When a couple or individual decides to try to conceive via in vitro fertilization, there are a lot of unknowns, including whether or not going through all the time, energy and money will actually result in having a baby. The financial factor is especially daunting. In fact, many people who would like to try IVF are unable to do so because of the high costs associated with the necessary fertility treatments as well as the procedure — especially when there’s a chance it won’t work.

In response, some fertility clinics have adopted baby-or-your-money-back guarantees for their IVF procedures. Sure, that sounds great in theory, but how does it actually work? We spoke to two fertility doctors about what this means and why parents may want to consider it.

How do money-back guarantees for IVF work?

Most money-back guarantee programs are linked to a successful pregnancy resulting in a live birth, Dr. Mark Leondires, the founder, medical director and partner in reproductive endocrinology at RMA of Connecticut, tells SheKnows. The clinic where he works does not provide this money-back guarantee on their IVF procedures. He explains that these policies range from a percentage of funds returned to 100 percent of returned funds.

Essentially, these money-back guarantee programs work by having the prospective parents shell out more money upfront than IVF would typically cost. One example from a 2017 New York Times article featured a couple that paid $50,000 for IVF, which is around $20,000 more than they would have paid taking a more traditional IVF route.

The reason for the higher price tag is that through this arrangement, the clinic agrees to perform multiple IVF procedures, until they have a successful pregnancy and birth. If that doesn’t happen, the couple would get their money back. If they do end up having a baby, then the clinic keeps the entire (higher) amount they paid. So basically, they either get a baby or their money back.

“Regardless, in this situation, with the successful birth of their child, they are able to look beyond the extra funds they expended in order to have the peace of mind that they would either have a child or get a refund,” Leondires notes.

Who qualifies?

Of course, not just any person or couple can waltz into a fertility clinic and participate in a money-back IVF guarantee — first, they must qualify.

“It is important to note that not every patient is accepted into a guarantee program,” Leondires explains. “IVF practices typically select patients with higher chances for pregnancy in order to limit their risks and to maximize both the patient’s and practice’s opportunity for the plan to be successful. The practice is then incentivized to achieve a pregnancy in as short a time as possible, and the patient is prepared and financially covered for more than one attempt.”

Reproductive Medicine Associates of New Jersey in Eatontown, New Jersey, offers a program called CareShare through which eligible patients can receive a 100 percent refund for unsuccessful IVF cycles. According to Dr. Thomas A. Molinaro, a reproductive endocrinologist at RMANJ, in order to qualify for CareShare, a couple must have a thorough medical evaluation to determine their prognosis for achieving a live birth. If accepted into the program, they are guaranteed a successful outcome or a financial refund.  

“This is a great opportunity for patients who qualify to reduce the financial risk associated with infertility treatment,” Molinaro tells SheKnows. “By sharing their risk, we also hope to share in their success. However, CareShare patients run the risk of being successful in their first few attempts and may end up paying more than they would have on a pay-as-you-go basis.”

So chances are couples or individuals who have had a long history of infertility or being unable to make it through a full-term pregnancy — essentially, the ones who you would think would gravitate toward a program like this — likely would not be eligible.

What’s in it for the clinic?

Aside from a potentially big payday after a successful birth (via parents who already had a higher chance of getting pregnant), there are other benefits for the fertility clinics.

“The IVF process is both emotionally and financially stressful, Leondires explains. “Having patients pay a single fee with the guarantee removes both financial and emotional stress for both the patient and the practice.”

The policy also allows the clinic and patient to pursue multiple cycles without additional financial spending. “This means the patient is committed to the practice for several cycles and the practice is able to collect an up-front fee and then simply focus on moving towards a successful outcome,” Leondires says. “The financials of an IVF cycle represent a real expense, and to remove these from the equation saves time and effort on the clinic’s part and the patient’s part.”

What’s in it for the prospective parents?

Yes, there’s the obvious: Hopeful parents who are eligible for this policy either get a baby or their money back. But beyond that, controlling for the financial side of the fertility equation can help to reduce stress for the individual or couple looking to get pregnant.

“This allows the patient to simply focus on optimizing her chances for success knowing that they have covered their financial responsibilities even if they require multiple attempts at pregnancy,” Leondires explains. “Additionally, it limits their risk in regards to financial loss if they do not have a child.”

Molinaro agrees: “Providing a level of certainty for these patients allows them to enter into treatment for the first time or continue care after insurance benefits have been exhausted. CareShare gives us the chance to work with patients who might not have otherwise entered into our care, allowing us to serve a greater number of people.”

Ultimately, like many aspects of health care, fertility treatments and programs come down to money. Money-back guarantees on IVF can certainly be a good option for those who can afford it but still remain largely out of reach for many people dealing with infertility. Regularly priced IVF isn’t exactly affordable, let alone treatments with a higher cost. But for those who do have access to the funds necessary to go this route, it must be a comfort to know they won’t be walking away from fertility treatments without a baby and a significant financial loss.

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