A Guide to the IVF Process, Costs, and Choosing Your Fertility Clinic
As you research your fertility treatment options, it helps to educate yourself on the medical procedures available, the best fertility providers for your case, as well as the costs to expect along the way. If you’re considering IVF as the next step in your journey, this article provides more information on the process and timeline to expect, factors to consider when choosing a fertility clinic, as well as the average costs to plan for. Learn more below!
Steps in an IVF Cycle
The first baby conceived via in vitro fertilization, Louise Brown, was born in England in 1978. Since then, eight million babies have been born via IVF, and assisted reproductive technology has continued to evolve. In this section we’ll provide a step-by-step guide to the IVF process so that you’ll have a better idea of what to expect along the way.
The IVF process may vary slightly from clinic to clinic and depending on your case, but it generally follows these steps:
1. Suppressing the Natural Menstrual Cycle
You or the donor will be given injectable medication to suppress the normal menstrual cycle. This helps the next treatment stage be more effective.
Time Span: two weeks
2. Ovarian Stimulation
Medications, commonly known as ‘fertility drugs’, are prescribed to boost egg supply. The medication comes in the form of an injectable follicle stimulating hormone (FSH) that should be self-injected for 10-12 days. During treatment, the ovaries are evaluated via ultrasound to see that the ovarian follicles are developing – at this point, a blood test is also done to measure response to ovarian stimulation medication. This determines if the follicles are ready for egg retrieval. A final hormone injection is given to help the eggs mature: the eggs are then collected after 34 – 36 hours.
Time Span: 10 – 12 days.
3. Egg Retrieval
A light sedative is used during the egg retrieval procedure to help you relax and not feel pain. Using ultrasound for guidance, a needle is passed through the vagina and into each ovary. This minor procedure is performed in the physician’s office or an outpatient center.
Time Span: 30-minute procedure, followed by 5-10 minutes to come out of sedation and an additional 30 minutes for recovery.
4. Fertilization and Embryo Culture
Following retrieval, the eggs are examined for maturity and quality. Mature eggs are mixed with the partner’s or donor sperm and left to fertilize for the next 16-20 hours. Around 60% of ART cycles utilize intracytoplasmic sperm injection (ICSI). In this procedure, a single sperm is directly injected into a mature egg. The eggs, now embryos, are monitored to ensure they’re growing well. Some clinics transfer day 3 cleavage stage embryos while others transfer day 5-6 blastocyst embryos. You can find more detailed information about embryo development and the IVF process in The Stages of IVF: What To Expect. A number of tests may be offered at this stage: Preimplantation Genetic Testing for Aneuploidies (PGT-A) and Preimplantation Genetic Testing for Monogenic disorders (PGT-M). Learn more about embryo testing here.
Time Span: 3 to 6 days (without genetic testing).
5. Embryo Transfer
The embryo is transferred into the womb using a thin catheter. The procedure is more straightforward than egg retrieval: no sedative is necessary and many liken it to a pap smear. The reproductive endocrinologist or embryologist will discuss the number of embryos that should be transferred – the decision will be based on the mother’s or gestational carrier’s age, and specific patient and embryo characteristics. The American Society for Reproductive Medicine (ASRM) provides guidelines for the number of embryos to be transferred. These can be viewed here. Any remaining embryos can be frozen (cryopreserved) for future transfers. This makes future IVF cycles less expensive and less invasive.
Time Span: The embryo transfer procedure takes around 20-30 minutes – considering checking in and rest time, you may be at the fertility clinic for around 2 hours.
6. The Two Week Wait
Once the embryo(s) are transferred, what’s commonly known as ‘the two-week wait’ ensues. It can be a difficult time for you and your partner: you may feel a roller coaster of emotions, from hope, to fear to exhaustion. This is normal and the National Infertility Association RESOLVE offers some emotional coping strategies to help see you through this time. You can also read a heartfelt personal account of the two week wait from here. A number of clinics suggest a regular at-home pregnancy test two weeks after the embryo transfer, while others request you to go in for a more accurate blood test. If the IVF cycle has been successful, ultrasound scans will be carried out in the following weeks, after which you’ll follow regular antenatal care.
Time Span: two weeks.
Now that you have a better understanding of the IVF process, let’s go into the factors to consider when researching the ideal clinic to work with.
What to Consider When Choosing an IVF Clinic
Choosing the best fertility clinic for you is highly dependent on your personal situation. Nonetheless, there are several common factors to consider during your research and decision-making process. While most fertility clinics have a structured discussion prepared for new patients, it helps to go into that appointment prepared. In this section, we’ll go over what you should consider as you research your options, as well as what to ask if you have further questions.
1. Experience and success rates: The number of successful treatments the clinic performs each year is a good indication of its success. Fertility clinics are bound by law to report and verify data annually related to the assisted reproductive technology (ART) cycles carried out in their clinics, as well as the outcomes of these cycles. This data can help you get a better idea of your average chances of success per ART cycle or transfer – though of course, ART success rates do vary from person to person.
Look out for success rates for patients with similar cases to yours, including your age and the fertility services you’ll need. This data can help you get a better idea, for example, of your chance of success per IVF cycle or embryo transfer. GoStork makes this part easier than ever before as we share each clinic’s most relevant success rates based on your personal journey ahead, taking both your age and the services you need into consideration.
2. Extent of patient-centered care offered: It’s fairly common knowledge that IVF can be an emotional roller coaster – which is not always easy to manage on your own. This is why you need providers who really care. As support is integral during the IVF journey, a number of clinics also offer access to patient support groups. You can also get a sense of the team during your consultation process, as well as by checking ratings and reviews. And on that note…
3. Patient ratings and reviews: Looking at past patient’s experiences is another great way to gain insight into the fertility clinic, its practices and, as mentioned above, how patient-centered the clinic is. Reputable IVF clinics openly feature reviews from patients - you can also read reviews directly on GoStork.
4. Specialists’ certifications and experience: You want the best possible care delivered by the best in the industry - all fertility clinic profiles on GoStork include a detailed overview of doctors’ education, certifications, experience, and research as well as the languages they speak.
5. Technology used: An elective single embryo transfer (eSET) enables the same success rates when transferring one embryo but with a greatly reduced risk of multiples. This is due to significant advancements in clinical and embryological techniques. In a double blastocyst embryo transfer (2BET), two embryos are transferred. The risk of multiples is high as one of the embryos (or – less frequently – both) can split and produce identical twins.
6. How they handle testing: Ask the fertility clinic how they handle the tests required as part of the IVF process, specifically FSH, LH, estrogen, and progesterone hormone level testing. Larger clinics handle these in-house, others use third parties. For the latter, check that the testing facilities they’re using are reputable.
8. Timeline: As you plan out upcoming months, it will help you to understand things such as the overall treatment timeline, how soon you can start, how many times you’ll need to visit the clinic, etc. Going even beyond that; you can look into if pregnancy isn’t achieved, how long you’ll need to wait to try again per treatment protocols and your case.
9. Consistency: Going through fertility treatments can be stressful. Knowing in advance that you can count on how frequently/consistently the clinic will communicate updates to you, or even that you will consistently have the same physician throughout all of your treatments, can help bring some peace of mind.
10. Location: You may need to visit the clinic often during treatment so we suggest you take travel time into consideration. A fertility clinic close to home does have its benefits, especially if you’re usually busy with work or family life - it can also reduce your travel costs. If location is not that important, you may want to consider a clinic with specific experience dealing with cases similar to yours as a higher priority over location.
11. Costs: You want to ask for a full breakdown of costs and not just the price tag attached to the IVF procedure. Ask the clinic to provide you with a list of all costs related to testing and medications (and feel free to ask if they accept payments in installments), as well as what can be covered by insurance. Insurance coverage varies according to your specific policy and your state, so it’s advisable to get in touch with your insurance provider for more detailed information. You may also want to keep in mind that many patients are successful at the second or third IVF cycle (not the first). For a more complete financial figure, factor into your calculations the cost of a hospital delivery. You can see an estimated total cost based on services for your journey for each clinic on GoStork. And on that note:
How Much Does IVF Cost?
IVF is a very effective treatment for infertility, but it can also get expensive. The cost of IVF varies from state to state and from one clinic to another. It is also highly dependent on your own specific case, the nature of treatments required, and how many cycles you’ll need.
According to the American Society for Reproductive Medicine (ASRM), the average cost of one IVF cycle in the United States is $12,400. This only covers the egg retrieval and embryo transfer and excludes all other accompanying procedures (such as ICSI or preimplantation genetic testing) and the required fertility medications. In addition, physicians speaking to RESOLVE, the National Infertility Association, note that most patients need 2-3 IVF cycles before they’re successful.
As you map out your journey, it helps to know which costs to budget for, the testing and treatment that can be covered by your insurance and how you can keep costs lower.
In Conclusion
Deciding to move to IVF, choosing the best fertility clinic for your journey, and identifying ways to pay for treatment can be challenging - it’s also a highly personal process. As you move through each stage of your family building journey, it’s important to have a supportive and patient-centered fertility clinic accompanying you along the way.
We hope that you find this article helpful as you map out your journey.
By Eran Amir, Founder & CEO of GoStork
Medical Disclaimer:
The information provided in this blog is intended for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider or qualified medical professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog.