How much does IVF cost in Russia and what does the cost of the procedure depend on?

Men and women who are recommended by IVF as their last chance to become parents are interested in two questions - how effective is the technique and how much does it cost. In this material, we will describe what the cost of the in vitro fertilization procedure is and what the prices for it are in Russia in 2018 on average.

Artificial insemination does not belong to the category of cheap medical care. IVF, as one of the types of artificial insemination, belongs to the category of high-tech types of medical care, and therefore its cost is quite high.

In vitro fertilization involves the fertilization of the female egg outside the woman's body. In practice, it looks like this: first, a woman is prepared with hormonal preparations for superovulation (not just one follicle matures in the ovaries, but several), then the ripened follicles are punctured and the mature eggs are taken. They are fertilized in the embryology laboratory with sperm, for several days they observe the development of embryos, and then the specified number of embryos is transferred into the uterine cavity of the patient. If the embryos are implanted, the protocol will be considered successful.

The success rate of IVF, alas, is not one hundred percent. The share of successful protocols, according to statistics, is 35-40% depending on many factors - the patient's health, her age, the tactics of the procedure chosen by the doctor.

It is accepted to pay each of the stages of IVF, making payment for the upcoming stage. If the procedure is interrupted for some reason by the decision of the doctor (there are contraindications, dangerous complications), only those funds that have been paid for the stage that has not yet been completed will be returned. In case of unsuccessful IVF, as a result of which the pregnancy did not take place, the funds paid by the spouses will not be returned, but the follow-up protocol, according to the practice in Russian clinics, will cost somewhat less than the first.

The cost of an in vitro fertilization attempt consists of the cost of each stage:

• testing before the procedure;
• training, stimulation of the female genital glands by hormones;
• puncture of mature follicles and collection of oocytes;
• fertilization itself and the subsequent cultivation of the embryo;
• replanting embryos in the patient's uterus;
• observation of the woman during the first weeks after the transfer and determination of pregnancy (or its absence).

At the stage of ovarian stimulation, hormonal drugs are used, the cost of which makes up the lion's share of the cost of the stage. It depends on what kind of drug will be chosen by the attending physician, but the price of even the most "budget" drugs exceeds 30 thousand rubles, and on average is about 60 thousand. In addition, at this stage, the woman makes several ultrasounds to track the ovarian response to hormonal effects, as well as to assess the degree of maturation of the follicles in order to select the right time for puncture.

At the puncture stage, anesthesia is paid (done under general anesthesia), as well as the procedure of puncture and aspiration of oocytes.

At the stage of fertilization, expenses can unexpectedly increase.If a patient has poor-quality oocytes, which cannot be fertilized, or there is a high risk of having a child with genetic abnormalities, donor biomaterial may be required. Egg donation in our country exists not so long ago, but in cryobanks - special vaults, there is a fairly large supply of oocytes. It is necessary to pay for donor eggs in excess of a certain protocol cost - the cost of the procedure can double, if not triple.

If the husband has a bad spermogram, IVF with ICSI (intracytoplasmic sperm injection) is often recommended. In this procedure, the sperm is placed by microtool directly into the cytoplasmic fluid of the egg. With the usual IVF, the female gonads are simply in the same laboratory bowl with the purified sperm. With ICSI, the doctors “help” one, the most healthy sperm, to go right to the right place. ICSI can increase the cost of the protocol by 25-40 thousand rubles.

Donor sperm may be required in the absence of sperm or at least one healthy full-fledged sperm in it. Donor sperm are also used during IVF for single women who want to give birth and raise a child on their own, without a husband. For donor sperm will have to pay up to 40 thousand rubles.

In some cases, pre-implantation diagnosis is recommended. Before transfer, an embryologist examines the characteristics of the embryos and excludes those that are not healthy. Such a diagnosis is necessary if partners have genetic abnormalities or they have occurred with close relatives of a man and a woman. Depending on the amount of information studied on the recommendation of genetics, pre-implantation diagnostics can increase the cost of an IVF protocol by 40-220 thousand rubles.

The transfer of cultured embryos to the uterine cavity is usually included in the total cost of the program. If “extra” eggs suitable for conception remain or unused embryos remain, the pair is offered to freeze them so that they can conceive a child later or replant the already prepared embryos in the next protocol if the first protocol fails.

Freezing embryos will cost about 20-25 thousand rubles, and about 1,5 thousand rubles will have to be paid in addition to saving them in a cryobank every month. Separate storage will cost more - from 4 thousand rubles per month. Cryoconservation of oocytes will cost 15-20 thousand, with subsequent payment for storage of biomaterial in the amount of about 1000 rubles per month.

The services of a surrogate mother, if a woman does not have the opportunity to bear the fetus due to age or anatomical and physiological problems, will increase the couple’s expenses for conceiving and carrying a baby by about 1-3 million rubles.

At the stage of waiting for a result, a woman will have to pay only for a blood test for hCG for 14 days after transfer (about 600 rubles) and two ultrasounds (for 21 and 28 days after transfer) - 1.5-2 thousand rubles for one ultrasound examination.

The price of IVF is quite unstable and can change every year, it is quite problematic to calculate the uniform average statistical boundaries in this connection. First of all, it is influenced by the region where it is planned to conduct a course of treatment - prices may differ quite significantly in different subjects. As of 2018, the average cost of one in vitro fertilization attempt in a standard protocol is 140-180 thousand rubles.

We’ll make a reservation right away that by the standard protocol we mean hormone stimulation of ovulation, follicle puncture, fertilization and embryo cultivation for 2-5 days, transfer. Further, we will talk about standard protocols, without the use of donor biomaterial, without ICSI, without pre-implantation diagnosis.

The most expensive ECO protocols, according to statistics, in Moscow and St. Petersburg.There the cost varies from 180 to 270 thousand rubles. However, it should be noted that abroad similar treatment of infertility is more expensive, for example, in Israel - by about 35%, and in Spain - almost 2 times.

In Barnaul, the cost of IVF is lower - from 140 to 180 thousand rubles. Almost the same prices are kept in most small cities of Siberia and the Volga region. In larger cities, the prices are slightly higher, but less than in the capital, for example, in Volgograd in 2018, the IVF protocol averages from 150 to 200 thousand rubles. The same price level holds in Voronezh, Yekaterinburg. Slightly more expensive than IVF in Kazan - on average, the price of the protocol varies from 160 to 210 thousand rubles. In Krasnodar, Rostov, Irkutsk and Novosibirsk, prices start at 145 thousand and can reach 240 thousand.

Depending on the type of protocol, prices may fluctuate up or down. If embryo replanting is carried out without prior medicinal stimulation, that is, doctors received one egg cell that has matured naturally, then the cost will be significantly lower - within 90-110 thousand rubles in the national average. The lowest prices for IVF in the natural cycle are registered in Ufa - from 87 thousand rubles. The effectiveness of such punctures is very low - the percentage of successful ones does not exceed 11-15%.

A short protocol in which stimulation will be short-lived (in the menstrual cycle that has come in its first phase) will be less expensive financially, since much less expensive hormone preparations will be required. The natural protocol of IVF this year on average in the country costs from 149 thousand rubles.

Much more expensive goes a long protocol IVF. When it stimulates the growth of follicles in the ovaries by hormonal agents begins in advance, 2-3 weeks before the start of the next menstrual cycle according to calendar calculations. The cost of such a course is 170-235 thousand rubles.

Accordingly, donor eggs, sperm or embryos will increase the cost of a particular service (the difference is indicated above).

Since 2012, the state has been supporting infertile couples, highlighting quotas for IVF. They can be both regional, which are paid from the budget of the region, or federal, paid from the state treasury. Any couple in need of IVF and having the appropriate conclusion of a doctor and a complete package of diagnostic studies and analyzes can receive a quota.

Also, single people and couples who live in a civil marriage can count on support. Age limits have been lifted, and there are no limits on the number of attempts that can be made at the expense of the state. The difficulty lies in the fact that the procedure for obtaining quotas is quite long and complicated. First, the couple will have to prove to the special commission of the Ministry of Health of the region that they can become participants in the IVF program, providing a lot of references. If such permission is received, the pair will be included in the register of infertile couples. This will provide an opportunity to make the procedure under the policy OMS.

As you can see, completely free procedure, most likely, will not work. Quota funds will be used to pay off the cost of individual stages, patients can choose which ones should be financed from the budget, and which ones from personal money.

It should be immediately noted that a number of procedures as part of the IVF protocol are not included in the list of OMS. But the regulatory framework is constantly undergoing changes, and you need to check with the latest decrees and orders of the Ministry of Health.Thus, the cryopreservation of oocytes and embryos has not previously been paid for by the compulsory medical insurance, and now it is included in the list of permissible associated medical services.

But donor eggs and sperm, as well as embryos are not included in the list of compulsory medical insurance, they will have to be paid for using their own funds. A complete list of IVF stages that can be paid for by means of federal or regional quotas can be obtained by reading the Order of the Ministry of Health of August 30, 2012.

According to this document, quota funds can be used to redeem the cost of ovarian stimulation, including the cost of expensive medications that are used for this, follicle puncture, fertilization in the laboratory, ICSI (if needed), embryo cultivation, cryopreservation, embryo transfer to a woman’s uterine cavity .

Subsequent diagnosis of pregnancy is already paid by patients at their own expense. Preparations for the next protocol, including physical therapy and hormonal drugs, also cannot be paid for by OMS.

Also, own funds will have to pay for the storage of frozen embryos, eggs, sperm. If a man cannot, for a number of reasons, get an ejaculate by masturbation, he will have to go through a testicular biopsy so that doctors can get germ cells for fertilization of female gametes. This surgical manipulation will have to pay at their own expense.

Also, using quota means, one cannot pay for a genetic assessment of the quality of the embryos obtained, the determination of their gender, which may be necessary if future parents have chromosomal pathologies linked to sex chromosomes and it is important that a child of a certain sex be born - only this guarantees his health.

Yes, recently there really appeared programs that are called “IVF with a guarantee”. The essence of the program with the guarantee is that for a fixed cost in excess of the cost of a single protocol, patients receive several IVF attempts. For example, in Moscow, the cost of IVF with a guarantee - 450-600 thousand rubles, and in St. Petersburg - 300-500 thousand rubles.

However, pregnancy can occur at the first attempt, and in the second. And in this case, the refund will not. The program’s meaning lies in the fact that you can buy one successful attempt for half a million rubles, and you can buy three or four for the same amount, which is beneficial in principle, since each individual attempt in the case of 3-4 protocols will be more expensive, and the total amount spent will exceed half a million rubles.

IVF with a guarantee - a program that is convenient for families experiencing cash constraints, as well as having serious pathologies and disorders of the reproductive system. No program in the world gives guarantees of successful conception. Therefore, having met the name of such a service, it is not necessary to be under a delusion and to believe that for a certain amount the doctors will give you guarantees that you will definitely become parents. Guarantee only a refund if success is not.

Most clinics that work with such a program offer three IVF attempts for the amount paid in advance. Deduction of funds for drugs may not be made, and then patients will get back the full amount paid by them (this question must be clarified directly in the clinic). The program is usually designed for two years (taking into account the periods of “rest” and restoration between the protocols).

Another significant plus is if the program is completed ahead of schedule at the request of the doctor (complications developed, no ovarian response to stimulation, inability to receive oocytes, etc.), then patients are reimbursed for the entire cost of the program paid by them without deductions and fees.

Women who have gone through several ECO protocols know how important it is from the very beginning to have a good idea of ​​how and what a pair can save on, because the costs will be high.

Not bad programs have proven financial risk insurance. In this case, the insurance company reimburses part of the funds in case of failure. In particular, Nova Klinik and a number of some other capital medical institutions work with such a program.

The choice of the clinic is half the success. There are quite budget options, for example, the Mother and Child clinic network, which has offices in most Russian regions. However, IVF under the OMS policy often deprives patients of the opportunity to make free choices, because they have a list of clinics that work with OMS, and there is no possibility to choose another one that is not included in this list.

Analyzes and surveys, which must be taken in preparation for IVF, usually cost a fairly “round” amount - about 20-30 thousand rubles. These costs can be significantly reduced if you go through some research in the clinic in the place of residence with the OMS policy. Thus, general blood and urine tests, blood tests for HIV status and syphilis, sexually transmitted infection tests, fluorography, pelvic ultrasound (woman), a urethral smear (a man) can be done completely free of charge. True, it will require more free time, because the queues at the clinics in the morning, when all the main tests are done, have not been canceled.

You can save money on the donor, if necessary. So, one of the relatives or close friends can become a surrogate mother, who voluntarily and almost disinterestedly agree to help the childless couple, and the donor of the egg can be not the anonymous woman, but the sister or girlfriend. In this case, you will have to pay the amount for which you agree among themselves. Most likely, it will be significantly less than the rates of cryobanks in clinics.

Many couples from among those whose incomes do not exceed the average, try to arrange the amount necessary for the protocol on credit - it is easier to pay in parts.

On thematic forums there are “branches” in which women themselves help each other save on IVF. So, those whose protocol was completed with success can give away the remaining expensive medicines to others completely free of charge.

However, sometimes some clinics do not take tests done elsewhere and do not allow the patient to use the drugs that she will acquire herself. In this situation, you need to understand, and do you need such a clinic. IVF services offers many clinics, there is a choice.

Significantly save on IVF can, if you go to do it in Belarus or Kazakhstan. There, the cost is slightly lower than the Russian.

For how IVF is done, see the next video.