{"id":328488,"date":"2025-10-24T06:44:44","date_gmt":"2025-10-24T06:44:44","guid":{"rendered":"https:\/\/www.europesays.com\/us\/328488\/"},"modified":"2025-10-24T06:44:44","modified_gmt":"2025-10-24T06:44:44","slug":"why-does-ivf-cost-so-much","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/328488\/","title":{"rendered":"Why does IVF cost so much?"},"content":{"rendered":"<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">The care was supposed to be just as good, and the prices were far cheaper. Torres started IVF in Tanzania, and then did Facetime consultations with clinics in the Czech Republic, North Cyprus, and Spain. She finally chose Greece, a place growing as popular for fertility medical tourism as Tijuana, Mexico, is for dental work and Turkey is for hair transplants.<\/p>\n<p><img decoding=\"async\" id=\"img-R5RXHKEG46E26W5DIERZDK5UFQ-image\" alt=\"Kristin and her husband, Ryan Torres, during their trip to Greece. The trip almost felt more like a vacation than a series of medical procedures. The land was so beautiful, the food so delicious, that Kristin would often forget she was there for IVF.\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/R5RXHKEG46E26W5DIERZDK5UFQ.jpg\"  loading=\"lazy\"\/>Kristin and her husband, Ryan Torres, during their trip to Greece. The trip almost felt more like a vacation than a series of medical procedures. The land was so beautiful, the food so delicious, that Kristin would often forget she was there for IVF.Kristin Torres<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Talking to a friend in Florida only underscored Torres\u2019s confidence in her decision.<b> <\/b>In that state, which doesn\u2019t have a <a href=\"https:\/\/www.ivforlando.com\/blog\/florida-fertility-insurance-coverage-2025\" target=\"_blank\" rel=\"nofollow noopener\">mandate for IVF<\/a> insurance coverage, her friend\u2019s entire IVF cycle cost more than $24,000, including $6,800 for medication. In Greece, Torres would spend just $10,000, including the hotel, travel, IVF procedures, and meds. Only $1,532 of that total was for drugs. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Not everyone\u2019s work or life is flexible enough to allow them to fly to Greece twice in a month. Torres knows she is lucky, but she wants more people to know it\u2019s possible to travel to another country and do IVF for a fraction of the price. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cWhy it is so expensive [in the US] is beyond me,\u201d said Torres, 41. \u201cIt\u2019s crazy it\u2019s gotten this out of control. And it\u2019s sad. We want to be home. We wanted to be home a year ago. But with the cost of everything with IVF, it\u2019s impossible.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">The Massachusetts mandate requiring that insurers cover infertility treatments was once considered the nation\u2019s strongest. Yet gaps in the law mean that more than one in four women in the state don\u2019t have coverage, <a href=\"https:\/\/apps.bostonglobe.com\/2025\/10\/metro\/ivf-insurance-coverage-costs-massachusetts\/\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/apps.bostonglobe.com\/2025\/10\/metro\/ivf-insurance-coverage-costs-massachusetts\/\">a Globe analysis found<\/a>. And even those who have insurance often incur significant out-of-pocket expenses.<\/p>\n<p><img decoding=\"async\" id=\"img-AZNDN67AZ2BCJBCXSYKFHLFV4I-image\" alt=\"Kristin Torres got a final scan before her egg retrieval with her doctor, Dr. Thanos Paraschos, in Greece.\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/AZNDN67AZ2BCJBCXSYKFHLFV4I.jpg\"  loading=\"lazy\"\/>Kristin Torres got a final scan before her egg retrieval with her doctor, Dr. Thanos Paraschos, in Greece.Kristin Torres<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">The procedure\u2019s punishing price tag, even for many with insurance, has led thousands of patients to try money-saving hacks. Some, like Torres, undergo the entire process overseas. Others just purchase drugs from international pharmacies, using companies that have sprung up to meet demand. Many turn to strangers to share leftover medications. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">They meet up in parking lots or drive to one another\u2019s houses or ship medications across the country. Some worry what they are doing is illegal, but many are past the point of caring \u2013 they do whatever they can to help others, or themselves, deal with the expense and isolation of infertility. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">\u201cIt\u2019s kind of like (the first rule of)<b> <\/b>Fight Club,\u201d said Kelly Clinton, a Salem mother who used IVF for her child and helps run a Facebook group on the topic. \u201cThey don\u2019t outwardly mention it. But if you are in a support group, you know it\u2019s an option. \u2026 That\u2019s probably the No. 1 dirty little secret of IVF, is the med sharing.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">A number of factors conspire to make fertility drugs prohibitively expensive. A modest market size coupled with an expensive regulatory process has stifled innovation. It can typically take years for new drugs \u2014 even ones already approved in Europe and elsewhere \u2014 to enter the US market. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">President Trump announced last week that the major fertility drug manufacturer EMD Serono, which has a US headquarters in Boston, would reduce the price of its portfolio of fertility drugs by up to 84 percent for eligible patients. His administration also said it would speed up the regulatory process for other meds. <\/p>\n<p><img decoding=\"async\" id=\"img-CN6UCVQ2HEI6PIGOB4XH4DIY4Q-image\" alt=\"A research associate worked on biologic drugs at EMD Serono's lab in Bedford in 2017.\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/CN6UCVQ2HEI6PIGOB4XH4DIY4Q.jpg\"  loading=\"lazy\"\/>A research associate worked on biologic drugs at EMD Serono&#8217;s lab in Bedford in 2017.Jessica Rinaldi\/Globe Staff<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">It\u2019s still unclear how the changes will play out. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">But medication costs are only part of the problem. A wave of fertility clinic acquisitions by private equity firms has also turbocharged the profit imperative in the field, and limited regulations mean few guardrails.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">\u201cThey have people by the balls,\u201d said Alexander Borsa, a PhD candidate at Columbia University and member of the GenderSci Lab, which looks at sex and gender in biomedical research. \u201cIt\u2019s understood patients are extremely emotionally vulnerable. There is a tacit understanding that things will be expensive. If someone tells you you need to do something to have a baby, you will find a way to do it.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Like many women before her, Torres found a solution. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">In late June, she was navigating the narrow, cobblestoned streets of the Plaka neighborhood in Athens, a green-apple frozen yogurt in hand. Bougainvillea spilled over ancient buildings. Vendors hawked trinkets and fruit. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">The worry and waiting of the egg-retrieval process melted away amid such beauty. She kept forgetting why she had come, only for the real reason to flash back.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">I can\u2019t believe I\u2019m here for IVF, she thought. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">In the most expensive classes of IVF drugs, there hasn\u2019t been innovation in 20 years. Evan Sussman is trying to change that. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">He co-founded his Duxbury-based company, Granata Bio, to bring products to market, some to compete with high-cost medicines. But developing fertility drugs for the US market is no easy feat. <\/p>\n<p><img decoding=\"async\" id=\"img-JM6RLF5SPZLY2RJDBJZJZ4V2XM-image\" alt=\"Evan Sussman (second from left), CEO of Granata Bio Corp., met with his team, from left, Leigh Guerra, Evan Sussman, Noah Siler, Shelly Frazier, and Stephen Medeiros.\" class=\"height_a width_full invisible width_full--mobile width_full--tablet-only\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/JM6RLF5SPZLY2RJDBJZJZ4V2XM.jpg\"  loading=\"lazy\"\/>Evan Sussman (second from left), CEO of Granata Bio Corp., met with his team, from left, Leigh Guerra, Evan Sussman, Noah Siler, Shelly Frazier, and Stephen Medeiros.Suzanne Kreiter\/Globe Staff<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">In the 2000s, the Food and Drug Administration tightened its process for approving fertility drugs. Instead of requiring companies to prove a medicine increased the number of mature eggs, for instance, drug makers<b> <\/b>had to prove they had achieved the end goal of infertility treatments \u2014 a live birth. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">There are hundreds of variables that factor into the birth of a baby, any one of which could affect the outcome. So the clinical studies for new treatments must be massive, involving thousands of patients and costing over a hundred million dollars. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">The market for fertility drugs is small compared to, say, drugs for cancer (<a href=\"https:\/\/www.fortunebusinessinsights.com\/u-s-oncology-drugs-market-108499\" target=\"_blank\" rel=\"nofollow noopener\">$87 billion in the US in 2023<\/a>) or weight loss (<a href=\"https:\/\/www.fortunebusinessinsights.com\/u-s-anti-obesity-drugs-market-108768\" target=\"_blank\" rel=\"nofollow noopener\">$2.7 billion<\/a>). The whole US market for a fertility drug might be only $400 million to $500 million, said David Stern, an industry expert.<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cIf you are going to spend $100 million to get a drug approved, what is your payback time? What market share will you get?\u201d Stern, who is now CEO of Kindbody, a New-York based company that offers fertility benefits, asked rhetorically. \u201cYou will be at a loss for a long period of time before you start even making profit.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Such challenges have allowed existing products, from companies with global reach, to dominate the market. In the United States, for example, there is only one human menopausal gonadotropin, or hMG, available to patients: Menopur. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Gonadotropins are key for IVF, stimulating the ovaries to produce more eggs and giving clinicians the best odds of creating a healthy embryo. Menopur is used in approximately 85 percent of IVF cycles, Sussman said. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Swiss-owned Ferring Pharmaceuticals reported   more than $1 billion in 2024 revenue from global sales of Menopur. <\/p>\n<p><img decoding=\"async\" id=\"img-V462KTUGGXKLIJX4BVQ2VPZQKY-image\" alt=\"A woman's IVF medications, including vials of Menopur, at her home in Maryland in 2022.&#10;\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/V462KTUGGXKLIJX4BVQ2VPZQKY.jpg\"  loading=\"lazy\"\/>A woman&#8217;s IVF medications, including vials of Menopur, at her home in Maryland in 2022.<br \/>\nThe Washington Post\/The Washington Post via Getty Images<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cThere has essentially been a monopoly created,\u201d Stern said. \u201cIt\u2019s actually the FDA that makes it very difficult to come up with a new product or biosimilar.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Trump\u2019s recent announcement may hasten the arrival of a competitor. He promised an expedited review for EMD Serono for its drug Pergoveris, which was approved and launched in Europe in 2013. It is unclear what kind of data the FDA will require, but the approval process could bring to market a competitor to Menopur much more quickly. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">As part of that deal, Trump said, EMD Serono would offer direct sales of its portfolio of IVF drugs to eligible patients, which could result in savings of up to 84 percent. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cIt\u2019s very positive, the steps the White House has taken to reduce the cost of fertility drugs, which has an impact on the overall cost of fertility treatment in the US,\u201d Stern said. \u201cIt will significantly reduce the cost.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Others were more skeptical. Davina Fankhauser, executive director of the advocacy group Fertility Within Reach, said medications are only part of the expense for an IVF cycle, and discount programs were already available based on financial need. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cIf you can\u2019t afford $10,000 for an IVF cycle, savings on medication won\u2019t be the determining factor that allows you to move forward with treatment,\u201d she said.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">In many other countries, especially those with socialized medicine, the government has more sway over drug prices, reducing the need for creative bargains like the one Trump has proposed with EMD Serono. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Regulatory hurdles are also lower overseas, where the endpoint for clinical trials isn\u2019t a live birth, but proof the drug does what it says. In Europe, Menopur has at least one competitor \u2013 which Stern said has helped drive down costs. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Patients have subsequently turned to markets overseas to access cheaper drugs. It is technically illegal to import drugs from international pharmacies, even when the drug has been approved in the United States. However Sara Shikhman, a health care lawyer with New York firm Lengea Law, said the rules are not strictly enforced, and the FDA permits some individuals to import drugs for personal use. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Patients are increasingly availing themselves of that option, using companies that have sprung up abroad largely to ship cheaper drugs to Americans. A round of 20 vials of Menopur typically costs around $5,000 here, according to GoodRx, but the Israeli infertility company IVFPharmacy charges <a href=\"https:\/\/www.ivfpharmacy.com\/drug\/menopur\/\" target=\"_blank\" rel=\"nofollow noopener\">just $760<\/a>. In Reddit forums, American patients describe saving big by buying abroad. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Shikhman herself looked into these options when going through her own IVF process. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">\u201cYou\u2019d think, I\u2019m a lawyer who runs a law firm, and should be able to afford something like IVF. But if I\u2019m being asked to pay, just for meds, $5,000 \u2026 that\u2019s a crazy price,\u201d she said.<b> <\/b><\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Doctors say many patients who lack fertility coverage or have already exceeded their insurance maximums explore traveling abroad to buy drugs. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">\u201cNot infrequently, we will have patients go to Mexico, Canada \u2026 go overseas where their parents live to get these medications,\u201d said Dr. Pietro Bortoletto, a reproductive endocrinologist who recently co-founded his own clinic, Terra Fertility. \u201cThe vast majority of people are using infertility coverage. But once you have run that dry and want to keep going, you have to figure out what\u2019s the thing to shave some dollars off.\u201d<\/p>\n<p><img decoding=\"async\" id=\"img-PSWLIAJPHT7NAWECCALKRFE5K4-image\" alt=\"Dr. Pietro Bortoletto, at Terra Fertility. &#10;\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/PSWLIAJPHT7NAWECCALKRFE5K4.jpg\"  loading=\"lazy\"\/>Dr. Pietro Bortoletto, at Terra Fertility.<br \/>\nSuzanne Kreiter\/Globe Staff<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">While some look abroad, others quietly \u2013 and anonymously as possible \u2013 look for swaps locally. One woman, who worked for a prominent fertility benefits company, discovered her fertility benefit was capped at $15,000. While she was grateful she had some benefits,<b> <\/b>they would be only be<b> <\/b>enough to pay for the clinic costs. For medication, she turned to women in Facebook groups. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cI\u2019ve told countless people afraid of going this route, \u2018I can help you,\u2019\u201d she said. \u201cI think this is something [where] there should be regulations, but we\u2019re being failed by the system. You figure it out on your own in another way.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">A woman from Andover had robust coverage from an out-of-state insurer for three rounds of IVF. But she only had enough medication coverage for part of one cycle. She subsequently drove up to a house in Medford and grabbed a box of meds at the front door. Another time she met a woman at the Tanger Outlets in New Hampshire. She bought an orchid for a woman in Worcester who provided thousands of dollars of additional medication.<b> <\/b><\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">For cheaper drugs, she would pay out of pocket. But for drugs like Menopur, she turned to Facebook.<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cI called around, probably half a dozen different pharmacies,\u201d she said. \u201cI tried my best. Some won\u2019t give you quotes over the phone. They have to wait for your doc to send the prescription there and then they\u2019ll quote you. \u2026 I spent hours one day to price compare, [only] to discover the donation sites. I\u2019m grateful, very grateful for them, and all the women helping each other. I wouldn\u2019t have been able to do it without them.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">She ultimately bought more coverage through the state\u2019s health insurance market to do another three rounds of IVF. She is now pregnant.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Sussman, the Duxbury entrepreneur, knows there is a US market for a competitor to Menopur. Granata\u2019s product is finally in the late stage of clinical trials. But the company has been working to bring its drug to market for five years. He estimates he has at least three more to go.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">The company is working on bringing other drugs to market as well. It is developing a new form of progesterone. Granata additionally has a drug, based on technology developed at and licensed out by Massachusetts General Hospital, that protects ovarian reserve and has potential applications in contraception, menopause, and IVF.<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cDrug development is a slog \u2014 long, arduous, and expensive,\u201d Sussman said. \u201cI love what we do, but you can see people deflate when you say when will this get to market. My kid could have entered and graduated college.\u201d<\/p>\n<p>Clinics consolidate; costs rise<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">The astronomical cost of medication only partly explains why a single IVF cycle in Massachusetts can cost<b> <\/b>up to $25,000, which may or may not be covered by insurance, according to the organization Fertility Share. There are many other drivers. Reproductive endocrinologists and embryologists don\u2019t come cheap. The same goes for the lab equipment and technology to freeze, store, thaw, analyze, and fertilize reproductive cells.<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">David Sable, a former OBGYN and IVF doctor who now manages a reproductive medicine venture portfolio, said the prices simply reflect supply and demand. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cThe industry in aggregate maxes out at a price point that is a balance of how much can we charge for it, versus how much can large groups of people afford to pay for it,\u201d Sable explained. \u201cThere is no conspiracy to keep the price high. But it\u2019s a kind of equilibrium the industry finds itself in.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Yet the mere presence of venture capital and private equity firms in the infertility market suggests investors are smelling a profit. And the downstream effect of the profit imperative on patients can be painful. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Christine Hochkeppel and her wife had been storing donated sperm at Fenway Health, a nonprofit specializing in care for LGBTQ patients,<b> <\/b>where they had done  intra-uterine insemination, in which sperm is placed into the uterus by a clinician. When they needed IVF, they had to seek care at a fertility clinic. But when they shipped the leftover sperm to Boston IVF, a for-profit clinic, their storage costs jumped from $200 to $1,200 a year. <\/p>\n<p><img decoding=\"async\" id=\"img-N6UT2DHQ2EI6HMKLUWQJ4LWJZ4-image\" alt=\"Reproductive endocrinologist Dr. Alison Zimon worked in the embryology lab at Boston IVF in Waltham in 2014.\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/N6UT2DHQ2EI6HMKLUWQJ4LWJZ4.jpg\"  loading=\"lazy\"\/>Reproductive endocrinologist Dr. Alison Zimon worked in the embryology lab at Boston IVF in Waltham in 2014.Wendy Maeda\/Globe Staff<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">In a statement, Boston IVF defended its sperm-storage costs, saying they are a function of the location and scale of their business. \u201cWe believe our rates are at or below market average for on-site storage,\u201d a spokesperson for the clinic said in a statement. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">However, at Terra Fertility,  the recently opened physician-owned clinic, sperm storage only costs $60 a month, or $720 a year.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">During the lengthy and expensive process to retrieve eggs and create embryos, Hochkeppel said, Boston IVF strongly recommended the couple pay another sizable bill, this one for pre-implantation genetic testing. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Genetic factors are a <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4736891\/\" target=\"_blank\" rel=\"nofollow noopener\">main cause of early miscarriage<\/a>, and such tests purport to decrease their odds. Some studies have shown the most common test, called PGT-A, <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11266849\/\" target=\"_blank\" rel=\"nofollow noopener\">increased live birth rates<\/a> in older women.<b> <\/b>However, professional groups have <a href=\"https:\/\/www.asrm.org\/globalassets\/_asrm\/practice-guidance\/practice-guidelines\/pdf\/use_of_preimplantation_genetic_testing_for_aneuploidy.pdf\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/www.asrm.org\/globalassets\/_asrm\/practice-guidance\/practice-guidelines\/pdf\/use_of_preimplantation_genetic_testing_for_aneuploidy.pdf\">contested studies with positive finding<\/a>s. Other studies have shown either no benefit to such tests or found they have a high false positive rate \u2013 meaning embryos initially deemed to be abnormal were actually fine. Many insurers still classify the technology as experimental and don\u2019t cover it. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">That hasn\u2019t stopped clinics from offering PGT-A testing. According to complaints filed by Constable Law, a Florida firm that has filed lawsuits alleging false and misleading marketing for the tests, their use has <a href=\"https:\/\/www.fertstert.org\/article\/S0015-0282%2822%2901602-8\/fulltext?utm_source=chatgpt.com\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/www.fertstert.org\/article\/S0015-0282%2822%2901602-8\/fulltext?utm_source=chatgpt.com\">roughly tripled<\/a> in less than a decade. By 2021, they were used in 40 percent of IVF cycles. In all, PGT-A testing generates as much as $400 million in annual revenue. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Hochkeppel and her wife ultimately opted for PGT-A testing, even though her insurance wouldn\u2019t cover it. The $4,000 test narrowed the number of embryos deemed viable from four to one. Hochkeppel had wanted to implant that one, but her doctor recommended banking more embryos first, given that she was already 40 and more embryos would improve her odds of getting pregnant. But that recommendation would come with even more headaches, and more costs \u2014 including more sperm.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Another woman, who spoke on the condition of anonymity, had tried repeatedly to get pregnant through IUI and IVF, but after spending thousands of dollars, hadn\u2019t had success. She and her husband found a couple online willing to donate embryos. <\/p>\n<p><img decoding=\"async\" id=\"img-AK4HRAZFLZCXOPNCND44SPLLEQ-image\" alt=\"A 5-day-old embryo, as viewed by technicians in Omaha.\" class=\"height_a width_full invisible width_full--mobile width_full--tablet-only\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/AK4HRAZFLZCXOPNCND44SPLLEQ.jpg\"  loading=\"lazy\"\/>A 5-day-old embryo, as viewed by technicians in Omaha.Misty Prochaska\/For The Washington Post<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Going that route has risks. The couples signed a contract and paid a lawyer to oversee it, but even the attorneys said the deal was in uncharted waters. When the woman went to discuss shipping the embryos to her Massachusetts clinic, private equity-backed CCRM, it said no. The clinic told her they couldn\u2019t be sure of the embryos\u2019 quality.<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cThey make a lot of money off their donor egg program,\u201d she said. \u201cAnd all they would get off this is the frozen embryo transfer fee, which is like $2,400 \u2014 instead of $20,000 off donor eggs. It makes me question if they want to do what\u2019s best for the patient versus what\u2019s best for their wallet.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">The woman decided against moving the embryos and will instead travel to the clinic where they are stored.<b> <\/b><\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cWe want a family. Period,\u201d she said, tearing up. \u201cWe will get there one way or another.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">In a prepared statement, CCRM said its mission is to ensure patients receive high-quality, individualized care. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cThe clinical and lab standards employed by CCRM\u2019s affiliated providers as part of a patient\u2019s care are solely focused on this goal,\u201d the company said.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">If fertility clinics are already expensive, private equity\u2019s increasing stake in the business may send prices further skyward. But tracking that trajectory will be hard, said Borsa, the researcher from Columbia.<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cThe fact that the costs in fertility are so high and unregulated is one of the reasons why it was attractive to PE,\u201d Borsa said. \u201cIn fertility specifically, it was looked at as this deeply unregulated industry. \u2026 Desperate people show up crying on your doorstep and will pay whatever you tell them.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">In 2018, IVF was described as the medical sector most dominated by private equity, with PE-owned clinics performing nearly a third of all cycles of assisted reproductive technology nationwide. In the years since, PE\u2019s outsize share has only grown, according to data collected by Pitchbook. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Massachusetts reflects that trend. In 2022, there were eight companies operating fertility clinics in the state, two of them owned by private equity. As of September, there were seven, three owned by private equity. <\/p>\n<p><img decoding=\"async\" id=\"img-4RMAW4DFYRD4ZDUJRC5V5JT2GQ-image\" alt=\"A embryologist worked at her work station in the IVF lab at the Brigham &amp; Women's Hospital in Boston in 2024.\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/4RMAW4DFYRD4ZDUJRC5V5JT2GQ.jpg\"  loading=\"lazy\"\/>A embryologist worked at her work station in the IVF lab at the Brigham &amp; Women&#8217;s Hospital in Boston in 2024.David L. Ryan\/Globe Staff<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Private equity involvement has boosted prices elsewhere.<b> <\/b><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6686986\/\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6686986\/\">One 2019 study <\/a>observed that consolidation in the Australia\/New Zealand fertility market, spurred by private equity, meant that three IVF companies controlled 80 percent of IVF cycles. The <a href=\"https:\/\/www.smh.com.au\/healthcare\/making-babies-20131014-2vhbk.html\" target=\"_blank\" rel=\"nofollow noopener\">Sydney Morning Herald<\/a> noted that at one Melbourne clinic, the cost of an embryo transfer rose an average of 13 percent annually from 2007 to 2012, though patients reported that nothing about the experience had changed. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Even if prices for specific procedures remained the same, private equity firms are likely to push more add-on services, researchers say. Research has shown that there were <a href=\"https:\/\/drive.google.com\/file\/d\/1vnzJJTaynPZEh2qCkRn1QmncjYT0-tqv\/view?usp=sharing\" target=\"_blank\" rel=\"nofollow noopener\">10 percent more patients<\/a> using any type of pre-implantation genetic testing at PE-affiliated practices. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cMore genetic testing may be helpful but could be of low value or unnecessary,\u201d said Zirui Song, an associate professor of health care policy and medicine at Harvard Medical School. \u201cIs this spending clinically necessary, and indicated, or unnecessary but a source of additional revenue?\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Hochkeppel wondered the same thing as she ponied up approximately $4,000 for PGT-A testing yet again after her third egg retrieval.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">This time, the test raised questions about all four embryos. One came back abnormal, while two showed two X chromosomes and one Y, which can cause fertility issues in boys. The fourth embryo had to be biopsied a second time, which could decrease its viability, until the results came back normal.<\/p>\n<p><img decoding=\"async\" id=\"img-P4UXCRPWCFUAL5BKCSVXWR2LBE-image\" alt=\"Christine Hochkeppel&#x2019;s wife, Stephanie Soares, drew Menopur into a syringe next to the next stockpile of drugs on March 21, 2023.\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/P4UXCRPWCFUAL5BKCSVXWR2LBE.jpeg\"  loading=\"lazy\"\/>Christine Hochkeppel\u2019s wife, Stephanie Soares, drew Menopur into a syringe next to the next stockpile of drugs on March 21, 2023.Christine Hochkeppel<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cIt\u2019s really frustrating,\u201d Hochkeppel said. \u201cIt makes you wonder, why are they selling this test that basically has just eliminated a lot of my embryos? If they are in the business of making money, it makes sense to eliminate as many embryos as they can to keep you coming back and paying more and get more from the insurance. It starts to shake your faith in the process, that it doesn\u2019t seem a reliable test.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Boston IVF defended its use of PGT-A testing and said it does not require or recommend it for all patients. But a spokesman listed \u201csignificant benefits\u201d from such tests, including higher pregnancy rates and lower miscarriage rates. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Boston IVF has since been acquired by a private equity-backed firm, one whose clinics require patients to freeze all embryos \u2013 which in turn is generally associated with higher prices. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">The firm\u2019s spokesperson said Boston IVF does not have such a policy now but noted that such policies can produce \u201chigher pregnancy rates and fewer complications.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Sable, the IVF fund manager, said in his personal experience doctors are trying to help patients, not talk them into unnecessary tests. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Still, private equity firms have a reputation for a relentless focus on profit. A person who works at a PE-backed fertility company \u2013 and has knowledge of the company\u2019s finances \u2013 said the top goal of the firm\u2019s clinics is to increase new patient visits and new cycles to drive revenue. The company closely monitors whether clinics are meeting their targets.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">\u201cI can\u2019t imagine a PE firm that will come in and be more focused on the mission than the profit,\u201d said the employee, who spoke on the condition of anonymity, as they were not authorized to speak on behalf of the company. \u201cI don\u2019t think those exist.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Back at home in Sagamore Beach in August, Torres held knitted baby slippers. There wasn\u2019t yet a baby to wear them, but there was still a lot of hope. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">Torres had completed her Greece trip a few months before and reveled in the memories of it. For two weeks, she had gone into the clinic for local monitoring, indulged in fresh Mediterranean food, had an egg retrieval, gone to a cooking class with her husband, and explored Santorini. Her doctor had transferred two of the six embryos the couple made before she left the country. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">She was so distracted by the beauty of Greece that she hadn\u2019t even thought about taking an early pregnancy test. Even after realizing that neither of the transferred embryos had resulted in a pregnancy, Torres was undeterred. Back in Massachusetts, she renewed her passport and made plans to travel back to Greece in November for another round of IVF.<b> <\/b><\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cI\u2019m super hopeful,\u201d Torres said. \u201cIt\u2019s such a different experience. If I can convince just one person to try it, I\u2019ll feel like I have won.\u201d <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Hochkeppel has complicated feelings about her IVF experience.<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">In some ways, she got everything she wanted.<b> <\/b>Miles Hochkeppel was born via C-section on Sept. 21, 2024. He looked slightly gray, part of his face a cast of blue. They brought him to Hochkeppel\u2019s cheek, but it wasn\u2019t enough. Not after a 36-hour labor followed by a C-section, not after the years of effort it took to create him. Hochkeppel demanded Miles be placed on her skin. She screamed for it. Miles was placed naked on her chest, and color blossomed into his face.<\/p>\n<p><img decoding=\"async\" id=\"img-QXCKNFSEQYY2I6ND7LG4XGCPWI-image\" alt=\"Christine Hochkeppel (left),  Stephanie Soares, and their 11-month-old son, Miles, at an Osterville beach.\" class=\"height_a width_full invisible width_full\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/QXCKNFSEQYY2I6ND7LG4XGCPWI.jpg\"  loading=\"lazy\"\/>Christine Hochkeppel (left),  Stephanie Soares, and their 11-month-old son, Miles, at an Osterville beach.Suzanne Kreiter\/Globe Staff<\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Now, it is as if all of the joy that was absent from those months has been distilled into Miles. His giggles and personality fill the couple\u2019s home. Hochkeppel can\u2019t imagine a world without someone this beautiful, this perfect. <\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">The hopelessness and desperation she felt before seem far away now. There\u2019s so much to focus on in its place. Though Massachusetts passed <a href=\"https:\/\/www.mass.gov\/news\/governor-healey-signs-parentage-act-ensuring-equality-for-all-families-in-massachusetts\" target=\"_blank\" rel=\"nofollow noopener\">a law in 2024<\/a> to ensure parenting rights for families made through adoption or IVF, those rights are not guaranteed nationwide. Even though Hochkeppel\u2019s wife is also Miles\u2019s official parent, she intends to legally adopt him as soon as the couple can afford it, to protect her rights in other states. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">Hochkeppel is grateful for her own stubbornness. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cYou have to be a pain in the ass,\u201d she said. \u201cYou have to feel it in your bones that you deserve it.\u201d<\/p>\n<p class=\"paragraph | gutter_20_0 text_align_left railless margin_horizontal_10 width_max_1080\">She knows the process could have been worse, and that for people in many other states, it is.<b> <\/b><\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">But she can\u2019t forget what she went through. At her six-week follow up, Hochkeppel\u2019s doctor asked if she\u2019d have another baby. Part of her yearns for another. But part of her wasn\u2019t sure then \u2013 and still isn\u2019t. <\/p>\n<p class=\"paragraph | gutter_20_0 railless margin_horizontal_10 width_max_1080\">\u201cIt seems like it shouldn\u2019t have been that hard,\u201d she said. \u201cIt should have been a more joyful process. But it wasn\u2019t. It was so hard to get to the happy part.\u201d<\/p>\n<p><img decoding=\"async\" id=\"img-CMTQKCOYKGX4I4QOJNTCVN4TNI-image\" alt=\"&#x201C;You have to feel it in your bones that you deserve it,&quot; Christine Hochkeppel (left) said of the in vitro process.\" class=\"height_a width_full invisible width_full--mobile width_full--tablet-only\" src=\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/CMTQKCOYKGX4I4QOJNTCVN4TNI.jpg\"  loading=\"lazy\"\/>\u201cYou have to feel it in your bones that you deserve it,&#8221; Christine Hochkeppel (left) said of the in vitro process.Suzanne Kreiter\/Globe Staff<\/p>\n<p class=\"tagline | font_primary inline_block margin_horizontal_10 margin_top_32\">Jessica Bartlett can be reached at <a href=\"https:\/\/www.bostonglobe.com\/2025\/10\/23\/business\/ivf-cost-international-medical-tourism\/mailto:jessica.bartlett@globe.com\" class=\"\" target=\"_blank\" style=\"font-size:inherit;letter-spacing:.5px\" rel=\"nofollow noopener\">jessica.bartlett@globe.com<\/a>. Follow her <a href=\"https:\/\/www.twitter.com\/ByJessBartlett\" class=\"\" target=\"_blank\" style=\"font-size:inherit;letter-spacing:.5px\" rel=\"nofollow noopener\">@ByJessBartlett<\/a>.<\/p>\n<p><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"The care was supposed to be just as good, and the prices were far cheaper. Torres started IVF&hellip;\n","protected":false},"author":3,"featured_media":328489,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[210,1141,1142,67,132,68],"class_list":{"0":"post-328488","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare","11":"tag-united-states","12":"tag-unitedstates","13":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115427798639218161","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/328488","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=328488"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/328488\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/328489"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=328488"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=328488"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=328488"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}