Ask Our Expert...
Ask Our Expert provides a way for you to ask some of your general affording infertility treatment questions. Our expert, Evelina Weidman Sterling, PhD, MPH, CHES is a public health educator and researcher specializing in reproductive and women’s health issues. She is a best-selling and award winning author of several consumer health books focusing on fertility-related issues, including Living with PCOS, Having Your Baby through Egg Donation, Budgeting for Infertility: How to Bring Home a Baby without Breaking the Bank, and Before Your Time: The Guide to Living Well with Early Menopause. Dr. Sterling is the co-founder and CEO of My Fertility Plan, an innovative consulting firmed aimed at providing action-oriented information and educational resources to help patients overcome infertility and build their families. Dr. Sterling also serves as the President of Rachel’s Well, a women’s health non-profit organization addressing menstrual health and ovarian insufficiency.
You can find additional information and resources on the Creating a Family Affording Fertility Treatment page.
Q: I listened to the Creating a Family show on buying fertility drugs cheaper. If I think I can save money using a specific drug can I request that my infertility clinic prescribe that drug or does each infertility doctor have their own drug regime that they want to use? How much say does the infertility patient have in the brand of infertility drug that the RE [reproductive endocrinologist] will prescribe?
A: I am a big supporter of patient-clinician partnerships meaning that all patients should be active participants in all aspects of their healthcare and medical decision-making processes. Patients are each very unique biological, social, economic, ethnic, and spiritual beings. So a team approach will provide help with achieving the best individual patient outcome. This is even more so with fertility care since there is no “one size fits all approach,” and it is just as much an art as a science. “Good” medical decisions, especially regarding medications and treatments, require patient involvement because they must reflect patient preferences and values. To encourage greater patient involvement in decision-making, clinicians should provide relevant information, allow patients time to digest and respond to the information, listen to questions and concerns, and solicit patient opinion before any medications are selected or a final treatment plan is agreed upon.
Q: We are getting ready to move to the big guns—in vitro fertilization. We have been saving for almost a year to afford this next step in fertility treatment. In preparation for this first IVF, I was wondering where is the best and cheapest place to buy our fertility medications. Our infertility clinic has told us that they will be very expensive.
A: Infertility medications ARE very expensive and can sometimes account for up to half of the cost of an IVF. The best way to save money on medications is to be a smart shopper. Different pharmacies will have different prices for different medications. Once you get your list of medications from your fertility specialists, start calling around and asking about prices. This includes not only your local pharmacy, but also specialty pharmacies (both online and brick and mortar) that focus only on fertility meds. Also, ask about other “hidden” drug related costs like syringes, delivery charges, and return policies.
Don’t forget to check into your insurance policy as well. Often medications are handled differently than treatments so just because you have been told that your insurance does not cover IVF does not necessarily mean they won’t help you get discounted drugs through their medication program.
Q: I know you say don’t spend too much time with your gynecologist and get yourself to an infertility doctor sooner rather than later. I think that’s good advice for us since we’re in our late 30s and have been trying to get pregnant for almost a year. I have an appointment next month with my gynecologist. I don’t have medical insurance coverage for infertility. Does it make sense to get the initial testing with my gynecologist and then take that to the fertility clinic? Or will they make me re-do the tests. I think my gynecologist will work with me on how to code the testing so that I stand a better chance of getting it covered.
A: Great question! Yes…if you have a great relationship with your gynecologist who understands your situation, it is good idea to work with her to get some of the initial testing done. You are correct that given fertility problems are so complex and affect much more than baby-making, that often your gynecologist can code it so it doesn’t look like you are being tested solely for infertility, which may help them to be covered under your insurance. Make sure you keep great notes and records (in addition to your "official" medical records kept by your Gyn) as to what has been done, what were the results, and what does this mean.
Some fertility clinics may want to repeat the tests so be prepared to make a case why you don’t need to be re-tested. “We just like to do these tests ourselves to be sure” is not a valid reason. To minimize your chances for re-testing, make sure your tests are less than a year old. Use a reputable lab. Make sure that all tests were completed during the correct time of your cycle and are not inconclusive. Also, make sure you understand what is being tested and why, as well as how this will influence any overall treatment recommendations. I’ve known a few women who got so caught up in testing that they racked up $20,000 in testing costs before IVF was even recommended.