it your partner, friends, family, professionals, or online networks. It doesn’t matter in what shape it comes, everyone needs a little help from their friends, no matter who those friends may be.
You may decide to let just a few close confidantes know of your situation with trying to conceive. You may tell anyone who will listen. Regardless, know that at some point, someone will say something wrong. Set the ground rules now. If you don’t want to be asked how things are going (secret speak for “Are you pregnant yet?”), tell your network up-front that you will let them know when there is something to know. Their overenthusiasm may annoy you time and again, but they are probably almost as excited as you are to hear about your success.
While you don’t want to anticipate a long, arduous battle with your fertility, or lack thereof, don’t set yourself up to expect that within a month you’ll be shopping online for maternity clothes. Decorating the baby’s room at this point is probably not a great idea either. If all goes well and success finds you early, that’s great — and we promise you that you’ll have plenty of time to find the perfect maternity wardrobe and baby collection. If not, you will only set yourself up for disappointment, and the goal is to keep that to a minimum as best you can, in the areas over which you do have control. Your thinking is one of them.
Recognizing how infertility affects your partnership
Whether the infertility issues are yours, your partner’s, or something you share, be certain that you most likely will share the ups and downs of baby making. Infertility is tough on the most resilient of individuals and couples. It will find the weak spots in you and your relationship. Steady yourself and your union for what could be turbulent waters ahead (this includes success and a new baby!)
When it comes to baby making, sooner is often better than later, but keep in mind that this is from a biological perspective. And although you may hear the biological clock ticking away, ready-or-not is not the best way to make your decision about when to conceive. The state of your union is an issue we revisit throughout this book, as it is one of the most important aspects in dealing with fertility, infertility, and baby makes three (or more). And although biology is a key issue in deciding if and when you’re ready to conceive, maturity, financial security, and stability are equally important, whether your challenge is trying to get pregnant or trying to raise said baby in a difficult and expensive world.
Adding up the financial cost
Talk about rubbing salt on a wound. Infertility treatments can be difficult enough, but treating infertility can be costly as well. The rising costs of medical treatment in general is a major problem in the U.S. today. It seems unfair that the limit to having children should come down to money but in many circumstances this is true. Dr. R. suggests that you explore the potential total cost for treatments that are suggested along with the overall chance of having a child (see Chapter 15 to look at dealing with the costs of IVF). Your allocation of resources may be significantly altered if you establish guidelines up front; otherwise, you run the risk of the “Vegas syndrome” (believing that just one more hand will make you a fortune or one more IVF cycle will get you a baby). For example, suppose a 41-year-old woman wants to use IVF to have a child that is biologically hers. One center has estimated that for some women in this situation, the chance to have a child can cost as much as $400,000. And even if a person spent that much, there is no guarantee that a successful pregnancy will occur. Knowing that, a couple may choose to use donor eggs for a much higher chance of success for much less money.
Like everything, infertility costs vary and can depend on where you live, which physician/practice you see, and most importantly, whether your treatment is small, medium, or large.
When you’re starting out, expect to pay $20 to $45 for an ovulation predictor kit and about the same for home pregnancy kits. This is the easy stuff. We haven’t brought in the professionals yet.
What about insurance, you ask? “What about it?” we answer. Only 16 states have mandated coverage for infertility, meaning that for those who aren’t fortunate enough to live in one of these areas, infertility treatments are paid for out-of-pocket — yours, that is. Even if you have insurance coverage, you may be amazed to see how little of your bill is covered. Some insurance plans cover only monitoring, meaning the frequent blood draws and ultrasounds. Because these can run well over $5,000 per cycle, this coverage is a help. Other plans cover only the medications (which can cost between $2000 and $9,000), which is a help, but by no means relief from the total cost.
Many insurance plans, however, will cover the tests and procedures related to diagnosing your particular infertility problem. This can be very helpful as well because many cases of infertility require blood work, ultrasound, and even an exploratory surgical procedure to determine a cause for infertility — a mere starting point for treatment. This generally applies to both you and your partner, but double-check this with your insurance company prior to signing up for the “party platter” of tests.
Once diagnosed, and even if you escape diagnosis (20 percent of infertility is unexplained), that’s when the real costs can kick in. Should your problem be resolved quickly and easily, you may get by with the cost of a few months’ worth of Clomid (a pill that causes super ovulation in order to push your ovaries into producing one or more follicles that can be fertilized), a few ultrasounds (which generally cost anywhere from $200 to $500 depending on where you live and which physician practice you frequent) and approximately $200 per blood draw for the basic tests needed to monitor your cycle. If you need IUI (intrauterine insemination), the cost is generally $600 per insemination.
If you are to be monitored via blood work and ultrasound throughout the month, some clinics offer “package” prices, which can range from $900 to $2,000 for blood work and ultrasounds for one month.
If your cycle requires injectable gonadotropins (Repronex, Follistim, Gonal F, Menopurto, to name a few), you are looking at a cost of $1 per unit. Gonadotropins now come in an injectable form containing between 300 and 900 units. IVF cycles can use between 75 and 600 units per day for 10–12 days. If you are also adding in luteal support (which occurs after the egg has supposedly been fertilized), progesterone and estrogen may run you a few hundred dollars per cycle (a bargain compared to other costs!).
Keep in mind that these are all approximate costs. Later on in the book, we discuss places to purchase medications that may offer better deals and other methods that you can use to cut your costs.
If you move up to the big time, keep in mind that the average IVF cycle costs between $10,000 and $15,000. Of that, about $4,000 to $5,000 is spent on
