National Cost for an IVF Cycle

Write Us with Your Question! Here’s a recent one we received.

Q: My husband and I are considering adding to our family. I am 42 and we have twins. I prefer not to have another set of twins. What are the costs for IVF using my own egg (roughly)?

Natalie Burger, M.D.

Natalie Burger, M.D.

Response from Natalie Burger, M.D., Texas Fertility Center:

A:  The national average for the cost of a fresh IVF cycle is $10,000 plus the cost of medication, which itself can range from $3,000 to $6,000.  As each situation is unique, some patients/couples may require additional IVF treatment steps that may add cost.

For instance, technology now allows us to genetically test embryos so that only chromosomally normal embryos are transferred into the uterus.  This increases the chance of successful pregnancy and significantly lowers the chance of miscarriage. This additional testing may add an additional $4,000 to $5,000 to the overall cost.

We’d love to see your question! Write Us with Your Question!

Proactive Fertility Planning

This is the column where our readers can write in with their questions. We’ll field the questions to one or more experts in the subject and post the responses typically within 2 weeks. Write Us with Your Question!

Q: I am 30 and starting a doctoral program soon, which I know is at least a five-year commitment. I am not yet married and know that I would like to complete my degree and be married prior to starting my family. Having never been pregnant before, what evaluations and tests can be performed to test my fertility?

Natalie Burger, M.D.

Natalie Burger, M.D.

Response from Natalie Burger, M.D., Texas Fertility Center:

A:  It is common for women these days to put off family plans until they become more settled in their career and life.  However, it’s important to not ignore the fact that, as we get older, we have fewer good eggs left.

Checking an AMH (antimullerian hormone) level is a easy way to give you information on your relative egg quantity – i.e. do you have a lot or only a few eggs left.  If the test shows a low result, it’s important to talk with a fertility specialist promptly to understand your options.  This blood test can be done on any day of your menstrual cycle and even if you’re on the birth control pill.

To safeguard your fertility, it’s important to also continue regular exams with your gyn provider, who can monitor you for any new gynecologic issues.  Also, avoid smoking as this can prematurely diminish your egg count.  Practice safe sex so that you don’t expose yourself unnecessarily to infections that can cause scar tissue.

Overall, it’s important to be proactive when thinking about fertility – this will help you to optimize your chances when you are ready to start a family.

We’d love to see your question! Write Us with Your Question!

Trying to Conceive at Age 36

We have begun a new column where our readers can write in with their questions. We’ll field the questions to one or more experts in the subject and post the responses typically within 2 weeks. Write Us with Your Question!

 

 Q: I’m 36, healthy and trying to get pregnant for the first time. How long should my husband and I expect it to take to conceive on our own? When should we seek a medical consultation and with whom?

Natalie Burger, M.D.

Natalie Burger, M.D.

Response from Natalie Burger, M.D., Texas Fertility Center:

A: Women in their mid-30s who are trying for pregnancy generally have a 10-15% chance of conceiving each month.  Approximately 80% of couples will be able to conceive within the first year.  However, if there has been no success for many months, the overall chance of pregnancy per month begins to decline – to even 1-2% after a full year of trying.

Women over the age of 35 should consider seeking fertility evaluation if they have been trying for 6 or more months for pregnancy without success.  As fertility significantly declines after the mid-30s, it is especially important for those 35 and older to seek prompt fertility evaluation to maximize the chances of success.

A woman is born with all the eggs she will ever have.  During her life, she will continue to lose eggs (both through the process of ovulation as well as through a process called apoptosis – or programmed cell death).  The eggs that remain continue to deteriorate in quality.  It is especially important to keep an eye on ovarian health as a woman approaches her mid-30s and beyond.

Some women will seek initial guidance from an obstetrician/gynecologist (a.k.a. OBGYN).  Many OBGYNs are quite comfortable performing basic fertility evaluations and some types of fertility treatment.

Reproductive endocrinologists (REs) are OBGYNs who have undergone 3 years of additional specialization in fertility.   They are able to handle all types of fertility treatments – from very basic to very complex.  Oftentimes OBGYNs will refer patients to an RE if the basic testing is abnormal and/or if the basic treatments are not working.  Some patients prefer to start off with an RE so that they are able to have access to full fertility evaluation/treatment from the start.

We’d love to see your question! Write Us with Your Question!

Expert Voices: Interview with Natalie Burger, M.D., Reproductive Endocrinologist

Editor Sharon had the opportunity to interview Natalie Burger, M.D. about her work with couples.
Natalie Burger, M.D.

Natalie Burger, M.D.

Sharon: What services do you provide to women?

Dr. Burger: I am a reproductive endocrinologist — most people know us as fertility specialists.  My primary practice is taking care of women and men who wish to become parents.  However, I also have specialized surgical and hormonal training to take care of patients with other kinds of reproductive health problems (e.g. endometriosis, premature ovarian failure, polycystic ovarian syndrome (PCOS)).

 

 

Sharon: Is there some bit of information that you find women tend not to know that you wish they had known prior to coming to see you?

Dr. Burger: Probably the most common misperception that we see is that we have overcome the challenge of ovarian aging.  Because there are more and more women in the news who appear to be having children in their 40s and even 50s, it may appear that we can overcome ‘tired ovaries’.  We can overcome many things (e.g. blocked fallopian tubes, low sperm count, etc.) but we cannot reverse aging of the ovaries.  Many of the older women in the media who seem to be achieving pregnancy are actually using donor eggs (eggs harvested from a young donor in place of their own.).  This certainly is a very private decision — and understandably one that many people may not want to reveal to the general public.  However, it is important to understand that ovarian function continues to decline with time, no matter how healthy or fit an individual is.

Sharon: Do you find yourself giving advice to women experiencing infertility to complement their diagnosis and treatment plan? What are some examples (e.g,. supportive words)?

Dr. Burger: Dealing with infertility can be incredibly challenging.  People often think first about the financial stresses, but even more important are the psychological ones.  Going through infertility (with or without treatment) can place huge emotional pressure on women and their relationships.  Men and women often approach the struggle of infertility differently, and we try to help them understand each others perspective.

After I discuss medical aspects of infertility, I try to also address some of the emotional aspects as well.  

First and foremost, it is important for my patients to understand that they are not alone.  

Fortunately, it is becoming more commonplace for people to talk more openly about their fertility struggles — but there are many, many people who are dealing with infertility who are not necessarily disclosing their challenges.

We are lucky to have many counselors in the area who work with a lot of our patients — and who understand some of the more specific issues our patients are dealing with.  This is especially helpful if someone is not yet ready to talk in a more public forum.  We also have an infertility support group that is run by a nurse at our clinic — it can be very cathartic to talk face-to-face with someone who understands the monthly highs and lows that an infertility patient faces.

Strengthening emotional health can give patients the stamina they need to get through the infertility journey successfully.

Sharon: Is there any advise that you routinely share with your patient’s partners?

Dr. Burger: Men and women commonly deal with infertility differently.  I think it’s important to recognize that even though your partner is not dealing with the situation the same way you are, it doesn’t mean that they don’t care.  They may just not understand your perspective.  If a couple is really struggling, I would highly recommend talking to a counselor or other third party.  It can prevent or at least mitigate some of the hurt and anger that can occur when it seems like your partner doesn’t understand.

Sharon: Approximately, how many of the women who come see you (%) have been older than age 35 and trying to conceive their first child?

Dr. Burger: As it is more common these days for women to defer childbearing to focus on career, it is very common for us to see women in their later 30s and 40s.  I would estimate that about 25% of the patients I see are women over the age of 35 who are trying for their first child.

Sharon: How often do you see women experiencing secondary infertility, even if they have conceived successfully after age 35?

Dr. Burger: Secondary infertility is very common.  As ovarian function continues to decline with time, what might have been easy a few years ago can turn into a real struggle with time.  In addition to the ovaries getting older, other medical issues can become more common with age (e.g., fibroids) and these things can also thwart fertility.

Sharon: What, if anything do you see as different about the older mothers? This could be about their health or attitudes toward health and pregnancy.

Dr. Burger: Older mothers have the benefit of life experience.  Mature women tend to be especially motivated and committed to the success of the process.  They are prepared to do what it takes to get to the end goal. 

 I would say that there is also a certain strength and resilience that I see in this group of (AMA) women.


Sharon: Thinking about the questions that they ask you in person (or by phone or e-mail), what if anything is unique or thoughtful about their questions? Is there any wisdom in advanced maternal age?

Dr. Burger: I think that many of the questions are similar no matter what age of patient I am working with.  Oftentimes more mature patients have already done their homework so to speak — and come especially prepared to discuss infertility evaluation and treatment.


Sharon: What else can you share about your observations and interactions with women of age 35 or better?

Dr. Burger: I would tell my current and future patients that their journey to motherhood may not happen in the way that they initially felt it would — however it will happen the way it was meant to be.  Be open to the different paths that can lead to you becoming a parent.

Natalie and Sons

Dr. Burger is married with 2 kids and a Board Certified Reproductive Endocrinologist with Texas Fertility Center in Austin.