Life comes with expected milestones and their associated costs: going to college, moving house, planning a wedding, saving for retirement. But even the best-planned lives can be derailed by unexpected challenges.
One event not on the typical outline: IVF (in vitro fertilization). While for some couples IVF is Plan A, others are blindsided. And in both cases, people find themselves trying to plan for a future full of uncertainty.
However, planning ahead matters, and mindset matters. With both the physical and financial costs of this procedure, people can be more empowered to meet the challenges.
The process for IVF is long, and starts before any embryos are implanted. First, IVF may not be the best option, or the first option for someone struggling to conceive. Many start with less invasive procedures such as ovarian stimulation and IUI (intrauterine insemination). These can also be costly and time intensive, and some insurances require doing four to six rounds of IUI before a patient moves to IVF.
Introducing medical help into family planning necessitates a counterintuitive shift in mindset. Straight couples learn caution—essentially, “Don’t have unprotected intercourse unless you’re actively trying to conceive”—but fertility treatments happen over many more steps, some of which patients can take months or years before they actually want to get pregnant.
Dr. Sanaz Keyhan, an M.D. certified in obstetrics and gynecology, reproductive endocrinology and infertility, says the embryo-freezing component of IVF is one of the things that allows people to plan ahead. “We can delay the embryo transfer, and the embryos are not aging,” she says. “And fortunately our uterus does not age the same way that our ovaries do.”
People who know they want to do IVF can improve their long-term chances of success by starting early with egg retrieval and embryo freezing. Then when they do want to try for a pregnancy, the embryos are ready to transfer. This is especially helpful for people who want to have multiple children with IVF, as they won’t have to go through the egg retrieval process again.
However, fertility treatments still come with an inherent uncertainty that defies planning ahead. “Know that it’s going to be hard,” Keyhan advises. “That it’s going to be a journey and it’s not usually a straightforward one. There are still so many unknowns that lie ahead. And there’s so much that both the patient and the physician are not going to have control of.”
Sometimes, the only plan to be made is to adjust to uncertainty. Friends and family can help people going through the emotional process of IVF simply by being there and listening. This is even more critical as some individuals and couples still keep their IVF journey private.
Unfortunately the physical and mental hurdles aren’t the only ones looming for people considering IVF. Everything costs money.
Kate Michaels, a managing partner at Northwestern Mutual, San Jose, took a special interest in financial planning around IVF after she went through the process herself.
“It was not on my radar, even in financial planning, until I experienced it myself, which is why I’m so passionate about the topic,” she says.
Michaels explains, “I was growing my career and trying to become a partner at the same time. Sometimes as women [it’s] challenging to have a peak of stress and excitement, as expanding your family can sometimes align with trying to grow your career too. Having those two things converge was challenging, yet it really helped me be clear on what it was I wanted to do.”
Each round of IVF—where success rates can be anywhere from over 50% to less than 10%—can run in the tens of thousands of dollars.
But other factors can affect the overall cost of IVF. For example, single people without a support system face all the costs alone, while couples can share the costs. Also, the many procedures and appointments mean lost work time and income. And with successful IVF, appointments continue into pregnancy, and the child will also require care.
Like with embryo freezing, the best time to start financial planning is early. But money and fertility are both topics fraught with stress, and the temptation to avoid even thinking about possible problems is strong. In the Bay Area, 52% of residents feel unprepared for retirement. And savings are necessary long before then.
Michaels says, “Sometimes we have as humans this perception of ‘this won’t happen to me,’ whether that be in financial planning life insurance or disability insurance, or when it comes to fertility needing to go through supportive treatments. Yet it can be a reality for anyone.”
Planning for the financials of IVF complements the planning for the medical realities. “You want to be able to focus on taking care of yourself,” says Michaels. “Taking care of your mental wellbeing, taking care of your physical wellbeing. So if you can remove one of those obstacles—which is usually the financial pressure of the decision making—it can allow clarity for you to be able to make the best decision for you and your family.”
Sometimes, options are limited, and answers aren’t easy. But people can always take a look at the options open to them, and make the best decision for their path forward.
