This story is part of our July 2024 issue. To subscribe, click here.

Sometimes Liz Conant jokes that for the cost of what she and her husband, Adam Guernsey, spent on in vitro fertilization treatments, they could have bought a fancy car instead. “A really, really nice car,” she says with a laugh.

The point is clear. IVF can be expensive — very expensive. “Obviously, I wouldn’t trade my two  boys,” says Conant, adding that she and her husband resorted to IVF after trying on their own without success. “And some people spend more than that.”

Cost is only one potential hurdle for those seeking IVF treatments. Conant and her husband spent approximately $60,000 on treatments, but it was also a lengthy and exhausting process that took several years and two clinics before the Sacramento-based couple first welcomed son Liam in 2018 and Aidan in 2022. 

Their experience isn’t unique despite decades of advancements since the 1978 birth of the first “test tube baby,” Louise Brown, in Manchester, England. In the 45 years since that momentous breakthrough, the number of people undergoing IVF has increased annually. More than 2 percent of infants born each year are conceived using assisted reproductive technology, according to the Centers for Disease Control and Prevention.

Increasingly, more people are choosing IVF as the route to parenthood, but the process remains expensive and time-consuming. Over the years, however, improvements in technology have helped and even streamlined treatments. And researchers aren’t done. With venture capitalists and a Davis-based startup company eager to cash in on the ever-growing industry, new developments may make IVF more accessible and affordable to millions of women. 

Conant, a public relations specialist who is now 39, first tried the fertility drug Clomid and then intrauterine insemination — a fertility treatment that gives sperm a better chance at fertilizing an egg. Finally, she and her husband decided to switch to another clinic to take the more aggressive IVF route. Today, she considers herself “lucky” that her first egg retrieval cycle was successful, resulting in approximately 10 frozen embryos.

“We were incredibly fortunate,” she says. “I know many people undergo much more challenging experiences, such as going through many retrievals because they didn’t get enough eggs.” Still, her journey was not without immense obstacles, including a chemical pregnancy, an instance in which an early miscarriage occurs within the first five weeks of pregnancy after an embryo forms and sometimes embeds in the uterus lining but doesn’t further develop.

Now, Conant says she wants to demystify the experience for others. “I’m an open book,” she says. “I want others to not feel like they were as alone as I did because there’s just so many people going through it.”

‘Is this all going to be in vain?’

In the years since Ernest Zeringue opened the California IVF Fertility Center in 2004, the doctor has treated thousands of patients like Liz Conant who, unable to naturally conceive, have sought help in getting pregnant.

Zeringue, who originally studied to be a cardiothoracic surgeon, says he switched his focus because he found the prospects of helping people conceive more fulfilling. Over the years, he says, IVF treatments have become more reliable, thanks in part to the increased use of genetic testing, artificial intelligence tools and sophisticated camera technology.

“For the longest time when things didn’t work, we didn’t know why,” he says.

Since its inception, success rates have improved as assisted reproductive technologies have become more efficient and hormone treatments safer. For example, Zeringue says, the use of AI and time lapse photography allows clinicians to thoroughly examine embryo data points at various stages or, better yet, feed the information to a computer that can look at far more data points.

Such advancements have led to more promising numbers for would-be parents. According to the CDC’s 2020 Fertility Clinic Success Rates Report, there were 326,468 assisted reproduction cycles, called ART cycles, performed at 449 reporting clinics in 2020, resulting in 75,023 live births (deliveries of one or more living infants).

Although success rates vary due to age and other factors, according to the Society for Assisted Reproductive Technology, women under the age of 35 doing their first IVF cycle had a 55.1 percent success rate from ART treatment. Notably, the numbers for those over the age of 40 are more disappointing with just an 8.2 percent success rate on the first IVF cycle.

“Your biggest fear is that it’s not going to work. Especially considering all the time and effort, money, … You worry that you’re not in control.” 

Tara Dossi
IVF parent

Still, it remains a lengthy and sometimes demoralizing process for just about anyone who undertakes treatments — and because of the cost, much of which is still not covered by most insurance carriers, an unaffordable option. The average cost of a single cycle in the United States, for example, can cost between $12,000 and $25,000, according to 2022 figures from the Society of Reproductive Medicine. Depending on the number of cycles and additional treatments, the total cost may be much higher.

For example, Conant, a senior vice president at a public relations agency, and Guernsey, an attorney, paid for all their treatments, a luxury Conant says she recognizes not everyone can afford.

“We paid 100 percent out of pocket for everything, and luckily, we could afford it,” she says. “Unfortunately, that’s another problem for many people: They’re maxing out credit cards and setting up a GoFundMe and moving into an apartment because they don’t have that kind of money.”

While their insurance covered approximately $15,000 in costs, the couple still spent upwards of $6,000 for genetic testing. “We probably also spent at least half that on gas and hotels,” says Guy Dossi, underscoring the types of untracked expenses that can rack up costs even more.

The Dossis married in 2018 and knew they wanted to have children. Guy, a sports reporter for the Calaveras Enterprise, was 30 at the time; Tara, a nurse, was 25. By 2019 they realized that Tara was only ovulating sporadically. They initially underwent five intrauterine insemination  treatments, which resulted in two pregnancies, both of which resulted in miscarriages.

“We were given pretty low odds of getting pregnant — around the 25 percent range,” Guy remembers.

After consultation with a specialist, the couple elected for IVF, a lengthy process that required Tara to finish a 12-hour nursing shift and then drive to San Jose for testing. When she wasn’t traveling, she was giving herself daily injections — three a day — or visiting clinics for monitoring. By 2022, after a successful egg retrieval, the couple was pregnant and their son, Charlie, was born in May. Eventually, they plan to try to get pregnant again using one of their frozen embryos.

“We might be lucky, and have it work the first time with baby No. 2, or it might not work, and it might take two or three more tries or all four of them might not work,” he says. “But we do have one now, and everything else is a bonus.”

The procedures can be exhaustively worrying, Guy adds. “The whole time you’re also sitting there thinking, is all this going to be in vain?” he says. “Is this all going to be for naught?”

Tara Dossi feels the same trepidations. “Your biggest fear is that it’s not going to work,” she says. “Especially considering all the time and effort, money. … You worry that you’re not in control.” 

The future of IVF

Gurkern Sufi, co-founder and chief executive officer for Ravata Solutions, hopes that his start-up company will give people more control over their parenting future. The Davis-based company, which also has a San Francisco location, bills itself as an assistive reproductive technology company “revolutionizing the path to IVF success.” Specifically, the fertility and reproduction startup specializes in hardware and diagnostics meant to transform IVF laboratories with automated assisted reproductive technologies.

One of Ravata’s current areas of research is work on a cell selection platform that will aid IVF clinicians and embryo transfer specialists in identifying and “grading” healthy embryos for improved pregnancy rates. Sufi calls the platform a “lab on a chip.”

“The perspective that I’ve heard is that it’s awful to collect 10 eggs and then have to tell someone that only three of them fertilized,” Sufi says. The process Ravata is developing, meanwhile, can “more or less guarantee that your eggs will fertilize.”

The new technology might not just improve the chances of healthy fertilization, it may also lower costs, Sufi adds. These may seem like lofty promises, but Sufi believes that the process, which has not yet been tested on humans, may be on track for FDA approval for one of its key developments by 2028 or 2029.

Investments in assisted reproductive technology startups have increased over the last decade. According to PitchBook, a company that tracks proprietary research data, venture capitalists seeded $854.5 million in fertility-focused technology in 2022 alone. Zeringue, who is on Ravata’s board as a medical director, says that even the incremental improvements that future embryo grading technologies may promise could significantly enhance the IVF experience.

“Some of these technologies could give us a boost in the right direction in terms of pregnancy rates to give us another bump” in success rates, he says. “Any clinic would be happy to take a 10 percent improvement.”

While Zeringue worries that start-up companies that try to tighten budgets and processes in favor of profits could pose a risk, he also knows that the increased exposure is positive. These developments, he says, “bring more money and interest, which in turn helps to bring in more technology.”

–

Stay up to date on business and technology in the Capital Region: Subscribe to the Comstock’s newsletter today!