The Cost of IVF: Dollars and $ense [Oh, It's Tuesday]

I’m really honored to have been asked to contribute to the multi-blog Dollars and $ense of Family Building Discussion. If you’re new to the this blog, I’ll start off with a simple overview of our family building process up to now.

April 2007: I went off birth control.

April 2008: After a year of trying to get pregnant to no avail, my husband, CH and I got a referral to a fertility specialist. Some people are surprised that I sought a medical opinion so soon, but hailing from a family of rabbits, I sensed that there was problem after the first six months of trying.

September 2008: After lots of testing, and two failed IUIs, our problem was diagnosed, and we were told that our best option was IVF. We went through one egg retrieval and then had our first embryo transfer.

October 2008: We got pregnant on the very first try, with five embryos making it into the freezer.

June 2009: Our daughter was born

January 2011: We started trying for a second child, this time with a natural (no fertility drugs) IVF cycle with one of our frozen embryos. I got pregnant again, but then I had a very early miscarriage.

March 2011: We tried again, this time with a natural cycle and two embryos, but didn’t get pregnant.

April 2011: I am now in the midst of one last IVF cycle, with a transfer of our last two remaining frozen embryos next week.

So here’s the question that I’m answering for today’s Dollars and $ense blog:

To what extent have finances determined the family-building decisions you have made? How have you able to balance financial considerations against other factors such as medical, ethical, emotional…?

It’s interesting, because being a mom has blown almost all of my theories about what parenthood is all about out of the water. In the lead up to having a child, you try to make a lot of decisions about what kind of parent you’ll be, which is a bit silly, because you have no idea who your child will be. And as all parents soon find out, the kind of parent you are greatly depends on the little person you’re dealing with, your energy-level situation, and all sorts of factors that you can’t possibly know or even fully imagine in the lead up to birth. So in most cases, I would advise against making too many major emotional or financial decisions before your child gets out of the womb.

However, as far as IVF is concerned, we’ve been making all of our financial and emotional decisions beforehand. I have a long story about why we decided to go about it this way, it involves me reading this article in ESQUIRE Magazine and watching a particularly wrenching episode of PRIVATE PRACTICE, where a father who has gone into terrible debt trying to conceive a baby with his wife switches their dying baby with another couple’s healthy baby without telling her.

But really the reason that we were able to be financially practical about infertility is that we’ve both been really broke at certain points in our lives and we don’t ever want to be that broke again. I’ve heard stories of people going into considerable debt to have a child. I think a lot of couples say, “I want a child at any cost.” I usually assume that these couples are professionals who have never actually been really broke before. I’ve found that a lot of people who were seriously broke in their early twenties and managed to turn their financial situations around are often deeply unwilling to go back to their previous level of financial despair once they hit their thirties.

CH and I both went into considerable debt to pursue artistic careers in the first place, and in our younger years had dealt with “broke” quite intimately. So when we started addressing our fertility issues, we knew that we didn’t want to go back there under any circumstances. We began our IVF journey with this notion: we were willing to let our savings take a huge hit, but we were unwilling to go into any kind of debt, I mean not even carrying a balance on our credit cards, to have a baby.

We decided before going into our first full IVF cycle that if it didn’t produce any viable embryos, we’d only do one more after that. And we also decided that if either cycle worked, we’d only do three transfers, and if I didn’t get pregnant, we’d reset and look into adoption through the foster care system. We ended up getting pregnant with our first transfer, but it’s been much harder trying to conceive a second child.

When we came up with our new plan for 2011, we once again decided to do three transfers and then to reset and look into adoption. After I miscarried the first embryo, though, we had to seriously consider the possibility of twins, since our next two transfers would be with two embryos. Before we got married, we did a big lifetime budget, planning for two children. This year after taxes, we sat down and came up with two budget scenarios, one that covered having only one child and one that covered having three.

I would highly suggest that any parent struggling to conceive a second child through IVF put together these alternative budgets. It strangely made us feel a whole lot better about the possibility of not being able to have anymore children. In one future CH is able to retire earlier, our daughter will be able to attend better schools, and we’ll all be able to take nicer vacations. In the other future, CH will retire a few years later than our original pre-wedding budget plan, no private school for the twins — in fact all the kids will have to take out loans for anything beyond state school, and our vacations will be confined to the sunshine state until further notice (read: when the last kid is out of our house).

Both futures have their pluses. We would still greatly prefer the latter with three children, but an around-the-world cruise right after Betty bounces off to my alma mater, Smith College (no pressure, kid) provides some pretty nice solace. And after redoing our budgets for both scenarios, we’ve decided not to take on the further expense of pursuing adoption in 2012.

Of course, I only have my perspective to go on, but I think making all of our IVF decisions before we were actually in the trenches of IVF made everything much easier, even my miscarriage. As a writer, whenever my story goes off the rails, I revisit my outline. Having a plan laid out beforehand has been really nice. We can go off the path we’ve laid out and scream in the woods, but it’s always there for us, nice and pre-paved,  when we’re done railing against the fates and are ready to continue on with our journey.

Visit Write Mind Open Heart for more perspectives on the Dollars and $ense of Family Building and to add your own link to the blog hop by May 1, should you want to contribute your thoughts.