Thursday, December 5, 2019

The price of infertility – does it help to be rich?

Bundle of joy. The three word phrase has become the holy grail of men and women wishing to prove their gender worth. It is feted as a rewarding and beautiful experience for woman but for those that cannot bear children it is at best a hankering and at worst a curse.

It is however one of those curses that money can exorcise.

It is common knowledge that fertility in women is known to decline steadily with age and as such complications can arise. Not only is it harder to have kids as a 30-something compared to a 20-something, but treatments — such as the increasingly popular IVF — can be prohibitively expensive .For many women, the major questions in contemplating pregnancy are “do I want children?” or “when is the best time for me to have a child?” However, for the unfortunate infertile couples in the path to parenthood there are many more questions like “How will we get pregnant?” and “how will we afford it?”

Dr Vincent Molelekwa of Gaborone Fertility Clinic says “IVF is available in the clinic but we are currently using the laboratory in Rustenburg, South Africa. The success rate depends on the woman’s age, if a woman is 32-33 her success rate is 45%. The higher the woman’s age the less her success rate of IVF treatment. We have a range of treatments from freezing eggs to IVF but with regards to infertility there are only two types of procedures available – artificial insemination and IVF. There is a small number of women who generally by-pass their gynecologists or general practitioners for aid in having a birth, most of which find that their tubes are usually blocked of which we recommend IVF. And then there’s a majority who come for solutions and are open to any solutions they get which are also cheaper because the truth of the matter is that these treatments are nowhere near cheap. “He further stated that the clinic is currently still under construction but once it is done then there will be surrogacy services available for those who prefer it since there isn’t a law that is against it in the country. “ Dr Molelekwa wasn’t in a position to disclose the fertility prices and said one can get them when they come to the clinic.

While advances in infertility and reproductive technology have increased the options open to infertile couples over the last several decades, most couples seeking treatment find that much or all of the cost, is not covered by insurance. Once a couple decides to seek medical assistance to deal with infertility, treatment options range from simple consultations to invasive, expensive medical interventions. IVF (In vitro fertilization), allows for more control over risks for a multiple pregnancy. In IVF, a woman’s ovaries are medically stimulated into making many eggs which are then harvested and mixed with sperm in a petri dish. One or more fertilized embryos are then implanted in the woman’s uterus. It has a higher success rate of 10 to 40 percent depending on the woman’s age but it comes with a much higher price tag, averaging $12,500, in addition to the $3,000 or so in medications. (IVF costs vary by region, type, doctor, and maternal age.) On average, it costs $50,000 to conceive a child through in vitro fertilization, and most Batswana don’t have the insurance to cover it and affordability has become a monumental issue.

Taboka Motsisi of BOMAID says, “Infertility affects one in six couples of reproductive age (15 to 44 years), and is one of the most common conditions that couples in this age group are diagnosed with. They only receive assistance from BOMAID in the form of diagnosis or investigations. This is lab visits, MRI and/or x-rays. The first step in treating infertility is correctly diagnosing it. This is the one area in which medical aids will help. Not all aspects of infertility treatment are covered by medical aids. To be more precise, In Vitro Fertilisation (IVF) is not covered by the scheme. Our medical aid schemes do not cover the costs of medications and specialized medical procedures relating to infertility. We as the company do not discriminate; it is just the company’s position not to cover the treatments.“

When it comes to infertility, chances are either you or someone you know has struggled with it. In surrogacy, fertilized embryos are created using the same process as in IVF. But instead of implanting them in the mother’s womb, they’re implanted in another woman’s womb. And the costs can be astronomical. Surrogacy agencies can charge $40,000 to $50, 000 just to match parents with a surrogate. After that, parents must pay the surrogate’s fee-$25,000 to $50, 000 depending on experience and location. In addition, they must purchase a year of life and medical insurance for the surrogate ($4, 000), pay for the IVF transfer to the surrogate with the possibility that more than one cycle will be needed ($7, 000 to $9, 000 per cycle), pay for the medications for both the donor mother and the surrogate ($600 to $3, 000, depending on insurance), hire lawyers for both the biological parents and the surrogate (about $10, 000), and cover smaller needs of the surrogate like a clothing allowance and fees for doctor’s visits. And of course, that’s not even counting the money needed to buy the normal stuff like a crib, car seat, and clothing once the baby arrives. There is no question that there is a clear division between the haves and have not’s when it comes to the ability to access fertility treatments to build a family. Women with a higher household income are likely to achieve success through treatments such as IVF than women whose incomes are less. Fertility costs are so high that some people don’t even consider these treatments not because they don’t want to but because of the fear of not being able to afford them and the frustration that comes with it. Some women wish to freeze their eggs and even so that option is out of the cards financially for them. And for some, adoption seems like a light at the end of the tunnel and even so adoption in Botswana is a rather grueling and tiring long process often without any yielded results.

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