Shared Risk IVF Programs Pros and Cons: What You Gain, What You Give Up

Shared risk IVF programs pros and cons come down to one trade: you pay a higher fee up front for a set number of attempts, and in return you can get part or all of it back if treatment doesn’t work.

Paying for IVF one cycle at a time can feel like a gamble. You don’t know how many cycles you’ll need, so you don’t know the final bill. A shared risk program can look like the safe answer to that worry.

It might be, but it also comes with trade-offs worth knowing about before you sign-up. This guide lays out both sides so you can make an informed decision. If you need a simple definition first, start with our guide to what an IVF refund program is.

What you gain from a shared risk IVF program

One number to plan around: Instead of paying cycle by cycle, you pay a single fee that covers a set number of attempts. That makes the cost of the contract easier to see before you start.

Lower cost for later cycles: According to the American Society for Reproductive Medicine (ASRM) Ethics Committee, patients in these programs pay a higher initial fee, and later cycles cost less.

A possible refund: The ASRM Ethics Committee describes programs where a specified percentage of the fee may be returned if treatment doesn’t lead to a pregnancy or delivery. How much comes back depends on the contract.

A cap on what you pay for the attempts in the contract: If you need several tries, the fee you agreed to covers the attempts listed. You aren’t re-pricing each one.

What you give up

A higher fee up front: You pay more at the start than you would for a single cycle. That is an important consideration if you’re paying from savings.

You may pay more if it works early: The ASRM Ethics Committee states that patients should understand they will pay more for IVF if they succeed in the first or second cycle than they would under fee-for-service. The same opinion notes that even when someone becomes pregnant before the program ends, total cost can be comparable to paying cycle by cycle, depending on how the fees are set up.

Screening gates: Many IVF refund and shared risk programs screen on age and ovarian reserve. The ASRM Ethics Committee says programs should make sure the patients they offer the option to are suitable candidates, and that inclusion and termination criteria must be clearly specified. If you don’t meet a clinic’s criteria, IVF refund and shared risk programs may not be open to you.

Extra costs outside the fee: According to the ASRM Ethics Committee, pretreatment screening and medication costs are ordinarily not covered by these programs, and refunds exclude them. Ask what the fee leaves out.

A refund only on the contract’s terms: The ASRM Ethics Committee notes that success is usually measured as a delivery or a pregnancy of a specified length, and that refunds are typically triggered when that doesn’t happen within a set number of embryo transfers or a set time.

Who a shared risk program tends to fit, and who may want something else

A shared risk program may fit if you:

• Expect to need more than one attempt and want the cost of those attempts set in advance.
• Can pay the higher fee up front.
• Meet the clinic’s criteria for the program.
• Understand that medication and screening are likely billed separately.

Consider something else if you:

• Want the lower cost of paying cycle by cycle in case your first cycle works. The ASRM Ethics Committee says patients should be counseled on alternatives, including fee-for-service IVF.
• Don’t meet a program’s age or ovarian reserve criteria.
• Want the refund terms to cover medication and screening, which these programs ordinarily leave out.
• Aren’t sure you can pay the full fee at the start.

For a closer look at what to expect from refund terms, read how to get an IVF refund. To see how a clinic’s multi-cycle package compares with other options, see Sunfish vs. a clinic multi-cycle package.

Another way to plan for IVF costs: the Sunfish IVF Success Program

If you want a different route, you should consider the Sunfish IVF Success Program. It isn’t a shared risk program, it’s an IVF package with financial protection. Here is how it’s set up.

• One price, quoted before treatment begins. Sunfish’s IVF and egg freezing Success Programs are packages a patient buys outright from Sunfish for treatment at a partner fertility clinic, for a price quoted before treatment begins. The price includes the treatment cycle at that clinic. You pay Sunfish for the program, and Sunfish pays the clinic. See what an IVF package includes and what it costs.
• All embryo transfers included. Sunfish’s IVF Success Program includes all single embryo transfers of a patient’s eligible embryos at one fixed price for up to a year,² in place of the separate fee a fertility clinic charges for each frozen embryo transfer. A clinic usually bills each frozen embryo transfer on its own, so a next attempt is another large payment. With Sunfish, those transfers are already paid for. Membership runs until a year has passed or all your eligible embryos have been transferred, whichever comes first.²
• Guaranteed partial refund of up to $15,000.¹ With the IVF Success Program Gold, you get a guaranteed partial refund of up to $15,000, or a discount to continue treatment, if you are unsuccessful.¹ Gold also includes savings on long-term egg and embryo storage and transport, at-home wellness IVs, one-on-one mental health coaching, and more.
• No qualification requirements for Gold. There are no qualification requirements for the IVF Success Program Gold. See the details here.
• A Planning Partner. Sunfish pairs every member with a Planning Partner, one named person for the whole cycle. They coordinate clinic and pharmacy logistics and give evidence-based guidance at each step. Members also get benefits, including embryo storage, mental health support, and at-home injection help.

What it doesn’t include. Sunfish’s Success Programs include the IVF or egg freezing cycle at one flat price, which excludes medication and PGT-A genetic testing; medication comes from Sunfish partner pharmacy with a guaranteed lowest-price match. PGT-A is billed by the clinic. The program is available only at Sunfish partner clinics.

Want one clear price, all embryo transfers included, and a guaranteed partial refund of up to $15,000¹ if you are unsuccessful? See how the program works.

Frequently asked questions

What are the main pros and cons of a shared risk IVF program?

The main pros are one upfront number, lower cost for later cycles, and a possible refund. The main cons are a higher upfront fee, paying more if you succeed early, screening criteria, extra costs for medication and testing, and a refund that depends on the contract’s own definition of success.

Is a shared risk IVF program worth it if you might need more than one cycle?

It depends on your situation. The ASRM Ethics Committee says patients should understand they will pay more if they succeed in the first or second cycle. If you expect to need several attempts, the set fee may suit you. Ask the clinic for its own success rates and how its refund works before you decide.

Who is a shared risk IVF program usually a good fit for, and who should consider something else?

These programs tend to suit people who can pay a larger fee up front and meet the clinic’s criteria. If you don’t meet those criteria, or you’d rather pay cycle by cycle, another route may fit better. See the section above for a full list.

Can you use insurance with a shared risk IVF program?

It varies by clinic and plan. The ASRM Ethics Committee notes that these programs mainly appeal to patients paying out of pocket. Ask your clinic and your plan administrator how a program would work with any benefits you have.

How does a shared risk program’s cost compare with paying for several IVF cycles one at a time?

You pay more at the start in a shared risk program, and later cycles cost less. If your first or second cycle works, you may pay more than you would have cycle by cycle. If you need more attempts, the set fee may come out lower than paying each time. In a shared risk program, medication and screening are ordinarily extra.

What are the alternatives to a shared risk IVF program?

You can pay for IVF cycle by cycle, which the ASRM Ethics Committee calls fee-for-service. You can look at a clinic’s multi-cycle package. You can also look at an IVF package with financial protection, such as the Sunfish IVF Success Program. Our IVF cost calculator can help you see what your own plan might cost.

Is the Sunfish IVF Success Program a shared risk program?

No. It is an IVF package with financial protection. You buy it from Sunfish for treatment at a partner clinic, for a price quoted before treatment begins, and it includes all embryo transfers of your eligible embryos for up to a year.²

Footnotes

¹ As part of the Sunfish IVF Success Program, Sunfish provides a Custom Financial Plan using Sunfish’s proprietary software that calculates the expected financial costs for each family to achieve a Live Birth based on a range of factors. If you fail to achieve a Live Birth within your custom financial plan budget and there are unexpected financial costs that were not accurately predicted by the Financial Planning Tool, our software Warranty may entitle you to receive a partial refund of your treatment package costs. Additional costs may be incurred outside of the Treatment Package Costs. See our Sunfish IVF Success Program Agreement for conditions and details.

² See contract for eligibility requirements.