Questions to ask a fertility clinic about cost and insurance

By Berkcan K., editor · Published 2026-10-22 · Updated 2026-10-24

The CDC publishes what each clinic achieved; nobody publishes what each clinic charges. Prices are set clinic by clinic, quoted in different bundles, and change with the medications, laboratory procedures and storage a particular treatment needs, so this guide gives you no dollar figures. What it gives you is the list of questions that turn a quote into a comparable number, drawn from how a cycle is actually structured and from ASRM’s patient guidance on insurance. Take it to the financial consult most clinics offer before treatment, and ask for the answers in writing.

First, know what a cycle is made of

ASRM describes IVF as a method “in which sperm and eggs are combined outside of the body in a laboratory dish,” reached through injectable hormone medicines that stimulate the ovaries, an ultrasound-guided retrieval of the eggs, fertilization in the laboratory, and a transfer in which “a catheter containing the embryo(s) is used to gently place it(them) into the uterus.” Each of those steps is a separate line on a bill, and some of them (medication, freezing, storage, a later frozen transfer) are often outside the headline price. Every question below is about finding those lines.

Questions about the quote itself

What exactly does the cycle price include? Ask for the list: monitoring visits and bloodwork, the retrieval, anesthesia, laboratory fertilization, embryo culture, and the first transfer. If any of those is “usually extra”, have it written down.
Is medication included, and if not, what is the typical range for someone with my protocol? Stimulation drugs are frequently billed by a pharmacy rather than the clinic. Ask which pharmacies the clinic works with and whether the dose depends on your ovarian reserve.
Which laboratory procedures are extra? ICSI (injecting a single sperm into each egg), assisted hatching, preimplantation genetic testing (PGT) of embryos, and the biopsy that PGT requires are commonly separate. The clinic’s CDC page shows what share of its transfers used ICSI and PGT, which tells you how often those lines appear on its patients’ bills.
What does it cost to freeze embryos or eggs, and what is the annual storage fee? Ask when storage billing starts and what happens to the fee if you move clinics.
What is the price of a frozen embryo transfer on its own? Most cycles today bank embryos and transfer later; the CDC table on each clinic page shows the share of transfers that used frozen embryos. A frozen transfer has its own monitoring, medication and transfer fee.
If the cycle is cancelled before retrieval, or no eggs are retrieved, what do I pay? The CDC reports the percentage of intended retrievals that produced no eggs and the percentage of cycles stopped between retrieval and transfer; ask how the clinic bills each case.
Is there a multi-cycle package or a refund program, and what are its eligibility rules? These programs often admit only patients with a good prognosis. Ask what the age and test cut-offs are and what is excluded from the refund.
Does the price change if I use donor eggs, donated embryos or a gestational carrier? Each adds agency, screening, legal and compensation costs that the clinic may or may not coordinate. The services list on the clinic’s page shows which of these the clinic told the CDC it offers.

How often do those extra lines come up?

The CDC file does not carry prices, but it does show how often clinics use the procedures that are commonly billed separately. Across the 449 clinics with a page on this site (CDC 2022 Final data), the clinic in the middle of the range reported:

Line on a bill	What the median clinic reported to the CDC	Clinics reporting
Frozen embryo transfer	91.9% of transfers used frozen embryos	435
ICSI	82.9% of transfers had at least 1 embryo with ICSI	435
Preimplantation genetic testing	59.2% of transfers had at least 1 tested embryo	434
Gestational carrier	2.5% of transfers	435
Cycle with no eggs retrieved	7.5% of intended retrievals	440
Cycle stopped after retrieval, before transfer or banking	10.8% of cycles	442

Services the clinics told the CDC they offer: embryo freezing 449 of 449, egg freezing 447, gestational carrier services 409, donor egg services 399, donated embryo services 274. Clinic-to-clinic spread is wide (some clinics report no PGT, others report it on every transfer), so read the figure on the clinic’s own page. The state pages for California, New York and Texas, the three states with the most reporting clinics (85, 44 and 44), list every clinic with its figures.

Questions for your insurer and your employer

ASRM’s patient FAQ puts it directly: “the degree of services covered depends on where you live and the type of insurance plan you have,” some states require insurers to cover or offer infertility diagnosis and treatment, but “the laws vary greatly in their scope of what is and is not required to be covered,” and the best route to the facts is to ask your employer’s HR department to “determine the exact coverage your plan provides.” Ask:

Does my plan cover infertility diagnosis, treatment, or both? Diagnosis-only coverage is common.
Does it cover IVF specifically, and with what limits? Limits are often expressed in cycles, in a lifetime dollar amount, or in both.
Are medications covered under the pharmacy benefit, and do fertility drugs need prior authorization?
Is my plan self-insured? ASRM’s state-law resource notes that “the Employment Retirement Income and Security Act of 1974 exempts companies that self-insure from state regulation.” Many large employers self-insure, which means a state mandate may not apply to you even if you live in a mandate state; only the plan document decides.
What counts as medically necessary, and is there a required period of trying or of less invasive treatment first?
Is the clinic in network, and is its laboratory billed separately? Some clinics’ embryology labs or anesthesia providers are separate entities with separate network status.

ASRM maintains a page for every state and territory on infertility insurance laws; read your state’s entry, then confirm with HR, because the entry describes the law, not your plan. Our table of which states require IVF coverage quotes the limits from each statute’s own text.

Questions that connect cost to the clinic’s report

Which success rate are you quoting me, and for which age band? Ask for the live-birth rate per intended egg retrieval for your band, the number of retrievals it is based on, and the cumulative rate for new patients, then check them against the CDC figures on the clinic’s page here. The CDC itself cautions that “average chances may not reflect actual success rates during ART treatment for an individual or couple,” so ask the clinic how your own history changes its estimate.
How many cycles do patients like me typically need? The CDC publishes the average number of intended retrievals per new patient and per live birth by age band. A per-cycle price only becomes a per-baby price once you multiply it by that number. Nationally in 2022 the CDC average was 2.0 intended retrievals per live birth for patients under 35, 2.8 for 35 to 37, 4.3 for 38 to 40 and 12.9 over 40; the success rate lookup shows the figure for a single clinic.
What is your single-embryo transfer policy? It affects both the risk of multiples and whether you will pay for additional frozen transfers.

Before you sign

Ask for a written estimate that itemizes the eight cost questions above for your specific protocol, keep the insurer’s answers in writing too, and compare clinics on the full per-cycle figure, not the headline. To set the reported rates of two or three clinics side by side, use the clinic comparison tool. This site can tell you what each clinic reported to the CDC; only the clinic and your plan can tell you what it will cost, and only a reproductive endocrinologist can tell you what is right for you.