A Live Baby or Your Money Back
Parenting is among the strongest and most basic of
human instincts. Clinics that market in-vitro fertilization
procedures to childless couples know this well.
Several fertility clinics around the country these days
aggressively tout such procedures, frequently offering couples
two options. The first is an a la carte program in which
couples pay $7,500 per attempt at having a so-called test tube
baby. Alternatively, clinics offer a money-back
guarantee. Couples pay $15,000 up front for three attempts
— and if these fail, they get a full refund.
Which of these options represents the better choice? A
study by David C. Schmittlein, Ira A. Lipman Professor of
Marketing and chairperson of the Marketing Department
at Wharton, and his associate Donald G. Morrison of the
University of California at Los Angeles, provides an answer
as it examines this controversial issue.
The study shows, expectedly, that from the patients’
perspective, the choice is usually a no-brainer: couples who
have traditionally been considering in-vitro fertilization
attempts would clearly be better off choosing the money-back
option. From the clinics’ point of view, however, the
decision to offer these money-back guarantees is harder to
explain. Chances of an in-vitro fertilization attempt resulting
in a live birth are roughly one in five. In addition, the
cost to the clinic per attempt is fairly high. Why, then,
would clinics offer patients a money-back guarantee, when
this is almost certain to result in the clinics’ losing money?
Schmittlein explains that aggressive marketing of
money-back guarantees in the media has brought about a
shift in the behavior of infertile couples. In the past, childless
couples tended to view in-vitro fertilization — a
procedure usually not covered by health insurance — as
their last resort. But now, for couples reassured by money-back
guarantees, “in-vitro procedures are becoming the first
choice,” Schmittlein says. As a result, younger and relatively
less infertile couples have been choosing in-vitro
fertilization. As they do this fairly early in their attempts to
have a child, clinics receive a steady stream of business from
couples likely to get a child on their first or second attempt.
Schmittlein points out that while neither clinics —
which profit from these procedures — nor patients — who
get a baby or a refund — are likely to complain about this
situation, it has serious public policy ramifications. Patients
should be made aware of the risks of in-vitro fertilization
procedures, such as the possibility of multiple births. Some
researchers also are concerned about a possible link
between in-vitro fertilization and ovarian cancer. If couples
were more fully informed, he adds, they might choose less
invasive procedures than in-vitro fertilization, especially in
their early attempts at parenthood.
David C. Schmittlein and Donald G. Morrison; A Live Baby or Your
Money Back: The Marketing of In-vitro Fertilization Procedures
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