Finding a list of the IVF costs worldwide for informed decisions on where you can get cost effective treatment is very difficult - I know I've been trying and failed! So I decided to do some research for you.
This article addresses three areas:
1. The costs that are incurred for any one IVF cycle;
2. A comparison of the basic IVF treatment cost Worldwide;
3. An estimate of the total basic IVF cost to get pregnant according to age and country based on average success rates.
The first thing you need to understand is how the total cost of an IVF cycle is made up.
The costs for one cycle of IVF
During any particular cycle the costs will include:
* Initial consultation (can be 6% to 10% of the basic IVF treatment cost).
* Basic IVF Treatment (varies by country as outlined in Table 1) Usually includes doctors fees for egg collection and embryo transfer, embryologist's fees for intro fertilization, anesthetics, ultrasound scans, theater charges.
* Intracytoplasmic sperm injection (can be 28% to 40% of the basic IVF treatment cost) Creation of embryos by direct injection of sperm into egg, procedure used for male infertility but increasingly common in standard IVF.
* Hormonal drugs (can be 20% to 80% of the basic IVF treatment cost) Precise cost will depend on which drugs are prescribed for stimulating the ovaries. A Times Body & Soul survey also found high variation in prices charged by pharmacists.
* Embryo freezing Sometimes included in the basic IVF cost. Other clinics can charge up to 20% of the basic IVF treatment cost, plus around 10% of the basic IVF cost per year for storage and between 20% and 100% of the basic IVF treatment cost for later thawing and transfer.
* Other investigations Immunological therapies: can be up to 50% of the basic IVF treatment cost. Pre-implantation genetic screening, to pick the best embryos: can be 55% to 120% of the basic IVF treatment cost. Both procedures are offered by a few clinics, though there is little published evidence that they are effective.
* Regularity fee (dependent on the country) can be 4% to 5% of the basic IVF treatment cost. Charged separately by some clinics and rolled into the general cost by others.
This IVF cost information was according to The Times, January 10, 2008 - to give an indication of how these will affect the total IVF cost around the world the figures, which originally were for UK clinics, have been converted into percentages of the basic IVF treatment cost, and it has been assumed that the percentages will be similar across the globe. Please note that if you, for example, purchase your hormonal drugs in a different country to where you have your IVF treatment then the percentage will not be an accurate reflection of costs.
The major extra cost on top of the basic IVF treatment cost that everybody has to bear is the hormonal drugs. The amount of hormonal drugs that are required depend upon your:
* age;
* length of infertility, and
* physical condition of your uterus and endometrium (uterine lining)
Understanding what makes up the IVF cost is important, and can be very confusing. The main point to remember at the stage of comparing clinics on cost is to check what is included in their price and what is excluded.
Bearing in mind what makes up the IVF cost we can now look at the basic IVF treatment cost across the world.
A comparison of the basic IVF treatment cost across the globe
It was very difficult to find comparative IVF cost figures from around the world. After much searching I realized that such a resource did not exist.
As a start I took some figures from an article in Human Reproductive Update, Vol.8 No.3, 2002, An international survey of the health economics of IVF and ICSI by John A. Collins. The article had determined IVF costs for 26 countries for 2002. Taking an average inflation rate in health care expenditure of 3.5% I used their figures to project these IVF costs forward and give estimates for 2008 and 2009 all costs were then converted to US$.
I then searched the internet and made some personal inquiries to find actual IVF costs now - August 2008. It was not possible to find costs for all 26 countries on the original list from John A. Collins (although I am still trying!), however I did find the costs for countries that were not on the list. So in total I had cost estimates for the basic IVF treatment for 46 countries.
Although I still have a lot of research to do to find enough costings to give a good overview for each country, my initial research indicates that the ten cheapest countries I found data for are:
* India;
* Korea;
* Hungary;
* China;
* Czech Republic;
* Latvia;
* Qatar;
* South Africa;
* Thailand and
* Turkey.
The most expensive five appear to be:
* USA;
* Hong Kong;
* Dominican Republic;
* Sweden and
* UK.
Once again it needs to be stressed that this is a difficult comparison to make as some costs include drugs and some do not - these drugs can account for an extra 20% - 80% of the basic IVF treatment cost.
Although currently there are still a lot of gaps I intend to continue with this research to give more detailed information on the IVF cost and IVF success within each country.
An estimate of the total basic IVF cost
Having found the basic IVF cost you have to realise that this will not be the total cost that you will pay in order to have a successful pregnancy through IVF.
IVF success rates depend on a number of factors including:
* age;
* number of embryos replaced, and
* cause of infertility.
The HFEA (Human Fertilisation & Embryology Authority) gives the average success rates from 2005 for each age group as:
* 29.6% for women under 35 years old;
* 23.6% for women aged 35 - 37 years old;
* 18.2% for women aged 38 - 39 years old;
* 10.0% for women aged 40 - 42 years old;
* 3.2% for women aged 43 - 44 years old;
* 0.8% for women aged over 44 years.
Using these figures it is possible to calculate the average total IVF cost for each age group in each country.
The chance of a pregnancy through IVF is increased if more embryos are replaced. The more embryos that are replaced the greater the probability of a multiple birth, since each embryo has a chance of developing to full term. Since multiple births is the single greatest risk to health in IVF the HFEA in the UK have imposed restrictions on the number of embryos that can be transferred in IVF to a maximum of two for women under the age of 40 and a maximum of three for women aged 40 or over who are using their own eggs (if you are using donated eggs the maximum is two). In India, however, these restrictions do not apply and six or seven embryos can be replaced at any one cycle, hence increasing the chances of pregnancy but also increasing the risks. To date I do not have details of the legal limits in all of the countries.
The cause of infertility is very specific to you. It is not an area which I will address here.
Summary
Having an estimate of the total IVF cost in each country now puts you in a position to be able to make an informed decision on the country to focus on for your IVF treatment depending on your budget.
India clearly comes out as the cheapest country on IVF cost. India also has the benefit of a vast amount of experience - they were the second country in the world to have a successful pregnancy with IVF, only a couple of month after the UK in 1978. In India many of the doctors have been trained and have practiced in the West and are fluent in English.
However, if you are from Europe and want to stay closer to home, Hungary (a beautiful country, and so clean. I have had personal contact with one of the clinics there and their communication was excellent) and Latvia (I have never been so I cannot comment) appear cheap options.
It should be stressed that the decision of where to have IVF treatment should not be made purely on cost but the reputation of the individual clinic is very important.
