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Financing Fertility Options in the U.S.

NEW YORK (MainStreet)—Senator Kirsten Gillbrand (D-NY) recently reintroduced a Congressional bill that would create a tax credit for out of pocket infertility medical treatment.

"Thousands of women struggle with infertility each year, with insurance companies denying access to treatments," said Gillibrand spokesperson Angie Hu. "Senator Gillibrand believes this legislation will provide women and couples with more options and bring the dream of raising a family within reach."

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It's not that alternative fertility options for people who cannot easily conceive a baby on their own – couples diagnosed with infertility, or gay male couples seeking a surrogate – are expensive, or not worth the money, says Barbara Collura, president of the non-profit national infertility association RESOLVE.

The problem is simply that the vast majority of insurance plans will not cover the hefty cost of assisted reproductive technology options like in vitro fertilization, or IVF, or a surrogate.

"It's a financial burden because you are paying out of pocket," said Collura. "You already have a lot of tension and stress and emotional and relationship upheaval that you are dealing with, and then you have to start thinking about making these really frustrating financial decisions."

About 10% of women, from ages 15 to 44, in the United States have difficulty getting or staying pregnant, according to the U.S. Centers for Disease Control and Prevention – about one third of infertility problems are attributable to the male partner, while another third are attributable to the female.

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IVF is only one option that people experiencing infertility might be advised by their doctors to consider – one that Collura herself underwent after she received a diagnosis of blocked fallopian tubes when trying to conceive in the late 1990s. But IVF did not work for Collura, and she wound up adopting her son from Guatemala.

IVF costs between $10,000 to $20,000 for one round of treatment, and couples can expect to undergo two to three courses for the best outcomes, as ART success rates range from 5% to 42%, depending on a woman's age, according to the CDC.

The average surrogacy can range from $50,000 to $200,000, says Corey Whelan, the program director of the New York-based non-profit American Fertility Association, which serves as a resource for couples considering different fertility avenues.

"People max out multiple credit cards trying to get pregnant one way or another," Whelan said. "There's no one that's more Type A than a woman trying to get pregnant. Once upon a time people were taking out second mortgages to do in vitro but that is no longer viable, since the recession, for a lot of people."

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Some people are increasingly turning to friends, family and strangers online through crowdfunding – appealing for financial support on web sites and fundraising their way to accumulate enough to cover the costs, says Whelan. But the process can be emotionally draining, as people share intimate details of their struggles to have a baby with a mass audience.

A handful of organizations, like the Cade Foundation, also offer $10,000 grants to couples that have been diagnosed with infertility, to cover fertility treatment or adoption service costs. But there aren't enough of these organizations to cover the heavy flow of couples, both straight and from the LGBT community, who seek out support from the American Fertility Association, says Whelan.

"It's a really heartbreaking element of what we do," she said. "A lot of the options out there are just rich people's options."

Mindy Berkson, a fertility consultant based in Chicago, says the majority of her clients, topping 150 a year, sell acquisitions and stocks, use credit cards or receive traditional bank loans, if they are able to do so, to finance the cost of a surrogate and possibly an egg donor.

About 30% of Berkson's clients come from overseas and an additional 25% of them are gay male couples.

Berkson and her company Lotus Blossom Consulting helps their clients through the entire process of pairing them with a surrogate, with an egg donor, if needed, and then covering the legal and financial and medical matters that come with the process. The total cost can range from $70,000 to $90,000 without an egg donor, she says, to $110,000 to $120,000 with an egg donor.

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She says insurance benefits are typically limited and people often have insurance policies that negate surrogacy.

But that isn't stopping the influx of people pursuing surrogacy. The biotechnology-focused research group the Council for Responsible Genetics found in 2008 that the surrogacy market in the U.S. is exploding, as the number of babies born via surrogate doubled from 2004 to 2008, from 734 babies to 1,400.

"There's a lot of growth in the industry and that is based on women consciously choosing to have kids later in life," Berkson said. "The second indicator is gay men choosing to have biological kids. I'm seeing a big increase in my business based off of that."

Written by Amy Lieberman for MainStreet

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