The Cost of Infertility

Resolve to know more about infertility...

www.resolve.org/niaw

Infertility is honestly one of the hardest things I've had to go through in life. Infertility is a trauma. It's a silent and invisible disease that most people don't understand. And it involves one of life's major rites of passage; becoming a parent. For most people, this happens without even thinking about it. They get pregnant with no planning or forethought. It just happens.

For the other 10% of couples, it doesn't "just happen". Many of us deal with hormone imbalances that can't be cured through "relaxing". Some of us have physical issues, like septums, blocked tubes, or endometriosis, that all require invasive surgery to correct. And to top it all off, most insurance plans don't cover ANYTHING related to infertility. So what are our options?

We can chose to live life child-free. This is the most heartbreaking option, because for some it's not a choice. We can pay thousands of dollars for treatment that may or may not work. Or we can just "wait and see" with our fingers crossed that we conceive naturally. For some couples, they will eventually conceive on their own. But for many, the only options are Advanced Reproductive Technologies (ART).

ART includes IUI, IVF, or surrogacy. IUI is the cheapest, but can still take a chunk from your wallet depending on meds. My IUI last year cost us about $1,000. IVF can cost about $15,000 per fresh cycle, plus the cost of meds. And then there's surrogacy. With a surrogate, you would need to do IVF,  plus pay for agency fees, attorney's fees, screening and surrogate fees, and medical and insurance costs, all of which could add up to $80,000 to $120,000. 

What about adoption? Well, that's not an easy decision to make. Personally, I'm not ready to give up having biological children. And financially, we just couldn't afford adoption. It could cost anywhere from $20,000 to $40,000, or more, to adopt a child. In addition to the financial cost, you must also consider the emotional risk. What if the birth mom changes her mind? Or what if you don't meet the standards for adoption because you are not very religious or your home doesn't meet requirements? It can be just as heartbreaking as a failed IVF cycle.

My point is this: when dealing with infertility, you are faced with one of the most difficult decisions in your life. How will I become a parent? The answer is different for everybody. Most couples never have to struggle with this question. But those who do find themselves at a crossroads, with hard choices that can lead them down a path of debt, disappointment, or both. 

In addition to the financial cost of infertility, there is an emotional one as well. Infertility is one of the most challenging and emotionally traumatic experiences of our lives. It has changed me forever. And when we finally get the family we've dreamed of, whether by chance, ART, or adoption, all of the pain and uncertainty will be worth it. The scariest part, though, is not knowing if we will ever get to that point. Not knowing if we will ever be a mother and father. Not knowing how much longer we will have to wait. But with that uncertainty is a glimmer of hope that life might eventually feel complete.

This is why there is a need for legislation to support the infertility community. The costs of ART alone can prevent some couples from becoming parents. Shouldn't everyone have a choice to get treatment? Many of the issues that cause infertility are no different from a thyroid disorder or birth defect that are covered by insurance, so why is infertility alone a reason to deny coverage? It's not fair and it's wrong. We need support to get through this, and the financial aspect is the most daunting and difficult part for many of us without coverage. We have got to speak up and have our voices heard, that's the only way we can promote change and make a difference in the lives of the infertiles who come after us. I look forward to the day when infertile couples have options that are covered by insurance and have an equal opportunity to seek the treatment they need to become parents.

Helpful links:
http://www.resolve.org/infertility101
http://www.resolve.org/national-infertility-awareness-week/about.html

Christmas Update

I hope everyone has had a good Christmas! But to be honest, I'm glad it's over with. I know it is a hard time of year for us "infertiles". It's a very kid-centric holiday. Most of us have younger nieces and nephews to spend the holiday with, and it reminds us of what we're lacking. The sound of little footsteps and laughter as they run through the house, the anticipation for the magical arrival of Santa Clause, and their sweet, joyful faces as they open each present to reveal a new toy or gadget to play with. It's the time of year when it's most transparent what we're missing, and the same images that cause others to feel overjoyed with love and contentment, cause the rest of us to have the distinct feeling of emptiness and doubt. A feeling that sinks to the bottom of our hearts and makes us wonder: how many more holidays will pass where I feel like I'm on the outside looking in?

I think 2013 was an unlucky year for a lot of us. Hopes and dreams still left unfulfilled will need to be rolled over to 2014. But for me, I have a little more hope and I feel like we have slightly better chances next year to finally have our dreams come true.

Yesterday I had my follow up appointment from my November surgery. I had a non-operative hysteroscopy and had the IUD removed. The RN in the room during the procedure turned the monitor towards me so I could see what was going on. After removing the IUD my doctor took a look around with the scope and found no evidence of a septum! I would say I was thrilled but to be honest I was kind of out of it. They gave me 2 Vicodin and a Valium before the procedure so I was nice and relaxed the entire time. I didn't feel much discomfort either, so overall it was a good experience.

After the procedure I was prescribed Provera to take for 5 days to induce a period so I can start over fresh. The timing is kind of perfect; I should get AF right around New Year's and then we can start TTC again!

The only hiccup I can see is if Daniel's surgery wasn't completely successful. We won't know for sure until we have a follow up semen analysis in April. But even if his sperm quality hasn't significantly improved, at least I'll know our chances are better than they've ever been before. I'd feel overjoyed if we finally get our baby next year!

Best of luck to all of you in 2014!!!

Surgery experience #2

I had my 2nd septum surgery on Wednesday, Nov. 6th. It was a much different experience than my first surgery in a couple of ways. 1) I had a different doctor doing the surgery and the location was different 2) I reacted to the anesthesia differently this time and 3) the doc placed an IUD after the surgery instead of a balloon catheter, like I had the first time.

Coming out of the surgery I was very much out of it and don't remember much. Apparently I was using profane language and telling one of the nurses that I was preparing for the zombie apocalypse. Hopefully they got a good laugh from my anesthetic stupor.

Dr. Roy told Daniel there was more of the septum left than she had anticipated, taking up about 1/3 of my uterus. She was confident that she divided the full septum and then she placed the Paragard IUD as a stint. The IUD will stay there for 6 weeks.

I was also given Estradial to take twice daily for the next 6 weeks to help my lining cover up the septal area and assist the healing process.

As far as pain goes, it's been pretty minimal. I've had some moderate cramping and have been bleeding off and on, but no major pain. In fact I feel ready to go back to work tomorrow, just 2 days after the surgery.

I have a follow up scheduled for 6 weeks from now to remove the IUD and check the inside of the uterus to make sure the septum is gone and that everything has healed properly. Once she removes the IUD we can start TTC again.

I really hope this was the last time I'll need a surgery for this. It's been a rough year for me and I'm hoping that we'll finally get pregnant in 2014! 

2 Surgeries

Well it's been a few weeks since my last post and I have a few updates to share. Daniel had a Varicocelectomy on October 18th. He had a varicocele on his left testicle so they "tied off" some of the veins and hopefully his fellas won't overheat so much anymore. It takes about 6 months to fully recover from this procedure (from a TTC standpoint) so for the moment our baby-making is on hold.

I figured since we're on a forced break, and 3 doctors have recommended that I get another surgery to remove the rest of my septum, that we might as well get my surgery over with too. So I scheduled my 2nd septum resection with a different doctor; she is a gynecological surgeon and this is her specialty, so I hope she does a good job and that I'll never have to worry about my stupid septum ever again.  Plus, my new doctor, Dr. Roy, said that instead of using a balloon catheter she might use an IUD instead to prevent the uterine walls from touching and allow the uterus to heal properly. I like this idea and hope that it works out for the best and that I have a fully functioning, "normal" uterus by the time this is all over.

So other than that not much is going on. I must say that this break was much needed, I'm sure you can tell that from my previous post. I've been feeling a very strong sense of abandonment and anger on a spiritual level. I'm starting to lose faith in everything I once believed in. I just don't feel like anyone is watching out for me.

Hopefully I can snap out of it soon and in the next few months build my strength so when we can start trying again, I can have hope and believe that we might actually get what we've been praying for, a baby.

Making progress!

Before I had the hysteroscopy, Daniel and I decided that we would take a few months "off" of TTC so I could give my body and mind a break. And I should clarify, by taking the past 3 months "off" just means that we haven't been doing my typical routine of OPK's, temping, etc. But that doesn't mean it's been off of my mind by any means. The question has been lingering in my head, "What's next?"

So Daniel and I talked it over and we finally scheduled an appointment with a Urologist on May 6th. The doctor he will be seeing specializes in male infertility so I'm confident he'll find what's wrong. I am SUPER excited!!! I'm just so grateful that Daniel is finally ready to take a step forward and hopefully get some answers. We both hope that whatever is causing his low motility and morphology will have a quick fix. We both think it could be a varicocele, which would require a minor surgery and Daniel would have to take some time off to recover. But he says he's willing to do whatever it takes. I'm so happy that he feels as ready for this as I do; it would be so much harder if he didn't.

And I've been giving more thought on my septum and having a 2nd surgery and I've decided that I'm not going to worry about it for now. I've heard so many stories of women having babies WITH a septum as big as mine was. I'm hoping that now it's much smaller that my chances of having any pregnancy complications will be much less. I don't want to put my body through another surgery if I may not need it.

Also I bought myself a bunch of Wondfo pregnancy tests online and will start using those this month. I've never been big on testing like I know a lot of other women are, but I think it's something I should be doing now to catch a Chemical Pregnancy (CP) if I have one. Plus knowing I'm not pregnant will make it easier when Aunt Flo finally decides to show her ugly face. It will still be hard like it is every month, but at least I'll know she's coming and make sure to have a bottle of wine on hand (or two!)

So I'll probably give another update after the appointment with the urologist. I hope everyone has a wonderful week! Talk to you soon!

F-ing Insurance!!

So I received a letter in the mail from my insurance company that after reviewing my medical records, they determined my hysteroscopy falls under "fertility" and therefore is not covered by my plan. Are you freaking kidding me?

Honestly, I don't think this has to do with fertility whatsoever and from my research the hysteroscopy is typically covered. In fact they even TOLD me it would be covered because I asked them prior to the surgery. I think they noticed that the surgeon was a fertility specialist and therefore decided to be a-holes and make me pay for everything. Here are my reasons why it should be covered:

1) It's correcting a congenital birth defect
2) By fixing it I will have much better chances of a normal pregnancy with less complications
3) How does this surgery in any way affect conception (i.e. fertility)?

So I wrote them a one page letter, I tried to keep it short and to the point, discussing this and hopefully they reverse their decision. Especially since I will need a 2nd surgery, I definitely want them to pay for it. I will fight as hard and as long as I have to to make sure my insurance company approves this because I think it's just ridiculous! It's not like I'm asking them to pay for IVF or something (that would be AWESOME if they did though...)

So if my appeal goes through and they pay the coinsurance for my surgery, I will post a copy of the letter I sent them to this blog so others can see it. I won't post it yet because if it's not approved, I don't want others using a bad example ... :-/

Other than that no news...my hubby will be going to see a urologist next month to figure out his MFI and see if it's anything that we can correct. Just to give you an idea of what we're dealing with, his count and volume are fine, but his motility is about 20% and morphology around 2%. So if there is a varicocele or something like that then we can fix it so that's what we're hoping for. Of course he is nervous about it but I say, it's better to find out what is causing the low motility and morphology. We just need some answers.

Anyway I will update once I have more news on insurance, urologist, or when I'm pregnant! (Ha ha ya right on the last one) But you never know :) Good luck to all my TTC'ers!

UPDATE: I won my appeal!!! I focused on the fact that this was a birth defect, not the cause of my infertility, and my insurance finally agreed!

Septate what?!

Hello! My name is Jessica and I'm 26 years old. My husband and I have been trying to conceive since April of 2011...it's been over 2 years now and it doesn't get any easier with time. Especially once I was diagnosed with a uterine septum. We finally decided to get fertility testing done and through this process realized that I have a very thick, deep septum dividing my uterus in half. I was told my chance of miscarriage was very high, as in 75% or higher. Even if I did get pregnant and make it to the 2nd trimester, I would still have a high risk pregnancy and potential complications like breach presentation, incompetent cervix, and preterm labor. Scary, right?

Here's a picture of the ultrasound prior to surgery:

As shocked as I was to hear this news, I was happy that this could actually be fixed. I had a hysteroscopy on January 14th which was meant to divide my septum and leave me with a "normal" uterus. After the surgery I felt pretty good and we started TTC again once I got my first period after the surgery. Then last week I went for a follow up appointment and had an SHG done (sonohystogram) which showed that the surgery was not completely successful, and that I still have about 25% of the septum intact. Fantastic. Could things get any worse?

On top of all of this we discovered that we are dealing with MFI (male factor infertility) and with our powers combined...unfortunately we don't make Captain Planet appear, or babies for that matter...

So now I just feel stuck. Should we continue trying even though there is still a septum that could cause complications? Should I rush to have another surgery? I'm not desperate (yet) so I think the 2nd surgery will wait, but I still think about TTC every day, wondering what other curve balls will be thrown our way.

So I decided to start this blog and maybe I'll find other women out there in the same or similar situation. Hopefully we can all achieve the thing we're hoping for, a family!