Bringing Home Baby--or a 90% Refund : After Newsweek Criticizes Infertility Clinics, One Center Counters With a Money-Back Offer for Some Patients Who Fail to Get Pregnant

In response to negative publicity about the success rates of in vitro fertilization, a local infertility clinic is offering a 90% refund of medical service fees to selected patients who don’t get pregnant after undergoing IVF.

The Pacific Fertility Center, which has offices in Glendale, Torrance, Westlake Village, San Francisco and Sacramento, announced its Pregnancy Partnership Plan last week on the heels of a Newsweek magazine report criticizing the operators of infertility clinics nationwide for charging exorbitant prices for experimental procedures that, the magazine charged, are a “crapshoot” based on “a little bit of science, a lot of art and a great deal of luck.”

According to the American Society of Reproductive Medicine, more than 30,000 women undergo IVF each year, at costs of $7,800 and up.

Under the Pacific Fertility clinic’s program, women who meet certain criteria--such as being under age 40 and possessing a healthy uterus and healthy eggs--receive refunds if they don’t achieve a pregnancy beyond 12 weeks’ gestation. (The miscarriage rate is higher among women who become pregnant through IVF.)

Women who use donor eggs can also qualify for the program, although only the medical costs are subject to reimbursement, according to Mary Windishar Nickell, a spokeswoman for PFC.

Costs for medications, which can run in the thousands, are not refunded. And, for women who use donor eggs, fees paid to the donor, the donor agency and for the donor’s medical care are not subject to refund. But treatments for males who are infertile could be refunded if their partners don’t become pregnant.

“It’s a whole new approach to this,” Nickell says. “For once, people don’t quite feel like they’ve gone to Las Vegas and gone gambling. They’ll lose a lot less money if they don’t get pregnant.”

But the offer to patients was also made due to the negative cast of the Newsweek article, says Dr. Mark Feinman, medical director of the Pacific Fertility Center in Westlake.

“I had heard that in China, you didn’t pay your doctor until you got better. That thought has haunted me for a long time,” says Feinman. “And we had mulled this program over for some time.”

The Newsweek article “painted a rather dim picture of IVF. And since we’ve done everything we can to prove we are better than that . . . we thought the ultimate symbol of our sincerity was to put our money where our mouth is.”

The Sept. 4 Newsweek article pointed out that after 20 years of research, only one in four couples who undergoes assisted reproductive technologies actually takes home a baby.

But, says Feinman: If the Newsweek article is correct that far too few IVF patients give birth due to the technology, “we’ll be out of business in six months.”

The program, indeed, will run on a trial basis until the end of the year. But Feinman says he is confident that many patients could get pregnant at the Pacific Fertility centers. In the last year in which statistics were audited, he says, women under age 35 had a 40% chance of taking home a baby after one IVF cycle while women under age 40 had a 26% chance.

Nationwide, the average success rate for women of all ages is 18.6% after one IVF cycle.

“We’re saying you have an excellent chance of getting pregnant, and we’ll take that risk,” Feinman says.

The program is only available to women whose insurance doesn’t cover IVF. But he says, “We’re also throwing down a challenge to insurance companies by saying if we’ll take this risk, why won’t you cover it?”

Insurance coverage for infertility treatment varies widely, but a great many couples have no coverage, says Barbara Michaelsen of the national office of Resolve, which helps people deal with infertility and their options for parenthood.

Thus, the PFC program may inspire intense interest, Michaelsen says. But she cautioned prospective patients to continue to shop selectively for the best financial plan. She called PFC’s charges of $12,500 for one cycle of IVF (for women under 35) excessive.

“That is really high. In most places, it would be about $6,000 without the cost of drugs.”

Moreover, she questions whether the clinic will be highly selective about which patients they consider “healthy” enough to qualify for the refund program.

“They can’t afford to do this with people who don’t have a good chance of getting pregnant,” Michaelsen says.

But Feinman says that physicians need to become more precise in evaluating a couple’s chances for pregnancy before they--or the doctors--throw money away.

Recent improvements in technology have made it possible for doctors to better ascertain who has a good chance of getting pregnant, he says.

“Couples should have some boundaries,” he says. “Those with poor prognoses shouldn’t go on and on.”

The Pacific Fertility Center refund program may be the boldest, but it isn’t the first. Two weeks ago, a Minneapolis clinic began a reimbursement program that a representative says has already attracted patients from outside the state.

In that program, couples pay $16,000 for three IVF cycles. If they don’t become pregnant by the final cycle, they are reimbursed $14,000. Women have to be under age 35 and meet certain qualifications.

“A lot of couples go through IVF with unsuccessful results,” says Valerie White of Reproductive Health Assns. “There is not only the emotional stress of not having a baby but the financial hardship. With this program, you do have a chance for a baby. But if you don’t succeed, the chance for a baby through adoption is still open because you haven’t been financially wiped out.”

To be sure, couples who undergo advanced reproductive technologies often say the pain of failing to become pregnant is compounded by financial ruin. They routinely take out loans, re-mortgage property and exhaust savings accounts in a futile quest for a baby.

“It’s devastating when you put out a lot of money and don’t get a child,” Michaelsen says. “At least with adoption, you have a 98% chance of success.”

Ann, a 47-year-old Bay Area woman who asked not to be identified, spent about $60,000 in a five-year quest to become pregnant.

“It’s very emotional; you make these decisions from your heart and not your head. You sign papers and you tell yourself it’s going to work,” she says.

While the 90% refund sounds great, Ann says most infertility patients learn quickly that total costs--and fees that may not be subject to the refund--often cannot be determined.

“You go into it thinking it will cost $15,000 and it ends up costing $35,000. It’s amazing. How do you come up with the money? It’s hard. You wipe out your savings account quickly,” says Ann, who became pregnant at a PFC clinic and is due to deliver twins in January.

“Anybody who is going to participate in any program should ask as many questions as possible so they understand what it’s going to cost. The emotions will overwhelm you. And if you know what you face financially, you can deal with it better.”