Budgeting for Infertility: How to Bring Home a Baby Without Breaking the Bank - Softcover

"Like many newly married couples, we had a vision of what our future was going to hold. We had an idealized picture of summer barbeques, holidays surrounded by friends and family, and the sounds of children's laughter filling our home.

"I remember sitting in the doctor's office as he discussed the options, and with each word, those dreams and plans were being taken away from us. Compounding the issue of our diagnosis was the financial obstacles. We were faced with concerns from family and friends, assertions from doctors, and decisions and sacrifices to make."

-- Jenna

The desire to have a baby is one of the most powerful forces in life, but for one in six couples, having a baby is no easy task. No one ever dreams of having to pay to get pregnant. It may be small comfort, but if you are struggling to conceive, you are not alone. According to the American Society for Reproductive Medicine (ASRM), more than 7.3 million women in the United States have difficulty getting pregnant or carrying a pregnancy to term. While infertility does not discriminate with regard to gender, ethnicity, religion, education, income level, lifestyle, or even family size, access to effective infertility treatment is often grossly unequal.

Infertility is a medical condition with a variety of effective treatment options. With appropriate diagnosis and treatment, nearly 90 percent of individuals struggling to become pregnant are able to bring home a baby. But many women are surprised to find that the costs for the medical treatments necessary to get pregnant are much more expensive than they'd originally planned for.

Several factors can place an undue financial burden on patients, but the most important cause is that infertility treatments are not usually covered by insurance. Some insurance plans cover a few of the expenses related to infertility testing and/or treatment, but most people (more than 70 percent) should expect to pay for the bulk of these costs out of pocket. Given failed IVF cycles, repeat attempts at treatment, and trying for additional children, the overall costs get expensive -- fast.

The infertility business is a $4 billion-a-year industry. As a result, fertility clinics are not required to provide the most cost-effective and streamlined care. After all, waste is profit. If a clinic can get you to come in for onemore appointment, one more test, or one more treatment, it earns more money. It's hard to tell if you received a good standard of care or if you just got ripped off.

Cost is a real impediment to treatment. In fact, less than half of the women and couples in the United States who experience infertility seek help from a doctor. Of those seeking treatment, about half become pregnant using treatments costing between $1,000 and $5,000 per cycle. While this isn't cheap, it's a relative bargain compared to the costs many other families face. Once you start with assisted reproductive therapies (ARTs) like IVF, expect to spend an average of $12,000 per cycle. Because many women don't become pregnant in one cycle, average costs per baby can easily range from $38,000 to $85,000 -- or even more in some cases.

For some, the path to parenthood is straightforward and short. For others, the road is long and rocky. For all, infertility takes its toll on time, energy, emotions, and finances. The good news is that you have a great chance of becoming pregnant, but be prepared to plan and be involved with all aspects of your infertility care. You will have many tough decisions to make throughout the process, so you need to fully understand your choices and their related consequences. In some cases, you will need to stand your ground, while other circumstances will require a great deal of flexibility.

As with all important money-related decisions, it's critical to start thinking ahead. You have already made an important step by picking up this book. First in this chapter, we're going to talk you through the typical costs for the various forms of fertility treatment that are available to you. Then we'll start to create a financial plan to help you determine how much money you have available to you for this process. In the rest of the book we'll investigate ways to cut the costs of the treatment, so you can be an informed consumer of your health care just as you would be with any other expense in your life. Regardless of your own personal financial situation, we will show you how to get the best quality care for your dollar. You can bring home that beautiful bundle of joy without going broke.

"At the beginning, the expenses were merely irritating. Since we had no previous experience with infertility, we assumed they were reasonable. Both my husband and I were working and had no children yet, so we expected that the procedures we were paying for would have results and eventually pay off. After eight months of no success and another miscarriage, my doc suggested IVF. By this point we were spent. We had no idea infertility would be so expensive, invasive, and medically affecting as it was. In hindsight, I think there was a lot we could have done to prepare ourselves better."

-- Tina

How much does it cost to get pregnant? It depends on many things -- age, cause of infertility, your and your partner's general health, your doctor's skills...even good old-fashioned luck. What's the short answer? Once you open the door marked "Fertility Treatment," getting pregnant will cost more than you expect.

Just because you are beginning infertility treatment doesn't necessarily mean you are going to undergo a $20,000 procedure. You have a lot of power and resources that can affect your course of treatment. With the right knowledge and skills, you can positively influence both your overall experience and ultimate outcome. First, let's focus on the basic progression of your baby-making journey starting from the very beginning.

Most of us entered adulthood thinking we could have a baby whenever we wanted. The reality is that, biologically speaking, it is amazing anyone gets pregnant. Conception results from a complex chain of events. A woman must first release an egg from her ovaries, the egg must travel through the fallopian tubes toward her uterus, and a man's sperm must join with the egg for fertilization to occur. Finally, the fertilized egg must implant itself into the uterus. Of course, next the embryo needs to grow. Infertility can result from problems that interfere with any of these steps.

Educate yourself about fertility. This can be done through doing your own research and through regular conversations with your gynecologist or other primary care physician (PCP). Don't be afraid to bring the topic up (multiple times if you have to) and talk openly about your family-building plans and concerns. There is no such thing as a stupid question. Your doctor can help you understand your fertility and address any problems as soon as possible.

As we will discuss in more detail in chapter 2, age is a huge factor for women trying to get pregnant. While infertility can strike at any age, with age comes decreasing fertility. The younger you are, the more fertility options you have and the greater the chances for success. If you want to have a baby, trying at thirty or thirty-five is more effective than waiting until after forty. Advanced age is not an impossible obstacle to overcome, but it may well include more time, more money, and more complications -- so it's important to plan accordingly.

Recognize, too, that lifestyle factors can affect fertility. Being unhealthy, including being overweight or smoking, can also decrease your fertility. If you want to get pregnant, it's never too early to start focusing on these issues and trying to get yourself as healthy as possible. Sometimes losing a little weight, stopping smoking, or adopting a more health-focused lifestyle can allow you to become pregnant without any further interventions.

When do you seek help? You may be considered to have impaired fertility if pregnancy has not occurred after one year of unprotected, well-timed intercourse. If you are a woman over thirty-five and have been trying unsuccessfully for over six months, you should consult your gynecologist. Your gynecologist can offer initial testing and information but may then recommend you see a fertility specialist known as a reproductive endocrinologist.

Routine infertility testing will be conducted, including a semen analysis for the male partner and hormone testing and an ultrasound of the female's reproductive organs. Initial treatments will probably include a prescription for fertility medications. This is often coupled with an intrauterine insemination (IUI) where either your partner's sperm or sperm from a donor is placed directly inside your uterus using a small catheter. The good news is that many women become pregnant with these measures, which can cost as little as a few hundred to a few thousand dollars per attempt.

If still nothing is happening, then it's time to try another tactic. More extensive testing will be recommended to assess your reproductive organs in more detail. Most likely, your fertility specialist will be looking for any problems that are prohibiting sperm and egg from meeting. For example, fibroids or endometriosis may be blocking your tubes. If this is found to be the case, your doctor could recommend minor outpatient surgery to check out your uterus and fallopian tubes as well as open up any blockages. Because this is surgery, this will most likely be covered by insurance. Testing and surgery can add thousands to your cost, but probabl...