L.A. CLINIC PROMISES PREGNANCY OR YOUR MONEY BACK.

Byline: Denise Mann Medical Tribune News Service

When we think of money-back guarantees, electronics and other consumer products generally come to mind. Now, doctors are applying the concept to baby making.

While some infertility clinics have been allowing couples to get back some of their financial investment if they do not become pregnant after undergoing infertility treatment, the Pacific Fertility Medical Center in Los Angeles has become the nation's first clinic to offer a 100 percent refund to couples who undergo treatment there but don't end up with a little bundle of joy.

Infertility treatment is not covered by insurance in most states, and couples trying to conceive can spend thousands of dollars out-of-pocket.

Enter outcome-based pricing plans. Under these plans, couples can get some - or now all - of their money back if they do not sustain a healthy pregnancy after undergoing in vitro fertilization (IVF), a technique in which egg meets sperm in a laboratory dish, and the resulting embryo is then implanted in a woman's uterus.

At the Pacific Fertility Medical Center, all couples are eligible for the 100 percent refund plan if IVF is considered a suitable treatment, said Dr. Geoffrey Sher, executive medical director of the center. The full-refund plan does not cover other assisted reproductive technologies.

But there are some important caveats. For example, women ages 40 and older must use donor eggs from young, healthy women, Sher said.

And prices vary according to a woman's age because advancing age is a known risk factor for infertility. A woman under 35 using her own eggs pays $13,400 for one IVF cycle, or attempt, while a woman age 35 to 39 who uses her own eggs pays $16,950. By comparison, statistics show that the average cost of an IVF cycle in the United States is $7,800.

Couples can participate in the full-refund program for no more than three cycles. The costs of medical screening tests and fertility drugs are not included, nor refunded if a woman does not have a baby.

Sher said that doctors can implant as few as two embryos in the woman's uterus, but there is no maximum number. On average, four embryos are implanted in women under 40, he said.

In the past month, more than 1,100 people in Southern California expressed interest in the full-refund plan, which was initiated in August, according to Sher.

Pacific Fertility Medical Center is only able to offer this plan because it has some of the highest pregnancy rates in the nation, Sher said.

However, some infertility experts are skeptical about outcome-based pricing plans.

``In reality these pricing plans are an advertising or promotional ploy to get people to come to your program,'' said Dr. J. Benjamin Younger, executive director of the American Society for Reproductive Medicine in Birmingham, Ala.

Undergoing infertility care is a ``very stressful and very emotional situation and the opportunity is there to exploit people,'' Younger said.

For example, if a doctor knows that he gets to keep the money if a woman achieves a healthy pregnancy, he may be tempted to implant five embryos in the woman's uterus, Younger said. And multiple pregnancies endanger the woman and the developing fetuses.

Typically, centers that offer such pricing plans will charge a higher price than centers that bill a patient per cycle, Younger noted.

And the Society for Assisted Reproductive Technology, an organization affiliated with ASRM, warned that some clinics may lure patients with false advertising and require expensive and unnecessary tests before allowing people to enroll in their programs, the group warned.