For a lot of people, a new year can mean new benefits. That’s why we hosted a free webinar for those just starting their family building journey with Progyny. We touched on how the Progyny benefit works, what’s included, the logistics, and what happens during an initial consultation. We also heard from a member about her experience with Progyny.
Life can be busy and it can be hard to sit down for a full webinar, which is why we’ve broken our webinar into bite sized chunks below—and provided a recap for those who’d prefer to read about it.
Building Your Family in 2021
- Selena Campbell, Director of Member Services, Progyny
- Susanna Park, Reproductive Endocrinologist, San Diego Fertility Center
- Kayleigh Hajny, Progyny member
- Joni Vick, Clinical Educator Supervisor, Progyny
Infertility 101 + Diagnosis
Infertility is actually very common—1 in 8 couples in the US suffer from infertility. To get a diagnosis of infertility and start your family building journey, you’ll need to visit a reproductive endocrinologist.
If you’re younger than 35, infertility is diagnosed when you’ve been trying for 12 consecutive months without conception, versus six consecutive months for females 35 and over. However, if you know you have a condition which affects ovulation or fertility—such as PCOS or endometriosis—you may need to evaluate your fertility earlier. For those in same sex relationships or who want to be single-parents-by-choice, you’ll want to visit a reproductive endocrinologist as soon as you’re ready to start your family.
For Progyny members, when you’re ready to start your journey it’s best to call your dedicated Patient Care Advocate (PCA). Your PCA will explain your fertility coverage, answer any questions you have, and offer guidance on how to pick the right provider for you. Your PCA will also check your eligibility right then and there so you don’t need to wait for insurances letters or follow up with anyone.
Initial Consultation + Different Treatments
In order to receive a diagnosis of infertility you’ll need an initial consultation at a fertility clinic. Although some of these consultations used to be virtual, since COVID the majority are and you’ll only come into the office for testing.
Although some of these consultations may be virtual due to COVID protocols, and you’ll only come into the office for testing.
During the initial consultation, your physician will go through your medical history, as well as your partner’s if you have one. Females will have tests that look at the egg, fallopian tubes, and uterus, while males will have sperm tests. Both partners will also have general medical tests and be tested for infectious diseases.
At the follow up you’ll go through your test results and talk through your treatment options.
Main Treatment Options
- Timed intercourse (TIC): You take a fertility drug to stimulate ovulation and monitor ovulation with ultrasounds. Based on the ultrasound you can figure out when is the optimal time for intercourse.
- Intrauterine insemination (IUI): You can either use fertility drugs to stimulate ovulation or follow your body’s natural ovulation. Much like TIC, your ovulation is monitored via ultrasound, but rather than having intercourse, concentrated sperm is inserted directly into the uterus via a catheter.
- In vitro fertilization (IVF): In order to stimulate ovulation, you give yourself daily hormone injections for 9–12 days. During this period your ovulation is monitored via ultrasound and bloodwork 4–5 times. Just before ovulation your eggs are retrieved under anesthesia vaginally in a procedure that takes around 15 minutes. Often sperm is manually inserted in the retrieved eggs through intracytoplasmic sperm injection (ICSI) to ensure best chance of fertilization. The fertilized egg, called an embryo, is developed in the lab for about 5–6 days. If you are pursing genetic testing for aneuploidy (PGT-A), which is included in Progyny coverage, your embryo is biopsied so it can be tested, and the embryos frozen for future transfer.
The treatment process can range from three to six months, but this depends on your treatment option and fertility clinic.
- Within two months of your initial consultation your testing should be completed and you should have decided on your treatment.
- Then within a month you’ll meet back with your provider to determine your treatment options at a follow up appointment.
- You should begin treatment within a month of two of your follow up appointment.
Seamless Member Experience
Kayleigh Hajny was diagnosed with infertility when she was 16, so she knew when she started her family she may have to look to assisted reproductive technology. Luckily, she had comprehensive Progyny fertility coverage through her husband’s employer, VMware.
With her provider from Boston IVF, Kayleigh and her husband decided to pursue IVF. After her initial consultation, she had follow-up in January 2020, and had her egg retrieval in February. Because she elected to pursed IVF, she immediately had an embryo transfer and the rest of her embryos were frozen, but unfortunately it failed. She had two subsequent frozen embryo transfers and with the third she became pregnant and is now the mother to her daughter. Overall, her journey to pregnancy took eight months. She found the process incredibly smooth and was particularly thankful for the guidance of her PCA.
“My family is complete because VMware chose Progyny,” Kayleigh said. “To me, infertility is a medical diagnosis, and it deserves medical coverage and that was brought to us through VMware. I’m so grateful.”
Understanding Progyny Smart Cycles + Financing Treatments
For those without comprehensive fertility coverage, financing treatment can be incredibly difficult. One round of IVF can cost between $15,000–$20,000—excluding medication.
Progyny is an employee-sponsored benefit that carves out from your medical benefit. Much like medical plan, your financial responsibility may include coinsurance, copayments, a deductible, and an out-of-pocket maximum. Your PCA will walk you through the specifics of your financial responsibility. Unlike other fertility coverage, members don’t have to worry about dollar maximums.
Because Progyny uses Smart Cycles you don’t have to worry about running out of coverage mid-treatment. To make your fertility benefit easier to use, we bundle all of the individual services, tests, and treatments into the Progyny Smart Cycle. Some treatment types will use only a portion of a Smart Cycle, while other more comprehensive treatments will require the use of an entire Smart Cycle.
Although Progyny works with 180 employers and covers 2.7 million lives, there are many people without comprehensive fertility coverage. For those that don’t have a fertility benefit, you can visit progyny.com/talktohr to learn how to best approach your HR team about fertility benefits to your organization. We know it works—65% of employers added a fertility benefit because employees asked for it.
Thank you for joining us as we learned about building your family in 2021. Be sure to check out our next webinar.