TL;DR:

Modern fertility treatments, like IVF, present a significant financial challenge for many aspiring parents. With costs often exceeding average salaries, especially in places like London, and limited support from public health systems such as the NHS, the dream of starting a family becomes a luxury for many. Hidden costs, including add-on treatments with varying evidence of efficacy, further complicate the financial landscape. As the debate on the commercialisation of fertility treatments intensifies, there's a pressing need for transparency, regulation, and equitable access to ensure everyone can experience the joys of parenthood, regardless of their economic status.

Introduction

The journey to parenthood is a deeply personal and profound experience. For many, it's a path filled with anticipation, hope, and dreams of a future family. However, in today's world, this journey intersects with advancements in reproductive medicine. While these treatments offer hope, they also unveil a stark socio-economic divide. The promise of cutting-edge fertility solutions remains out of reach for many, raising questions about equity, access, and the commercialisation of this profoundly human experience.

The High Cost of IVF and Other Fertility Treatments

Fertility solutions, from IVF to egg freezing and surrogacy, can be expensive. In many countries, IVF costs can be overwhelming. For individuals or families without nationally funded healthcare or insurance coverage for IVF, these costs can be daunting, making parenthood seem financially unattainable, especially with current success rates requiring most patients to undergo multiple cycles to achieve a live birth. Table 1 below compares the average price of privately funded IVF treatment amongst four IVF clinics in London.

Country

Clinic A

Clinic B

Clinic C

Clinic D

Price of IVF treatment with own eggs

£9,140

£8,694

£8,460

£8,380

Table 1- the average price of IVF treatment in London adapted from each clinic's price list and MyFertility's Clinic Finder. Prices include consultation, couple diagnostics and screenings, monitoring during stimulation, IVF treatment with ICSI, timelapse incubation, blastocyst culture, embryo freezing and storage and pregnancy test (without medication costs).

The average London wage is just under £37,000, so in order to afford treatment at one of these clinics, the average Londer has to fork out 24% of their gross annual salary. This means privately funded fertility treatment is well and truly a luxury that can only be afforded by the wealthy, especially when patients need to undergo an average of three IVF cycles to have a successful outcome.

The role of the NHS

A public health system should be able to alleviate some of that financial burden from prospective patients, however, access to NHS-funded fertility treatment continues to drop. In 2019, 23% of IVF cycles in London were NHS-funded. The latest preliminary data shows a further 16% drop in all NHS-funded treatment nationwide. This trend shows that IVF treatment is not a priority for a struggling NHS in the UK. To access NHS-funded treatment, patients need to go through a long and arduous process of referrals, approvals, and meeting eligibility criteria that differ by postcode.

The number of NHS-funded IVF cycles in the UK in 2019 by region, from the HFEA

Figure 1- Showing the number of NHS-funded IVF cycles in the UK in 2019 by region, from the HFEA

The added burden of hidden costs and add-ons

According to data from our Clinic Finder surveys, 59% of patients undergoing IVF treatment have ended up paying more than they had expected on their fertility journeys. This can be attributed to hidden costs, like the costs of medication, extra blood tests and investigations, storage costs when freezing embryos, and extra add-on treatments that show up later on in their treatment journeys. Add-on treatments in IVF have always been a strongly debated topic, with varying degrees of evidence supporting their efficacy and the extra costs they incur (these treatments will be the subject of a future post from MyFertility). Most of these treatments show up later in the journey, after a patient has committed to treatment and thus is faced with a choice to make of paying extra for something that may potentially help their chances. This upselling has been met with a lot of scrutiny from regulators and the media, yet this has not stopped it from happening worldwide. If these treatments genuinely enhance success rates as claimed, why aren't they absorbed as sunk costs by clinics? Wouldn't showcasing higher success rates benefit clinics in the long run? Are short-term profits overshadowing long-term success and reputation?

Closing remarks

Navigating the path to parenthood in the modern age is not just an emotional journey, but also a financial one. The advancements in reproductive medicine, while promising, come with a hefty price tag that many find daunting. As we've explored, the socio-economic divide in accessing fertility treatments is evident, with costs often surpassing what the average individual can afford. The role of public health systems, like the NHS, becomes crucial in bridging this gap. Yet, with declining support and a myriad of challenges, many are left to navigate these waters on their own.

The commercialisation of fertility treatments, especially with the introduction of add-on treatments, further complicates the landscape. It's essential for patients to be well-informed, not just about the medical aspects, but also about the financial implications. Transparency from clinics, better regulations, and more support from public health systems can make a significant difference.

The dream of starting or expanding a family should not be a luxury reserved for the few. It's a fundamental human desire that should be accessible to all, irrespective of their financial standing. As we move forward, it's crucial to advocate for more equitable access to fertility treatments, ensuring that everyone has a fair shot at experiencing the joys of parenthood.

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