I Could Not Afford to Have Children
By Kristin Thompson
“The good news is, there’s nothing wrong”
I can’t tell you what I really felt at that moment. I was torn between relief – there had not been an actual problem and all the medical tests had come through free of abnormalities – and at the same time an uneasiness of, well, where does this leave us?
As the doctor continued to drone on over our Zoom consultation, because it still was not safe enough to unnecessarily be within arm's length distance of someone, I remember the conversation ending with, “We’ll email you the details on your two options and their costs.”
As I opened up that email I found myself scrolling to the bottom line and deciding whether I’d be spending $1,500 or $15,000 to try to have a baby.
Any one who has struggled with infertility or had to go through these procedures knows that the price tag is actually way more than this, but more on that in a bit.
The goal of this article is to un-taboo the taboo of discussing struggles with infertility and conquer the vulnerability I felt as a financial advisor whose job is to help clients plan for the unexpected and who was also unprepared to handle the financial burden of trying to conceive.
How I got to this place began in the pandemic, and, like so many things involving COVID, it pitted my health against my finances.
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Along with the rest of the planet, we had to hunker down for two weeks starting on March 16, 2020. That meant we needed to stock up on food, supplies, toiletries (including a gratuitous amount of toilet paper), and like so many other women out there, sufficient birth control. That’s what I was doing one day in the Walgreens’ drive through when I was told that my bill for said birth control was “$400.”
I was shocked, not only by the amount, but that I was being charged at all.
“Are you sure?” I asked the masked pharmacists on the other side of the window. “I’ve never had to pay anything for this before”
“Yes," She replied, "it says this is the price your insurance is now asking for.”
Feeling like there was no way that could be true, I went home to figure out what was going on. I got on the phone with my insurance company and they explained that at this point in time, over a month after open enrollment had ended, my birth control would no longer be covered under the health plan I had chosen.
They gave me multiple excuses: a patent had expired or that the current administration led by an unnamed carrot top man did not see my birth control as a “medical need.” I sought the help of this incredibly patient customer service representative who was now giving me advice well above his pay grade, and reached out to my doctor before being given options on how to proceed. I could either switch to a $20 generic version of my preferred medication, or I could go without birth control.
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Now, let me step back to give you some more background on what was happening in my life at the time. My husband and I had just celebrated our 2nd wedding anniversary in February of 2020. I was 30, almost 31, and felt I was in my prime: I had a successful career and several awesome trips ahead. We had too much going on to slow down now and have a child. At least that was the conclusion we came to when we discussed things early in the new year.
But then a once in a century global health crisis hit, and by late March it seemed that we might be stuck at home for a little longer than two weeks. Things had changed, and my timeline was changing with it, and I knew that I had to have a conversation with my husband about it. One day when he came home from a walk around the block, I looked at him and said, “We need to talk”.
That’s when I explained to him that it didn’t make sense to me to adjust to a new birth control when I might go off within a year. “Are you open to this?” I asked. He was. Neither one of us knew what we were getting into, but I felt better that we were on the same page, and were ready to return to our routine of evening Hulu binges, daily walks, Friday night “Houseparty” calls with friends, and preparing for the long hall of the monotonous unknown that was 2020.
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In an effort to speed along what comes next, I’ll jump to March of 2021 in the office of my nurse practitioner, where I sat with a heavy heart. I told her about my mood swings (which are normal when going off birth control), and the acne (that too), and the fact that I only got two weeks each month where I felt like my “normal” self (three for three).
I asked her about the many false alarms we experienced as my body tried to regulate when and what a period was and how the moments where we thought we might be pregnant made us more sure that we wanted to be parents together more than we had ever before.
I lamented how the first round of basic hormone tests ($$) conducted on us both in early 2021 came back normal and full of false hope and yet here we were, two months later, with no further progress and, at a loss for what to do next. She listened and when I was done, offered to direct us to a specialist…if you're tracking cash register rings, we’re up to a modest two.
At least the first meeting with a fertility specialist is free. How lucky are we? From there, the clinic booked and scheduled exploratory tests for each of us. When those results came back negative for any abnormalities, the doctors had no choice but to tell us that we had the very real diagnosis of unexplained infertility.
While there was nothing overtly wrong, that did not mean that we could continue on what I now call the “free-baby” path. In fact, in this call the fertility doctor also told us that our likelihood of conceiving naturally was significantly lower than normal (about 10% or less[1]).
That brings us to where this story started, 100 bucks here and there for medical bills, another 100 here and there for therapy and couples counseling, and no baby.
The doctor laid out the two options and cost structures.
The first one was IUI[2], which I had never heard of before. As it turns out, you do not have to automatically begin your fertility journey with IVF. The Intrauterine insemination, or IUI, process allowed us to create a super powered reproductive cycle, in my terms. The first step in the process is for the woman to take a bunch of hormones, fortunately I was able to ingest these orally, in order to determine the timing of exactly when I will drop an egg.
Then you have your “trigger night” where you take a shot about 48 hours before your attempt to get the egg to drop at the exact moment that will be best for it to mix with the specimen provided by the male:
Procedure and blood work - $1,400
Medication - $250
Actual amount we paid for one round of IUI: $1,650
We tried it twice.
I was optimistic. Our tests had shown nothing wrong, so why not try IUI?
I should mention the opportunity cost that also came with missing work for appointments.
For one round, I had five doctor appointments in a three week span. Potentially another $1,130 loss.[3]
Realistically however, IUI only brought my percentage of success to slightly higher than someone that was trying to conceive naturally: about 20 - 30%[4]. The odds were still against us.
So you'd think it would come as no surprise that it didn’t work the first time… Or the second...
After our second failure we took a trip to Mexico ($$), where I did some “I’m not getting any younger math” and made the decision to move forward with IVF in the spring of 2022.
To many women, including me, In vitro fertilization, or IVF[5], sounded intimidating. First, multiple eggs are collected from the woman (in that sense, this part of the process is similar to what a woman goes through when freezing her eggs). This is a surgery ($$$).
Second, said eggs are then combined with the male’s sperm to create embryos ($$$). Then, your medical team will set out to prep your body for a, in my terms, Xena The Warrior Princess type menstrual cycle: trigger night ($$), transfer ($$), more meds ($$$) to attempt to keep said embryos, a hope, a prayer, and a wish (free).
Cost for our clinic:
Embryo Banking - $11,500
Transfer of embryo - $5,000
Full single cycle that will include banking and transfer* - $14,500
Genetic testing procedure - $2,800
*Medication not included
We chose a two transfer package (seemed a better deal with our odds). So our actual cost were,
Two transfer package - $17,400 (embryo banking, two transfers)
Genetic test procedure- $2,800
Actual biopsy per embryo ($200), we sent 11 - $2,200
Medication - $5,864
Office visits (about $265 a visit) - 2,650
Grand total of $31,202
Emotion burden of IVF? Priceless.
My one piece of advice on how you can save money while going through IVF? Read the fine print. I was getting more and more savvy and educated as we moved along in the process and I was finding the brain power to be the financial advisor I knew I could be.
I had always thought IVF was a sure thing before this journey started, but it only raised our prospects of success to about 50%. That’s why we chose the clinic’s “Two Transfer” package, not just to save money, but to mentally give myself peace that it might take more than one time for all this to work (and you better believe I confirmed how to receive a refund if we did not need two rounds).
I researched medication donations, Facebook groups and began to communicate more about our journey to get support from friends and family.
Interest rates were low and the market was good, so I took out a home equity line of credit at 3% rather than have credit card debt or sell investments.
Work was the only thing I felt like I could do well. So I tried as best I could to have doctor appointments early before the work day started. I got savvy at the best top or blazer for blood draws, pants or dresses for quickly getting in and out of stirrups. Which appointments you could knock out in 15 - 30 minutes and what took an hour so I could plan my next meeting accordingly.
It was this business mindset, along with a great deal of perseverance, that got me through.
To summarize what comes next,
May 2022 - Start of IVF process including egg retrieval, transfer attempt and negative pregnancy blood test
October 2022 - Second IVF transfer attempt and negative pregnancy blood test
December 2022 - “Mock round,” or a round of IVF with no intended transfer to investigate what is actually happening once the embryo is implanted. What were the results? More of the same. All looks good, nothing wrong here. - $3,032
January 2023 - Decision to complete another retrieval for more eggs for future children before our next transfer - $14,500 and testing $2,800 plus $1,000 for five biopsies
February 2023 - Third Transfer
– Total cost $54,184 –
● November 2, 2023 - Baby Poelker due date
Now if you scroll back up to the title of this article, you might be surprised that I conclude with this: I feel extremely lucky and blessed.
I had the financial means to continue going through this process when nothing seemed to be working. I had the financial knowledgeto review all my options and logically decide the best way to move forward.
Finally, I had a career that allowed me to attend all of these appointments when others would have needed to use PTO or simply stop if they would be unable to travel to the doctor’s office so regularly with a tighter work schedule.
As we prepare for our little girl’s arrival none of this is lost on me.
I do not believe there is anything someone has worked hard for — running a marathon, climbing Everest, writing a novel — where the journey is not filled with the mindset, “whatever means necessary” and only at the end do you look back at the sweat, tears, and money it took to get there.
Yet, when it’s for a child, people seem to think you could have done something else. As if you knew it would be this hard, and as if it was you did not like every moment brought you more and more the image of your child, your genetics, your path to a new extension of yourself and relationship with your spouse.
That’s why it is my goal to both open the door to discussing infertility, and ensure that it does not slam behind me. Ideally, bringing these difficult topics forward will lead to change and more opportunities for anyone who wants to have a family and was not lucky enough to be able to start one on their own.
Thank you for reading my journey.
In the words of one of history’s most intellectually stimulating shows, Desperate Housewives, “Looking at what has been taken from us is a bad way to go through life; looking for what we can give to others is far better”.
