In Vitro Fertilization (IVF) Refund Plan

Along with our long track record of setting the standards in reproductive endocrine and fertility care, we have established steps to lead the way in cost containment as well. As a result of the consistently high success rates our Center has established, we have in place an IVF Refund Plan for couples with no insurance coverage for IVF therapy. This financial plan will refund the majority of the fees a couple pay if they do not achieve a pregnancy following IVF treatment. The following summarizes the specific details of this program.

IVF REFUND PLAN

Thank you for your interest in the IVF Refund Plan offered by The Center for Advanced Reproductive Medicine & Fertility (CARMF). Like you, we believe that having a baby should be as stress-free as possible. That's why we have in place this plan for couples interested in pursuing in vitro fertilization (IVF) therapy. Now you can choose to undergo IVF without the worry of cost versus chance for success, and without in the least bit sacrificing high quality medical care.

We are the first fertility clinic in New Jersey to have directly offered such a plan. While the state laws that mandate fertility coverage have allowed many couples the option to now undergo IVF, a great number of patients remain excluded from such benefits. Our philosophy is to offer these patients a financial alternative for funding their IVF treatment. To this end, we have introduced the concept of refunding a majority of the fees paid by qualifying couples that do not achieve a pregnancy following IVF. Because of our consistently high success rates, we have the confidence necessary to offer such a plan that financially assists our patients in pursuing their dreams.

Many couples have limited financial resources to allocate towards building their family. IVF is consistently the most successful therapy available, and most couples are excellent candidates for IVF. Nevertheless, the high and at times unpredictable costs associated with IVF, along with the uncertain outcome, are often major concerns. The IVF REFUND PLAN was developed to reduce a couple's financial anxiety by: a) fixing the cost involved in participating in an IVF-ET treatment cycle, and even more importantly, b) limiting the amount of money "at risk" should the treatment fail. For a fixed fee, a patient is given the opportunity to overcome infertility through IVF, and if the therapy is not successful, she will receive a 70-90% refund! If the treatment is not successful, CARMF assumes the bulk of the cost. This program thus preserves financial resources for affordably undergoing multiple IVF-ET attempts (as medically appropriate), or for pursuing other family building options should IVF fail.

The IVF Refund Plan provides for a refund on all in-cycle clinical and laboratory services associated with an IVF-ET treatment cycle performed by a CARMF physician if a 12-week pregnancy does not occur. The percentage of fees to be refunded ranges from 70% to 90%, based on the age of the woman producing the eggs (see below). The embryo transfer (ET) procedures include all fresh and/or frozen/thawed cycles resulting from the initial fresh cycle. All remaining frozen embryos produced from the fresh IVF cycle have to be exhausted prior to a patient's eligibility for any refund. Please be advised that this plan is designed to offer patients some degree of financial indemnification against treatment failure, and is not in any way meant to be interpreted as a "guarantee" of success. Eligible patients (see Inclusion/Exclusion criteria below) undergoing IVF therapy are unconditionally free to elect other financial options. In addition, treatment recommendations for couples that participate in this plan are not different than for those who choose not to participate. Specifically, ovarian stimulation protocols are not more aggressive, and recommendations for the number of embryos to be transferred are not influenced by plan participation.

• Medical services provided by a CARMF physician in our clinic, including determination of appropriate clinical protocols, interpretation of, and recommendations related to in-cycle monitoring, and in-cycle medical consultations related to the IVF treatment.
• Blood hormone and ultrasound monitoring tests.
• Egg retrieval and embryo transfer procedures.
• Services of the IVF laboratory, including the in-vitro fertilization procedure, cryopreservation and storage (up to 1 year) of excess embryos (if any), and initial blood tests for the diagnosis of pregnancy.
• All physician, laboratory, and blood hormone and ultrasound monitoring fees related to the subsequent thaw and transfer of any frozen embryos resulting from the initial egg retrieval. Such frozen/thawed cycles must be performed until all of these frozen embryos have been exhausted, and must be completed within a one-year period from the date of the egg retrieval.

• Pre- or post-cycle lab work, testing, consultations, or other procedures.
• The cost of any medications and/or the administration thereof.
• Anesthesia ($600) fee for the egg retrieval.
• Fees for intracytoplasmic sperm injection* (ICSI - $1,950), when applicable.
• Fees for assisted hatching* ($500), when applicable.
• CARMF laboratory fees pertaining to epididymal or testicular sperm extraction or aspiration (MESA or TESE), when applicable.
• Obstetric ultrasounds.
• The cost of services not provided by CARMF.
• The cost associated with obtaining donor sperm, when applicable.
• Any fees associated with complications related to the IVF process, including, but not limited to, treatment of hyperstimulation syndrome, pregnancy complications, miscarriage, or ectopic pregnancy.
• Frozen embryo storage beyond the first 12 months.
• Frozen embryo storage after delivery of a baby. A monthly storage fee will begin at this point.
• Any frozen embryo cycles done with remaining embryos after the birth of a baby. These would be billed on a fee-for-service basis.

• Female partner shall not have reached her 39th birthday at the time that she starts her injectable fertility (not Lupron) medications.
• Clomiphene Challenge Test with both FSH values of less than 9.0 (lab results from CARMF) within 6 months prior to signing the agreement.
• Normal uterine cavity based on a hysterosalpingogram (HSG), hysteroscopy, or sonohysterogram within 6 months prior to signing the agreement.
• The couple has no insurance coverage or contracted payor for any component of her IVF or frozen embryo transfer therapy. However, if the couple has an insurance plan that covers the cost of their medications, they will still be eligible for the IVF Refund Plan.
• A consultation with one of the CARMF physicians will be required. Routine qualifying tests and consultations that are recommended for patients planning IVF are not included in IVF Refund Plan package price. The package price is meant to apply to those couples that have been carefully evaluated, and IVF (or ICSI) has been recommended.
• Obese patients (BMI > 35) are excluded.
• Patients with a total of < 7 antral follicles seen in both ovaries are excluded.
• Patients with a hydrosalpinx(ges) are not eligible for this plan. However, they can have the hydrosalpinx(ges) surgically removed or occluded, and then are eligible to qualify if all other inclusion criteria are met.
• Other inclusion and exclusion criteria may arise, and these would be thoroughly reviewed and discussed at the time of the appointment

IVF-ET Treatment Cycle Fees:

*Please note that the additional fees collected for ICSI ($1,950) and Assisted Hatching ($500) are also eligible for the applicable percent refund if a 12-week pregnancy does not result.

NOTE: These plan fees are subject to change without prior notification. If the couple or individual and CARMF have executed a financial agreement, the price stated in the agreement will be honored for the cycle, regardless of any increase in fees occurring after the document was signed.