Fertility Blog

I thought the expense of having a baby would come after conception.

Turns out – I’m wrong.

Cost of Assisted Reproductive Technology

For those of us struggling to get pregnant, sticker shock hits even before we get a positive pregnancy test. Many of us head to an infertility clinic in the hopes of getting pregnant. But the exorbitant price tag on technological procedures make having a baby seem out of reach – even for those of us with insurance.

According to RESOLVE, an infertility patient advocacy organization, most insurance policies don’t cover most assisted reproductive technologies. So when you’re struggling with infertility and you go to your doctor for help, you’ll probably need to have your wallet ready. The average costs of infertility treatments look like this (1):

IUI cycle: $865
IVF cycle using fresh embryos (not including medications): $8,158
IVF Medications: $4,000
Average additional cost of ICSI procedure: $1,544
Average additional cost of PGD procedure:  $3,550

Who has $12,158 to hand over to give IVF a try?

Not too many people, which is why infertile couples often take out loans to finance their hope of having a child. Some can afford only one attempt and others have to turn away before the first consultation.

Fortunately, banks, institutions and some clinics have developed financing programs specifically for infertility and a few organizations are awarding infertility scholarships. This is a good start but not everyone is in a position to take out a loan – especially in today’s economy – and the winners of scholarships are limited to just a few couples.

So the decisive factor for many infertile couples is money.

Unfair? Yes. Wrong? Absolutely.

But that’s the reality right now: in the US there are only fourteen states that currently have laws that require insurers to either cover or offer to cover some form of infertility diagnosis and treatment (2). And within those states self-insuring businesses do not have to implement these regulations at all (3).

Throw into this difficult situation an economic crisis that caused the loss of 2.6 million jobs in 2008 (the worst year since 1945) with many more fearing the loss of their income this year. It’s not a bright picture but there is a bright side for those of us suffering from infertility and willing to try something else: natural infertility treatments.

Fertility Treatments – Free and Effective

Many natural fertility treatments are not only proving to be effective but they are also considerably cheaper than assisted reproductive technology – costing near next to nothing.

Diet and exercise are two of the most thoroughly researched – and cheapest – natural fertility treatments.

Dr. Jeremy Groll, an expert in fertility treatment and author of Fertility Foods, noticed the effectiveness of diet with one of his patients who had been trying to conceive for two years with an irregular cycle. He had her change her diet and, after two months, she lost eight pounds and achieved a successful pregnancy. This was just the beginning though; he has since gone on to help countless women realize their dream of having children with his diet and exercise program that is, “low-cost, painless and free of detrimental side effects” (4).

Published research results are also beginning to pile up in support of effective and free natural fertility treatments.

In 2007, scientists reviewed published research on the effect lifestyle factors have on reproductive health (5). They concluded from the evidence that a program to encourage and facilitate the necessary lifestyle changes will improve couples’ chances of successful pregnancies, “minimizing the need for costly and invasive infertility treatment.”  More studies are needed on the effects of lifestyle on fertility but there was enough evidence to support the recommendation of a lifestyle intervention program that includes exercise, a healthy diet, no smoking, caffeine reduction and stress reduction.

A group of researchers from Australia went as far as conducting a cost savings analysis of a weight loss program for obese infertile women (in Australian dollars) (6). Their results show that weight loss results in improvement of reproductive outcome for all forms of fertility treatments and costs considerably less.

Before the program, 67 women had two live births with infertility treatment costs totaling A$ 550,000, a cost of A$ 275,000 per baby. The same women went through a 6 month weight loss program (losing an average of 10 kg or 22 pounds) which resulted in 45 babies (18 of the pregnancies were spontaneous, i.e. natural) and A$ 210,000 worth of treatments, a cost of A$ 4,600 per baby. This shows that weight loss is very effective in boosting fertility and much cheaper with a savings of A$ 270,400 (or over US$ 180,000) per child.

Let’s not pretend like weight loss is easy but, this study shows that with support and the right diet, it can lead to a priceless reward.

There are other inexpensive and effective natural fertility treatments other than just diet and exercise. I’ll be covering them in detail on a naturally getting pregnant page soon (there’s that ‘s’ word again). But right now my stomach is grumbling for a snack, so I’m going to go eat something healthy and improve my fertility without having to break the piggy bank.

I’m wide awake. Staring into the darkness, I have no idea what time it is. I fell asleep so early last night it could be as early as 4am. Quietly, I try to get out of bed and head to the bathroom. My roommate is apparently also awake because she asks me if I need a light. I’m relieved that I don’t have to feel my way through the darkness.

I settle back into bed waiting for the time to pass. Breakfast eventually comes. The nurse comes in to check our blood pressure. Then a doctor comes in to take blood. I think, due to my apparent health, that I’m not going to be subjected to his basket full of needles. I’m very wrong. Sitting down on my bed he reaches for the biggest bundle of vials. Then it hits me. I’m scheduled for surgery on Monday. They’re doing all this blood work in preparation.

The hours go by as I stare at the pages of my book thinking I will be able to concentrate if I try hard enough. Guests for my roommate come and go. The phone rings for her several times. I start to feel a little abandoned. When is the doctor coming? When will my husband be here? It’s 11:00 already. I head out into the stairwell to escape the lonely feeling in my room and to use my cell phone to track down my husband. The nurse stops me to tell me that the doctor just called and that I shouldn’t go anywhere. He’s on his way in. Good. Let’s get things going. As I start dialing my husband’s number from my cell phone he comes up the stairs – with some extra clothes, a bag from the bakery and bouquet of flowers. He gives me a hug and apologizes that it took him so long. My emotions make an instantaneous recovery.

We are back in my room when the nurse tells me my single room is ready. Things are getting better and better. It’s a cozy corner room with a round sitting corner flooded with light. The bed is electric which I realize if I do have an operation will be a god send. Richard sets my flowers on the counter and then I see it, a baby changing station. “That has to go,” I say like a general. Richard grabs it and stuffs it in a cabinet before I can even get teary eyed. Lunch is delivered and Richard and I chat while I try to eat the horrible meal of odd tasting potatoes and overcooked vegetables that taste like water. Just as I decide I’m done eating, the phone rings. It’s the nurse telling me the doctor is ready to see me.

We head over to the doctor’s office like we are going out for coffee: chatting, joking, and laughing. The doctor has me up on the table for another ultrasound. “Any pain?” he asks. “None,” I report proudly. He inserts the ultrasound wand and starts the usual exploration. He settles on my right ovary. Moving the wand back and forth he says, “See this mass? This was not here yesterday. See how it moves independently from everything else when I move the wand back and forth? I believe this is the pregnancy in your right fallopian tube.”

The final verdict: I have an ectopic pregnancy.

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It’s Monday and the doctor who conducted the surgery for my ectopic pregnancy is back. He calls Richard and me into his office, and we settle into the chairs across from him like a couple of regulars. In my hand is the print out of my surgery photos – not for the faint of heart. It shows everything: my ovaries, my uterus, and there in the center of one the photos is a large grey glob being pulled out of my right fallopian tube with a pair of extra large tweezers.

I spent much of this morning examining the photos and Richard has already briefed me on everything the doctor said after my surgery on Saturday. I’m anxious to hear everything he has to tell us so when he starts by saying that the surgery was “very interesting,” I move to the edge of my seat.

“During the laparoscopic surgery I found stage one endometriosis, one cyst and two myomas,” the doctor says with compassion. He rotates his computer screen so we can see the surgery pictures in high resolution. “The surgery went great,” he proudly announces. “I removed the endometriosis, the cycst and one myoma. The other myoma was attached to the outside of your uterine wall, which I can not touch during pregnancy due to the high risk of bleeding.”

He brings my attention to the pictures on his screen again by pointing out my fallopian tube prior to surgery. The tube is stretched so thin by the mass growing underneath that it’s transparent. The grey color shines through providing a stark contrast to the deep pink color the rest of the fallopian tube has. “We did the surgery just in time,” he says matter-of-factly. Although, I have no idea how much pressure a fallopian tube can hold, the picture creates an eerily convincing case by itself. Lastly, he points out the empty fallopian tube and the stitches. “It’s still so stretched out,” I remark. He reassures me that it will shrink back to its normal size. The stitches will dissolve on their own.

Now comes the interesting part. He turns to us and begins to talk about our desire to have children. Somehow, he knows that despite this dramatic experience we are not deterred. Or shall I say: I’m not deterred. Richard is still so shaken that his enthusiasm to try again is noticeably absent. The doctor explains that we do have an increased risk of another ectopic pregnancy. He goes on to recommend that we continue trying again as soon as the waiting period is over since the endometriosis may come back and the most likely time to get pregnant is directly after the removal of endometriosis.

Wait a minute. “Waiting period?” I blurt out, surprised. Obviously, I have not given this one ounce of thought because had I thought about it, I would know that my body needs time to recover and at a minimum my tube needs to heal. How is a fertilized egg going to make the trip through a tunnel under construction?

“Three months,” the doctor says sternly. It seems like an eternity. Three months of lost time. “Why so long?” I plead. He explains all the medical details of how my body needs this time to get back into equilibrium and heal. The look on my face must have revealed my disappointment because he said, “Well, the third month is mostly for the emotional aspect.” “So, two months,” I say completely oblivious to the feelings I’m harboring and have yet to deal with. I suddenly realize that I am trying to negotiate the waiting period: totally ridiculous but I stick with the two month reply. It still sounds long but much better than three months.

For the next hour the doctor continues to answer our questions and provide emotional support and guidance. I feel lucky that we ended up in such good hands. Lucky is not something I thought I would be feeling after this surgery. But at this moment I feel lucky and decide to savor it.

The only follow-up I need to do is to have my HCG value checked weekly to make sure that it goes back down to zero. Then I’ll need to see my OBGYN for a post-op check up.

As Richard and I walk out of the doctor’s office and head back to my room, I ride an emotional rollercoaster. My feelings are so mixed. I’m sad thinking about what could have been had the egg traveled just a little further. I’m happy my endometriosis has been removed. I’m frustrated the doctor could not remove the second myoma on my uterine wall. I’m thankful I could keep my tube. I’m scared that my tube may not heal properly. I sigh and bring my attention back to my loving husband walking next to me. Holding is hand right now is helping me heal already.

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