Many couples have limited financial resources to allocate toward building their family. The high and often unpredictable costs associated with IVF along with the uncertain outcome can be major concerns. Most couples are good candidates for IVF. The IVF Shared-Risk Financial Program was developed to reduce a couple's financial anxiety by fixing the cost involved in participating in multiple IVF cycles. By limiting the amount of money "at risk", this program preserves financial resources for other family-building options should IVF fail.

The Shared-Risk payment program represents a dramatic change from typical fee for service. The American Society of Reproductive Medicine (ASRM) has reviewed this concept and stated that with the appropriate checks and balances this program can be ethically pursued and offers great benefits. We offer this program as an alternative financial option but do not try to persuade patients to participate. We advise everyone considering IVF to consider this option, carefully weighing the benefits of Shared-Risk vs traditional fee-for-service payment. The couple's decision to participate will not affect medical decisions or care provided.

How It Works
Eligible couples will have undergone a screening evaluation prior to entering the program. Up to three cycles of traditional IVF treatment cycles and any subsequent cryopreservation cycles may be attempted over a two year period for a flat fee.

Once you have delivered your baby, GRS has earned its' fee. In the event treatments have been unsuccessful, you will be refunded the fee less the specified non-refundable enrollment fee. Obviously, couples who successfully achieve pregnancy and deliver during the first cycle will pay more for their care than with traditional fee-for-service medical payments. On the other hand, if you are unsuccessful, GRS assumes the bulk of the cost. That is why this program is called IVF Shared-Risk.

Who qualifies?
The IVF Shared-Risk Financial Program is offered to couples who are considered good candidates for IVF after completing a full medical screening. Women must be 37 or younger (at the start of the first stimulation cycle), with normal ovarian reserve testing and must not have begun three or more prior IVF treatment cycles.

What costs are included in the IVF Shared-Risk Financial Program?:

• Ovulation induction monitoring, unless Stimulation Rider has been chosen (Stimulation Rider is explained in great detail on following page)
• Facility, anesthesia and physician fees for the egg retrieval and embryo transfer
• IVF laboratory services including identification of egg, semen processing, fertilization of the eggs (including ICSI as needed), embryo freezing, assisted hatching (if indicated), and frozen embryo storage fees for the first two years
• Donor medications
• Anesthetic supplies and drugs
• All medical and surgical supplies required for egg retrieval and embryo transfer
• If pregnancy is not achieved in the fresh cycle, then this program will include subsequent thaw, culture and transfer fees. All cryopreserved embryos must be transferred before the second or third fresh cycle is initiated.
• Verification of pregnancy including one ultrasound verification of fetal number, position, and heartbeat

• Normal IVF prescreening tests
• Recipient medications, except anesthetic agents used during egg retrieval
• Any expenses related to embryo biopsy or prenatal genetic diagnosis (PGD)
• Any non-IVF related surgical procedures (laparoscopy, hysteroscopy or D&C for pregnancy loss)
• The cost associated with obtaining donor sperm
• The cost for egg donor recruitment, screening and donor fees
• All care or other medical services provided by non-GRS physicians (other than anesthesia professional fees for egg retrieval)
• Any complications related to the IVF process including, but not limited to treatment of hyperstimulation syndrome, pregnancy complications, miscarriage or ectopic pregnancy

For convenience, some couples choose pre-retrieval IVF monitoring in an agreed upon facility outside of Atlanta. In that case, the clinic providing that care will be paid directly by the couple or they will file if these services are a covered benefit. If you choose this option and ultrasound monitoring or blood tests are provided by GRS during the course of your treatment, you will be required to pay at the time the service is rendered.

In these two situations, couples may choose the Stimulation Exclusion Rider. The following services are included in the Stimulation Exclusion Rider:

• Hormonal testing during the ovulation induction
• Ultrasound monitoring of ovulation induction
• Physician fees directly attributable to ovulation induction

Can I use an egg donor?
For many couples, pregnancy is unlikely due to advanced age or diminished ovarian reserve. For these couples, the use of an egg donor will often allow a successful pregnancy. After completion of a comprehensive medical evaluation, the age restriction may be waived and participation in the IVF Shared-Risk Egg Donor Program may be offered. Options include the use of a known egg donor provided by the participants or an anonymous donor screened and selected by Georgia Reproductive Specialists.

Additional per cycle fees will be incurred if egg donors are to be used.