Commenters on my posts about the Suleman octuplet situation and on Madeline Holler’s post about the problem of fertility clinics breaking the rules pointed out that a big elephant in the room of this discussion is healthcare, insurance and the cost of fertility treatment in the United States. In countries that more carefully regulate the number of embryos doctors can transfer into women, healthcare is universal and access to at least some fertility treament is covered by it. In the United States, it is rare to find a health insurance policy that covers fertility treatment of any kind, rarer still to find a policy that covers IVF, which can run from $7,000 to $15,000 per try depending on the drugs needed and procedures used.
When couples have double-mortgaged their houses to come up with the cash out of pocket for a round of IVF, it must be awfully tempting to increase their odds by transferring more than one–or two—or three embryos in a single cycle.
Guess what? No one is particularly hoping for high order multiple pregnancies. In fact, research conducted by a well respected fertility center in Maryland found that when cost is not a factor, couples prefer to transfer one or two embryos and that pregnancy rates are not effected significantly by the lower transfer numbers, though multiple birth risk is significantly reduced:
“[This study] showed that patients prefer to transfer one embryo when freed from financial pressures to transfer multiple embryos, which can occur when patients have limited or no insurance to pay for treatment.”
When you weigh the costs of care for high order multiples born prematurely against the cost of trying for an extra round or two of IVF, the IVF starts looking like a bargain. So as we enter a national conversation about how to get every U.S. citizen covered with health insurance and what to cover, it would be a good idea to keep fertility treatment in mind. With one in seven couples now seeking some form of treatment to help them conceive, a certain amount of coverage for these treatments needs to be part of the package. What society pays in IVF costs, it will save many times over when those treatments result in healthy singletons, rather than children who need weeks of NICU care and possibly rehabilitation and special care for many years after birth.