The price of a family

Niamh Quinlan

For the estimated one in seven couples who experience infertility and the one in four who struggle to conceive, there are many options available in today’s day and age. Medication in the form of fertility pills, artificial insemination and In Vitro Fertilisation (IVF) are just a few of them.

If you Google the latter treatment, a list of informational pages and support groups will come up. With them, come the suggested questions that the search engine gives you.

The first of which is “How much is IVF in Ireland?”. The answer cited the treatment to be between 4,500 euro and 5,000 euro in most private clinics in the country. And that’s excluding add-ons.

These “add-ons” are described by the Human Fertilisation & Embryology Authority (HFEA), in the UK, as “optional extras that you may be offered on top of your normal fertility treatment, often at an additional cost.”

Some of these treatments are experimental and have not shown any conclusive proof to show making a difference to a couple’s chances of having a baby.

The add-ons include embryo glue, to improve the chances of the embryo sticking to the uterine wall, and artificial egg activation [using calcium ionophore] to increase the chances of activation when a sperm is introduced to an egg.

The HFEA have a red-amber-green rating system as to how effective these add-ons are. The most effective add-ons are labelled as green, of which there are none, and the two mentions above are rated amber.

Access Fertility, a fertility clinic chain that have clinics across the UK and Ireland, have the prices of such add-ons on their website. Embryo glue is an extra 150 euro on top of the 3250 euro cost of the IVF cycle.

The National Infertility Support and Information Group (NISIG) say that the decision to get any of these add-ons differs from person to person and couple to couple. “Each [add-on] is a decision thought out carefully by the patients,” said Niamh Magee, a team member of the NISIG Administration.

“Some people decide to do pre-implantation genetic screening as they have had previous recurrent miscarriages and cannot go through the pain of the positive pregnancy test followed by the utterly painful upset of a miscarriage.”

A pre-implantation genetic screening, which allows the determination of either too few or too little chromosomes in the embryo.  This is rated by the HFEA as red, being one of the least affective add-ons, for days three to five of embryo development. It can cost about 2700 euro.

In April of 2019, The Irish Times published a survey they conducted with 38 couples who received IVF treatment. One third of those who did not successfully conceive through IVF were unable to afford further treatment as a result of previously purchasing these add-ons.

On top of this, 62 per cent of these couples were not made aware of the lack of scientific evidence to support these add-ons boosting the chances of conception.

“We have heard that some clinics feel that some couples are offered add-ons when they are very vulnerable and not given a whole lot of context in terms of success rates associated,” said NISIG.

“Some clinics have a policy of add-ons whereas other clinics don’t stand over the lack of research and don’t believe in them.”

When searching the prices of anything online, the first thing to come up, above the top results, are the ads that have paid to be there. One of the top ads recommended are for IVF treatment in clinics abroad.

Clinics in Spain are one of the advertised countries, where treatment costs about 5,000 euro and can increase to 8,000 euro with certain packages.

Invicta Clinics, a chain of IVF clinics in Poland, price their standard IVF treatment at 1,625 euro. According to their website this is a straight exchange from 6,500 Polish złoty as at the time of writing, 1 Polish złoty is worth 23 cent. The price increases with add-ons, the most expensive treatment costing from 6293 euro.

“Treatment abroad is cheaper in the long run; however, you also have to factor in the additional costs of going abroad,” said the NISIG.

A lot of additional factors need to be taken into account, such as holiday spending, time off work, flights, etc. For some couples, depending on their income, the organisation doesn’t think it could be a feasible option.

The biggest question with any treatment as expensive and meaningful as this will always be: is it worth it; and will couples walk away with financial and emotional loss? For those who can’t afford another IVF treatment because their first one failed, both factors are equally important.

But many companies do offer a full refund in the event that conception does not occur. Access Medical, for example, will refund someone, provided they haven’t had over three failed cycles.

Other clinics can also provide deals and discounts through links with health insurance providers. ReproMed, who’s IVF treatment costs upwards of 4,500 euro, offer discounts for those who are with VHI healthcare.

The provision of IVF treatment by public health services in Ireland (the HSE) is not currently available, unlike in the UK, where citizen women under the age of 40 can receive publicly funded treatment.

Ireland’s absent public service IVF funding is due to the lack of legal framework, but it is not against the law.

In 2018, 1 million euro was given to the HSE to fund the development of new legislation to provide for publicly funded fertility treatment. However, it was delayed due to the development of the abortion legislation, which was being conducted by the same team.

But there are charities and services in Ireland who provide financial aid to those who need fertility treatment.

The Merrion Fertility Foundation, a non-profit organisation based in Dublin 2, “provide financial assistance to those who require assisted fertility treatment and who are unable to afford it.” However, their funds do not cover initial consultations and patients must pay 500 euro towards the treatment.

A woman must also have been referred to the foundation by a doctor in order to receive funding, and the foundation has said that previous failed IVF most likely won’t have an effect on eligibility.

On average, birth rates due to IVF are between seven and 30 per cent, depending on age. With each successive attempt, the chances of conceiving decrease and the price will increase.

Niamh Quinlan

Image Credit: Piqsels