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When to give up?

post #1 of 13
Thread Starter 

We're in a kind of unique situation here where my DW isn't 100% on board with having a baby, although she's adamant she wants to carry and so she is the one who is trying to get pregnant.  Its not the most ideal situation, since I'm the one who wants the baby and I'm the one who does all the tracking, etc. but it is her body.  


We've been doing low-tech/low-cost (OPK's, BBT, CM) inseminations off and on with a KD for the last year and so far only BFN.  To further complicate everything, DW has mild PCOS and our insurance only covers infertility and no pre-conception visits or RE's.  We both work for non-profits and haven't wanted to pay the $800+ out of pocket for an RE plus the $200+ a month for in-office insemination.  We could probably scrape this together for an attempt or two, but DW is 34 and who knows what other tests, etc might be required.   


My question for everyone, and maybe this isn't the right place to ask, when do you say that enough is enough?  We've been doing low-tech for about a year and I think any RE would tell us its time to up the intervention for clomid (which insurance won't cover), femara (which insurance won't cover), injectables (same) or IVF (which we could never afford without taking on incredible debt).  I've debated ordering clomid online, but don't want to risk my DW's health.  What do other people do?  We've debated switching donors and we already do acupuncture.  Any advice would be appreciated and if not, I appreciate the space to rant.  

post #2 of 13
Hugs. That's a lot of trying. It sounds like you need to have a big talk about what you both want your next steps to be. I hear two different issues here- cost, and desire. The cost you can figure out. A cycle of inseminations with clomid/Femera (which are not $$) at the REs will cost you less than a month of daycare. It feels overwhelming to come up with the money, but you can find a way to make it happen, and after a year of trying, I think it's a reasonable step. However, it sounds like perhaps you and DP aren't on the same page about things, and that seems like a bigger issue. Is there some way for you two to move forward on that conversation? Counseling? Mini-retreat? Old fashioned conversation? If you want a baby, you will most likely find a way to get one. But you've got to figure out if that's what you both really want.
post #3 of 13

If you don't have PCOS or any other problems that effect fertility- it sounds like it would really be better to have you be the one to try. Someone I know with PCOS who's TTC with a KD has PCOS and, according to her, the OPKs don't work properly for people with PCOS. She's talking about her journey on tumblr. It may help to see what they're going through, although they're at the start of their journey.


I agree that talking is a good thing. Make sure you're on the same page. Also, take a step back and see if this is dominating your life- maybe it would help to reconnect and take away the pressure to conceive?


As for when to give up- that really depends on you. If you reach the point where you two just can't handle the disappointment of BFNs, it may be good to either give up or take a break from the cycle of anticipation and disappointment. Giving up doesn't have to mean forever. It doesn't mean you can't find a way to adopt or start trying again (although I know that, given age, there is a small window of opportunity)


Also- is it possible that your donor has insurance that would cover fertility testing if they haven't already gotten it?

post #4 of 13
I agree with everything that's been said already, and really wanted to echo the idea of getting a semen analysis done for your KD if you haven't yet. Unfortunately we've seen stories in these boards too many times of women who are jumping through all kinds of hoops to try to get pregnant and then find out that their donor was actually not producing enough (or any) quality sperm.
post #5 of 13
Thread Starter 

I really, really appreciate the responses.  My DW is on board with having a kid, but at this point, where is hasn't just happened, we're having to face the reality that it might not happen for us or that we'll have to go more high-tech.  Money is tight, as it is for most of us, but its also the question of do we want to spend $$$ when it might not work.  Our KD has had all the testing and his numbers are perfect.  


My question really was how do people decide to get more high-tech or when do folks just decide that pregnancy isn't in the cards?  I know its a personal decision. 

post #6 of 13
Ahhh, ok. We had this talk early on. My DW has PCOS and little desire to be pregnant. I've never heard a doc give a range for how severe the PCOS is, but she doesn't get her period without being on birth control. She decided early on that the interventions necessary to get her pregnant would not be worth it to her. She wants kids but would be happy to get them through another method. So it was me (my cycles are very regular) or adoption. We decided we would do 6 "DIY" tries and then take a break to decide whether to keep going or talk to any medical professionals. It took us four tries to get pregnant so we never got to that point. Not sure how far down a medical path we would have gone had we reached that discussion. Being pregnant was never a necessity for me, and I found the TTC process emotional and exhausting. I think meds and docs would have taken that stress to a whole new level. I would have been happy to look into adoption instead if I had trouble conceiving, and actually, we still might anyway if we decide to expand our family. We aren't rolling in the dough or anything, but we did have family willing to help with some of the costs, so that was not as much a factor for us when deciding our plan.
post #7 of 13
It is a tough question. We slowly went more aggresive over the course of a year. Started with home insems, then IUI at a local doctors office with follicular monitoring, trigger and progesterone, addd thyroid meds after a mc and ended at the top with ICSI after a heavy stim protocol at a specialized clinic 200miles from here which got us pregnant. During that time we discovered more and more issues with my body. We knew of my short follicular phase at the beginning because I had tracked temps for ages, but everything else seemed fine.
Well, later we learned that there might be an autoimmune thyroid disease and finally the fertility specialist diagnosed a low amh which gives me the fertility of a mid-forty-year old and we also found a slightly abnormally shaped uterus. The decision to be more aggressive was led by some research I did about effectiveness and cumulative success rates of the differrent methods and medical recommendations like switching methods after 6 failed IUIs and such. We tried to pay for the insems mostly from our monthly income. If money was too tight we skipped a month.
It worked for us, because we didn't take a vacation, own no car, rent our home and have paid off our college loans. So we spent about half of my income on treatments. Only the ICSI was paid mostly from savings (was about 6800$). We were prepared to use all savings ecxept the emergency stash and go into debt up to 30.000 $ for more IVF treatments because we feel that a child is the most important 'investment' one can make besides a good education.
We had also talked about going abroad for reciprocal IVF with my wife's eggs. For us , she never wanted to carry but we both want a child. I had that wish much earlier and more strongly though, she was reluctant but she did a lot of therapy in the last years and we only started TTC when we were at a point when I felt that it is sth. we equally want to do.
If we had hit our financial limit without a pregnancy we probably would have done more therapy together to work though that first. There we would have to work out new plans. Adoption of infants is almost impossible here (1 child to 20 prospective parents), so we would have looked at adopting an older child or foster parenting or living without children. We didn't think about it too much because for now biological parenthood was our primary goal and dealing with that was stressful enough. It helped us a lot to agree on the next steps, like the financial limit, the set number of insems with each method and so on.
post #8 of 13

i could not imagine life without a baby. (AND i never imagined life with two babies!) i am sure there is a point where i would have had to give up, but i was willing to finance IVF for me, convince my wife to carry the baby, take out loans for adoption, done foster-to-adopt if it came to that, whatever the journey was. when i was convinced i would never get pregnant, i said many times that i wasnt sure if i really wanted to have a kid at all. it was a self-defense mechanism against my enormous disappointment in the process and my body. 


i tracked my cycles at home for years and we searched for a known donor at the same time. neither was successful. my cycles were so irregular, i could never have picked a day to order sperm. after years of trying to make the DIY method work for us, we decided to go to a fertility clinic. we chose a clinic that was budget-minded. our initial consultation was maybe $150. we paid for all of the testing, frozen sperm and the entire first year of trying out of pocket. many insurance plans will cover clomid & lab work even if they dont cover any fertility stuff. clomid cost like $12 with my plan. when clomid didn't work, we took months off, i started metformin (also cheap! and can be really useful for people with PCOS!) and we saved money. my insurance changed and they started covering some part of the monitoring. we switched to injectable meds ($$$$). i got pregnant on the second cycle. i am so much poorer, but there was never a point where i could imagine life without a baby, so there was never a point where i could give up. im really grateful that it happened when it did, so i wouldnt have to call my own bluff! 


i would suggest a lot of communication, like others have mentioned. think about your finances in creative ways. see if you can get help from a regular gyno or other women's health provider that might be billed to your insurance in a way that they would cover it. it's great news that you have a donor who has good SA results! and now that i am holding the world's best babies, i realize that THESE are the babies im supposed to have, and if i had gotten pregnant earlier, well, it would have been the wrong baby. 

post #9 of 13
We agreed to try 3 times naturally, without medications. I was 36 at the time. That didn't work so we moved on to Clomid for 3 tries. I got pregnant and miscarried early on the third round. Knowing that I did get pregnant was encouraging so we kept going. We tried Femara and them moved onto Femara with injectable meds. I got pregnant on the 3rd round with these meds. It was our 9th try. If I hadn't gotten pregnant that time, DW wanted to discuss other options. We couldn't afford IVF but I would have done it if I could have. DW felt differently. It was important to me to be pregnant so that was our priority. I had coverage for 50% of fertility treatments but no IVF coverage. 9 tries is a lot when you are paying for sperm and meds, but if the swimmers are free, that's not so bad. If you look at the statistics, an average healthy woman has a 20% chance of getting pregnant each cycle. According to this link--http://www.babymed.com/getting-pregnant/how-long-does-it-take-get-pregnant --this is how long it takes to get pregnant.

About 50% of healthy couples get pregnant after 4-5 months
70% get pregnant after 9 months
85% get pregnant after one year.

If you've been trying for one year but not every cycle, you may not be that far off from normal. It may just take more time. It's the emotional aspects you need to consider. Trying and getting BFN's over and over is tough. Does your DW have a flexible spending account? That can be used for treatment and medical expenses are tax deductible if they reach a certain percentage of your income. Has DW talked to her insurance company? Some plans cover diagnostic testing but not treatment for fertility. So you may be able to do testing to see what's going on without a big expense and then you could consider what to do. As Tigers said, Clomid and Femara are pretty cheap. It's the monitoriing that's expensive. You could still do the insems yourself. You may have to because usually doctors can only do insems with sperm if it is from a sexual partner or spouse. Since you are paying out of pocket, an RE may give you a deal. You could ask them about paying cash. They will often charge less for cash patients because they don't have to deal with insurance companies. I wish you all the best in whatever you decide to do. When it's all said and done, it's worth it. You don't think about the expense and treatments when you are holding your baby.
post #10 of 13
Agree with all of this, and also hope I didn't sound flip about the costs involved. We were lucky to have some insurance coverage this time around, but I had none with my first pregnancy, and was living on a grad student stipend. I took out a student loan to buy sperm! And I don't regret it at all, because my kids are all so incredibly perfect.
post #11 of 13
For our first pregnancy, DW carrying, we tried at home for three years. We did a couple of cycles of black market clomid that didnt help at all. We did a few cycles of progesterone cream which did actually help I think.
It took us a long time. It was really really really hard. DW was absolutely adamant that she didnt want medical assistance. We had just gotten to the point where we couldn't take it anymore and needed to move on. We toured an Ivf place and happened to get pregnant our last ditch cycle at home.

The struggle was extremely hard (and now we've just had a loss while ttc #2, it's hard again), but our daughter is perfect. She's perfect for us, she was worth the wait and the struggle, I couldn't imagine life without her. Remembering those three years is like a tiny blip in time. I've been in grad school for eight years, three years was barely a tiny spec of that. At the time it seemed so massive, but now as we are looking at potentially a long road again for #2 we can remember that pain and the great reward and survive it all.

Being a team is the most important part. Talk to each other. Take a break when you need to, travel, drink, party, whatever you need to do at that moment. It's a long road for all of us, but it's an important journey and destination.
post #12 of 13
Hi, just wanted to chime in as someone with PCOS (and 35 weeks pregnant)! Because of PCOS I went directly to a fertility clinic and asked about my options. At one, my insurance covered diagnostic testing so they used the medical code for that each of the 4x I tried. My insurance had a deductible followed by an 80/20 plan (I pay 20% of bills after deductible met). The only thing not covered that I had to pay out of pocket were the insems (I think $200-250). After 4 unsuccessful tries I switched clinics. The new clinic said I wasn't covered at all because they used a different billing code. I begged them to use the code from the other office and they agreed (they were worried about legal issues so I agreed that if the claims got denied I would pay the full amount). Turns out the code was accepted and I got pregnant on my first attempt at their office. I also paid out of pocket for the insem there.
In terms of finances, we did take a break one month to save. We knew we could never afford IVF (insurance covered none) so we figured we would just do as many iuis as possible If the docs would allow it. Biggest game changers: switching from Clomid to follistim (always using trigger shot) for tries 4 & 5. And switching donors after try 4. Good luck!
post #13 of 13

i'm going to share my experience to tell you what came up in my head while reading your post.  i have PCOS and only found out when we were doing our pre-ttc testing with our first RE.  up until then, i had always assumed i would carry my children, or at least one of them.  since my partner is older than i am by 6 years, she "went first" so to speak, and because we didn't have a KD and sperm was a whopping $705 per vial plus shipping and storage fees, we decided that each month was already expensive, so why not do everything possible to up our chances.  which meant doing each insem through an RE, using a trigger from the first try, clomid from the second, and progesterone from the 3rd.  we got pregnant on the fourth, and so far so good.  i am a grad student who depleted a $10k savings account for sperm and insems, lady has great healthcare with really homophobic (and anti-single mother too btw) rules, so we would only get coverage for up to $20k of IVF (which varied from covering 2 cycles to all but $4-6k of 1 based on which RE practice we asked) once we paid for "six failed IUIs through an RE."  we also didn't know that until the month of our first insem.  so this whole process has been finding out totally game changing information and just trying to adapt, because the end goal was the most important thing.  we knew we would do whatever it took to have children, starting with ttc, then going into adoption/foster/other options, but having a bio baby was our first choice, so we invested in it.  heavily.  money is a LOT tighter than it used to be, but like someone above said, think about a month of day care.  depending on where you live, that's $1200, so our insems, which cost sperm plus $700-$900 plus meds (triggers were $90 and clomid was $10, i believe) were more than that, but not absurdly so and just for four months.  at the time, it felt like we were insemming and failing forever, but now i realize how incredibly fast that was.  [oh no i just heard my cat puke in the other room.  can't wait til our lives are filled with even more spit ups and vomits to clean...! but i digress] so i guess what i'm saying with all of this is, a) keep checking in and evaluating your "for the time being" plan based on the information and motivation you both have at each point.  it can change, but do your best to stay on the same page not only about finances and trying, but also backup plans and time limits.  and even if you say "3 more months and that's it" or whatever, check in AGAIN at the end of those 3 months, because maybe you've changed your minds.  b) things just dont' happen the way you plan.  they really don't.  and if you move forward with ttc, there will almost certainly be more surprises and shake ups ahead.  but for something you want, that's going to feel unsettling but also perfect.  like i said, i always imagined carrying my child and having savings for that child's LIFE, not just its conception, but i'm just happy to be on this ride, you know?  my experiences with this process have just taught me to reprioritize from time to time, and to revise my vision of what this was going to be like.  and to roll with the punches so long as we both think it's worth it.  good luck with figuring out your next steps.

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