The financial aspect of LGBTQ+ family building is often the most overwhelming part of the entire process. In this guide, you'll learn how much it really costs for same-sex female couples to have a baby, how to navigate insurance coverage (if you have it), and ways to afford care.
In this article:
- The Price of LGBTQ+ Family Building
- Understanding Your Fertility Coverage
- Questions to Ask An Insurance Provider
- Insurance Codes for IUI & IVF
- What impacts the cost of treatment?
- Family-Building Costs for Moms-to-Be
- Consultation & Fertility Testing Costs
- The Cost of Using Donor Sperm
- How much does intrauterine insemination (IUI) cost?
- How much does in vitro fertilization (IVF) cost?
- How much does reciprocal IVF (RIVF) cost?
- Feeling overwhelmed?
Editor's Note: Throughout this article, we may use "women" or "female couples" to refer to those assigned female at birth. We acknowledge that not all people born biologically female identify as such, so if you are AFAB and non-binary, trans, or queer, please know that we are simply using these terms in a medical context.
As a hopeful mom-to-be, you've likely already put many hours of research into exploring your options. You may have asked friends or family for advice, searched the internet for resources that point you in the right direction, or even begun your journey as a patient at a fertility clinic.
You likely know what your goals are and have a sense of how you'd like to achieve them if you're pursuing biological family building (i.e. IUI, IVF, or reciprocal IVF). Achieving those goals begins with understanding potential treatment costs so you can plan, budget, and start your family-building journey feeling confident you know what lies ahead.
For LGBTQ+ moms-to-be, calculating fertility treatment costs begins with understanding whether or not you have any fertility coverage through your insurance plan (if applicable). Here's a quick breakdown of how to determine what insurance coverage you have, as well as what to do if you don't have insurance.
When it comes to your fertility coverage, the best first step is to reach out to your insurance provider (and/or your HR department at work) to determine what options are available to you, if you have opted into an insurance plan.
Your fertility insurance coverage depends on a variety of factors, including your employer, the plan that your company offers, and even the location in which you live and work. Many insurance companies still only cover fertility treatment based on the archaic traditional diagnosis of infertility.
This narrow interpretation excludes many hopeful parents within the LGBTQ+ community who need medical assistance to grow their families. This is one of many reasons we continue to advocate for more inclusive coverage for all patients.
The American Society for Reproductive Medicine announced a more inclusive definition of infertility in 2023, which advocates hope will be reflected in insurance policies soon.
We want to acknowledge that this is both unfair and discriminatory, as ALL individuals should have access to the care they need to grow their families.
If you find yourself pigeonholed by this frustrating definition, we encourage you to reach out to your employer to urge them to offer family-building benefits to all employees. Not sure what to say? The resources below offer some helpful places to start:
We recognize that financing self-pay fertility treatment options can be challenging. To ensure our patients can access high-quality care at more affordable prices, Illume Fertility offers a variety of plans that bundle services for those who do not have insurance coverage.
These self-pay plans cover services like IUI, IVF, PGT, embryo transfer, egg freezing, surrogacy, and fertility testing. To learn more, reach out to our team today.
We encourage you to check out our grant guide for further financial support, as well as resources from organizations like Family Equality, who also offer extensive guides. In addition, companies like Progyny offer expanded fertility coverage if your primary policy isn't cutting it.
While open enrollment is a critical time to plan for fertility treatment in the next year, you can get started with exploring your financial options at any time. Remember, if you're feeling overwhelmed, our team is here to guide you!
After you speak with your insurance provider or HR representative to determine whether or not your plan includes fertility coverage, a great next step would be to follow-up with your insurance provider to figure out exactly what you have coverage for. Insurance policies can be full of confusing language and require clarification.
Below, we’ve provided a list of basic questions to ask your insurance provider and/or HR department that will help you dig deeper to find out what's covered. Even when treatment itself is not covered, diagnostic tests often are, so it’s important to ask these questions:
Additionally, you can ask your insurance provider to check specific procedure codes for IUI and IVF. Some insurance carriers offer the ability to confirm coverage through their websites.
The following IUI and IVF codes are the most commonly used for patients at Illume Fertility:
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After you’ve determined your insurance coverage, you will meet with a board-certified reproductive endocrinologist to discuss your options and next steps. If at all possible, choose a fertility practice that is welcoming of the LGBTQ+ community and offers special resources for queer parents-to-be, as this can make a big difference on your journey.
At your first consultation with a fertility specialist, you will discuss your goals and preferences and begin creating your family-building plan. This plan will be personalized to you (and your partner, if applicable), based on a number of factors, including:
Note: In Dr. Cynthia Murdock’s experience, many couples who come in for a consultation have already discussed this before even beginning treatment!
No matter what shape your family-building journey takes, your fertility clinic should work alongside you to help you understand your options for affording treatment. Below, we break down cost estimates for four common pathways to family-building for LGBTQ+ moms-to-be.
Family-Building Costs for Moms-to-Be
As you explore the following pathways to parenthood, remember that there are many different factors that can impact the total amount you'll pay. We'll walk through each treatment option, providing estimated costs for each one.
Before we discuss treatment methods, let's talk about consultation fees, fertility testing, and selecting a sperm source.
Reminder: The following price ranges only applicable to those without insurance coverage who are paying out-of-pocket. Reduced pricing may be available if your fertility clinic offers financial packages, which bundle services together to give you additional discounts.
The average cost of fertility testing ranges from around $2,300 to $4,000. Please note that these costs vary considerably by clinic, state, region, and your insurance plan. Testing costs may be covered by your insurance plan.
These steps will likely be the first ones you take as you begin your journey:
Note: If you are using a known sperm donor, you may also incur costs for a semen analysis ($200 to $450), plus additional infectious disease testing and genetic screening.
Your choice of sperm donor will also impact your family-building costs. There are a few main options when it comes to selecting a sperm source:
This person may be a friend, acquaintance, or family member. If the donor is a relative, they should not be linked to the genetic intended parent.
Costs will vary, but it's important to understand that when using a directed donor, you may be responsible for some of the donor's screening and genetic testing costs (which would typically be completed by a cryobank before donor sperm is frozen), as well as any psychological screenings and legal costs to ensure parentage is protected.
If your partner cryopreserved sperm prior to a hormonal or surgical transition, utilizing their sperm may be an option on your shared family-building journey. Your doctor will help you determine the viability of any cryopreserved sperm to give you the best chance of success.
What's next? Once you understand your donor sperm options, there are three main pathways to biological parenthood for you (and perhaps your partner) to consider.
IUI is a technique that delivers sperm directly into the uterus. Other terms for this treatment pathway are "artificial insemination" or "assisted insemination." IUI allows for optimal sperm delivery to the fallopian tube and helps the sperm and egg interact in closer proximity.
IUI treatments are typically used in conjunction with fertility medications that increase the number of eggs per cycle and trigger ovulation. This treatment method also creates better targets for the sperm and identifies ideal timing for insemination.
The out-of-pocket cost for one IUI cycle ranges anywhere from $800 to $1500. Remember that this can vary greatly depending on your chosen fertility clinic and other factors.
Medication costs for IUI procedures are separate from the cycle cost, and also vary depending on whether your doctor prescribes you oral or injectable fertility medication.
In vitro fertilization (IVF) is a fertility treatment pathway ideal for situations where only one partner wishes to biologically and genetically participate in the pregnancy, has completed IUI treatment unsuccessfully, or has other fertility challenges that require IVF.
The average cost of an IVF cycle is around $20,000* when including medications and monitoring (blood work and ultrasounds). Preimplantation genetic testing for your embryos can add $1,500 to $3,000.
Here is a more detailed breakdown of the potential costs in an IVF cycle:
*Costs vary based on clinic, region, state laws, and insurance coverage.
With reciprocal IVF, one partner’s eggs are used to create embryos, and then the other partner carries the pregnancy and delivers the child. This allows both partners to contribute to the family-building process in a unique and beautiful way.
So, how does it work? One partner "donates" their eggs (taking fertility medications to produce multiple eggs and undergoing an egg retrieval). After egg retrieval, those eggs are combined with your chosen donor sperm in the IVF laboratory. The carrying partner then goes on medication to prepare her uterus for an embryo transfer.
Instead of the costs applying to only one person, the procedures (and associated costs) would be allocated between the two partners, but you will not necessarily incur additional costs for RIVF. Although this may seem like a more complicated process, when it comes to the cost breakdown, it ends up looking very similar to the cost of a traditional IVF journey.
Note: Refer to the IVF pricing breakdown above (or ask your Illume Fertility Insurance & Billing Advocate) for more information.
We get it! Exploring the many ways to grow your family (and thinking about how you're going to afford the journey ahead) can feel daunting. Whether you're still researching your family-building options, ready to get started with fertility testing or treatment, or are simply feeling confused by all these choices and want some guidance, we're here to help you navigate it all.
Reach out to our team today and we'll get back to you within 48 hours to answer any lingering questions about the cost of LGBTQ+ family building for moms-to-be.