When Erica Walther Schlaefer was 26, she and her husband were devastated to discover that they would need medical intervention to conceive a child. In the end the couple tried in vitro fertilisation (IVF) three times at a cost of $9,000 per cycle and had to borrow money to cover the costs.
When this proved unsuccessful, they decided to adopt a baby boy from Korea, and then a second baby boy a few years later, incurring significant adoption costs. Schlaefer, now 35, was so affected by her experience that she and her husband started a foundation called Parenthood For Me to help fund adoptions and assisted reproductive technology costs for others.
“We wanted to help other people in a similar situation,” she said. “We felt that the size of one’s bank account should not dictate whether or not they become parents.”
Unfortunately, for most people, the cost of medically-assisted pregnancy can be crippling. That said, the price tag varies — as does the level of financial help available. Here’s how to plan for the expense:
What it will take: US couples facing infertility treatment will pay more than $5,000 on average to cover clinic visits, drugs and other expenses, according to a study in the San Francisco area from the University of California. Opting for IVF? That will cost an average of $12,400, according to the American Society for Reproductive Medicine. In the UK, the average amount spent on fertility treatment was £8,678 ($14,299), according to the Red Annual National Fertility Report from Red magazine. While in Australia, IVF costs are closer to AUD$4,000 ($3,559).
“Fertility treatment in Australia is far more affordable than the US experience,” said Mark Bowman, president of the Fertility Society of Australia and associate professor in the Department of Obstetrics and Gynaecology at the University of Sydney. “The Australian Medicare system and private health insurance meet part of the cost.”
There are times when couples will spend more money, of course. “You might need a donor egg, or you might choose to use a donor egg in collaboration with your IVF cycle,” said Barb Collura, CEO of the US organisation RESOLVE: The National Infertility Association. “That is going to cost $30,000 to $50,000.”
Considering building your family via a surrogate? In the US, that will run $50,000 to $100,000 whereas surrogacy in Australia costs between AUD$20,000 and AUD$65,000 ($17,796 to $57,837). In the UK, however, surrogacy may be less expensive, because families are only legally allowed to cover the surrogate’s expenses and loss of wages. But because of this, surrogates are difficult to find — many couples go to other countries.
How long you need to prepare: Infertility is usually a surprise for couples, consequently most do not have much time to save. You may have to try for a baby naturally for some period of time (a year, for example) before health insurance will cover any type of medical intervention. About 20% of US employers cover assisted reproductive therapies, according to a survey from Resolve.
It might be wise to talk to a financial planner before you even embark on the process. “I show the couple how much it will cost, and I develop a financing strategy and show them that they may have to work longer to accommodate this expense,” said Ann Terranova, a financial planner with Union Financial Partners in San Francisco, California.
“I show them the trade-offs. Then it is up to them to decide how much they want this particular aspect of their lives. There may be a point where the cost is too much and the endeavour will be abandoned,” Terranova said. Consider what you are willing to spend, the number of treatments you might consider having, and at what point you will consider other avenues, such as adoption.
Do it now: Most private fertility clinics will have someone on staff dedicated to guiding clients through the financial part of the process. That person can help you understand the costs, and any assistance that might be available. Many clinics also offer financing. “We provide careful written information as well as making sure that one of our financial team will sit down with a couple contemplating IVF,” said Peter Illingworth, medical director of IVF Australia.
Check with your insurance. Some health insurance plans may cover part or all of your fertility treatments, depending on your location, your plan and your needs. In the UK, for example, some fertility treatment may be covered by the National Health Service (NHS), but there may also be a waiting list for treatment. In Australia, some fertility treatment costs are covered by Medicare and others are covered by private health insurance. If your private insurance does not cover infertility treatment, upgrade now, because there could be a waiting period before benefits are provided.
Talk about cash. “If you do not already have one, you should implement a monthly cash flow budget as soon as possible to plan for the large expenses and debt repayment,” said Adam Burch, a financial planner with Briaud Financial Advisors in Texas, who spent nearly $30,000 on fertility treatments before having his daughter recently. “This is what helped us most when going through this process and allowed us to effectively manage the cost.”
Apply for financial aid. In the US, there are non-profit organisations that offer grants to help fund infertility treatments and adoption costs. You can find a list of resources at US site Resolve.org.
Consider egg sharing. In the UK, many private clinics offer free or reduced cost IVF for patients that are willing to donate eggs for others to use. This is a very personal decision, but it may make IVF a more affordable option for you.
Do it later: Keep track of your expenses. In the US, fertility treatments are not eligible for a tax credit in the way that adoption costs are, but they are deductible to the extent that they exceed 10% of your income, Frederick said. While, in Australia, it may be possible Medicare Safety Net may reimburse some out-of-pocket expenses.
Sign up for better medical insurance. If you have an insurance plan that does not offer coverage for infertility help, check with the benefits department to see if another option is available to you. Or consider switching providers at open enrolment time.
Maintain a cash cushion. If your efforts are successful, you will have a child (or multiple children) to bring up, so depleting your savings entirely is not a smart move. “I once advised a local couple who did in vitro fertilisation and ended up with triplets,” said J. Jeffrey Lambert, a financial planner in California.
Do it smarter: Think carefully before tapping in to retirement savings. In the US, for example money taken out of an IRA or 401(k) for fertility treatments might be excluded from a 10% early withdrawal penalty as an unreimbursed medical expense, but you will still have to pay taxes on it said Brian Frederick, a financial planner with Stillwater Financial Partners in Arizona.
No matter where you live, withdrawing from a retirement account will reduce any future growth potential for your assets. It will also be challenging to make up this withdrawal through future contributions as disposable income goes down when you have children.