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Infertility is widespread but many Utah couples can't afford help

Published March 1, 2014 7:26 pm

Health care • Utah couples sometimes go deep into debt to pay for treatments that are rarely covered by insurance.
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Amy and Jordan Labrum celebrated their youngest daughter Lilly's fourth birthday Tuesday. But the couple are still paying off the cost of conceiving her.

The Sandy couple spent $8,000 in 2008 on infertility treatments to be able to conceive a baby. Marissa and Matt King, of Orem, spent $20,000. Tiffany and Jon Alleman, of Sandy, spent $25,000. While the cost of infertility treatments is comparable to other medical-care costs, most insurance providers don't cover it, and the only way to pay is out of pocket.

That's why Amy Labrum and her husband paid for their infertility treatments with credit cards and she started selling crafts on Etsy, babysitting and cleaning to help cover their expenses. After hormone shots, ultrasounds and artificial insemination procedures — none of which were covered by insurance — the cost started to add up.

Since their last daughter was born, they have had five unsuccessful infertility treatments and their next option is to try in vitro fertilization (IVF), one of the most successful but also most costly fertility procedures. The cost is upward of $13,000, and with her husband's commission-based job, Labrum says they can't afford it.

"We're trying to grasp whether we're done having kids or not. I've always wanted five kids but because of the cost, I am learning that I may not," she said. "We heard the total price for IVF and my heart sank. What do you do? Sell your cars? What am I going to live without to have that blessing?"

Infertility is a diagnosed disease and affects 15 percent of the population. One in seven couples has difficulty conceiving or carrying a pregnancy to full term. Although treatment for infertility is widely available with improving success rates, few can afford it.

High cost • Russell Foulk, an infertility doctor at Utah Fertility Center, said without question, cost is the largest obstacle for people who want to receive treatment. While no more expensive — and in some cases less — than other medical procedures, infertility treatments are rarely covered by insurance, Foulk said. So the financial burden is left solely to the patients.

The average cost of treating infertility ranges from $7,000 to $15,000, but many cases can be treated for as little as $2,000, Foulk said.Still, many couples "stay suffering in silence because they're afraid of the cost of having a baby."

A bill currently before the Utah Legislature would allow insurance companies — but not require them — to offer coverage of infertility treatment for married couples. The proposal, HB347, sponsored by Rep. LaVar Christensen, would also allow couples to reallocate coverage mandated for adoption and use it instead for infertility treatment.

Tiffany Alleman, the bill's primary advocate, said the bill is a huge step for Utah and will give hope to the many couples facing infertility. All three of her children were results of successful infertility treatments, each with two miscarriages between. "When I was going through this, I didn't tell anyone. It's a hard thing to talk about. The diagnosis of infertility is just as devastating as cancer."

Kelly Atkinson, director of Utah Health Insurance Association, said he wants people to understand that the impact of the bill would be small. While it would allow insurance providers to offer infertility coverage, it's not likely they will, he said. Those who choose to offer coverage likely would boost premiums to the point they may be pricier than the treatments themselves.

Before the details of the Affordable Care Act were revealed, many hoped the health-care law would cover infertility. But because states get to decide the specifics of what is mandated in their Essential Health Benefits plan, Obamacare does little to impact the cost of infertility treatments. Utah's chosen benefit plan does not require coverage of infertility treatments.

If this bill were passed, however, Christensen, R-Draper, says the law is a "little nudge" that would make a "positive contribution" to the state.

Passed the House • Originally HB347 would have limited the infertility coverage to married couples, but that provision was removed Friday before the bill passed the House floor. The amended version also removed a provision restricting eligibility to women between the ages of 21 to 44. Several of the existing laws in other states also specify that recipients of infertility coverage be married. Maryland, a state with one of the oldest and more expansive infertility coverage mandates, still requires that a patient's eggs be fertilized with her spouse's sperm. Similar provisions are in Hawaii's and Connecticut's statutes.

Barbara Collura, president of Resolve National Infertility Association, said getting the legislation passed is an important start. Resolve is a nonprofit organization helping people with infertility and it has been involved in all 15 state laws similar to that proposed in the Utah bill. Of the 15 states with infertility treatment laws, the level of coverage varies. Eleven states mandate infertility coverage while some states only prohibit excluding it.

Many fertility centers have financing options and Foulk said 15 percent of his patients are covered by their insurance through their employers. Foulk said companies like Adobe, Fidelity Investments, Microsoft and Harley-Davidson cover the cost of infertility insurance for their employees. But as for other companies, "getting pregnant causes women to leave the workforce, and employers have figured that out," Foulk said. The cost of covering infertility treatment, he said, is not simply the medical expense but the cost of replacing employees during maternity leave.

Collura says HB347 is unique because it would allow couples to take the $4,000 currently mandated for adoption coverage and use it for infertility instead. Although the permissive law isn't her ideal, she said it's a "realistic assessment of what can be done in Utah looking at existing code."

Other options for couples with infertility exist, like fundraising and being sponsored. Resolve compiles a list of nonprofits that support or help sponsor infertility treatments.

Marissa and Matt King were able to raise about $15,000 to pay for the cost of their treatments through online donations and a 5K race. Before the fundraising, they maxed out their credit cards, cut every cost in their budget and took out loans.

They say the hardest part about saving up for IVF is there is no guarantee it will be successful. After four years of treatments and $20,000, the Kings' first IVF cycle was successful. But only one month after learning they had conceived for the first time, the fetus miscarried.

Both the Labrums and Kings say any infertility coverage is a win for couples with the disease. But for now, both couples say they are taking a break from treatment because of the financial, physical and emotional exhaustion of the process.


Twitter: @amymcdonald89