Welcome to Refinery29’s Fertility Diaries, where people chronicle their joyous, painful, and sometimes complicated paths to parenthood.
History: I always imagined myself as a mom and thought that having a baby would be so easy based on my own mother’s experience and seeing all my friends get pregnant soon after going off the pill. When it came time for my turn to try, though, life had a different path in mind for me.
Age: 35
Location: San Francisco, CA
Occupation: Marketing Manager
Household income: $140,000 (£102,000)
Jan 1, 2020
New Year, New Goals
My partner and I decide it’s time to officially start trying. It feels weird to be purposeful about conceiving when up to this point in my life I’ve been trying to avoid getting pregnant. Here’s hoping for a promising 2020!
Cost: $0.
April 1, 2020
First positive pregnancy test
It’s a Wednesday. I’m in my bathroom, and my heart is racing. I take another look at the pregnancy test and see a faint line. In the midst of the COVID-19 pandemic, it seems that my body is ready to do what I’ve been wishing it would for the past few months. I pee on another stick to make sure my eyes aren’t playing tricks on me. The second test assures me that, yes, I’m really pregnant. I immediately take a picture and send it to my sister.
Next, I share the news with my partner. He comes home tired from a long day of work, but at dinner I show him the positive pregnancy test. He’s suddenly full of energy — I don’t think I’ve seen him this excited in a long time. The next day I call my OB/GYN and she asks me to come into her office in two weeks so they can do an ultrasound and make sure the pregnancy is progressing.
Cost: $100 (£73), on ovulation kits and pregnancy tests.
April 9, 2020
Miscarriage
Last night, I was feeling crampy, and on April 9, I wake up thinking I need to pee, then see blood everywhere. It’s bright red and there are clots. I know this isn’t a good sign. I wake my partner up and say matter of factly: “I’m having a miscarriage.” I run to the bathroom. I get up from the toilet and wipe myself, but fall to ground crying. No one can comfort me now, and it feels as though this pain will never end.
I get in touch with my doctor, and she tells me that I’ll need to confirm the miscarriage by getting my blood drawn twice at a local lab, 24 hours apart. The tests assert that, yes, this is really happening.
Cost: $0, insurance covers the lab tests to determine I’m miscarrying.
April 25, 2020
Talking it out
I sought out therapy because I keep blaming myself. I believe my body failed me — or that I failed it. During this session, my therapist — who specialises in miscarriage and pregnancy loss and has great reviews — asks me to talk about the miscarriage and I start breaking down in tears. My heart hurts. My partner seems to want to avoid discussing what happened together. This feels awful because it’s all I want to talk about. And during the pandemic, since I’m not seeing friends and family, I feel more isolated than ever. My therapist urges me to grieve, and suggests involving my partner in a “saying goodbye” ceremony. Acknowledgement helps, she says. Even though it was an early miscarriage, I still feel the loss intensely and that’s completely valid, she says. The life I imagined for my child disappeared in a day. I feel so much better after therapy, and am reminded how important it is my partner and I support each other — especially as we quarantine from the outside world.
Cost: $0, since my doctor is in my insurance’s network.
May 5, 2020
Diving into wellness
I make an acupuncture appointment as soon as COVID-19 regulations will allow it and my aunt, who also had trouble conceiving, refers me to a herbalist who practices traditional Chinese medicine. It costs a pretty penny to combine acupuncture and herbs but I feel that this is a better option for me than turning right to fertility treatments, which can run thousands of dollars. Week after week I boil pungent herbs that look like tree bark and leaves. I take countless supplements — prenatals, fish oil, and Theralogix vitamin D — in hopes of providing an ideal environment for an embryo to stick and grow.
Cost: $900 (£656) total. $300 (£219) for monthly acupuncture, $400 (£292) for herbs, and $200 (£146) for supplements.
August 15, 2020
Other options
I’m feeling restless. I’m an impatient person to begin with, so not having control over the baby-making process is probably the most frustrating thing in my life to date. On YouTube, I stumble upon a reproductive endocrinologist who seems to know what she’s talking about. I decide I want her to be my doctor and trust her with my fertility journey.
I come to find out she does not take insurance and all costs will be out of pocket. But I’m not sparing any expense at this point. I’m willing to pull money out of my retirement (which I’ll most definitely have to) and put medications on credit cards to get to my goal.
My partner and I go through the standard testing and I undergo a hysterosalpingogram (HSG) test, which checks that my fallopian tubes are open and not blocked by fluid or something else.
Cost: $1,125 total (£821). $675 (£493) for initial video consultation, $200 (£146) for hysterosalpingogram procedure, and $250 (£182) for more blood tests and genetic carrier tests.
September 3, 2020
My 35th birthday and first IUI
As my 35th birthday nears, my doctor asks if I want to start with intrauterine insemination (IUI) or in vitro fertilisation (IVF). IUI is less invasive and less costly, but has a lower success rate.
Ultimately I decide to try an IUI first. My doctor emails me to let me know that my follicle-stimulating hormone (FSH) levels are slightly elevated, which could indicate egg quality issues. Great. If this doesn’t work the first time, she suggests we take the plunge and go for IVF.
It’s my birthday, and my partner and I end a relaxing celebratory trip to Marin County at our fertility clinic. My partner gives a sperm sample, which my doctors inserts into my uterus through a catheter. Leading up to the treatment I took the drug Letrozole, which was supposed to help my eggs grow to maturity.
At my doctor’s suggestion, I wait 12 days after the IUI to take a pregnancy test. She says by that time, there will likely be enough Human Chorionic Gonadotropin, (hCG, known as the “pregnancy hormone”) in my system for the test to pick it up if I’m pregnant. But I don’t see any type of line, not even when I squint real hard. In my heart I know the IUI didn’t work and that I’ll have to email the doctor to give her the bad news. I’m on progesterone pills so it’s now time to stop taking them and let my period return. Sigh.
Costs: $2,000 (£1,459) for the IUI, including medications.
November 5, 2020
FSH is a bitch
My doctor took another blood test, and found that my FSH levels have nearly tripled, and are not conducive to any sort of fertility treatment because it means my eggs will not grow — even if I do take the fertility injections. My doctor advises me to wait until my FSH comes back down before embarking on my IVF journey. In the meantime, she asks me to take injections of human growth hormone, which has been shown to possibly help with egg quality.
Cost: $600 (£438) total. $300 (£219) for ultrasound and blood tests, $300 (£219) for human growth hormone.
November 29, 2020
Starting IVF
I finally get my period and my doctor says I can start my first cycle of IVF. I have about 10 “follicles” growing in my ovaries, which could grow into 10 possible eggs. My FSH levels are still a little higher than my doctor would like, but we decide to go for it.
Every night at the same time I must inject medication into the skin of my stomach. I feel like a human pin cushion. I return to the doctor’s office every few days to monitor my progress.
Soon we’ll do the egg retrieval. Of the ten eggs we were hoping would mature, it seems we’ll only be able to get four or five, because the rest are too small to be viable. I’m nervous but so ready.
Cost: $0 — I’ll pay a lump sum later.
December 10, 2020
Egg retrieval day
On the day of the retrieval I show up to the clinic and am in the room alone because of COVID-19 restrictions. I feel surprisingly calm. This is my first surgery ever, and I wince a little when they stick the IV into my arm. A nurse walks me over to the operating room and I lay down on the cold table. A few straps are put around my stomach and arms, which scares me a little. But the next thing I know I am waking up and the procedure is already done. I feel pretty brave for going through it all and my doctor comes by to tell me she got four mature eggs to be fertilised with my partner’s sperm in the lab.
Costs: $27,000 (£19,700) total for monitoring visits, the egg retrieval, and embryo genetic testing. I end up pulling some of these funds from my retirement account since it was such a big cost up front.
December 12, 2020
A dream
I have an awful dream, in which my RE told me that two of my eggs couldn’t be fertilised. I wake up feeling so anxious that I email my doctor right away and ask her if she got any results from my retrieval. When I open her response, I see a lot of exclamation points and smiley faces. All four of my mature eggs were fertilised. Hot damn! I know we have a long way to go, but it’s so important to celebrate small wins.
Cost: $0 as I’ve paid all my fees for this full cycle.
December 15, 2020
Waiting
I got the call from my RE today that all four of my embryos survived the benchmark of five days (when they become “blastocysts”), and three of the four seem that they’ll be able to be frozen, based on their quality and chances of survival. Now for genetic testing. With each embryo at 35 years old, I’m told there’s a 50% chance each embryo will have no abnormalities. These odds, I can handle. I’m elated. I don’t want to get too excited, but, damn, reaching this milestone feels nice. I want to celebrate the small wins and thank my body for getting me this far.
Cost: $0 — genetic testing is up next and is already paid in full.
December 23, 2020
Results
I see my phone ringing and know that my doctor is calling with the results. Three embryos were successfully frozen, and have made it through genetic testing. At first, I’m incredulous because, based on the statistics I’d heard, I assumed I’d be lucky to have even one embryo that could be implanted. Then, I start tearing up. I call my partner right away and tell him the good news. He starts jumping (literally) for joy while he’s at work, and laughs as though he still doesn’t believe our good fortune. We bask in the good news after a long road of treatments. We can’t wait to share the news with our family during the holidays — it’s the perfect Christmas gift after a very difficult year.
Cost: $0.
Total Cost $31,725 (£23,148).
Reflection: Holy cow, the amount of money I’ve spent over the last year is staggering. Not to mention the toll my fertility journey has taken on my mental and physical health. And all in a pandemic! But, at the end of the day, I believe this time has brought me closer to my partner and helped me get to know my body and my mind better.
Mixing holistic methods with science was definitely the right approach for me, although I know it’s not for everyone. For me, the next step is more testing to make sure my embryo will have a healthy environment to stick and grow (which will be another $3,000 (£2,189)) and then the frozen transfer of the embryo into my uterus (an additional $6,000 (£4,378)).
I choose to make financial sacrifices along the way, but, to me, they were worth it. I’m hopeful that one day I’ll have the family I’ve been dreaming about since I was little. I will look around and see my children playing outside or reading a book to their grandparents. This is the vision that keeps me going every single day.
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