What IVF costs (more or less) 

It’s one thing to hear the words, “Your only option to get pregnant is IVF.” It’s another thing entirely when you get the quote.

It’s a lot. And it’s overwhelming.

We were so unprepared for what our first IVF cycle would cost us. In fact, it took us a few years to save up. When you’re already grieving what you thought pregnancy would look like, adding financial stress to the mix feels cruel.

Generally, you’re looking at anything between R80,000 and R120,000 for a single cycle. A quick Google search will frustratingly give you a similar estimate, but for good reason: IVF treatment is personalised.

For the most part, there are “fixed” costs like egg retrieval and transfer. But the total spend depends on what protocol your doctor recommends and how much medication your body needs. Some people respond quickly to lower doses. Others, like me, need more. It’s impossible to predict until you’re in it.

While it feels like an enormous amount to pay upfront, the good news is you’re unlikely to have to swipe your card again during the cycle itself. Most clinics bundle everything into one payment, which at least removes the surprise of hidden costs along the way.

A breakdown of costs

If you think about what happens in a cycle of IVF (you can read about the day-by-day timeline here), there are a lot of steps involved. And each one costs money.

1. Stimulation meds

This is where things start to vary. The medication you’ll need depends on what protocol your doctor decides will work best for your body.

During my last cycle, I took:

• Gonal F (stimulates your ovaries)
• Menopur (stimulates your ovaries)
• Cetrotide (prevents ovulation)
• Ovitrelle (trigger shot)

The cost of these meds alone can be anywhere from R20,000 to R40,000, depending on the dosage and how long you need to stimulate for.

2. Scans and consultations

You’ll have several scans during the stimulation phase to monitor how your ovaries are responding to the medication. These are usually transvaginal ultrasounds, and they happen every few days as you get closer to egg retrieval.

Each scan comes with a consultation fee, so factor in at least three to five appointments during this window.

4. Egg retrieval

This is one of the bigger line items on your quote. The amount you’ll pay for egg retrieval covers:

• The egg retrieval procedure itself
• Anaesthetist fees
• Theatre fees
• Day ward recovery

You’ll be under sedation or light anaesthesia, so you won’t feel anything during the procedure.

5. Lab fees

Once your eggs are retrieved, the real science begins. Lab fees cover:

• Fertilising the eggs with sperm (usually through ICSI, which is intracytoplasmic sperm injection)
• Monitoring embryo development until day 5 (blastocyst stage)

This is where your eggs become embryos. And it’s also where you start to understand that not all eggs make it. Not all embryos make it either. That’s one of the hardest parts no one prepares you for.

6. Fresh embryo transfer

If you’re doing a fresh transfer (meaning the embryo is transferred in the same cycle as retrieval), this fee covers:

• The embryo transfer procedure
• Consumables like the catheter used during transfer

The transfer itself is quick and usually painless, but emotionally, it’s huge. This is the moment you’ve been working toward. Read about it here.

7. Freezing and storage

If you have embryos left over after your fresh transfer, you’ll pay to have them frozen. Storage fees are usually paid upfront for 12 months.

This is actually a relief if you have embryos to freeze. It means you won’t have to go through stimulation and retrieval again if this cycle doesn’t work. You’ll just do a frozen embryo transfer (FET), which is less invasive and less expensive than doing a full IVF cycle.

Additional costs to consider

PGT-A (genetic testing)

Some clinics offer PGT-A, which is preimplantation genetic testing for aneuploidy. This tests your embryos for chromosomal abnormalities before transfer, which can help identify the embryos most likely to result in a successful pregnancy.

It’s optional, but it can add R15,000 to R30,000 to your overall costs. Your doctor will discuss whether this is recommended based on your age, medical history, or previous pregnancy losses.

What you’ll pay here is:

• A fee to your clinic for the biopsy of the embryos
• Courier fees
• Testing per embryo

If you fall pregnant

If you fall pregnant (and I really hope you do), you’ll have to factor in a few more expenses:

• Pregnancy test. This is a blood test done at Pathcare or Lancet, usually around 10 days after transfer. Your medical aid should cover this, either from your maternity benefit or from savings.
• Early pregnancy scan. To confirm a heartbeat, usually around 6-7 weeks.
• Additional medication. You’ll stay on hormones (progesterone and sometimes oestrogen) up to around 12 weeks of pregnancy.

Ask your clinic for a quote on these extras so you’re prepared. The medication you’ll be on depends on your protocol, but it’s not insignificant. Some people need daily progesterone injections. Others use pessaries or gel. Either way, it’s another cost to carry.

Frozen embryo transfers

Now this is one cost that tripped us up: frozen embryo transfers. In our first two IVF cycles, we didn’t get as far as having embryos to freeze. So we didn’t have to think about this cost until we got a quote ahead of our first FET.

FETs cost between R19,000 and R25,000, depending on the type of cycle your doctor recommends. There are two main protocols:

1. Natural modified cycle
This is where your body ovulates naturally, and the clinic monitors you with scans and blood tests to time the transfer perfectly. You’ll take minimal medication, usually just a trigger shot, so you ovulate and progesterone support after the transfer. Transfer would typically happen six days after ovulation. This option is more affordable because there’s less medication involved. But you will need more frequent monitoring (blood tests and scans), and you are at risk of missing ovulation, which will result in a cancelled transfer. You will need to have flexibility if you choose this route because it can be unpredictable.

2. Fully medicated cycle
This is where your natural cycle is suppressed using a medication like Lucrin Depot, and your uterine lining is built up artificially using oestrogen. Progesterone in oil intramuscular injections are added six days before transfer. The transfer date is scheduled based on when your lining is ready. This option costs more because of the additional medication needed. The plus to this option is that you are in control in terms of what happens when. And you have more flexibility if a day doesn’t necessarily suit you for transfer.

Dr Oosthuizen gives a great overview here.

Your doctor will recommend which approach is best for you based on your cycle regularity, previous responses to medication, and your specific circumstances.

If I could offer a piece of advice, it’s this: get the quote at the start of your retrieval cycle. And ask yourself the tough questions:

• Can you afford this on top of the cost of your first IVF cycle?
• If you have four embryos to freeze, can you afford to do another transfer if the first one doesn’t take?
• Will you be prepared to wait a year if that’s what it takes to save the money you need?

It’s easy to spiral into debt because you’re chasing hope. I know how hard this is. The pull to keep going, to try one more time, is so strong. But please, think about the long-term implications, too.

It’s easy to keep pushing forward because “the next one might work”. But don’t lose sight of the fact that this isn’t always a short and easy journey. Protect your financial future while you’re protecting your hope.

The hidden costs no one mentions

Beyond the clinic invoices, some costs don’t show up on a quote but add up quickly.

Time off work

IVF requires a lot of appointments. Scans every few days during stimulation. The egg retrieval itself (you’ll need at least a day off, maybe two). The transfer. Follow-up scans if you’re pregnant. If your work doesn’t offer flexibility or paid leave, this can mean lost income on top of everything else.

Travel to and from the clinic

If you don’t live near your fertility clinic, factor in petrol or Uber costs. Some people travel from other provinces for treatment, which means accommodation and meals on top of transport. These trips add up over the course of a cycle.

Emotional support

Therapy isn’t a luxury during IVF; it’s survival. Whether it’s individual counselling, couples therapy, or a support group, having someone to talk to who understands the weight of this journey is invaluable. But it’s also another line item in an already stretched budget.

Supplements and vitamins

Before you even start a cycle, you’ll likely be told to take supplements to improve egg quality or support your hormones. CoQ10, folic acid, omega-3s, vitamin D – the list goes on. These aren’t cheap, and you’ll be taking them for months.

None of these show up on your clinic quote, but they’re real. And they matter. When you’re budgeting for IVF, try to leave room for these hidden costs. They’re easy to overlook until you’re in it.

Disclaimer: The information shared on What the Fertility is for general awareness only and should not replace medical advice. Always consult a qualified healthcare professional for guidance on your personal situation.