x Abu Dhabi, UAEThursday 18 January 2018

IVF loans: the cost of borrowing for babies

Doctors in the UAE have raised concerns about a bank loan tailored for couples undergoing in-vitro fertilisation.

Harold and Wilma Alvarez spent Dh30,000 on IVF before giving birth to Daphne.
Harold and Wilma Alvarez spent Dh30,000 on IVF before giving birth to Daphne.

Doctors have raised concerns about a bank loan tailored for couples undergoing in-vitro fertilisation.

The National Bank of Abu Dhabi (NBAD) recently launched the loan, for a maximum of Dh100,000, for those with a minimum monthly income of Dh10,000 who are unable to have children without IVF.

There is a 6.49 per cent interest rate on a reducing balance and the loan must be repaid within a year.

While doctors are pleased that couples can receive financial help, they are concerned about the long-term repercussions.

"Of course, this will help many who otherwise can't afford the treatment," said Dr Michael Fakih, founder of Fakih IVF in Dubai. "But what would happen if they cannot make the repayment?

"In the US, banks assess the financial situation in detail before approving a loan. There should be a rigorous qualification process to make sure that the loan will not negatively impact their lives, regardless of whether or not the procedure is successful."

Others say a longer repayment time with fixed interest would be better.

"You have at least three years to pay back a car loan," said Dr Keya Shivadey, a gynaecologist at Aster Medical Centre. "Here we're talking about human life coming into the world, which again will take another financial toll.

"I think it deserves more flexibility. If people can pay it back between three to five years, it would have a more positive effect and more people can avail it."

Figures from the bank show there are about 7,000 couples undergoing IVF a year at an average cost of Dh20,000 a cycle. On average, couples have the procedure three or four times before they conceive.

Insurance companies generally do not cover fertility treatments. Thiqa, the Abu Dhabi insurance plan for Emiratis, is an exception.

Financial experts are also concerned about the loans.

"Having children under any circumstances is expensive, so I'd be very worried about a couple's financial situation if they had to take out a loan at this stage," said Keren Bobker, a senior adviser at Holborn Assets who writes for The National.

"How will they manage at a later date with a child to pay for, the potential loss of one income and a loan to repay?"

There are personal loans available at lower interest rates, with longer repayment periods and lower income requirements, but it is common for banks to ask the purpose of the loan and a personal loan for IVF can be impractical or impossible to get.

"If I was underwriting a loan I'd be concerned about lending to someone who is likely to have significant other outgoing payments before long," Ms Bobker said.

NBAD representatives said the loan conditions were designed to protect customers and the bank.

Clients' financial commitments are also factored in to ensure they can afford it, said Amani Al Saba, a senior manager of marketing and communications at NBAD.

"We value our customers and are committed to ensuring they borrow within their means and repay the debt comfortably," Mrs Al Saba said.

IVF is offered on the National Health Service (NHS) in the UK but the criteria include that the mother be between 23 and 39 years old, at least one partner must have a diagnosed fertility problem, and the couple must have been unable to conceive for at least three years.

Primary Care Trusts also set extra criteria, including body mass index, child-bearing history and an age bracket for the father.

For those who cannot get access through the NHS, some medical financing options are available.

First Medical Loans, for example, offers an interest-free, 10-month repayment option. The minimum income requirement is £1,000 (Dh5,865) a month and the maximum loan amount is £10,000.

Patients can extend the repayment term for up to three years, but based on a 21.9 per cent annual rate.

The American Society of Reproductive Medicine says the average cost for one cycle of IVF in the United States is US$12,400 (Dh45,544).

Although 15 states have laws requiring some degree of cover for infertility with private insurance plans, most residents are not covered for IVF.

Some US clinics have launched risk-sharing programmes, for which patients pay a higher fee. If the patient achieves an ongoing pregnancy or delivery, the provider keeps the entire fee. If the treatment fails, 90 to 100 per cent of the fee is returned.

But these programmes have strict qualifications and are hard to get into. Pretreatment screenings and costs of fertility drugs are not usually included.

Dr Awatif Al Bahar, medical director of the Dubai Gynaecology and Fertility Centre, expressed serious reservations about charging interest for this type of loan.

While acknowledging the need for banks to protect themselves, Dr Al Bahar said they must meet patients halfway, adding she would not recommend the loan with its current terms to her patients.

"They're already very fragile," she said. "To get Dh100,000 and then [pay interest], and then she doesn't get pregnant and loses everything plus the stress of the treatment … I wouldn't go for this."

Mrs Al Saba said the interest rate offered is among the lowest personal loan rates prevailing in the UAE.

She said the concerns would be shared with the bank's senior management.