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Dana Rodriguez for Vox

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The best $55,000 I ever spent: IVF

It was worth the loans, the credit card debt, and the stress.

Paying thousands of dollars for a chance at pregnancy is a little like playing Russian roulette. Either you’re going to be relieved when you find yourself still breathing at the end or your whole life will seemingly be over.

This is how I found myself flat on my back, feet in stirrups, as the doctor squirted two microscopic embryos into my uterus. I had been here before — four other times, actually — but I swore to myself that this was going to be the last time. I owed people a lot of money and was sick of injecting myself with hormones on a daily basis.

“Do you see them?” The nurse pointed as a little blip moved slowly across the monitor.

My husband squeezed my hand, but I couldn’t take my eyes off the screen. This was it. This was the last chance for us, and all I could do was pray one or both of these babies stuck around.

IVF was never the plan. Pregnancy scares while I was still in nursing school, sure. Maybe a few months of wondering why it hadn’t happened yet when I finally did want it, complete with some ovulation kits — that I could see as a worst-case scenario. But not IVF. Not Follistim and Gonal-F, which both sound vaguely kinky but really are just hellishly expensive fertility medications. Not years of waiting, crying, and screaming into my pillow.

I was 24 when my husband and I thought seriously about my going off birth control. We hadn’t even been married for a year; it’s been so long now that I can no longer remember why we decided to toss the pills and try for a baby much earlier than we’d ever discussed. Perhaps it’s just that I’d always wanted to be a mom, and the time seemed right for us to get pregnant.

I figured if we started right after graduation, I could be established in my first nursing job by the time the baby was born. I’ve always been a planner, and I thought pregnancy would be no different because I was young and healthy. I thought I could practically schedule my due date on the calendar.

As much as I assumed it was just going to happen because it happened for everyone else around me, it didn’t go that way. After 18 stressful months of my husband and me trying, we realized we were officially in uncharted territory. Regular, old-fashioned baby-making wasn’t getting us anywhere, so I spoke with my doctor and she recommended timing sex according to my cycle and using ovulation predictor tests to up our chances.

News flash: Having sex dictated by a smiling face on a pee stick or on a doctor’s schedule gets to be a chore quickly. Soon after, I found myself swallowing fertility drugs like candy — small white pills meant to help me ovulate, spread out over two years. When that wasn’t working, we threw in a fertility clinic a year later and three cycles of IUI (intrauterine insemination) to increase the odds of conceiving. IUI was meant to take the best sperm and shoot them right up where they were supposed to go.

I didn’t get pregnant. Instead, I started feeling like I was on some nightmare merry-go-round of endless fertility treatments. I think on some level, I knew the tame procedures we had been doing weren’t working. It was time to bring in the big guns.

That meant IVF: a hardcore, intense month of blood draws, doctor appointments, and multiple shots in my stomach daily. I had read a lot of infertility blogs at this point. I prepared myself for the egg retrieval, the emotional turmoil that is waiting to see how many embryos were growing, the transfer where you were officially deemed PUPO — pregnant until proven otherwise.

I read all these things, but nothing can truly prepare you for it. I remember swallowing hard at the price tag, but I had read about that too. It was like you were part of an exclusive club where you paid more than you could afford; still, you did it, because you believed it would be meaningful in the end.

We did three sessions in a span of 13 months. Ambitious, but probably foolish. I mixed powdered medications into syringes like the expert pharmacist I was not. I became hip with the IVF lingo while spreading my legs for yet another internal ultrasound. Changing diapers was still foreign to me — waiting on my embryo fertilization report felt safe and familiar even through the stress.

After our fourth round of IVF, in which we used donor eggs for the first time, had failed, I sat with my laptop open, thumbing through my phone as I added up numbers from our invoices. Each of our three IUIs averaged $400. Even with the insurance program at our clinic, we were responsible for $12,000 for three rounds of IVF. There was no further coverage for fertility treatments using our egg donor; that fourth cycle had cost us $15,800.

I turned to my husband, who was watching a docuseries next to me. “We’ve spent over $28,000 on this.” I didn’t have to explain what “this” was. I said a swear word and then I said it again louder. It was the moment I started wondering what we were doing. What was the point to all this? I’d said it would all be worth it if we could have a baby. But what if we couldn’t? What if we just kept spending money on treatment after treatment, racking up hundreds of thousands of dollars, for nothing? I wanted to throw my laptop.

We had already taken out one loan during our IVFs, and had just taken out a second to pay for our donor egg cycles. Living paycheck to paycheck while racking up credit card debt wasn’t supposed to be in our plan. Our careers had allowed us to comfortably afford kids — but being thousands of dollars in debt before we even had them gave me a sick feeling that we were being irresponsible.

Our situation came to a head one evening at our favorite restaurant, when the waiter had just brought our food. In a matter of weeks, we were heading back to our clinic for a final cycle. If that didn’t work, we would be done, because the money was dwindling and there was only a certain amount of loans we could take out. Five rounds of IVF was enough for anyone.

I was not a fragile person. I didn’t back down from challenges easily, but that night I was tired. I was angry. At 28, I was certainly not old, but the fun of trying to have a baby had worn off a long time ago. I couldn’t fathom a life without kids, but we were barreling toward it at an alarming pace.

I could have continued shooting fertility medications all the livelong day. It was, after all, the only life I knew. If it weren’t for the money, I could have kept going. Knowing this was the last attempt, solely because of money, broke me. I cried as I sat across the table from my husband and told him I didn’t see much of a life afterward if this didn’t work. I know it was probably depression talking; I know I was hurting him with my words. We had married each other not to have gobs of children, but to spend our lives together, and yet here I was telling him he wasn’t good enough on his own.

So when I was lying in that hospital bed a few weeks later for my fifth embryo transfer (and another $13,000 poorer), I concentrated on happy thoughts as the doctor concentrated between my sheeted legs. I tried really hard not to think this was all for nothing once again. It was hard to feel positive and optimistic and all the other upbeat feelings I thought I should have as I watched our embryos slide gently through the tube into my uterus, their home for the next nine months. I hoped.

Even when I saw the single beating heart on the ultrasound a few weeks later, I wanted so desperately to believe this was it, but experience had cautioned me not to let down my guard. My career as a health professional had given me a lot of insight into the medical world, and I was well-versed in everything that could possibly go wrong. I knew how precarious early pregnancy could be. I was well aware of how often miscarriages occur, especially early on. Since more than one of my friends had lost a baby well into the second and third trimester, I couldn’t let down my guard, even then. For the first time, I cringed at my medical expertise.

In fact, it wasn’t until my baby took her first breath and wailed that I even let myself believe I would ever hold her in my arms. It didn’t seem real. We had been trying for a baby for nine years, and suddenly we found ourselves parents to a newborn.

What was more, for the first time, there were leftover embryos. The final cycle really wasn’t the end for us, as we had assumed. Not only did I now need to adjust my worldview that we were going to have a baby after infertility, but there was the potential for more.

It’s a little-known secret that when you’ve struggled to have kids, and you’ve succeeded in getting one, you may have the longing for another. You feel greedy that you already have everything you’ve ever wanted and still wish for just one more. Because that’s exactly what infertility robs you of: the choice. The ability to get pregnant on your timeline, and the choice to decide how big or small your family is going to be.

I remember the herculean effort that came along with those last embryos, physically, mentally, and financially. I was a mom to a 3-year-old. I did mom things like play dates and reheating my coffee three times a day. I had found comfort in my normalcy. I had a life like everyone else: a kid, sleepless nights, discussions over potty training and fevers. There was a lot of denial during that time, and a sense of feeling pulled in two directions. I had a child, but I also had three frozen potential children waiting, ones that could only come by more fertility treatments.

I was so sick of being that infertile person, but we knew we were seeing this thing through to the end. Still, it didn’t negate the fact that there was more than a little bitterness as I went back to the ultrasounds, the medications, and the dictating by medical professionals. It was another $14,000 we ended up spending on the two frozen embryo transfers it took to bring our last daughter into the world, almost exactly four years from where we left off.

Infertility is messy, and it can leave permanent scars; I’m still in therapy and working through the aftereffects. Still, now my 4-year-old is running around shooting imaginary ice pretending to be Elsa, and my 6-month-old only lets me sleep in three-hour increments. Out of those three frozen embryos, one little girl came out and was the perfect caboose to our family.

I can’t say for certain when I’m going to stop “feeling infertile,” but it helps that there will be no more treatments. I still feel slightly sucker-punched when I see a pregnancy announcement on social media. My two girls are my world, but I feel exhausted when I think back on the past 10 years trying to bring them into it.

There’s a part of me that feels sick to my stomach about how much we spent. I don’t have any regret — it’s not about that. Some people just have to work a lot harder to grow their family, and that’s okay. We had the option to pursue multiple fertility treatments — something a lot of people don’t get to do for a variety of reasons, but primarily financial. When I’m sitting on the floor building a Lego tower with my daughter while trying to bounce a fussy baby, I think back to that morning in the hospital bed, watching the grainy blip of light on the screen, and how everything was riding on that moment. There was fear and uncertainty and hope. Through it all, there was always hope.


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