake Reproductive Health, we stand by our live birth success rates as being among the highest in the state of Washington.

Our Peace of Mind® 100% IVF program comes with a money back guarantee to take home a live baby, or all your money back. Not every clinic is confident enough to offer that!

Plus, it is important to note that our IVF programs include everything you might need to become pregnant including assisted hatching, ICSI, Preimplantation Genetic Screening, biopsy on day 5, 6 or 7, and vitrification (freezing) and thawing of your embryos by the best embryologists in the country.

We believe if you’re going to go through the trouble and expense of IVF, you might as well get the best treatment and care available. That’s why, at our clinic, we biopsy your embryos on day 5, 6, or 7, when your embryos tell us they are ready for the most accurate results. Our flash-freeze, or vitrification process, has a 99.9% successful thaw rate. Other fertility clinics may biopsy for PGS screening on day 3, which takes less skill and gives much less accurate information. Many clinics offer PGS testing for some patients, but we strongly believe all patients going through IVF benefit from PGS screening.

When we biopsy on Day 5, 6 or 7 the embryo has matured to the blastocyst stage, and its cells have multiplied to over 100. Inside the egg’s protective shell (zona pellucida), two different types of cells serve two different purposes:

  • The inner cell mass (ICM) will form the fetus.
  • Trophectoderm cells become the placenta.

ORH’s skilled embryologists tap through the egg’s outer shell so that a small proportion of trophectoderm cells begin to push through the microscopic opening. They remove about 6 to 9 of these cells and send them off to a lab for genetic testing. Then all of your tested embryos are flash-frozen, or vitrified, for safekeeping until it’s time to plan the embryo transfer in a future month.

The trophectoderm biopsy performed in PGS will not harm your embryos. The cells that are removed make up the placenta, not the baby, and their removal does not affect implantation of the embryo or development.

Why do we wait a month between retrieval and implantation?

The short answer is so we have the results of your PGS test in hand and can choose the healthiest embryo. But it’s worth noting, that IVF requires over stimulating the ovaries with prescription drugs to produce multiple mature eggs at the same time. By producing multiple eggs, we hope to gain one (hopefully more) perfect egg that will fertilize successfully and go on to mature into your healthy baby. A fresh IVF cycle will farm your eggs, not test for chromosomal abnormalities and genetic defects that typically cause miscarriages, and place a fertilized egg into your uterus to implant during the same cycle.

Blastocyst

We now know that the medicines used to make multiple eggs can impair the lining of the uterus, leading to lower success rates for fresh embryo transfer cycles. Knowing that, other clinics will often place two of more embryos at the same time hoping that one will be genetically normal and grow. Implanting multiple embryos helps increase fertility clinics’ success rates but can also result in twins or triplets. While multiples may seem like a great idea initially, they often cause complications that can be harmful or even fatal to the mother or fetuses or both. The best clinics, like Overlake Reproductive Health, perform PGS on day 5 and only transfer one embryo at a time for a safe, healthy pregnancy.

Reasons why Day 5, 6 or 7 Trophectoderm Biopsy is preferential.

  • Significantly more accurate
  • Less False Positives
  • Less damage to the embryo

In addition to PGS, we also use a MitoScore to choose the healthiest embryo to implant. Overlake Reproductive Health has the most experienced embryologists in the country, fertility doctors, IVF lab capabilities, and advanced technologies to perform these intricate processes.

RFID Tags for Security

ORH is the first fertility clinic in the NW to add an extra layer of security through our RI Witness program which labels all patient samples with a digital ID tag that is continuously monitored throughout the process. Thanks to self-adhesive RFID tags attached to all the laboratory plasticware, it is possible to ensure only compatible samples are worked on at any one time. We implemented this secure process for total confidence. While this system is required in Europe, you’ll find very few clinics with it here in the US.

Getting it Right the First time Saves You Money

Our goal is to compete on being the best and stand behind our success rates (82% Implantation Rate and 66% Live Birth Rate). And, because we often achieve a healthy pregnancy right out of the gate, we do wind up being the least expensive option. Especially because many of our package programs offer money back with early success!

We are confident that no matter what your individual challenge with infertility is, we have the right expertise and skillset to help you have a healthy pregnancy and a healthy baby.

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Affording IVF Step By Step

Despite what your inner screamer is telling you, just walking into a fertility clinic will not cost you millions of dollars. In fact, it will most likely save you time and money.

The truth is, no one’s ever gotten pregnant from just eating Goji berries. Women will often go to great lengths to get pregnant. With so much information out there, we try and take it all in, and sometimes we can make ourselves nuts. When truthfully, often the best thing we can do for fertility is relax.

Easier said then done, I remember. I still have a cabinet filled with Basel Body temperature charts, saliva thermometers, primrose oil, and horse pills of god-knows-what.

If only I’d known then what I know now. The key is to keep your eye on the time. All these things may work, but while you’re busy scouring the underbrush of Amazon for the perfect fertility berry, your ovarian reserve could be getting low.

If you’re under 35 and have been actively trying to conceive for one year, or 35 and over actively trying for 6 months, it is time to have some basic tests done by a fertility specialist.

Step one; you absolutely must—even if it takes a breadcrumb trail of blazing hot chicken wings—get your partner in for a semen analysis. Over 35% of infertility is caused by men. It’s relatively easy to rule out and, if there’s an issue, a hurdle that can often be overcome.

Step two; get a Snapshot of your ovarian reserve by a board certified fertility specialist. Do not send in a cheek swab to some anonymous online website. They cannot reach through your computer and give you an ultrasound—yet. It will not save you time, money, or sanity in the long run.

Women are born with over 1 million eggs but by the time of puberty, only about 300,000 remain. Of these, only 300 to 400 are ovulated during a woman’s reproductive lifetime. Testing your ovarian reserve gives you a rough estimate of time left in your fertility window. And though that information is priceless, it’s actually very affordable.

The Fertility Snapshot at Overlake Reproductive Health in Bellevue, WA is an assessment of a woman’s current reproductive potential that includes the following:

  • Blood work: AMH, LH*, FSH*, E2*
  • Ultrasound to assess antral follicle count (AFC)
  • Summary report of results reviewed under MD supervision

*unless on hormonal birth control

The cost is $249 out of pocket with or without fertility insurance. If your ovarian reserve is low and you choose to take action, you’ll already be a patient at ORH and in the capable hands of one of the best fertility clinics in the Pacific Northwest.

The truth is, walking into a fertility clinic does not cost you millions of dollars. It can be a life-altering time saver. And if you keep your eye on the prize—a baby—then the sooner you find a fertility specialist you can trust, the sooner you’ll be up all night changing diapers instead of Googling the latest fertility craze.

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Bye Bye Fresh IVF Cycles, and Why This is a Good Thing for Your Pocketbook

Fresh IVF is leaving us

2014 is winding down and I really hope that everyone had a great year. I know that sometimes life has a way of throwing curve balls and those who are visiting this site probably know that fact quite well. Still, it is how we deal with the events in our lives that really affect who we are and how we feel. So if you are stressed out about life or are having a hard day I would encourage you to sit still for a few seconds and take a couple deep breaths. I guarantee you will feel better and more relaxed. Then the next time you are stressed out, try to remember how a simple thing like taking 30 seconds to breath can make you feel so much better (seriously, it’s science).

OK, I’ll get off my soapbox now. What I really wanted to talk about today was an exciting new trend in the infertility world that will mean higher success rates for everyone going through IVF with their own eggs. I am talking about the end of fresh transfers (using your own eggs) as we know it. Recent evidence has shown that the medications women take to hyper-stimulate their ovaries in order to force their body to mature many more eggs than it would in a normal cycle can have a negative effect on implantation rates, and thus lower the chances for a successful pregnancy. Essentially the stimulation required for IVF is, in fact, bad for IVF success. (Now some of you might be thinking, “what about minimal stim IVF?” – That is a whole another topic for a different day.)

What this means is that an increasing number of fertility clinics across the country have switched from offering fresh cycles where your embryos are retrieved and subsequently transferred during the same cycle to a fresh/FET (frozen embryo transfer) model where your embryos will be retrieved and grown in the lab then frozen (vitrified, hopefully) and then transferred back the embryo(s) on another cycle in which you will receive no stimulation medications, just like any other FET cycle.

This trend is bolstered by recent advances in freezing technology/techniques. Now the industry standard is vitrification. Where the egg/embryo is frozen quickly and, most importantly, the thaw survival rate is in the 95-98% range. Compare that with slow freeze techniques of the past which boasted rates between 30-50% and it’s a game changer. Effectively, the embryos can be frozen and thawed again with little chance of something going awry.

Most importantly, these new treatments have increased the success rates for all patient populations using their own eggs as much as 10% across the board! That is a huge increase! Higher success rates mean less cycles will be required on aggregate to achieve pregnancy.

What this means to IVF costs is a higher cost to get to the transfer stage, but a reduced average cost per successful cycle, across the board. On a cycle by cycle basis there might be some cost increases, as the newer techniques require more work, but, on average, less cycles will be required. Resulting in lower total average costs. This is a good thing!

If you are looking at IVF clinics right now for treatment I would encourage you to ask about both the clinic’s use of vitrification in the lab, as well as if they offer this type of fresh/FET cycle (often referred to as Freeze-all cycles). If they don’t then you might want to think about another clinic – it could save you money.

Cheers!

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How much is your care going to cost? It depends on where you live…

We all know health care costs a lot in the States, but did you realize that your potential costs can vary dramatically by the state? Or even by county? By how much you ask? Well, this awesome infographic aims to help answer that question. The data was taken from the Centers for Medicare and Medicaid Services (CMS). They looked at the costs of 100 different diagnosis-related groups and their costs in different regions of the country.

As you look at the data, remember an important note.

In medicine, just like all aspects of life, you often get what you pay for. Meaning the best care, by the most highly trained specialists will cost you a lot more. However, how much more can certainly vary – as you will see by looking through some of the data. Just by living in certain areas of the country you might end up paying 5x the amount you would have been charged elsewhere.

This brings up the question of whether or not you would be best served to get that procedure done locally for more, or somewhere else in the county for less. I am always a fan of locally, as a medical intervention can be stressful enough without having to add in travel and recovering in an unfamiliar location. Still, it might be worth thinking about in certain situations. Before you even think about getting your procedure done somewhere else, remember to consult your doctor to make sure traveling in your condition is safe!

Well, without further ado.. Enjoy!

Visualizing Hospital Price Data

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IUI Discount Programs

saving on IUI treatment
IUI Discount programs give patients more options. Image credit

Hi! First off I want to apologize for taking some time off from writing for this blog. Life had gotten a little hectic and I couldn’t find enough time to sit down and work on this site. I am happy to say that things have calmed down a bit, and I have started working on a series of new posts! It’s super exciting to be getting some momentum going again on this project :)

Today I wanted to talk a little about IUI, or intra-uterine insemination, treatments. IUI is a great first treatment option for many couples. It is relatively non invasive and much cheaper than IVF. It is often recommended for women or couples who have:

  • ovulation issues
  • are unable to properly time intercourse, / sexual dysfunction
  • mild male factor
  • unexplained fertility
  • or for women using donor sperm

An IUI is a type of artificial insemination. Basically, instead of having the male inseminate the female naturally via sexual intercourse, a medical professional uses a tiny catheter to inject a small amount of prepared sperm directly into the woman’s uterus. This procedure is timed to occur right around when ovulation (when a female is most fertile) occurs, and can be done either naturally or accompanied by fertility drugs. The idea is to coordinate the whole operation so that the sperm and the egg can meet in a favorable environment at the proper time for fertilization to occur.

iui explained
Prepared sperm is injected directly into the uterus during an IUI procedure. Image source

The IUI process can increase a woman’s chances of becoming pregnant over practicing timed intercourse and can be a successful treatment for many of the disorders listed above. The procedure is relatively simple, and, as such, does not cost much compared to an IVF cycle. The cost can vary depending on the complexity of the monitoring and if fertility medications are used. I will list out the main varieties in order of ascending costs.

The cheapest, and often least successful are natural IUI cycles where ovulation is determined through the use a combination of a best guess based on cycle lengths, temperature readings, and maybe ovulation kits to confirm ovulation. No fertility medications are used. These are less successful then the more monitored counterparts, as more is being left unknown throughout the process.

Next up would be natural cycles with monitoring. These are IUI cycles without any medication but with a clinic monitoring the woman’s cycle to more accurately determine the optimum time for the insemination to occur. The amount and type of monitoring can vary depending on the fertility clinic. Clinic monitoring can be very important as proper timing is very important to IUI success.

Medicated cycles with or without monitoring are the most expensive variant, but also the most successful. These cycles use fertility drugs to increase the chances that a healthy egg will be ovulated. The amount of monitoring can vary depending on the clinic you go to, but most often they will have you come in for one or more blood draws and ultrasounds to precisely determine when ovulation occurs. Sometimes ovulation is even triggered through the use of other medications.

Regardless of the type of IUI cycle that is recommended by your doctor it is probable that you will need more than one cycle to be successful. If you are looking into, or about to start an IUI treatment cycle I sincerely hope you will get pregnant on the first round, but the odds are against you. It has been said that the odds of any given IUI cycle to succeed are around 20-30% for a young healthy couple. Depending on the severity of the issues affecting you or your partner those odds will be go down.

Since the cost disparity between a round of IUI and an IVF cycle is so pronounced many couples will want to pursue a couple IUI cycles before moving on to IVF. Sometimes against the recommendations of their physicians who understand that the chances for success with IUIs will be very low for that patient. I certainly can’t blame a patient for trying an IUI or two even when the odds are stacked against them. However, that money is more often than not just thrown away with unsuccessful cycles before the patient ultimately ends up pursuing IVF.

That doesn’t have to happen! The other day I came across a fertility clinic in Seattle that addresses this issue with two separate programs designed to make the whole decision process much easier for patients. One program is for patients who have a good chance succeeding though IUI treatment, but will likely need more than one cycle to achieve a healthy pregnancy. They call the program an IUI Discount Program, and it basically allow a patient to get a third IUI cycle free, if they prepay for the first two. The best part is that they will refund the patient the second cycle if the first one is successful. They also give an option for patients to go through the program again at a slightly higher rate.

Their next program is called an IUI Credit Program. This one is my favorite of the two as it allows patients to first try a couple IUI cycles, and if those are not successful, apply the money they have already spent against the cost of an IVF cycle. This gives patients the ability to first try the low cost option, before having to commit to an IVF cycle.

Both these programs are innovative and among some of the best I have seen. They give patients the ability to reduce their financial burden as they pursue lower cost fertility treatments before jumping into the much more expensive options. I just wish more fertility clinics would offer programs such as these as they have the potential to really benefit the patient.

Cheers!