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To wrap up my series on PCOS, I wanted to discuss more advanced assisted reproductive methods for those who have not been able to conceive from lifestyle changes and the use of fertility drugs, such as Femara and Clomid. Although this is part of my PCOS series, this would be a great resource for anyone who is facing infertility and starting to consider their options. I'm going to compare 3 common techniques in terms of success rate and cost. Ultimately, it depends on your individual health, your partner's health, and financial ability to determine the best option when moving forward. Overall, these methods will be expensive, which is why I strongly advocate for lifestyle changes first, followed by medical management. Once you have exhausted those free and affordable resources, then it's time to start thinking about advanced methods as age truly does make a difference. Let's take a look at them below.
Intrauterine Insemination (IUI)
To conceive, your partner's sperm (or a donor's sperm) has to travel through the vagina, cervix, and uterus before making it to the Fallopian tube that is holding your awaiting egg. This can be a long journey, especially if your partner has low sperm count or decreased motility (how well it moves). IUI cuts the journey in half as your provider will insert the sperm directly into your uterus during or just before the time of ovulation. This can make it easier for the sperm to find the egg and result in fertilization.
Cost - Can vary depending on where it is done and whether medications are needed to aid ovulation, but averages $500 - $4,000 per cycle. This is not cheap by any means but still vastly more affordable than IVF.
Success Rate - 10 - 20%
In-vitro Fertilization (IVF)
This is probably the method that most people have heard about and what their mind jumps to when they think of assisted reproductive technology. With IVF, fertilization occurs outside of the woman's body in a Petri dish, and the resulting embryo(s) are then transferred into the woman's uterus. There are some ethical decisions concerning IVF. In order to increase the success rate, the woman receives hormone injections beforehand so that her body produces multiple eggs at once. There is a chance that there will be more than one viable embryo, and the couple has to decide what they will do with the others. Instead of discarding the remaining embryos, they can be frozen in case the first transfer isn't successful.
Cost - $8,000 - $20,000+ per cycle. Many insurances will not cover this procedure, and if they do, they may only cover one cycle. Unfortunately, it could take a few cycles to result in a live birth. IVF is a huge financial commitment, as well as an emotional one.
Success Rate - Almost 40% if under 35 and about 11% if over 40. As you can see, the success rate is higher than IUI, but the cost is substantially more.
Surrogacy
This is a great option for those who are unable to carry a full term child, whether that's due to health reasons or if it's a same sex couple. A surrogate is a woman who carries the child for you throughout the pregnancy, gives birth, and then relinquishes all rights to the child. You can either choose to use your own egg and partner's sperm, which would be fertilized outside and then placed into the surrogate's uterus once it is an embryo. Or you can receive a donor egg from your surrogate, which means the child would share her DNA. You could also get another donor egg or sperm and then place into your surrogate's uterus. The more steps that are involved, the higher the price would be. If your surrogate is a family member or close friend, you also want to be sure that they truly understand that this will be your child and have agreements signed before starting the process.
Cost - $80,000 - $150,000. This is definitely the most expensive method, as you not only pay for the procedures, but also compensate your surrogate.
Success Rate - 75% when used with IVF
As you can see, the trend is that the more expensive methods have the higher success rates. However, it's important to note that no method is 100%, and conception rate is very different from live birth rate, as miscarriages can occur. Deciding to start any assisted reproductive technology will take a huge mental, emotional, physical, and financial toll. Start when you are ready and take breaks as needed, as it can be a long road. However, when you finally have your bundle of joy, it will be worth it!
xoxo, Global Midwife
Disclaimer: This is only to be used for educational purposes, not as medical advice. Always check with your individual healthcare provider.
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