In the very beginning stages of an IVF cycle you learn about success rates and (hopefully) what the expectation is for you. You learn about fees and can get an estimate of what your particular protocol will cost. You will also probably hear about, or get information on a shared risk program. To do or not do the shared risk program was, for us, a big debate. “Shared Risk” is a guarantee program that typically offers a flat fee for three IVF cycles. If you do not become pregnant within three cycles you are refunded a portion of the money. If you do get pregnant on any of the three cycles you do not get any money back. The benefits are pretty obvious. If you do not get pregnant you are refunded money that you can then use for further fertility treatments or to pursue other options. The cost is also usually cheaper than if you paid for three separate cycles. The downside is that if you do get pregnant on the first cycle you have overpaid. If it takes two cycles you have paid about what you would have for two cycles anyway. If it takes three cycles you end up saving money over having paid for three separate cycles.
I tried to use my go to method for decision making – a pros and cons list. The pluses and minuses were just about equal and I could not decide which option was best for us. The literature said that doing the shared risk program almost doubled our chances of conceiving and pointed out that most couples must endure more than one cycle to get pregnant. It was also a great way to finance the treatment and to have an opportunity to try the procedure more than once. We only had enough money (barely) to try it one time without financing so the “back-up” plan was especially appealing. There was always that nagging thought, though, that we could be one of the lucky ones to be successful on the first try and then we would have spent way more than we could afford. The decision making process was like a ping pong game in my brain – back and forth, back and forth and it was frustrating!
Ultimately, the decision was made for us. The shared risk programs have criteria for qualification and we did not qualify. It almost seems criminal that these programs are touted as helping people conceive, but then they only accept the ones most likely to do so, not the ones who are percentage wise facing a longer road. The programs consider the woman’s age and likelihood that she will be able to complete 3 cycles before age 38, the results of day 3 hormone (FSH and E2) tests, semen analysis, the health of the fallopian tubes and uterine cavity, Body Mass Index, the need for PGD (Preimplantation Genetic Diagnosis testing), and medical history including prior IVF and IUI cycles and the occurrence of miscarriage/ectopics. I am not sure why we didn’t qualify – could have been a number of reasons; only one fallopian tube, history of both miscarriage and ectopic, who knows. What I do know is that our physician was a lot more positive and in hindsight it looks like he was right. I also know that in looking back and considering that our first cycle did work I am ecstatic how things worked out – not only that we got our precious babies from one cycle, but that we didn’t spend even more money and three cycles having only used one, that we didn’t end up financing and now have debt on top of skyrocketing expenses, and that I can take just a tiny bit of joy out of keeping some money out of that company’s pockets. Moreover, having gone through one cycle I honestly don’t know if we could have managed it again physically and emotionally and if we had done the shared risk program we would feel compelled to keep going on a path that I never want to be on again.