Doctor Grabbing Money
Fertility treatment is seen as a luxury and often charged at the highest the market will allow, rather than actually what it costs the clinic.
Dubious treatments, conflicts of interest, unproven tests and exploiting the emotionally vulnerable. These are just some of the words used in news stories about private fertility treatment (try googling them to see just how many articles there are). What these news stories fail to tell you though is how to avoid getting ripped off yourself.

This why I have created this guide to help prevent you from being ripped off. It is based on feedback from colleagues, stories from my patients and my own personal experience. It will teach you how to identify and avoid the following:

  • How some clinics push for more expensive treatments, when cheaper ones work just as well or even better
  • The add-on treatments that cost you extra, but don’t improve your chances of getting pregnant
  • How to find the cheapest price for any fertility drugs you may need
  • How to find any hidden costs so you don’t get a surprise bill for them later
  • How to recognise when they are trying to take advantage of your vulnerable emotional state

Before I let you into the dirty little secrets of the fertility industry, I would just like to say that the majority of clinics and doctors have your best interests at heart and will do their best to help you achieve you dream of a healthy child. It is only a small number of clinics and individuals out there who abuse the system for their own profits and give the private fertility industry a bad name. Now I have got that out the way, let’s get back to exposing the bad practices and profiteering.

If you would prefer to watch a YouTube video guide summarising the key points on this page, you can access it by clicking here.

 

IVF Is Not Always the Best Treatment

If your favourite tool is a hammer, suddenly all your problems look a lot like nails.

There is a tendency for private fertility clinics to jump straight to suggesting you have IVF treatment without first exploring other options. However, quite often there are cheaper and less invasive treatments that could work just as well or even better. So why push IVF?

The less cynical answer is that IVF is what the doctors have the most experience in and therefore what they prefer to perform. The more cynical response is that IVF treatment makes the clinic more money than some of the other treatments available (I’ve been told one private fertility doctor allegedly said “Most people who go private expect to be given IVF treatment. Since the customer is always right, give them what they want and make a bit of money doing it.”). So what are the alternatives to IVF?

A few examples of alternative treatments to IVF are: ovarian stimulation, Intrauterine Insemination (IUI), and follicle tracking. And some couples just need to try a little longer or make a few cheap and simple changes to their lifestyle. But how do you know if one of these is better for you than IVF?

The simple answer is that you can’t. But if you are told you need IVF, then there are some simple steps you can take to find out if other options might be better.

Step One: Make sure you know why you are having problems conceiving

The treatment you receive should be based on what is wrong with you. So if you don’t know what the problem is, you don’t know if another treatment may be better for you (or that IVF will even work for that matter). Of course you may be given a diagnosis of Unexplained Infertility, but you should only receive that after all the standard fertility tests have been completed and no cause can be found.

Step Two: Ask about alternatives

If a clinic only recommends IVF, ask them what alternative treatments may be appropriate to your situation. If they then say that other treatment types won’t work for you, ask them to talk you through the alternative treatment types and why they won’t work for you. That way you’ll know they have at least considered the alternatives and you’ll have reasons why they won’t work in your case.

Step Three: Get a second opinion

You are not committed to a clinic just because they have performed tests and given you a treatment plan. Any test results belong to you and you are free to take them to other clinics. Have these doctors look over the results and offer you a treatment plan based on what they think is best for you.

 

What Do You Mean the Price of the Anaesthetic Wasn’t Included?

Do you know the difference between a quote and an estimate? I found out the hard way when I hired an electrician to do some work for me and got a much bigger bill than I had expected. When I challenged him over this, he said that it was quite clear on the paperwork I signed that the price he had originally gave me for the work was an “estimate” and the cost had gone up when he had to buy additional parts. It was only after he left that I found out that if I had wanted a fixed price, I should have asked for a “quote”.

Unfortunately, some fertility clinics use a similar tactic and the headline cost you are shown may be missing things. These hidden costs can include drugs, scans, embryo freezing, lab work, anaesthetic charges and additional procedures like intracytoplasmic sperm injection (ICSI). Unfortunately, this list is not exhaustive and there may be other necessary items not included.

So you don’t get caught out by hidden costs, ask for the full amount you can expect to pay, making it clear that they should include all costs, whether they are the clinic’s responsibility or not.

 

A Pint of Milk, a Loaf of Bread and Some Fertility Drugs Please

Would you pay 3 times the price for a packet of aspirin when the shop next door sells them at the normal cost? No? Well the same applies to fertility medications and they cost a lot more than a packet of aspirin.

Treatments like IVF require you to take fertility medications. Your private fertility clinic will offer to sell you these drugs, but usually at a premium. If you shop around, you can often find other suppliers that are much cheaper. As long as it is the same drug, there is no difference if you get it from another licenced retailer.

Hospital pharmacies are a good place to start comparing prices as they often have fertility drugs at cheap prices. And strange as it may sound, the supermarket ASDA in the UK has been known to have very good deals on fertility treatment drugs. They are able to do this as they sell the drugs on without making a profit. Make sure you do your own research though as prices do vary between regions.

A word of warning: Do not purchase drugs from “unlicensed” or “off-label” websites. You have no way of knowing whether the drugs you receive are real or not. This doesn’t just apply to fertility drugs and you may be endangering your own life by taking medication purchased this way. Always buy medication from licensed suppliers.

 

Would You Like Some Snake Oil to Help You Get Pregnant?

If you broke your arm, would you pay someone for a foot massage in the hope that it might make it better? Yet the equivalent of this is what some fertility clinics offer their patients.

Acupuncture, homeopathy, fertility massage, reflexology, guided mediation, homeopathy and hydrotherapy. While these treatments may have their place in treating other conditions, repeated testing has shown time and time again that there is no direct link between them and improving your fertility.

However, they are relatively cheap, can help to relieve stress and can give you the feeling of being in control, which improves positive feelings. So, if you’ve got the money to spare and you think they may be of some benefit, then there is no harm in you going for them. But if you are on a tight budget or don’t believe in them, don’t take them.

What you really want to avoid are the expensive, unproven, experimental and potentially dangerous add-on treatments that I’m going to talk about next.

 

Blinded by Pseudo Science

If a stranger down the pub told you the best way to get pregnant was to get a cheap bit of plastic and waggle it around inside your womb, would you believe them? Probably not. But if that advice came from a doctor and was given a fancy scientific sounding name, would you believe them?

Some fertility clinics offer add-on services as a supplement to the core treatment (i.e. in addition to a treatment like IVF). While these add-ons sound scientific, they have no evidence to prove that they improve your chances of getting pregnant. They won’t just harm your bank balance; some may even harm your chances of getting pregnant.

At the time of writing this, the following add-on services have no conclusive evidence that they improve your chances of getting pregnant:

  • Endometrial scratching
  • Embryo glue
  • Ultra-high magnification sperm selection (also known as Intracytoplasmic Morphological Sperm Injection or IMSI)
  • Multiple Ejaculation Resuspension and Centrifugation (MERC)
  • Fertility immunotherapy
  • Embryo time lapse imaging
  • Assisted hatching
  • Preimplantation Genetic Screening (PGS) – Not to be confused with Preimplantation Genetic Diagnosis (PGD), which is a legitimate treatment

This list is not exhaustive and new add-on services are being developed all the time. So, how do you stop yourself being taken in by one or more of these?

What You Can Do to Avoid Unnecessary Services

Step One: Ask to see the scientific evidence that proves the add-on service improves the chances of getting pregnant. Don’t be fooled by newspaper articles (here is an example of a newspaper article that is misleading: How Scratching Womb Lining Doubles Chances Having IVF Baby) and don’t accept anecdotal evidence or coincidental evidence (just because someone had it and they got pregnant, doesn’t mean to say that the add-on service was the reason they got pregnant).

Step Two: Ask how it specifically improves your personal chances of conceiving, as everyone’s situation is different.

Step Three: Look up the treatment on www.cochrane.org. The Cochrane organisation is a global independent network of 37,000 researchers and professionals dedicated to providing scientific, evidence based health information. It is independent and free from commercial sponsorship and other conflicts of interest. It is one of the most trustworthy sources of medical information I know.

Once you have undertaken these three steps, you should then be able to make an informed decision as to whether you want to take up the offer of the additional service or not.

Side Note

If the man has no infertility problem and Intra-Cytoplasmic Sperm Injection (ICSI) is offered as part of your treatment plan, ask for clarification as to why this is required. ICSI is a proper treatment that is proven to work for men with poor sperm quality. However, if the problem is not with the man, it may be unnecessary to have this expensive procedure and you should question the reasons for having it. If you would like to know more about what is normal for a man’s sperm, then please check out the section: Semen Analysis Test
 

Smiling Babies and Emotional Manipulation

Beware the emotional marketing techniques some fertility clinics use to try and get you to make decisions with your feelings and not logic.

The first time I visited a private fertility clinic was on an open day. My husband and I were seated in a big room with other couples and shown a video. This video featured smiling babies and children happily playing, while couples told us how happy they were with the clinic and treatment.

At this point I had been trying unsuccessfully to get pregnant for almost 18 months and this video nearly brought me to tears. I wanted what these couples had and this clinic could help me get it. My husband broke the spell when he leaned over to me and whispered “This video is full of emotional blackmail, isn’t it?”

That clinic was the first of five on a list to check out that my husband and I had put together. It wasn’t even our favourite and here I was, already looking to spend money with it without first checking out the other clinics.

As I learnt that day, emotion is a very powerful thing and your natural instinct to have children can make you very vulnerable to it. However, if you are aware of these marketing tactics, you can reduce their impact on you.

The most common and obvious of these techniques is to expose you to plenty of pictures of smiling happy babies and happy couples. The subconscious message here is that if you use this clinic, you too can have a baby like this and be like that smiling couple. These pictures can be found on the website, in brochures, or sprinkled around the waiting room.

Another common ploy is to tell you success stories from individuals or provide testimonials from couples. These stories usually follow the line that the couple had been trying unsuccessfully for ages, but when they came to the clinic they became pregnant immediately. I’m not saying these stories are untrue, but they are from only one or two happy individuals and are not a good indicator of the clinic’s true overall success rate.

Yet another marketing technique is to tap into the emotion of fear. Examples of this includes statistics on infertile couples and quoting (incorrectly) that fertility drops off a cliff at the age of 35. Don’t let them scare you; these stats are generic and don’t apply to individual cases, and a few months either way won’t make much of a difference.

However, don’t reject a clinic just because it uses these marketing tactics. Marketing is commonly done for the clinics by other hired in companies and the clinics aren’t necessarily trying to take advantage of your emotional state. Just try to not let your emotions make your decision of clinic for you.

Remember that a glossy, professional looking leaflet is a better indicator of the size of a clinic’s marketing budget than the quality of the treatment you will receive.

 

Want to Know More About Private Fertility Treatment?

If you found this useful, then you may also want to check out the section The Beginner’s Guide to Private Fertility Treatment. This is a step by step guide for people who are looking into going private for their fertility treatment. It details what you need to do before you go private, what to expect when you visit a clinic and aids you in making key decisions.

Also helpful is the section: How to Choose a Fertility Clinic. This section helps you to understand success rates, specialisations, regulation and treatment abroad. Along with other tips on how to find the ideal clinic to help you get pregnant.

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