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an infertility guide for fertile people (part 1)

Infertility is a term that you’ve likely heard many times. But unless you’ve dealt with it in your own life, you may be unclear on the whole ordeal.  After personally experiencing it for almost a decade, I realized that even those closest to me still had some very basic, fundamental questions. Let’s be honest even I still had a few gaps until this latest round of treatment. I went to the intranets (Duh- isn’t that where all credible information is gathered?) and did a mini poll. It turns out many of you have questions about the process. So, here is my super basic, non-medical attempt to describe some of the major components of the world of infertility. 

Every time I'm in one of these exam rooms I think, "Man, this would be a better experience if they put up some floral wallpaper and cute art."

Every time I'm in one of these exam rooms I think, "Man, this would be a better experience if they put up some floral wallpaper and cute art."

DISCLAIMER:I am not a doctor. I am not a nurse. I am not any kind of medical professional. I barely passed Biology in college. This is solely my opinion. Also, I’m not great with numbers. Don’t say I didn’t warn you.

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Statistics*
A couple aged 20s to mid 30s with a normal functioning reproductive system has only a 20-25% chance of conceiving in any given month. WHAT. When I first met with our fertility doctor and he told me that number I said, “HOW do we have any humans walking around this earth?” I’m still baffled.  20-25% is an F on a test. Like, a get-your-parents-to-sign-this-slip-because-you-failed kind of F. Turns out human beings aren’t the best at procreation.

To get pregnant:
-A woman’s body must release an egg from one of her ovaries (ovulation).
-A man's sperm must join with the egg along the way (fertilize).
-The fertilized egg must go through a fallopian tube toward the uterus (womb).
-The fertilized egg must attach to the inside of the uterus (implantation).
(If you paid attention in 5th grade when they split the boys and girls up and gave us “the talk”, you already know this information. I did not pay attention. I almost lost consciousness when the nurse said I’d be regularly bleeding and expected to be cool with that. All facts after that statement remained fuzzy for the next twenty-ish years.)

1 in 8 couples have trouble getting pregnant or sustaining a pregnancy.

The Process
How does someone become the lucky recipient of an official infertility diagnosis? That can vary from doctor to doctor. Generally, however, it is recommended for a woman (within a certain age range who has no preexisting conditions that would prevent pregnancy) to try for approximately twelve months to conceive naturally before seeking medical assistance. 

And then what? Then enters (Read this very dramatically and theatrically.  Because that’s how I’m writing it.) the specialist. Also known as a reproductive endocrinologist.

Once a woman gets a referral to a specialist, she sort of starts over again. There’s a ton of paperwork to fill out (his and hers medical history), one zillion preliminary exams, blood draws (They took 7 vials at my initial appointment. Then, I almost passed out.) and other fun things of this nature. Once the clinic has gathered all this information, treatment options are presented. 

Here I am recently right before I had my fallopian tubes flushed with dye. Totally as much fun as it sounds. 

Here I am recently right before I had my fallopian tubes flushed with dye. Totally as much fun as it sounds. 

I think of fertility treatments in three different categories. There are the low level treatments (this includes Clomid and other oral medications), mid level treatments (this is where you add injectables and Intrauterine Insemination), and then the big dogs… high level treatments (this is Invitro Fertilization and its add ons). I’ll write more detailing each of these processes later but that works for now.

How long does it take?
I’ve had some friends get pregnant after one round of oral meds. I know others who’ve been in the process for years. Most doctors try and find success with the least invasive option(because of both physical and financial reasons) so, usually people start with oral meds, move on to IUIs if needed and then proceed with IVF as a last resort. 

The CDC says that approximately 85-90% of infertility cases are treated with low or mid level treatments. Fewer than 3% need advanced reproductive technologies like in vitro fertilization (IVF).

How much does infertility cost?
Only fifteen states have either an insurance mandate to offer or an insurance mandate to cover some level of infertility treatment. Eight of those states have an insurance mandate that requires qualified employers to include IVF coverage in their plans offered to their employees. Alabama is NOT one of the states with mandated coverage. We have had to pay out of pocket for all of our procedures and medicines. Here is a SUPER SUPER guesstimate of our costs:

Low level treatments: $30-70 for oral meds + several copays for office visits
Mid level treatments: $30-70 for oral meds + $300-400 per IUI + copays for office visits
High level treatments: $5,000 for meds plus $8,000 for one cycle of IVF

These are just some of the drugs for one cycle of IVF. We found an amazing pharmacy that offered discount pricing, but without them, our out of pocket costs would have been about $9,500 for drugs alone. 

These are just some of the drugs for one cycle of IVF. We found an amazing pharmacy that offered discount pricing, but without them, our out of pocket costs would have been about $9,500 for drugs alone. 

What are the side effects of fertility treatments?
The oral meds aren't terrible. Usually you're extra emotional. It's also common to have hot flashes, blurred vision, nausea, bloating, and headaches.
The shots, or stim meds, up the ante on side effects. With them, it's common to feel mood swings and depression, nausea, headaches, swollen and painful ovaries, pelvic discomfort, bloating and ovarian cysts.
Finally, with IVF, you're just straight crazy for a while. You're potentially experiencing all of the above symptoms plus more due to an influx of synthetic hormones in your system. And also you just spent more money than you can wrap your head around on those meds that are making you crazy. 

How adorable is my husband? This is him giving me my stim shot on valentines night. Because, we know how to party. 

How adorable is my husband? This is him giving me my stim shot on valentines night. Because, we know how to party. 

 

I feel like we’ve reached information overload, so I’m going to stop here for tonight. Tomorrow I’ll write a Part 2 of this blog that will cover more specifics of different levels of treatments and also ways to support people you know who are experiencing infertility. 


Thanks for all of your love and support! I love to hear from you so please let me know you're reading. ❤

 

 

 


*The numbers, statistics and other complicated medical things on this document have been gathered from the CDC’s website and resolve.com  

a permission slip for mother's day

stop telling me i'll have kids "if it's in God's will" for me