Interesting article from NY Times on one type of infertility treatment package offered by some clinics.

Patients pay a set amount (in the article it was $50,000) and if at the end of several cycles of IVF they are not pregnant, they get a full refund to pursue other family building options. If they are successful, even if on the first cycle, they get no partial refund. This type of infertility treatment payment package is often called a shared-risk package.

The article was critical of this payment package, calling it “infertility casino” with the “house” (read: fertility clinics) as the usual winner. They point out that the money-back packages are only available for patients that have the highest odds of success with IVF.

Here’s how the house can stack the deck: by admitting only people who have a better-than-even chance of bearing a child early in the process. Those people, however, may not need to pay extra for such a plan, given that their clinics picked them precisely because they were such good bets.

Many doctors and infertility clinics offer shared-risk packages, but some are critical because they view it as unnecessary for most of the patients who are eligible for these packages because they are likely to get pregnant for less money if they do not pay for the shared-risk package.

“What you really have here is a patient self-insurance group,” says Dr. Alan S. Berkeley, who is concerned about the language of these shared-risk packages. “They band together, and the ones that get pregnant quickly overpay significantly to insure the ones who don’t, the people who wind up getting refunds.”

Patients, at least those interviewed for the article, are less critical:

Ms. Burke, the Pittsburgh mother, sized up the large sum of money for a refund program and, together with her husband, considered it this way: If they couldn’t have a child after several attempts, they would get their money back and use it for adoption, or — if they ultimately decided not to have children — for travel. If they needed a few tries at I.V.F. to have a baby, they would have spent less on the refund plan than they would have on à la carte purchases.

And if they got pregnant on the first cycle? Well, that’s what happened.

“You get used to failure after failure, so we were thinking that we were never going to get anything other than what we were already used to,” Ms. Burke said. “We’d dealt with so much heartbreak, and I’ve never been happier to make a bet and be proven wrong.”

Photo Credit: Gabriella Demczuk for The New York Times