Insurance

Many states require insurance companies to cover part, or all, of fertility care expenses. But this can be very tedious to sift through, and it varies by locale. For anyone even considering fertility testing or treatment, it’s good to know just what’s up in your state. 

Can you expect some help on the testing front? What about in vitro fertilization (IVF), are there any mandates for coverage here? So with no further adieu, here’s what you can expect in terms of your state’s fertility insurance:

Alabama

No fertility insurance here. Currently out of luck.

Alaska

No fertility insurance here. Currently out of luck.

Arizona

No fertility insurance here. Currently out of luck.

Arkansas

With Arkansas fertility insurance, you do have some benefits, albeit limited. If you have an individual or group policy that includes maternity benefits, IVF must also be covered, as well as cryopreservation. 

But, there is a lifetime cap of just $15,000 here. You also can’t just move right to IVF. First, you must try a less costly fertility approach such as undergoing an intrauterine insemination (IUI). Also, HMO’s and employers who self-insure are exempt.

California

California fertility insurance looks promising, but may be far less helpful than meets the eye. You will only receive coverage here if your employer decides they want to provide fertility coverage as part of their benefits package.

Fact is, here insurance companies only have to offer infertility coverage. It’s then up to employers to decide whether they want to include fertility treatment coverage for employees or not. 

Colorado

Thanks to some new legislation, as of January 1, 2023. Colorado fertility insurance now offers eligibility for three egg retrievals with unlimited embryo transfers covered. This is true provided that your insurance coverage is from a large group of 100 or more people. 

Those with individual or small group plans will unfortunately not have access to this coverage. Also, religious organizations, even large ones, are not required to provide fertility coverage.

Connecticut

With Connecticut fertility insurance, diagnosis and treatment of medically necessary infertility expenses must be covered. You may be entitled to up to two cycles of IVF, zygote intrafallopian transfer (ZIFT), or gamete intrafallopian transfer (GIFT), up to four cycles of ovulation induction and up to three cycles of intrauterine insemination.

But, only those who have had coverage under the policy for at least one year will be eligible. Also, if your employer self-insures, they do not have to provide this coverage, or, if they are a religious organization, this is also not mandated.

Delaware

Delaware fertility insurance offers an array of services that includes IVF with eggs, sperm, or embryos from a donor, and even allows for a surrogate or gestational carrier. You are even entitled to six egg retrievals with unlimited embryo transfers. 

But there is a hitch. This coverage is restricted to those with fertility issues as a result of a medical treatment such as chemotherapy, surgery, or radiation. Also, any egg retrieval must be done before age 45 and any embryos transferred before age 50. 

Florida

No fertility insurance here. Currently out of luck.

Georgia

No fertility insurance here. Currently out of luck.

Hawaii

While you can get some Hawaiian fertility insurance coverage that may be beneficial, it’s limited. You’re entitled to one and only one IVF cycle. That’s for those with a minimum of a five-year history of issues such as endometriosis, blocked or removed fallopian tubes, DES exposure, or male infertility factors.

You also can’t move on to IVF until you’ve tried other covered fertility treatment first. So, if you are eligible, you truly don’t want to give away your shot…

Idaho

No fertility insurance here. Currently out of luck.

Illinois

With Illinois fertility insurance coverage, provided you have tried lower-cost treatments under your insurance umbrella first without success, you do have coverage for IVF, GIFT, and ZIFT. What’s more, you get four bites at the apple and if you are successful and a live birth occurs, you’re actually entitled to two more covered egg retrievals.

But this only applies to work-related group policies that cover more than 25 full-time employees. There is, however, some additional good news. As of January 1, 2022, this fertility protection extends to same-sex couples and single-women over age 35 who have a medical issue keeping them from getting pregnant.

Indiana

No fertility insurance here. Currently out of luck.

Iowa

No fertility insurance here. Currently out of luck.

Kansas

No fertility insurance here. Currently out of luck.

Kentucky

No fertility insurance here. Currently out of luck.

Louisiana

The Louisiana fertility insurance law provides a fig leaf of coverage. You are only eligible here for diagnosis and treatment if your fertility issues are the result of a correctable medical condition. Even that has exceptions. There is no requirement to cover fertility medication or to offer IVF or even other fertility treatment. Also, if you or your partner have undergone a tubal ligation or vasectomy, any reversal here is on you.

If your employer self-insures, then even if you would be eligible otherwise, there’s no requirement that you be covered.

Maine

While this state doesn’t have any coverage at the moment, a Maine fertility insurance law will kick in beginning January 1, 2024. Then, fertility patients who have health plans here will be entitled to fertility diagnostic care, treatment and fertility preservation services. 

Coverage is expected to include both individuals and couples battling infertility, those who carry a heightened risk of transmitting a severe genetic disorder to an offspring with natural conception, and those who don’t have the needed reproductive cells to conceive. This coverage will exclude anything experimental or any non-medical related cost.

Maryland

With Maryland fertility insurance, you are golden. This insurance offers coverages not only to traditional heterosexual couples, but also same sex couples and unmarried patients. Those who qualify are entitled to undergo three IVF rounds for every live birth. There is, however, a $100,000 lifetime cap here.

But, this coverage is not a requirement for religious employers, those with fewer than 50 employees, or those employers who self insure.

Massachusetts

Massachusetts fertility insurance stipulates that insurers that provide pregnancy-related benefits are also expected to offer coverage for diagnosis and treatment of infertility. This means access to artificial insemination procedures such as IVF and GIFT. It may also include procurement of eggs or sperm, processing and banking for fertilized eggs and sperm. 

There’s also no state lifetime cap on the amount of fertility insurance available and no limit on the number cycles. But, insurers are able to use their clinical guidelines and patient’s medical histories to set some limits here. 

Michigan

No fertility insurance here. Currently out of luck.

Minnesota

Not only is there no Minnesota fertility insurance, but also there’s a law prohibiting coverage for meds specifically used to enhance fertility. Talk about kicking those already down… 

Mississippi

No fertility insurance here. Currently out of luck.

Missouri

No fertility insurance here. Currently out of luck.

Montana

Montana fertility insurance offers some vague help as long as you get your insurance through an HMO. But unfortunately, there’s no definition of infertility that’s given in the law and no description of the type of services that need to be covered. So, it appears to pay only lip service here. Anyone with non-HMO insurance has absolutely no coverage.

Nebraska

No fertility insurance here. Currently out of luck.

Nevada

No fertility insurance here. Currently out of luck.

New Hampshire

If you have a group policy that offers benefits for medical or hospital expenses, the New Hampshire fertility insurance mandate provides for medically necessary fertility treatment. This includes coverage for evaluations, laboratory testing, and medication. If fertility preservation is needed, such as if you must undergo chemotherapy or radiation treatment, coverage includes both procurement and cryopreservation of reproductive materials such as eggs, sperm, and embryos, and may even include storage for a time.

But experimental infertility procedures are not included. Also, anyone covered through the Small Business Health Options Program (SHOP) or have an Extended Transition to Affordable Care Act-Compliant Policy funded by the state, is not eligible here. 

New Jersey

With New Jersey fertility insurance, as long as you are under the age of 46 and have a group policy that includes at least 50 people, with pregnancy-related benefits, you are potentially eligible for a variety of infertility treatments. This includes a menu of items such as up to four IVF cycles with ICSI, GIFT, or ZIFT, as well as use of donor eggs and even the potential to use a gestational carrier or surrogate. 

But except in cases where the patient must undergo treatment that puts fertility at risk, such as chemotherapy, cryopreservation is not covered.

Also, there are some exceptions to which insurers must follow the mandate – neither religious employers or those who self-insure are required to provide this coverage.

New Mexico

No fertility insurance here. Currently out of luck.

New York

As part of a new law enacted in 2020, New York fertility insurance offers those who have large group insurance plans of 100 or more, up to three IVF cycles. Also, those that include prescription drug coverage must provide medication for the diagnosis and treatment of infertility. 

What’s more, it’s now necessary to cover egg freezing for all private insurance companies in medically necessary cases. So, you are eligible if you have a condition such as sickle cell anemia, are undergoing chemotherapy, or are undergoing sex-reassignment surgery. 

Those who self-insure are exempt here.

North Carolina

No fertility insurance here. Currently out of luck.

North Dakota

No fertility insurance here. Currently out of luck.

Ohio

Ohio fertility insurance must be covered in cases where this is medically necessary, by HMO’s that offer “basic health services.” But don’t count on coverage for IVF, GIFT, or ZIFT. None of these are legally required. 

What you may be covered for includes diagnostic procedures to detect fertility issues, or surgical treatments to correct issues with the reproductive organs such as endometriosis or issues with the fallopian tubes.

Oklahoma

No fertility insurance here. Currently out of luck.

Oregon

No fertility insurance here. Currently out of luck.

Pennsylvania

No fertility insurance here. Currently out of luck.

Rhode Island

The Rhode Island fertility coverage is mandated for all of those with an HMO or other insurance policy that includes pregnancy coverage. Beginning at age 25 and extending up to age 42, women here with such a plan are entitled to coverage for diagnosis and treatment of infertility. 

Also, if someone is undergoing a procedure that may result in infertility, insurers must cover fertility preservation treatment. There is, however, a $100,000 lifetime treatment cap. 

South Carolina

No fertility insurance here. Currently out of luck.

South Dakota

No fertility insurance here. Currently out of luck.

Tennessee

No fertility insurance here. Currently out of luck.

Texas

With Texas fertility coverage, although insurance companies must provide this as an option, there is no mandate that any group is required to actually offer this as part of their health plan. In instances where such coverage is offered, it only pertains to those who can show that they’ve been infertile for at least 5 years or who have a medical issue such as endometriosis, tubal blockage or removal, or DES exposure. 

Also, IVF won’t even be considered until less costly measures, like IUI, have been tried. 

Utah

Utah’s fertility coverage involves a pilot program through 2024. This targets those who are on a Public Employee Health Plan. Here, if you have a maternity benefit, then you must likewise be able to receive $4,000 toward a “qualified reproductive technology cycle.” With this, just a single embryo is transferred during a cycle using reproductive technology.   

This, however, is not a mandate. The aim of the program is to determine the efficacy of providing this kind of coverage. 

Vermont

No fertility insurance here. Currently out of luck.

Virginia

No fertility insurance here. Currently out of luck.

Washington

No fertility insurance. Currently out of luck.

West Virginia

The West Virginia fertility insurance mandate is low on details. While HMOs that offer basic health services are required to cover infertility, what “infertility” actually means here is not defined. All in all, this is way too vague – more clarity needed here.

Wisconsin

No fertility insurance here. Currently out of luck.

Wyoming

No fertility insurance here. Currently out of luck.

When coverage is lacking

If you’re lucky enough to live in one of the 20 states that offers a fertility insurance mandate, that’s, of course, a big win. Still, as you can see, even these can leave you wanting. If your state doesn’t deliver on fertility coverage or if the coverage is, in a word, lacking here, reach out to Resolve: The National Fertility Organization to find out who to contact to lobby for improvements.

When it comes to using donor eggs to build your family, even those who are veterans of traditional in vitro fertilization (IVF) may not be clear on what to expect from the donor egg process. But you’ll be happy to hear that those who have already worked with a fertility clinic using their own eggs will absolutely not be starting from the beginning. If you’re in this situation, you already have a solid understanding of what goes into an IVF cycle, which is the foundation of the donor egg process.

Women consider using donor eggs for various reasons. Some have low ovarian reserve (egg supply). Some have been through several IVF cycles before without success. Others have been told that their egg quality makes it unlikely that they will become pregnant using their own eggs. In these situations, using a donor egg can significantly improve the chances of having a baby. Especially if someone is over 40, the success rates with donor eggs will be considerably higher than many women can expect with their own eggs.

According to the Society for Assisted Reproductive Technology (SART), if someone is over 40, IVF success rates after one cycle can range from five to twenty percent if she uses her own eggs. But when using donor eggs, the success rate for one cycle is around 50%. So, depending on the situation, using a donor egg can significantly increase your chances of having a baby through IVF.

For others, donor eggs may be the only way to build a family. Whether you are a single dad, LGBTQ+ couple, or cancer survivor — every conception needs an egg.

Getting started

If you’ve already been through IVF before, you’re most of the way there in terms of understanding the how a donor egg cycle will go. There are just some additional steps with a donor egg that you may not be aware of yet.

Before beginning any donor egg treatment, many clinics will have you and your partner initially speak with a counselor.  He or she will talk through using donor eggs to help ensure that this is the right path for you. The idea is to consider how you feel about using a donor egg to help create or expand your family. You may also consider how you will talk to your future children about using an egg donor, including what information you will share and when.

You will then go through an egg donor selection process to find the best donor for you. There are tons of factors to consider here: the egg donor’s education, medical history, values…the list goes on. So it’s worth spending some time with your partner to decide what factors to prioritize.

Also, if you are over age 45, the American Society for Reproductive Medicine notes that you may need to undergo more intense screening, such as a visit with a high risk obstetrics doctor or a heart workup, to make sure that you are a good candidate for an embryo transfer and can carry a healthy pregnancy.

If you choose a matching platform like Family by Co or an egg donor agency, your egg donor will go through a screening process at your clinic to determine if she is eligible for egg donation. You will also sign a legal contract with her regarding the details of the egg donation process. If you match with a donor in our fresh egg donation program, after her screening, she will do an ovarian stimulation cycle and an egg retrieval. If you have been through an IVF cycle before, you are well aware of all the medications and monitoring she might need during her cycle. If you match with a donor in our frozen egg program, we will help ship the already-frozen eggs to your clinic.

Fertilizing and growing embryos

Whether you obtain donor eggs from a fresh egg donor cycle or from a frozen egg bank, once your clinic is in possession of the eggs, they will need to be fertilized and grown into embryos. Your IVF clinic will update you to let you know how many of the eggs fertilized and how many developed into embryos. Some intended parents decide to do genetic testing on embryos. If so, the clinic will biopsy the embryo at the blastocyst stage (day 5-6) and then freeze the embryos while they wait for the result. 

It’s important to remember that not all eggs become embryos. In general, approximately 70% of eggs will fertilize and of those, about 50% will grow into day 5 embryos.

Preparing for embryo transfer

If you’ve already gone through IVF, you may have already been through the pre-transfer testing. This testing includes infectious disease testing and an assessment to make sure your uterus is normal. Your clinic may do a saline ultrasound or a hysteroscopy to evaluate the inside of your uterus before a transfer. This test rules out fibroids or polyps inside the uterus that could interfere with pregnancy.

At some centers, doctors like to also perform a mock embryo transfer. During a mock embryo transfer, the doctor will pass a transfer catheter into your uterus in advance so they’ll know the embryo transfer catheter will pass easily on the transfer day. If you’ve already done IVF with your own eggs, they may already have this information and can skip this step.

Prior to an embryo transfer, you (or your gestational carrier) will first likely use medication to quiet your own cycle, such as birth control pills or the drug Lupron. Then, you will then be put on estrogen to mimic what would happen during your normal cycle. The estrogen can be given orally, vaginally or with an estrogen patch depending on the protocol your doctor chooses. 

Once your lining reaches a good thickness (many clinics have a goal of 7-8 mm), you’ll then start taking progesterone. The progesterone can be in the form of vaginal suppositories and intramuscular injections. This progesterone will stabilize your uterine lining for embryo implantation. Keep in mind, though, that if by some chance you ovulate on your own during the first stage, any embryos will be frozen and the transfer will be postponed.

Embryo transfer

Your clinic will then schedule your embryo transfer. The embryo transfer is typically performed on the sixth day of progesterone, in order to synchronize the embryo development with your uterine lining.

On the day of the embryo transfer, your doctor will perform a speculum exam and clean the cervix. They will then place the embryo transfer catheter through your cervix into your uterus. An abdominal ultrasound is typically performed so that you and your doctor can see the embryo transfer catheter inside the uterus. The embryo is often loaded into the catheter with a small amount of fluid and an air bubble. At the time of the embryo transfer, you may see a small flash of bright white on the ultrasound screen - that’s where your embryo was placed!

Pregnancy

Your clinic will schedule a pregnancy test following your embryo transfer. If you are pregnant, you’ll need to continue to take estrogen and progesterone during the first part of your pregnancy. Although taking these hormones may seem inconvenient (especially the injectable progesterone!), keep in mind that they are essential to sustaining your pregnancy until your body can effectively take over. If a pregnancy test shows that you are in fact pregnant, you will need to continue to take hormones until your placenta can ultimately support the embryo at around week ten.

Hopefully, this provides a solid overview of the donor egg IVF process. The first step here, however, is to find a donor match. We encourage you to take a look at our incredible donors, who are ready to match with your family. Unlike egg donation agencies and banks out there, our donors aren’t motivated by traditional cash compensation. Rather, they get to freeze their own eggs for free when they give half of them to another family — so every donor we work with is not only altruistic and kind, but also motivated for her own future fertility. 

No matter what avenue you choose, we’re wishing you all the best!

If you’re an intended parent who is planning to use an egg donor to help build your family, you’re probably wondering how much that egg donor is going to cost.

You’re certainly not alone on this journey — there were 24,042 donor egg cycles in the US in 2019, the most recent year for which data was available from the CDC. That’s up nearly 6,000 from data collected just nine years prior.

But knowing you’re far from alone doesn’t answer a question that’s been weighing heavily on your mind: How much does using an egg donor really cost? Is any of this covered by insurance?

How much does it cost to use an egg donor?

There’s no way around it — there are costs involved in getting pregnant with donor eggs. After all, there’s a lot that goes into retrieving eggs from an egg donor, fertilizing them and growing embryos in the lab, and then transferring an embryo into the uterus.

Typical egg donor costs can range anywhere from $5,000 – $30,000, but fees can go much higher. So what goes into that big range? Let’s take a look at some of the biggest cost factors, so you know what to expect along the way.

Costs of using a fresh egg donor through an agency

One option is to work with a donor egg agency to find a donor that will go through a fresh IVF cycle.

Egg donor agency fees

The Cost: $5,000 to $9,000

An egg donor agency will identify women interested in donating their eggs, and likely perform some initial health screenings on prospective donors to ensure they’re qualified to donate. In return, you’ll pay the agency a fee for helping you find your perfect match.

Donor compensation

The Cost: $5,000 to $60,000

Wait, can the range really be that wide? Well, yes.

There are no federal laws that regulate how much an egg donor can — or even should — be compensated. Some states, like New York, forbid donors from being paid for their eggs themselves, but allow for donors to be compensated for things like medical risks, physical discomfort, and inconvenience. Others, like Maine, have no regulations on the process.

That means donor fees can range wildly, and some donors are compensated five digit fees as high as $60,000 — particularly donors who attend Ivy League schools. Typically, however, the range for a donor fee is closer to $5,000 to $10,000 for a single egg donation cycle, says Janene Olega, a reproduction lawyer from Maine. That compensation may increase if a donor agrees to additional cycles, she adds.

Legal fees

The Cost: $1,500 to $2,250

You need to set aside money for legal fees which will be used to put together a contract to protect both the rights of the donor and your rights as the intended parents. You will also be required to pay the legal fees for the donor who will need her own lawyer to review the contract.

If you need to go to court to establish your parental rights, you may also need to hire a lawyer. Unfortunately, parentage intent laid out in egg donor contracts is not necessarily enforceable in all states without a court order to enforce it, Hasenbush explains. Because donor eggs are not biologically related to the child’s mother, that can sometimes present a problem without proper legal steps.

The good news: If a judge declares a single parent or a couple parents of a child, that judgment is required by the US Constitution to stand in every state in the union!

Egg retrieval and fertility medicine

The Cost: $9,500 to $25,000

Medical fees for a fresh egg donation cycle will include the cost of screening the egg donor, the stimulation cycle and the egg retrieval.

First things first: In order to donate, all egg donors go through a number of health screenings, including infectious disease testing, genetic carrier screening and a physical exam. After these screenings, your doctor will either approve or decline an egg donor.

Your agency may have already done certain screenings as part of their fee, but depending on your situation, you may end up wanting additional testing — for example, if you or your partner are carriers of a genetic condition and you want to ensure your donor isn’t. Be sure to ask your agency upfront about what screening is included in their fee.

Egg donors then use injectable medications to help their ovaries produce mature eggs. The cost of injectable medications will depend on the dose of medication needed, but generally these medications cost at least $2,000.

Throughout the stimulation cycle, the egg donor will be seen for regular monitoring visits including ultrasounds and labs. The cost of the monitoring will depend on how many visits the donor needs throughout her cycle. Most stimulation cycles involve between 5-8 visits to the clinic for monitoring. Some clinics will charge a flat fee for the cycle and others will charge per monitoring visit.

When ready, an egg donor undergoes a medical procedure called an egg retrieval. During the egg retrieval, egg donors go under anesthesia (costing about $700) and a fertility physician removes eggs from her ovaries. The egg retrieval procedure can cost as much as $7,800, but costs will vary depending on your specific clinic.

Laboratory fees and embryo transfer

The Cost: $3,500 to $10,000

Yes, this is another large range. However, there are a few variables to consider.

For everyone using an egg donor to create embryos, after the egg retrieval, the eggs will be fertilized with sperm and grown into embryos in the laboratory. An embryo will then be transferred into the uterus of an intended parent and any extra embryos can be frozen for future use.

Post-retrieval, intended parents may spend about $3,500 to $5,000 for the laboratory fees associated with fertilization and culture of embryos. Some intended parents may choose to do genetic testing on embryos (PGT-A). Genetic testing may cost approximately $3,000 in addition, but that cost might depend on the number of embryos tested.

Finally, the mother-to-be will need to prepare her uterus for an embryo transfer. The cost of an embryo transfer, including medications, monitoring visits and the embryo transfer procedure may be around $5,000, depending on your specific clinic and the medications used.

You may also need to consider the costs of freezing extra embryos that aren’t used right away. The freezing fee may be approximately $2,000 with a storage cost of around $300-600 per year. You may not have extra embryos to freeze — but it’s good to keep the costs in mind ahead of time.

The cost of donor eggs through an egg donor bank

Some intended parents use a donor egg bank to find already frozen eggs. In that case, the donor egg bank will already have frozen eggs available. This means the donors have already gone through the medical screening process, stimulation cycle, retrieval and legal consultation.

The costs of using a donor egg bank are somewhat similar to using an agency. The egg bank covers the donor costs, then charges the potential parent or parents a fee.

Going this route is also a lot faster — after all, eggs are already frozen. But there are still fees to contend with.

Egg donor bank fee

The Cost: $2,400 to $6,000 (per egg)

If you’re going the route of using frozen donor eggs from an egg bank, the costs are a bit more straightforward.

An egg donor bank takes care of much of the work of screening donors, helping them through the process of taking medicines, egg retrieval, and even takes care of legal fees, and getting legal permission from the donor for the use of their eggs.

As an intended parent, you then pay the egg donor bank a fee, either per egg or batch of eggs, depending on the donor egg bank. This is different from going the agency route, where you pay for the donor’s individual cycle.

Are there any other fees?

Laboratory fees and embryo transfer

The Cost: $3,000 to $5,000

Similar to going with an agency, the donor’s medical fees aren’t the only ones to think about here!

Whether you opt to use an egg donor agency or an egg donor bank, you will also have to pay medical fees for the in vitro fertilization process, including medications that an intended parent will have to take, and the transfer process.

Will insurance cover egg donation?

The answer to this question is a tough one: while there are some insurers that cover fertility treatments for the intended parent, they may not cover egg donor cycles.

Right now just 19 states require insurers to cover fertility treatments in some capacity. Even in those states, the amount of coverage varies. In California, New York, and Louisiana, for example, insurers are not allowed to cover IVF, a procedure that is necessary for intended parents who have turned to egg donation.

You may want to start by calling your insurance company directly. If your employer supplies your health insurance, their human resources department may also be helpful in pointing you to parts of your policy that can help cover the costs of your fertility journey. If they don’t already cover it, consider pushing them for this benefit — you’d be surprised what a difference some persistence can make.

How can I get financial help for egg donation?

Even if health insurance doesn’t cover your fertility treatments or only covers a small portion of the costs, there are other options:

• Tax deductions — If your insurer hasn’t covered the costs of your fertility expenses, talk to your accountant. Some medical expenses for egg donation may be used as tax-write-offs, although there are limitations. For example, write-offs do not apply if the intended parents have used a gestational carrier to conceive.
• Grants and discounts — Yup, there is money out there to help intended parents achieve their dreams! There are grants available to folks who have served in the armed forces, money for those who live in specific states, and more.

Bottom Line: While there are costs involved in using an egg donor, the growing number of intended parents opting for this route means there are more and more options out there for you.

If you've been trying to have a baby with no luck (yet), the idea of IVF can be exciting...but the costs can sound scary. After all, more than 8 million babies have been born as a result of this procedure. But it's known to be pricey, too. So how much money would IVF cost you, really?

According to the Society for Assisted Reproductive Technology (SART), the average cost of an IVF cycle in the US is $10,000-$15,000. But, like with any fertility treatment costs, that completely depends on your insurance coverage, your own health status, and your clinic. A Journal of Urology study, for example, showed that out-of-pocket IVF costs averaged at around $19,000. And for those doing multiple cycles, each additional cycle cost about $7,000.

In other words, it depends. And, unfortunately, there may be additional costs for some people. Don’t shoot the messenger!

Why IVF costs vary so widely

Insurance is one of the biggest factors. Some health insurance plans cover some or all of infertility treatment costs and some don't. Some cover the cost of procedures but not the cost of medications—or vice versa—and others don't cover either.

Currently, only some states have laws that require insurance to cover (at least some) IVF costs. If your employer is located in one of those states, you're more likely to have coverage than if IVF assistance isn't mandated. Check out this article to see how your state is handling fertility treatment insurance. 

Your area's cost of living can also influence costs greatly. In some parts of the country, fertility procedures may cost twice as much as they do in others, says David Bross, co-founder and Vice-President of Parental Hope, Inc., a non-profit that provides financial support to couples battling infertility. And different fertility clinics may offer different rates.

Plus there's your own unique infertility situation to take into account. For example, couples who will need to use an egg donor will have additional costs related to that. Fortunately, our Family by Co platform makes that process more positive, transparent, and affordable than other options out there.  You can read more about our pricing and commitment to you here.

So, what's included in IVF costs?

Here's how IVF costs typically break down:

Monitoring

Everyone who undergoes IVF has to have a basic workup, evaluation and monitoring via ultrasound and bloodwork. This can cost around $2,500 before any insurance coverage, but because of different plans, some of that may be covered and your personal out-of-pocket costs can vary drastically. Some plans don't cover the costs at all, others pay part or even most or all of it. For more specifics, call your health insurance carrier to see what your policy covers.

Retrieval and labs

Your egg retrieval is a procedure that needs to be done under anesthesia to (you guessed it) retrieve those eggs (a.k.a oocytes). Then, in a lab, those eggs are fertilized with sperm. The egg retrieval and fertilization process can cost around $7,000.

Embryo transfer

If you're lucky enough for at least one of those fertilized eggs to grow into an embryo, then there's another procedure to transfer it into your uterus. This part can cost around $1,400.

Here's what's *not* included in typical IVF costs

Heads up: there may be extra costs involved with IVF too, like additional testing or procedures. This could include:

• PGS or PGD testing: Preimplantation genetic testing can be performed before the transfer to check the embryo(s) for chromosomal abnormalities or inherited genetic disease.
• Frozen embryos or sperm: If you decide to freeze embryos or sperm as part of your IVF plan, then there's the cost of freezing, plus usually an annual fee for storage, which can be around $600 to $1,200 per year.
• Medication: Medications are given to stimulate the ovaries and trigger ovulation in preparation for retrieval. Medication can cost $2,500 to 5,000 for one round of IVF, says Bross. Some prescription plans cover all or part of it and some don't.

You can totally reduce IVF costs

While the actual total cost can vary widely from person to person, there are ways to reduce them for you.

Research health insurance options as early as possible

Lilli Dash Zimmerman, MD, Fertility Specialist at Columbia University Fertility Center (CUSFC) recommends that people interested in IVF take a close look at their health insurance options when they first start considering it. See what plans are available to you and what they cover, as far as fertility treatments are concerned. In some cases, it may make sense to pay for a pricier plan if it saves you money in the long run.

Compare costs (and success rates) at different clinics

If you're considering more than one different fertility clinic, don't just look at the fees they charge, says Bross. "First look at the quality of the clinic. What are their success rates?" he asks. "Number two should be prior patient satisfaction." If the fees end up being about the same at the different clinics, a higher success rate could translate to being less money spent in the long run.

Look into medication discount programs

Some pharmaceutical companies offer discount programs, where people under a certain income level can apply for a certain percentage off their medication. Check out our Find a Grant tool for some of these opportunities.

Weigh your payment options

Cost structure can vary widely, so find out what offerings your clinic has. For example, some clinics offer bundle pricing, in which one dollar amount covers monitoring, retrieval, labs, and a certain number of embryo transfers—whether you need that many or not—says Travis Lairson, director of operations at Inception Fertility. This can take some of the guesswork out of how much you'll pay and could help you feel confident you'll be able to afford the full amount of IVF, even if you have several transfers.

Apply for grants

There are a variety of grants available to help people financially through their fertility journey. Don’t be afraid to put yourself out there! 

Bross tells us that, sometimes, he's surprised how few people apply for certain grants. Your odds of getting one could be higher than you think.

Crowdfund

Many people look to friends and family for help paying for fertility treatments like IVF, and so if yours are supportive, you may want to reach out for potential financial help.

Work closely with a finance coordinator

Fertility treatment is expensive, and your clinic knows this. That’s why your clinic likely has an in-house finance coordinator to help you through the process. They can answer all your questions about pricing and your own individual needs, and may also be able to help you choose a payment plan for costs you can't pay upfront.

Summing it up

With all the unknowns, it can be scary trying to figure out how and if you can afford IVF, but don't go it alone. Start with your insurance company, work closely with your fertility clinic, and don't be afraid to put yourself out there by applying for grants or asking family and friends for help. Finances can be totally tricky, but the resources available may help you save some costs for this investment in a (hopefully) future family member.

Between IUI vs. IVF vs. ICSI vs. PICSI...looking into fertility treatments can feel a lot like you're trying to make sense out of all those noodles floating around a bowl of alphabet soup.

At first glance, it seems like IUI vs. IVF are similar. They both have an I in them...so maybe they're related? And what's with ICSI and PICSI? Is that P just a typo? Don't worry, you don't need a crystal ball to figure all of this out. Consider this your secret decoder ring for all those fertility treatment acronyms.  

There are plenty of new terms to learn when you're starting the fertility journey—or at least terms to dig out of your brain from your high school science class days. But there are four major acronyms that tend to come up when you sit down with a fertility doc to talk options.

IUI

Short for: Intrauterine insemination (although it's also sometimes called artificial insemination)  

How it works:  

• IUI involves donated or a partner's sperm being placed in the uterus. Sperm are "washed" (essentially, sorted to weed out the strongest, best swimmers) and injected through a catheter up through the cervix directly into the uterus, at the time of ovulation. That's the end of expert intervention when it comes to IUI—the goal is for fertilization to occur in the body, up in the fallopian tube, in the same exact way it would if the sperm swam there on its own.  
• This procedure may be combined with medications to induce ovulation, such as Clomid or Letrozole, typically given for five days, or medication prescribed after the procedure, like progesterone (which can be used during IUI or IVF).

Who does it: Usually a reproductive endocrinologist, though it can also be performed by a general OB/GYN.

IVF

Short for: In vitro fertilization

How it works:

• IVF typically involves stimulating the ovaries with medications in order to boost the number of eggs you produce and mature them enough to the point of almost ovulating. However, donor eggs can also be used with IVF. If a donor egg is used, the mother-to-be will typically take medications meant to sync her cycle with that of her donor.  
• Next step? A mom-to-be or her donor has to undergo minor surgery to retrieve the eggs. "The eggs are collected using ultrasound guidance, using a syringe to withdraw the eggs from the ovaries," says Dr. Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine.  
• Eggs are later mixed with donor or a partner's sperm in a lab—this process is called insemination.
• If insemination is successful and the embryo continues to mature after a few days, the embryo (or sometimes more than one, depending on your situation) is transferred directly into the uterus by a specialist, again using a catheter. Some first undergo genetic testing to ensure the embryo is chromosomally normal and/or isn't a carrier for certain conditions. If all goes well, the embryo will implant in the uterus, getting you pregnant.

Who does it: The retrieval and embryo transfer portions of IVF are typically performed by a reproductive endocrinologist, while the insemination process is handled by a clinical embryologist in the fertility clinic lab.  

ICSI

Short for: Intra-cytoplasmic sperm injection (usually pronounced ick-see)  

How it works:  

• The ICSI procedure is a part of the IVF cycle that's often used in cases of male factor infertility, such as poor sperm count or quality, says Dr. Alyssa Dweck, M.D., an OB/GYN at CareMount Medical in Westchester County, NY.
• A male partner's sperm is usually collected into a collection cup, though it may be retrieved surgically by a urologist from a male partner's testes or epididymis (that's a tube in his testicles where sperm collects).
• It is then studied in a lab to determine which specific sperm cell (sometimes called the spermatazoa) is the best candidate for potentially inseminating the eggs retrieved during the IVF process. "This technique allows a single sperm to be injected directly into a mature egg," Dr. Dweck says, hopefully resulting in a fertilized egg.
• The fertilized egg develops into an embryo, which is then placed in the uterus via the IVF process. And you know where this is going now, right?

Who does it: The ICSI process is typically performed in a fertility clinic or center's lab by an embryologist.  

PICSI

Short for: Physiological intra-cytoplamsic sperm injection (usually pronounced pick-see)

How it works:  

• No, that P isn't a typo. PICSI is essentially ICSI with an extra step, says Dr. Jaime Knopman, M.D., a reproductive endocrinologist at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM).
• This procedure involves adding a special enzyme to the sperm to enhance insemination chances, but it otherwise mirrors ICSI. After an embryo forms, it's transferred to the uterus, and all fingers crossed…pregnancy hopefully occurs.  

Who does it: Like ICSI, PICSI is typically performed by lab specialists called embryologists.  

Consider artificial insemination and fertilization costs

It all depends on the treatment type. Something like IUI can cost you around or just over $400. Where on the other hand, IVF can cost upwards of $8,000, not including the required medications or ICSI treatment that can range from an additional $1,000 - $2,500. Surrogacy can exceed $100,000. 

With all of these different methods of insemination and fertilization, these processes can’t be cheap, or can they? This lies in the hands of your health insurance coverage.

If you’re looking to become pregnant and require one of these methods, you may save yourself a decent chunk of change by opting for a plan that covers fertility treatments. While each plan will vary as to what degree of coverage is provided, don’t forget to read the fine print before choosing your insurance plan.

The insurance policy carrier will determine what all is included. For example, if the man is the carrier of the policy, the plan may include fertility treatment for him but not for the female partner including the main event of the actual insemination.

If your employer doesn’t offer insurance that covers fertility treatments, you should take the issue to HR or a higher power to see if it’s possible. If it’s a large organization that has other employees dealing with the same issues, it may be something they’d be willing to change.

You should also conduct some research around grants offered by non-profits. There are many that exist to help with the cost of insemination.

Out of pocket expenses

If you are unable to obtain a plan that fully covers the artificial insemination process from start to finish, you’ll likely find yourself fronting the artificial insemination cost which can be an accrual of numerous things.

Medications

These are required to ensure that the woman is ovulating one or more eggs at the right time. There will typically be medications prescribed at each cycle and also one used to induce ovulation (otherwise known as a “trigger shot”). These medications vary in cost. For IUI, a prescription could cost you as little as $10. For IVF, depending on your insurance coverage, you could rack up a cost of $5,000 or more.

Bloodwork and check-ups

During the process of artificial insemination, it’s important that the woman is frequently monitored and evaluated. Not only will this require doctor appointments, but also blood work that can monitor hormone levels and the status of follicles throughout the process. While these costs vary, you might see costs of $500-$1,000 during each cycle.

Insemination

The event you’ve been working so hard for, the actual process of artificial insemination may cost around $150 to $400. However, sometimes an additional injection is suggested the day after the initial to improve success rates, so double that number if your doctor recommends this approach.

Additional fertilization costs

There is a chance you might need some additional assistance throughout the process, which may — you guessed it — make things more expensive. 

Embryo testing and freezing

Embryo testing for chromosomal abnormalities can cost $1,000 or more. Depending on timing or if you want to use them at a later date or after a lengthy transfer protocol, embryos will require freezing. This can cost a couple of hundred dollars. Freezing for a year will cost closer to $800. 

If you use a frozen embryo, the transfer will also come with a cost. The average cost to transfer a frozen embryo is $3,000-$5,000.

Egg donors and sperm donors

If you need an egg donor, you’re looking to endure a cost for just one cycle somewhere between $25,000 and $30,000. If you need a sperm donor, on the other hand, it’s significantly cheaper. On average, it can be about $15,000 per cycle. 

Gestational carriers

In the event that you need a gestational carrier, this will put you in the upper tier or near the top range of the total cost of insemination. This cost can range anywhere from $50,000 to $100,000. 

Total cost

Again, costs will vary depending on the treatment. It’s best to consult with your doctor to determine which route you should go and what additional costs may be required in your situation. Some fertility treatment costs can be offset by insurance and potential grants. 

To ensure you can afford IUI, IVF, or whatever fertility treatment you might need, it’s best to consult with your fertility doctor beforehand so you can determine how much you will have to pay in the end.

Summing it all up

Starting your fertility journey is a lot like learning a new language, and it can feel a little overwhelming at times. Don't be afraid to ask your fertility specialist to slow down, back up, and explain if you didn't understand the medical jargon they threw at you or simply spoke too fast.  

And hey, now that you've got the big four acronyms under your belt, you can start dropping some knowledge on those Facebook support groups like you're a pro…or at least understand what the heck they're all talking about.

Complicated used to be the word you used to describe your relationship status — but if you're considering IVF and trying to figure out what the heck your health insurance will cover, complicated is probably a word you've been throwing around a lot lately.

Does insurance cover IVF? Are there going to be surprise bills popping up like a bad ex?

The truth is…well, it's complicated. Amanda Garcia, practice administrator at New York fertility clinic CCRM NY, estimates 90% of employers now offer plans with some form of fertility treatment coverage, but that doesn't always expand to IVF. And plans with IVF coverage often have criteria a prospective parent has to meet, such as an age limit or a certain number of other procedures tried before IVF will be covered.  

So how do you know if your insurance will cover IVF? And what can you do to convince them to cough up the funds to finance your fertility treatments?  

Making friends with your insurance company

First off, a little good news. If you've already been undergoing fertility treatments, you may already have found an in-network provider who takes your insurance. Maybe some (or even all) of your treatments have been covered by your health insurance company.

If that's the case, Garcia recommends turning to the billing office of your fertility treatment center for help negotiating with your insurance company to get the IVF process covered. That's what they're there for. The billing office staff can:

• Go line by line through your treatment plan to ask your insurer what is or isn't covered
• Advocate for coverage for different procedures or drugs
• Help you find loopholes in your plan, like billing ultrasounds under OB/GYN care instead of classifying them as part of fertility treatment
• Help you maximize your coverage—such as determining which procedures are best to have billed to insurance vs. paying out of pocket

Haven't found a clinic yet, or have a doctor you adore with a billing staff that makes Cruella De Vil seem warm and fuzzy? You've still got this; you'll just need to do a little more of the homework yourself. Caitlin Donovan, director of outreach and public affairs at the National Patient Advocate Foundation advises making your own calls to your insurance company to suss out what's covered.  

Some questions you ask will be specific to your area, your chosen clinic, and your situation, but Donovan says the following can really help you make your decision:

• Do I need a referral from my primary care physician or OB/GYN?
• Do I need prior authorization from the insurance company for IVF?
• Are diagnostics covered by my IVF coverage?
• What are my prescription drug benefits?
• Are there different coverages for oral medications vs. injectable medications?
• Are there different coverages if I receive medications in the office vs. at home?
• Is the anesthesiologist covered under my plan?
• Is the radiologist covered under my plan?

"Ask for their responses in writing after they talk to you," Donovan says. "If they end up reneging, that will be crucial in an [insurance claim] appeal."  

Get on the right side of the law

It always helps when you have the law on your side to get help, and in some parts of the United States, you might be able to use state mandates to your advantage.  

According to the National Conference of State Legislators, several states have laws on the books regarding health insurance coverage for fertility treatments:  Check the laws before you call your boss and demand better coverage. They might be offering exactly what your state requires (and nothing more).  

New Jersey, for example, requires insurers cover up to four egg retrieval procedures, while neighboring New York's legislation doesn't require much IVF treatment coverage at all. You'll also need to brush up on any age limits and any requirements that doctors try less invasive procedures before OKing IVF. Some insurers will deny IVF coverage until a woman is 30 or even 35, and some will require a certain number of intrauterine insemination attempts before providing authorization for IVF.  

Fight for your right to in vitro

After all that, what happens if your insurance company says no? Hold onto your wallet; you may still be able to get coverage.  

Insurers are required to give you up to three appeals for a denied claim. For your best chance, Donovan suggests you:

• Get your doctor on board: Many doctors will get on the phone with your insurance company's medical director to explain why they've chosen the treatment plan they have and why it's so necessary for you. Others will write letters to your insurance company, including details of your medical history that might be pertinent in changing the insurers' minds.
• Write your own appeal: This should be in addition to, not instead of your doctor's submission. For the best results, take emotion out of it, Donovan says. Review your plan's language and use similar language to back up your reasoning.

A little extra help

If every phone call with your health insurance company continues to make you break out in hives, you've still got options. There are other ways to cover your costs:

• Talk to the billing department. Yes, them again. They may be able to help you negotiate a self-pay rate if your insurance won't cover anything or secure an IVF grant to cover some of your costs.  
• Ask your doctor if they've got sample medications on hand to help reduce the number you have to buy.  
• Friends and family may want to help support your journey. It never hurts to ask.
• Apply for help from a fertility treatment charity.  

At the end of the day

It can feel like it would be easier to run a marathon without training than it is to get your health insurance company to pay for IVF. But don't be afraid to ask for help—whether it's asking the billing department to advocate for you or the person on the other end of the line at the health insurance company to answer your long list of questions.

If you’re thinking that a surrogate might be the answer to your “how will I become a parent” question, you’ve probably already started doing some math in your head to figure out how you’re going to cover all those surrogacy costs.

But just how much does working with a surrogate cost? You’ll likely be using a gestational carrier — that’s the term you’ll hear thrown around a lot to describe a woman who gets pregnant to help someone else fulfill their dreams of parenthood but is not biologically related to the baby. She is impregnated via in vitro fertilization (IVF) and carries an embryo made up of someone else’s sperm and someone else’s egg.

But does she get compensated? And what about the surrogacy costs after the baby is born?

How much does working with a surrogate cost?

The cost of surrogacy can run you anywhere from $100,000 to $200,000 in the United States — depending on where you live, who your gestational carrier is, and just exactly what fertility services you need along the way. It’s a pretty big range — and you’re probably wondering what’s included in that figure. 

According to Amira Hasenbush, a California lawyer and founder of All Family Legal who specializes in surrogacy, it can totally vary depending on the individual or couple’s needs and decisions.

What do surrogacy costs include?

Even if the costs are still a question mark, by now you’re probably familiar with the basics of the surrogacy process. A gestational carrier becomes pregnant, and after 40 weeks (give or take), a baby is born. But it’s the lead-up to the day that you get to hold your sweet little bundle of joy that will determine which end of that price range you’ll end up on. 

You’ll likely need to pay for IVF in some capacity, whether it’s to fertilize an embryo from you and your partner or via donor eggs or sperm. IVF costs can totally vary between $8,000 - $30,000, but can have varying degrees of insurance coverage depending on where you live.  In addition to those fees, here’s what other surrogacy costs could include.

Agency fees

First things first! You’ll need to find a surrogate, and you may need to engage an agency to help you find the perfect person. Or maybe you’re lucky, and you’ve already got someone in your life who’s more than happy to help make your parenting dreams come true by carrying the baby. If that’s so, you can likely strike the surrogacy agency fee from your list. Next, however, you’ll have to consider whose eggs will provide half of the baby's DNA.

Egg donor compensation and medical coverage

If you’ll be going the egg donor route, you can review the Family by Co matching platform to see if you find a good fit for your family. Our model of free egg freezing when our donors give half of their eggs to another family who can’t conceive ensures that all donors on the platform are not only altruistic, but ambitious and excited to preserve their own fertility. 

To better understand costs involved with working with Family by Co, please review more about our commitment here.  

Sperm donation

If you need donated sperm to help this process along. If you don’t have a friend or family member on board to help (which most of us don’t), expect to pay somewhere around $700 to $1,000 to get frozen sperm from a sperm donation bank. 

Embryo donation

For parents-to-be who opt for an already fertilized egg, there can be cost savings — many embryo donations are handled by religious non-profits that will match unused embryos to would-be parents for free. You’ll still need to consider the costs of the IVF procedure, however, just as you will with sperm and egg donations or even transferring your own embryo into your gestational carrier’s uterus. 

Legal fees

Agreements will need to be made with the egg donor if you have one, as well as the surrogate herself. Intended parents pay not only their own legal fees but those of their donor or surrogate, Hasenbush says. These fees vary by location, and again by what a parent- or parent-to-be needs in the process, but overall the lawyer and legal fees could cost around $8,000 - $15,000. 

Insurance

Your surrogate is also going to need insurance “The medical/insurance often surprises folks,” Hasenbush warns. “The insurance coverage needs professional review to make sure it covers surrogacy.  Premiums can be very high, and if they buy surrogacy-specific insurance, it is particularly expensive.”  

Some surrogates have health plans that will cover her costs once she starts getting treated by an OB, but it’s important to get this all evaluated up front, and to have it re-evaluated every fall to make sure that it hasn't changed from one year to the next, Hasenbush says. Some other insurance stuff to keep in mind:

• Out-of-pocket maximums start over each calendar year.
• Some insurance companies have a lien policy where they can put a lien on the surrogate's compensation to recoup their costs. This doesn't mean that the surrogate loses her compensation, Hasenbush says, but it does mean the intended parents have to set aside the maximum amount that the lien could be as an additional amount in escrow for if/when the insurance company requests it.
• Some surrogacy contracts require other insurances for the surrogate including life insurance and loss of reproductive organs insurance (should something happen during the pregnancy).
• Egg donor and IVF complications insurance may also be recommended.

Surrogate base compensation

Unless you have a family member or friend who will be acting as gestational carrier, one of the biggest costs will be compensating the surrogate herself — anywhere from $35,000 to over $55,000. This is the portion of pay to the surrogate that acts as a salary for the service she’s providing, but it’s not all she gets. 

Multiples compensation

Expecting twins or triplets? You may need to pay an extra $5,000 to $10,000 as part of your surrogate’s base fee. 

Additional surrogate fees

Typically, surrogacy contracts include an itemized list of compensations that come on top of that base, so that your gestational carrier will be covered for other difficulties and expenses she’ll incur while pregnant. That can include things such as

• Lost wages for surrogate when she is on bed rest or traveling for the surrogacy
• Lost wages for a surrogate’s partner while she’s on bed rest or traveling for the surrogacy
• Surrogate (often and a companion) travel for medical visits, including visits for embryo transfers, regular check-ups, and any other pregnancy-related doctor visits
• A monthly allowance to cover odds and ends such as parking at doctor’s offices, postage, etc.
• Clothing allowance for maternity clothes
• Additional compensation if delivery has to happen via C-section instead of via a vaginal birth
• Childcare and housekeeping costs if the surrogate is placed on bed rest
• Therapy coverage for the surrogate to work with a counselor during the pregnancy if she wishes to

Escrow fees

Surrogate and egg donor fees are typically held in an escrow account. Intended parents will place money upfront in a special, locked account according to the agreement outlined in the contract. Many surrogates are paid in monthly installments after pregnancy is confirmed.   

Any medical out-of-pocket surrogacy costs not covered by insurance

From over-the-counter medications to medications and procedures the insurance company decides not to cover, there may be additional costs that add up.

Surrogacy costs after baby is born

Once the big day arrives and your baby is born, you’re going to have a ton of diapers to buy. But before you start thinking about all the costs of getting a child to 18, you’ve still got some surrogacy-related bills you’ll need to pay.

• Legal fees: Yup, there are more of them after the baby’s born. Because your baby was delivered by a gestational carrier — even if the baby is biologically related to you — you may have to establish parenthood in the eyes of the court, which means attorney fees and court costs. If you traveled internationally to find a surrogate, you may also have to pay to establish your child’s citizenship.
• Breast milk: You may want your surrogate to pump her breast milk for your baby. If she’s amenable, you’ll need to compensate her as well as paying for her supplies such as the breast pump and bottles. If she isn’t local, you’ll also need to factor in shipping costs for the milk.
• Lost wages: Maternity leaves aren’t just for moms to bond with baby — they’re also for a woman to recover from delivery. You should expect to pay your surrogate for the time she may be out of commission after the baby comes — anywhere from four to 8 weeks.
• Health costs for the surrogate: As her body heals, you’ll likely still be paying for your surrogate’s medical care. Health and life insurance premiums are typically paid by the parents for at least three months after the delivery, but it could be extended to six months if there were complications during the pregnancy or delivery, Hasenbush notes.

Is that everything?

The fertility journey can be a bumpy road, and sometimes Mother Nature doesn’t cooperate. If a surrogate does not get pregnant after three rounds of IVF or if she suffers a miscarriage, you may need to find an alternate surrogate and this could incur more fees. Your agency will help you find another surrogate most likely, but you may not recoup the money paid to or on behalf of the first surrogate.

Anything else?

At the end of the day, surrogacy does cost money. There’s just no way around that. But we recommend you take advantage of the resources out there — talk to the doctors and lawyers in the business and form your team to make it happen. We’re here for you, keeping our fingers crossed.

Ready for a big number? There are about 480 fertility clinics scattered all across the United States.  

The good news? Depending on where you live, you hopefully have plenty of places to choose from to take the next step in your fertility journey. The bad news? Pretty much the same thing—you've got to choose between 480 different clinics, spread all across the United States.  

So how do you find the best fertility clinic for you? There are plenty of factors to consider, but here are some of the biggies to help you decide between the clinic your OB/GYN suggested and that hotshot doc your friends are raving about.  

Location, location, location

Don't start packing your bags just yet. While you may have heard amazing things about a nationally-known doctor, it's best to start your search close to home, says Dr. Paul Lin, M.D., a reproductive endocrinologist with Seattle Reproductive Medicine and president-elect of the Society for Reproductive Technologies (SART). If possible, he even recommends starting with a clinic within 50 miles of home.

The benefits of sticking as close to home as possible?

• Less stress: Traveling always has the potential to create some degree of stress. Now imagine adding that to the stress you might already have when going through fertility treatments. These treatments are often specifically timed with your cycle, and you may need daily monitoring or to head into the clinic on super short notice (say, if your period comes a day or two earlier). In most cases, save your sanity and go where is most convenient.
• Lower costs: Even when health insurance pays for fertility treatment, it rarely pays for travel to and from a clinic, so Lin reminds couples to consider whether or not they can afford airplane tickets and hotel bills if they choose a clinic far from home.  
• Time to build a relationship with your clinic: Clinics try their best to make things easier on patients who have to make a long haul to get to them. Typically that means phone or Skype sessions in place of face-to-face meetings with everyone from the billing department to the actual doctor when you can't make the trip. It's good when necessary, Lin says, but the more time you have to sit face-to-face with everyone on staff, the easier the process can be.

What if you don't find the right clinic close to home? Don't worry. There are other factors to keep in mind that may end up being more important to you than location.  

Treatments offered

They all get the same degrees and go through the same kind of training, so every reproductive endocrinologist (that's the doc who you'll see at a fertility clinic) must offer the same treatments, right?  

Well, no.  

Some clinics run the gamut from providing patients of any age with follicle stimulating hormones through working to help them achieve pregnancy with a gestational donor, Dr. Lin says, but others focus solely on in vitro fertilization (IVF), and they limit their patient pool to women 35 and up.  

When you start scoping out an office, it's best to find out just what sorts of procedures they offer, and what they'll do if you end up requiring treatments that they don't currently offer. Some questions to ask:

• Do you have an age requirement for your patients?  
• Do you have an embryologist on staff, or are the lab portions of IVF done by an independent lab?
• Do you have an in-house egg donor team or would I have to find an agency?
• Do you work with gestational carrier surrogates, should I need one?

Practice size

Does size really matter? That depends on what you're looking for in a clinic.  

When a doctor has a small office, they may not get much demand for certain procedures, Dr. Lin says. In turn, the treatment you need may not be available at that smaller clinic.  

Other things you'll need to consider when it comes to practice size:

• Do you expect to see one doctor, every time? Small practices tend to offer more one-to-one time with your chosen doctor, while you may see a mix of practitioners in a large office, including nurse practitioners and/or physician's assistants.
• Could you use a (free) second opinion? At Dr. Lin's clinic, for example,there are 12 reproductive endocrinologists, and they're constantly bouncing ideas off of one another. Larger practices offer a second opinion that's just one chat between colleagues away.
• Is there a support team to help you? Regardless of how many doctors are in the practice, it's standard for clinics to have a billing office. But not every office has people available to help walk you through all your concerns and help you talk to your insurance company or find grants to pay for your treatment.

Costs

OK, deep breath. You already know fertility treatment can be costly, and when it comes down to it, the right clinic for you might just be the only clinic you can afford. Don't be shy when it comes time to talk dollar figures. This is your future on the line.  

• Do you take my insurance? If you've got insurance coverage for fertility treatment, this is the very first question to ask.  
• Do you have a global fee, and what does it cover? Many clinics lump their costs into a flat or "global" fee, says Amanda Garcia, practice administrator at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM). But just because it's "global" doesn't mean it covers everything. Ask the billing office to address everything that's included and anything that's not—such as medication or the freezing of embryos.  
• Do you have any grants I can take advantage of? Some clinics have their own grants, while others are partnered with nonprofits to provide them. In New York State, there are even clinics designated to receive state funding to cover patients' treatment. So look around, and choose wisely.

Success rates

Why did we save this factor for last? Surely, it must be the most important one. Yes, and no, says Dr. Lin. In fact, SART, which maintains a database of all accredited fertility clinics within the United States, also keeps track of clinic data—the same data that's collected by the federal government—to confirm their reported outcomes are actually true.  

"If they're doing Octomom-level practice, we're going to ding them and go and see what's going on," he adds, alluding to a clinic that made headlines in 2009 after one of its patients gave birth to octuplets. That doctor eventually lost his medical license.  

Success rate data is yearly, providing a look at the number of patients, their ages, types of procedures performed, and how many babies were born as a result; i.e. how successful the treatments were at creating brand new bundles of joy.  

So why did we leave this one for last? SART discourages patients from using the data to compare clinics en masse because different fertility clinics, with their different treatment offerings and patient population, are like apples and oranges.  

Instead of picking the "best in the country" based solely on numbers, Dr. Lin suggests using the data to find out:

• Individual clinic experience with patients your age and with like diagnoses
• An across-the-board look at the chances that a new patient to the clinic (regardless of age or fertility diagnosis) will end up giving birth

To sum it all up

You've got a lot to consider. But believe it or not, there's not as much variation from clinic to clinic as you might think, at least not according to Dr. Lin. All fertility specialists undergo similar training, and all labs are held to rigorous standards. At the end of the day, what matters most might just be the relationship with your doctor.  

So, you (and your doctor) have made the big decision about your fertility future. It’s time to try IVF. Now comes the question of the hour: How are you going to pay for it all? 

It might be time to apply for a grant. Yup, IVF grants are out there, and they’re not that different from the funds your local fire department gets to outfit their firefighters or the grant a city snags to provide extra programs for the local kids. 

Could you qualify for an IVF grant or is this all too good to be true? Let’s take a look.

Where are IVF grants hiding? 

Ok, so you know the basics about grants. The money comes from the government or a non-profit with beaucoup bucks to fund something worthwhile. But where is this magic money for IVF?

• Local grants: You may not have to look too far to find the money you need. Several IVF grants are limited to folks living in very specific geographic regions. At the Starfish Fertility Foundation, for example, one grant is awarded only to uninsured folks living within a 50 miles of Nashville, TN. Others are offered through specific clinics. 
• State grants: Time to cast your net a little wider? There are grants out there that cover entire states. In New York, for example, the state’s Department of Health funds grants that are open to residents across the Empire State (provided they use an approved clinic). Other grants come via non-profits that cover care in specific states, and sometimes, you don’t even need to actually be a resident of that state—just willing to travel there for treatment. Stardust Foundation provides financial assistance to all types of jewish couples and/or individuals, regardless of their Jewish denomination or involvement, sexuality, or marital status, in the Tri-state area who are struggling to begin or grow their family.
• National grants: These grants come from non-profits located throughout the country. The good news? You don’t have to travel far from home to find fertility help, as the funds can often be used at clinics across the US. The bad news? The competition for national grants is fierce. You’re no longer up against just the folks in your town or state. You’re competing against applicants from everywhere. 

Do IVF grants cover it all? 

Maybe you’ve already put some savings aside for fertility treatments. Do you need to keep saving or will a grant be your golden ticket? 

The answer is a little bit of both, says Dr. Camille Hammond, M.D., CEO of the Tinina Q Cade Foundation, a Maryland non-profit that funds fertility treatment grants. Some grants have funding limitations to keep in mind: 

• Parent match: Grants can take some of the burden off, but many grant funding sources expect a parent or parents to kick in some of the cost of treatment. This shows the teams who comb through grant applications that you have the financial means to provide for a baby after they’re born. It also shows your level of commitment to the process. “If you’re telling me this is the most important thing in your life right now, I’m not sure how important it is to you if you’re not willing to contribute at all,” Hammond says. 

• Number of rounds: You never know just how many rounds of IVF you’ll need. Sometimes it just takes one; sometimes you’ll need more. Be aware your grant may have a specific number that are covered, warns Amanda Garcia, practice administrator at New York fertility clinic CCRM NY. 
• Just the meds: Sometimes insurance will cover your procedure, but the medication cost is dragging you down. Good news: some grants are tailored to pay for just the meds! 
• A flat number: Many of the grants out there provide a flat dollar amount to folks, regardless of what their treatment plan looks like. So you might be able to get as much as $5,000 or $10,000, but it will be up to you to allocate it wisely, balancing out any insurance coverage or help from the clinic that you might have wrangled. 

Sounds good, sign me up! 

Hold up, not so fast. Aside from location stipulations for local and state grants, most of the funding out there comes with eligibility guidelines you need to meet right out of the starting gate, including:

• Age limits
• Income limits
• Insurance coverage: Some grants will only cover treatments if you have 0 insurance coverage; others require you’ve exhausted all fertility coverages.
• Marital status: Some grants are allocated specifically for married couples; others will help single parents. 
• Diagnosis: Some grants require a diagnosis of infertility, but some will make exceptions for same sex couples or single parents.
• Religious affiliation: Some grants are specifically focused for individuals who identify with a particular religion, or even a specific denomination within that religion.

Grants for egg donation

IVF plus egg donation can be a huge expense. Fortunately, most grants do not exclude egg donation. This means that you can use the grant towards the cost of matching with a donor, as well as the egg donor’s egg retrieval procedure and medications.

Affordable egg donation options 

We get it, egg donation and IVF can be a huge expense. At Cofertility, our $500 match deposit and one-time coordination fee of $7,500 come with a baby guarantee. We want to help you bring your baby home, and we will re-match you for free until that happens. 

What does that mean? If a donor doesn’t pass your doctor’s screening, we’ll help you match again (or you get your money back). If a cycle leads to no blastocysts, we’ll match you again. If none of the blastocysts turn into a pregnancy, we’ll match you again. We’re doing things differently around here, and hope this guarantee can bring you peace of mind.

Press and public relations requirements

Charities that dole out funds depend on awareness of their mission to keep donors donating. That’s why many will require grant awardees to be willing to do occasional interviews with press about their fertility journey, says Pamela Hirsch, co-founder of BabyQuest, a California non-profit that funds fertility grants. And it’s not just moms-to-be who have to be willing to be open. If there’s a dad in the picture, he may also be called on to speak openly about his part of the process.

How to apply

Checked all the boxes on the guidelines, and you’re a match? Congratulations. Now it’s homework time! Most grants require you to fill out an application, and that’s going to come with a fair amount of paperwork. 

• Proof of income: This might include last year’s taxes, paystubs, and other means to prove how much you make a year.
• Medical records: Your doctor’s office can provide these, and they may also need to write a letter to describe your treatment plan and why you’re a worthy candidate. 
• Your personal story: Why should they pick you as a grant recipient? You (and your partner if you have one) are going to have to share your fertility journey and your hopes and dreams for a family. 

Nailing that application

With thousands of applicants and only so much money to go around, there’s no one secret to nailing that application. Still, there are a few things you can do:

• Follow the instructions: No. Really. Do everything exactly the way the grant application directs you to do it. “A lot of people want to make up their own instructions,” Hammond says. All that does is make it harder for the reviewers—and more likely you won’t be chosen.
• Double check everything: Doctors are well-meaning but they’re also juggling myriad patients. Hirsch advises re-reading everything they’ve sent over to support your application, just to make sure they haven’t missed a crucial piece of the puzzle that could sway things over to your side. 
• Be honest: It may sound obvious, but Hammond says people are often surprised that her team really does look at those tax documents and other supporting paperwork. The numbers need to match!
• Be sincere: One major red flag for Hammond’s team? When a couple applies, and they’ve copied and pasted their answers so they’re an exact match. “We really want to hear from everyone who has a stake in this,” she says. 

The bottom line

IVF grants are just one way to fund a fertility journey, but if you fit the eligibility guidelines, applying may be worth it. We’re wishing you the best of luck on your journey!

Learn more

• 10 Donor Egg Grants to Know About

For lesbian and other LGBTQ+ couples, a fertility journey isn't always straightforward. After all, you've got to work out the whole sperm + egg + uterus thing, and you may not have all of the above. Needless to say, things can get complicated; not to mention any fertility hiccups along the way.

One option for lesbian couples (and for some couples where at least one partner is transgender or nonbinary) is called reciprocal IVF. In reciprocal IVF, one partner's egg is used, but the other partner carries the pregnancy. This way, each partner gets to play a role: one is the biological parent, and the other gets to feel all the kicks and jabs (and morning sickness…blah) and deliver the baby. This could help both partners feel super involved in the pregnancy and connected to the baby.

Sounds kind of perfect. But with reciprocal IVF, there's a lot to understand and consider before diving in.

Reciprocal IVF 101

Here's how it works: First, you'll both have to take drugs that will get your periods synced up. It's important that you're ovulating at the same time. Then, the partner donating the eggs will take fertility meds to help her ovulate, and hopefully one or more eggs can be retrieved. They'll be fertilized in a lab with donor sperm in hopes of getting at least one viable embryo.

Resulting embryo(s) can then be transferred fresh or frozen to her partner. Basically, it's pretty similar to the standard IVF process, except the transferred embryo was made with the other partner's egg.  

If your fertility specialist recommends freezing embryos (and possibly chromosomal screening), syncing your cycles is not a necessary step. Eggs can be extracted first, embryos created and frozen and implant planned in the future. The menstrual cycles don't need to be synced.

Who's doing what

You'll have to decide: Who's going to be pregnant for nine months, and who's going to go through the egg retrieval process? You may be able to choose based on the question of who's more into the idea of being pregnant. But you might not have the luxury of choice—if one partner has trouble with her egg reserve or her uterus, for example, or has a health problem where pregnancy is dangerous.

Neither role is free of risks. Because you'll both be taking fertility medications, you may experience side effects. The woman carrying the baby will carry all the risks of pregnancy and childbirth.

Sperm: anonymous vs. known

You're going to need some sperm to make reciprocal IVF happen, so part of the process is choosing where it comes from. Would you want an anonymous donor from a sperm bank? Or is there someone you know who'd be willing to donate some sperm to you?

Going with a sperm bank is pricey, but the sperm is screened for illnesses, and in the U.S., usually the donors have signed paperwork waiving any parenthood rights. If someone in your life donates, they often do it for free (besides the necessary costs of sperm workup/bloodwork you’ll need to consider), and you both can go through this process with someone important to you. However, as the Family Equality Council suggests, you should draft a contract with that person. Also, with widely available genetic testing, bear in mind that no donation is truly anonymous these days. 

But what about money?

If neither you nor your partner have been diagnosed with infertility, your health insurance may not cover the costs of reciprocal IVF. Bummer, we know.  

Reciprocal IVF costs are similar to that of regular IVF. A cycle of IVF can cost anywhere from $16,000 to more than $30,000 when all is said and done. And, we're going to be candid here: it doesn't always work the first time. If you're using frozen embryos left over from the first cycle, additional transfers  may cost less—more like $3,000 to $5,000 per cycle, plus fertility meds.

The laws aren’t great

Parenting laws are complex and vary from state to state. And frankly, they haven't quite caught up with fertility technology. So they may not automatically recognize both parents as biological parents of the child, whether you're legally married or not. So, so frustrating.

An attorney experienced in assisted reproduction laws can help you through all the legal rigamarole. Some states allow "second parent" adoptions, where one parent is deemed the biological parent and the other is able to adopt the child, so they both have equal rights and responsibilities as parents.

If your state doesn't allow second parent adoption or doesn't allow married or unmarried same-sex couples to adopt (yes, both are a thing), the Human Rights Campaign suggests drafting a co-parenting agreement or custody agreement with your partner. A good attorney can help you through all of that.  

What about being pregnant at the same time?

Some couples even choose to both be pregnant at the same time, which is known as concurrent IVF.

In concurrent IVF, each woman goes through IVF followed by embryo freezing for each. Once each woman's uterus is deemed by her doctor as ready to receive the embryos created from her partner's eggs, each partner's embryos are transferred to the other. They can therefore carry each other's baby at the same time.

But keep in mind, concurrent IVF could pose some challenges. "Their babies could possibly be born very close to the same birth date," Dr. David Diaz, MD, reproductive endocrinologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California notes. While it could be a wonderful option, "If one woman's pregnancy is complicated, it may be difficult for her pregnant partner to easily care for the woman struggling with the complication."  

And then you'll have two newborns. "After the birth, it may add physical stress and fatigue in caring for two newborns by both moms who are recovering from childbirth," says Dr. Diaz.

Think about the future

If you're hoping to have more than one child, you may consider a few different options. Perhaps you freeze some of the embryos from this cycle for a later transfer. Or you could swap roles: the egg donor becomes the pregnant partner and vice versa next time.

All that said, reciprocal IVF can be a good choice for lesbian partners who want to have a baby together—so long as you've discussed all the above with each other, your doctors and a lawyer. Be sure you'll both be comfortable with your role in the pregnancy and beyond. And get ready to become parents…together!

While donor egg IVF offers hope for individuals and couples facing infertility, as well as same-sex couples looking to have children, the significant cost associated with retrieving donor eggs can be a barrier to access for many patients. The increasing demand for donor eggs has highlighted the need to make it more accessible and affordable. 

The good news is that there are ways to lessen the financial burden. This article explores various payment options and financial solutions that can help you navigate the financial challenges of pursuing donor eggs. From financing programs and employer stipends to tax credits, Health Savings Accounts (HSA)/Flexible Spending Accounts (FSA), egg sharing, and grants, we provide a comprehensive analysis of these avenues to make donor eggs more financially attainable.

1. Financing donor eggs

Some fertility clinics offer financing programs that allow you to pay for egg donation services over time, often with little to no interest. These programs can make the cost of egg donation more manageable by breaking it down into smaller, more affordable payments. However, it's essential to understand the terms and conditions of the financing program, including any fees or penalties that may apply.

If you’ve decided you want to go the loan route, you have many options to choose from. There are general lending companies as well as companies that specialize in loans just for fertility treatments.

If you’re pursuing egg donation and are interested in working with us to find your perfect match, we've partnered with Sunfish to offer you fertility financial resources and support throughout your journey. Sunfish offers the most comprehensive marketplace of financial options for IVF, egg freezing, embryo preservations, gestational surrogacy, egg donations, and more, up to $100,000 at industry-low rates. 

Sunfish has also waived their application and membership fees for all intended parents who are working with Cofertility. To take advantage of Cofertility’s infertility loan partnership with Sunfish, click here.

2. Employer stipends and insurance coverage for donor eggs

Some employers recognize the significance of fertility treatments and offer comprehensive benefits that include coverage for donor eggs. Employer-sponsored fertility programs and stipends can significantly reduce the financial burden for individuals pursuing donor eggs. It is crucial for patients to review their insurance policies to determine the extent of coverage for fertility treatments. By understanding the benefits offered by their employers, individuals can maximize their financial resources for this reproductive option.

3. Tax credits and deductions for donor egg IVF

The tax landscape offers potential relief for individuals pursuing donor eggs. Several tax credits and deductions are available for qualifying medical expenses, including fertility treatments. 

In order for donor egg IVF to be tax-deductible in the United States, it must be deemed medically necessary. This means that the procedure must be recommended by a healthcare provider and must be performed to treat a medical condition. For example, if a woman is unable to conceive naturally due to premature ovarian failure, then donor egg IVF may be deemed medically necessary. But if two men in a same-sex relationship need an egg donor to build their family, unfortunately the IRS does not view this as tax deductible. 

Additionally, the expenses associated with donor egg IVF must be significant enough to meet the threshold for medical expense deductions. In the United States, this threshold is currently set at 7.5% of a person's adjusted gross income (AGI). This means that if your AGI is $50,000, you can only deduct medical expenses that exceed $3,750.

It's also worth noting that not all expenses associated with donor egg IVF are tax-deductible. It’s best to speak with a tax professional or financial advisor to determine your eligibility for tax-deductible donor egg IVF and to ensure that you are following all necessary procedures for claiming the deduction.

Read more in Is Egg Donation IVF Tax-Deductible?‍

4. Using health insurance for donor eggs

Across the country, 17 states (and counting!) have laws requiring insurance companies to cover or offer coverage for infertility diagnosis and treatment. 

However, the specifics of these laws vary widely from state to state, and not all necessarily mandate coverage for procedures involving donor eggs. While most laws are vague without any mention of donor eggs, a few specifically require coverage of donor eggs. Let’s look at those:

Delaware 

The DE law states that “in vitro fertilization, including IVF using donor eggs, sperm, or embryos and IVF where the embryo is transferred to a gestational carrier or surrogate must be covered”

Maine 

The ME law states that health plans must cover fertility diagnostics and treatment, without “any limitations on coverage for any fertility services based on an enrollee's use of donor gametes”. However, any nonmedical costs for using donor eggs can be excluded from coverage.

Massachusetts

The MA law requires insurance plans to cover treatment of infertility including donor egg procurement.

New Hampshire

The NH law states that health plans must provide coverage for medically necessary fertility treatment, including “treatments associated with the procurement of donor eggs.”

New Jersey

NJ law requires health plans to provide coverage for four egg retrievals per lifetime, and 

IVF using donor eggs.

Even if your state has infertility coverage laws in place, your specific health plan might not be required to comply, or may have specific qualifications (like being under age 40 or in a heterosexual partnership). Self-insured or self-funded insurance plans are exempt from state law and employers do not have to follow the state insurance laws. Some states also exempt employers under a certain size from having to provide coverage. The best way to find out is to talk to your health plan directly.

Read more in Does Health Insurance Cover Donor Eggs?

5. Using HSA/FSA accounts for donor eggs

HSA/FSA accounts present an opportunity to utilize pre-tax funds for fertility treatments, including the cost of donor eggs. Contributions made to these accounts can be used to cover eligible medical expenses. Patients should be aware of the eligibility criteria, contribution limits, and documentation requirements associated with HSA/FSA accounts to ensure compliance and maximize their use for donor eggs. It’s best to talk with a tax professional to understand which parts of donor egg IVF can be paid for using HSA/FSA.

6. Egg sharing programs

Egg sharing programs, like Cofertility, provide a more affordable and ethical egg donation experience. Instead of cash compensation, an egg donor gets to keep half of the eggs retrieved for her own future use. 

One significant advantage of the egg sharing model is that donors have a personal stake in the outcomes. When donors contribute a portion of their eggs in exchange for their own IVF treatment down the line, they are invested not only in helping intended parents but also in achieving their own fertility goals. This shared interest leads to a greater sense of commitment and dedication from the donors, potentially resulting in higher-quality eggs and improved success rates.

At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing.

Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

We aim to be the best egg-sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
• Diversity: We’re proud of the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
• Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
• Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account to get started today!

Read more in Six Reasons Why Egg Sharing is a Better Egg Donation Model for Intended Parents

7. Grants and financial assistance programs

Grants and financial assistance programs specifically designed for fertility treatments can offer significant financial relief to individuals pursuing donor eggs. These programs provide funds to eligible patients based on various criteria such as financial need, medical conditions, or specific demographic considerations. 

You can research and explore available grants and financial assistance programs, carefully review eligibility criteria, and complete the application process diligently to increase their chances of receiving financial support.

• Local grants: You may not have to look too far to find the money you need. Several IVF grants are limited to folks living in very specific geographic regions. At the Starfish Fertility Foundation, for example, one grant is awarded only to uninsured folks living within 50 miles of Nashville, TN. Others are offered through specific clinics. 
• State grants: Time to cast your net a little wider? There are grants out there that cover entire states. In New York, for example, the state’s Department of Health funds grants that are open to residents across the Empire State (provided they use an approved clinic). Other grants come via non-profits that cover care in specific states, and sometimes, you don’t even need to actually be a resident of that state—just willing to travel there for treatment. 
• National grants: These grants come from non-profits located throughout the country. The good news? You don’t have to travel far from home to find fertility help, as the funds can often be used at clinics across the US. The bad news? The competition for national grants is fierce. You’re no longer up against just the folks in your town or state. You’re competing against applicants from everywhere. 
• LGBTQ+ grants: Our partners at GayParentsToBe maintain a list of LGBTQ+ friendly grants for family-building.

The financial cost of donor eggs should not be an insurmountable barrier for individuals and couples seeking fertility treatment. Continued efforts by healthcare providers, policymakers, and advocacy groups (like Resolve!) are necessary to promote equitable access to fertility care and support individuals in their journey toward building a family.

Find an amazing egg donor at Cofertility

At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing. 

Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

• Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
• Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
• Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account to get started today!

If you’re considering using donor eggs to grow your family, oftentimes, the associated costs can be a significant financial burden. In this comprehensive guide, we delve into the question of whether Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can be utilized to pay for donor eggs. We also explore other financing options available to individuals seeking fertility treatments. 

The TLDR: you can use your HSA or FSA towards some (but not all) expenses related to donor egg cycles, and if you’re part of the LGBTQ+ community, you may unfortunately face a harder time getting reimbursed, given what the IRS defines as “medical necessary”. 

Let’s dive into the details. 

How HSAs and FSAs work

First, it’s important to have a fundamental understanding of how HSAs and FSAs work. These are both valuable financial tools that allow you to allocate pre-tax dollars toward qualified medical expenses, and can help reduce the burden of healthcare costs and out-of-pocket expenses.

To maximize the benefits of HSA and FSA accounts, it is important to understand eligibility criteria and contribution limits set by the IRS. These guidelines ensure compliance and provide you with an opportunity to save for future healthcare expenses. 

While HSAs and FSAs serve a similar purpose, there’s actually some nuance to it. their differences to make an informed decision about which one best suits your needs. Let's delve into the specifics of each type of account, and how it relates to donor eggs.

Health Savings Accounts (HSAs)

To be eligible for an HSA, you must be enrolled in a high-deductible health plan (HDHP). Here's what you need to know about HSAs:

• Pre-tax contributions: Contributions to an HSA are made with pre-tax dollars, which means the money is deducted from your paycheck before taxes are calculated. This offers an immediate tax benefit by reducing your taxable income.
• Tax-free growth: Any contributions made to your HSA can grow tax-free through investment opportunities. This allows your HSA funds to accumulate over time and be used for future medical expenses.
• Portability: HSAs are portable, meaning you can take the account with you even if you change jobs or health insurance plans. The funds in your HSA remain available for qualified medical expenses, regardless of your employment status.
• Contribution limits: The IRS sets annual contribution limits for HSAs, which may change each year. For 2024, the contribution limit for an individual is $4,150, while for a family, it's $8,300. Individuals aged 55 or older can make additional catch-up contributions.

Flexible Spending Accounts (FSAs)

FSAs are another tax-advantaged option for healthcare expenses. Unlike HSAs, FSAs are typically offered through employers. Here are the key aspects of FSAs to consider:

Pre-tax contributions

Like HSAs, contributions to an FSA are made with pre-tax dollars, resulting in a reduction in your taxable income. However, unlike HSAs, there is no requirement for enrollment in a high-deductible health plan.

Use-it-or-lose-it rule

FSAs operate under a “use-it-or-lose-it” rule, which means any funds contributed to the account must be used within the plan year or within a limited grace period. However, some employers offer a carryover option or a grace period to allow some unused funds to be carried forward.

Employer control

FSAs are typically established and managed by employers. The employer determines the contribution limit and plan rules, such as eligible expenses and rollover options. It's important to review your employer's FSA plan details to understand its specific features.

Contribution limits

The IRS sets annual contribution limits for FSAs as well. For 2024, the maximum contribution limit is $3,200 per individual. However, employers may set lower limits, so it's essential to check with your employer for their specific FSA contribution limit.

Using HSAs and FSAs for donor eggs

HSA and FSA accounts can potentially be used to pay for donor eggs. When utilizing these accounts for payment, you’ll need to obtain detailed receipts from whatever party you are working with to match with an egg donor (be it an agency, egg bank, or matching platform like ours). This receipt can then be submitted to your HSA or FSA plan administrator for reimbursement, ensuring that the process is in compliance with the account guidelines. Better yet, discuss with them upfront what the pricing breakdown looks like so you know what expenses are involved ahead of time. 

HSA and FSA eligibility for donor eggs

While HSA and FSA funds can generally be used for eligible medical expenses related to egg donation, depending on your unique expenses, it’s not outside the realm of possibility that something might not be covered. To be 100% sure, we recommend discussing with a tax professional or your company’s specific plan administrator which expenses are eligible for reimbursement.

LGBTQ+ considerations for HSAs and FSAs

The IRS guidelines and regulations governing eligible medical expenses are periodically updated to accommodate the changing landscape of fertility treatments. And when it comes to tax deductions, benefits, and credits in general, LGBTQ+ individuals may be impacted by the IRS’ specific wording around eligible expenses. 

If you are part of the LGBTQ+ community, we recommend speaking to a tax professional to find out what may apply to you — at least until the Equal Access to Reproductive Care Act gets passed and modernizes federal tax codes to be more inclusive. 

IRS guidelines and equal treatment

The Internal Revenue Service (IRS) has provided guidance to ensure that same-sex couples have equal access to the benefits and rights associated with HSA/FSA accounts. According to the IRS, same-sex couples who are legally married or in registered domestic partnerships are eligible to establish and contribute to an HSA or FSA, just like opposite-sex couples.

Qualified medical expenses and donor eggs

However, the IRS defines “qualified medical expenses” as those incurred for the diagnosis, treatment, or prevention of a medical condition. While specific guidance regarding the eligibility of donor eggs for HSA/FSA reimbursement is not explicitly stated, the expenses related to fertility treatments, including donor eggs, may be eligible if you meet the criteria for qualified medical expenses. However, with courts narrowly defining infertility as a medical inability to conceive, this unfortunately limits many LGBTQ+ couples. 

Documenting eligible expenses

To ensure compliance and facilitate potential reimbursement, it is crucial to maintain proper documentation of your medical expenses. This includes obtaining detailed receipts and documentation of every related expense. 

Maximizing HSA and FSA benefits for donor eggs

Strategic planning can help you maximize the benefits of using HSA and/or FSA funds for donor eggs. Understanding the timing of fund availability and expenses is important. Some people choose to utilize their funds earlier in the year, while others may find it advantageous to wait until the end of the year.

In addition to timing considerations, HSA and FSA accounts offer potential tax advantages and savings. The contributions made to these accounts are typically tax-free, and qualified withdrawals for eligible medical expenses are also tax-free. By understanding and leveraging these benefits, you can optimize you financial resources for fertility treatments.

Other financing options for donor eggs

Beyond HSAs and FSAs, there are other avenues to explore when seeking financial support for donor eggs. Insurance coverage for donor eggs varies depending on individual plans and policies, making it crucial to research and discuss potential coverage options with insurance providers.

Tax deductions may also be available for certain fertility treatments, including those involving donor eggs. Consulting with a tax professional can help determine eligibility criteria and potential deductions, providing individuals with further financial relief.

Additionally, there are grants, scholarships, and financial assistance programs specifically designed to support individuals undergoing fertility treatments. Researching and applying for those programs can offer additional avenues of financial assistance to those pursuing the dream of building a family through donor eggs.

At Cofertility, we understand the financial challenges individuals and couples face when pursuing fertility treatments, especially the use of donor eggs. To make the journey more accessible, we work with financing partners that can help alleviate the financial burden. While we do charge a coordination fee, we’re committed to accessibility and improving the family building process for all. To learn more about how we can help you grow your family via egg donation, create a free account to get started.

Costs of donor eggs with Cofertility

Our goal is to provide a family building experience that’s as human-centered and transparent as possible. As such, you can find a full breakdown of all costs involved with a donor egg journey through Cofertility, right here on our website. 

Here’s how our unique egg sharing model works: rather than compensate a donor with cash, we empower women to take control of their own reproductive health while giving you the gift of a lifetime. Through our program, egg donors keep half of the eggs retrieved for their own future use, and donate the other half to your family. Because our donors aren’t paid in exorbitant cash lump sums, our structure helps lower costs for intended parents. It also means that the women in our program are truly incredible — and especially motivated to successfully help grow your family. Our model honors everyone involved: the intended parents, the donor, and ultimately, donor-conceived children.

When you work with Cofertility, your Member Advocate will be sure to provide itemized receipts and necessary paperwork that you may need to submit to your HSA or FSA plan. 

Financial help can be out there

The journey to parenthood through donor eggs may present financial challenges, but with careful planning, research, and exploration of available resources, it may be possible to find the support you need. We’re here sending luck (and a helping hand) your way.