What the 'Win a Baby' Contest Really Says About Fertility Treatments in America
A Florida couple won the prize of a lifetime after entering a radio-station sponsored contest called Win a Baby. Despite the unusual name, the contest wasn’t sinister at all—the winner was guaranteed to receive one round of IVF treatments for free. Earlier this year, the winning couple, Krista and Anthony Rivera of Cape Coral, Florida, delivered their happy, healthy baby named Garret Campbell Rivera.
The contest, sponsored by radio station B1039 in November 2017, asked applicants to send in videos explaining why they thought they’d make a great mother. The 2017 contest, won by the Rivera family, was such a success that the radio station sponsored a second one this year. Entries were collected in May and voting occurred that June.
But the contest belies a darker truth about IVF—for many couples, the financial burden can make assisted reproductive technology (ART) a dream that just can’t come true without once-in-a-lifetime help, like winning a contest. According to Centers for Disease Control and Prevention (CDC) statistics, 12 percent of women aged 15 to 44 struggle with becoming pregnant or carrying a pregnancy to term and, though ART has become more common since it’s inception in the late 1970s, only a fraction of those struggling with fertility can afford it.
The Cost of IVF
Geographical region, patient needs, and several other factors can impact the cost of IVF, but on average one cycle costs about $12,000, which includes egg retrieval, fertilization, and insertion, monitoring, ultrasound imaging, anesthesia, and embryo storage. In addition, patients can expect to pay anywhere from $3,000 to $5,ooo for medications per cycle. According to the Society for Assisted Reproductive Technology, many patients need to undergo multiple cycles, which dramatically increases associated costs.
Writer and New Jersey native Kristin Diversi and her husband Blair are among the numerous couples battling infertility without deep pockets who have incurred substantial debt in the process. The Diversis went through several rounds of intrauterine insemination at the beginning of their treatment. “We did six IUIs prior to starting IVF. One round was canceled right before egg retrieval due to a cyst, then there was an egg retrieval about three months later.” Sadly, the embryos from Diversi's egg retrieval did not mature. In 2019, the Diversis opted for embryo adoption and received a transfer of two donor embryos that May.
Diversi, who is currently in her third trimester, shared on her personal Facebook page that she and Blair paid close to $4,000 every two weeks for 10 months just for the necessary medications for her IUI cycles. Their total costs, including office visits and procedures, are close to $100,000 at present. “I'm not sure how much we spent in total because every time I think of it I panic,” she says.
Despite a rise in demand for fertility assistance services, insurance companies that provide benefits for IVF are far from the norm. As reported by CNBC, there are only 10 states that require insurance companies to offer consumers coverage for IVF and only 16 that provide fertility coverage at all, and that may not cover IVF.
IVF and Insurance
The Diversis’ insurance did not provide benefits or coverage for any of the costs they’ve incurred. The pair set up a crowdfunding campaign to help offset costs and raised around $5,000. “The rest was split between a medical loan and maxing out a bunch of credit cards,” she explains.
Some insurance programs do offer some amount of coverage, but that coverage may be limited. “For example,” says Lisa Greenbaum, chief client officer at Progyny, a fertility benefits management company, “Many carriers require an infertility diagnosis in order to receive treatment and since most carriers define infertility as 12-months of heterosexual sex without a successful pregnancy. This means the LGBTQ+ community and single parents by choice are excluded from receiving the treatment they need to build their families.”
Another problem with conventional insurance providers is that if they do offer coverage, there is often a woefully low lifetime maximum. “Most coverage plans have a dollar maximum, for example, $15,000. One of the biggest problems with this type of coverage,” says Greenbaum, “is that most patients will exhaust their dollar maximums on treatment that isn’t effective.” She adds that by the time IVF is even on the table, most couples will have maxed out their benefit on IUI and other less invasive procedures, meaning the IVF must be paid for out-of-pocket.
Few other options exist for those not blessed with a huge bank account. According to Greenbaum, some of the most common options include “paying out of pocket through savings or income, engaging with payment programs available at some clinics, applying for grants or scholarships, or asking friends or family members for a loan.”
There is hope though. In 2017, the American Medical Association took a major step in increasing the potential for insurance coverage by declaring infertility a disease. Already recognized by the World Health Organization and the American Society of Reproductive Medicine as a disease state, the move by the AMA has the potential to open the doors to coverage by more insurance companies and make the dream of parenthood without exorbitant debt or by winning a once-in-a-lifetime contest attainable to more than the just wealthy.
