Susan, 33, and her husband of two years don’t feel ready to have kids quite yet, so she’s thinking about freezing her eggs. So far Susan, who declined to share her last name and who makes more than $100,000 a year at a San Francisco tech startup, has gotten medical advice and lab tests through a new startup, Future Family. If she decides to freeze her eggs — a procedure worth at least $16,000 by one estimate — Future Family would lend her the cash for that, too.
Future Family, which officially launches on Thursday, aims to make the complicated, expensive, and emotionally fraught world of fertility treatments “accessible and affordable,” in the words of CEO Claire Tomkins, a former SolarCity executive. “We think of it as modern insurance for a woman,” she told BuzzFeed News. Future Family is one of several companies capitalizing on the high cost of — and demand for — fertility treatment.
But these plans aren’t without risks. They require a significant financial commitment, potentially over several years. And while egg-freezing is often marketed as a way to stop the biological clock, the odds that IVF will actually work — and that the investment will pay off — are low.
Future Family’s nurses dispense concierge-style advice about tests and procedures by text, email, and phone, and schedule hormone tests to give patients a snapshot of their fertility status. And for those who can’t afford the five- or six-figure costs of egg-freezing and IVF, Future Family offers subscription plans in which it pays for those services upfront, and customers pay them back on a monthly basis.
Liz Weston, a columnist and certified financial planner at the personal finance site NerdWallet, said that Future Family’s financial plans could be a good deal, but that customers should pay attention to the fine print.
“This is expensive, it could go a long time, the failure rate is still high,” said Weston, who reviewed the standard customer contract at BuzzFeed News’ request. “Even though IVF is much, much better than it used to be, it could be this is all money down the drain.”
Because most insurance plans don’t cover these services, fertility patients tend to have high incomes to begin with. In one survey by FertilityIQ, an online advice resource for patients, 42% reported yearly earnings between $100,000 and $199,999. But not everyone has necessarily saved enough to comfortably afford IVF, which costs around $20,000 on average, according to FertilityIQ. In a 2015 Prosper-commissioned survey of 213 US women, 84% said they had financial concerns about their treatments, and nearly half said that those concerns affected how much treatment they pursued.
Many patients ask their parents for loans, or stick everything on a credit card. FertilityIQ cofounder Jake Anderson-Bialis routinely hears of patients taking on second jobs and mortgages, and selling their cars and houses to pay for treatment. Some go to the extreme measures of crowdfunding their treatments online, and illegally paying strangers for IVF medications that stimulate the ovaries into making eggs.
“People empty their bank account to do this,” Anderson-Bialis said. “People do not have this kind of money necessarily lying around. But those who do not have it, where do they turn?”
Future Family’s standard IVF plan, which covers one cycle, is $250 a month, with no down payment. Customers can sign up for a minimum of 5 years and a maximum of 10 years, making the total cost at least $15,000. That would be cheaper than the national average cost of $20,000. The top-tier plan, which covers one cycle as well as egg storage, costs as much as $33,000 ($275 a month for up to 10 years).
But research shows that only about 30% of patients succeed the first time around. So patients can take out a second or third subscription to cover multiple cycles, at an equal or potentially cheaper price, Tomkins said.
Meanwhile, Future Family’s top-tier egg-freezing plan costs as much as $21,000, at $175 a month for up to 10 years of storage. FertilityIQ’s Anderson-Bialis estimates that, nationwide, egg retrieval and freezing costs average $16,000, while storage costs about $3,700 for five years.
If doctors determine that a procedure can’t be performed on a patient for medical reasons then they can cancel — for a $500 fee, plus the cost of “all expenses incurred by Future Family” up to that point, according to the contract. Otherwise, a customer is on the hook for all the payments, even if, for example, an IVF cycle succeeds one year into an eight-year plan.
Customers’ payments cover an “implied” interest rate of 7–12%, according to Future Family. Tomkins said the rates are “based on what we see in the market today.” NerdWallet analysts said they seem typical. To Anderson-Bialis, however, they aren’t “especially compelling.” Patients of his, who take out loans elsewhere, usually report interest rates of 5–10%, he said.
If a customer falls behind, they are charged a late fee that, for a standard IVF plan, would amount to an extra $30 per month. Upon examining this policy as described in Future Family’s contract, NerdWallet analysts found it “really confusing.” In response to BuzzFeed News’ questions, Tomkins said that the company was rewriting the clause to make it clearer.
There are other limitations too. Customers are required to choose a medical provider from a list provided by Future Family, or pay an unspecified fee to go elsewhere. As Weston put it, “Are you going to be able to use the doctors that you want to accomplish this?”
Tomkins says the company partners with dozens of clinics nationwide, mostly in New York, California, Washington state, Massachusetts, Illinois, and Utah. It does not make commission on patient referrals, but aims to steer patients to clinics known for delivering a good experience, she said. Future Family said it would only charge patients a fee in “the rare case” that a clinic charged more than what was covered by the plan, and that the amount of the fee “would depend on that specific clinic’s pricing.”
Tomkins, a former product marketing director at SolarCity, was inspired to cofound the company after her own grueling attempt to conceive, which involved six IVF cycles and several miscarriages. Today she has a 2-year-old daughter. Her cofounder, Eve Blossom, is an entrepreneur who founded the online fashion boutique We’ve, while their medical adviser is the director of fertility preservation and third-party reproduction at Stanford University’s medical school. A spokesperson said that Future Family has raised an undisclosed amount of venture capital.
Future Family isn’t the only company with fertility-specific financing programs: As these treatments become more mainstream, a growing number of financial programs have emerged to fund them. Clinics such as IntegraMed Fertility offer loans to pay for their services. Two years ago, Prosper, a peer-to-peer lending service, purchased, for $21 million, a lender with loans for fertility and other non–insurance-covered medical procedures. And in 2014, LendingClub spent $140 million on a similar acquisition. Its fertility loans range from $2,000 to $50,000, while Prosper’s go as high as $100,000.
Sameer Gulati, LendingClub’s chief operating officer, said the popularity of that business has grown. “The question of ‘Can I afford this?’ is an easier answer now because it’s more prominently available and the payment options are more flexible,” he said.
Susan, the 33-year-old who is one of Future Family’s first customers, isn’t yet at the point where she’s committed to freezing her eggs. But she’s found the advice from Future Family’s nurse to be helpful, and the blood tests she’s had suggest that she has at least a few more years in which to conceive.
Meanwhile, Susan and her husband are still grappling with how a family would change the lifestyle they’ve grown used to — one that allows them to travel whenever they want. “I think it’s more about emotional preparedness than anything, because obviously, once you have children, it’s a lifetime, it’s a change forever,” she said.