Our journey through infertility, failed adoptions and now parenthood through the miracle of embryo adoption/donation.

Friday, July 30, 2010

insurance and infertility

Another blogger posted a link to an article in Newsweek about a local clinic. It is actually the clinic I plan on using next time around as they are developing an EA program. You can view the article here: Should IVF be Affordable For All. This clinic explains it reasons for offering IVF at almost half the price of other clinics ($7500 including ICSI). I applaud them for believing that having a child should be attainable for all couples, not just the wealthy or those willing to go bankrupt. What bothers me about the article is the criticism they receive for lowering their costs.

David Fleming, director of the Center for Health Ethics at the University of Missouri, says the main concern with making fertilization affordable for more people is the risk of “commoditization” of babies. “The more you have access, the more people will do it,” says Fleming, arguing that the unfortunate part of making IVF more widespread is its increased ethical stakes, such as those surrounding more premature births, which ultimately increase the cost of health-care coverage for everyone, and more babies with congenital malformations, which are twice as common in babies conceived through IVF than naturally. “The concern is that we are placing these little humans in danger,” he says. “IVF, with all due respect—is it a question of need or a question of want?”

Really?? He thinks that couples that don't have serious infertility issues will do IVF because it is affordable?? Has he ever done IVF? As a man can he really comprehend what an IVF cycle does to a woman's body? I only did FET which is much less than a full IVF, but the shots and appointments dictate your whole life! I would have preferred to have sex in order to get pregnant, believe me! Just because a clinic will offer IVF at a lower, more affordable cost does not mean I will skip the nookie and go straight to IVF.

And this quote by a RE that I highly respect really irritates me:
A complicating factor, according to St. Luke’s Silber, is that up to 80 percent of infertility cases are caused simply by increasing maternal age. “It’s hard to call infertility a disease. It’s normal aging,” he says, adding that only about 20 percent of women who seek treatment have what’s called a “valid diagnosis,” such as that they don’t ovulate. “Most of the time you can’t make a valid diagnosis,” Silber says. “The incidence of infertility is zero to 1 percent in teenagers. For women in their early 20s, only 1 to 2 percent are infertile. In their late 20s, 16 percent of women are infertile, and in their mid- to late 30s, 25 percent are infertile. By age 40, more than half of women are infertile, and pregnancy beyond age 43 is very uncommon.”

80% Really? He is going to stand by that statistic? I would like to see where that statistic came from. And does that statistic take into account that most couples in their 20s do not rush to do IVF or even see an RE unless their fertility issues warrant it. I started ttc in my early 20s. It took us 11 years to get where we are today. Look at it this way:

A women gets married at the age of 28 and they decide to wait a year to have children. She is still young so there is no rush. At 29 they begin trying but nothing happens. They give it the full year that doctors tell you to wait before seeking help. They go to her OB and begin preliminary testing. It takes 2-4 months for all of the tests to be complete and she has an issue with ovulating and he now needs to see a urologist because his counts are low. It takes another 2 months to get into the urologist, repeat the tests, discover he has a varicocele and needs surgery. By the time the surgery is complete the woman is now 31 years old. The surgery can take a few months before you know whether it is successful or not. So now she is 31 and they have the results and his count is better and they return to their OB to begin treatment. They just need her to ovulate, so begins the clomid. After another 6 months of this and no success the OB sends her to an RE. Another 3 month wait for an appointment. And more tests. She is now past her 32nd birthday. They spend years 32, 33 and 34 trying IUIs with different combinations of drugs only to be told that IVF is their only chance. They spend another year saving for IVF and at age 35 have their first cycle. Negative. A second cycle. Negative again. The reason: AMA (advanced maternal age).

Can this scenario really be considered in the above stated statistics? Most couples do not put off having their children until their 40s. Yes, some do to advance their career or maybe they are not sure if they want children. If you make that choice knowingly then you have to suffer the consequences of natural aging. But for those that do not find Mr. Right until age 38, should she be punished? Or the couple that has tried for 10+ years and are now getting older, should they be penalized?

Sadly, infertility affects couples of all ages, races, and economic status. And no, we do not need children to live. But insurance companies pay for erectile dysfunction and the last time I checked no man ever died from having a softy. Or what about eczema or psoriasis? Neither will kill you but make life uncomfortable. Insurance pays for these treatments. There are many issues that insurance companies will pay for that are not life threatening and infertility should be one of them. And now, after reading this article, I wonder if it is sources like these that keep insurance companies from seeing the need to cover treatments.


  1. Okay...first...YES!!!!! You are spot on! I did not meet mr. right until 36....by 38 we were trying to conceive...but he had a known MFI so combine that with my age and we were doomed!...in comes the RE...luckily my OB was so proactive and didn't even make me do the whole 6 months to a year of trying on our own...BUT...NO INSURANCE....we forked over about $8000 for 3 medicated IUI's that did not work...and then...on Jan 1st our insurance actually included an infertility clause and we did get $15000 worth of coverage (10k for treatment, 5k for meds) which basically paid for our 1st IVF..BUT..that was a bust and no more insurance...then comes IVF#2...We fork over $15k of our own money...and Yay...we got a baby...but that is still $23k out of our pocket over the insurance coverage. Fast forward 2 years...what about a 2nd child? We went strait to EA...no IVF for us...but even that was another $6k after all the testing, fees and meds...so we are looking at $30k ($45k if you include the insurance coverage)...just for us to have the 2 children that everyone else seems to get from a $10 bottle of wine and a $50 dinner! ANd...our children have no birth defects and were not premature (at least the 1st one wasn't...2nd one is only 23 weeks along).....So I totally agree that these "opinions" from other fert specialists are bogus...they are just worried that their pockets won't get lined so easy off the suffering of others.

    We were soooo lucky...we had the money...so we could move quickly...but I know younger couples who are basically held hostage to starting a family because of money...they can't even adopt because those fees are as much as, or more, than a round of IVF....It just makes me mad!

    But...I just about choked on my bagel laughing when you said "no man ever died of a softie"!!!! So true and gave me a huge belly laugh this morning...!!!!


  2. This article pissed me the eff off. The "experts" cited were absolutely irreponsible with their statements. It’s hard to call infertility a disease - I practically did a spit take when I read that last week. Sorry, but did he miss the memo back in, what was it, December, that even the World Health Organization defines infertility as a disease??

    That article was rubbish, capitalizing on IVF as a hot sexy topic in the media right now. For shame on Dr. Silber - a highly damaging comment setting back years of hard work on cultural and medical perceptions. And I think there is some truth to your statement- I bet it IS statements like these that insurance companies use as fuel for their denial of coverage fires.

  3. AHHHH! That pissed me off so much! I'm not even 30 yet and we have been struggling with IF for EIGHT years. We were diagnosed with IF when I was 26 and DH was 31. And I highly doubt we are only TWENTY PERCENT of the IF couples like this. What a crock!

    But it WOULD be nice to have a cheaper solution. However we cant even afford $7500 for IVF.

  4. Yeah, I'd also like to see references to back up his stats. We didn't officially start TTC until 29, but there were plenty of times before that where we didn't try to prevent pregnancy, and still, nada. Hope he gets a softy that can't be fixed ;o

  5. Wow, awesome post! I, too, would love to see that RE's research. I'm in my early 20's, and I'm infertile, and I know others, too! 1-2%, my butt! Some people need to shut it!

  6. AMEN!

    I just signed up for my policy and when I asked about infertlity treatments they said they don't cover it because it is not an end to a means.

    Well, cancer treatments are guarenteed either- but insurance pays for that.

    I wish more people understood that having a baby should not just be a blessing to the fertile or the wealthy.

  7. I love that I'm not alone in this. I started TTC at 31 and went to 3 doctors in 4 years to finally find out that my tubes were blocked. I did my 1st IVF at 35. It didn't work and then I had to change insurance companies to get a 2nd IVF covered. Unfortunately that didn't work either. Infertility is a disease and these so-called experts don't know what it's like or how it feels. I wish IVF was more affordable. It should not be something that only the rich can afford to keep doing to realize their dream, but everyone else who wants to have a family but can't achieve it the natural way.

  8. I have been swamped, busy, and out of pocket, but wanted you to know I was thinking about you today!!

    hugs, Shannon

  9. I was irritated by that comment as well. 80% is ridiculously high.
    I have to point out that he did not even consider male factor. A fertile 19 year old is not going to get very far if male factor is an issue.

  10. What a great post!! And I totally agree with the comment above, I am 24 and we have male factor IF. My age cannot help DH's guys swim any faster or farther or make his sperm be of better quality. How sad to have articles like that in print.


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