Money Makes the Follicles Abound
I’m going out on a limb here and making the assumption that we’re not the only couple who has made family building decisions based on our lack of insurance coverage. If we were only considering the money it takes to bring a child from birth to adulthood, we have the means to bring a few more kids into the world.
But we’re not talking about the money it costs to bring a child from birth to adulthood. We’re talking about spending several thousand dollars each month for the chance to have a child. In other words, it would be like plopping down $10,000 for a car, having the salesperson beam at you as he takes your money and says, “no car today, but try again soon!” and have you leave the lot empty-handed. I mean, literally empty-handed. No car and no $10,000.
Makes you throw up a little, right?
I’m in a mandated state but we’ve managed to always have insurance that finds the loopholes. The first time through treatments, I approached treatments without regard to the cost. By which I mean that I fretted over the cost and made myself sick over the cost, but like a gambler unable to leave the craps table, I kept entering the game again and again.
I started out the second round of treatments with much the same mentality. Let’s just do what we need to do and spend what we need to spend to get through this. And then the recession hit. And then it was unclear whether we’d have jobs tomorrow much less a house and food on the table. Like most Americans, we lived in this precarious state for many months wondering what would happen next. And not knowing what would happen next suddenly made the money decisions loom large.
At one point, we needed to decide whether we’d spend our savings on a cycle — yes, on a single cycle — and part of me wanted to take the gamble. But when Josh asked me how I’d feel if the cycle didn’t work, I replied that I would want to kill myself for making life hard for the twins for the sake of providing a sibling. And there we had our answer. Because it makes me nauseated just to think about it. I couldn’t live with myself if we didn’t hit the jackpot and that money was gone. And with it, opportunities for the twins.
Would our decision have been different if we had insurance coverage — absolutely. I think I have the mental and physical fortitude to do a few more cycles. But it’s the financial side impacting the emotional side that terrifies me. I don’t want to end up hating myself.
So we’re in limbo. We haven’t stopped and we haven’t started.
We talk so much about the emotional side of infertility and we certainly bitch about the physical side of infertility, but we rarely touch on the hard questions that pop up in the financial realm of infertility. Our kids will one day know that we paid a lot of money to have them (even if we don’t yank out the receipts, they’ll know at some point how much fertility treatments cost and be able to do the math) — will this make them feel special in the future? Will they feel like they owe us something? Will they be ashamed that their parents paid a lot when they know their friend’s parents simply coughed up a co-pay? I hope they never feel indebted. If they had to feel anything, I’d want them to understand how much we wanted them in our lives that we were willing to do anything physically (and pay any price) to get there.
It’s hard to talk about money; for some reason, it’s harder and feels more impolite than speaking about my vagina. I’m glad Lori and Cassandra raised these questions in their blog carnival.
What are your thoughts? Has the financial side of infertility ever impacted the emotional side of infertility? Have you made decisions about family building based on money (and how you’d feel about said money if the cycle didn’t work)?
Visit Write Mind Open Heart for more perspectives on the Dollars and $ense of Family Building and to add your own link to the blog hop, should you want to contribute your thoughts.
P.S. Rather than provide my answers in a Q and A format, I wove the questions into my post. Click over to read the full list of questions. You’ll easily be able to see the ones I answered.
P.P.S. I wrote this before I went to the theater, therefore, the story of whether I got the autograph/picture/used my time differently will need to wait. I’m here, I’m around, but I wrote this post earlier in the weekend so I could take a few days simply to catch up on my Google Reader rather than write.
47 comments
My husband and I have been very,very lucky when it comes to insurance coverage. When we first started found out that ART was the only way we were going to conceive, we were surprised to find that we had unlimited coverage, including storage, which according to our RE’s office NEVER happens. It is a good thing, because it took 4 cycles to have our twins. Then our state (CT) mandated 3 cycles of coverage, and our insurance company followed suit and changed to a lifetime maximum coverage of 3 cycles. We had two embryos in storage that we had been thinking about using, and the insurance change forced our hand. It was literally now or never. We quickly jumped in with a FET, which ended in a chemical pregnancy. It was then that we decided to do one more fresh cycle. If it didn’t work, we would most likely have embryos to do a future FET with. At only (har har) 3500, a FET would be tough but not impossible. It was November so we got it in right under the wire. Without the looming insurance change, we probably would never have hopped off of our fence and had our little girl. With the current insurance we have, we would have no kids at all because 3 rounds of IVF wasn’t enough. If it wasn’t for insurance coverage, we would have had to choose between having children and having a home for them, because we have used our savings to buy a house. This isn’t a choice that anyone should have to make.
Hmm, the link to Write Mind Open Heart doesn’t seem to be working.
But this is a huge, huge topic for me. We are dealing with MFI and are not in a state that mandates coverage. We have been kind of paralyzed by the financial problem because we just don’t have the money to cycle. It really makes me feel like I don’t deserve to be a parent — like, if I can’t come up with this giant chunk of money, how do I expect to be able to support my child? And intellectually I know that like you said, the money to raise a child is totally different than $14k (our clinic’s estimate) plunked down at the outset for just the CHANCE at pregnancy. It really makes pregnancy into a privilege for the wealthy.
I’m really saddened by the part of your post where you note that your insurance company found loopholes even though you’re in a mandated state. I have been imagining those states as being full of ponies and rainbows and pregnancy, not thinking about the obvious fact that companies will do whatever they can to avoid paying.
Yes, definitely. I find myself thinking over and over again – will the cost of IVF negatively impact my ability to retire financially stable? Will I end up being somehow reliant on my child(ren) during my retirement? And that, in my books is just plain selfish… And don’t even get me started on how many starving children could be fed by my spend on IVF. It’s just guilt, guilt, guilt all round!
And PS there isn’t any insurance coverage in South Africa that covers IVF.
My husband and I want to start a family, but we cannot afford the cost of IVF, IVSI, sperm retrieval. We have also cruelly been denied access to public funding here in New Zealand. My heart breaks whenever I think about it, which is several times a day. It is so incredibly unfair.
Wes and I were umbrella stroller shopping recently and the finality of it (last big baby purchase) threw us into a ridiculous fit of baby-considering. Now, the reality is that we only ever wanted one (more) child but that baby store… What a terrible place for making rational family-building decisions. For that weekend, we both came to the conclusion that if we had a lot more money and if the donor were still available, we would probably try again. It doesn’t help that Beckett has been telling me flat out that I AM going to have another baby, a girl. I need to write a post about this. Sigh. I don’t actually want another child, is the bottom line, I like the spoiling possible with one child (at a time). But the decision not to have more is still financial. Not only would we need scads of money to create another, we’d need scads more to live the life we want to live with it.
In my previous job, my insurance did not cover anything related to infertility. No testing, no treatments, NOTHING. Thankfully, I had found a wonderful doctor who was able to get some testing done AND get it covered by insurance based on how he coded the tests. The fact that he took the time to research which codes would be covered by my insurance was awesome. Not so awesome was the diagnosis of unexplained infertility.
Fast forward a year (nothing’s happened) and I have a new job with new insurance. This insurance covers infertility testing, but not treatments. So that means no IVF or IUI coverage. And, I don’t know exactly which tests are covered since it doesn’t spell it out. Unfortunately, I had to switch doctors since the awesome doctor that I’d seen isn’t covered under the new insurance. My first appointment with the new doctor is this afternoon and I’m all kinds of nervous.
So, my answer is that insurance coverage is definitely the deciding factor in whether I can do something about my infertility. I know that IVF is out of our price range (out of pocket), but I hope that we might be able to do one or two IUIs if needed. In the meantime, I just keep hoping for a miracle and to get pregnant on our own, but after 2+ years, the chances of that are less likely.
P.S. The link to “Write Mind Open Hearts” doesn’t work.
I think about this all the time. We made enormous sacrifices to be able to afford to have our son. We live in a tiny house in a…friendly but run down neighborhood. We are looking at trying for another but the idea of spending five grand just to try is so scary. Just to TRY. Was our son worth it? Absolutely. But is spending thousands of dollars on something that only might happen worth it when we would be depriving our actual child? We are struggling too. Five grand is a hefty contribution to his college fund.
I used to tell my RE that I felt we were buying a baby and it clearly made them feel uncomfortable but lets face it- if we had not had great insurance and some extra money no one would have helped us. I am always open about how much we spent, because it was a huge life changing sacrifice for us. It decided where we live, where we worked, what we ate, what we wore- EVERYTHING. And the crazy thing is, we got off easy compared to some. We would love to try again soon but are waiting till we can pay cash. JUST TO TRY.
Financial considerations have absolutely impacted our treatment decisions. We never did IVF with my eggs because we couldn’t see gambling $12-15 K on a 1 in 3 chance of pregnancy. If insurance had paid for all, or even most, of an IVF cycle, I would’ve been willing to try once or twice. As it is, we are moving straight to donor egg IVF because eve though it costs a lot more, it is much more likely to be successful.
I also live in mandated state. However, my husband and I both work for companies with less than 50 employess and those companies are not required to provide infertility benefits.
We made a lot of our decisions based on money. I’m not sure where we go from here. (I am currently pregnant with twins).
The cost of doing treatment has held us back in some ways. Granted, we have other reasons why we aren’t currently working with out RE towards our goal of a family, but we know that if we have to do anything other than medication, it isn’t covered. As such, we will have to wait until we can save up enough to be able to even attempt a cycle that requires fertilization in a doctor’s office.
We are in a non-mandated state and consider ourselves lucky that testing and treatable problems such as medication or surgery to correct things are at least 80% covered.
Haven’t gone over to Lori’s yet, but yes, finances were a big part of the equation for us. We’re fortunate that, by the time we finally ventured into the world of ART, we both had established ourselves in good jobs, paid down our mortgage substantially & had built up some savings. But neither of us are big spenders, & the cost of simply trying to have a child, at odds that most gamblers in Vegas would never accept, really did give us pause. We actually consulted a fertility counsellor about whether we should try ARTs & if so, just how far we should go with it. We eventually agreed to start with clomid, then IUIs with injectable drugs, & to limit ourselves to three cycles, then reevaluate.
This was 10-11 years ago, & I’m sure prices have gone up since then. Our medical benefits through work covered a lifetime maximum of $1,500 for fertility drugs, which I think lasted me about a week on Gonal-F. The fertility testing & workup was fortunately all covered by our provincial health plan. Strangely enough I believe the IUI itself was covered too, but we paid $350 a pop for sperm washing (!). In all, each IUI cycle wound up costing us between $2500 & $3000 (they kept upping the dosage of drugs with each cycle, which of course cost more). So in less than a year, we had blown through $10,000. We knew just one IVF attempt would cost at least that if not more, & IVF was not & still is not covered by our provincial health plan. Yes, we had the money in savings to cover an IVF cycle, possibly more — but we knew it was a huge, huge gamble — & we had worked so hard to save that money. We knew the odds were not in our favour, when you factored in our ages, the success rates, & our various problems.
Beyond the money factor, I was an emotional wreck by then, & I could feel the drugs were taking a toll on my body. So we made the decision to stop & remain childless/free without ever trying IVF. Would we have tried IVF, if it were covered? Probably at least one cycle.
I live in a mandated state, and that has made it much more feasible to do fertility treatments. We did still spend a lot of money seeking out the best treatment in the States, but we were even able to consider this because so much had been covered and paid for already. And we elected to do a single embryo transfer because we knew transfers would be covered by insurance. Money and insurance coverage played a huge role in the entire process for us. We are the example of what those with coverage can do, meaning a single birth from IVF.
I believe that I am lucky that now my new insurance covers at least some IVF, should we need it.
The clotting panel I just had done? It costs about $3000, according to my doctor. I called my insurance company ahead of time to see if they’d cover it, but I am quietly hyperventilating and I will keep doing so until I get confirmation that the insurance company actually DID cover it. It seems unfair that they hold all the cards and I have to make my decisions based on their policies.
When it was determined that IVF was our only chance to have a biological child, we sat down and created a plan. We great insurance and we have worked hard to get it. The plan offers up to $70,000 for “family planning”. The term includes almost all infertility treatments …. but it also would be available for adoptions.
We didn’t even start this process until I was 42 and my husband was 44. One very important consideration, for us, was that fact that we would be retiring at the same time any children would be graduating from high school.
We were determined not to touch the nest egg we had worked so hard to build. The bottom line for us? …. We would spent “X” amount of dollars (from savings and insurance) period and we would go no further trying to have biological children … if we were unsuccessful we would go immediately to adoption … no question … no what ifs. We had heard too many stories of couples using every dollar available of savings, equity from homes etc. We couldn’t risk that because we didin’t have the years to build those savings again.
The decision was maybe easier for me to jump quickly to adoption … I had grown up in a family that took in many foster kids. And, my parents divorced when I was 4 and my father remarried about a year later. When I was 8 I went to live with my dad … I am closer to my step mother than I am with my biological mother eventhough she was always present in my life. That relationship with my step mother perhaps made me more aware that I would have no problem NOT having my own biological children.
It turned out that we were extremely lucky and got pregnant quickly. I can’t imagine how difficult it is for the couples who struggle with this for years and years …. and then have to make decisions based on money … my heart just aches for them.
Absolutely. My insurance covers all testing, treatment, and drugs–except for ART. So what did I do? Tried injectables with TI instead of IUI, because I was afraid that they would reject everything related to the IUI cycle–the phrasing of my benefit booklet indicated they could. (In retrospect, having seen how my RE bills, I think the monitoring would have been covered and we would only have paid for the IUI procedure, which, after 3 TI cycles, we were prepared to do.) Wise for my wallet, but not my BCBS plan, because it may have cost them more money than if they’d just shelled out the extra $300 for IUI. Since that would have doubled my chances, and Follistim worked for me, I could have been pregnant on cycle #1 instead of #3, saving them $5K.
We’re still better off than we might have been, though; we moved here from the UK, and the NHS does not generally treat secondary infertility. At best, I might have gotten them to do some testing and possibly Clomid. Even PIF would have been a disaster in our area; they were supposed to provide one cycle of IVF as well as Clomid, but the waiting list was years long. British clinics rarely do IUI cycles, so we would have faced paying private prices for both testing and IVF.
Thank you so much for participating!
Your image of the gambler unable to leave the table is exactly right. The next one has to be the big score. The next one. This one’s got to be it. Just one more.
Most of my costs have been associated with the medications, and my mindset has been “I’m spending whatever it costs” because I have that luxury right now. I do have coverage, hoops must be jumped through, and my doctor’s office has been somewhat helpful. I try to pay it forward by donating my unused medications back to the clinic for those without coverage. I’m just feeling lucky that we’ve had both coverage and success.
I bet if many of us in the ALI community won the lotto (or a big chunk of change at a casino) the first stop would be to whatever building houses the ability to make us parent to one more child.
I’m in a manadated state. Everything was covered. I have no clue what we would have done if it wasn’t.
Actually, I think finances are the one consideration that hasn’t necessarily impacted our family planning, at least as it concerns treatments. We are incredibly lucky that my husband is employed by a university that has an associated medical school (and an associated major hospital system which has an excellent reproductive medicine clinic), and so that association offers us extremely cheap RE treatments. I think all told we were $600 out of pocket for everything, which means that our IVF/ICSI cycle was a total of $6000, which might have been doable even without coverage. We don’t have unlimited coverage, but we do have up to $10k. After reading so many blogs talking about $25k cycles, I was terrified of what our out of pocket cost would be and spent forever not believing the billing person that I’d actually be able to most likely get TWO cycles out of $10k in coverage. It kinda makes me wonder why there aren’t more people cycling at my clinic…
I think we must be the opposite of you, because if we could afford the long-term costs of a third child, we would probably try again, at least giving the frozen embryos a chance at sticking. And beyond those costs, I think (also opposite of you) I don’t know if I have the mental fortitude to go through another 8 weeks of progesterone-in-oil. I still tear up thinking about my experience with it. I am not needle-phobic, but that was horrifying to me– painful, scary, sad, totally out of my comfort zone, and not something I think I can ever do again.
Anyhow, I hear a lot of buzz lately with getting insurance coverage and how that would ensure that patients were willing to do eSET, and I kinda think that the emotional costs are discounted in favor of the financial costs. Were it just about the cost of a cycle, would I have only transferred one embryo? Maybe. But probably not. The emotional costs of the cycle were too high to want to risk the lesser chance of a sticky pregnancy. So I guess that’s what I mean when I say that finances really did take a back seat to other concerns during our cycle.
Oh, wow.
I married in to infertility (my DH had had a vasectomy many years earlier, in a prior marriage), and into stepmotherhood (and I love my stepkids and being a stepmom), and imagined, sort of like Merri Ann wrote in her comment above, that ” … I would have no problem NOT [experiencing pregnancy or ] having my own biological children” and would readily move to adoption (though I don’t think I had any clue how expensive, complicated, or uncertain that was, either).
Not true for me, as it turned out. If there’s one thing this journey has taught me (and, oh, there are many) it’s that I don’t know how I’ll feel or what I’ll do before I’m there, and it turned out having a child genetically related to me and DH was very important to both of us. We’ve been lucky to have some insurance coverage, reasonable (arguably excellent, if compared to say the US median income/wealth) financial resources, and access to cheap credit (read: credit card teaser rates). We spent $60K (of our own) conceiving our son and $20K not conceiving (or more accurately, conceiving but failing to achieve the implantation of) his younger sibling(s). I’m fine with how things have turned out, honestly, and don’t feel we’ve missed doing much that we’d have done but for financial reasons either in terms of treatment or in terms of other parts of our lives, though I’m still rolling balances from credit card to credit card and — happily — still (astonishingly) enjoying cheap credit.
Yet had money not been an issue we might have started ttc earlier and/or moved through treatment faster, and that might have meant I got to have 2 kids in addition to my stepchildren, instead of one. Honestly I’d still be trying were my DH willing, but with me in my early 40s and him in his late 50s, I’ve come to peace with the idea that doing so probably doesn’t really make sense. Come to peace mostly. For now.
But — and here’s the reason I’m posting this one anonymously — had you told me when I started this that I, a boringly middle-class, middle-of-the-road, risk-averse US woman would inject myself with prescription drugs I got in the mail from another woman I had never (still have never) met, taking on faith (as I still do) that she really is a fellow infertile who was at the end of her ttc road but had some leftover Follistim (a lot of leftover Follistim) she was willing to donate to my efforts? I’d never have imagined. I’d just never have imagined. But there came a time when doing that seemed less risky, or at least more feasible, than rounding up the $3K that Follistim would have cost. That was the stuff I injected for the one cycle that worked, as it happened.
Regular poster/commenter but am going anon for this one …
Oh, wow.
I married in to infertility (my DH had had a vasectomy many years earlier, in a prior marriage), and into stepmotherhood (and I love my stepkids and being a stepmom), and imagined, sort of like Merri Ann wrote in her comment above, that ” … I would have no problem NOT [experiencing pregnancy or ] having my own biological children” and would move readily to adoption.
Not true for me, as it turned out. If there’s one thing this journey has taught me (and, oh, there are many) it’s that I don’t know how I’ll feel or what I’ll do before I’m there, and it turned out that having a child genetically related to DH and me was far, far more important to me (us) than I (we) would have imagined. We’ve been lucky to have some insurance coverage, reasonable (arguably excellent, if compared to say the US median income/wealth) financial resources, and access to cheap credit (read: credit card teaser rates). We spent $60K conceiving our son and $20K not conceiving (or more accurately, conceiving but failing to achieve the implantation of) his younger sibling(s). I’m fine with how things have turned out, honestly, and don’t feel we’ve missed doing much we’d have done but for financial reasons though I’m still rolling balances from credit card to credit card and — happily — still (astonishingly) enjoying cheap credit.
Yet had money not been an issue we might have started ttc earlier and/or moved through treatment faster, and that might have meant I got to have 2 kids in addition to my stepchildren, instead of one. Honestly I’d still be trying were my DH willing, but with me in my early 40s and him in his late 50s, I’ve come to peace with the idea that doing so probably doesn’t really make sense. Come to peace mostly. For now.
But — and here’s the reason I’m posting this one anonymously — had you told me when I started this that I, a boringly middle-class, middle-of-the-road, risk-averse US woman would inject myself with prescription drugs I got in the mail from another woman I had never (still have never) met, taking on faith (as I still do) that she really is a fellow infertile who was at the end of her road but had some leftover Follistim (a lot of leftover Follistim) she was willing to donate to my efforts? I’d never have imagined. I’d just never have imagined. But there came a point where that seemed less risky, or at least more feasible, than spending the (additional) $3K for that cycle that the Follistim would have cost me.
We had insurance for diagnosis, (worthless) varicocelectomy, and IUIs through coverage at my old job and then COBRA. But by the time that IVF was on the table, we didn’t have any coverage. That had a lot to do with taking a year off. At that point, we were ready to gamble once, MAYBE twice, on IVF/ICSI. And we definitely feel that we hit the jackpot with twins on the first cycle. But having a failed cycle and loss of $13,000 would have been a tremendous blow. There would have been a lot of arguments about another cycle. DH is very debt averse and, considering that we racked up another $8K in PG- and multiple birth-related out-of-pocket costs (no NICU) on a high-deductible insurance plan, I would never tell anyone to just go for it regardless of the cost. Set a limit, see how far you can push it, but then stick to it.
Finances also affected our decision to stop right here and not try for more children (I am on BCP). Money is tight enough as it is. $13,000 seems a great deal more now. Also, if we had a third child, we would need larger vehicles and possibly a house with another bedroom. But finances are secondary to my readiness to just get on with life after years of stagnation due to infertility, and also to my mixed experience as the only sibling of twins. Our family is complete.
The only post I have written on my blog in the last six months was about this very thing. I always assumed that after he turned one (these eggs aren’t getting any younger ya know), we would start talking about and making a plan for having another. But after he actually turned one and it all became a little more real and I thought long and hard about the emotional and financial toll that trying would undoubtedly take, I came to the realization that we did not HAVE to try again. And that would be okay. If money was not an issue, we would definitely do it – I would dread it, it would be hard and scary, etc etc….but we would do it. Like you, I think I have “the mental and physical fortitude” for some more trying. I very much want another child – for me, for my husband, a sibling for my son. But I am not willing to blow through our savings on a big fat MAYBE. And when I think about the financial gamble combined with the emotional risks – the definite stress on my body and mind and the potential (probable) heartbreak – I just cannot do it. But it is definitely the money factor that pushed us to this decision. Plus, I am very happy. I know I would be okay if we end up being a family of just three. My son brings me so much joy – its so different now that he is our lives. Before we had him, I probably would have spent ALL THE MONEY. But now, I just can’t do it. I can’t sacrifice the money we need for the child who is here NOW, for the one we still want.
I love you.
Insurance sucks. Sure, they are all about ripping out your ute and ovaries at any age, but won’t help you adopt or have fertility treatments. I could go on and on forever, but my heart would break in two. I ache for each of us who hurts…emotionally and financially.
I’ve been thinking about this a lot lately, especially since I have a close friend who is also going through IVF right now in a country that covers it all. Right now, we’re both in the same boat. On our last embryo(s). I’ve been working on accepting that we might not have any more children, but she’s more working through the emotional aspect of it. She says that she’ll probably take a break before starting the IVF process all over again, b/c she can’t emotionally handle going through that right away. On one hand, I’m a bit jealous that she lives some place where she can try and try again. On the other hand, b/c our insurance doesn’t cover any kind of infertility treatment or testing, after this cycle, I know it will be over. So I’m in a place where I can work on acceptance as opposed trying IVF over and over again for years until we conceive a second child. There’s something to be said for that.
I loved your gambling analogy. Funnily enough, we’re handling IVF the same way we handle gambling. We go in with a certain amount of money, and when that’s gone we leave the table and go see a show. Literally in this case. We’re taking the pregnancy test for our last round of IVF, then we’re driving to Vegas to see THE LION KING. We didn’t originally plan our spring vacation this way, but now it seems really appropriate.
The car salesman is so appropriate. As are the empty hands, all too often.
“We talk so much about the emotional side of infertility and we certainly bitch about the physical side of infertility, but we rarely touch on the hard questions that pop up in the financial realm of infertility.” — kudos to BabySmiling for bringing this up.
I meant the car salesman analogy. Duh.
we were lucky and had family support for the financial aspects of it, and a tiny bit of insurance coverage. but i don’t know if we could have gone back to the well for a fourth cycle. of course, i was really too old then, so an attempt at a 2nd child was moot…
Thinking about the cost of IVF, domestic adoption, and international adoption, and weighing the sacrifice of a gamble vs. saving for a house (at the same time that our condo is underwater) has been absolute paralyzing agony. Helplessness, fear, and indecision are by our sides any time we think about these things and it feels so completely impossible to choose. I once asked for prayer in deciding whether to even try to conceive, and the person (in his beautiful, sincere naivety) said that I shouldn’t let money be the deciding factor. Spoken by someone who has never been in these shoes.
Now I have decided to reject fear, and pursue a course that I feel God is leading me in. That is the only way for me to have peace.
yes yes yes.
I also considered the car salesman analogy with my RE who I adored but who could find a way to sell us on anything. and of course the gambler unable to walk away. yes. next in my mind is the big black vortex, the black hole that could so easily suck you in — in there you’d find the depression and anger you’d feel if the cycle failed. buh-bye.
and I totally agree with this: “It’s hard to talk about money; for some reason, it’s harder and feels more impolite than speaking about my vagina.”
Very much so.
My husband and I can afford one more attempt (so, a second fresh cycle) at IVF. If it doesn’t work, here are our options:
(1) Donor sperm
(2) Move to a mandated state
I’m not sure which we’ll go with. Both options suck. Childfree or straight adoption are not options for us right now. Ask us again in 10 years, though.
If we had the money or insurance company, we would keep doing IVF right here, in our house we intentionally bought right across the street from the elementary school that feeds into the 2nd-best high school in the state. We’re the worst house on the block by far, even with all the work we’ve done on it. We bought this house on purpose. Who knew we’d be infertile?
Interesting and timely topic for discussion. Last year I paid out of pocket about 11K for infertility treatments (non IVF, including acupuncture) with high-deductible insurance. I thought that I was over that hurdle when I switched to our PPO Plan that had much, much better coverage. I’m prepping to start stims on friday. Today I called the pharmacy in my Doctor’s Office Building about what my co-pay would be for the meds they had called in for me to pick up-the answer: $3K! While my insurance is mandated MEDICAL coverage, the medications seem to be up for debate. A long day of back and forth between insurance company, specialty pharmacy, and doctor’s office ensued. Lot’s of I don’t knows and I’m not sures…eight hours later: Follistim and Growth hormone have been denied coverage, Ganerelix approved but required specialtly pharmacy is out of stock until at least 5/16 (so scrambled and got coverage for supply through freedom pharmacy). So I’m still out of pocket, hopefully not 3K worth. While on the perpetual hold today I actually thought “One more roadblock/frustration. Is not being able to get pregnant enough?” To think insurance is going to cover you, only to find the medication is somewhat out of pocket; that is, if it’s not out of stock. And I also know I’m going to have to pay out of pocket for ICSI. I at least have medical coverage (I think) and am thankful about that. The financial issues seem to never end, and the emotional issues just keep coming too. I’ll do what it takes to get pregnant or know that I tried my hardest-but what scares me is the collateral damages to both finances and emotions in pursuit of that goal.
I live in NZ, but after two ectopic pregnancies, had my first fertility consultation the week before my 40th birthday. Free IVF cycles end once you turn 40. I was lucky that we could afford to try privately. (Infertility treatments/procedures/investigations are not covered under private medical insurance). And perhaps (in a weird way) we were lucky that we had to stop because of lack of success after two failed (cancelled) cycles, rather than having to make a financial decision about when to stop, or having to make a financial decision to not even try. That would have been really hard.
We also do not have insurance coverage of any kind so I have stayed working for a company I hate, doing a job I hate even more, just so all my pay can be spent on treatments that aren’t even working. If we didn’t have this expense I would be in school working towards having the career I actually want. But no one ever asked me what I want so I try not to think about that too much and keep my focus on that one thing that would bring more fulfillment and happiness than any job or amount of money could…
A great post and those are some tough decisions. We did 5 medicated cycles (each leading to 1 lead follicle and no IVF, unfortunately) last year and it broke the bank for us. In fact we used donated meds for our final cycle. Now I am spending $1000 per month on Traditional Chinese Medicine, which feels like a bargain by comparison (hell, I injected myself with $600 a day during one cycle!). It sucks to make these choices based on money. I love your analogy of the car dealership!
I think your children will feel very wanted when they discover what you went through (and may feel a little guilty for being sassy with you when they’re 16!). 🙂
Love,
Maddy
Yikes, money was HUGE in our decision making. We embarked on the ART journey expecting to pay 100% out of pocket only to discover our insurance covered 12 cycles of the fertility meds and there was no limit on meds that could be used for other things and were not ART specific. I know we would not have gone as far as we did and would have pulled the pin a lot earlier if we had been paying for the meds out of pocket. As it was, it took a large chunk of our savings to pay for just the proceedures.
When we made the decision to switch to adoption, money again played a huge role in our decision making but we lucked out and suddenly found ourselves in the position to not have it be an issue right as we had a match.
Of course, money is an enourmous part of our decision not to pursue further ART or adoption to give our daughter a sibling. As much as I want her to have one, I can’t justify the gamble. I would rather save that money and know she has a guaranteed college fund should she want/need it, which at this point, she has enough there to cover 2 full IVF cycles.
If I’m going to buy her a car, I would prefer she actually HAVE the car.
thankfully with the exception of our very first IVF cycle, our attempts have been covered by insurance. we went out of our way to get jobs that follow our state’s infertility mandate.
now we are covered, and lucky, and free to worry about the damage 4 IVF cycles have done to my body. hoping i get to enjoy my children for a long time before, inevitably, the residual effects of all of the chemicals kick in.
I simply needed Metformin for PCOS but my insurance COULD NOT KNOW it was for infertility- it had to be labeled “painful periods” for them to cover it- they were that opposed to it. Your analogy of the car salesman and the lost 10,000 is awesome because it really helps those who haven’t been there get a visual of what this is really like. Sigh.
Isn’t if funny how money is harder to talk about than vaginas? But it’s true because somehow it feels more personal to admit we don’t have the money. That we are putting it on a credit card, that we are taking a loan out against the house. That we borrowed it from a grandparent. It is to soul reason we will only have one child if this last FET doesn’t work. We are just out of money. Our house doesn’t feel full, our family doesn’t feel complete, but the fact is that we can’t take it away from Henry at this point. What would 15K do for him in the future? Would it be wise to max out our house equity and leave him with nothing but debt, and possibly no sibling? It’s just heart breaking.
I have chosen to remain with a job that does not fulfill me personally or professionally only because it has phenom health insurance in a state with the best mandated coverage. (You can see why I’m using my alias here as opposed to my real name as usual.)
If it weren’t for the health insurance, I would walk away from this job and never look back and dive into the work that feeds my soul: infertility/reproductive advocacy. My husband’s company is based in GA, and his health insurance is based out of NC – both states with no mandates, so it’s not like I can just quit and jump on his.
And ultimately, when we were still in the “do we go IVF or adoption” planning stages, we toyed with adoption for a good, solid 6 months. But in the end, we realized IVF would cost us HALF the cost of adoption w/insurance coverage. And assuming the first try didn’t work, we’d still be saving money even by putting embryos on ice. The other part of that decision was that it’s really important for me to at least try to get pregnant, even with the use of DE/IVF. But a lot of this decision has come out of the financial aspect. And even then- our original family-building timeline, had we not had any IF issues, would have been to start trying this May. We have to wait until November now at the earliest b/c we’re still saving the money to fund our first DE/IVF cycle (which means, even if we said Bam! This Donor! in November, it’ll still be like, Jan or Feb of next year before I would even get a retrieval/transfer).
It’s a little nuts the way money has totally factored into our ability to just start our family. It still angers me, and it’s something I really have to reconcile with when I read yet another pg announcement on Facebook – that fertile folks get to do this for free. It’s so fucking unfair.
Unfortunately I live in a state where I can’t even get health insurance let alone infertility coverage. I was offered state coverage insurance, but there’s a 3+ year waiting list and private insurance is over $300 a month and doesn’t cover maternity. So it’s not worth it in my opinion…
I pay for every little thing out of pocket. To talk to my ob/gyn was $200 as a “new patient”. Clomid prescription was only $17. DH’s semen analysis was $75, 3 hour drive, and the cost of a hotel room for 1 night. We’re saving money right now just to get a consultation with the closest, 3 hour away RE. To talk to him for 15 minutes will cost us $416 plus the gas, time off work, and food. Who knows how much monitoring, procedures, and possibly another surgery will cost. I’m not even salary! I have no idea how we’ll afford it, but our only option is to save and pay as we go. Credit cards and debt are not an option for us.
I feel like I could have wrote so much of this post. Granted you say it way better than I could. All of these thoughts about the money of TTC and infertility have been swirling around my mind so much lately that it just makes me nuts.
I don’t think, once the initial “weirdness” reaction wears off, that IVF kids will feel uncomfortable about their unique history. At least I hope not. I’m just at this point now with my IVF 13yo girl. The health class at school gave me the perfect opening to really explain IVF…she always heard she was an IVF baby but didn’t really get the picture. And yeah, I totally smirked my way through those super early inquiries about where babies come from. “Well, when we wanted you, we just went to Dr. K” She has cousins born thru IVF and twins in her class as well. Seems kids this age really don’t want to think about their parents “doing it” or anything else about creation.
I don’t think they’ll feel indebted due to the cost, but will likely know they were wanted more than anything. And if there is a part of them that feels some very small level of debt, maybe it will just cause them to live a good, kind, moral life to make us proud. Nothing wrong with that, right?
I blog for my RE. And I encourage women doing IVF to find a program that backs up its SET rates with free cryo, free storage, and free FETs until the patient has a baby, for pts who pay for the fresh cycle and do SET. No one should have to put back more embryos than they are comfortable with simply because they hope to get more for their buck. There’s a better, safer way to get two for the price of one now.
Yes, yes, yes. Money is the main factor in our decision making. We have no insurance coverage for infertility. We got a little bit with the diagnostic, but for IVF or IUIs or drugs – nada.
Two IVF cycles and around $25,000 later, we’re left with nothing. No pregnancies. We do have one frozen embryo, but it will cost around $4,000 to transfer it. I don’t know if I’m willing to bet that much money again on an even smaller chance with a frozen cycle.
Well, insurance and the lack of it, has affected us too. Money is not the only thing, but it is one resource we have to take into consideration with great seriousness.