The financial aspect of family building can be confusing and overwhelming, and even after you understand your benefits and fertility treatment costs, affording the care you need can feel like an insurmountable hurdle. In this guide, you'll learn how much it really costs for two hopeful moms to have a baby, how to navigate insurance coverage (if you have it), and much more.
In this article:
- The Price of LGBTQ+ Family Building
- Understanding Your Fertility Coverage
- Questions to Ask An Insurance Provider
- Insurance Codes for IUI & IVF
- What impacts the cost of treatment?
- Family-Building Costs for Moms-to-Be
- Consultation & Fertility Testing Costs
- The Cost of Using Donor Sperm
- How much does intrauterine insemination (IUI) cost?
- How much does in vitro fertilization (IVF) cost?
- How much does reciprocal IVF (RIVF) cost?
- Feeling overwhelmed?
Editor's Note: Throughout this article, we may use "women" or "female couples" to refer to those assigned female at birth. We acknowledge that not all people born biologically female identify as such, so if you are AFAB and non-binary, trans, or queer, please know that we are simply using these terms in a medical context.
The Price of LGBTQ+ Family Building
As a hopeful mom-to-be, you've likely already put many hours of research into exploring your options. You may have asked friends or family for advice, searched the internet for resources that point you in the right direction, or even begun your journey as a patient at a fertility clinic.
You likely know what your goals are and have a sense of how you'd like to achieve them if you're pursuing biological family building (i.e. IUI, IVF, or reciprocal IVF). Achieving those goals begins with understanding potential treatment costs so you can plan, budget, and start your family-building journey feeling confident you know what lies ahead.
Understanding Your Fertility Coverage
For LGBTQ+ moms-to-be, calculating fertility treatment costs begins with understanding whether or not you have any fertility coverage through your insurance plan (if applicable). Here's a quick breakdown of how to determine what insurance coverage you have, as well as what to do if you don't have insurance.
If you have insurance:
When it comes to your fertility coverage, the best first step is to reach out to your insurance provider (and/or your HR department at work) to determine what options are available to you, if you have opted into an insurance plan.
Your fertility insurance coverage depends on a variety of factors, including your employer, the plan that your company offers, and even the location in which you live and work.
Unfortunately, many insurance companies only cover fertility treatment based on an archaic medical diagnosis of infertility, which is typically defined as "the inability to conceive after 1+ year of egg and sperm exposure."
Clearly, this narrow interpretation excludes many hopeful parents within the LGBTQ+ community who need medical assistance to grow their families. This is one of many reasons we continue to advocate for more inclusive coverage for all patients.
We want to acknowledge that this is both unfair and discriminatory, as ALL individuals should have access to the care they need to grow their families.
Resources for LGBTQ+ Employees
If you find yourself pigeonholed by this frustrating definition, we encourage you to reach out to your employer to urge them to offer family-building benefits to all employees. Not sure what to say? The resources below offer some helpful places to start:
- Building LGBTQ+ Families: The Price of Parenthood
- RESOLVE's Guide to Getting Insurance Coverage at Work
- Access to Fertility Insurance Coverage for LGBTQ+ Employees
- Employee Toolkit by Fertility Within Reach
- Making the Case for Fertility Benefits
If you don't have insurance:
We recognize that financing self-pay fertility treatment options can be challenging. To ensure more patients can access high-quality care at more affordable prices, we offer a variety of Opportunity Plans that bundle services for those who do not have insurance coverage.
To learn more about these plans, reach out to us today.
What do Opportunity Plans cover? These self-pay fertility treatment plans cover services like IUI, IVF, PGT, embryo transfer, egg freezing, surrogacy and fertility testing.
Explore LGBTQ+ Family-Building Grants
We encourage you to also check out our grant guide for further financial support, as well as resources from organizations like Family Equality, who also offer extensive guides. In addition, companies like Progyny offer expanded fertility coverage if your primary policy isn't cutting it.
Take Advantage of Open Enrollment
While Open Enrollment is a critical time to plan for fertility treatment in the next year, you can get started with exploring your financial options at any time. Remember, if you're feeling overwhelmed, our team is here to guide you!
Questions to Ask An Insurance Provider
After you speak with your insurance provider or HR representative to determine whether or not your plan includes fertility coverage, a great next step would be to follow-up with your insurance provider to figure out exactly what you have coverage for.
Below, we’ve provided a list of basic questions to ask your insurance provider and/or HR department that will help you dig deeper to find out what's covered. Even when treatment itself is not covered, diagnostic tests often are, so it’s important to ask these questions:
- What is my deductible?
- Do I have a copay for office visits?
- Are there any exclusions to my plan?
- Do I have coverage for diagnostic testing for infertility treatment?
- Is cycle monitoring or fertility medication covered under my plan?
- Do I have IUI and IVF coverage? If so, how many cycles are covered for each?
- Are there any requirements I have to meet before that coverage kicks in?
- Will blood work and ultrasounds have a copay or be applied to my deductible and co-insurance?
Insurance Codes for IUI & IVF
Additionally, you can ask your insurance provider to check specific coverage codes for IUI and IVF. The following IUI and IVF codes are the most commonly used for patients working with our partner clinic, Illume Fertility:
- IUI: 58322, 58323, 89260, 89261, S4042
- IVF: 58970 58974
What impacts the cost of treatment?
After you’ve determined your insurance coverage, you will need to meet with a board-certified reproductive endocrinologist to discuss your options and next steps. If at all possible, choose a fertility practice that is welcoming and inclusive to the LGBTQ+ community, as this can make a big difference on your journey.
At your first consultation with a fertility specialist, you will discuss your goals and preferences and begin creating your family-building plan. This plan will be personalized to you (and your partner, if applicable), based on a number of factors, including:
- If you’re a single mom-to-be, congratulations on the start of a wonderful journey! Your doctor will personalize your plan based on some of the factors in the next section, and your journey will most likely include donor sperm and IUI or IVF cycle(s).
- If you’re a cisgender female in a relationship with a trans partner, your doctor will personalize your plan based on your biology (and that of your partner), and that journey may take the shape of IUI, IVF, or reciprocal IVF cycle(s). If your partner preserved eggs or sperm prior to a hormonal or surgical transition, be sure to tell your team during your consultation so they can help explore all your options.
- If you’re two cisgender females who both want to participate in a biological family-building journey, your doctor will personalize your plan based on some of the factors in the next section. Your journey may take the shape of IUI, IVF, or reciprocal IVF cycle(s).
- Your age, hormone levels, and ovarian reserve are all factors that your doctor will consider when guiding you through the family-building process.
- If you or your partner have previously frozen gametes (eggs or sperm), this may also inform your treatment plan.
- Do you (or your partner, if applicable) wish to carry a pregnancy? Some people have a strong desire to experience pregnancy and birth, and others do not.
No matter what shape your family-building journey takes, your fertility clinic should work alongside you to help you understand your options for affording treatment. Below, we break down cost estimates for four common pathways to family-building for LGBTQ+ moms-to-be.Relationship
BiologyFamily-Building Costs for Moms-to-Be
As you explore the following pathways to parenthood, remember that there are many different factors that can impact the total amount you'll pay. We'll walk through each treatment option, providing estimated costs for each one.
Before we discuss treatment methods, let's talk fertility testing and selecting a sperm source.
Reminder: The following price ranges only applicable to those without insurance coverage who are paying out-of-pocket. Reduced pricing is available through our partner clinic's Opportunity Plans, which bundle services together to give you additional discounts.
Consultation & Fertility Testing Costs
The average cost of fertility testing ranges from around $2,300 to $4,000. Please note that these costs vary considerably by clinic, state, region, and your insurance plan. These four steps will likely be the first ones you take as you begin your family-building journey:
- Initial consultation with physician: $350 to $500
- Hysterosalpingogram (HSG): $850 to $1,400
- Sonohysterogram (SHG): $850 to $1,400
- Vaginal ultrasound: $250 to $450
Note: If you are using a known sperm donor, you may also incur costs for a semen analysis ($200 to $450), plus additional infectious disease testing and genetic screening.
The Cost of Using Donor Sperm
Your choice of sperm donor will also impact your family-building costs. There are a few main options when it comes to selecting a sperm source:
1. Anonymous or open-door donor sperm from a cryobank
- Cost varies based on chosen donor, cryobank, and number of vials, but you can expect to pay around $1000 to $1,500 per attempt.
- Your fertility specialist and a licensed clinical social worker (LCSW) will help counsel you on your donor choice from a psychological perspective, as well as offer guidance on the number of vials to acquire before you make any donor decisions.
2. Known donor sperm from a friend, acquaintance, or family member
Costs will vary, but it's important to understand that when using a known donor, you may be responsible for some of the donor's screening and genetic testing costs (which would typically be completed by a cryobank before donor sperm is frozen), as well as any psychological screenings and legal costs to ensure parentage is protected.
3. Partner's Sperm
If your partner cryopreserved sperm prior to a hormonal or surgical transition, utilizing their sperm may be an option on your shared family-building journey. Your doctor will help you determine the viability of any cryopreserved sperm to give you the best chance of success.
What's next? Once you understand your donor sperm options, there are three main pathways to biological parenthood for you (and perhaps your partner) to consider.
Treatment Option 1: Intrauterine Insemination (IUI)
IUI is a technique that delivers sperm directly into the uterus. Another term for this treatment pathway is "artificial insemination" or "assisted insemination." IUI allows for optimal sperm delivery to the fallopian tube and helps the sperm and egg interact in closer proximity.
IUI treatments are typically used in conjunction with fertility medications that increase the number of eggs per cycle and trigger ovulation. This treatment method also creates better targets for the sperm and identifies ideal timing for insemination.
How much does IUI treatment cost for moms-to-be?
The estimated out-of-pocket costs for one IUI cycle are anywhere from $800 to $1500.
Remember that costs will vary depending on your chosen clinic and other factors. Medication costs for IUI procedures are separate from the cycle cost, and also vary depending on whether your doctor prescribes you oral or injectable fertility medication.
Out-of-Pocket IUI Medication Costs
- Oral medication: $30 to $150
- Injectable medication: $3,500 to $5,500
Note: Our partner clinic Illume Fertility offers an IUI Opportunity Plan for those paying out-of-pocket, where services are bundled together to save you money. The cost for one IUI cycle is $1,000. Contact us to learn more!
Treatment Option 2: In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is a fertility treatment pathway ideal for situations where only one partner wishes to biologically and genetically participate in the pregnancy, has completed IUI treatment unsuccessfully, or has other fertility challenges that require IVF.
How much does IVF treatment cost?
The average cost of an IVF cycle is around $20,000* when including medications and monitoring (blood work and ultrasounds). Genetic testing can add $1,500 to $3,000.
Here is a more detailed breakdown of the potential costs in an IVF cycle:
- Medications: $3,500 to $5,500
- Blood work & ultrasounds (monitoring): $2,300 to $4,000
- Anesthesia: $650+ (varies based on time units)
- Egg retrieval: $2,000 to $3,400
- Laboratory fees (i.e. egg wash, culture, sperm prep, hatching): $2,000 to $4,000
- Donor sperm (varies based on donor selection): $800 to $1000
- Intracytoplasmic sperm injection (ICSI): $1,500 to $2,500
- Preimplantation genetic testing (PGT): $1,500 to 3,000
- Embryo transfer: $2,550 to $5,000
- Embryo storage: $700 to $1,000 annually
- Consultation (without insurance): $350 to $500
*Costs can vary by clinic, region, state and insurance coverage.
Note: Our partner clinic Illume Fertility offers an IVF Opportunity Plan for those paying out-of-pocket, where services are bundled together to save you money. The cost for this plan is $11,300, reducing the above costs significantly. Contact us to learn more!
Treatment Option 3: Reciprocal IVF (RIVF)
With reciprocal IVF, one partner’s eggs are used to create embryos, and then the other partner carries the pregnancy and delivers the child. This allows both partners to contribute to the family-building process in a unique and beautiful way.
So, how does it work? One partner "donates" their eggs (taking fertility medications to produce multiple eggs and undergoing an egg retrieval). After egg retrieval, those eggs are combined with your chosen donor sperm in the IVF laboratory. The carrying partner then goes on medication to prepare her uterus for an embryo transfer.
How much does reciprocal IVF cost for moms-to-be?
Instead of the costs applying to only one person, the procedures (and associated costs) would be allocated between the two partners, but you will not necessarily incur additional costs for RIVF.
Although this may seem like a more complicated process, when it comes to the cost breakdown, it ends up looking very similar to the cost of a traditional IVF journey. Refer to the IVF pricing estimate above (or ask your Insurance & Billing Advocate) for more information.
We get it! Exploring the many ways to grow your family can feel daunting.
Whether you're still researching your family-building options, ready to get started with fertility testing or treatment, or are simply feeling confused by all these choices and want some guidance, we're here to help you navigate it all.
Reach out to our team today and we'll get back to you within 48 hours to answer your questions!
Tnori Shelton is the Patient Accounts Manager at Illume Fertility. She joined the team back in 2014 and has been working with patients ever since. Tnori works to help patients better understand their insurance benefits and get access to the care they need to grow their families.