IVF…IVF…IVF…I slept, ate, drank, and breathed the same thought over and over again…IVF. Wasn’t there another way to get pregnant? An easier way? A less expensive way? As soon as our reproductive endocrinologist uttered the words intrauterine insemination (IUI), I was ecstatic! But, before I was even able to share my enthusiasm, she shot down my hopes with the number 10.
10-15% success rate for us with IUI? My heart sank once more. I didn’t want to waste anymore time, and we couldn’t afford to waste any money. Since we would be paying out-of-pocket for everything that insurance didn’t cover (which our doctor informed us would be most things) she advised us to think through our options carefully. IUI was more than a long shot, and at $1,500 a cycle, it sounded like money down the drain. But, one cycle of IVF (in vitro fertilization) would cost us around $15,000! Talk about sticker shock! I almost fell off of my seat! With my husband still in residency and my student loans coming due, how would we be able to afford that? Was it worth trying intrauterine insemination at what now sounded like such an affordable cost? But, what if it didn’t work and we still had to go onto IVF? Again, my mind was racing.
Dave and I needed to make a decision quickly because my work up would depend upon which intervention we chose; if IVF, then they would need to make sure that my uterus looked good. If we wanted to do IUI, then we would need to check the ovaries and fallopian tubes as well. IVF skips the egg release into the fallopian tubes, so a simple camera into the uterus (hysteroscopy) in the office could be done instead of an additional test with dye through the fallopian tubes (hysterosalpingogram). Our reproductive endocrinologist told us that we could think about it for a few days and then give her a call to schedule.
The same day that we found out that IVF was our only real option for having children, I was scheduled to leave for Michigan to volunteer with my sister’s non-profit which runs performing arts camps for disadvantaged children in inner-city Detroit. On top of being devastated by our situation, I had not shared our struggle with infertility with anyone yet, including my family. It was too personal. Somehow, it felt embarrassing. I felt inadequate and like we were broken.
In the midst of being unable to have a baby, it seemed that everyone increased the frequency with which they asked when or if we wanted a baby. My polite answer was always the same, “Yes, we would love to have a baby, but we will just have to see. Dave is still in residency, and I am working on my Masters in Public Health while practicing medicine at the same time. We are just so busy. We want to make sure that we are able to give a baby all of the attention it needs.” Our story, which had once been true, now felt like such a lie…a line just to get us by.
Patients loved asking me if I had children while I examined their own children. It was always an innocent question. My answer was, “Not yet!” with a smile. Their response was always, “Oh, really, but you are so good with kids! You should really have a baby.” My mental response… “No kidding!” while I politely smiled and tried to change the subject.
My mother in law would jokingly ask when we were going to give her a grand baby. Since Dave was an only child, we were her only hope for grandchildren. Somehow her question made me want to point the finger at her son and say, “It isn’t me. Ask your son why we can’t get pregnant.” That sounds horrible to say. It sounds like I am the mean wife blaming her husband, but in the midst of pain and grief comes some anger.
In addition to everyone asking when we were going to get pregnant, everyone around us was getting pregnant…at the drop of a hat. Stories such as, “Well, I had just stopped the pill for half a day” or, “We weren’t even trying”or, “It is such bad timing but…” Although I was happy for everyone about to add to the human race, their fertility only cemented my devastation. I won’t lie; The painful reminder of our silent infertility did create moments of jealousy.
Now, back to my Michigan trip. In addition to the pain of working with little children (as a constant reminder that I may not be able to have my own), I had the added pleasure of starting my menstrual cycle. Yes, just to confirm once again my inability to conceive. My family noticed that I was not my usual self, but I tried to put on a brave face and just said that I was working some things through. All I wanted to do was to go home so that Dave and I could decide on our next step. I didn’t want to be away from him at a time like this. I wanted to make a decision and move forward.
When I finally got home from Michigan, I spent more time than I should have looking at medical sites on infertility. I looked at our chances of success based on the statistical breakdown of causes leading to infertility. I was consumed. After lengthy discussions over just a few days, Dave and I decided to proceed with IVF. We poured over our bank accounts and tried to figure out where the money would come from.
The Infertility clinic had advised me to call our medical insurance to find out about coverage. The conversation with the insurance company still makes me fume. The woman on the other end of the phone felt that she needed to educate me on the definition of infertility. She informed me (with her vast amount of medical knowledge) that infertility was not actually a medical problem. Therefore, treatment was not covered by insurance. NOT A MEDICAL PROBLEM! I calmly asked her if it was not a medical problem then what type of problem was it. She conceded that infertility was a medical problem, but that treatment was not medically necessary. “Not necessary for whom?” I asked, because according to my reproductive endocrinologist it was necessary for me!
I guess her point, which she eventually got to was that having children was not medically necessary. Hmm, interesting. I could have insurance cover procedures to tell me that I couldn’t have children, but I couldn’t get them to help me get pregnant. It seems that preventing pregnancy is medically necessary since birth control is covered, but on the flip side, helping someone get pregnant is not necessary. This is a little counterintuitive. If a woman should be able to manage her own reproductive health and sexuality…shouldn’t she be able to get the assistance she needs to have a baby? From my perspective, comprehensive women’s health care should include enhancing fertility not just limiting it. Regardless, our conversation did not change the system or my access to infertility care. Instead, I was tersely informed that I would be a self-pay patient.
From The Mom in Me, MD