Infertility comes with costs, challenges

Nicole and Chris Witt knew when they got married that pregnancy was going to be a challenge.

A genetic condition made it difficult for Nicole to conceive naturally. So it only made sense that a $10,000 wedding gift they got "for something that will last forever" would help them try and start a family.

But their first attempt at in vitro fertilization, or IVF, didn't work, and the couple learned they would have to dig deeper if they wanted biological children. They needed more - $55,000 in all - for an egg donor, medications, lab tests and procedures that produced their daughter, now almost 7, and a 5-year-old son.

Many couples expect the emotional and physical stress associated with infertility, but they don't take the financial implications as seriously, says Nicole Witt, one of the local leaders of Resolve, an infertility support group. And it's one of the most significant investments they'll make.

Putting it into perspective, she says, "You take out a $25,000 loan for a car, so why not do it for a baby?"

Infertility - the inability to conceive naturally after trying for 12 months - affects 1.2 million of the 62 million American women of reproductive age (15-44), according to the Centers for Disease Control and Prevention. Another 5 million women have sought some form of infertility-related treatment. Similar numbers apply to sexually-active adult men.

The cheapest fertility alternatives can be as simple as changing one's diet and exercise routine, or taking a common fertility hormone called Clomid, which is on Wal-Mart's $4 prescription list. However, couples need thousands of dollars to afford insemination, or tens of thousands for a single in vitro fertilization procedure with a donated egg.

Bills can climb to $100,000 for doctor visits, diagnostic tests, procedures, egg donors, surrogates or even adoption, says Evelina Weidman Sterling, chief executive of MyFertilityPlan.com and co-author of "Budgeting for Infertility" (Fireside, $16).

As there is never a guarantee you will get pregnant, she says couples need to know the odds associated with any possible fertility treatment. Insurance often covers the initial testing and diagnosis of infertility, but Sterling estimates 70 percent of couples will pay the other expenses by taking out home equity loans, cashing out retirement savings or asking family members for help.

Witt says some local families in the Resolve support group used creative means to afford a baby. One couple traveled to Estonia for less-expensive in vitro fertilization treatments. Another couple opted for a surrogate based in India. And another couple moved from Florida to one of the 13 states that require insurers to cover infertility treatments.

Anyone embarking on the process should get an itemized cost estimate that includes all procedures, lab costs and even pregnancy tests, Sterling says.

"They want a baby and think the sky's the limit. But you do need to talk and you need to know. Don't be shy. Ask, and shop around," she advises.

If a couple is referred to an infertility specialist, they will often find the staff is educated in financing options. That's the case with the Reproductive Endocrinology and Infertility program at the University of South Florida, says its director, Dr. Shayne Plosker. A financial team helps couples look for any possible insurance coverage, and can direct them toward unsecured loan programs with interest rates comparable to that come with credit cards.

"You don't go in and see your lawyer or accountant without knowing costs up front," Plosker says.

That information is as important to patients as knowing the odds of success. In Plosker's practice, more than half of the women under 35 who undergo in vitro fertilization end up pregnant. The rate drops to 25 percent to 30 percent for women ages 35 to 40. And just one of every six women older than 40 became pregnant after in vitro fertilization, Plosker says.

Though some women may feel the tick of the biological clock, couples shouldn't assume they have to spend loads of money, says Victoria Jennings, director of the Institute for Reproductive Health at Georgetown University.

Most couples take an average of eight ovulation cycles before conceiving. And up to 20 percent of couples who think they have infertility problems instead are miscalculating the woman's ovulation cycle, she says.

"We are a society of instant gratification, If something doesn't work right away, we go to the doctor," says Jennings, who has developed a string of colorful beads that help women track ovulation - the time when their eggs are ripe for fertilization.

Insemination and in vitro fertilization often require more than the initial $10,000 to $15,000 attempt to get pregnant. Those odds and today's rocky economy make it a painful situation for some couples, Plosker says.

"We've got a huge group of people we can't help because of the economic realties," he says.

Sterling says some couples look at fertility treatments as the only family planning option. She wishes more couples would include private adoption, which can cost more than $30,000, in their financial plan.

"The most heartbreaking thing we see is people end up with no baby and no resources for adoption," Sterling says.

Witt, who was able to cover all her costs without financing, needed to undergo four in vitro fertilization procedures before becoming pregnant with her daughter She knows couples who have spent money on six or more unsuccessful attempts.

Those huge costs in part led her to open The Adoption Consultancy, which offers another option to families who want to grow. Though she and her husband don't regret one step of their family journey, she says infertility and a limited budget shouldn't keep a determined and committed couple from becoming a family.

"If you want to be a parent," she says, "you can be a parent."

NATIONAL INFERTILITY AWARENESS WEEK

National Infertility Awareness Week starts April 24 with the New Beginnings Fertility Conference 2010 at the Marriott Waterside Hotel in Tampa.

The free event runs from 8 a.m. to 3 p.m. Speakers include:

Kathy Fountain, founder of the Tampa Bay Mind/Body Infertility Program

Evelina Weidman Sterling, CEO of My Fertility Plan and author of "Budgeting for Infertility"

Tracey Serebin, radio show host and author of "Searching for Inspiration on the Infertility Rollercoaster"

Nicole Witt, executive director of The Adoption Consultancy

Physicians from The Reproductive Medicine Group

Howard Heidenberg, urologist

Discussion topics include infertility evaluation and treatment, advances in in vitro fertilization, donor egg and surrogacy, male infertility and financing options.

Pre-registration must be completed by Monday. For information, call (813) 676-8861 or visit www.floridafertility.com.