The prevailing wisdom is that ICSI is cheap in the grand scheme of IVF costs, but that doesn’t mean it’s always good value, or that the money couldn’t be better spent elsewhere in the process.
Dollars and Sense
On average, ICSI costs range from $800 - $2,500, depending on where you have it performed. Nearly all ICSI is done in-house at your clinic’s laboratory, where we estimate the clinic’s costs to perform ICSI are in the $50 - $250 range. If your insurance covers IVF, it’s likely they’ll also cover ICSI, and we do see doctors ordering ICSI more frequently when the patient doesn’t have to pay.
Is ICSI Worth It?
ICSI For Male Factor Patients
ICSI’s value is different for different types of patients. For patients with severe male factor (e.g. azoospermia), ICSI is mandatory. Without ICSI, these patients could not conceive. However, many male factor infertility patients are not in that group, and so calibrating the value of ICSI might make sense.
ICSI has been shown to be effective for male factor infertility patients broadly defined, driving lower likelihood of canceled cycles (measured between retrieval and transfer) and higher live birth rates. Presumably ICSI improves a couple with male factor’s chances of foregoing another IVF cycle by 3% (absolute difference in live birth rates) to 7% (absolute difference in canceled cycle rate).
If you wanted to try and quantify the value of ICSI, let’s presume ICSI reduces one’s rate of needing to undergo another IVF cycle by 3 – 7%. Thus, presuming each IVF cycle costs about $23,000, based on that 3 - 7% risk reduction, ICSI on average saves $700 - $1,600. Of course, there are forms of male factor where IVF will simply not work without ICSI (e.g. azoospermia) and so the value of ICSI is untold, because it would be simply impossible to father a child without it. And of course, none of this analysis contemplates the lost time, and drained emotion, from having to try again.
ICSI for Non-Male Factor Patients
ICSI has not yet been shown to be more effective than IVF without ICSI in patients without male factor. In that case, there are lower or equivalent “take home baby” rates, and so on a dollars-and-cents basis, ICSI may not have much, if any, financial payoff. Below are some common “non male factor” reasons for doing ICSI, and their associated outcomes when deploying ICSI versus not.
How Else Could $1,500 Be Spent
While $800 - $2,500 may seem like a small expense in light of IVF’s overall costs, the money can still go a long way towards other costs during your fertility journey. Namely, $1,500 can likely cover the cost of your interest payments (presuming an 8% APR) for a whole year if you financed your IVF treatment. It can also pay for nearly half the cost of a frozen transfer (typically around $3,000) of additional embryos, or psychological counseling during your treatment.