Fertility treatment options if you need help getting pregnant
Researching infertility treatments? Here is our guidance on the most common fertility treatment options to help you make the right decision for your family.
If you need help getting pregnant, doctors have more treatment options available than ever. But it can be hard to figure out which one is right for you. That’s especially true because the stakes and financial costs can seem so high.
If you’re feeling overwhelmed by all the medical-speak and statistics, help is here. Below, we offer a look at some common fertility treatment options—along with ballpark costs. (Note that how much you’ll pay out of pocket will depend on your health plan.)
Donor Eggs or Sperm
This may be one of the most well-known fertility treatment options. Donor eggs may be used when a person with ovaries has started menopause or has diminished ovarian reserve (DOR). (DOR happens when an ovary loses its normal potential to reproduce.) Or they may be used for family building with same-sex couples, says Lora Shahine, M.D. Dr. Shahine is a reproductive endocrinologist at Pacific NW Fertility in Seattle.
Donor sperm is used when a person with testicles has poor sperm or no sperm. It can also be used for family building by single people with ovaries and same-sex couples.
Cost: It’s about $38,000 for a donor egg with in vitro fertilization (see below). For donor sperm, the cost can range from $300 to $4,000, depending on the donor.
These are medications that help ovulation. They’re often used in people with ovulation disorders. Dr. Shahine says fertility doctors often start with 2 medications: clomiphene (Clomid®) and letrozole (Femara®). Both release FSH and LH hormones. These hormones help start the growth of an ovarian follicle containing an egg.
Cost: If you use them alone, you can expect to pay about $1,200.
Intrauterine Insemination (IUI)
In this procedure, sperm is washed and prepped. Then it’s placed in the top of the uterine cavity around the time of ovulation. “It essentially gives the sperm a head start on finding an egg and fertilizing it,” says Bradley Trivax, M.D. Dr. Trivax is a reproductive endocrinology and infertility specialist at Stony Brook Medicine’s Island Fertility in Commack, New York.
Unlike IVF, fertilization takes place inside a person with ovaries, rather than at the lab. “An IUI is a good starting place for those with adequate sperm and open fallopian tubes,” says Dr. Trivax. “Otherwise, IVF is a first option.”
Cost: With medication, it’s between $3,500 and $8,500.
In Vitro Fertilization (IVF)
IVF is another of the well-known fertility treatment options. During IVF, mature eggs are taken from the ovaries. They are fertilized by sperm in a lab. Then the fertilized egg or eggs (embryos) are moved to the uterus. “Anyone with fertility challenges can be a candidate,” says Mark Leondires, M.D. Dr. Leondires is the founder and medical director of Reproductive Medical Associates of Connecticut.
IVF is normally considered:
- After an unsuccessful IUI.
- In cases of severe male factor infertility.
- If fallopian tubes are blocked.
“It’s the most successful fertility therapy we have, even though it’s more invasive and expensive than other methods like IUI,” Dr. Leondires says.
Cost: The average cost is around $24,000.
This is done in a lab, along with IVF treatment, when asked for. “When the embryo develops, it’s surrounded by cells that make up a protective shell,” says Dr. Trivax. The embryo naturally breaks out of this shell as it grows. But for assisted hatching, the embryologist makes a small “crack” in the outer shell of the embryo. This is done right before it’s placed in the uterus.
“The goal is that assisted hatching will help the embryo expand and implant into the uterine wall and lead to a pregnancy,” Dr. Trivax says. It’s not right for everyone. But it may be helpful in people older than 37. It may also be helpful for those who’ve had an IVF failure in the past.
Cost: If not included with the cost of the IVF procedure, then it’s between $500 and $1,000 extra.
Intracytoplasmic Sperm Injection (ICSI)
This occurs during IVF. A tiny needle is used to inject a single sperm into the center of a mature egg. ICSI is helpful in cases of infertility in people with testicles. “Doctors will often recommend ICSI in cases of unexplained infertility, since fertilization may be an issue,” says Dr. Shahine. ICSI leads to a birth 25% to 30% of the time.
Cost: It’s about $1,300, plus the cost of the IVF procedure.
Natural Cycle IVF
This is still IVF. But it’s done without the large amounts of medications to stimulate the ovaries to make multiple eggs. “This may make sense in a patient that has an extremely low egg reserve and doesn’t respond to the injectable medication,” says Dr. Trivax. “The thought being that if they are only going to make 1 egg, then there is no need for the medication.” It’s also an option for couples who are doing IVF due to male factor infertility. It helps avoid multiple pregnancies and unneeded stimulation for the partner.
Cost: On average, it’s about $17,000.
Preimplantation Genetic Testing (PGT)
This is used to find genetic abnormalities in embryos created with IVF. It’s done before the embryos are moved to the uterus. “The goal of PGT is to significantly reduce the chances of transferring an embryo with a specific genetic condition or chromosome abnormality,” says Dr. Trivax. This may also be important if you have a genetic history of a certain disease, such as cystic fibrosis or sickle cell anemia.
Cost: It’s an extra $3,000 to $5,000 for each IVF cycle cost.
Do you have conditions that can contribute to infertility, such as fibroids or endometriosis? If so, your fertility specialist may suggest surgery to help manage them. This is usually a minimally invasive procedure such as a:
- Hysteroscopy: A thin, lighted tube is used to check the inside of the uterus. It can remove any polyps, fibroids, or scar tissue.
- Laparoscopy: This is a type of surgery done using small incisions and a camera. It’s used to remove any endometriosis or cysts, says Dr. Trivax.
Cost: It’s about $2,600 if done in a doctor’s office. It can be more than $14,000 if done at a hospital.
It may not be a fertility treatment, but surrogacy is a valid option. Surrogacy involves a person with a uterus carrying a pregnancy for another person or couple. There are two types:
- Traditional: The surrogate is artificially inseminated with a parent’s sperm.
- Gestational: A fertilized embryo is transferred to a person with a uterus.
“In certain medical situations where carrying a pregnancy is dangerous to the health of the patient, a gestational carrier is an excellent option to have a child,” says Dr. Trivax. It’s also an option if a patient has problems with their uterus, such as recurrent miscarriage or fibroids. Because of various legal issues, traditional surrogacy is less common than gestational surrogacy.
Cost: It can vary a lot depending on where you live. It can cost from $100,000 to $300,000, including surrogate, medical, and legal fees.
Many health plans offer prenatal support and postpartum recovery programs for their members. Some may also help cover costs of fertility treatment options. Ask your health plan if you have access to Wellframe.
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