Wednesday, February 22, 2012

The Money Game aka IVF

Grab a cup of tea and settle in...this will probably be a long one!

We had our RE consult today and he went over all of the next possible steps.

1. Continue with Clomid.  I respond well to a very low dose (50mg) which is not always the case and is definitely a good thing.
2. Move to Injectibles.  His concern with them is first, that they cost way more than Clomid and second, that there is less control over the amount of follies produced.  It could be tons, a la Kate Gosselin or it could be none at all if I'm a poor responder.

3. IVF.  He said that if money was not an issue, that as a scientist (and doctor) he would want the greater amount of control and information that IVF offers.  

Our individual issues and concerns:
  • Morphology - Mr. RE said that a normal couple fertilizes 70% of the time. (What!?)  We have fertilized 1/19 times, so closer to 5% (or maybe more if implantation is the issue).  This took Mr. GG back a bit because last time the doctor was very reassuring that we could conceive with his 4% morphology.  Either way, IVF solves the fertilization issue although it's possible that we would have fewer follies embies fertilize normally I guess (my own take, not RE).
  • Lining - My lining was a 6 pre-Clomid and 6, 5, 7 during Clomid (and acupuncture).  This may be our biggest culprint, i.e. poor implantation.  And/or my issue and Mr. GG's issue are working against each other to make our overall success even lower.  Probably the case.
We were pretty set on moving to IVF before the appointment so that's basically what we said and were then given the IVF spiel.


I'm a teacher.  You could look up my pay online if you knew my school district, but I make teacher-pay.  With my Master's and other units I am at the high end of the pay scale for my year, but I still just make a little over $50k.  Mr. GG is the president of his company and does pretty well.  So we are extremely lucky to be able to afford IVF.  But even so, we don't have money just lying around.  Much of it is tied up in our mortgage payment as well as a condo Mr. GG owns where renters cover mortgage only (no taxes).  So I would call us comfortable, but by no means rich.  And I can think of a lot of things that I would rather spend money on than creating a paying for baby's college.

Anyway, here are the options we have to decide between and I would really like some advice and help.  Decisions are not my forte.  I second-guess everything!

I left all of the specific info at home, but I want to post today, so I'll do my best off the top of my head.

Options 1, 2, 3 consist of 1, 2 or 3 fresh IVF cycles including associated monitoring.  Option 4 is the "Success Guarantee" plan which means they keep going until you have a take home baby, sort-of.

We are pretty sure we are going to only pay for 1 fresh IVF cycle.  This is tricky, but I think it's what I want.  Only one round of injections, retreival, etc.  Since I ovulate on my own, I probably have decent quality eggs and therefore have a good chance to retrieve a decent amount of eggs.  But what if I don't?

So that leaves Options 1 and 4.

First, every single cycle, fresh and FET (frozen) each cost $1,500 for the hatching and whatever fancy stuff they do at the lab to conceive for us.  So add $1,500 to everything below for each cycle.

Option 1 is $10,000 for one fresh cycle. Any additional FET cycles are the same $1,500 fee plus $3,500.

Option 4 is $17,000.  ( seemed really big when I just typed it.)  But all FETs are free under this option.  Basically you get to keep going for free until you have no frozen embryos left.  Well, except for the $1,500 each time.

Don't forget the meds though!  Meds run from $4-8,000.  Less if you respond well to lower doses, more if they have to keep adding and tinkering.  Plus anesthesia which I think was $400 as well as some additional testing (which I am hoping insurance will cover).

So wow, we are about to shell out a ton of money no matter what option we choose.

The big questions are:

  • Is one fresh cycle a good bet, or do I need to plan for 2?
  • Should we do the "Success Guarantee" or should we pay for each additional FET?
OH WAIT! I forgot to mention that you get ALL of your money back if you do the guarantee and are not pregnant at the end of all of your frozen embryos.  That would pay for adoption (ish) or a wonderful trip to Europe for like a month.

Mr. GG is definitely leaning towards that option and I think I am too...

PLEASE tell me what you think!


  1. Okay, this is not something I have done, yet, but it is something I have considered. Since you get all your money back if you don't get a baby after using all your frozen transfers in the success guarantee program, I would seriously consider that option. I might kick myself for "overpaying" if we did have a baby from our first fresh cycle, but I think I'd kick myself harder if I didn't buy a package like that and had to pay individually for several frozen transfers and then ended up with no baby anyway. Just my 2c. Take it FWIW.

  2. Such a hard decision! I would be leaning towards the last option - the pain of paying all that money for a full cycle, not having success, and paying additional amounts constantly... I just don't think I could do it.

  3. Wow these are tough choices. The clinics in Cinci and Louisville that offer a guarantee, or Shared Risk Program, are not as good as this one - more like $20-$25k for 3 fresh 3 frozen with only a 70% refund if you don't get a take home baby. Does your Option 4 specify pregnancy only, or take home baby. This is sort of a biggie.

    We ended up going with a local doctor so we don't have to travel for each appointment, and paying per cycle/per FET. Our doctor said he is not a fan of the refund programs offered in Cincinnati and Louisville (your area may be different). According to him, only the women with the highest chance of pregnancy are accepted into these programs and more times than not the clinic comes out ahead. He compared the Cinci clinics to the "used car salesmen of IVF."

    All that said, I still think I would have gone with a shared risk/guarantee program if it was offered in Lexington. What ultimately lead to our decision was the location and the conservative treatment protocol of the local doctor.

    Good luck in making your decision!

    1. 1) It specifies take home baby which I covers miscarriage I believe through the first trimester (I just need to check the actual timeline).

      2) I agree that I was "accepted" because I have good chances, also the refund is contingent on age, so at 31 I qualify for 100% refund. But I love my RE and office and he really seems like he does his job to make babies more than money. And not one person pushed one option over the others which also nice. And finally, the financial lady admitted that they were in the mid-price range for my region but I think the lower priced one does mainly a la carte which can really add up.

      I didn't mention it, but the office is 15-20 minutes from my work and about 30 from home. It's the absolute best location!

  4. A very tough decision that I have not gone through yet. However, I think since option 4 is *only* 7,000 more (ugh), I would go for that because you get so many more potential options. Like the first commenter said, I would be more mad at not having taken the option if I don't get pregnant the first time, than mad I spent the extra money and got pregnant the first time (cause, let's face it, when you get pregnant you won't be mad about anything!).

    If you do get pregnant the first time, do you get to keep those FETs for child #2, or does the process start all over again?

    1. That's a really good question, but I'm pretty sure it covers all FETs with 1 retrieval. They definitely talked about baby #2. Worst case it would be $3,600 but I think it's included.

      But Mr.GG and I have a pre-marriage agreement to only have 1 child. So the only way I get two is if IVF results in twins : ).

  5. Tough Choices. I think I would go with the guarantee if I could afford it. My clinic has a neat program if you're under 39. I think you pay around 20,000 plus meds and you get up to six fresh cycles. You get a refund if you don't bring home a baby. After each Fresh cycle you do have to use all frozen embryos in FETs before you can do a new fresh cycle. Nothing carries over for a second baby. This clinic is in the DC area.

    Our clinic also offers multiple cycle discounts. Not sure what restrictions age wise there are on those.

    1. 6 is a ton! That basically makes the guarantee that they will do all the IVF they can reasonably do which would be very reassuring. (Although 6 times buying meds would be ridiculously expensive!)

  6. Though I've never been in your situation and thus have only the info you've offered the Success Guarantee sounds like the way to go! Though as a few other people said that better mean a take home baby and not just a pregnancy!

  7. Wow! I would 100% go with the guarantee option. You have the money (obviously you don't necessarily want to spend it on this but the point is that you do have it) and if it guarantees you a take home baby I'm on board. That's always been something that I think I'd worry about with IVF, spending a lot of money on a few cycles individually and it still not working, and the guarantee/refund if unsuccessful would make that seem a lot more comfortable to me.

    What an exciting step! I'm SO excited for you!

  8. So I have been following you from weddingbee. I am 36 have PCOS and husband has severe male factor. We tried one IUI with clomid just because and it didnt work. We went to IVF and did my first egg retreival on monday and transfer is Saturday.
    We found a loophole with our insurance for the meds. They will pay for injectibles for an IUI but nothing for IVF. So we pretended we were going to do an IUI with injectables and then cancelled it after our first apt. So I never started the meds and had them to start for IVF this month. Trust me it has killed me to keep putting this off for the past year and a half. We got married right after you. My clinics cost also covers ICSI and Assisted hatching. And if you paid cash there is a 5% discount. For 2 cycles it was just under $6000. Plus my insurance covered the every other day labs/US but I still had a copay. Not sure where you live but alot of people travel for better IVF deals.

    1. I live in Southern California so there are a ton of options, but I think the convenience is important for me. There are 4 offices in my immediate area with good ratings.

      My insurance does cover IUI now (after I already paid for 3) so I might have to see if we can finagle the medications in some way!

  9. We also were going to skip injectibles and go straight to IVF - though I considered injectibles to see how I responded to the meds...We were prepared to do the refund program as we felt that it would be $$$ well spent even if we were successful in the first round - plus it covered three FETs with each round. Because I was over 35, it only offered a 75% refund but with a 100% refund opportunity for you, I wouldn't hesitate :)

    I encourage you to start doing fertility acupuncture ASAP, if you aren't already. It has been proven to increase success rates of IVF. "They" say to do it at least two-three months in advance of your IVF cycle. I was on my 8th month of fertility acu when I got pregnant naturally the cycle before moving onto IVF.

    I wish you lots of luck as you make your decision!

    1. I've been doing fertility acu since the beginning of the year so this will be the third month coming up. : ) I am SOOO hoping that I will be like you and get pregnant this month, my last chance...

  10. Hey - thanks for commenting on my blog. I'm not sure what to advise, but this is what I know:

    1. Although some women do have success the first cycle, MANY need more than 1.
    2. There is no guarantee, even if you have a good cycle and have some embryos to transfer, that you'll have some to freeze. Freezing is like the icing on the cake - not everyone has ones that make it to freeze.

    With all that in mind, if you did have an awesome cycle, with some to transfer and some to freeze, I would be glad I did the guarantee.

    Good luck!!

    1. I know all of those aspects are so scary! But...if there are none to freeze, the guarantee still applies which is good.