The true cost of IVF treatment
Tamsin Bowers, 35, and her husband Andrew, 42, started trying for a family when she was 21.
Two years later, looking for medical help, they went down the NHS route, but after surgery and unsuccessful treatment with fertility drugs, Tamsin discovered she would have to wait a further two to three years to begin the in vitro fertilisation (IVF) procedure.
"I decided to take the bull by the horns and pursue IVF privately," she says.
The Bowers are not alone. Infertility is estimated to affect around one in six couples in the UK. Nearly 45,000 cycles of IVF are performed in Britain each year, 20,000 of them privately.
Most people, however, start with the NHS. The official guidelines state that couples should be offered up to three cycles of IVF on the NHS if the woman is aged between 23 and 39, and either the couple has a diagnosed reason for infertility or they have been trying for three years.
However, different Primary Care Trusts (PCTs) have additional rules. Some, for example, will not fund IVF where one of the couple already has a child.
To make matters worse, in the current round of government cuts, IVF has been a significant casualty. Research by health magazine Pulse found one in five PCTs had cut the number of IVF procedures offered in the previous three years, while eight of 151 PCTs had not funded any IVF for two years. That number is set to rise.
This means thousands more couples are likely to be at the mercy of the private sector. The danger of going private is that you leave an environment where the entire focus is on medical care and become subject to something of a corporate money-making machine.
The costs can be outrageous and opaque, and the end result can actually damage your chances of having a family.
According to the Human Fertilisation and Embryology Authority (HFEA), which regulates private IVF clinics, the average cost per cycle is around £5,000. But it can easily cost as much as £12,000 if more complex treatment is needed.
The problem is, when you embark on the process, you have little idea of how many cycles it might take for you to conceive – if you do at all.
In fairness, the clinics can't do much about this. IVF only has a one-in-three chance of success, so clinics can't tell how many rounds you may need. There's also an endless list of potential treatments, depending on the precise nature of your problem, which you'll only find out about after expensive investigations.
Critics claim, however, that clinics carry out too many tests. Tamsin says: "When I was enquiring about costs, the problem was the need for scan after scan and blood test after blood test. Some clinics wanted to do 10 scans at a cost of £200 a scan, and numerous blood tests for between £50 and £100 each.
"At the time I thought this was how the treatment should be done, but when I eventually had treatment, the clinic I chose only carried out three scans at the crucial points in the cycle and the same number of blood tests. I know now that a lot of the scans required are pointless."
Tamsin began to see this more clearly after her first successful round of IVF, when she visited clinics to enquire about trying for another child.
"Although we had a letter from our doctor saying exactly what we needed and what we'd already had done, the clinic said we would need to do every test again," she says.
Despite what could be viewed as blatant money-spinning, the clinics stand by the tests they provide. Tim Mott, a spokesperson for The Bridge Centre (not one of those Tamsin visited), says: "No one knows in advance of the investigation and diagnostic process whether these tests are necessary or not. In our view, there's no such thing as
an unnecessary test."
But Robert Foreman, medical director at fertility clinic CRM London, says some clinics do get carried away.
"In my opinion far too many investigations are done prior to IVF and you have to question why that is," he says.
"You need investigations to establish why someone isn't getting pregnant, but if someone says they have a sperm problem diagnosed elsewhere, for example, there is no reason to duplicate tests."
Another issue is that clinics can charge whatever they wish for each aspect of treatment. As Keith Pollard, managing director of comparison service privatehealth.co.uk, points out: "These clinics are commercial enterprises. They are regulated by the Human Fertilisation and Embryology Authority (HFEA), but it doesn't have any control over pricing, so costs will vary."
Adding insult to injury, clinics make comparing costs exceptionally difficult. Pollard says: "They have different payment models, so it's not easy to compare what you're getting." Tamsin spent months researching different options and says it was a nightmare trying to compare like with like.
A gloomy future
A Moneywise mystery shop of 10 random clinics found that no two clinics charged the same amount for any of the treatments investigated. The cost of IVF itself ranged from £2,750 to £3,350, but in some instances this included scans and blood tests, and in others it didn't.
Our investigation also discovered a vast array of services offered to couples.
There are several forms of screening, different charges for consultations depending on the areas discussed, and various options for blood tests. Confused and naive couples could easily be drawn into opting for the 'belt-and-braces' approach and pay well over the odds.
The clinics were all reluctant to discuss what a typical procedure could cost, although one with an advertised price for IVF of £3,350 told us it would cost "a minimum of about £5,000".
Following the government cuts announced in October, things could be about to get much worse. The HFEA was one casualty of Osborne's axe, so IVF clinics will now fall under the remit of what is already an overstretched Care Quality Commission. It's fair to say these clinics are unlikely to come under more scrutiny than they currently do.
So it seems couples are on their own, and are poorly placed to get the best outcome financially. "Couples don't compare costs as much as they look at success rates," says Pollard. "People will look for the clinic that has the best chance of success and pay whatever it takes."
In its 2010 Annual National Fertility Report, Red magazine found couples would be prepared to spend an average of £15,000 on IVF, with one in 10 prepared to spend £50,000 – a desperation clinics are quite prepared to prey upon.
In the boom years patients' homes have been a major source of finance. Tamsin has been through IVF twice now and for both treatments she remortgaged her house. "It was a huge step, because you're remortgaging to pay for something which you don't know will work," she says.
She spent £5,000 on each treatment and says: "Financially, as we raised the funds against the house and increased the mortgage both times, we know that we will be paying it off for the next 10 years."
The effort and cost proved worthwhile in the end, though. Tamsin had twins after her first round of IVF, for which she travelled to Sweden. She went on to have another child on a second round and has since had a fourth child naturally.
Tamsin now works with ivfsupportservices.com, to help other couples going through the process. She says one of the main sources of angst is that couples find the money for treatment, only to discover they have to pay much more than this. This becomes even more stressful if the first cycle is unsuccessful and they can't afford a second.
Clinics accept there are issues. Mott says: "There are times when higher than expected investigation costs have caused problems and unhappiness." So is there a solution? "Not in our view, although we would like to think we're getting better all the time."
However, with such a huge and unpredictable cost attached, there is still a long way to go.
Questions to ask IVF clinics:
- What are your success rates?
- What tests will I have to undergo before you know what fertility treatment I need?
- How much will the tests cost?
- Exactly how much will I have to pay for the treatment as a whole and precisely what will this include?
- Will you offer a fixed price?
- What's the worst-case scenario?
- What can I do if I'm not happy with the service?
Changing mortgages without moving home. Property owners chiefly remortgage to get a better deal but some do so to release equity in their homes or to finance home improvements, the costs of which are added to the new mortgage. Even though you’re not moving house, you still need to engage solicitors, conveyancing and the new lender will require the property to be surveyed and valued.