More than half of European countries prohibit access to assisted reproduction for lesbians and queer couples – but even in countries where IVF is legal and accessible to LGBTQIA+ folks, there remains a serious barrier: the price.
Take the UK, for example: queer couples’ access to IVF on the NHS is fundamentally messed up. While cis-heterosexual couples only have to try to conceive naturally for about two years – a process that is (famously) free – before accessing IVF via the NHS, it’s a completely different story for queer couples.
Historically, queer women and trans people were required to pay for artificial insemination in order to prove their fertility status before accessing state-funded IVF. In 2022, NHS England published the Women’s Health Strategy for England, which promised to remove this additional financial burden for queer couples.
However, in practice, only four of the 42 Integrated Care Bodies (ICBs) responsible for planning health services in local areas have made this change as of April 2024. This means that access to state-funded IVF is, effectively, a ‘postcode lottery’ for queer people and the cost of IVF can vary hugely from location to location. But even when queer folks access private fertility care, they may incur further costs than their cis, straight peers.
“If you’re a same-sex couple accessing IVF privately, you will typically pay more than heterosexual couples for a couple of reasons,” says Kayleigh Hartigan, founder and CEO of Fertility Mapper. First, there’s the cost of sperm. This can be even more expensive if a couple knows the donor they want to use instead of opting for one from a clinic.
On top of that, same sex female couples (and other couples featuring two individuals with uteruses) will have more expensive pre-treatment costs if they both need fertility testing.
IVF access is a class issue
Saving for IVF is unfortunately not as straightforward as it sounds, especially now that the cost of living is so high. And this isn’t just in the UK – it’s an issue in multiple countries across the world, as our interviewees in Europe and the US attest.
“I think it’s so problematic and sad that having a kid, especially if you undergo IVF treatments, is in many cases a class issue,” says Sofie Nötzli, who had a daughter via IVF with her wife.
Sofie and her wife spent between €20,000 and €25,000 on their IVF journey. This included medical checks and medication, sperm, egg retrievals, embryo transfers and embryo storage as well as flights to and from Denmark, which is where the clinic they were using was located. “Switzerland wasn’t an option because it wasn’t yet legal for same sex couples to undergo fertility treatments so we had to look abroad for options,” Sofie says.
There is no one who is going to be able to tell you or reassure you and say hey it’s going to take time but at the end of it you’ll have your kid.
“We’re really privileged to be two people with full time jobs and good salaries in comparison to many other people out there who are struggling,” Sofie adds. “Many people cannot even try or start the process because they simply can’t afford it or they end up taking loans or credits to be able to pay for the costs of a fertility treatment process.”
Additionally, Sofie points out, there are no guarantees. “There is no one who is going to be able to tell you or reassure you and say hey it’s going to take time but at the end of it you’ll have your kid,” she says. “You never know so you’re just going into it in the dark not knowing how much time, effort, tears, money that you need to spend on a process like this.”
How to pay for IVF
“If there’s any advice I would give to anyone who’s starting IVF whether you’re gay, straight, having fertility issues, you’re single, in a relationship – make sure you save,” says Christina Bailey, a mum of four children she had through IVF.
“There’s all kinds of costs that pop up. I went into IVF thinking round one was going to work. I now have four amazing kids but I’ve gone through four rounds of IVF. And you could not have told me when I first walked into that clinic that I’d be going through four rounds of IVF in my lifetime.”
Rounds one and two of IVF cost Christina over $21,000. The egg retrieval alone for rounds three and four cost her $17,500. For rounds one and two, she managed to save up around $30,000 with her wife at the time because they had saved up a lot of money by forgoing a big wedding.
You could not have told me when I first walked into that clinic that I’d be going through four rounds of IVF in my lifetime.
Genna Jaffe, founder of IVF resource Connecting Rainbows and mum of two babies conceived via IVF, spread the $50,000 cost of her IVF journey throughout different credit cards with her wife. They also had savings they could use, and decided to delay buying a home to put the money towards IVF instead.
In the US, blood work and ultrasounds will often be covered by insurance – but that’s about it. When this is included in insurance policies, the language used is very heterosexual, Christina says, which places same-sex couples at a disadvantage. “If we were a straight couple we might have had a pass at the insurance coverage,” she says.
Something she didn’t look into the first time around however are grants, which is something queer couples can pursue.
For example:
- In the US, there are grants you can apply for to help cover the cost of IVF.
- In the UK, organisations like Access Fertility are offering refund programmes for failed IVF treatments, but these also come at a cost to parents.
What should you look out for when paying for IVF?
“Costs can vary from clinic to clinic and person to person,” says Kayleigh. “And, whilst it can feel like time is not on your side, the most important thing you can do to save cost is take your time to do the research upfront. Once you have the information in hand, you should also speak to a few clinics to answer any questions you have before you commit to treatment.”
“Some clinics offer payment plans, which couples may wish to consider if they do need additional support – however, we have also seen some patients try funding via alternative means, such as asking for family support or exploring bank loan options,” adds Professor Geeta Nargund, Senior NHS Consultant and Medical Director of CREATE Fertility and abc IVF.
Whilst it can feel like time is not on your side, the most important thing you can do to save cost is take your time to do the research upfront.
“There’s so many aspects to take into consideration so whatever figure you see on the price list is most likely not going to be the final figure,” says Sofie. “Plus it’s the aspect of time. You don’t know how much time or how many attempts you’ll need before you’re able to succeed, if ever.”
“Set a plan with your partner, talk, talk, talk – and bear in mind that it can take time, and ask yourself the question of how much time you are willing to invest in this process,” Sofie adds. “It doesn’t sound very romantic or sexy but at the same time this process is everything but that unfortunately. You’re very much aware of every single step all the time.”