infertility: questions, costs, treatments, and resources

The purpose of this blog post isn’t necessarily to provide spiritual encouragement to someone in the midst of infertility. I’ve done that in many other places and will continue to do so. But I wanted to provide a place where I could compile the nitty-gritty of our experiences with fertility treatments in case they might prove helpful to someone else who is walking this path or considering medical intervention for infertility. I’m sharing all the details—procedures, prices, timelines, side-effects, treatment plans—in an effort to be a resource in some way to others who are on this road.

This is simply our experience. Everyone will walk through infertility differently and even have different convictions on whether to / how to pursue medical treatment. These conversations and decisions are nuanced and incredibly weighty, and honestly I think however you choose to walk through this is good as long as you are seeking to remain faithful to your convictions and—if you’re a Christian—obedient to the Lord. My purpose isn’t to start debates or to say that the way we’re doing things is the right way…these are just the places we’ve landed as we’ve journeyed through infertility over the last three years.

Year 1 (February 2019-2020)

We started trying to get pregnant in early 2019. At the time we had no reason to consider that fertility might be an issue, so we simply tried naturally by using a fertility tracking app (this one and this one) to gauge my fertile days.

Around that time, after a routine check, we realized I had some signs of under-active thyroid—hypothyroidism. I started seeing an endocrinologist in July and began taking Levoxyl. We spent a couple months adjusting my dosage, with my doctor’s main concern being bringing my TSH level down (my TSH was at 4.6; she recommended that number being below 2 in order to have a healthy pregnancy).

There were a couple months during this year (August-October), when our endocrinologist recommended we stop actively trying to get pregnant, because when a mother’s TSH levels are as high as mine were there can sometimes be intellectual delays in the baby.

Year 2 (February 2020-2021)

After 1 year of trying with no success, we decided to see a fertility doctor for the first time. We found a great doctor where we lived in Colorado, who tested all of our levels and routine checks (sperm analysis, blood tests, and a “femvue” procedure for me). Nothing looked out of the ordinary for either of us, and as he does for all of his patients he recommended we take some vitamins, supplements, and implement some diet changes.

For several months I did all of the things he suggested: Vitamin D, Folate, Omega3, Prenatals, and a gluten-free / dairy-free / high fat Mediterranean-type diet. I even cut out coffee and running (my chosen form of exercise, which he said it could be a small factor in infertility). *After several months of this with no success, I stopped some of these recommendations because at some point, I reasoned, I just had to live my life*

Treatments:

March 2020 and April 2020: We did two months of Clomid (a hormone stimulator to help with ovulation) paired with timed intercourse, both with no success.

May 2020: We tried our first IUI (intra-uterine insemination). This treatment was paired with Clomid again, as well as Pregnyl (an ovulation trigger-shot that helps the doctors know how to time the IUI). We had no success with this treatment.

*Sidenote: fertility treatments have a significant physical effect on your body, but they also take a mental / emotional toll as well. We started these treatments in the middle of an incredibly stressful period of life for us, as well as in the middle of the beginning of a global pandemic (not necessarily recommended). After the failed IUI, we discussed moving forward with another fertility treatment. Matthew did not want to continue and I did. We decided to take a break from treatments at this point. This was one of the hardest points of the process, but I’m so glad we took a break when we did. And I’m so glad we did not move forward until both of us were on the same page again. It’s crucial that with each step of the fertility process you and your partner on the exact same page. Don’t forget to see each other and love each other well through this. ❤ Sadly, there were many times I did not do this well.

Year 3 (February 2021-2022)

After the chaos of 2020 and our failed treatments, we took a break from fertility treatments for the rest of the year while still trying naturally (using tracking apps and ovulation predictor kits—I used these because they were the cheapest; they’re not super user-friendly but they can pair with this app for helpful tracking).

In August, after getting set up with our new (and current) fertility doctor, we decided to move forward with IUIs again. We did an IUI in August, September, and October, all of which failed.

Typically a doctor will recommend that you discontinue after four failed IUIs. Each IUI has about a 20% percent success rate, so if you do not conceive after four IUI attempts, it is not likely that you will have success with that method. Since we did one IUI in 2020 in Colorado, and then three IUIs in 2021 in Alabama, we decided to stop after our fourth and talk with our doctor about our next step.

*Another sidenote: Three back-to-back IUIs took a huge toll on my physical and mental health. The previous year I did not have many side-effects from fertility medications, but during this treatment phase I experienced several side-effects from the Clomid and ovulation trigger shots. These included hot flashes, spots in my vision (especially at night), and what seemed to be the cruelest of all, a lingering bloating that to this day sometimes makes me feel/look 3-4 months pregnant. It also came with severe depressive swings. Reminder: if at any time in your journey you experience mental health difficulties (whether related to medication or not), I seriously recommend you seek out a counselor.

Year 4 (February 2022-present)

Towards the end of our third year of infertility, we met with our doctor about our next step forward. Our doctor said that after three years of trying, six total months of fertility aid, and four failed IUIs, she didn’t think we would ever conceive naturally or with IUIs. Obviously this was a huge blow for us. She diagnosed us with “unexplained infertility,” meaning there is no known cause for our difficulty in getting pregnant. To us, that news is incredibly frustrating, but to her as a doctor that is incredibly reassuring. She doesn’t see any reason why we won’t have success with IVF, which was her recommendation for our next step.

Our main concern going into the conversation about IVF centered around excess embryos.

Excess Embryos:

With any IVF cycle, there are many things within your control: the level of meds you take to release multiple eggs, the number of eggs you choose to fertilize, the number of embryos you choose to implant. But there are even more things outside of your control: the number of eggs your body will release, the number of eggs that will fertilize, the number of fertilized eggs that will develop into embryos, the number of heathy embryos, and the implantation success of a healthy embryo.

A typical IVF cycle could leave you with anywhere from zero to upwards of 10-15 healthy embryos. Depending on how many children a couple wants, they might be left with embryos that they don’t want to use. These would be called “excess embryos,” and there are a couple options as to what couples can do with these embryos. A couple can choose to discard the embryos, donate them to science and research, or donate them for embryo adoption by another family.

Our convictions have led us to not feel comfortable discarding or donating any excess embryos. In fact, even the term “excess embryos” makes us feel uncomfortable. We believe that each embryo is a little life, a little child of ours, and our conviction is to give any embryo created from our combination of DNA a chance at life in our family.

That said, we’ve chosen to move forward with IVF given the consideration that we will use every embryo that is created. Our doctor gave us two options for how we might best achieve this desire: limited fertilization and mini-IVF. *our doctor also told us about a process called Invo-cell, but she does not do that at her clinic and finds it has a lower success rate, so we did not consider this option*

Limited Fertilization

Limited fertilization utilizes the same technology as traditional IVF. The same doses of medication are given on the front end for the woman to release as many eggs as possible. However, at this step there is a pause to consider how many of the eggs will be fertilized. Depending on how many embryos the couple hopes to end up with, only a certain number of the released eggs will be fertilized. The rest will be frozen to be thawed for later use and fertilization. A difficulty with this process is that eggs do not freeze as well as embryos. There is a chance with limited fertilization that you could go through the process, freeze your leftover eggs to be thawed later, and lose some of the eggs in the thawing process later on.

Mini-IVF

In a nutshell, mini-IVF also utilizes the same technology as regular IVF, but with a smaller dose of medicine on the front end. The goal in this is for the body to release a lower number of eggs, meaning a lower number of fertilized zygotes, meaning a lower number of embryos in the end. Mini-IVF slightly cuts down the costs because the couple is paying less for medications, although the risk is that by lowering the number of eggs and therefore embryos, the couple might have to do the full IVF process multiple times in order to have the number of children they wish to have.

We have chosen to move forward with mini-IVF. We feel this option can meet our considerations and our convictions, while still utilizing the technology that is available for us to have children. Ideally this process would yield the perfect number of embryos (and therefore children) that we wish to have, but we’re not naive. We know that we could go through this whole process and have zero successful pregnancies. We could go through the process and only have 1 successful pregnancy and then have to go through the process again, but we feel that this method best meets our desires and convictions.

A side-note about endometriosis and IVF: During our third year of infertility, I started to wonder whether I might have endometriosis. I don’t show many of the signs (only excessively painful and heavy periods), but it’s so common (about 11% of women) that I wondered. Unfortunately the only way to check if you have endo is through a laparoscopic surgery. I asked my doctor about this, and she was absolutely willing to do the surgery. However, she said while endo is a common cause of infertility, if we were going to do IVF, having endometriosis surgery would not increase our chances of IVF. Because we had decided to move forward with IVF (and because we took finances and the cost of an additional procedure into consideration), we decided not to pursue the surgery. This is something we might pursue in the future for pain management.

The Costs

In most cases—unless you have amazing health care—fertility tests, procedures, and treatments are not covered by insurance. Below are the costs only of the various steps we went through. There are additional costs that different couples might have to face. I share these just to give an idea of what costs might be involved for someone walking through these steps. You’ll note that in our three years of infertility we saw three doctors in three different states (with several different insurances). Prices for most of these are self-pay rates, since our insurance never covered fertility treatments. You’ll see that even for the same treatments, costs were drastically different. *Also, I’m sure I’ve forgotten some costs—it’s a lot to keep track of!*

Colorado (2020):

Initial OBGYN Appointments: $177

Endocrinologist Appointments: $75 per visit

Endocrinologist labs and thyroid meds: $350+

Doctor Consults: $200 each

Sperm Analysis: $95

Femvue: $550

Blood Tests: $200 (an estimate)

IUI: ($601-$754 per cycle)

  • Clomid: $15-33
  • Ultrasounds: $153 (1-2 per cycle)
  • Pregnyl: $115
  • IUI Procedure: $300
    • Artificial Insemination: $200
    • Sperm Wash: $100

Total we paid at this clinic: $2,739

*a rough estimate for 3-4 months of various tests and treatments—1 IUI*

Virginia (2021):

Initial Consult: $300

Blood Tests: $59

Sperm Analysis: $205

Ultrasounds: $1,600

Genetic Testing: $5,000+ each billed to our insurance (we, Lord willing, won’t have to pay this full amount)

Follow-up Consult: $200

IUI: Quoted at $2,000 per IUI procedure (we did not do an IUI here)

Total we paid at this clinic: $2,364

*a rough estimate for 2-3 months of various tests, no treatments*

Alabama (2021-2022):

Initial Blood Tests: $169

IUI Costs: ($900-$1,135 each cycle *depending on how many ultrasounds, dose of Clomid, etc.)

  • Clomid: $15-33
  • Trigger shots: $107
  • IUI Procedure: $395 (broken down below)
    • Artificial Insemination: $235
    • Semen Analysis: $100
    • Sperm Washing: $60
  • Ultrasounds (usually 2-3 per cycle): $150-200

Total we paid at this clinic: $4,977

*a rough estimate for 3 months of IUIs plus initial IVF pre-check steps*

IVF Estimates: (initial estimate $9,000 plus meds)

*we were pleasantly surprised by this IVF estimate, as our Colorado and Virginia clinics quoted us MUCH higher IVF costs ($20,000-30,000 for a cycle)*

Meeting with Doctor: $264

Monitoring Ultrasounds: $150 per visit

Blood Tests: $489 (broken down below)

  • Blood draw: $31
  • Rubella: $76
  • Infectious Agent Test: $204
  • HIV Test: $66
  • Trep. Test: $36
  • Hep B Test: $76
  • Estradiol Labs: $91 per visit

IVF Pre-check: $450 (broken down below)

  • Echo Exam/Ultrasound: $200
  • Hysterography Catheter: $250

IVF Procedure Charges: $8,920 (broken down below)

  • IVF Facility Fee: $1,250
  • Ultrasound for Retrieval: $385
  • Ultrasound for Transfer: $164
  • Egg Retrieval: $1,700
  • Egg Identification: $755
  • Sperm Prep/Analysis: $240
  • Gamete Labs & Fertilization: $2,800
  • ICSI (Sperm Injection): $1,000
  • Embryo Prep for Transfer: $326
  • Embryo Transfer: $300

Potential Additional Charges:

  • Embryo Freezing: $1,000
  • Egg Freezing: $1,000
  • Embryo Storage Fee: $300 per year
  • Assisted Hatching: $750
  • Biopsy for Embryo Genetic Testing: $2,000

Medication Estimates: $5,000-7,000 (for mini-IVF) Estimated $7,000-12,000 for regular IVF

Total cost we’ve paid to date before starting IVF: $10,080+

*a rough estimate (probably a low estimate, honestly) for 3 years of various tests and treatments*

Total estimated cost for our IVF + meds: $14,000-$16,000

Total estimated cost for 3 years of fertility treatments and IVF: $24,000-26,000+

These amounts may seem high or low to you, depending on your own experiences and treatments. At the end of the day, it is a LOT of money. We are incredibly grateful to be able to move forward with these treatments, but obviously it comes with an incredible financial toll. For us, this means saying “no” to a lot of things and putting our dreams of buying a house on hold while we prioritize starting our family. Some couples take out loans to pay for fertility expenses, and I’ve heard there are many programs out there that offer affordable interest rates should you need to do so.

There are also grants available that couples facing infertility can apply for. You can search for these online. You can find some lists of available grants here and here (and here if you’re military).

What Does the Bible Say About IVF?

As Christians, one of our main considerations in thinking through IVF was how the process would fit with our faith and convictions. Obviously the Bible does not explicitly mention the concept of in-vitro fertilization. This is the case for many modern technologies and medical interventions. But, like all things, I still think we can diligently look to Scripture to inform our understanding of how to faithfully walk the road of infertility and assisted reproduction technologies.

These resources were both incredibly helpful to us as we thought through whether or not to pursue IVF:

  • Jen Oshman’s All Things episode on IVF: Episode 26: The Embryonic Storage Crisis Caused by IVF: Various Issues for the Christian to Consider
    • This episode helped me wrap my mind around many of the moral issues surrounding IVF and unused embryos. Jen’s nuanced handling of the topic helped Matthew and I as we prayed through IVF, and was a big factor in why we landed where we did.
  • The Gospel Coalition’s article by Wayne Grudem: How IVF Can Be Morally Right
    • This article broke down some of arguments for and against IVF for Christians, and provides some helpful insight into how we might think about IVF as Christians
  • We are also blessed with many wonderful Christian family members (many of whom are doctors). We sought council from them, as well as our friends and church community, before making the decision to move forward. I strongly encourage you to invite your people into this process so you’re not thinking through it alone.

Other Helpful Resources:

There are probably a million more things I could say about infertility—and specifically about our journey through it these last three years. I’ll update this post as we continue through this process (and would happily add resources you recommend too!). I’m an open book, so please do reach out to me if you have questions or want to talk about your own journey. This is a heavy road to walk, but know that even though it may feel like it sometimes, you’re not alone ❤

5 thoughts on “infertility: questions, costs, treatments, and resources

  1. Anonymous says:

    Wow, this is all almost identical to our journey. We just haven’t actually started ivf yet, just met for our initial appointment. We are starting this year. We started treatment during an extremely difficult and stressful point of mental health for both of us, and right before the pandemic. It’s so so so hard. But you are not alone!! Keep fighting!

    • laurenbowerman says:

      Oh friend! It sounds like our stories are so similar. I wish we could sit down and have a cup of coffee to talk about it all. Thank you for your encouragement. I’m taking a moment to pray now that you would have peace as you take the steps forward toward IVF this year. Praying that the Lord would refresh your soul and bring comfort too on the hard and dark days. 🤍

  2. Isabelle Carroll says:

    I just found your blog via the Journeywomen podcast! I’m so sorry to hear you’re going through this. I will certainly be praying! I was diagnosed with hypothyroidism my senior year of college in 2016. Levothyroxine didn’t end up working for me. So i finally met with an endocrinologist in 2020 who switched me to Tirosint, and it’s working so much better! In 2020 I was blessed with a little boy (he’s almost 2!) but since then have had 2 miscarriages in 2021. I know how hard it is to believe that God is a good and loving Father and yet be going through one thing that feels very far from good and loving. I’m praying that the Lord blesses you with a sweet rainbow baby, and that you experience joy and contentment in His providence.in Christ, Izzie

    • laurenbowerman says:

      What an encouraging message this was to me. Thank you for taking the time to share some of your story! I’m so sorry you’ve walked through this kind of heartbreak. It really is heart-wrenching. Praying that the Lord would continue to be so near to you even as you grieve and continue to walk forward in obedience to and trust in him!! 🤍🤍

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