I’m 40, I Live In CA, And Have Spent More Than $12k On Fertility So Far

Age: 40 
Location: California 
Occupation: Payroll Specialist
Household annual income: $100,000 to $120,000 per year 

I’ve spent the past 10 years addicted to drugs. The path to recovery is never straight, and after a few tries and relapses, I finally got clean at the age of 34. Of course, I missed my deadline to have a baby at 30. Now I’m aiming to be sober for a year before “trying.” But if I don’t have a partner at 35, I’ll do it all on my own. I’m also starting to date around on the apps. Eventually, I message this cute blue-eyed girl in a beanie with the sweetest smile.

Cost: $0 

On New Year’s Day, I get engaged to the woman in the beanie. She proposes to me during what is supposed to be her surprise birthday party (yes, she knew all along). We’ve been together a few years, which delayed my attempts to get pregnant on my own. 

Pregnancy is still my dream, not hers, so I’ll be the one initiating fertility treatments. As a first step, that means getting a sperm donor. (Being in a same sex relationship there is no chance of accidental pregnancy.) I’ll also need an experienced midwife because I want to do at-home intrauterine insemination (IUI), when the sperm is injected into the uterus (versus intracervical insemination). This seems to be one of the cheapest routes, but if I struggle to get pregnant that way, I’ll have to look into more expensive options. 

The cryobank is having a sale, and ultimately I’m able to get four vials of sperm from the donor I’ve reserved at a discounted rate. Still, it’s pretty expensive. 

I’m excited and nervous. I don’t expect to have any troubles getting pregnant. My periods are super regular, and I was pregnant once before when I was in my early 20s, so I know I am capable. (Sadly, this pregnancy came at a time in my life when I was living out of my car, deep in the throes of my addiction. I made the hardest decision and chose to terminate that pregnancy.) The only thing that worries me is that my mom struggled with fertility; my parents lovingly call me their $100,000 baby. 

Cost: $3,184 for four vials of donor sperm.

What better day to try and get pregnant than Valentine’s Day? The time is right, according to my ovulation-tracking strips and midwife. We have dinner plans tonight, so the midwife comes in the morning. My fiancée doesn’t want to be the one to inject the semen, so the midwife does her thing. It’s awkward but not painful. I heard that having an orgasm can increase your chances of getting pregnant, so we have sex after the midwife leaves. Then I relax in bed with my hips raised on a pillow. 

Cost: $754 total, including blood tests ($54), ovulation and pregnancy tests ($40), sperm pickup ($60), and the midwife costs ($600). 

After two more failed inseminations at home with the midwife in March and April, I decide to see a fertility specialist. Our initial (free) consultation goes well. I let him know what I've done thus far with the midwife and that I would like to have some tests run to make sure I’m able to get pregnant. In particular, I’m interested in doing an Anti-Müllerian Hormone (AMH) test for both my fiancé and I, which, in part, tests our ability to produce eggs. I’ve been researching reciprocal In vitro fertilization (IVF) and I would love to have both a baby with my egg and with hers. 

With the assistance of the clinic, I can do medicated cycles of IUI, using fertility drugs and progress-tracking ultrasounds to increase my chances of getting pregnant. The doctor also recommends a hysterosalpingogram (HSG) test to check the health of my uterus and fallopian tubes. My doctor warns me that this procedure will be painful, and boy is that the truth. Luckily, the test shows everything is normal. 

Cost: $2,409 total, including two more midwife-assisted inseminations ($1,200), two more vials of sperm with delivery ($320), the tests ($875), and Clomid, a fertility medication ($14). 

So far we’ve tried five inseminations in total, but nothing took. On a happier note, we got married! With the political climate and stress over the election we decided to make it legal, just in case. 

Today, I’m meeting with the doctor to discuss more options. He has mentioned a new technology I'd never heard of called INVOcell — which is billed to us as the step between IUI and IVF — multiple times. It's cheaper than IVF and less intrusive, the doctor tells me. We ultimately decide to give it a go. 

Like IVF, INVOcell requires taking fertility drugs and doing an egg retrieval. But instead of being fertilized in a lab, the eggs are placed in a capsule called an Intravaginal Culture System (IVC). Then the IVC is inserted into the vagina, where it’s held in place by a diaphragm-like device for five days. Ideally, this produces several embryos; one or more are transferred to the uterus, and you can freeze any extras. 

Now, we just need to figure out how to pay for this. We decide we’re going to need a loan. 

Cost: $3,008.50. That includes $2,933.50 to cover two more IUIs, including medications, ultrasounds, trigger shots, the sperm, and the sperm delivery fees, and $75 for more ovulation and pregnancy tests.

I just got the email that our application for an interest-free fertility loan from the Jewish Free Loan Association was approved. We applied for $7,500, which won’t cover everything, but is a good start. My parents have been so supportive and agreed to be the guarantors, and will also lend me money to cover the rest of the procedure. The monthly repayments will only be $210, which is completely feasible. I feel a huge weight has been lifted; we can finally give the INVOcell a try. 

I have also gone back to therapy with the same therapist I saw when I was getting clean. I figured with this possibly being our last try, I will definitely need to talk to someone if it doesn’t work. My wife has pretty much reached her limit on investing in this journey. She’s supportive of my dream of being a mom but has plans of her own that require her to save up. 

Cost: A $20 co-pay for therapy, because it’s covered by my insurance. 

The clinic told me that they hoped my period would arrive by the 19^th, and like clockwork Aunt Flo made her appearance this morning. I go to the clinic for my baseline ultrasound, but when I get there my doctor has bad news: He’s going to be out of town the week we’d want to do the INVOcell transfer. Everyone apologizes to me and can see the disappointment written all over my face. I’d ordered the medications and INVOcell device last week, plus another donor vial of sperm (and would you believe they raised their prices at the cryobank?). The doctor suggests I go on birth control so that we can manipulate and time my period to line up with the newly proposed schedule and to keep my hormone levels low. I leave the office so upset that I will now have to wait another few weeks for my next cycle. I hope my doctor enjoys his friggin’ vacation!

Cost: $5,065.50 total. Birth control is $18, the INVOcell Device is $535, and another vial of sperm is $1,045. The fertility drugs come to a whopping $3,467.50.

I’m on my period again. It’s super-heavy today and I’m really not looking forward to the vaginal ultrasound, which they’re using to check the health of my uterus and count the number of follicles (sacs that contain developing eggs). 

This is the week my doctor is on vacation so another health care professional is doing the procedure. She is very nice and communicative, and counts five follicles in the right ovary and around four in the left (it’s hidden under my uterus so she can’t see for sure). 

Time to pay up. The clinic is a pay as you go, but since this cycle is a package deal, I know I’ll have to pay $6,000 upfront for the procedure. I’m about to hand a receptionist my card and she tells me today is actually going to be $6,645. Excuse me? She says the extra $645 is for some blood work that isn’t included in the INVOcell package. I ask her to not charge me for this yet — I’m going to try to get the same blood work done by primary doctor. My anxiety is through the roof about this extra charge. 

Cost: $6,015. $6,000 for INVOcell, and I do end up being able to do the bloodwork at my PCP’s office for a co-pay of only $15. 

I’ve been doing injections to stimulate my ovaries to produce eggs for almost a week now, and today I have an ultrasound to check my ovaries for matured eggs. I’m hopeful but anxious. I know it is quality over quantity, but I'm wishing for a high number of eggs. Today I wore rainbow unicorn men's boxer briefs to bring me good luck. 

The doctor tells me he only believes he’ll be able to retrieve two mature eggs tops. This is not the number I wanted to hear.

I have to make a choice on how I wish to proceed: continue with the INVOcell process with only two possible eggs, or switch to an IUI and, if it doesn’t work, try the whole process again and hope for more eggs. My doctor seems to think the latter option will save us money, but I don't see it that way. If IUI works, I’d get part of the $6,000 back for the procedures I didn't do. But I’d still have the INVOcell device sitting around, unused and paid for. And if it doesn’t work, I’d have to pay for more sperm, more meds, and start the INVOcell process over again — which could cost another couple thousand dollars, potentially.

I'm horrible at making big decisions like this. I call my wife and my parents to discuss. I can't even get through one sentence before I start crying. We ultimately decide to move forward with the INVOcell and egg retrieval. I will continue the meds through the weekend, and I have another ultrasound scheduled for Monday. 

Cost: $0. 

I’m in the car on the way to my egg retrieval today, feeling a flood of anxiety and nerves. With only two eggs, I can't afford anything to go wrong. I haven't been under anesthesia in years, so that has me a little on edge as well due to my history of drug use. My wife is driving, although they won't let her wait inside because of COVID-19. 

After filling out a zillion forms and releases they walked me back for the procedure. I’m wearing a hospital gown and knee-high panda socks. Pandas are my thing, so I'm hoping they will bring me luck, even though the unicorns did not. I hop onto the table and place my legs in the stirrups. Then I’m out. 

When I wake up, it feels like no time has passed. I asked the doctor how it went and if they were able to get both eggs. He says no — somehow, I had already ovulated, so they weren’t able to retrieve the eggs. I feel all the blood drain from my head. My uterus betrayed me. This can't be real. I timed everything exactly as he instructed. I try to hold back the tears, but I'm overcome with sadness. 

Even worse, he tells me that they already opened the INVOcell device to prep for the procedure, and it can’t be used again once it’s opened. Money down the drain. I literally want to scream and punch this guy when he tells me that. Since the vial of sperm has been defrosted, he asks if I’d like to do an IUI anyways. I am still disoriented from the anesthesia, bawling my eyes out, and now I have to make another important decision. He takes me into a procedure room, and they let my wife come in. I tell her what happened, and she’s furious. She blames him for everything. I want to blame him for everything too. The truth is nothing is ever guaranteed when it comes to infertility. We agree to do the IUI. I figure there are two eggs somewhere in my tubes, so that’s two possibilities for pregnancy. He apologizes again and says he won’t charge me for the anesthesia, since I really was put under for nothing.

I don't even know where to go from here. No medication, no sperm vial, and no INVOcell device. I pray to god I’ll get pregnant from this IUI. I go home and cry myself to sleep.  

Cost: $0. At this point the $6,000 is sitting in my account with this fertility clinic as a credit since they didn’t go through with the INVOcell procedure. I don’t know if they’ll be deducting anything for the ultrasounds, or the IUI. 

I'm sitting in the bathroom staring at the applicator for the progesterone vaginal suppositories I’m taking to help aid implantation, and I’m in disbelief. There is a slightly red discharge on the applicator, but it is nowhere near my period. Could this be implantation bleeding? I’m really trying not to get my hopes up. It is taking everything in my power to not take a pregnancy test. I decided to wait it out and see what happens. I have an appointment scheduled in a few days to go in for blood work that will tell me if  I’m pregnant or not. Of course, if this is menstruation then there is no need for me to go in. 

Cost: $0. I already have the progesterone on hand from the batch of fertility drugs I bought in March.

Unfortunately, it was not implantation bleeding. I took a pregnancy test as the blood became heavier and it was negative. I did not go in for the bloodwork, and instead I stopped the progesterone vaginal inserts and allowed my period to come full flow.

Cost: $0. I already have pregnancy tests lying around the house. 

Total cost: $12,956, when deducting the $7,500 loan, which helped cover the medications, the vial of sperm, and a portion of the clinic fees. I'll pay that $7,500 back over the next few years and ultimately will pay the full $20,456.

I don't know where we're going to go from here, but I need a mental and emotional break from this process. I’m going to wait until after my annual bonus from work at the end of our fiscal year in June before I even think about trying again. My insurance covers nothing, especially without a diagnosis of infertility. The system is flawed; there aren’t proper accommodations for same sex couples, considering the medical intervention needed to achieve pregnancy. But I’ve spoken with my doctor about getting a discount after the last cycle, and we’re hoping that the pharmaceutical company will donate another INVOcell device to me once I’m able to try again after my doctor tells them what happened. At the moment, the $6,000 that we’d intended to put toward the INVOcell process is sitting as a credit on my account.

It took my parents 10 years before they finally got pregnant with me. I don't know how they did it. I could not continue doing this, continue being disappointed, continue spending thousands of dollars, for 10 years. Adoption has always been an option, but I am not ready to let go of my dream to carry a child. I feel broken. Thank God for therapy. I've started journaling as a way to process and express the rollercoaster of emotions that is part of every fertility journey. I like to think of my path like a sitcom with twists and turns, and an unlikely happy ending. My story isn't over yet — I'm just going on hiatus for a while. I leave you with this cliffhanger and I'm optimistically look forward to another season.