The Potential Costs of IVF…

Although I’m still hopeful that I’ll get pregnant with less invasive and expensive means, I have to be realistic that we may have to resort to IVF in order to have a kid (or, at least, any faint hope of having a kid.) IVF, i.e., “In-Vitro Fertilization,” is a fairly common practice nowadays. When I tell people that I’m having trouble getting pregnant, everyone  jumps to share with me how they know “so and so” who got pregnant with IVF. Simple.

In many cases, these friends of friends lived in a state where IVF is covered by insurance. They mention their friend had to “pay a lot,” but don’t realize that “a lot” is actually co-pays and deductibles, which is still a lot, but it’s not the a lot a lot that is what IVF costs without any infertility coverage, which is the case for most women/couples in America. (Only Massachusetts, New Jersey, Maryland, Connecticut and Illinois require insurance coverage of IVF — elsewhere it’s up to your company if and what they want to cover, which is usually nothing unless you work for Facebook or Google or a giant bank.)

The average cost of a “fresh cycle” of IVF in the US is $12,000-$16,000. Think that’s a lot of money? That doesn’t include any of the medication required  (that’s an extra $3000-$5000+), or optional add ons, such as embryo biopsy and screening. If you get enough eggs out in round one, they can be frozen (and fertilized), for an annual fee, and then frozen cycles later are a little cheaper, at $3000-$5000+ per cycle, plus medications and the optional costs.

According to AdvancedFertility.com, IVF with preimplantation genetic testing (with meds) and a subsequent frozen embryo transfer usually costs about $17,000 – $25,000 in the US.

For women under 35, there is a 47.5% chance that $25,000 will amount to a child. There’s more than a 50% chance that you won’t get pregnant, and that $25,000 will be out the door, never to be seen again. When you turn 35, your chances of live birth decrease slightly to 39.6%. After you turn 38, those go down much more to 28%.

It’s a strange industry — medical clinics set up to give you hope, but also provide a realism in how you’re throwing substantial money at something that may not work, not to mention that if you do have a kid you really need that money to feed, clothe and shelter it. As a woman gets older, the clock is ticking, and suddenly money seems less important than just giving it all you’ve got to have a child. Maybe it won’t work, and maybe you’ll be $100k poorer for it, but at least you’ll know you tried.

Or, perhaps, you move to a state where they cover a cycle or two of IVF.

Not Pregnant, Not Surprised.

When there were two beautiful properly-sized follicles on my first ultrasound post starting Femera, I had this surge of optimism in my mind that I maybe would be lucky and this try would take. I knew, scientifically, that even in the perfect setup odds of getting pregnant any cycle are less than 1-in-5, so I *shouldn’t* get my hopes up… but odds are still odds, and they’re not impossible.

When I felt cramps in my ovaries and could almost feel my eggs releasing, I thought maybe they were the ones. When I had a strange cramping sensation a few days before I was supposed to get my period, I thought maybe something took… but then a few days later, in unfortunate perfect timing, came the standard setup of cramps and bleeding. No dice.

Due to travels this summer, it’s going to be challenging to find time to try another cycle that works for the doctors and my husband and I. It’s hard to time these things since my period is so irregular anyway, and I need to be available for an ultrasound on the 9th day of my cycle along with the 11th day, and to be able to complete triggering and the following required acts for the few days following. This time I’m traveling internationally so I have to skip this cycle. Each missed cycle feels like a lost roll of the dice – will I look back in a few years and wish I just never left my area until I managed to get pregnant?

I’m not doing myself any favors by being out of town so much — I’m pretty much committed to traveling through October and then heads down and really focusing on getting pregnant (since I’ll be 34 somehow in November.) Thirty-four will be the year when I’ll be stabbing myself with tons of hormones, spending my savings on IVF, and maybe, if I’m lucky, being able to enjoy the wonders of pregnancy and having a child. My doctor says I need 2 more tries with the Femera and Trigger shot alone before we do anything else (though I can opt for a tube test to make sure they aren’t blocked… which I’ll have to do before IUI or IVF… but everything I’ve read about that test makes me cringe (sounds painful) so I’m avoiding… so far we know my (major) problem is that I don’t ovulate, and Femera seemed to “Fix” that, so maybe that’s all that needs to be fixed. Why believe something else is wrong with me for no reason other than being completely unlucky?

So I haven’t written here in a while because I was hoping if I didn’t think about it or write about it I’d be pregnant. That didn’t work. I’m not. On to cycle two… eventually…

 

First HCG Shot: How it Felt and the TWW

Last night, I had to – for the first time in my life – self-inject a drug into myself. I realize that diabetics and others have to do this regularly, and it’s not that big of a deal, but I let my fear-of-needles take a hold of me, which led to an hour-or-so panic attack and my poor husband trying to help me calm down, accomplished only by a shot of whiskey and finally getting up the guts to poke my stomach fat with the needle, injecting 1cc of HCG and water mix to “trigger” ovulation.

Admittedly, it wasn’t that painful – the injection itself didn’t hurt (I guess it’s a good thing I have so much fat) and it was only slightly uncomfortable when my husband helped me inject the substance – and then it was over. There was slight soreness at the site of the injection, but mostly I just felt a little dizzy and warm for a few minutes – I’m not sure if that was the medication or me just breathing for the first time in an hour.

The process of setting up the injections wasn’t that hard — we had a vial of water and one of powder, and we had to mix 1cc of water into the powder vial and shake it for 30 seconds, then the mixture was ready to be stabbed injected into my body.

As per doctor’s orders, we are to have TI twice this week, once after the injection and once two days later for the the best chance of insemination. I really wonder if this will work — there are so many variables that have to be right to get pregnant, it’s amazing anyone ever does. Now we enter the “TWW” – two week wait – and see if anything stuck. I don’t expect to get pregnant this cycle, though it could happen.

Cycle 1 CD11 2nd Ultrasound & Trigger Shot

So far, so good. I went in today for my second ultrasound of the cycle (another $350) and was informed that each ovary has one mature follicle — 17.7mm on my left and 19.4mm on my right. My lining is 9.6mm, which is good I guess (they didn’t tell me anything was abnormal with the lining) and DH and I are set to stab me (ahem, take my first “trigger shot”) tonight and then we’re instructed to have TI twice this week. And then we have our TWW (two week wait) and see if it worked – if not, we repeat the same thing again.

I wasn’t thrilled with my doctor’s bedside manner today – I understand he is much more engaged with patients who require IVF and my current treatment is fairly basic, but I’m paying $350 per appointment, it would be nice if I didn’t feel like I was being a nuisance asking questions. Apparently I should have taken better notes during the consultation (which was almost a year ago because I took some time before I decided to get started) — or I’m asking too many questions in general and should just do what they tell me to and not really know what is going on. I like to understand things, esp. medical-related things happening to my body, so I do ask a lot of questions.

If this cycle works, great. I’ll be freaked out in the way anyone is when they realize they’re about to bring another life into the world and there will be a nine month wait when they blow up like a watermelon leading up to the most painful experience in a normal human’s life (other than, you know, death, or, as my husband reminds me, stepping on a lego) — but also, ecstatic. And odds are still very slim right now… even super healthy women at my age only have a 20% or so chance of getting pregnant each month.

There’s also a slim chance that I’ll get pregnant with twins. I asked the doctor if the trigger should might make both of the mature follicles release eggs and he looked at me like I’m dumb and said “might? It will.” Now, just because two mature eggs release does not mean both (or either) will be fertilized and even if they are there are a host of things that could go wrong which is why it’s unlikely in any given cycle I’ll get pregnant at all. I’m saying this based on Internet research, not based on what my doctor told me, because he didn’t seem interested in explaining much of anything to me.

If it works, it works. I guess the TWW starts on the 13, with testing starting on the 27. That’s all we do at this point… trigger… TI… x2… then wait. It’s basically like normal reproduction with the added help of ensuring mature follicles and knowing when you’re ovulating.

Please send baby dust our way.