Unlike virtually every other form of medical treatment in America, IVF is largely not covered by insurance.  To make matters worse, patients often require more than one attempt to have a reasonable chance for success and the majority of people needing this treatment cannot afford enough attempts to shift the odds in their favor. 

When it comes to selecting an IVF program, consumers often find themselves faced with two harsh realities. First, IVF affords them the only realistic chance of having a family and second, given failure on the part of the Society for Assisted Reproductive Technology (SART) and the Centers for Disease Control (CDC) to publish verifiable IVF outcome statistics, there is presently no reliable method by which to evaluate the competency of any IVF program on the basis of their performance. Simply stated, in the U.S.A when it comes to choosing an IVF program for treatment, it is still a case of “consumers beware”!

Against this background, many quality IVF programs, by offering a financial risk to their patients are providing a creative approach to building consumer confidence in their ability to help them go from “infertility to family”. Such financial Risk-Sharing Plans (RSP) link the cost of IVF services to a successful outcome (birth). In the process, the IVF program provides consumers with more than one IVF attempts for a single, much-reduced fee. The RSP requires that the IVF program continue to treat until such time that a baby is born, or the promised services have been exhausted (whichever occurs first).  In this manner, financial risk is shared between the provider and the patient. Consumers immediately and instinctively recognize that only those IVF programs that are capable of achieving good results would be able to offer (and benefit financially from) such an arrangement while those that cannot, would lose and soon be forced to abandon the plan.

While generally speaking, contingency pricing in medicine is in large part ethically questionable, IVF is, in my opinion, a clear exception because here, the outcome is actuarially measurable, terms are clearly definable, and expectations are realistic. Thus, in the absence of insurance reimbursement, who is being hurt?