Should I do shared risk? (Pros and cons for IVF ers)

November 17, 2006 at 7:55 am 11 comments

There has been a lot of talk about shared risk programs in forums lately, and I have decided (for lack of anything better to do) to write down everything I have learnt about the pros and cons of doing one.I am deliberately writing this before I know the outcome of my cycle. Hindsight 20 20. Obviously someone who lands a BFP on first try and spent $$$$$$ on shared risk might feel slightly biased that it wasn’t a good deal. Converseley, someone whose first cycle was a bust would wish they’d done shared risk.

These views come from reading great books about the IVF experience, talking to lots of women, doing my own research and also discussing this with my RE.

For anyone who is wondering what a shared risk program is – in gist, it is a program where you prepay a certain amount, and in return you get a package of X amount of “free” IVFs, and FETs. If you do not have a take-home baby after all those cycles, you get some (or in some cases all) of your money back.

This sounds wonderful to someone doing IVF. Afterall, the cost of an IVF cycle is HUGE. We are talking thousands of dollars here, ladies and gentlemen. So doesn’t it sound good to pre-pay for 2.5 cycles and get 3 in return? And your money back if all else fails?

If you are considering shared risk, here’s the scoop on things to think about and do without further ado.

1. First, read the fine print. NEVER jump into something this big before you know EXACTLY to the last detail of what you are getting for it. There are hundreds of shared risk programs, some done by REs and some by independent parties. You need to know what is covered, what is NOT covered, how many times you can cycle and in what time frame, and exactly how much money you are getting back.
For example a huge cost of an IVF cycle is the meds. You can spend about 3K on meds alone, and shared risk programs usually do not cover them.
Add up exactly what the shared risk program will cost you, including all the things it will not pay for that you might still have to pay for out of pocket.

2. KNOW YOUR SCENARIO. IVF statistics are very general. You usually see women lumped into categories of “under 35” or “over 40” but the truth is, no two individuals are alike. Medical chances could vary between individuals enormously, based on their diagnosis. It is crucial that you ask your RE (preferrably one not affiliated with the shared risk program, and therefore not being biased) what YOUR chances of conceiving via IVF are.

It is interesting to note that shared risk programs typically are only open to “pre-qualified” individuals. How incredibly strange and unbelievable (not!) that those individuals are typically candidates that are VERY likely to conceive on first or second try. Trust me, the shared risk programs are not out there to “save you money”. They are a business. And the odds (after they screen their candidates) and heavily in their favor.

This does not mean that there aren’t some potential wonderful deals, which is why you gotta read all the fine print and know YOUR situation. But a typical shared risk program will cost you the equivalent of about 2.5 fresh cycles (not including the meds) and will include 3 fresh cycles, all FETs and “some” of your money back if all else fails.

I had a talk with my own RE on this. And the way he explained it, of the candidates that typically qualify for shared risk, 2 out of 3 get pregnant on first try. Furthermore, the 3rd one goes on to have a second successful cycle. VERY rarely would someone be actually going to round 3. In short, there is a 90+ percent chance that if you are selected, you will overpay for your IVF. A very tiny percentage will actually go on to use their entire 3 cycles or get their money back. Cases, that he says are almost never seen. Remember, the program is not there to make YOU money.

3. Find out what your insurance covers. Don’t assume that just because your insurance “does not cover IVF”, that it will not cover part of the procedures that make up the entire IVF cost. Insurance may not cover ER or ET (retrieval and transfer) but it may cover bloodwork and ultrasounds. Also insurance may cover some of your meds, like lupron and progesterone even if it does not cover the stim meds.

In short, figure out EXACTLY what you cycle will cost YOU, and compare to the price of the shared risk program to see if it makes sense.

Typically a VERY general IVF cycle breaks down like this:

1000-3000 for meds

1000-3000 your doctors fees (for ER and ET)

2000-4000 – hospital and lab fees (for ER and ET)

1000-2000 – ultrasounds/bloodwork (you may need fewer or more monitoring appointments depending on how you stim)

1000-2000 ICSI (if you are doing ICSI, it is an additional cost)

1000-2000 PDG (if you are doing genetic testing it is an additional cost)

500-1000 embryo freezing (you may or may not have embryos to freeze)

As you can see, your cycle, depending on what insurance will cover or not, or on what you need or not, may vary enormously in price. You can spend as little as 6000 dollars or as much as 15000.

Find out exactly what your cycle will cost YOU at your clinic. You may have to guestimate the meds or u/s costs, but the doctors fees and hospital/lab fees are usually standard, which is a good guage to go off of, and especially since shared risk will not cover meds anyway.

Once you estimate what a cycle costs you, you can usually easily see whether the shared risk program is a good deal for you or not. Bear in mind the risk YOU are taking, in that if you conceive on first try you lose your money.

In the end, the decision is yours. Many many couples are extatic that they did a shared risk program. There is an emotional benefit to knowing that you have X many cycles and you might not feel as devastated if you are not lucky on first go, when there are 2-5 more cycles to try.

If you decide not to do shared risk, put aside the money for 2-3 cycles in your “IVF box”. (figuratively speaking of course). If you conceive on first go, great. If not, it helps if you have mentally planned to spend more.

Whatever you decide good luck to you! And most importantly – may you end up with your dream and that beautiful baby!

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Entry filed under: All Posts, Tips and Thoughts on TTC.

Day 55 (cycle day 27) – I don’t think OHSS is coming Day 56 (cycle day 28) – cramping and doubting

11 Comments Add your own

  • 1. beckyZ  |  November 17, 2006 at 11:22 am

    My RE told me exactly that at our first meeting, when I queried him about shared risk. Moreover, he seemed to think that it was a racket, and I think I insulted him by asking him if he offered that kind of “deal’. If you’re going to go for 3 cycles, having the last one “half-off” seems like chump change by then. I wouldn’t do it.

    And since you seem bored, TAG you’re it! list 5 things about yourself 😉

    Good luck, too!

    Reply
  • 2. Heather  |  November 17, 2006 at 3:07 pm

    I’m glad I did even though I was successful on the first try (at least so far – I don’t have my baby yet). Sure, it would have been nice to not have paid all that money, but I knew that if it didn’t work, I had 2 more fresh cycles and 3 FETs already paid for (if we had anything to freeze, that is). It relaxed me because I knew I had more chances and I didn’t have to worry about finding the money for the next try.

    Reply
  • 3. Josie  |  November 17, 2006 at 4:24 pm

    I like your synopsis. I am one of those folks who people thought was crazy doing a shared risk because of our age, BUT little did we know that their may be an egg problem. We are that small percentage that is going on to their 3rd cycle. We made our decision becasue we miscarried before and the lost of losing everything becasue of a miscarriage was too much, so we were more comfortable with the thought of overpaying the first cycle for peice of mind. Lucky we did, I guess.

    Reply
  • 4. Jys  |  November 17, 2006 at 8:14 pm

    Hey girls!
    Wow Becky! I’ll have to think about 5 things to post soon!!! I went to read your own 5 and they were so interesting. Suddenly when I thought of myself I just drew blanks…
    I actually wrote this shared risk thing a while back but had it as a draft and just finally posted it today.
    I researched it so much before, and I do think that for peace of mind it is great, esp if you end up with a good plan. Some are definitely worse than others.
    I think in some cases though, esp with a good plan, its great to have it.

    Reply
  • 5. MrsLack  |  November 20, 2006 at 5:07 pm

    This is really helpful….we’re trying to make the decision now of whether or not to do shared risk, and we just can’t decide. Thanks for the input!

    Reply
  • 6. Wiilysfnd  |  December 1, 2007 at 2:41 am

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    Reply
  • 7. L Weber  |  October 26, 2008 at 6:17 pm

    I purchased a shared risk plan thru Integramed for a donor egg cycle. My donor messed up her meds and the cycle was canceled before egg retrieval. Integramed is considering the cycle as 1 of my 3 fresh cycles…the contract reads that a fresh cycle is considered after the stim meds begin. I wish I had known this beforehand…

    Reply
    • 8. Marilyn Winsett  |  August 8, 2009 at 1:29 pm

      Hi,

      We are also considering a shared risk plan through Integramed. Our first donor cycle was unsuccessful. We had a chemical pregnancy. I did much research, and the stats. show that the undetected number of early miscarriages, including chemical pregnancies, in the normal population were as high as 50%. The detected number, or i.e. the number of people who realized that they had an early miscarriage, including a chemical preg. was only 15-20%. In donor cycles, your using a different donor each cycle b/c if you are not successful one the first then you pick a different donor the next time. Since you are using different eggs each cycle, your incidence of early miscarriage could be high! Only 10 % of embroys make babies! I didn’t know all of this before our first donor cycle. I just thought that if we had implantation then all would work out! Now, we are considering a shared-risk plan. Do you have any advice or comments?

      Thanks

      Reply
  • 9. Stef  |  May 5, 2009 at 9:49 am

    I’m 37 going on 38 and I have no clue which way to go on this. Is anyone that posted on this forum is/was my age when they decided to do the IVF?

    According to my Dr. she says that we need to do ICSI which is a bit more expensive.

    We’ve been considering going out of country to do it as well.

    Any comments/suggestions greatly appreciated.

    Reply
    • 10. Jys  |  May 8, 2009 at 2:59 pm

      Hey Stef, I know there are TONS of women your age going through this, and even older too. Definitely don’t wait, because every day is precious. And do everything your doctor recommends.
      I know that out of the country it is all certainly cheaper – but that is relative when you add up costs of tickets, hotels, etc etc etc. You have to make sure you go to a REALLY good program out there. Add up all the costs and figure out whether it is worth it. I hope you have great luck!

      Reply
  • 11. chris monge  |  March 5, 2010 at 5:23 pm

    is anyone out there? I am 50 and just went through IVF with donor eggs. Unsecc. donor had bad quality eggs Does anyonek now anything extra to do to make this work. (I am trying acupunture right now. It does relax you.

    Reply

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Expecting Number 2… :)

My TTC History

Started TTC May 2005
RE diagnosed as unexplained in Feb 06.
natural IUI #1 March 06 - BFP, m/c :(
natural IUI #2 May 06 - BFN
clomid IUI #3 July 06 - BFN
femara IUI #4 August 06 - BFN

Skipping suggested injectables,
moving to IVF
Bloodwork: Oct 12 for lupron
ER estimated 1st week of Nov

UPDATE:
25 eggs, 15 fertilized.
1 blast transferred, 6 frozen.
Precious baby Girl born in July 07.

After 2.5 years of Bliss since that BFP...

April 2009: Start of TTC #2.
(Going back for the embies I left)
Apr 15: Start of Natural FET cycle.
May 1: Transferred single blast
May 11: BFN :(
Straight to Natural FET #2
May 29: Transferred single blast
June 4: BFP!!!!
June 8: 1st beta - 177
June 10: 2nd beta - 506


UPDATE:
Healthy baby Boy born 2010!

Fast forward several years...

June 2013: Surprised with a completely natural and completely unplanned BFP!
November 2006
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