In this episode of The Egg Whisperer Show, I’m joined by Dr. Alexander Kucherov, a Reproductive Endocrinologist at Illume Fertility, to talk about one of the most important (and often most stressful) parts of the fertility journey: how to afford treatment. Dr. Kucherov shares practical strategies for navigating the financial side of fertility care, including how to access grants, choose smart loan options, and make the most of insurance coverage. We also talk about the role of clinics in providing transparent pricing and financial education, and new innovations on the horizon that could help reduce costs for patients.
Whether you’re preparing for IVF, egg freezing, or other fertility treatments, this conversation offers clear steps to help you plan ahead, ask the right questions, and feel more confident and empowered on your path to parenthood.
In this episode, we cover:
- What to consider when planning for the financial side of fertility care
- How to find and apply for fertility grants
- Tips for choosing medical loans and avoiding common pitfalls
- Understanding insurance coverage and fertility riders
- Innovations like bundled pricing and tech-driven solutions that improve access
Resources:
Find Dr. Alex Kucherov at Illume Fertility
Find Dr. Aimee’s Fertility Essentials & Supplements
Full Transcript:
Dr. Aimee: Hi everyone, and welcome back to the Egg Whisperer Show. I’m your host, Dr. Aimee, and today we’re diving into one of the most important and often overwhelming parts of fertility treatment, how to afford it. With the rising cost of living and the emotional investment that comes with trying to grow a family, it’s no surprise that many people are putting their dreams on hold.
But what if the right information and support could change that? To help us break it all down? I’m so excited to welcome Dr. Alexander Kucherov, a Reproductive Endocrinologist at Illume Fertility, who’s passionate about making fertility care more accessible. At Illume, they prioritize financial conversations from day one because they know that costs shouldn’t stand between someone and their chance to build a family.
We’re gonna talk about grants, loans, insurance, and all the smart ways to reduce financial stress while staying focused on what really matters to you: your goals, and your family building future. Let’s get started. Welcome Alex. Thanks for joining me today.
Dr. Kucherov: Thank you so much for having me, Dr. Aimee.
Dr. Aimee: So Alex, cost is one of the most daunting aspects of fertility treatment.
What should patients know as they start planning for the financial side of the journey?
Dr. Kucherov: The most important thing to know is that we are here with you at every step along the way, trying to get it figured out. A lot of the choices that have to be made are medical, of course, after doing a fertility checkup and moving forward with fertility treatment. Once we know what that treatment is though, a lot of it does come down to insurance and other coverage situations that they might have. It can come down to geography, where they live in the country. It comes down to not only who their insurance provider is, but where the company that they might work for provides that insurance for them. But we’re here with them every step along the way to help them through that journey.
Dr. Aimee: Those are really good points for those who are listening ’cause I don’t think people realize those subtle nuances.
Dr. Kucherov: It’s a huge deal. For instance, there are many commercial insurance carriers in this country. But if your insurance is through the same company in New York, in California, you may have total full coverage for every fertility treatment you can imagine, or absolutely zero coverage.
It’s kind of shocking.
Dr. Aimee: I mean, I’ve had patients move to different states just because of that, for that very reason.
Dr. Kucherov: Absolutely.
Dr. Aimee: So there are also several fertility grants out there, and I’ve had patients apply for them. Can you tell us how they typically work and what advice do you have for patients who want to apply?
Dr. Kucherov: So fertility grants are typically privately funded financial sources for folks who are having difficulty moving into fertility treatment. They can be from any number of groups. They may have restrictions for people who can apply to them based on their own personal medical history or their fertility diagnosis.
In some cases, some grants are open to folks of certain ethnic backgrounds or religious affiliations only. There’s a lot of them in this country and it can be really hard to figure out which ones are appropriate and which ones to apply for. I do recommend, there’s a wonderful organization known as Resolve (resolve.org) and they have a really nice list of many of the biggest companies that work to provide fertility grants.
But also a really great resource is your fertility practice. Many times they will know which grants might be available and when they become available because some are only available at certain times of the year, maybe for short periods of time for application. So that’s a really good resource as well, your own local fertility practice.
Dr. Aimee: Yeah, I mean, I see a situation in the very near future where grants are just not going to be something you apply for. You’re automatically going to be given funds to do IVF just because of how the world is changing.
Dr. Kucherov: Boy, do I hope so. This goes really to the ability to provide everybody with the care that they really need, the medical care and appropriate treatment that they need.
Dr. Aimee: Right. So let’s talk a little bit about medical loans. This is another option for patients to consider. What should someone look for in a loan, and are there any common pitfalls to avoid?
Dr. Kucherov: Yeah. So things to look for in a medical loan in many cases are: what are the terms of the loan, of course, can you afford it? All the things you would typically look for in a loan. Interest rates, if those apply. Many fertility loans may come with guarantees, and money back guarantees even, believe it or not, in terms of the outcomes.
They also might provide some services or not provide some services. And so it’s important to know what they actually cover. The term of the loan is very important to know. When do you have to pay it all back, and also whether your practice accepts loans from the company.
There are many fertility financing companies out there but not all of them work with all fertility practices.
Dr. Aimee: That’s a very important point. So you should check with your clinic first before you get a loan, because your clinic might not even work with that company. And then, yeah, and the other thing is oftentimes cycles are delayed for whatever reason. I hate the word cancel, it just feels very rude. Sometimes cycles are placed on pause because of things like cysts, or sometimes you decide to switch plans completely and move on to egg donation.
If you don’t feel like this is a good option for you anymore to consider your own eggs. So knowing and understanding what happens if, let’s say the loan is already dispersed to the clinic and now who’s gonna get the refund? How is that gonna work? Is it gonna go back to the loan company? Is it gonna go back to the patient to pay the loan company?
Those are the kinds of things in the fine print that I also think patients should know.
Dr. Kucherov: It is a really good point. And, just to that point is that, some loans may cover, for instance, autologous fertility treatment using your own eggs, but they might not cover donor services and that might be something that you require. So those details are extremely important.
Dr. Aimee: Or I had a situation where a patient was using the financing company to pay for her IVF medications and then when she found out that the cost of the meds that she was ordering was actually not that much and she didn’t need it to be financed. The loan company still charged her $200 even though she wasn’t gonna use them.
So those are like the subtle things that you may not, people just don’t know up front. What are the hidden costs? And like, tell me everything. Go through all the worst case scenarios if you use them. If you don’t end up using them, what are you gonna be paying? So I wanna talk about insurance.
Can people actually buy a plan that covers fertility treatment? People tell me that all the time. I’m gonna get insurance that covers IVF. I’m like that’s kind of hard because you kinda have to work for a big company, but sometimes you can. So can you speak to us a little bit about that?
Dr. Kucherov: Yeah, so again, this depends a lot on geography. So as an example, there are some states where our fertility coverage is mandated for private insurance, but it may only be mandated if you work for a big company that has over a hundred employees, as it’s not a self-funded plan, self-funded by the company itself.
So smaller companies, for instance, are not mandated to cover that. However, do know that there are insurance plans that cover fertility treatment. Again, at least where we are in New York and Connecticut through the healthcare exchanges. Many of the gold and platinum level plans do cover fertility treatment, including IUI and IVF.
It does take a fair amount of legwork, I will say, to go onto those websites and dig through the plans and maybe have to call them and see what’s going on. And the plans are typically quite expensive. However, a single IVF cycle typically would cost more than a yearly premium, though even on one of those plans.
So it does overall pay for itself in some ways. But it does take a lot of effort to take a look. But yes, insurance plans can be purchased that cover fertility treatment.
Dr. Aimee: And that’s exactly what I tell patients too. If you’re going to get your own plan that covers IVF, you’re gonna spend thousands a month on the premiums. So it’s basically just like paying out of pocket for your IVF cycle. Okay. So let’s talk about some of these things that clinics offer, like bundled or package pricing.
What are the potential advantages of those plans, and are they usually offered upfront or something patients need to ask about?
Dr. Kucherov: So many of the practices in the United States offer bundles. They typically advertise it pretty heavily. I’ve certainly seen that when they’re looking around at other fertility practices, they’ll say, “Hey, if you pay X, Y, Z, then you’re guaranteed, you know, however many egg retrievals and embryo transfers.”
Now, I will say, you know, sometimes that may cost more than a single cycle. A part of that strategy of cost sharing sometimes that does benefit the practice. There’s a lot of those kinds of nuances to look at. Beyond that, I think the details are very important. And the package, what does it actually cover?
Does it cover one cycle of IVF as an example? Does it cover multiple cycles? Does it cover multiple embryo transfers? If the first one doesn’t work, do you keep getting transfers as part of that package until you have a pregnancy? And you can, you know, talk to your finance counselor at the practice.
And sometimes, you know, it takes making a spreadsheet to do the math and see if it’s worth it or not. But a lot of it is based on those underlying factors that we talked about in the past and the chance of success upfront.
Dr. Aimee: And what do you do at your clinic?
Dr. Kucherov: So at our practice, we have self-pay options for folks that do not have insurance. And there are, for instance, we call it an “opportunity plan” that includes a full IVF cycle, egg retrieval, embryology process and an embryo transfer. However, we are now working also with a financing company.
There are a couple of very exciting options that they offer. This company is called Sunfish. It’s a very cute name. Sunfish, huh. But they offer fertility loans, of course, but they also offer what’s called an IVF Success plan, which basically includes the IVF cycle and unlimited embryo transfers until you achieve a pregnancy.
I think that that’s a really great option for a lot of people. It may, this gets in the weeds a little bit. It may reduce PGTA utilization in some ways. If you can just keep doing embryo transfers until you conceive, maybe people won’t do chromosome testing of those embryos. I don’t know what remains to be seen, but that’s what we do at our practice.
Dr. Aimee: Oh, that’s exciting. Yeah, I can see how that would be very attractive for patients. Let’s go to the next question here. Okay. Are there certain questions patients should ask their clinic or insurance provider to better understand their options and avoid surprise costs?
Dr. Kucherov: Oh my goodness. Absolutely. At least at our practice, we run a benefit check for patients before they come through the door. When they meet with me, for instance, for their first visit, we were able to actually go over their benefits with them on their first visit. And the finance team has already reached out to them even beforehand to review their benefits with you.
However, sometimes the actual details of the benefit check are not totally clear, and I have certainly run into circumstances where when we do the benefit check, it looks like something’s gonna be covered, but then actually it’s not. Or there’s other exceptions to that. I’ve run into that most commonly with same sex couples.
Unfortunately, sometimes there is a little bit of fine print, a bit being able to access certain fertility treatments earlier versus later. So for instance, sometimes same sex couples may have to do multiple IUI cycles in order to qualify for an IVF cycle. And it’s not necessarily spelled out in that kind of detail in the benefit check.
So it’s very important to, number one, find that out ahead of time if you can talk to your fertility practice. But then independently, unfortunately, call the insurance company, something we all love to do to go over those benefits and make sure you know exactly the details. That being said, before we do a fertility treatment of any kind, we do get authorization from the insurance company.
And that is unfortunately sometimes the time when some folks find out about those details. And that can be very distressing and I think rightly so.
Dr. Aimee: Yeah. And then the other thing that can happen sometimes with insurance that can be really frustrating and distressing is you might have coverage for three IVF cycles, but you have to use all your frozen embryos first. And for families who, let’s say are over 35 and wanna bank embryos for their future, and that might not be the right plan for them, sometimes they’re forced to just do what insurance is requiring them to do because of the affordability, and I find that so upsetting.
Dr. Kucherov: It’s extremely upsetting, especially, as we know, egg quality changes very quickly, especially once we get into our mid to late thirties, and certainly over 40 every six months makes a difference. Some insurance companies, as you know, do allow for folks, “Hey, you have your three cycles. You do them whenever you want.”
Great. Some don’t even need authorization sometimes, but in some cases, nope, there’s a lot more paperwork and a lot more denials of benefits and what we would consider medically appropriate.
Dr. Aimee: Okay. So if someone’s feeling overwhelmed by the financial aspects of treatment, what steps can they take to feel more in control and informed?
Dr. Kucherov: It is very important to try to stay plugged into all of this and try to feel like you’re in control because this process in general can make you feel out of control. I mean, we’re talking about situations, trying to build your family, and especially for folks that have had challenges for months, years leading into it, it is totally natural to feel out of control.
And so getting empowered and getting the information, the details immediately, in my experience, can make people feel more empowered. It’s like, okay, at least I know what the options are here. You know, at least I know a little bit of what’s available to me. Then we can look at the medical decisions, see what’s appropriate to move forward, and work with the finance team at the practice to do that.
Dr. Aimee: Yeah. And if you were to coach a finance team or another clinic and doctor, what do you think clinics and providers could do better for their patients when it comes to billing, insurance and financial planning?
Dr. Kucherov: It’s all about communication. Feeling like you don’t know what’s going on is extremely common for folks entering fertility treatment. I mean that part of it in many cases is like, “What is going on? Am I ovulating, am I timing things correctly?”, amongst so many other things. Being able to make sure that the patient feels empowered with all that information as soon as possible, I think, is the most important thing.
Dr. Aimee: So looking ahead, are there any innovative trends or tools on the horizon that you think could make fertility treatment more accessible and affordable?
Dr. Kucherov: There are some things it looks like coming through the federal pipeline as well as the state pipeline from governments. I will say New York State, this just happened, I believe a week or two ago. The 2026 fiscal year budget just passed, which I think we’re in already, but I don’t know exactly, which is now mandating for the first time that Medicaid cover egg and sperm freezing for patients with cancer.
Dr. Aimee: I mean, that’s huge. Like for the first time ever. Mind blown. That’s huge. Huge.
Dr. Kucherov: It’s unbelievable and I am so grateful. It’s a long way to go for the equity of fertility treatment, especially in this country.
Really one of the goals I feel should be that anybody who needs fertility treatment should be able to access it. And this is why it’s so different from so many other medical treatments. If you have appendicitis and you go to the hospital, guess what…you’re getting an appendectomy if you need an appendectomy.
If you have cancer, you can access cancer treatments, typically, regardless of your ability to pay. There’s a lot of different ways to access that. Fertility is really the one thing where you can have state insurance or commercial insurance and you might not have any coverage to treat medical diagnosis and medical disease.
It does look like there is some support. We’ll see what form it comes in from the federal government, maybe coming down the pipeline, but it is at least in the national conversation for the first time in a long time. And that’s a step forward.
Dr. Aimee: Yeah, I agree. And then what do you think is missing in general from the conversations that we all have around finance, insurance, and fertility care?
Dr. Kucherov: It’s a couple of things. I think access to care, in my opinion, is the most important thing. There is a paucity of fertility specialists in this country. I mean, we graduate 50 to 55 new Reproductive Endocrinologists per year.
Dr. Aimee: In my year, my year, it was 13.
Dr. Aimee: 13. It was like a recession, like all the universities were losing funding. But yeah, no, talk about paucity. 50 is like nothing.
Dr. Kucherov: It is like nothing in a country of 350 million people. I mean, there are states that maybe have one fertility center. So there are a lot of innovative things coming down about increasing access to care. Some of them are controversial, and they include utilization. This gets in again in the weeds, but utilization of mid-level providers like nurse practitioners, PAs, et cetera, to do certain aspects of basic fertility care, including monitoring of certain types of fertility treatments using general OBGYNs and those skills, that we all have as general OBGYNs. For instance, some practices have general OBGYNs doing egg retrievals, which compared to a hysterectomy is not a big deal, but needs a little bit of (a word was left out here).
Dr. Aimee: Yeah.
Dr. Kucherov: It’s not the hardest thing. You have to get trained at it, but once you’re gonna be good at it, you’re gonna be good at it. And maybe having Reproductive Endocrinologists do more high level management and certainly more complex cases is one way to increase access to care. Get more providers involved at a level that they’re not currently involved in.
Dr. Aimee: Or turn the two of us into avatars, like AI avatars, and then you just talk. You think you’re talking to me, but you’re not really talking to me.
Dr. Kucherov: That would be very cool.
Dr. Aimee: You know it’s gonna happen, Alex. I mean, you know, it’s coming.
Dr. Kucherov: It’s absolutely coming. I mean, we see things. I know another automation component is there are companies now that are fully automating the IVF lab, which is an extremely costly component of fertility care. The folks that work in the lab, all of the machines, the incubators, manually doing ICSI, putting one sperm into each egg under the microscope, talk about time consuming.
But there are companies that have machines that are doing all of that now and that’s maybe gonna be the standard in 15, 20 years once they can reach scale.
Dr. Aimee: Yeah. I mean, it’s been a race to the finish line, so I’m excited to see who’s gonna get there first. So that’s pretty great.
Dr. Kucherov: It’s very exciting the technology coming down the pike.
Dr. Aimee: I didn’t really have a chance to have you talk about Illume and the work that you do, and you’re so lovely and I’m sure people are gonna listen to this and they’re gonna say, “He seems really great. Where can we find out more about him?” So can you just tell us a little bit more about yourself and where people can work with you?
Dr. Kucherov: So I am a Reproductive Endocrinologist at Illume Fertility. We have five clinic sites, four of them in Fairfield County, Connecticut. So in Danbury, Stanford, Norwalk, and Trumbull, Connecticut. And we also have an office in Harrison, New York. Our main office, and operating room is in Norwalk, Connecticut.
So, about 15 miles from the New York border, we have this quick train ride from New York City. We have a really big catchment area. You know, I see patients as far north as Albany, New York, as far south and west as New Jersey, even into Massachusetts and Rhode Island sometimes.
You can find us at our website at illumefertility.com. It’s very easy to make an appointment. Our wait time is typically pretty quick, maybe one or two weeks to get a first visit. And we do telehealth if you want, for the first visit.
Dr. Aimee: Thank you, Alex. Thank you so much for joining us today. I really appreciate your insights on, you know, the financial considerations for patients going through fertility treatment and, and I just really appreciate all the work that you’re doing on the East Coast.
Dr. Kucherov: It’s absolutely my pleasure. Thank you for what you do and getting the message out there and educating folks and it’s my pleasure to be here. Thank you so much.
Dr. Aimee: Alex, before we close, is there anything that you want to share with our listeners today?
Dr. Kucherov: Fertility is a very challenging diagnosis, a very challenging treatment course. But if you think positively, stay the course step by step, you will eventually get there. It may be more challenging, it may be more time consuming, certainly and harder than you think, but if you put in the effort, you will get there.
Dr. Aimee: Thank you so much for joining me today and for sharing such thoughtful insights, the financial. The financial side of fertility treatment can feel like an impossible puzzle, but with the right tools, guidance, and support, it becomes something you can navigate.
Whether it’s through grants, bundled packages, insurance, or creative financing, there are ways forward. If you’re listening and feeling overwhelmed, just remember, you are not alone in this. There are more options than ever before, and your dream of building a family is worth fighting for, one step at a time.
You can find links to the resources we discussed today in the show notes. And as always, visit me at draimee.org for more fertility tips, education, and support. Thanks for listening, and I’ll see you next time on The Egg Whisperer Show.
