I’m Struggling With Fertility & Wish I Could Tell My Coworkers

History: My husband and I have wanted to be parents our whole lives. While I’ve been trying for a baby since 2017, I’m struggling to balance a demanding job in a traditionally masculine industry with fertility treatments. I love what I do, but I just can't talk about this at work — and I don’t want a baby to hinder my career progression. I feel as though I’m leading “multiple lives.” 

Age: 33
Location: Brooklyn, NY 
Occupation: VP Technology 
Household Income: $300,000

I’m going off birth control, after being on it for 11 years. I’ve heard it can take months to regulate your body again after stopping. I plan to track my cycle on a fertility app, but I'm going to try not to obsess. With that said, I do buy six months worth of pregnancy tests. Just in case.

Cost: $54 for the pregnancy tests. 

I’m getting antsy. I read fertility books, pee on ovulation sticks, schedule sex, reduce the intensity of my workouts, cut back to eight ounces of coffee a day, and start going to acupuncture. I’ve heard all these things may help me conceive, and, at this point, I’m throwing everything at the wall in the hopes that a fertilized egg sticks. 

Cost: $1,293 total. $20 for ovulation sticks and $23 for the book. Acupuncture is $1,250 for 10 sessions and not covered by insurance.

After being on the waiting list for two months. we finally get in to see a specialist at a fertility center in New York City. They run a semen analysis for my husband, an ultrasound for me, bloodwork, genetic testing — the whole shebang. 

After we get the test results, we're diagnosed with "unexplained fertility." My doctor gives us our options. We can try the less-invasive intrauterine insemination (or an IUI, during which sperm is injected into the uterus via a catheter) which my doctor says will have a 15 percent success rate for us. Alternatively, we could go straight to in-vitro fertilization (IVF), which has higher success rates. But insurance dictates our life plans: I can’t get approved for IVF unless I have three unsuccessful IUIs. 

Cost: $600 total. $450 for the semen analysis, $30 copay, and $120 out of pocket for genetic testing. 

After months of incessant calls with both my insurance carrier and my doctors office, my IUI has been approved and we schedule it for October. 

Cost: $480 total. The IUI is covered under a $30 copay, but the sperm analysis isn’t, and costs $450.

I step out of a meeting to take a call from my doctor. They say I’m not pregnant. I walk right back into the conference room and continue presenting like nothing is wrong. When I get home that night, I tell my husband the news and cry in his arms.

Cost: $0. 

My doctor recommends we do a HSG test to determine if there's a blockage in my fallopian tubes we couldn't detect on the ultrasounds. There is one in my right fallopian tube, so they increase the pressure of the liquid iodine they’re pushing into my uterus during the test to unblock it. This is easily the most excruciating pain I’ve ever been in in my life, and I’ve been given nothing but Advil. I start screaming and the nurses have to hold me down. After about 90 seconds of agony, I lie there in shock. I can work from home the rest of the day. Thank God, because I have brown-colored liquid discharge from the iodine.

Cost: $625 total — all hospital fees. The procedure would have been around $900 without insurance. 

We do a second IUI, with an oral medication this time. After the procedure, I feel awful. As I come off the medication, I feel bloated, nauseous, and have night sweats.

I’m running out of excuses for why I have to miss so much work for these appointments. I try and assure my coworkers that I’m fine without giving details. 

Cost: $765. It’s $450 out of pocket for the sperm washing upfront, $30 for a trigger shot to kick-start ovulation, and $10 for the medication. I'm still doing acupuncture, which is $275 for this month. 

I’m at a conference getting ready to go speak on a panel when I get a call from my doctor. I don't pick up, even though I’m dying to know; I can't deal with it before I go on stage. When I finally get back to my hotel room that night, I listen to the voicemail. Not pregnant. I call my husband and fall asleep crying. 

Cost: $0.

We took the summer off from fertility treatments, and are coming back to it this fall with fragile but high hopes. It feels futile to put my body through another attempt at IUI, but insurance dictates that I must. I do my third one, taking the same drugs as last time, plus new medication, including estrogen patches. Fingers crossed this combination of drugs works. 

Spoiler alert: it doesn’t.

Cost: $515. $450 out of pocket for the semen analysis, $30 copay for the trigger shot, and $35 for the medication. 

We’re ready to start IVF. But as soon as I get insurance approval for my first cycle, everything shuts down due to COVID. I’m devastated. 

Cost: $450, for an additional semen analysis 

My clinic is re-opening with new social distance rules to keep people safe. We schedule our first IVF cycle for July. Because of COVID-19, I’ll have to go to all my appointments alone, including the egg retrieval and embryo transfer. It sucks — but I want to get this started so I try not to dwell on it. 

Cost: $0

Though this IVF cycle is "covered by insurance,” it’s billed by the center and not my doctor, so it’s out of network. That means I’ll have to pay upfront and get reimbursed later. I cannot get any real answers from insurance about how long that will take or how much I will be reimbursed — they give me a range of 10% to 25%. So frustrating. (Months later, I’ll find out I can get back about $3,100 per cycle.)

My husband and I have spent the last six months saving for this, in addition to our emergency savings, which we have been building for the last three or so years. We haven't had takeout, gone out to eat, bought takeaway coffee, or bought anything non-essential in a year. I know it's worth it, but nothing can prepare you to see “$14,500” appear in front of you on a credit card machine. We use our credit card to get travel points, but we’ll pay it off in full. During COVID, when unemployment is so high, it feels risky to liquidate my savings, but I feel I have no other choice. I want this baby. 

I’m terrified of needles, but have to inject  three shots of fertility drugs into my abdomen a night. On the first few shots, I’m shaking so badly I can barely hold the syringe. 

Every morning, I go to the doctor’s office for a blood test and ultrasound to monitor my hormone levels. I take Ubers to and from the clinic, which is so pricey, but I don’t want to take the subway, as I need to minimize my exposure. 

Cost: $16,642 total. $812 in Ubers, $15,750 for the IVF procedure which includes the daily monitoring, the upcoming egg retrieval, and the upcoming transfer. I have an $80 copay for the medications. 

Scheduling the egg retrieval is difficult — they give you 24 hours notice based on your ultrasound and bloodwork results. So I have to scramble to cancel all my meetings and take the day off. After the retrieval, my doctor tells me they got 30 eggs! Only seven were fertilized, though, and a meager one is mature and of good enough quality to transfer. I’m heartbroken but in love with the idea of what this little embryo could become. 

Cost: $0. We already paid for everything up front. 

The doctors transfer the embryo into my uterus, and I wake up from the procedure all alone because of COVID. Two weeks later, I get a call saying I’m not pregnant. This happens 10 minutes before a webinar I’m leading starts. I don't process it. I hang up, and I put on a smile for the camera. Just three hours later, I’m crying on the shower floor, grieving my embryo, and the 29 other eggs that didn't make it. 

After a weekend of moping on the couch in my PJs, I start calling the insurance company and doctor’s office to get reimbursed for my out of network claims and get the paperwork in order. This takes hours, but it's a good distraction. 

Cost: $0. We paid for IVF up front. 

We get IVF cycle number two approved by insurance — the folks who answer the phones at the company know my name by now because I call all the time. For this cycle, we’re trying a new cocktail of injections and medications.

The second round of IVF has better results. We get 30 eggs, 11 are fertilized. Three are viable long-term, so one will be transferred and two others are frozen on ice. 

I cry nightly about how we’ll pay for it (though I’m sure the hormones I’m taking also have to do with my tears). We sell some of our stocks now to help cover the costs. 

Cost: $17,630. We pay another $14,500 out of pocket, up front, plus a $1,250 fee to do the transfer at the hospital, and $80 copay for meds. We pay an additional $1,800 to cryopreserve the remaining two embryos. 

After another transfer, I’m injecting progesterone into my butt muscle to essentially trick my body into thinking it’s pregnant so the embryo is more likely to stick. The shots hurt and leave dark purple bruises. Then, a huge bump on my butt forms: an allergic reaction. The doctors can’t give me anything to help with the pain as I may be pregnant, but they do prescribe a different type of progesterone (not covered by insurance and $225) and I’ll have to supplement with suppositories, too. Ugh. 

Two weeks after the transfer and a pregnancy test, I get the call on Christmas Eve that I am not pregnant. My husband and I decide not to celebrate the holiday with our family. Instead, I put on sappy music and cry. 

Cost: $240 total. $225 for the new progesterone, $15 for the suppositories. 

Somehow during all of this, I have been interviewing for a new job. I’m offered a really  compelling offer, but deciding whether or not to take it is utter hell. What should matter most is my career progression, salary, and the work culture, but right now some of the biggest considerations are health benefits with IVF coverage, maternity leave, and flexibility. This job is perfect for me in every way, but the maternity leave policy improves drastically after 12 months of employment. Because of this, we decide to delay my next transfer until summer 2021 after I take the job.

I’m so dismayed that these considerations didn’t factor in as heavily in my husband’s job trajectory. 

Cost: $0. 

Total cost: $33,094 total, considering we got $6,200 back in reimbursement from insurance for out of network costs. 

Struggling with fertility on top of a pandemic has been difficult. I’ve felt isolated. On the other hand, I’m so grateful to be working from home right now; it's easier for me to sneak away for all the appointments and I am grateful I can wear leggings all day because the bloating from all these fertility drugs is real.

The costs of fertility have been both emotionally and financially draining. I know deep down that this is the best use of my savings, but I’m grieving the loss of security. It’s also been tough find work-life balance. I want to have my work projects succeed, but also want to process my emotional load so I can give my embryos the best chance at success. 

My biggest takeaway from this experience has been to make a conscious choice to focus on joy every day. Yes, the daily doctor appointments, needles, and pressure to get pregnant are major pains. But right now, I’m deciding to appreciate the little things — whether I'm taking a walk outside, Zooming with my friends, or taking a great yoga class in my living room. Although I want a baby so much, I’ve reframed my thinking from “it will come” to “my life is so full and a baby will only improve it.” I’ve had to surrender to the possibility that this may or may not happen, and it’s out of my control. I’m living in the moment.