Infertility brings care, financial, mental challenges

Support resources and a fertility-focused benefit can help members during a trying time.
Infertility Brings Unexpected Challenges

Patients going through fertility treatments invest every ounce of themselves, physically, emotionally, and often financially, all in the hopes of becoming a parent. It’s common for patients to experience a number of challenges on the road to parenthood, some of which you might not expect.

Clinical fertility challenges

Before the patient even starts fertility treatment, there are challenges in finding the right doctor or clinic, especially if a patient has access to a small network. Once a doctor is found, there is additional ambiguity over what lab tests and procedures boost success rates enough to justify the cost and potential side effects, especially as private clinics are not required to disclose the effectiveness rates of add-on procedures. There are also often difficulties determining the cause of infertility, since one third of infertility cases are attributed to women, one third are attributed to men, and the remaining third are attributed to a combination of problems in both partners.

Even after a doctor and procedures are settled on, it still is a challenging process. Procedures can be physically demanding, with daily bloodwork and ultrasound appointments often required. Procedures like IVF can be especially taxing on a pregnant woman’s body if she conceives multiples – including risks such as thyroid disordershigh blood pressure or gestational diabetes.

Patients also face a lot of waiting and disappointment, as they can sometimes feel like they are going through a period of trial and error. IVF is highly effective, but, even in ideal circumstances, a woman won’t conceive approximately 70 percent of the time per cycle. This isn’t always the case, but many patients will often have to go through several cycles before conceiving, getting their hopes up each time. Another barrier that contributes to a long waiting period is that many benefit plans require patients to try less invasive procedures before moving to IVF, such as a year of natural attempts.

Financial fertility challenges

For many, the decision to proceed with treatment can also be a financial one since only 11% of employed Americans say their employer offers fertility benefits.

If patients have limited coverage or reach their fertility coverage cap, they can wind up in serious debt to achieve their goal of having a family. Price tags of $50,000+ for IVF treatments are not uncommon, especially considering 66 percent of women require more than one cycle. To cover these hefty amounts, more than half of IVF candidates have used their credit cards to cover treatment expenses. In more extreme cases, they have taken out personal loans or tapped into their retirement accounts.

This financial stress can even impact a person’s productivity. Employees who are bringing financial worries to work lose about a month of productivity in a year

Social and behavioral fertility challenges

Combine clinical and financial challenges with the fact that many individuals choose not to discuss their diagnosis and treatment with friends and family, and it’s easy to see how it can lead to an overwhelming and stressful experience. Studies have even shown that 87 percent of women facing infertility had anxiety and as many as 41 percent suffered from depression. Their emotional strain was correlated with how long they had been experiencing infertility problems.

In addition, patients may compound their stress by worrying that their infertility is caused by stress. Fortunately, researchers haven’t seen a correlation

Overall, having access to support resources and qualified fertility-specific professionals can help to minimize many of the stressors associated with treatment. From time-specific medication protocols and early bloodwork appointments, to navigating benefits and financial considerations and finding affordable pharmacies, fertility treatments are highly customized and require special attention and care at every step. By working with teams who are solely focused on fertility treatments and the complexities associated with care, patients are well-positioned to have a better overall experience from start to finish, regardless of the outcome.

Originally published on 4/21/20 and updated on 6/15/23.

See how our solutions can help
FamilyPath
FamilyPath has expanded benefit offerings across family-planning, fertility, pregnancy and postpartum care for employers and health plans. Evernorth is committed to addressing disparities in this category of health benefits and has designed an end-to-end, inclusive benefit in family-planning care for members across both in-house capabilities and new partnership solutions.
Inside Rx
Inside Rx, an Evernorth company, believes everyone should have access to the medications they need, and negotiates meaningful discounts with retail pharmacies and pharmaceutical manufacturers for consumers to compare.