# OE-IVF payment question



## lumpy123 (Feb 22, 2013)

Hi,

Quick question regarding OE-IVF (I'll be asking the clinic we are going to but thought I'd ask you guys for some input)

My wife has very low "AMH"? (BTW what is the difference between AMH and FSH?) and few follicles..

Anyway,  I gather this means that we are lacking in the egg department. 

Now if/when we try OE-IVF which costs about 5k for one try(from egg collection through to implantation), surely if the clinic does not get enough(or any) eggs to try and fertilize, then of course we don't get to try and fertilize them and then get to implant the embryos etc, then do most clinics expect people to pay up front for the whole treatment.  Or are they reasonable enough to say, (eg)OK this stage costs 2k the next stage costs 1k , then the last stage costs 2k.

I'll be asking the clinic, but I'm just curious as to whether any of you have had this kind of experience.  I mean if they couldn't collect any viable eggs to try and fertilize then we shouldn't have to pay for services that we don't receive, right?

(Hope that made sense...


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## staceysm (Nov 18, 2010)

Hi Lumpy,

I am nearly 40, so thought I would reply : ). From my own experience, the drugs and egg collection are the most expensive.  If there are no eggs retrieved then there shouldn't be any embryologist or transfer costs.  However, I am under the impression that if there are eggs and they don't fertilise with the sperm over night then you will have to pay the pay embryologist cost and no transfer fee.  Unfortunately I don't know what these would be, as my last payment was on the morning of egg collection, so I don't know how this payment would have been broken down.

Perhaps talk to your clinic, as they should have a policy in place which would tell you what you would be entitled to.

If anyone has any better knowledge, then feel free to correct me.

Good luck
X


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## lumpy123 (Feb 22, 2013)

Thanks very much.

That makes sense, it would be silly to have to pay for services that we might not need(  )  Though fingers crossed we blitz through each stage and kick infertility in the head!! (Feeling quite positive at the moment, who knows how long that will last  for though


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## Dudders (Jun 18, 2012)

Clinics really do vary on this sort of thing, and some will charge piecemeal for what you've done and others would still charge full whack.  You'll usually pay upfront for most of the cycle anyway.

It will also completely depend on what stage you found out the cycle couldn't go any further.  If you don't have egg collection, you would pay for all the scans and bloods you've had along with probably an admin fee.  If you have egg collection but don't retrieve any eggs or they are immature or fail to fertilise, you might get a refund but the amount and if it happens at all will depend purely on the clinic.

If this is something that particularly concerns you (which obviously it does) shop around and make sure you get the answer in writing.  We had a cycle that resulted in all of our embryos being frozen, and although it was something I'd asked in advance they'd never answered us, so we had several days of worry that not only weren't we going to have a transfer, we didn't know whether there would be any allowance for the fact we hadn't had a transfer and that we might get slapped with a bill for freezing on top!  Fortunately they basically did the freezing free instead of the transfer, but it certainly added to our stress.

As for AMH and FSH .... Anti Mullerian Hormone is produced by the immature follicles in the ovaries, so the higher the better as this indicates you have more follicles that can possibly grow.  Follicle Stimulating Hormone is what makes a follicle grow to contain a potential egg, when measured on day 1-3 of the cycle, the lower the better as it indicates the follicles don't need as much stimulation to grow.

Good luck


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## Jacobsmum (Feb 23, 2013)

Dear Lumpy

my last clinic had a set of refunds at the bottom of the price list (still there online, but right down the bottom), and basically the majority of the costs are up to and including EC. I had  couple of cycles (different clinics) where there was no transfer - both cycles I got eggs, but on one only 1 out of 6 fertilised, and then it stopped doing anything else; another time I only got 2 and neither fertilised normally. The refunds were ET only - can't remember exactly, but about £600- £700. They also knew more about what worked/ how I responded for the next time.

The only refund that was big was if you didn't get to egg collection - then it was £2k+ depending on how many scans etc you had needed.

fingers crossed you won't be getting any refunds!  

best wishes
Jacob's mum


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## Duck007 (Feb 7, 2012)

Hi Lumpy, 
If your wife's first cycle doesn't go to plan (i.e. too few follicles to go to egg collection) you may want to try natural IVF.  It is so much cheaper (my clinic charge £1800 per cycle or set of three for £4500 - you have to pay for drugs on top which adds approx £200 per cycle) and you don't have to have a break between cycles.

Fingers crossed you won't need a second cycle xx


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## Cheesy (Jul 4, 2012)

Hi Lumpy
I'd echo everything the ladies have said. 

I did have one tx that resulted in no eggs at EC, which I found devastating because the indications at all the scans were that it was my best ever response. I worried it was game over foe OE. At our clinic you pay in stages so we didnt pay embryologist or ET fees. But that cycle I was on the highest dose of drugs so even with those payments excluded it still worked out the priciest. 

I completely agree with duck on natural. After the disaster cycle the doc suggested a modified natural approach and I'm currently 15 weeks preg. So always worth trying OE and adapting protocols to find the one that works. Natural requires some drugs to control ovulation and trigger as per other tx and I took lowest dose stims for a few days to boost a second follie but so, so much cheaper and our clinic package fees were way cheaper too. 

Good luck.


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## Ozy13 (Jul 19, 2013)

Dear Lumpy
I was wondering the same question myself. I'm currently stimming but was told on Tuesday that I won't get to Egg collection but to carry on for a few days more and that 99% my cycle will be cancelled on Monday. My hubby has been asking me how much we should get back  (as yes we paid for everything in advance) and again I know most of the work done by the hospital/clinic is done after Egg collection, therefore if couples don't get to that stage they should get a large amount back (very important when you need that money to assist with any future treatment!). I will report back on Monday regarding this issue, as my cycle will be cancelled then and we will make all the necessary enquiries about refunds. 

I really hope you don't need a refund too. Wishing you both all the best. Ozy


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## goldbunny (Mar 26, 2012)

my clinic keep some of the drugs in their pharmacy up 'til the last minute we need them (after having paid for them) so they can easily organise a refund if they turn out not to be needed. So for example if we didn't get as far as using the trigger shot we wouldn't end up paying for that. But most of the costs are unavoidable, and there may be extras on top of any quoted charges. Some people end up paying for: extra scans, extra drugs, overnight hotel bills to be next to transfer clinic, etc etc. both my cycles we had to pay out for extra drugs because we spent longer down-regulating than was originally in the plan. I also had extra progesterone once I had a successful pregnancy test (although I later m/ced) which isn't included in the original cost. Plus there's things like supplements and extra folic acid and so on. 
if a clinic says you don't qualify for as much refund as you would like I think it definitely worth asking if they can reduce the costs of further treatment and get them (if they will) to agree to that in writing as soon as possible don't wait til you are ready for another cycle. 

You can also theoretically save money by getting the prescriptions for the drugs you need from your clinic but then sourcing the drugs yourself. They might be only small savings on each item but it could all add up. Of course then it could be harder to organise refunds, so I guess there's a decision to make there. You can't sell on drugs. 

so sorry for anyone who gets cancelled and good luck for future plans.


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