Personal financeDebt

The cost of IVF in New York City

For those who are following me on my main blogging platform, Instagram, you’ll have known that I became pregnant this year through IVF – in-vitro fertilization, and that Mr. Savemycents and I are expecting a baby boy end of October. I will talk about the costs, the mindset, and share some recent maternity photos with beautiful pieces from Dear Collective to mix it up.

The out of network experience

We are two very busy professionals, for two years as we tried on and off, we sometimes blamed ourselves for not ever having a positive pregnancy test. That was a wrong assumption. It wasn’t because of stress. I can’t tell you how many times I wanted to shoot darts out of my eyes when I heard “just relax! So and so got pregnant when they stopped working so hard / went on a vacation”. No Susan, I got pregnant during one of the busiest times of my life.

April 2018 I visited the first fertility clinic I could find an opening at which was RMA of New York, a very well known and highly regarded clinic by several of my friends. I was desperate and didn’t think through the costs of using such a clinic by going out of network. They ran through a panel of blood tests with me and shared with me the costs of IVF, and sure enough, they were more costly than I could imagine. Then I knew that I hadn’t done my homework and had to go with an in-network doctor.

My amazing coverage

Throughout this time period I was double insured – both through my company’s, as well as my husband’s. My company offered 100% coverage of IVF as a result of infertility, with no cap on treatment. His company offered 100% coverage of IVF as a result of infertility with a $60K cap. I would later learn that making sure everything did get covered is a whole paperwork and phone call headache, but in the end, everything got resolved.

The doctor I chose

After a bit more research and calling my insurance company, I found that Dr. Hey-Joo Kang at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Care at Weill Cornell took my insurance, and was recommended by at least two friends. In addition, Mr. Savemycents and I used the CDC data base for Assisted Reproductive Technology Fertility Clinic Success Rates Report (2016 link here) to confirm that of all the clinics my insurance would cover, Weill Cornell had the highest success rates. The Physician-in-Chief of this center, Dr. Zev Rosenwaks, is actually one of the leading pioneers within the field of IVF, including developing the nation’s first egg donation program.

Our diagnosis, and how to think about infertility in general

I would learn that it does not matter who you are – ethnically, body type, lifestyle, etc., infertility could happen to anyone. 40% of infertility is female, 40% is male, and 20% is unexplained. And as much as all of us like to think we have life controlled with science, I still think the power to imbue life is a mystery at best, and we’re all just doing our best. Our diagnosis, which we received around end of June / July, was that we had male factor infertility. This diagnosis skipped us through other less invasive treatments (e.g., IUI) right through IVF with ICSI (intracytoplasmic sperm injection – where the sperm is injected directly into the egg rather than mixed with the egg on a petri dish – extra cost) which was our only option to have a child with our genes. The day I found out, I cried for half a day. There was relief in knowing the diagnosis, but also anxiety at what lay ahead.

Our IVF journey in a nutshell

Being religious, it took us some more consulting the bible and friends to reconcile our beliefs with the technology of IVF. We decided that we would limit the number of embryo created (by not stockpiling embryo throughout the process), and that every embryo created that was deemed viable by the lab, we would implant at some point in my life. This was our journey

  • Cycle 1: Stimulation and fresh embryo transfer, 2 day 3 blastocysts, BFN (Big Fat Negative = forum speak for unsuccessful cycle). August 2018
  • Cycle 2: Frozen embryo transfer, 2 day 3 blastocysts, BFN. October / November 2018
  • Cycle 3: Stimulation and fresh embryo transfer (Clomid round – my medicines were also changed to grow larger eggs), 2 day 3 blastocysts, BFP (Big Fat Positive = successful cycle) with one baby boy. January / February 2019

After the all the cycles above, the rest of our embryo had arrested in development in the lab, so we do not have any embryo remaining. All our hopes and dreams rest on this one baby for now. It all sounds so scientific when I boil it down to those three bullets, but in reality, it was one of the hardest periods of my life emotionally.

During each stimulation round (about two weeks) I went to the hospital every morning to get my blood drawn, and then work. Every day I was injecting myself, whether in the stomach or in my butt. There were the side effects of the medicine (fatigue, foggy brain, mood swings endless pain at injection sites, nausea), the emotional turmoil, and mourning, at all the embryos who did make it, and wondering if we’d ever meet those children again. The constant paperwork and administrative time dealing with incorrect insurance claims, the phone calls from nurses at any time in the afternoon to tell me my medicine dose for the night, the restless anticipation during the TWW (two week wait) while you wait for the pregnancy test. The isolation, because those who don’t have infertility, don’t know how to relate. I withdrew from the world a bit, unfollowed a few friends with beautiful babies, because I needed to protect my own heart. I never blamed this infertility on anyone, not God, but I also knew that I had limits, and prayed each day for God to give me more strength and a bigger heart to care for things and people beyond infertility. In my final round, I had my blood drawn 10 days in a row, injected myself in my stomach 23 times, and injected myself in my butt 42 times.

The costs

All-in, we paid about $800 in co-pays for doctor’s visits, drug co-pays, but our insurance paid out so, so much more. The below Excel screenshots reflect a) the prices in 2018 that Weill Cornell charged its cash paying patients b) the most approximate drug prices I could find for the drugs I was prescribed, using GoodRx. This is not a perfect methodology – every patient’s drug protocol can be a bit different, but based on a sampling of forum posts and estimates, more or less this is a good representation of what it costs to do IVF in New York City. Is it a little less elsewhere in the country? Absolutely – the cost of living is lower elsewhere. We were so very lucky to be covered. These are costs per CYCLE. So all-in, had we paid cash, we’d be looking at two ~$24K cycles + one ~$9K cycle = ~$57K in costs. I know of people who have gone into debt for IVF. It’s an agonizing decision, and either way, it’s hard.

Would I do this all over again?

I haven’t met our child yet, but as I draw closer and closer to our delivery date, I feel the love for this little dude growing stronger every day. From a conceptual amniotic sac and a 150 bpm heartbeat at 6 weeks, to a kicking, living being of 30 weeks inside me today, I already feel like I have become a mom. While the idea of going through IVF is tough, I know that I can do it, God willing. He was the source of my strength. The one prayer that got me through it all was “God, I believe that You are good, and that Your plans, no matter what they are for me – whether it is a child, or not – that those plans are good. I trust in nothing else”.

I wanted to thank all of my friends who were there for us throughout. It takes a village to raise a child, and I apologize if I have not been supportive in return when you had a kid. You don’t know until you know. I want to thank both our parents for being kind and loving during this time, and giving us the space to figure out the journey to parenthood on our own. It cannot be easy to watch your child go through something you didn’t have to, but we made it!

The amazing staff at Weill Cornell over these months – it’s incredible how many patients they support. Your knowledge, expertise, and skill, are what has led to this baby today.

Dear Collective is a maternity clothing brand I discovered on Instagram and LOVE. Their clothing is perfect for a working woman like myself who needs something modern, but not potato sack like. Many pieces also transition to nursing with hidden zippers. They are based out of Singapore but ship all over the world (if you’re US based, be sure to display everything in USD).

 

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