More and more companies are adding egg freezing related benefits to attract top talent. My company recently added a $10K fertility benefit to our health package, and after a motivating phone call from a fellow entrepreneur, Alyssa Atkins, who shared her egg securing journey with me, I decided to pursue it.
The motivation quickly dissipated, when I realized I didn’t know how to start the process — there were major information gaps that prevented me from pulling the trigger — Like how much is going to cost? How do I use the $10,000 benefit? Did I have to go to an in-network provider? What was covered by my health insurance plan? How much should I put into FSA? How long does it take to prepare? How much time would I need to take off work?
I almost gave up multiple times after that first conversation with Alyssa, and after many false starts, I am proud to say I have some eggs sitting on ice, giving my future self options.
I’ve started to gather information and answers that I wish I had when I started. In the spirit of making women’s health more open and easier to navigate, I’m hoping the transparency from my journey and the retrieval experience of my peers, can help others who are considering a similar path.
Finding a provider
I started the search where most people would — talking to primary care and learned this is a dead-end for most people. For a majority of corporate fertility benefit programs, one does not need a referral from primary care or your OB/GYN. It often takes months just to get an appointment, only to be told information you could have found on the internet
In-Network vs. Out-of-Network
With a lack of answers from primary care I turned to my insurance provider Aetna, assuming I should be picking someone in-network. I ended up calling a few of the providers and booked consultations after prioritizing based on FertilityIQ ratings, Yelp and Google reviews for the doctors.
I later learned that choosing someone in-network is not necessary for most of the procedures since Aetna does not cover the retrieval process in elective egg freezing, but using someone in-network can help reduce costs for initial appointments including pelvic ultrasounds, fertility examinations and most blood work.
Years of Experience
If you’ve been browsing you’ve seen that there are many up and coming facilities focusing on working females, but I decided to go for a clinic that had experience (10+ years), great reviews and fertility success via FertilityIQ. Although the egg freezing rating was important, I weighted the provider heavier based on their IVF ratings and pregnancy rates, because if I ever needed to use the eggs this was critical.
Location really matters
Location matters in a few ways. You will be visiting this provider daily for two weeks when you start taking fertility drugs, and accessibility is important for many who continue to work during the process. I ended up picking a location that was close to work/home and was able to continue working even with daily appointments.
Your location long-term may also influence your decision. If you do have to use the frozen eggs in the future, is this where you want to pursue IVF treatments?
What are the real costs of the entire process?
Drugs and Drug Costs
The Prescription & Speciality Pharma
The drugs are not only a major cost of egg retrieval, they are the most important part of the process, and if they are off, you could risk the effectiveness of the retrieval. Before I started, the provider warned me drugs are often not covered by insurance and can cost between $4000–$8000 depending on your situation and retrieval plan.
In the US you can’t just go to your local pharmacy. Instead, you will likely be referred to a speciality pharmacy that will ship you drugs day-of or overnight. You have the right to change your pharmacy, and, you can request that your prescription is moved to a pharmacy you are comfortable with. This is important for people that want to shop around for the best price and brand of drug.
The drugs you are prescribed varies per person based on age, weight, height and your fertility situation. The drugs will also vary if they are generics or a brand name.
Your doctor will give you a calendar of what they think you will need based on the dosage you are comfortable with, but it is important to note this plan will likely change depending on how your body reacts in the initial days.
Understanding Your Drug Plan
As mentioned, the doctor will adjust your drug plan as they begin to monitor your egg production with daily pelvic ultrasounds and blood tests. It is important not to run out of any medications at any point, but if you are paying for this medication out of pocket, you could over-order based on the doctors first estimate and it could be costly.
I ended up having 2 extra units in Gonal-F and extra Centroide ($1500 ). These prescriptions cannot be returned or resold. Often patients can split up the prescription until the provider has a better idea of how your body is reacting to the drug plan.
I learned that speciality pharmacies often deliver same day or next day, which can be helpful if you split up your order. Some people would rather have a surplus and not have to worry about ordering more, but always assume your drug plan will adjust as they learn more about how your body is reacting to the stimulation.
Certain drug companies promote a rebate program, but the savings are small compared to how it is advertised. After submitting receipts, I received $270 back.
What is your company benefit actually worth?
When I first heard of the $10,000 benefit from my company, I naively assumed that would cover most of the costs related to egg retrieval. After talking to several women who had used the benefit, this amount is taxed as part of your income and will be in the range of $5000 — $7000, depending on where you reside.
Some companies like Facebook cover all procedure and drug costs, so it is important to ask your employer for details on your program. If your HR department doesn’t have clear info, asking around to other employees who have had the procedure, is often the fastest way to get answers.
10 Things I wish I would have done differently
1. Alyssa’s company has a saying Ignorance is NOT Bliss, and I truly believe many of us, like myself, don’t know as much about our female health as we should. I urge any female to get a pelvic ultrasound and fertility exam earlier in life — whether you want a family or not. Don’t wait until you are ready for egg retrieval to become more aware of your fertility health. Doing a pap test every year is encouraged by most doctors, but we need more insight into our fertility health. In my first assessment, the fertility provider discovered a large cystic tumor on my ovary that required surgery!
2. Start with your own online research and more importantly start talking to others that live in your area who have had either the IVF or egg retrieval process. This will help reduce research time needed and will help you feel more confident in your choice of provider.
3. Although the procedures for egg retrieval are the exact same as a female undergoing IVF, the costs and coverage are drastically different. IVF is covered under some insurance plans, including the fertility drugs! This coverage is not provided to those pursing elective egg retrieval, so if you hear of an IVF patient receiving Gonal-F drug at a low co-pay, you will waste your time trying to get that rate.
4. Elective egg freezing and storage is considered elective 😱 in FSA and HSA programs and an ineligible expense. To be an eligible FSA expense, a Letter of Medical Necessity (LOMN) from your provider is necessary (e.g. Damage of Ovary due to a complex cyst or tumor, Certain Cancers and Cancer treatments effecting fertility).
5. Split my drug order into two for the more expensive drugs to see how my body reacts so I don’t over-order. After just 3 days the doctor saw my body was reacting differently than expected and I stopped Gonal-F shots completely.
6. Check out costs of the prescription at different speciality pharmacies. Don’t assume you have to order at the location that your provider sent your prescription to! You have the right to move your order.
7. Remove implanted birth control earlier, so you can have a few months for your body to adjust. This isn’t proven and in fact, some providers will let you keep it in during the retrieval, but do what you feel will give you the best results.
8. Take time off while taking the drugs. These drugs are intense, and I wish I was kinder to myself by taking some time off prior to the procedure. Even a day or two will put you in a better headspace for surgery day.
9. Take time off after the procedure… I had the procedure on Friday and was back to work on Monday, not realizing that my body still had a lot of recovering to do.
10. Talk about it to your friends and co-workers. At first, I didn’t want my male dominated team to judge me, but I ultimately had more power when I talked about it, and people had a greater understanding of what I was going through.