Treatment

April 17, 2025 by Andrea Mathis

Navigating your insurance benefits at RSC is an important step in your fertility journey. Understanding your coverage can help minimize out-of-pocket expenses and streamline your treatment process. This guide provides an overview of how to effectively navigate your insurance benefits and highlights common insurance codes related to fertility treatments.

Coverage for fertility diagnostics and treatment can vary significantly depending on your insurance provider, employer plan, and state of residence. Review the plans we accept on our insurance coverage page to get a sense of where your coverage starts.

Understanding your coverage for fertility diagnostics and treatment

Insurance coverage for fertility diagnostics, testing, and treatment isn’t one-size-fits-all, and the details can shape both your care plan and your budget. Before starting treatment, it helps to know exactly what’s covered, what isn’t, and where your out-of-pocket costs are likely to fall.

Initial consultation and treatment coverage: RSC patients often have insurance coverage for their initial consultation, and many have some coverage for infertility treatment.
Review your benefits summary: Obtain a copy of your benefits summary from your employer to understand what is covered under your plan. Be aware that benefits and out-of-pocket expenses can change annually. Pay attention to both in-network and out-of-network benefits, since coverage levels and costs often differ between the two. Plan type matters as well—a PPO and a high-deductible health plan (HDHP) can cover fertility care very differently, even through the same employer.
Flexible spending accounts (FSA): Consider utilizing an FSA or Health Savings Account (HSA) to cover medical expenses not paid by insurance, such as deductibles, co-pays, and treatments not covered.

Verifying your benefits

Contact your HR department: If infertility coverage isn’t listed in your benefits summary, reach out to your Human Resources department or benefits coordinator for clarification. They can provide detailed information about your specific plan. Your HR team can also tell you which fertility benefit vendors or third-party administrators, such as Progyny or Carrot, are included in your plan, when you become eligible to use them, and whether additional family-building resources, like adoption assistance or surrogacy support, are offered.
Consult RSC Financial Educators: RSC’s Financial Educators are available to explain treatment costs and help maximize your insurance benefits before starting therapy.

Gaining coverage

Employer-sponsored plans: Employers may offer plans that include infertility benefits. Discuss available options with your HR department.

California’s Insurance Expansion Benefit

Since January 2026, expanded insurance benefits have been making fertility treatment, including IVF, more accessible to California residents—offering the coverage they need to grow their families.

California’s expanded insurance coverage will require large-group health plans to cover:

Fertility testing and diagnosis
Infertility treatment, including IVF
Up to 3 completed egg retrievals
Unlimited embryo transfers, based on clinical guidelines

The law also takes an inclusive approach to defining infertility, ensuring that LGBTQIA+ individuals, single parents, and others have fair access to fertility care.

Additional financing options

When insurance, state-mandated coverage, or an employer-sponsored plan doesn’t cover the full cost of care, additional financing options can help close the gap. We offer several programs designed to make treatment more manageable and predictable.

Payment plans and financing: Manageable financing, offered through CapexMD, provides 0% financing for the first six months of treatment, with loan terms up to 84 months. Grant programs, including the Tinina Q. Cade Foundation, can also help offset costs for qualifying patients.
Fertility Access refund and multi-cycle discount programs: We partner with Fertility Access to provide bundled IVF cycle discounts and refund programs that can help patients save up to 40% on treatment costs. Some exclusions apply.
HSA/FSA funds and discount programs: An HSA or FSA typically can’t be used for insurance premiums, but it may cover co-pays, deductibles, lab tests, over-the-counter pregnancy tests, ovulation predictor kits, breast pumps, and prenatal vitamins.

Common insurance codes for fertility treatments

Familiarizing yourself with common insurance codes can facilitate discussions with your insurance provider and help ensure accurate billing. Here are some frequently used codes:

In vitro fertilization (IVF) procedures:
- 58970: Follicle puncture for oocyte retrieval
- 58974: Intrauterine embryo transfer
- 89250: Culture of oocyte(s)/embryo(s), less than 4 days
- 89254: Oocyte identification from follicular fluid
- 89268: Insemination of oocytes
- 89272: Extended culture of oocyte(s)/embryo(s), 4-7 days
Artificial insemination (AI) and intrauterine insemination (IUI):
- 58322: Artificial insemination; intrauterine (IUI)
- 58323: Sperm washing for artificial insemination
Assisted reproductive technology (ART) procedures:
- 89251: Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture
- 89255: Preparation of embryo for transfer
- 89258: Cryopreservation; embryo
- 89261: Sperm isolation; complex prep (e.g., Percoll gradient, albumin gradient) for insemination or diagnosis

These codes are based on the Current Procedural Terminology (CPT) system and are used for billing and insurance purposes. Discussing these codes with your provider and insurance company can help clarify coverage specifics. This list is regularly updated, and other codes could be billed for your treatment plan. Please speak with your Financial Educator for more information. This list is not a comprehensive list of all codes that may be billed but can serve as a helpful guide.

Additional tips before starting fertility treatment

Pre-authorization: Some insurance plans require pre-authorization for certain fertility treatments. Ensure all necessary approvals are obtained before starting treatment to avoid unexpected expenses.
Keep detailed records: Maintain copies of all communications with your insurance company, including pre-authorizations, denials, and appeals.
Appeals process: If a claim is denied, don’t hesitate to appeal. Provide additional documentation and work closely with your healthcare provider to support your case.

By proactively managing your insurance benefits and understanding the associated codes, you can navigate the financial aspects of your fertility treatment more effectively. For personalized assistance, contact RSC’s Financial Educators who are ready to help you through this process.

March 27, 2025 by Kate Stephens

The staff at the Reproductive Science Center (RSC) understands that the decision to seek fertility treatment can be difficult. For a couple considering fertility treatment, it is important to ask the right questions about success rates, costs, medical services, and financial options. Also, consider your relationship with, and trust in, your physician.

Our advice to patients considering fertility clinics is to be certain they understand all aspects of their decision, and to make certain they receive understandable answers to any questions they may have. Understanding these issues before beginning treatment can save time, energy, frustration, and money. It may also increase your chances of achieving a successful pregnancy.

1. What factors should be considered when choosing a treatment program?

Success rates
Full range of procedures performed
Treatment flexibility and customization
IVF program stability over time, with an established “good track record”
Financial options, including insurance participation and financing
Staff accessibility and response

2. Is it possible to evaluate clinics objectively?

Interpreting statistics of fertility programs requires patience and care. Individual assisted reproductive technology (ART) programs do not use a standard format for reporting their success rates in advertisements and promotional literature, making comparison among clinics difficult. The Centers for Disease Control and Prevention (CDC) and the Society for Assisted Reproductive Technologies (SART) publish clinic-specific data on most of the ART programs in the U.S. Each clinic reports its annual outcome data to SART in a standardized format.

The SART report is comprehensive and provides valuable information about each clinic, including the number of cycles performed, pregnancy rates by age (with or without male factors), miscarriage rates, and average patient age.

You may be able to see trends or patterns that will help you understand the quality, stability, and experience of the programs you are considering, especially if evaluated over time. The SART reports are available online on a clinic-by-clinic basis.

We encourage you to visit the American Society for Reproductive Medicine (ASRM) for information on objective criteria.

3. How do I evaluate clinics based on current statistics?

While recent advances in fertility treatment are improving patients’ chances for success, it can also mean that the most recently published statistics available from CDC/SART may not reflect your actual odds. Ask the clinics you are considering for current statistics. Be sure to ask for documentation on the statistics, as well as for statistics for your age range and infertility diagnosis.

Since beginning an IVF program, RSC has published a comprehensive statistical analysis. of all ART cycles performed in its center and outcomes. We strongly encourage anyone considering advanced fertility treatments to obtain the same information from each clinic they are considering. View our most recent success rates.

4. How important are the statistics?

Couples with normal fertility have a 20-to-25-percent chance of conception each month if they have intercourse at the proper time of the cycle. Therefore a fertile couple has at least a 93 percent chance of achieving pregnancy within a year.

To help you understand how important success-rate statistics are, we’ll compare two theoretical clinics, Clinic A with a 30-percent delivery rate per cycle and Clinic B with a 12-percent delivery rate. From the chart below, you can see that the average couple undergoing IVF can expect:

Clinic A (30 percent delivery rate): a 65 percent chance of delivery after 3 cycles
Clinic B (12 percent delivery rate): a 31 percent chance of delivery after 3 cycles

	Clinic A: 30 % Delivery Rate		Clinic B: 12% Delivery Rate
	# of Couples	# of Deliveries	# of Couples	# of Deliveries
Cycle 1	100	30	100	12
Cycle 2	70	21	88	10
Cycle 3	49	14	78	9
Total Deliveries		65		31

You may also notice that you have nearly the same odds of success in one cycle at Clinic A as you have with three cycles at Clinic B. So, even if Clinic A’s fees are higher than Clinic B’s, you may save money with treatment at Clinic A.

5. How do I know that the fertility center I am considering offers a full range of services?

First, ask a lot of questions and listen carefully. Some centers specialize in one form of treatment, and all patients receive that form of treatment; unfortunately, other, more effective treatments may be overlooked. At RSC, we offer a full range of fertility treatments, and each patient undergoes a comprehensive assessment to ensure that all options are considered.

Secondly, we encourage patients to ask about all possible treatments, including surgery, intrauterine insemination (IUI), in vitro fertilization (IVF), egg donation, embryo freezing, and a full range of embryology services, including intracytoplasmic sperm injection (ICSI), embryo hatching, and preimplantation genetic testing (PGT).

6. Does it matter how long a program has been in existence? Isn’t newer better?

At RSC, we believe one of our strengths is our stability and longevity. Our physicians have been working together for almost 10 years, and we have worked with the same embryology laboratory director for over 20 years.

We recommend that anyone considering fertility treatment ask each clinic under consideration about stability and years of experience of the physicians and the embryology staff. Infertility treatment, particularly IVF, requires a great deal of timing, coordination and communication between doctors and embryologists. The longer teams have worked together, the more effective they are in assuring a well-executed treatment plan.

7. How much does treatment cost?

The costs for infertility treatments vary widely among clinics. The best way to assess your ultimate cost is to ask each clinic for a copy of its fee schedule. It is important to determine if there are any additional fees not included in the fee schedule such as hospital charges, drug costs, and testing.

At RSC, we recognize that cost is an important factor when selecting an ART program. Our financial options page provides information related to our refund and discount programs, as well as financing options.

In the San Francisco Bay Area, the costs for one cycle of IVF range from $14,000 to $19,000, plus medications.

The cost of medications is a significant portion of the total IVF expense, and can vary. RSC has developed a relationship with a pharmacy offering competitive prices and the convenience of shipping to your home. There is the added benefit of verifying your insurance coverage for medications.

8. Will my medical insurance cover infertility treatment?

Approximately one-half of insurers provide limited coverage for intrauterine insemination services. RSC participates in many local physician groups that represent the many commercial health plans in Northern California.

It is not highly likely that your insurance plan will provide coverage for in vitro fertilization, although some of the initial diagnostic examinations, and the medications, may be covered. In most cases, you will be covered for pregnancy resulting from fertility treatment. There are a few insurance plans that do cover IVF services.

Insurance companies usually have hundreds of plans to offer employers, each with different benefits. Contact your insurance provider and ask them what your insurance plan benefits are for infertility treatment. Our practice can investigate insurance benefits for you. We can also provide you with the necessary forms so that you may submit claims for reimbursement by your insurance company.

You may wish to consult ASRM’s website for information regarding state infertility insurance laws.

9. What other financial matters should I be considering?

When choosing an ART program, look for flexibility and evidence of programs designed in response to patients’ needs. The Reproductive Science Center has many financial options for patients, including a refund program, a discount program, and financing options that cover medication costs. See our financial options page for additional information, or contact one of our financial counselors at (925) 867-1800.

10. Who will be on my fertility treatment team, and how will I know how I am progressing?

Communication is a vital element in successful fertility treatment. The physicians at RSC are joined by a highly qualified team of nurse case managers, working collaboratively to coordinate your care. All of the physicians in our center may be involved in your care, along with IVF nurse case managers, operating room nurses, and embryologists.

At RSC, we have one of the most experienced teams around. Every IVF patient is assigned a nurse case manager, who will provide an overview of IVF, assist in communications, provide instructions, and make certain that any questions you may have are addressed.

We encourage individuals considering several clinics to ask about the availability of nurse case managers, and methods of care coordination and communication.

11. What other online resources are available for evaluating a fertility program?

The ASRM has a helpful publication “Selecting an ART Program” – a consumer’s guide to evaluating a fertility clinic, including a review of how success rate claims are calculated by providers.

March 25, 2025 by Jacqui Behler

1. How are embryos frozen and thawed?

Embryos may be frozen at different times after fertilization. At RSC embryos are frozen five or six days after the sperm and eggs are combined.

The freezing or vitrification process at the blastocyst stage causes minimal to no harm to the embryo. At RSC Bay Area, we have an embryo survival rate of 98 percent.

The embryo is loaded into a small straw, and placed in the cooling chamber of a controlled rate freezer. The embryo is cooled slowly to maximize water extraction from the embryo and to prevent the formation of large ice crystals that can damage the embryo. The entire process takes several hours and the frozen embryo(s) are stored in liquid nitrogen at -1960 C.

Embryo thawing is simply a reversal of the freezing procedure. The embryos are removed from the storage tank and are warmed to room temperature in 30 seconds. For the next 30 minutes, the embryos are stepped through four different solutions until the cryoprotectant, the chemical used in the freezing solution to protect the eggs, is gone and all the water has been replaced. This thawing procedure is performed at room temperature. When completed the embryos are warmed to body temperature (37°C). Thawed embryos are ready for transfer to the mother 40 minutes after their removal from storage.

2. How long can my embryos be stored?

No one knows the maximum storage period. Procedures for human embryo freezing were developed in 1984 and went into widespread use in the late 1980s. To date, the longest time a human embryo remained frozen and successfully created a child is 19 years. Patients who store embryos for this long usually do not return for them. RSC has stored an embryo for 18+ years and successfully assisted a patient in having a child.

3. How am I going to be billed for storing my embryos?

A precise inventory is maintained for all embryos in storage by the laboratory staff. Patients with embryos in storage are billed monthly. It is the patient’s responsibility to notify RSC of changes to address, email or credit card. We request a credit card be placed on file for automatic billing.

4. What are my options if I/we no longer wish to store the embryos?

Patients who no longer wish to store their frozen embryos have several options. Frozen embryos may be discarded as medical waste. They can be released to the IVF lab for quality control & staff training and then discarded after a few days. Typical research topics include new techniques for freezing or thawing embryos, new ways of growing embryos in the laboratory, or understanding genetic composition of the embryos. The third option is that embryos may also be donated to another person or couple.

5. How are embryos discarded?

To discard frozen embryos, a consent form must be signed by both partners, (as applicable), notarized, or witnessed by RSC staff. After a 60-day waiting period, at least two embryologists fulfill the patients’ wishes. They locate the embryos in the storage tank and carefully confirm the identity. The embryos are thawed and discarded. The embryologists initial and date the consent form and other storage documents, attesting that they performed and witnessed the disposition according to the patients’ wishes. The paperwork is kept in the laboratory files. If requested on the consent form, written confirmation of the disposal of the embryos is sent to patients.

February 7, 2024 by Ari Simon

Understand the pros and cons of the medicated frozen embryo transfer and natural frozen embryo transfer protocols to prepare the endometrium to receive the IVF embryo.

If you are planning for a frozen embryo transfer (FET), you should know that the two types of treatment protocols utilize either a medicated cycle or a natural cycle. A cycle refers to one round of in vitro fertilization (IVF) treatment, and an embryo transfer cycle refers to one attempt at embryo transfer.

Both medicated and natural frozen embryo transfers involve providing your uterus with estrogen to thicken the endometrial lining and then adding progesterone for a fixed amount of time to induce changes in the endometrium to make it “receptive” to an embryo.

However, the medicated and natural cycles provide these two hormones in different ways. Fortunately, our data from the Reproductive Science Center of the San Francisco Bay Area shows that pregnancy rates are similar after both types of cycles. So, this article is aimed at explaining each protocol further, and helping you decide which protocol is right for you.

Medicated frozen embryo transfer cycles

In the medicated cycle, also called a controlled cycle or programmed cycle, your body relies entirely on estrogen and progesterone medications to prepare the uterus for embryo transfer. Estrogen, usually in the form of an oral pill but sometimes via patch or vaginal administration, is taken for approximately 2-3 weeks. Then, an ultrasound is done to ensure the endometrial lining is adequately thick and developed. If not, the estrogen dose is increased, and a repeat ultrasound is performed in a few days.

If the endometrial lining is adequate, progesterone medication is started, via daily vaginal suppositories and intramuscular injection, exactly 6 days before a scheduled frozen embryo transfer. Both estrogen and progesterone are continued for approximately 6-7 weeks after the embryo transfer.

Pros of the medicated frozen embryo transfer

Requires fewer visits for monitoring and bloodwork, typically just one visit for measurement of the endometrial lining.
Given that the administration of medications is controlled and scheduled, the date of an embryo transfer can be chosen around your work schedule/availability, or that of your doctor to ensure they perform your embryo transfer.
Because estrogen levels can be made higher than in a natural cycle, this is a good option for patients who have struggled with a thin lining in the past.

Cons of the medicated frozen embryo transfer

Requires more medications than a natural cycle, including daily intramuscular progesterone injections.

Natural frozen embryo transfer cycles

In a natural frozen embryo transfer cycle protocol, estrogen and progesterone are “naturally” produced by your body during the process of ovulation. Estrogen levels rise steadily in the first half of the cycle. Then, when ovulation occurs and a corpus luteum is created, progesterone starts to be produced and an embryo transfer is scheduled for 6 days later.

To ensure that the embryo transfer is scheduled relative to the time of ovulation as closely as possible, this protocol requires frequent (sometimes daily) monitoring after cycle days 9-10 to capture when ovulation will occur. Specifically, monitoring is aimed to assess for the luteinizing hormone (LH) “surge” that precedes ovulation by 24 hours.

Variations of a natural frozen embryo transfer cycle can add some predictability and convenience. An ovulation induction medication called letrozole can be taken for 5 days at the beginning of a cycle to almost reliably help your body ovulate 5-7 days after finishing the medication. Furthermore, rather than waiting for your body to ovulate naturally, in a “modified” natural cycle, an injection of the human chorionic gonadotropin (hCG) hormone is taken to enact ovulation approximately 36 hours later, and then an embryo transfer is timed accordingly. Both of these strategies can reduce the number of monitoring visits.

Though the progesterone produced by your body is likely sufficient to support implantation and a pregnancy, in any natural cycle we still recommend patients take a vaginal progesterone suppository starting after ovulation and continued for 5-6 weeks after the embryo transfer.

Pros of natural frozen embryo transfer

Utilizes fewer medications and injections compared to the medicated protocol and is therefore more “natural” and easier on the body.
Research studies show that pregnancies conceived after natural cycles have lower rates of hypertensive disorders including pre-eclampsia.

Cons of natural cycle frozen embryo transfer

Given this protocol relies on regular cycles, women with very irregular cycles or who are peri-/menopausal and no longer have a cycle are not eligible for this protocol.
Requires more frequent appointments for monitoring via ultrasound and bloodwork, especially around the time of ovulation. Furthermore, if the timing of ovulation is missed, then a cycle may have to be canceled.
Given that the day of embryo transfer is determined by the day of ovulation, it can be less reliably scheduled around your convenience and availability. Furthermore, this unpredictability increases the chance that your embryo transfer will be performed by a doctor different than your own.

December 12, 2023 by Dr. Eduardo Hariton

An insider guide to freezing your eggs: Freeze early to extend fertility

Whether you’re a woman focused on a career, haven’t met the right life partner yet or just aren’t ready to have a child, the topic of freezing eggs might be the farthest thing from your mind. However, as a fertility specialist, I always suggest that women consider preserving their fertility as the quality and quantity of eggs will inevitably decrease over time.

Here’s the scoop: the timing for freezing your eggs can make a difference in your fertility journey, and there’s a sweet spot for optimal results. Egg quality tends to be at its best during your mid-20s, so considering egg freezing in your 20s and early 30s is a smart move.

The American Society for Reproductive Medicine suggests that most experts agree your chances of success are higher when you freeze your eggs before you hit 38. It’s an exciting option that can empower you to plan your family on your own terms. While women in their late 30s and up tend to have eggs that will likely result in lower pregnancy rates, their bodies can still carry a healthy pregnancy, even in the late 40s.

How fewer eggs affects fertility

Even though a female baby is born with around two million eggs, by the time she hits puberty, that number drops to around 350,000. With every menstrual cycle, follicles in her ovaries stimulate to release an egg, but in the end, only one dominant egg gets released while all the other contenders that month undergo programmed cell death, a process called atresia.

This natural tendency for a woman’s eggs to deteriorate culminates in her mid-30s when not only the number but also the quality of her eggs decreases rapidly. The loss of egg quantity and viability eventually leads to diminished ovarian reserve, a primary cause of infertility for older women.

Here are some practical tips:

Consider your family planning desires now, especially if you might want to have children using your own eggs someday.
Acting sooner rather than later is a good approach, but don’t feel pressured.
Take some time to research how egg freezing works.

Prepare emotionally for freezing your eggs

Freezing eggs offers women the opportunity to take control of their reproductive health and align it with their life goals. It is a decision that deserves careful consideration of the emotional, physical, and financial aspects involved.

Most women don’t anticipate fertility issues. In fact, many women are diligent and careful not to get pregnant until they are ready to conceive. But once they are, nearly 1 in 6 to 1 in 8 women of reproductive age face fertility challenges. In one-third of infertile couples, the infertility complication can be attributed to the woman, with a third to the male and a third to both.

My insider tip on freezing your eggs: don’t go it alone

While egg freezing can offer a sense of security, it may also cause anxiety or feelings of uncertainty. Identify these emotions early and seek support from loved ones and professionals who can help you navigate the process and your emotions more confidently.

Take charge of your reproductive health and extend fertility

The benefits of freezing your eggs are compelling. Freezing eggs can help preserve future fertility options, enable career flexibility, and protect your fertility against possible medical conditions or treatments that could harm your reproductive health.

The latter happened to the nursing supervisor in our fertility clinic, Chelsea Spencer, RN, BSN.

“I had a few life instances that were pretty unexpected come up, and it just made me realize that I knew I wanted to be a mother down the road, but I was not ready for it at that moment,” she said in our podcast called Why I Chose To Freeze My Eggs. “So, when my 30th birthday rolled around in 2020, I was like, ‘I think I’m going to give myself this gift.’”

My insider tip: Take a holistic health approach

Work toward a prepared body as well as a prepared mind with a holistic approach to freezing your eggs. Maximize the viability of future embryos by eating healthy, finding helpful ways to manage stress, and exercising regularly now. Schedule regular check-ups with a fertility specialist to monitor your reproductive health and stay abreast of advancements in reproductive technology that may enhance your future fertility potential.

More advice about freezing your eggs

If you’re contemplating freezing your eggs, it is crucial to choose a reputable fertility clinic that has expertise in this form of fertility preservation. When meeting with a specialist, ask questions about success rates, the number of eggs recommended for freezing, and the procedures involved.

Furthermore, take care of your overall well-being during the process. Engage in activities that reduce stress, maintain a healthy lifestyle, and prioritize self-care.

Remember, this journey is about empowering yourself and making choices now that align with your hopes and dreams for the future.

November 7, 2023 by Ari Simon

Dr. Hartion discusses AI’s Future in the Embryo Transfer Process

Artificial intelligence (AI) is beginning to learn how to choose the most viable embryo to be transferred during in vitro fertilization (IVF). Dr. Eduardo Hariton, a reproductive endocrinologist with RSC Bay Area, is highly motivated by the possibilities this innovative technology offers fertility patients.

“Price is one reason this is an area of interest,” says Dr. Hariton. “More meds mean more money, and ovarian-stimulating hormones can cost $2,000-$5,000 per cycle.” AI tools could be used to detect high quality embryos without requiring a biopsy or genetic testing, potentially saving fertility patients thousands of dollars.

AI could also speed up the selection portion of the embryo transfer process, allowing reproductive endocrinologists to treat more patients in less time. “The reality is when you have an access issue … and you’re trying to make sure that you can get more patients in, this is an efficiency tool,” says Dr. Hariton.

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