How Much Will it Cost to Have a Child: The Cost of PCOS-Caused Infertility

*Warning – TMI post. If talk about fertility freaks you out, skip this one.

He sat, staring at me inquisitively, as if he had never seen a 33 year old before – at least one asking about embryo freezing. Quoting various studies and having the sort of semi-formal talk one has in a brief consultation before a casual vaginal ultrasound to check out the ovaries and uterus of yet another infertile woman. I came in seeking answers and options.  I left with a sense of hope and more confusion. My case is maybe not that bad – but there are so many variables of things that can be wrong and go wrong that I may be hopeless. We’ll only be able to find out after we spend thousands of dollars. That’s just the way infertility treatments work.

Some states cover infertility treatments, or partially cover them. My state does not. No states require the coverage of embryo freezing, that’s just a benefit that some big tech companies have decided to offer to help women wait until late in their careers to have children, which is a nice benefit although massively offensive and sad at the same time for so many reasons. In any case, infertility treatments are expensive, even if you don’t have to go the full-blown IVF route.

The first consultation appointment was $350. With that, we had a conversation about my options, and observed my insides. The resulting information regarding my fertility was mixed — my ovaries have 12 articular follicules each, which is in the top 5% according to the doc. However, at this time in my cycle one of them is supposed to be growing into an egg, and it isn’t. This means that something is wrong with something. The likely cause is that the signals my brain sends to my ovaries is getting mixed up and thus the first line of treatment is Clomid or a similar drug that makes this signal much stronger. He says Metformin, the diabetics and high blood sugar lowering drug that I’m prescribed, doesn’t actually help you get pregnant – it just helps you get your period regularly, so says science. However, science often conflicts itself so who knows?

Doc drew me a picture he’s drawn for thousands of women. Here are your ovaries. Here is your uterus. Here is the signal from your brain that isn’t working. Here are your odds…

Odds are decent for now, outstanding any various other things that could be wrong with my partner or my body. Right now it looks like it’s just a signal issue that is often fixed by the Clomid. There lies the hope – I can potentially get pregnant and potentially get pregnant without costly IVF. Possibly.

But then we got into the discussion of child #2. I’m still coming to terms with procreating one child so it’s not ideal to have to think about planning my second immediately. He basically told me that I should have my second by the time I’m 35 or 36. Well, given that I’m turning 33 in a month I won’t have my FIRST until I’m 34 if all goes as planned. That means I’ll have one year until I need to be pregnant again. How does that work? I know it’s never ideal to have kids, but I always imagined I’d have at least 3 years before getting pregnant with #2. I figured I’d have one at 33/34 and one at 37/38. But doc says I shouldn’t wait until 38. If I’m really set on having #2 at 38 then I should freeze my eggs – but that’s basically the craziest thing he’s ever heard. He seemed fairly confident that if I can get pregnant without IVF now with basic medication, I should be able to do so again at 35/36, so I should. Why wait?

Well, for starters, I’ll be going back to work 6 weeks after my child is born. How the fuck anyone does that I have no idea, but I’m going to have to do it. I’m hoping my company will be flexible and let me work from home for a bit longer than that. So, assuming they do, it seems in rather poor taste to notify them less than a year later that I’m pregnant again. Of course, who knows if I’ll still be at the same company then. I probably won’t be. But I need to be at the same company for a year to qualify for any sort of maternity benefits. At that point, I’d be really stuck. I mean, the timeline all sorts of sucks…

34 – give birth to child #1, take off 6 weeks from work, work semi remote for 3 months if my company lets me

… sometime around now, after I go back to work, I need to look for a new job, because I need to be in my job for a year before I have child #2. Of course, I just went BACK to work at the company that gave me flexible maternity leave (if they do) so leaving them now would be really shitty. And hard. Because how the hell am I going to find time to interview when I’m breastfeeding an infant, barely getting any sleep and trying to stay gainfully employed in my existing FT job. Spoiler alert – I won’t. So, really if I’m having child #2 at 35/36, I SHOULD be in the company I want to stay in throughout my children’s infant and toddler years. AKA – something stable and not an hour-and-a-half from my home.

35 – get pregnant again, if I’m so lucky, and have child #2 at 36. The age difference between the kids will be ok… two years is actually kind of nice (there were seven years between my sister and I, but I can see the benefits of having a sibling closer in age.)

However – how on earth do I then have TWO kids under 3 and work FT? And, given that I work for a startup, by the nature of being a startup, in 3 years the company will look incredibly different. Even if I manage to be really good at my job and maintain employment for the next three years all while having two children (ahhhhhhhhhhhhhh!!!!!) i’ll be in a very different company three years from now than the one I’m in today. Perhaps we will be a huge successful business and the company will be stable. Or we’ll be acquired and all of my team will be laid off due to redundancy within our acquiring organization. Or the market will shift and we’ll stop doing so well and run out of funding.

I typically don’t mind uncertainty, but in this case, it does make me rather nervous. Doc doesn’t want me to freeze my embryos and have kids at 38 because I should be able to do this in a much easier, healthier and more cost effective way at 36.

Now, let’s talk about costs. I haven’t spoken with the financial advisor yet, but doc gave me a rundown of general ranges. I’ll post more when I have the details, but it sounds like for the Clomid route we do this in 3 month cycles…

To start, we have to do genetic screenings. That’s ~$400 though he wasn’t really sure exactly how much. I was kind of surprised to find out the doctor’s office refuses to do any sort of ovulation stimulation without clearing you for being a carrier of health defects. And, lucky for me, Ashkenazi Jews have the jackpot of  potential diseases. Mr. HECC is as WASP-y as they come, so hopefully even if I’m a carrier for something he isn’t. But they make the woman get the blood test and if she’s a carrier for anything then he has to get the test. If we’re clear, we can try to have a baby. Sheesh. One more thing to worry about.

After we’re cleared on our DNA, we can proceed with three-month cycles of various treatments to try to induce ovulation and have a successful pregnancy. When I asked how much THIS would cost, doc didn’t know, but said there are monthly required ultrasounds which cost in the ballpark of $1100. This isn’t accounting for any other bloodwork needed or the required medication. I’m guessing it adds up to north of $2000 per month, but if it works in 1-3 months, $6k is a lot cheaper than the alternative (one woman I’m talking to online has spent $100k on IVF thus far and she’s not done spending!)

Embryo freezing is $14k-ish but that’s separate from the Clomid adventure. If Clomid and its comparable medication ends up not working, they do more in depth analysis of my partner’s health and make sure it’s not partially him causing the issues. If he checks out clear then we move onto IVF. This can be 6-12 months after trying everything else and doing other tests to figure out if other parts of me are broken (i.e. are my fallopian tubes working? who knows.) So the ONE good thing about having do IVF is that as part of that process we will get a bunch of embryos and we can freeze them. So we don’t have to go through the “embryo freezing” process getting dirty looks from my doctor who thinks I should just get one with having both my kids so soon after one another.

Now, I can have my first in the next year and wait to see what life brings – maybe I will want to wait until 38 and if I have to do IVF then and it doesn’t work, then I end up with 1 kid and that’s not the end of the world (though I really want two.) I can’t help but have the fear that even if somehow the drugs work at 33 they won’t at 35/36 and I’ll be wishing I froze my younger embryos but not able to go back and make that choice at that point. It’s only 5 years from now, which seems like no time at all, and really isn’t that much time – but my entire life will be completely different. I’ll either be a mother, or I won’t be, and either outcome will have a very serious impact on the rest of my life.

The good news is that after my latest freakout about cost of living and Mr. HECC becoming a teacher he has returned to me with a more reasonable plan — he’s still going to apply to school for teaching, but he’ll apply for the fall and allow me to help him apply to other jobs this winter to see if he can get a position that he likes that pays decent money. That way he can work for a few months in another role (he has held one job throughout his entire 20s at one company and while it was once a FT role it no longer is) so I think it’s good for him that he’s willing to try out a FT job before he makes the investment into becoming a teacher. It meant a lot to me that he has come up with that option as he realizes that if he’s going to become a teacher we’re going to have to move from this area and he prefers to stay here as well… so maybe we can work something out. Or maybe we move and life becomes more about family and time spent together and camping and low(er) cost fun.

In any case, this infertility stuff is going to cost an arm and a leg. I was very happy to hear that I seem to have a good number of follicles (I believe that means I will get more eggs per cycle in IVF and more likely to get pregnant on oral medication) and that my bloodwork for fertility came back normal. There’s just this stupid broken signal that we have to deal with. And, other than that, just the reality that I’m getting old – at least in terms of baby-birthing years. It’s so surreal to be turning 33 and to really be approaching the end of the years when my body should become a mother. And it’s time to really make this happen, even if it ends up costing more than a new Tesla.

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