Wednesday, April 20, 2011

Dollars and $ense of Family Building

Ack! I’m late with my post. Sunshine has the crud … again. By that I mean pink eye (in one eye) and an ear infection on the same side. So yesterday involved a trip to the pediatrician, a day off from work for mama, and fighting with a squirmy toddler over eye drops. Today my mother is watching her so I can go to work.

So here’s my post for Write Mind Open Heart’s and Baby Smiling’s blog carnival called The Dollars and $ense of Family Building.

How did finances play into my family building decisions? Well for many years I was without insurance. I was struggling financially, and without any insurance, attempting to have a child, particularly on my own, seemed impossible. I will admit to being “lax” about birth control in relationships during that time. But without insurance, I had no way of knowing I had a rather large polyp in my uterine lining. Nothing was going to stick with that there. On the other hand, I am glad I didn’t have a child with previous boyfriends. It may sound odd, but I’m glad for the obstacles on my journey to motherhood, because it brought me my daughter. I am so over the moon for HER. So I’m grateful for everything it took for me to have HER.

Once I had insurance, I learned that becoming a mom was not going to be a walk in the park. First I learned that at the advanced maternal age of 44, my chances of conceiving with my own eggs WITH IVF were in the neighborhood of 5%. Then I learned about the polyp. Having the polyp removed was actually one of the easiest parts of the journey. Totally covered by insurance, and back to normal two days later. I was very lucky in that I had fertility coverage as well. But there was a cap on the benefits. And at my age, the dosages of medication were so high, that they cost a fortune. Although covered by insurance, when a cycle’s worth of medication alone costs over $8,000, $20,000 worth of fertility coverage can be gone very, very quickly. I had one IVF cycle cancelled after 7 days of injections. That’s over $5,000 worth of meds. One evening I had an epic meltdown when a needle came loose on a syringe while I was mixing up my injection. Hundreds of dollars worth of hormones spilled onto my hands. Again, I was lucky in that I connected with a woman from an IVF message board who donated a full cycle’s worth of gonal-f to me. It enabled me to get through one complete IVF cycle. I didn’t get pregnant, but it helped me feel ready for the next step, embryo donation.

I feel so incredibly blessed to have connected with the woman who donated her extra embryos to me. As I’ve written about in the past, her IVF clinic would not treat me due to my unmarried state, so we moved the embryos to a clinic in Canada. Most of my fertility expenses were covered. Of course there were plenty of co-pays. My insurance company misinformed me about coverage for procedures in Canada. I was initially told that they would be treated as out of network bills, and I would be reimbursed 80%. After the fact I was told that only emergencies are covered out of the country. Still, embryo transfers alone are not that expensive. And at the time I went to Canada for my two transfers, the Canadian dollar was weak against the US dollar. I probably paid the Canadian clinic approximately $3,000 US for the initial consult, and the 2 thaws and transfers it took to become pregnant with Sunshine. Of course, there were the added expenses of two round trip airfares, two hotel stays, days off from work and other miscellaneous expenses. Price1ine helped with hotel costs, and for my second trip I flew up the morning of my transfer instead of the night before, even though it was more stressful, because the airfare was $200 less. My monitoring before and after the trips to Canada was fully covered by insurance. My donor very generously paid to have the embryos shipped to Canada. But still, compared to other methods, embryo donation was not at all cost prohibitive.

I’ve never added up the costs of becoming pregnant with Sunshine, but I know I got off relatively easy compared to others.

Now to the blog carnival questions:

1. Consider your now or future children as adults, and consider the fact that you had to spend money to either conceive them or make them part of your family. What effect do you think the latter will have on the former one day? What, do you think, your grown children might feel about the funds it took to create your family?

I hope it doesn’t matter to her at all. Hey, she might have cost less than the children conceived when their parents tried “relaxing and taking a vacation.” Other than our internet friends, we also have friends in our day to day life who have ART babies, donor egg babies, baby born with a gestational carrier, and adopted children. Sunshine will undoubtedly grow up knowing that sometimes family building is expensive.

2. How did/would you handle it if your child asks you, "Mom, how much did I cost?" How would you answer at age 7? At age 18?

I would probably truthfully say I didn’t know. Since I had insurance coverage, I did not have enough out of pocket expenses for a medical tax deduction, so I never added it all up. I might pull out the sharps container full of PIO needles I can’t seem to bring myself to get rid of and tell her she cost me an ouchy, lumpy butt. ;-)

3. When calculating the costs of your family building, what do you include? The direct costs are easy (such as RE fees for a cycle or homestudy fees), but what about fees that didn't directly lead to your child's existence in your life, such as cycles that didn't work, adoption outreach avenues that didn't work, failed adoptions, avenues that were explored (and that cost something) but not pursued, etc?

It all counts. The sperm donor profiles I paid for before my friend agreed to be my known donor count. The medical testing, semen analysis, and sperm cryo for my friend, even though we did not conceive together, counts. The first unsuccessful FET with donor embryos obviously counts as well.

4. If two children in a family "cost" different amounts, should that have any significance?

This is theoretical to me since I always planned on an only. I don’t think it should have any significance. It just is what it is. A blogger I met while in Canada for my first transfer (and also visited with on my second trip) has a daughter from an IUI, a son via IVF (after many failed IUIs), and now is pregnant with a freebie. I would imagine she feels that all her children are precious miracles.

5. To what extent have finances determined the family-building decisions you have made? How have you able to balance financial considerations against other factors such as medical, ethical, emotional...?

Finances are what led me to explore embryo donation. My BFF has a son via egg donation, and I knew that was not within my means. I also wasn’t sure that adoption was within my means either. And I really, really wanted to be pregnant. I wanted to be a mother most of all, but I wanted to experience pregnancy. I will never forget how it felt to feel Sunshine (aka in utero, my Rockette) doing high kicks before she was born. I grateful to have experienced that.

6. Has institutional and governmental support for certain family-building paths impacted your choices? For example, ART being covered by insurance, tax deductions for adoption expenses, etc.

Oh, yeah. As I’ve said, my insurance coverage was vital.

7. Have you considered having ART treatments abroad, either due to lower cost or due to certain methods being unavailable or illegal in your own country? In your decision-making, how did you balance the financial savings against issues like the unknowns of the country, perhaps not speaking the language, and medical practices that may differ from those of your home country? If you did travel abroad for treatments, what was your experience? Would you do it again?

Well, technically I did go to another country for treatment. But that was because, as I said above, the original US clinic wouldn’t treat me, and it was MUCH less complicated to move the embryos to Canada than another US clinic due to FDA guidelines regarding donor embryos.

I briefly considered overseas egg donation after my first FET failed. My donor offered to help finance a donor egg cycle after first FET. It was an incredible offer, and made me feel so supported and loved at a difficult time. But I just had a feeling there was a viable baby in the batch of embryos I received. Over and over again I looked at photos of my donor’s children, and imagined my own child with their coloring and features. Lately, Sunshine looks so much like her big brother, right down to the rosy cheeks he had at her age. Her hair color is smack in between the shades of her brother and sister’s hair. In other words, GORGEOUS!

Visit Write Mind Open Heart for more perspectives on the Dollars and $ense of Family Building and to add your own link to the blog hop by May 1, should you want to contribute your thoughts.