I knew raising kids was going to be expensive. The bottles, the crib, the diapers, the clothes, the care… those are known expenses that are going to add up. But when you add the caveats of “single household earner” and “woman with fertility issues,” suddenly your costs expand exponentially. The transvaginal ultrasounds, the hormone injections, the (seemingly endless) doctor’s visits, the egg retrievals, the embryo transfers, the purchases and shipments of donor sperm… well, that’s just more and more dollar signs.
For me, the whole process to become pregnant cost $36,839. I wish I could tell you that thanks to the magic of insurance most of these expenses were covered. They were not.
When you live in Indiana, one of the 33 states in the country that does not have fertility insurance coverage laws, everything tied to assisted reproduction is up to you to fund, somehow. Fertility assistance is seen as an elective procedure. By the laws of my state, my inability to conceive naturally was as medically concerning as calf implants. (If your state does mandate employers to have some sort of fertility coverage, the coverage often has limitations based on number of cycle and procedures, depending on the state.)
I wish I could tell you I am the Scrooge McDuck of my generation with oceans and oceans of gold coins stockpiled in the vault located within my palatial estate. I am not.
At the time, I was a 38-year-old single woman, who lived in a moderate three-bedroom home on a busy street, with a career in the not-for-profit sector. I had a small savings account and a mediocre 401K. I did not have $36,839.
Not many people do. According to a report published by the American Society of Reproductive Medicine, it is estimated that only 24 percent of infertile couples and individuals in the United States can access all of the care they would need to become pregnant. That means 74 percent of infertile couples and individuals are left with lackluster options—and in my case, sad options and a hefty bill.
My Indiana-based fertility clinic delivered the news of my new treatment plan which was now IVF. The detailed plan filled a huge stack of papers, included a quote for over $26,000 for one round of treatment, and a $210 bill for my recent 20-minute consultation. (The average expense for one round of IVF is $12,000, but that does not include necessary medications and other expenditures, which can add on thousands, even tens of thousands, of dollars.)
The detailed plan filled a huge stack of papers, included a quote for over $26,000 for one round of treatment, and a $210 bill for my recent 20-minute consultation.
I was crushed. I took my binder of papers and my bill and went home to cry and consider. I was lost to why something that so many people medically need was so unfordable. According to Betsy Campbell, chief engagement officer for RESOLVE: The National Infertility Association, it’s a bigger conversation than just sticker shock. “I think the only reason we are talking about affordability is because most people lack insurance coverage and are forced to pay out of pocket for medical treatment that should be covered by insurance,” says Campbell. “No one talks about the cost of hip replacement, hysterectomy, or other medically-necessary treatments because they are covered by insurance.”
As I cried and thought about my options, I also hunkered down and binged TV. During my binge I came across a local evening newscast, featuring a story about another woman from Indianapolis who was just like me. She was single, she was in her late thirties, she wanted a family, and she wasn’t wealthy. She was a patient at a clinic in Syracuse, NY called CNY Fertility. At CNY they offer IVF for $3,900 per round. The motto at CNY: “Making priceless affordable.”
Just like that I had stumbled upon my answer.
I connected with the woman in the newscast and picked her brain for information on CNY. I googled and found another CNY Indiana-based patient and got her input as well. Both of my sources were a wealth of knowledge, and now, the mothers of twins. With my newfound information and these glowing references, I too became a patient of CNY Fertility.
While a $3,900 price tag is an extremely better deal than the $26,000 invoice I was considering, I still didn’t have that kind of money laying around under the couch cushions. My paltry savings wasn’t really going to cut it.
Will Kiltz, communications director of CNY Fertility, and his team work to help those as they struggle between fiscal responsibility and their dream. “The average cost of IVF in the United States is over $20,000 and that’s just for one cycle,” says Kiltz. (Many need up to three cycles to conceive, if not more.) “There’s a major discontinuity between what people can afford and what they’re asked to pay.”
Campbell agrees: “We know of patients who go into credit card debt or bankruptcy. Patients have taken out home equity loans or been forced to sell their homes, raided their 401Ks and other savings, [and we’ve had patients whose] parents have delayed their retirement or sacrificed their retirement accounts to help their children. Some patients have also taken second jobs at Starbucks just to qualify for family-building benefits.” (Starbucks has actually very generous fertility coverage benefits, even for part-time employees. The more you know!)
While I didn’t want to declare bankruptcy, I was willing to dig a pretty big fiscal hole to have my family if that’s what it took. What I lacked in riches I tried to make up for in determination, resourcefulness, and a reliable (read: rideshare-worthy) vehicle.
With my small arsenal of attributes and abilities I worked towards making a try for a baby affordable. I drove for Uber every chance I could. I drove kindly 80-year-old men who needed lifts to see their 65-year-old girlfriends. I drove hungover 20-somethings who had to change their pants in my car as said pants wreaked of booze. I drove creepers who screamed at me. (Before I reported them.)
A fare here, a fare there, it all added up. I applied for fertility grants. I won one for $1,000. I took out a home equity loan. I took advantage of CNY’s in-house financing program which allowed me to break up my payments over the course of two years. When you put all those things together they added up to be enough to cover three rounds of IVF at CNY, the necessary medications, the travel and lodgings to and from New York, and four packages of size one diapers for my now 11-month-old son.
As you can see, it’s not an easy or guaranteed road, but there are resources available to at least try to make the fiscal burden a little less heavy. “In addition to the financing options, grants and scholarships listed on our website, I would also encourage employees to advocate for family-building benefits with their employers,” says Campbell. “RESOLVE has a ‘Coverage at Work’ program dedicated to helping employees ask for coverage and helping employers understand the benefits of providing such coverage.”
In the end, I placed a $36,839 bet on myself. I was a gambler. Not by nature, but by necessity. Did people think I was crazy? Yes. Were the odds against me? For sure. Did I come up with a winner of a hand? You’re damn straight. Best bet I ever made.