Just because you are beginning infertility treatment doesn’t necessarily mean you are going to undergo a $20,000 procedure. Here’s the the basic progression of your baby-making journey, from Budgeting for Infertility: How to Bring Home a Baby Without Breaking the Bank by Evelina Weidman Sterling, Ph.D., and Angie Best-Boss
How much does it cost to get pregnant? It depends on many things — age, cause of infertility, you and your partner’s general health, your doctor’s skills… even good old-fashioned luck. What’s the short answer? Once you open the door marked “Fertility Treatment,” getting pregnant will cost more than you expect.
Just because you are beginning infertility treatment doesn’t necessarily mean you are going to undergo a $20,000 procedure. You have a lot of power and resources that can affect your course of treatment. With the right knowledge and skills, you can positively influence both your overall experience and ultimate outcome. First, let’s focus on the basic progression of your baby-making journey starting from the very beginning.
Most of us entered adulthood thinking we could have a baby whenever we wanted. The reality is that, biologically speaking, it is amazing anyone gets pregnant. Conception results from a complex chain of events. A woman must first release an egg from her ovaries, the egg must travel through the fallopian tubes toward her uterus, and a man’s sperm must join with the egg for fertilization to occur. Finally, the fertilized egg must implant itself into the uterus. Of course, next the embryo needs to grow. Infertility can result from problems that interfere with any of these steps.
Educate yourself about fertility. This can be done through doing your own research and through regular conversations with your gynecologist or other primary care physician (PCP). Don’t be afraid to bring the topic up (multiple times if you have to) and talk openly about your family-building plans and concerns. There is no such thing as a stupid question. Your doctor can help you understand your fertility and address any problems as soon as possible.
As we will discuss in more detail in chapter 2 of Budgeting for Infertility, age is a huge factor for women trying to get pregnant. While infertility can strike at any age, with age comes decreasing fertility. The younger you are, the more fertility options you have and the greater the chances for success. If you want to have a baby, trying at thirty or thirty-five is more effective than waiting until after forty. Advanced age is not an impossible obstacle to overcome, but it may well include more time, more money, and more complications — so it’s important to plan accordingly.
Recognize, too, that lifestyle factors can affect fertility. Being unhealthy, including being overweight or smoking, can also decrease your fertility. If you want to get pregnant, it’s never too early to start focusing on these issues and trying to get yourself as healthy as possible. Sometimes losing a little weight, stopping smoking, or adopting a more health-focused lifestyle can allow you to become pregnant without any further interventions.
Initial Evaluation and Therapy
When do you seek help? You may be considered to have impaired fertility if pregnancy has not occurred after one year of unprotected, well-timed intercourse. If you are a woman over thirty-five and have been trying unsuccessfully for over six months, you should consult your gynecologist. Your gynecologist can offer initial testing and information but may then recommend you see a fertility specialist known as a reproductive endocrinologist.
Routine infertility testing will be conducted, including a semen analysis for the male partner and hormone testing and an ultrasound of the female’s reproductive organs. Initial treatments will probably include a prescription for fertility medications. This is often coupled with an intrauterine insemination (IUI) where either your partner’s sperm or sperm from a donor is placed directly inside your uterus using a small catheter. The good news is that many women become pregnant with these measures, which can cost as little as a few hundred to a few thousand dollars per attempt.
Intermediate Testing and Therapy
If still nothing is happening, then it’s time to try another tactic. More extensive testing will be recommended to assess your reproductive organs in more detail. Most likely, your fertility specialist will be looking for any problems that are prohibiting sperm and egg from meeting. For example, fibroids or endometriosis may be blocking your tubes. If this is found to be the case, your doctor could recommend minor outpatient surgery to check out your uterus and fallopian tubes as well as open up any blockages. Because this is surgery, this will most likely be covered by insurance. Testing and surgery can add thousands to your cost, but probably not out of pocket.
Advanced Reproductive Technology (ART)
If the sperm and egg are meeting without fertilization or if any blockages cannot be cleared through surgery, in vitro fertilization (IVF) will be considered. With IVF, the doctor is able to facilitate fertilization by putting the eggs and sperm together in a lab. Once fertilization has occurred, your fertility specialist will place the growing embryo into your uterus.
IVF is no longer considered a high-tech or experimental treatment. The first successful IVF cycle was performed in 1978, resulting in the birth of Louise Brown. Since then, more than 1 million babies have been born through IVF worldwide. More than 70,000 cycles of IVF are performed each year in the United States alone. Today, IVF is often combined with intracytoplasmic sperm injection (ICSI), which allows a single sperm to be directly injected into the egg with a small needle in order to maximize fertilization. IVF is expensive (the average cost ranges between $6,000 and $25,000 per cycle), but success rates are encouraging, with about 40 percent of women bringing home a baby.
Third-party reproduction (also known as collaborative reproduction, or surrogate reproduction) is used only as a last resort. Third-party reproduction includes egg donation, embryo donation, sperm donation, and traditional surrogates/gestational carriers. For families who have tried previous options without success, or for families who know from the beginning that they are unable to use their own eggs or uterus, third-party reproduction offers promising hope. Because fertile women are enlisted as donors, surrogates, or gestational carriers, success rates for these treatments are significantly higher — although they are also much more expensive, usually topping $30,000 to $60,000.