Embed Size (px)
Citation preview
1
PRICELIST FOR TREATMENTS
2
DISTRICT HEALTH BOARD STAFF FERTILITY BENEFIT: Fertility Plus offers staff working at any of the northernregion DHBs a 10% discount on appointments and treatments (IVF,IUI and FET), excluding medication charges. This is inclusive of ADHB, CMDHB, WDHB, NDHB and also includes St John Ambulance Staff.FIT:THINGS TO NOTE ABOUT BILLING AND PAYMENTS:• A cost estimate for your cycle will be prepared at the time of cycle
planning.• Invoices will be sent in the first week of treatment.• Payment for the treatment is required in full by the day of trigger for IUI
and IVF cycles, and by the day of embryo thawing for FET cycles.• Treatment will not proceed if the payment has not been made.• Subsequent cycles including frozen transfers will not be commenced if
there is an outstanding balance.• Medication is required to be paid at the clinic when picking up the
prescription. • Prices may be subject to change without notice.• All appointments are to be paid on the day of the appointment.• The chance of pregnancy depends on many factors; there are no refunds if
you do not become pregnant.• Please ensure that your contact information is up to date as your invoices
will be emailed or posted to you.
HOW TO MAKE A PAYMENT: • Payment methods: Cash, EFTPOS, online banking, credit card.• Prices are in NZ dollars and include GST.• Online payment details:
• Remit to: Auckland District Health Board• Bank: BNZ Account Number: 02-0500-0416029-00• Particulars: enter your NHI• Reference: enter the invoice number
3
CANCELLATION/ REFUND POLICY:• If your IVF, FET or IUI cycle gets cancelled
you may be eligible for a partial refund (see page 14 for details).
• Drugs, scans, blood tests and booking fees are not refundable.
• Unused medication cannot be refunded once been issued.
• If your ovulation induction cycle with Letrozole or Clomiphene is unsuccessful there is no refund.
CONTACT INFO:
For further information regarding costs, refunds and payment plans contact the Accounts Coordinator at: [email protected] or call 09 6309810 ext: 26794 Monday – Friday.
ADHB is using a 3rd party (HealthSource) for their Accounts Receivables.
4
WHAT MAKES US DIFFERENT?Fertility Plus has been leading IVF treatment in New Zealand for more than 35 years. We provide a comprehensive range of fertility investigations and treatments, and have helped thousands of people fulfil their hopes of starting a family.• We offer both publicly funded and private fertility treatment.• We focus on the individual delivering the latest, evidence-based treatment
care options.• A part of the Auckland District Health Board, you’ll have access to the best
specialist and expertise available.• Our fertility services are integrated with general gynaecology, maternity
and medical services at Auckland City Hospital, ensuring we can support all aspects of your fertility treatment and on-going care.
HOW MUCH DOES TREATMENT COST?We tailor your treatment plan to your needs and estimated costs are discussed in a consultation with one of our fertility specialists. This brochure outlines the costs for:• Consultations • Investigations • Fertility Treatments• Medications
Talk to us today to discuss your fertility pathway.
At Fertility Plus, we work with you to deliver a personalised treatment plan based on your diagnosis and best treatment options while honouring your individual values.
Talk to us today to discuss your fertility pathway.
5
At your first visit at Fertility Plus you’ll meet with the doctor who will walk you through your fertility options and plan your personalised fertility plan.
You may be advised to have pre-treatment tests for fertility investigation purposes.
CONSULTATIONFirst Doctor Consultation to discuss diagnosis and treatment options (45 mins)
Follow-up Doctor Consultation (30 mins)
Counselling Consultation when not included in a treatment cycle (60 mins)
PRE-TREATMENTSUltrasound scan - when not part of a cycle
Genetic Carrier Screening. Testing for: Cystic fibrosis, Fragile X Syndrome and Spinal Muscular Atrophy (SMA)
First semen analysis, includes antibody screening
Repeat semen analysis
Trial semen wash - after full semen analysis has already been completed. Not on first semen analysis
Sperm freezing
Sperm Chromatin Structure Assay (SCSA) test• Including semen analysis and shipping
$195
$140
$140
$150
$210
$150
$250
$380
COST
$280
$585
6
Monitored Ovulation Induction (Tracked Cycles)
Tracked cycles help indicate when your most fertile time is and stimulate the ovaries.
ESTIMATEDMEDICATION
COSTSTracked Cycle - a fully monitored natural cycle using blood tests and ultrasound of the ovaries to detect ovulation
3 x Letrozole Cycle Package - a three-month package using Letrozole to stimulate ovulation• Monitoring of your blood test results and
feedback will be provided• One review appointment is included if your
treatment is not successful
Letrozole Cycle - a single treatment using Letrozole to stimulate ovulation• Monitoring of your blood test results and
feedback will be provided
Clomiphene - ovarian stimulation using Clomiphene, tracked with blood tests and ultrasound (if needed)
$25
$25
$25
Follicle Stimulating Hormone (FSH) - ovarian stimulation using injectable FSH• Monitored stimulated cycle using blood tests and
ultrasound of the ovaries to detect ovulation
TREATMENT COST
$420
$485
$180
$420
$850 $1,500 - $3,000
No refunds are available for the cycles above.
7
IUI - Intrauterine Insemination
IUI is a fertility treatment that aims to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilisation.
ESTIMATEDMEDICATION
COSTS
INTRAUTERINE INSEMINATION (IUI) - WITH PARTNER SPERMIncludes:• Monitoring with blood tests and ultrasound scans
(if applicable)• Intrauterine Insemination
4 X CYCLES INTRAUTERINE INSEMINATION (IUI) - WITH PARTNER SPERMIncludes:• Monitoring with blood tests and ultrasound scans
(if applicable)• Intrauterine Insemination• One counselling appointment after completion of
all the cycles
DONOR INSEMINATION (DI) - WITH FERTILITY PLUS SPERM DONOR:• Monitoring with blood tests and ultrasound scans
(if applicable)• Intrauterine Insemination• Two counselling sessions are required(Not included in treatment price (2 x $140)
$25 - $350
PER CYCLE
$25 - $350
TREATMENT COST
$1,350
$4,000
$1,800
$25 - $350
8
IUI - Intrauterine Insemination
IUI is a fertility treatment that aims to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilisation.
ESTIMATEDMEDICATION
COSTS
DONOR INSEMINATION (DI) - WITH PERSONAL DONOR SPERM:• Monitoring with ultrasound scans and blood tests• Intrauterine Insemination
PREPARATION OF PERSONAL DONOR SPERMThis applies both to IVF and donor cyclesIncludes:• Virology screening• First semen freeze• Counselling
TREATMENT COST
$1,350
$1,330
$25 - $350
4 X DONOR INSEMINATION (DI) - WITH FERTILITY PLUS SPERM DONOR:• Monitoring with blood tests and ultrasound scans
(if applicable)• Intrauterine Insemination• Two counselling sessions per cycle are required(Not included in treatment price (2 x $140)
$5,600 $25 - $350
9
In Vitro Fertilisation (IVF) Treatments
In vitro fertilisation (IVF) is a process of fertilisation where mature eggs are combined with sperm at the lab. IVF is used to help with fertility or prevent genetic problems and assist with the conception of a child.
ESTIMATEDMEDICATION
COSTS
IVF CYCLE - EMBRYO FREEZE ALLIncludes:• Monitoring with scans and blood tests• Egg collection• Sperm preparation and fertilisation of the eggs• Embryo culture and embryo freezing
IVF CYCLE - EGG FREEZINGIncludes:• Monitoring with scans and blood tests• Egg collection and egg freezing
TREATMENT COST
$6,995
$6,895
$2,000 - $6,000
IVF CYCLEIncludes:• Monitoring with scans and blood tests• Egg collection, including deep sedation with
anaesthetist• Sperm preparation and fertilisation of the
eggs• Embryo culture• One fresh embryo transfer and embryo
feezing (if applicable)• Early pregnancy monitoring up to 7 weeks,
or a follow-up consultation with the doctor if negative outcome
• Two counselling sessions (optional)
$7,995 $1,000 - $6,000
$2,000 - $6,000
10
COST
$2,100ADDITIONAL IVF ITEMS & LAB PROCEDURES
$1,000
(POA)
Annual cryo-storage for frozen sperm, embryos or oocytes
$1,400
$800
(POA)
$300
$264
Testicular surgery for sperm retrieval: specialist urologist
Testicular surgery for sperm retrieval: routine
Sperm collection device
$25 - $350
$1,050
$25
Egg Thawing & Embryo Transfer
ESTIMATEDMEDICATION
COSTS
TREATMENT COST
FROZEN EGG THAWING CYCLE WITH ICSIIncludes:• Monitoring with ultrasound scans and blood tests• Egg thawing• Sperm preparation and fertilisation of the eggs
with ICSI• Embryo culture• Embryo transfer• Two counselling sessions (optional)• Early pregnancy monitoring until up to 7 weeks, or a follow-up consultation with the doctor if negative outcome
SPERM COSTS
FROZEN EMBRYO TRANSFER (FET) CYCLEIncludes:• Monitoring with ultrasound scans and blood tests• Embryo thaw and culture• Embryo transfer
$1,750
$4,000
$1,620 $25 - $350
HCG infusion
PGT-M and PGT-SR genetic testing
PGT-A genetic testing per embryo for 4th embryo onwards
PGT-A genetic testing per embryo for 1st, 2nd and 3rd embryo
Egg collection in full operating theatre
Eggs or embryo vitrification
ICSI - Intra-Cytoplasmic Sperm Injection, sperm microinjection
11
COST
Third Party Treatments
$3,100
DONOR EGG REIMBURSEMENT- CHARGE BILLED TO ALL RECIPENTS• Reimbursed to egg donors as petrol vouchers
SEE PG 3FOR
PRICES
$1,500
$1,050
$250
$400
DONOR EGG WORK UPIncludes:• Two medical consultations
(one for recipient and one for donor)• Up to three counselling sessions
DONOR EGG ADDITIONIncludes: Cycle co-ordination and monitoring Screening blood tests (does not include FET cycle)
DONOR SPERM ADDITION IN IVF
SURROGACY WORK UP - CHARGE WORK UP OF POTENTIAL SURROGATEIncludes:• Screening tests and co-ordination with nurses
This is separate to ECART application which holds all counselling and medical interviews
SURROGACY - FET CO-ORDINATION OF MULTIPLE PARTIES
ECART APPLICATION - SURROGACY AND EMBRYO DONATIONIncludes:• All preparation and submission of required documentation
to ECART• All appointments with a counsellor and consultant
$2,600
This does not include the costs for legal advice and reports. This will be discussed during your initial counselling appointment.
12
InVitroFertilization(IVF)TreatmentsInvitrofertilization(IVF)isaprocessoffertilisationwherematureeggsarecombinedwithspermatthelab.IVFisusedtohelpwithfertilityorpreventgeneticproblemsandassistwiththeconceptionofachild.
TreatmentCost
Estimatedmedication
costs
IVFCycle - includes:*Monitoringwithscans&bloodtests,*Eggcollection,including deepsedation withanaesthetist*Spermpreparation&fertilisationoftheeggs,*Embryoculture,*Onefreshembryotransfer&embryofreezing(ifapplicable)*Earlypregnancymonitoringupto7weeks,orafollow-upconsultationwiththedoctorifnegativeoutcome,*Twocounsellingsessions(optional)
$7,995 $1000- $4000
IVFCycle- EmbryoFreezeAll - includes:*Monitoringwithscansandbloodtests,*Eggcollection,*Spermpreparation&fertilisationoftheeggs,*Embryoculture&embryofreezing
$6,995 $2000- $4000
IVFCycle- EggFreezing– includes:*Monitoringwithscansandbloodtests,*Eggcollection&eggfreezing $6,995 $2000- $4000
IVFcyclerefundforcancelledorincompletecycles.Norefundsonmedication
Refundamount
WhenIVFcycleisstoppedbeforethefirstblood test $7,695WhenIVFcycleisstoppedbeforetheeggcollection $6,995Iftherearenoeggsateggcollection (OPU) $1,200Iftherearenoembryostotransfer $1,000
Miscellaneous Charges
$350
$80 / HOUR
$175
$25
INTERPRETER • Face to face or phone
• Overseas co-ordination charge
• Administration fee for transporting frozen gametes to or from another clinic in New Zealand
$200
EARLY PREGNANCY MONITORING Includes:• Blood monitoring and early and pregnancy scan
COST
• Prescription charge
• Administration fee for transporting frozen gametes to another clinic outside New Zealand (excludes courier costs)
$750 / CYCLE
13
Medication
The duration and dose of the medications will vary according to your cycle plan.
COSTDOWN REGULATION PER LH SURGE PROTECTION
$250Buserelin
Orgalutran $125
STIMULATING EGG PRODUCTIONGonal 300 $350
Gonal 450
Gonal 900
Puregon 300
Puregon 600
Puregon 900
Elonva 100per150
Menopur
$525
$1,050
$350
$195
$1,050
$1,500 / 7-DAY
$65 / VIAL
TRIGGERING OVULATIONOvidrel
Decapeptyl (2 syringes) $150
MAINTAINING THE UTERINE LINING (LUTEAL PHASE SUPPORT)Crinone
Utrogestan
$25 / DAY
$35 / BOX
$700
14
Refunds
No refunds on consultations, pre-treatments, monitored ovulation Induction (Tracked Cycles), Third Party Treatments, medication.
CHARGED AMOUNTCHARGES FOR CANCELLED IUI CYCLES BY PATIENTS – IF NOT MEDICALLY INDICATED
$150Booking fee
REFUND FOR UNUSED 4 X IUI CYCLES WITH PARTNER SPERM
If only 1 cycle is used $2,650
If only 2 cycles are used
If only 3 cycles are used
$1,400
$800
REFUND FOR UNUSED 4 X IUI CYCLES WITH FERTILITY PLUS SPERM DONOR
REFUND AMOUNT
If only 1 cycle is used $3,800
If only 2 cycles are used
If only 3 cycles are used
$2,200
$1,200
REFUND AMOUNT
15
When IVF cycle is stopped before the first blood test
IVF CYCLE REFUND FOR CANCELLED OR INCOMPLETE CYCLES
REFUND AMOUNT
When IVF cycle is stopped before the egg collection
If there are no eggs at egg collection (OPU)
If there are no embryos to transfer per freeze all
$7,695
$6,995
$1,200
$1,000
CHARGE FOR CANCELLED OR INCOMPLETE FET CYCLES CHARGED AMOUNT
Booking fee
Ultrasound scan
$150
$100 PER SCAN
If you wish to discard or use your frozen gametes, we will refund the unused months of storage when we receive the valid discard forms or when your treatment is completed
REFUND AMOUNT
UNUSED MONTHS OF
STORAGE
STORAGE
16
The National Women’s Health website has good, accurate and up to date information which you may find helpful.
Telephone: 09 630 9810Email: [email protected]
FOR FURTHER INFORMATION, PLEASE VISIT OUR WEBSITE:
www.fertilityplus.co.nz
OR FOLLOW THE QR CODE BELOW:
Fee schedule as of 1st July 2021
