The title of this post is actually a bit misleading – intentionally. But it typifies the perception that IVF is the last and most expensive resort in fertility treatment – that everything else has been tried and has failed. In reality, IVF might never be indicated for a patient, and at other times, a move to IVF might be the most effective and efficient option for their personal situation and diagnosis.

Please don’t think that I am minimizing the financial burden associated with fertility treatment at all. On the contrary. I understand that very few couples have the disposable income to pursue treatment at will, regardless of the expense. In reality, pursuing the correct treatment approach typically saves a couple money over the long term. Undergoing 6 rounds of IUI at $2,000 apiece costs nearly as much as an IVF cycle. And if it is not an effective treatment given your diagnosis, it is hardly a “more affordable” option.

Unfortunately, I see many patients that have been directed into this approach. It is a natural tendency to want to start with the least expensive treatment option both from the patient’s perspective and the physician’s. It eases the blow to the patient when the doctor can say “Let’s start with this approach and move onto more expensive approaches if that doesn’t work.” In some cases, the least expensive treatment can actually the best approach, while in others, IVF with donor eggs and a surrogate may offer the best or only viable option for having a baby.

For effect, let’s apply the “least expensive” mindset to something outside of infertility treatment…say, car repair. If I try to start my car one morning and it won’t turn over, there are a range of potential causes. It could be a dead battery, it could be a faulty electrical connection, it could be a problem with my starter, it could be that my cylinders are seized up because I ran out of oil…on and on. Now, applying the “start with the least expensive option” approach, I could replace the battery and see if that helps, replace the wiring, move on to my starter and replace that, working my way up from least expensive to most expensive, finally replacing my entire engine if all else fails. Makes lots of sense, right? After all, a battery is cheaper than a starter is cheaper than an electrical system is cheaper than an engine. Throw it against the wall and if it doesn’t stick, at least you didn’t pay that much for it.

Would you take your car to a mechanic that took this approach? I really don’t think many logical people would. Our assumption with a mechanic is that they will assess the symptoms, test various components to isolate the problem/cause, and then repair or replace the part that is causing the problem. So if my car just needs a battery, that’s what I’ll get. If, on the other hand, the engine needs to be rebuilt, then replacing the battery and the starter first, before moving on to the full rebuild isn’t actually the least expensive OR the most efficient approach.

Doesn’t it make more sense to do a thorough analysis of the causes of infertility, then apply the most effective approach, rather than “just trying” something that may be completely ineffective? For example, if a woman has blocked or obstructed fallopian tubes, IUI is a completely useless and wasteful treatment approach. If there are male factor infertility issues involved, timed intercourse is highly unlikely to lead to conception. On the other hand, if her tubes are clear and there are no male factor issues, Clomid and timed intercourse may be the most effective and least expensive approach to begin with.

Another very important consideration is the “cost” of wasted time. This is especially pertinent if a woman is in her mid to late 30’s. With the biological clock ticking louder and faster with each passing month, many couples can’t afford to “try out” treatment approaches that offer a low likelihood of success. Instead, they should be moving directly to the treatment options that give them the greatest chance of success in the shortest time – especially if they are hoping to conceive more than once.

At Caperton Fertility Institute, our focus is on identifying the most effective course of treatment based on your individual history and diagnosis, and we invite patients to include this in the questions they ask when meeting with us for the first time. So if IUI makes the most sense from a diagnosis, time and budget perspective, that’s what we will recommend. If the most effective option is a move to IVF, that’s what we will recommend. We lose much more than we gain if we are recommending more expensive treatment options than are indicated by your diagnosis. After all, our hope is that you will recommend us to friends, associates and family members when they are in need of fertility services. If you feel like you were taken advantage of or pushed into treatment that you didn’t need, how likely are you going to be to give us a good recommendation or write a good review? Not very. Your success is our success and we want to facilitate the smoothest journey and most successful outcome possible.