Clinician to Clinician: Shared donor IVF

In vitro fertilization (IVF) ignited a revolution in infertility treatment. At first, it was used for tubal factor infertility. Soon its application expanded to other female disease states and eventually to cases of male-factor infertility.

But few couples actually have coverage for IVF since insurance companies are reticent to reimburse for it. Many couples abandon this reproductive technology or consider adoption when they hear that one IVF cycle can cost $10,000 to $25,000. Many couples also face a need for donor eggs because the woman has premature ovarian failure, is of advanced reproductive age, or has a genetic problem that precludes use of her own eggs. As it may be with IVF, the cost of a donor is not covered by insurance and may be prohibitively expensive.

To help reduce the cost of IVF and give couples who need donors more selection, we have devised a "shared donor" program. Women who need IVF but cannot afford it and have no factors that would reduce egg quality or response to stimulation share some of their eggs with couples who need them. The cost of their IVF cycle is offset by the reimbursement from the recipient. The recipient couple, in turn, avoids the screening and preparation costs for the egg donor. They pay for the donor's retrieval, fertilization, transfer, and medications and split the egg harvest. Some costs are not shared, but those are relatively minor. Thus a couple that needs "normal" eggs has a better chance to get them while the egg donor has a chance at IVF; both at potentially lower cost.

CLINICIAN to CLINICIAN offers the hard-won wisdom and expertise of physicians "in the trenches." We’re looking for unusual case reports, anecdotes about innovative treatments, and practical solutions for professional problems from community physicians. Send your submission of 750 words or less to Editor in Chief Charles J. Lockwood, MD, by e-mail:Dr.Lockwood@advanstar.com
fax (973-847-5340) or mail (5 Paragon Drive, Montvale, NJ 07645). All submissions are subject to peer review by the Contemporary OB/GYN Editorial Board. Nevertheless, the concepts discussed may be anecdotal in nature.