IVF Costs: The ULTIMATE Guide

Introduction to the Ultimate IVF Cost guide

IVF (In Vitro Fertilisation) is an assisted reproductive technique which assists couples with infertility and sub fertility get pregnant.  It is a complex long-term procedure which can be had on the NHS however there is a complex IVF postcode lottery which means that many people are forced or wish to use a private clinic to have their treatment.

In this article we will take a deep dive into the IVF costs and a look at the infertility market overall. We will look at the total market share. The market in the UK and how this will likely change and grow. We will explore the cost to the NHS and importantly the individuals and couples going through IVF treatment. This is a detailed article with over 50 hours of research into the content so please use the contents section below to skip to the sections you are interested in.

For those of you who would prefer a video here’s a video witha quick breakdown of what’s included.

What is the total IVF Market size Worth?

Market size is the number of individuals, couples or organisations that are looking to spend on a specific product or service.

Market size of IVF was calculated to be $16.68 billion (£13.37 billion) in 2018. This has gone up in recent years, predominantly down to two key factors. Couples are waiting later in life to be ready to start a family. Recent studies from HFEA show have shown that the average age of first-time mothers has risen from 23.9 in 1973 to 28.8 in 2017 this trend is reflected across the rest of the developed world.

 

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With the average (mean) age of all those going through IVF in the UK being 35.5 years old. It appears that people are getting married later, focusing on careers and choosing to have children later in life. With age having an impact on fertility it means we are seeing a large increase in the number of people seeking IVF treatment to have children at a later stage.

A further consequence of people choosing to have children later; some women are also now opting for an all-freeze IVF cycle, this means that they then have the option later of using these younger eggs in the future when they are ready for children.

 

Country IVF Market Share in 2017
USA £2.204 billion ($2.76 billion)
Australia £440.8 million ($550 million)
UK £ 320 million ($399.2 million)
Denmark £55.6 million ($69.3 million)
China £537 million ($670 million)
Spain £412 million ( $513.2 million)
Greece £264 million ($329 million)

In the table above I have just given you a quick overview of the IVF market size in those specific countries, I specifically included Denmark, China, Spain and Greece because they have some interesting IVF facts including: –

  • Denmark has a population of approximately 5.7 million people. However, it has the greatest percentage of babies born through assisted reproduction at around 9%. Compared with the USA which is around 1.7%
  • Since the abolition of the 1 child family law in China the government is now concerned at the very low birth rate. IVF is growing around 22% per year, with an expected 1 million IVF births to hit by 2025
  • Spain is now the most active country for assisted reproduction in Europe, performing 109,275 treatments per year. About two thirds are these are ICSI even though birth rates are around 33% for ICSI vs 35% IVF. It is a key IVF tourist hotspot
  • Greece is a rapidly growing IVF tourism hotspot for UK citizens seeking IVF with more relaxed regulation and cheaper costs.

UK IVF Market overview and Market Share

As you have seen in the above section The IVF market in the UK is currently worth about £320 million pounds per annum. In 2017 there were a total of 69,822 cycles of IVF treatment, 45,944 of them were fresh cycles and 23,828 were frozen embryo transfer (FET) cycles. Of these 23,822 used ICSI.

The market in the UK over the last few years has grown at about 3% per year and it looks to at least continue this trend, however the CAGR (Compound Annual Growth Rate) for the global IVF market is predicted to be around 9.8% until 2025.

In the UK 39.9 % of all IVF cycles performed were funded by the NHS. However, this includes Scotland and Wales which pulls the average up heavily due to more generous IVF funding than most of England. England CCG’s funded 35.5% of all IVF cycles with 65,087 of the 69,822 being performed in England (93.2%).

The UK market is predicted to grow over the next few years in line with the global market. The HFEA monitors the clinical outcomes and practices of private IVF clinics. However, it has no remit to look at the commercial aspects of private clinics. This includes costs, mergers and marketing practices.

One key risk which has been identified which we can see the impacts of in the US is this. If we allow large clinics and private healthcare providers to merge and create a monopoly on the private IVF market, then this will cause less competition. This lack of competition will likely result in higher IVF prices to patients. This has been clearly seen in the USA where competition is fairly low and prices are very high.

The second key risk is the selling of IVF addon’s such as embryo glue and assisted hatching. The evidence is limited as to the impacts of these addons. But with individuals being desperate to try anything to increase they’re chances of conceiving, especially for those having previously failed attempts they can become an easy sell even if the clinical evidence doesn’t indicate that they would help.

How are People in the UK getting IVF

As you have read the UK statistics show that 69,822 cycles of IVF were performed in the UK however this is does not show the whole story for couples and individuals who need assisted reproductive technology. Many people chose to go abroad to get their treatment due to lower cost, less regulation and lower waiting times. This is not regulated in the UK and as such the statistics are hard to come by, however, from our and other research it is likely as high as 21,000 people per year. Let’s look at the NHS, private in the UK and going abroad in a bit more detail.

NHS

The number of NHS funded cycles in the UK in 2017 was 27858 cycles of 69822 total performed. Which averages 39.9% of all cycles. Further research into NHS funded cycles by region is shown in the table below.

 

Nation and English region 2017
Wales 40.6%
Scotland 62.4%
Northern Ireland 49.9%
England 37.8%
North East England 59.3%
East of England 35.9%
West Midlands 43.1%
North West England 55.5%
South West England 45.5%
Yorkshire and the Humber 44.1%
South East England 37.9%
East Midlands 37.3%
London 26.5%

As I’m sure you will agree what jumps out from these statistics is the huge difference between Scotland and the North of England (North East and North West) in comparison to London and the South. You begin to understand this more thoroughly when we look at the number of IVF cycles offered by CCG’s (Clinical Commissioning groups). The image show’s the map of number of cycles funded with: –

Green = 3 funded cycles

Amber = 2 funded cycles

Red = 1 funded cycle

Bright red = No funded cycles

You can find the data behind this map here (downloads a simple excel sheet ordered alphabetically)

From this information it is clear that the CCG’s funding decisions are impacting how many people in those area’s are having to pay for IVF treatment.

As a final point of note. The NHS will only fund treatments which have evidence-based outcomes including, IVF, ICSI, IUI, Embryo and sperm freezing and some genetic testing where there are specific conditions which mean this will make it safer for mum and baby.

Private

As you would expect Private IVF is the exact reverse of the NHS map and those area’s which have highest number of private treatments are coloured red in the map and the lowest coloured green.

There are currently 97 clinics with the greatest number of these existing in London and greater London, which you would expect with it having the largest population and most Boroughs only offering 1 cycle.

The one advantage of having so many clinics to choose from for private treatment is that there is a huge variety of costs and locations so you can choose one which is right for you. However, there are some really important things to remember when choosing a licenced clinic for your IVF and they are as follows: 

  • They are commercially focused – This means that you need to do your research into what you want before you get in touch to ensure you aren’t sold something that won’t help you.
  • Advertised success rates – As we mentioned earlier HFEA can’t regulate the commercial aspect of clinics which includes marketing. Many private clinic websites advertise success rates above the national average. However, most are using statistics to their advantage. There are only 4 clinics in the UK with substantial statistically significant rates above or below the national average. Many will quote stats like “birth rate per embryo transfer” (this could include one or multiple embryos) or “pregnancy per embryo transfer event” (pregnancy rate is not the same as birth rate) these are misleading and not the same as those measured by HFEA which is “birth rates per embryo transferred” these seem similar, but they are different so don’t fool for them. You can compare the clinics success rates at HFEA Clinic search. The image opposite show’s an example of what you can expect to see.
  • Before approaching them ensure that you understand your infertility diagnosis
  • The quoted costs (unless expressly stated) almost always don’t include medication and initial consultation costs, so check these carefully.

Private Abroad

The data for the number of patients going abroad for IVF isn’t captured in the UK so figures are very hard to come by, we found 2 studies of around 1000 patients which had average quality data which indicated about 40% of those surveyed had gone abroad for treatment, if this data is extrapolated across the UK infertility community who are seeking treatment this indicates about 21,000 people are going abroad for IVF treatment each year. There was a news article from 2018 which said 25,000 but no link to how this information was obtained.

However, what is clear is that there is a large number who choose this option. We have known several people who have chosen to go abroad for their treatment and have had varying experiences. However, what they all agree on are that you should perform the following checks: –

  • Ensure that the clinic is registered and licenced in the country that it operates. There are many clinics abroad that aren’t which can be very cheap however the risk just isn’t worth it.
  • Check that they are a member of an appropriate professional association like the ESHRE (European Society of Human Reproduction and Embryology) or IFFS (International Federation of Fertility Societies)
  • You should check the success rates of the clinic; but be aware of advertised rates. You should specifically ask what “the birth rate per embryo transferred” is to compare like for like.
  • You should check reviews online about the clinic from independent sources.
  • Get total quotes including, medications, initial appointments and any postage of medications to the UK.

One final point is that ICSI is even more common abroad than it is in the UK and is used more than normal IVF cycles.

How much does IVF cost

Now that we have a detailed understanding of the global and local markets and how individuals are choosing to get IVF let’s look at the specific costs associated with IVF for the NHS, for individuals, for addons and for those going abroad.

How much does IVF cost the NHS

IVF and assisted reproduction are a VERY small piece of the total health spend in the UK around 0.31% of total NHS spend per year.

Recent costing studies have shown that the NHS spends on average £3,123 per fresh embryo transfer cycle, £768 additionally every time ICSI is required and £1,348 for a FET cycle.

One of the issues with NHS costings, is that private clinics charge the NHS different rates across the UK with some areas paying significantly lower than the £3,123 and some paying much higher (some over £5,000 per cycle). So, work needs to be done to standardise these costs across the UK.

The total cost to the NHS for just the IVF cycles is around £95.09 Million. One of the great things about the NHS is that they also take on complex genetic cases, mitochondrial research, genetic research into infertility and clinical trials. This constitutes approximately another £232million per year to the budget.

NICE (National Institute for Health and Care Excellence) produced a costing report for the NHS funding as per their recommendations of 3 cycles per eligible individual which if we take all cycles performed in the UK and add the abroad would come to 90,822. However, this his number would likely be lower as some who go abroad and choose private UK wouldn’t be eligible as they already have children or fall outside of other criteria, from research we have found this would account for about 27% of all IVF cycles so the NHS would be responsible for 66,300 cycles. Using the average live birth rate of all IVF cycles of 27.9% it calculates to approximately 2.2 cycles per live birth, which when all figures taken into consideration would cost the NHS an additional £129,000 per 100,000 people there are just 66 million people in the UK so this would cost the NHS a further £85.14 million a very small additional spend. 

How much does Private IVF cost Couples

I imagine this is the bit that most of you have come for. We have spent 30 hours researching this and this is what we have found. Firstly, I’ll start with how much the average IVF and ICSI cycles costs in the UK. These are the key figures we calculated using the advertised prices of the clinics across the UK (25/07/2019).

Average pre-treatment IVF costs: £536

Average IVF treatment including drugs and fees: £4589

Average ICSI treatment cost: £897

Average Frozen Embryo Transfer cost including drugs and fees: £1448

Average Freeze all cycles including drugs, fees and freezing for 1 year: £4293

Average yearly freezing charge: £378

Average use of donor sperm from a clinic: £706

Average PGS testing: £2605

Average Embryo Glue Addon: £193

Average Assisted Hatching addon: £355

Average Endometrial Scratch Addon: £232

If we use that data above in combination with the number of cycles from the HFEA website we get a figure of

 

£254.8 million per year spent by couples per year on IVF treatment in the UK

Yes, that’s right it costs people in the UK just over 254.8 million pounds per year for IVF and ICSI This doesn’t include IVF addons or those going abroad, which we will look at later.

We can go further than this and use the NHS figures, which is that over a large population set, each couple will require an average of 2.2 cycles of IVF to achieve a live birth. Using this we will explore the cost of having children for people with specific circumstances.

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Couple that need a standard IVF cycle (for example unexplained infertility) and get embryos to freeze

They will need to include pre-treatment, IVF treatment, Freezing costs, and FET costs

The average cost for couples in this specific circumstance would be

536 x 1 = £536 (consultation)

4589 x 1 = £4589 (IVF Cycle)

£378 x 1 = £378 (Freezing)

£1448 x 1.2 = £1737.60 (FET)

Average total = £7240.6 per live birth

Couple that need a standard IVF cycle (for example unexplained infertility) but don’t get any embryos to freeze

They will need to include the pre-treatment costs, IVF treatment costs assuming they don’t get any embryos to freeze.

The average cost of a live pregnancy for these individuals would be

£536 x 2.2 = £1179.20 (Consultation)

£4589 x 2.2 = £10095.8 (IVF Cycles)

Average Total = £11,275 per live birth

Couple that need ICSI and don’t get any embryos to freeze (E.G. Male factor infertility)

They will need to include initial consultation, IVF cycle and ICSI costs

£536 x 2.2 = £1179.20 (Consultation)

£4589 x 2.2 = £10095.8 (IVF Cycles)

£897 x 2.2 = £1973.40 (ICSI)

Average total = £13,248.4 per live birth

A couple with a complex genetic medical history which require genetic testing (E.G. have Huntington’s disease)

£536 x 2.2 = £1179.20 (Consultation)

£4589 x 2.2 = £10095.8 (IVF Cycles)

£897 x 2.2 = £1973.40 (ICSI)

£2605 x 2.2 = 5731 (PGD/PGS)

Average total = £18,979 per live birth

There are lots of other combinations, but this gives you a good idea of what it costs couples not only to go through IVF but to conceive through IVF. I’m sure you will agree that this is a huge amount of money which can cause financial hardship. A recent news article about a woman who asked her family for money for IVF where the mother refused and asked her to never to bring it up again caused a lot of discussion in the comments. Many people stated things such as ‘if you cant afford IVF then you can’t afford to bring up your child’ I hope that this article helps show that it’s a huge outlay and not many people who have children have £10,000 just sitting around for something that may or may not work. If you’re interested here’s a link to the news piece.

As you can see from the above costs, addons can add up to a great deal of money if you need multiple cycles of IVF. Some addons are better value than others and the research on most of them are still not mature enough to make a firm decision as to whether they improve pregnancy rates from IVF. The only one on this list that I might recommend is  , due to some moderate quality evidence and moderate cost (see link for more details on that).

Other costs of IVF in the UK

Above we looked at the direct cost of IVF but there are other costs associated with IVF which are often overlooked.

Travel

Couples going through private IVF or needing specialist PGS testing often choose a clinic which isn’t the closest to their home. This means that you will need to factor in fuel or public transport, overnight stay on the day of retrieval, parking and sustenance which can really add up. Even though we had our IVF only about 20 miles from our home, we still spent a further £250 just on these seemingly minor expenses.

Employment

IVF is tough on the woman’s body, it can cause a raft of nasty side affects which you can read more about in our guide to IVF medications article. But many people have to either take sick-leave or planned medical leave through their IVF journey, which can have further financial impacts upon people. This is especially true in those industries without good sick leave or absence policies or those that are on flexible non-permanent contracts.

Emotional costs associated with IVF

IVF and infertility can have impacts you don’t expect especially emotionally and many who go through the process suffer with anxiety and depression that can be eased through specialist therapy and counselling services. These can be accessed through the NHS through however the waiting lists are often 12-20 weeks. You can also access limited counselling through your clinic, however after a small number of sessions you need to start paying. So, if you are impacted and you need support sooner rather than later, getting specialised counselling can set you back £30-£50 per hour.

The costs of IVF for individuals traveling abroad.

You have probably already come to the same conclusion as we did whilst deeply researching this article. Using private IVF in the UK all the way to a live birth is an expensive business.

With it taking on average 2.2 cycles per live birth it is clear that even saving a small percentage per cycle can lead to large total savings for couples trying to conceive.

Let’s take a look at the costs of IVF in other countries, below is a list of the most popular IVF tourism destinations from the UK, these costs are inclusive of medications and all appointments. So, as you can see there is some real savings to be had.

Brazil £2,525
Czech £1,870
Greece £2,500- £2,800
Hungary £1,500
India £1,265- £1,895
Lithuania £1,275
Russia £2,000
Spain £3,500- £4,150
Turkey £1,250
Ukraine £1,150

When people travel abroad for their treatment, they also often treat it as a holiday. Many people choose to book long package holidays to keep the costs down which are close to the clinic they are choosing.

The graph shows the total savings per country from 1-5 cycles and this includes just the most basic option, which is the pre-procedure and IVF treatment, nothing else, so if you require more treatments your savings will be even greater. If we take the Czech Republic for example you save £3,255 per cycle, which means over 3 cycles you’d have spent almost £10,000 less on your treatment.

Even if you add a package holiday or a self-built 2-3-week holiday into the equation you are still going to save money. You can understand why the draw of saving money, a holiday and potential less stress can lure people out of the UK. However, there are a couple of risks which you should make yourself familiar with.

The first is that each country is regulated differently as such some allow up to 3 embryos to be transferred in a single cycle, whilst this may seem like a good idea, multiple pregnancies come with significantly higher risks and you should understand those risks to both yourself and your unborn babies before you make a decision.

The second is how you can deal with problems and complaints, in the UK HFEA means that all clinics must deal with complaints and major problems in an appropriate manner however, you don’t have the same protections if something goes wrong abroad.

The future of IVF costs

As we have shown in the above sections IVF is big business and only going to get bigger, a recent very detailed analysis showed that the IVF market had a CAGR (Compound Annual Growth Rate) which means that the market is predicted to grow by almost 10% per year.

This could mean that the economies of scale mean the prices per treatment drop.

However, in our opinion what is more likely is that large mergers and companies will swallow competition and reduce the competition in the market which will likely lead to higher prices. This has been seen in the US market where average IVF prices are around £11,000-£12,000 per cycle.

 

If the growth rate of IVF is correct for the UK market then the number of IVF cycles will increase as shown in the graph and by 2026 there will be 136,775 IVF cycles performed.

The costs to individuals will also be highly dictated by the adoption of NICE guidelines by the NHS if things continue down the current trajectory, then less and less total cycles will be funded by the NHS in the UK. Although if the continued lobbying of charities such as Fertility Fairness manage to change public and government perception of infertility being a treatable health condition (as per the World Health Organisation and NICE definitions).

This would then mean the cost to individuals will hopefully go down. We here at I Need IVF will support all lobbying attempts to mover all CCG’s to the 3 cycle recommendations in the hope that the financial impacts for IVF are minimised to future generations.

 

The costs are huge how am I going to fund it?

Talking about how you’re going to fund IVF can often cause people to say stupid things like the individuals in the recent news article I mentioned! We know children are expensive, but let’s be frank you don’t need to fork out £10-£15k on your child usually whilst it’s still a foetus.

With you needing such a large amount of cash in a short amount of time your options are limited unless you had the foresight of a god and started saving for the possibility of infertility through your younger days. But I doubt many did. Here’s a few thoughts on little things that may be able to help:

  1. You don’t have to get your medications from the clinic you’re having IVF with. From the research we have seen a massive variation in medication costs with some stating up to £1,800 for a standard IVF medication run. This is overpriced and by shopping around you could likely bring this down to around £350.
  2. Egg sharing are becoming more popular in the UK as we have a shortage of donor eggs. This means that you often get a decent discount on your IVF treatment if you are willing to donate your left-over eggs from that specific cycle. It might be worth thinking about.
  3. A baby or your money back options are becoming more and more common. They usually are around £11,500-£15,000 and are usually over 3 cycles. Essentially the IVF clinic will return some or all of your money (this will be mentioned in the fine print, so be sure to read it) if you are unsuccessful over a specific number of cycles. If you get pregnant on the first cycle it will mean you have paid a fortune for an IVF cycle, but it can reduce the risk that you pay a fortune and are unlucky. The eligibility criteria for these can be very specific so if you are older or have a more complex history the clinic will likely not accept you as they are trying to reduce risk to them. These options are right for some people but do your homework before signing up to them.
  4. Take out a loan. Now I know this isn’t the ideal option and going into debt to have a baby won’t sit comfortably with some. However, for many, especially those who have waited till later in life to try, the time they have to save for IVF can often mean that their chances of success become very small. So, if you do go for an IVF loan then make sure it is affordable and that you get the best interest rate you can.
  5. Finally, as we discussed above go abroad. If you have a holiday every year or every couple, then you can use that money to go towards your IVF treatment and still have a holiday. Just remember to do your research on the clinics first.

Closing remarks on the costs of IVF

Firstly, whichever option you choose or are forced into be it NHS, Private in the UK or going abroad I wish you the best of luck on a successful outcome. Having spent hours pouring over the data and research I can see the benefits of all three options.

I think as we have been lucky so far in that our second cycle was successful, if Rachel and I were to have further cycles then I will look at going abroad for treatment and having a cheeky break to go along with it. I think going abroad for our first cycle would have been tough, as you get a package with medications in it and often a generic plan which you need to try and make sense of, but now we have been through the process we feel we have enough knowledge to deal with any complexities which may come up through communication.

Please let us know in the comments if you have any thoughts on what we have discussed and what your experiences have been whether in the UK or abroad we would love to have more stories to add to the site.

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