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Mark R. Bush, M.D., FACOG, FACS Dana R. Ambler, D.O., FACOOG Robert A. Greene, M.D., FACOG Natalia Grindler, M.D., FACOG 100% IVF USING DONOR EGG REFUND PROGRAM Conceptions goal is helping patients build the family of your dreams. For many couples a Donor IVF Refund Program maximizes the possibility of taking home a baby while making the cost affordable and minimizing the financial risk involved. Conceptions’ in-house IVF Refund Program using donor egg is designed to provide a 100% refund if IVF is not successful. The program offers a 6 attempt treatment option. Prior to an application being submitted the egg donor is required to meet specific criteria to be considered. If the egg donor meets all criteria an application can be requested and submitted to the Conceptions in-house medical review board. If an application is approved a detailed contract will be issued to the Participant. Participation in the program is not effective until a signed contract and the program fee is received. Submission of an application does not guarantee acceptance into the Program and may not be an indication of your chance of success. Age Limitations: Service: Program Fee: Maximum Age of 49 In-vitro Fertilization/ICSI using donor egg $45,602 In-vitro Fertilization/ ICSI with Chromosome Assessment (CCS) using donor egg $55,052 Maximum Age of 49 Criteria used to determine eligibility for the DONOR: Age 19 - 30 AMH 2.0 or greater Total Resting follicle count 12 or greater Normal BMI Non-Smoker Criteria used to determine eligibility for the RECIPIENT: Normal BMI Normal Semen analysis Normal Uterine Cavity No more than one miscarriage Non-Smoker Psych screening Max of one failed transfer with own oocytes and no uterine factor Application outcomes by the Review Board are final. All prices are subject to change. Patients approved for the IVF Refund Program using donor egg will be responsible for the one-time program fee and all non-covered services. Additional discounts do not apply on services covered under the refund program. SERVICES INCLUDED IN THE REFUND PROGRAM Coordination of Care Recipient/Donor cycle lab assays and ultrasounds Retrieval and Transfer CRA embryo biopsy for CCS Vitrification – ONLY when doing CCS PROGRAM FEE: $45,602 - $55,052** ** 100% of program fee is refunded if you do not take home a baby or Conceptions withdraws you from the program. 100% of the program fee is retained by Conceptions if patient withdraws from the program. SERVICES NOT INCLUDED IN THE REFUND PROGRAM** ** Estimated additional out of pocket for services NOT included in the Program Fee typically range from $11,500 - $13,500 per Fresh attempt and are not eligible for a refund. Estimate excludes medication cost) Donor work up (Inc; Office Hysteroscopy, Doppler) $4,500 - $6,500 Medications (typical range) $3,000 -$7,000 / Fresh $500 - $1,500 / Frozen CRA Donor Compensation/ Fresh cycle $5,500 First Time / $6,000 Repeat FDA Communicables – Recipient and Partner $1,400 Anesthesia with MD/NA $400 Natera, INC – Chromosome assessment $2,170 per attempt Vitrification (Included in CCS Program Fee) $900 ($350 yearly storage fee) Male Fertility Treatment (Fees vary on complexity) PESA- $2,995, MESA- $6,195 Non-IVF surgeries and Obstetrical Care Fee Varies THERE IS NO COST OR OBLIGATION TO SEE IF YOU QUALIFY! CONCEPTIONS REPRODUCTIVE ASSOCIATES OF COLORADO Visit www.conceptionsrepro.com today or contact an IVF Financial Representative at 303.794.8165 www.conceptionsrepro.com ____________________________________________________________________________________________________________________________________ CONCEPTIONS REPRODUCTIVE ASSOCIATES OF COLORADO 271 W County Line Rd Littleton. CO 80129 T: 303.794.0045 F: 303.794.2054 4500 E. 9th Avenue, Suite 630 Denver, CO 80220 T: 303.720.7887 F: 720.763.9140 300 Exempla Cir., Suite 370 10107 RidgeGate Pkwy, Suite 260 Lafayette, CO 80026 Lone Tree, CO 80124 www.conceptionsrepro.com T: 303.449.1084 T: 303.586.6598 F: 303.449.1039 F: 720.459.5112