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INTRODUCTION:

THIS SHARED FINANCIAL RISK PROGRAM FOR FERTILITY SERVICES was developed as a creative alternative to the traditional payment method for medical services and treatment associated with assisted reproductive technologies (ART). The traditional payment method (which of course we also offer to you) requires payment for each treatment cycle regardless of outcome. Patients have expressed concern about the cost of multiple treatment cycles and the uncertainty regarding outcome. For an agreed upon fee to George Washington (GW) Medical Faculty Associates (MFA), INC you are allowed up to 6 stimulated IVF treatment cycles and the use of cryopreservaton on order to achieve one (1) successful pregnancy which ends with the birth of a live born baby. The Shared Financial Risk agreement is completed with either withdrawal, completion of the 6 IVF cycles (and transfer of any cryopreserved embryos if applicable) or the birth of a live born baby, whichever comes first. If you do not deliver a live born baby with this treatment, 100% of the fee will be refunded to you. We offer this program as evidence that our confidence in our success rates. This Shared Financial Risk Program is offered selectively to couples who have completed a full medical prescreening and are considered good ART candidates by GW-MFA, Inc. Many health insurance plans cover ART in some form, to a greater or lesser extent. You should check with your own insurance carrier to determine whether or not you are covered for IVF. We may assist you with your inquiry, but we cannot be responsible for determining whether or not you are covered for IVF. Generally, this Shared Financial Risk Program is for couples without insurance coverage.

ELIGIBILITY:

You must be approved to participate in this Risk Program by GW-MFA. This Shared Financial Risk Pro gram is offered selectively to couples who have completed a full medical prescreening and are considered good ART candidates in the sole and subjective opinion of GW-MFA. Only couples in whom the female partner will be able to complete 6 stimulated cycles before her 39th birthday will be considered. The only exception to this is if donor eggs are used. The determinate of GW-MFA is final.

The Shared Financial Risk Program was designed for patients with no insurance benefits. However, we do allow patient s with insurance to participate in the program. Due to the nature of this program, itemization is not possible, to participate you must waive your insurance benefits. Insurance can be used for medications, prescreening, non-ART related surgeries, and OB care.

COST:

The cost of the Shared Financial Risk Program is $20,000 for IVF and $22,000 for IVF with ICSI. In the event that you complete 6 stimulated IVF cycles and transfer cryopreserved embryos (if applicable) without the birth of a viable baby, or if you elect to stop treatment of if GW-MFA terminate your participation in the Shared Risk Program, you will receive a full refund. (If paid by credit card any returned funds will be credited back to the credit card.)

GW-MFA will not charge any additional fees for cryopreservation or thawing and transfer of cryopreserved embryos cryopreserved as part of any of your 6 IVF cycles. The embryo freezing and the thawing/transfer cycles are included as part of, but do not count against, the 6 treatment cycles for which this Shared Risk Program was established while the contract is still in effect. The transfer of any embryo(s) that are cryopreserved as part of any stimulated IVF cycle under this Shared Financial Risk Program must be transferred in attempt(s) to conceive before commencing a new Shared Financial Risk stimulated IVF cycle.