Having a family : What’s its worth to you ?

Hi folks. Eric here again. I was just reviewing our posts to date, stepping back to take a sort of holistic look at the thoughts Cathy and I have shared so far. We’ve talked about emotions, fears and feelings, and some of the more pragmatic concerns as well; the sometimes bewildering and awkward process, tests and the like.

Here’s one you might not have thought about ahead of time, but since we’ve apparently already committed ourselves to telling the entire Internet every uncomfortable and embarrassing bit of the experience (in hopes that it might help someone else on this path), I’ll just jump in with both feet and throw another taboo topic on the pile.

Money.

We’re already neck deep in a discussion that is rife with questions, conflicts and deeply personal feelings rooted in family dynamics, personal beliefs, faith and/or sex. Let’s see here… How could I make that painfully personal and emotionally charged situation even more difficult? Oh, right. Add money to the mix. Well (to use an appropriate old saying), in for a penny, in for a pound.

Here is yet another uncomfortable, complicated and potentially conflict-inducing part of the discussion. I don’t highlight these issues just to stir up trouble, by the way, but to attempt to help some of you understand and navigate the challenges ahead.

Now some of you may be in the fortunate circumstance that you have the personal wherewithal that this will not be an issue in your treatment decisions. And some may live in a location where many or most of the services required are provided via insurance, national health service or other payer so that you do not bear the full costs of any treatment program personally.

For a great many of you however, like it or not, money will have to play a role in the conversation, as it did for us. Cathy and I live in Virginia and, as is the case with the majority of full-time US workers, our health insurance is provided via my employer. Under the best available insurance plan open to us via that employer, the portion of fertility treatments, IVF procedures and other condition-specific services needed to address our situation that were covered or paid for by insurance was… zero. Zip. Zilch. Nada.

And as ugly or callous as this may sound at first, you simply can’t ignore the financial aspects of this process. Unless you are, as I said, personally wealthy or otherwise not bearing the costs of the process yourself, infertility is not just emotionally difficult, physically painful and socially stigmatized, but also can be frighteningly expensive. And that in turn raises a lot of very painful questions.

Based on our experiences, the total cost of a “full on” IVF cycle – drugs, supplies, procedures and the like – is perhaps $15-20,000 per cycle. And let’s not forget that biology waits for no one. That cycle runs every 28 days. In other words, if a cycle proves unsuccessful on a Thursday, you have until about Monday to decide if you’re ready to ante up and play another hand.

Some people have wonderful success right off, but some do not. A few months of failed IVF, and you not only have all the heartbreak, pain, uncertainty and conflict that comes with the frustrated effort of making a family, you may well have now burned through years of diligent, careful savings and have nothing whatever to show for it.

Should you be paying these types of costs personally, and not enjoy the resources to do so indefinitely, let me assure you that you can face brutal, soul-searching questions, and wrestle with them literally every four weeks. Do you enlist family, if there are any to call upon, such as parents or grandparents willing to help in the quest to continue their family lines? Do you go into debt? Remortgage the house? Sell off your assets?

The emotional complexity of these questions, and the staggering speed with which they can deplete the resources of the average family, can be devastating to emotional stability and domestic felicity – both of which will already be under strain for some of you.

I would never presume here to dictate any answer, or even opine, on what is right for you. What I simply hope to do is raise your awareness as you consider, begin or undergo the fertility treatment process. No one wants to think of a human life, a baby, a family or their legacy in the ugly, cold terms of dollars and cents. That’s utterly antithetical to what love, family and parenthood is about. But doctors, drugs and procedures cost money, in some cases lots of money. And depending on your circumstances, resources and the length of your treatment, some of you may be forced to ask yourselves truly painful questions about just how much having a baby is worth to you?

I will close with a personal anecdote. When we were engaged, Cathy gave me a book she had read and loved called “Smart Couples Finish Rich” by David Bach. I have an MBA from a good university and previously worked at Price Waterhouse, one of the world’s largest accountancy firms. I didn’t really think I needed a primer on the power of compound interest or finger-wagging advice on how to save by skipping the Starbucks.

What I didn’t anticipate, and what I found most valuable about this little gem of a book, was not the basic financial concepts it provided for the financially clueless (though that was all useful, even to a bean-counter like me.) The actual heart of the book was not the mathematical mundanities, but rather the early chapter on starting with your values. What do you each, and as a couple, believe? What is important to you? What are your priorities? Are you in agreement about these points?

Infertility, and the challenges, pains and yes, costs, that come with it will raise painful, difficult questions about what you value, what you can do without, and how far you’re willing to go for what you want. The time to ponder these questions together is not standing at the doctor’s billing office, deciding on the fly the level of risk and financial commitment you can bear.

Talk to your partner, your doctor, your family and anyone else who can help you navigate these waters, and do so as early in the process as you can. We might all wish that questions of love and family and emotion and legacy could be divorced from the prosaic questions of money, but at least for some of us, that just isn’t the real world. Prepare, ponder, discuss, and plan. It will not be easy, but I assure you, it is absolutely “worth” it.

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