Today’s post comes from a reader named Melissa who is facing the expensive decision of trying IVF with her husband in order to have their first child. Infertility is a sensitive and grappling topic that many couples are facing today. We're having children later now due to our careers, and many of us are struggling to conceive.
Unfortunately, a lot of infertility issues are still unexplained and couples are left facing a foggy future of many unknowns. Even though IVF has enabled many couples to have children, it has also disappointed many others. How much would you be willing to pay to start a family if IVF was your best chance at having a child? Let’s take a look at the costs of IVF and the emotional and financial challenges couples like Melissa and her husband face when trying to start a family.
According to the Center For Disease Control, 6% of women (1.5 million) in the US are infertile. Other sources such as the National Institutes of Health say the percentage of infertile couples is as high as 15%. The numbers are significant and unfortunately I’m one of them.
Even though you don’t know me personally, chances are pretty high that you and your spouse or someone you know has also dealt with the struggles of infertility. The average couple trying takes around seven months to conceive. Meanwhile, I know plenty of couples who've taken years.
Speaking from experience, infertility is not an easy subject to talk about, especially the longer you try to get pregnant without success. But a lot of times people don’t realize how emotional infertility can be, especially if you never had any issues yourself or had a “surprise” or two. And to top off the roller coaster of emotions people like me have to deal with, it’s crazy expensive!
DISCOVERING IVF TO COMBAT INFERTILITY
I decided to put myself out there because my husband and I are at a crossroads and sometimes writing things out can help when facing tough decisions. Our doctor recently told us that if we want to have a baby, our best option is in vitro fertilization (IVF). The first things that popped into our minds were “how much does IVF cost” and “can we afford IVF if it takes multiple tries?” While some people might jump straight to yes, we’re not so sure.
We’ve both done well in our careers making six figure incomes, but we definitely don't feel rich living in San Francisco. We aren’t into fancy cars, designer clothes, or 5 star resort vacations. Target is my favorite store, for example. We’re simple people but we are willing to pay a premium for things like great food and good service. We like to save, we’re already happy with just us as a couple, and we don’t like to rush into any major decision that involves money and well…life.
So to help in our decision-making process I’ve crunched some numbers on the various costs, analyzed some pros and cons, and also want to hear what your thoughts and experiences are. Ultimately we will have to decide which route to take ourselves, but I think it will be helpful to get feedback from other Financial Samurai readers with a decision this significant on lifestyle, health, and our finances.
WHY EVEN CONSIDER IVF?
To help you understand why we’re even considering the expensive costs of IVF, here’s some background on our situation. For a little over one year, we tried unsuccessfully to have a baby on our own. We didn’t take it too seriously at first but every single pregnancy test I took for two years was negative. I can’t even describe how frustrating and sad that was, and still is.
Last year, a few months before I turned 34, we decided it was time to see a fertility specialist. After my exam my doctor explained that I have endometriosis and large cysts on my one of my ovaries. My throat choked up and tears started to flood down my face when I heard the news. That was a tough day. But the good news was our doctor said at our age we still had a good chance to get pregnant despite my condition. We wanted to try the cheapest and least invasive treatment first, so we tried IUIs for about seven months. Our insurance covered the vast majority of the procedures and most of the medications, so we were feeling lucky. But unfortunately none of the IUIs worked.
While we could still continue trying IUIs using our insurance, my doctor doesn’t think it will be successful at this point, and time is becoming more and more valuable. She wants me to get pregnant within six months because my cysts and endometriosis could cause complications if I don’t get pregnant soon. Gee, no pressure right?
All this leads us to the present day, trying to decide if we should do IVF or not, which our insurance doesn’t cover at all. The good news is my doctor thinks we are good candidates for mini IVF, which is a lot cheaper than normal IVF, so we have more options but the downside is it’s also less successful.
HOW MUCH DOES IVF COST?
Ok, so just how much does IVF cost? It can vary a lot between clinics and the specific medications and procedures you require, but the general range at my clinic is $13,000 – $24,000 for one attempt. It’s absolutely ridiculous! Most insurance plans like mine don’t cover IVF at all, which means we've got to fund everything ourselves.
Here’s a look at the summary of costs at my clinic for conventional IVF:
HOW MUCH DOES MINI IVF COST?
Mini IVF is appealing because it’s much less invasive, less complicated, less shots, and less expensive. But the downsides are the success rates are lower that conventional IVF and there's also very limited chance to have enough extra embryos to freeze for a second cycle.
Here’s a look at the breakdown of costs at my clinic for mini IVF:
HOW MUCH WOULD YOU PAY FOR A 33% CHANCE?
The success rates for IVF are another important aspect to consider because if you do the math, a lot of the times a single attempt isn’t going to be successful. Here’s a look at the success rates in 2012 for my particular clinic:
I’m just turning 35, so I figure I have about a 32-34% chance of having a baby in each attempt. That certainly isn’t high enough to get very excited about. It’s very hard to feel comfortable paying $15,000 for a 33% chance.
From a simple mathematical standpoint, one must therefore spend $45,000, or three attempts, before one is successful. Unfortunately, each attempt is independent of the next, which means we could be trying to bet on black at the roulette table while red keeps showing up. Just like investing, there are no guarantees.
NON-MONETARY FACTORS TO CONSIDER BEFORE DOING IVF
As much as money is a huge factor in our decision, it isn’t the end all be all. We all know the major pro of doing IVF is being able to have a baby and raise a family. But here are some of the cons I’ve come with beyond the costs.
Time – I haven’t even mentioned the amount of time involved in doing an IVF cycle. There are a lot of doctor appointments, trips to the pharmacy, lab tests, and procedures involved. Fortunately we have fairly flexible work schedules, but the more time away we spend from work, me in particular, the less time I have to earn money.
LOTS of shots – Getting blood drawn is not fun. I just had three vials taken today. But injecting myself with needles is much worse. It seriously sucks getting up the nerve to shove a needle in your stomach, especially as someone who gets queasy at the sight of blood. The fear and unpleasantness of all the shots involved with IVF is one of the major cons I have with IVF. Perhaps you’d argue it gets easier each time you do it, but I still cringe at even the thought of injecting myself.
Emotional factors – Infertility is incredibly emotional. It’s frustrating, sad, painful, hopeful, and disappointing. We’ve come to peace that IUI didn’t work and having insurance helped us a lot. I worry that it will take a lot longer to get over the disappointment of IVF if it doesn’t work. Having a supportive partner or spouse is incredibly important.
Surgery risk – It seems silly now, but I didn’t realize that IVF is actually a surgery until recently. It makes sense when you think of how expensive it is. And as with any surgery there are always risks. The only other surgery I’ve had before was getting my wisdom teeth out, so taking anesthesia still freaks me out.
Chance of miscarriage – Even if IVF results in a pregnancy, there’s no guarantee I could carry a baby full term (life birth). I can’t imagine the emotional roller coaster of going from total elation of finally being pregnant for the first time to the devastation of losing a baby. There’s a delicate balance between staying positive while also setting expectations really low.
Ethical considerations – While I don’t want this article to spew into a debate over whether IVF is ethical or not, there’s no denying that some people are flat out against it. My husband and I don’t have any moral conflicts with IVF nor are we trying to have a giant family. But sometimes I wonder since I haven’t been able to get pregnant for 3 years now, perhaps it just wasn’t meant to be?
An unhealthy baby – Who knows whether IVF can affect the health of a baby, but what if we have a baby with abnormal symptoms? Would we end up blaming IVF or ourselves for going against nature? Taking care of a child is no easy matter and we will be full-on, committed parents. One of the benefits of IVF is the clinic can supposedly choose the highest quality embryos for insemination.
ALTERNATIVES TO IVF
Although my doctor recommends IVF as the next step, there are certainly other alternatives. But of course, none of them are guaranteed either.
Chinese (Eastern) Medicine – One of my friends over 40 has had multiple miscarriages and was told by her ob-gyn that her only option to get pregnant was using an egg donor. After finding a Chinese Medicine infertility center, however, she was able to get pregnant and gave birth last year through the help of acupuncture and herbal medicine.
The process can be slow, roughly 5-7 months, and also involves weekly appointments. The combined use of IUI or IVF with Chinese medicine can be more effective than by itself, but it all depends on your condition. I’m leaning towards giving it a try. It can still get expensive over time, but by itself it’s a lot cheaper than IVF. The estimated cost of treatments is below:
Initial consultation $120
Herbal Medicine $272/month
1st month $672/month
2nd month on $552/month
6 months $3,432 total
Clinical Trials – If you can’t afford IVF, you can consider participating in a clinical trial. The difficulties are finding one in your area that you qualify for and of course there are always risks to consider when participating in any research study. One of my friends lived near a clinical trial, but didn’t qualify due to too many failed prior attempts at IVF. If you do qualify, the entire treatment could be covered and you may even be compensated on top of that. But this can range wildly depending on each study and the amount of funding available. I’ve considered doing a clinical trial, but admit the risks intimidate me, and I haven’t found one nearby yet either.
Adoption – Adoption is a fantastic option to raise a child in need and is certainly something my husband and I are considering. It’s not necessarily a cheaper option compared to IVF, and it can also take 2-4 years. According to Binti, the range of US adoption costs ranges from $20,000-$45,000 and international adoption costs are similar at $20,000-$50,000. If you qualify for the IRS adoption tax credit, you can reduce the expenses by $13,400 in 2015. But if your modified adjusted gross income falls between $197,880 and $237,880 the tax credit begins to phase out, and if you make above that range, then you don’t qualify at all. Adoption can be complicated too and it isn’t as easy as it used to be. According to CNN, international adoptions have dropped 50% since 2004 and many countries like China have become much more restrictive or closed down entirely such as Russia, Ghana, Guatemala, Nepal.
Surrogacy – Typically even more expensive than adoption is paying for a surrogate to carry your baby. We have thought about this option, and while it would be nice to avoid the challenges of pregnancy and giving birth, it feels way too complicated and unaffordable. The cost of surrogacy can range between $80,000-$125,000 in the US! That is out of the question for us but we might consider international surrogacy later. If you’re willing to deal with the complexities of long distance travel and government paperwork there are cheaper options in countries such as India for around $35,000. But there are many risks, legalities, and logistics to consider. Some international agencies have been shut down due to fraud in the past too, so don’t underestimate the importance of due diligence if you have the means to consider surrogacy.
DECIDING ON THE BEST OPTIONS
My husband and I have the means to afford a few rounds of IVF without going into debt, but we’re not rolling in dough. I think the absolute max we would want to spend is about $30,000-35,000 (enough for two attempts), but I still wouldn’t call that “comfortable.” It’s incredibly hard to swallow actually! And IVF isn’t a walk in the park either though we can afford it. There are a lot of appointments, tests, unpleasant medications to take, side effects to cope with, and emotions to bear.
We will have to sell some of our stock positions to free up enough cash flow for the IVF self-pay invoices as we go, postpone a trip abroad, delay some work we wanted to do on our house, and maybe shelve some trips to see my parents who live out of state too.
As much as we don’t want to have to spend tens of thousands of dollars, we also realize that IVF won’t be a realistic option for us indefinitely. Our best chance for success is within the next six months and we don’t want to look back when we’re much older and regret not trying when we had the chance. Even if we pay for one or two attempts and fail at least we can always say we tried. And then we can take our time considering adoption and rebuilding our savings.
I put the below table together of the various options we’re considering sorted by cost. I’m leaning towards incorporating acupuncture and herbal medicine as a first step. It does involve a lot of weekly appointments and drinking bad tasting tea every day, but doing it in preparation of IVF could increase our chances of success with such an expensive surgery.
And who knows we could get lucky “trying” on our own in the months leading up to IVF which is why I’m counting the months of taking herbs and getting acupuncture in the count of total attempts. But the percent chance is probably quite low in the first 1-3 months. There are so many possibilities I feel pretty overwhelmed! Of course we don't have to decide our entire plan now, but it's helpful to think of the big picture especially in regards to time and the expenses.
Updated for 2018 and beyond. Melissa ended up having a handsome baby boy two years after this post in 2017 via natural conception. God works in mysterious ways.