NerdWallet's Smart Money Podcast - The Price of Parenthood: In Vitro Fertilization and the Future of Parenthood

Episode Date: June 29, 2023

In vitro Fertilization — or IVF — is an effective way to become pregnant. But is it only for the wealthy?  In this final episode of our Nerdy Deep Dive into the price of parenthood, Sean and Ronita explore IVF and hear from a mother who went through the process.  To send the Nerds your money questions, call or text the Nerd hotline at 901-730-6373 or email [e-mail]. Like what you hear? Please leave us a review and tell a friend.

So you want to have a baby, but it's not happening for you in the traditional way. You have options, but hopefully you also have insurance, especially if you're going for IVF. I knew I had three chances where I would only be paying a copay. And I had in-network coverage, so I had to find, you know, I couldn't just like pick the doctor that was available or nicest or that I felt most comfortable with, it had to be someone on my insurance because otherwise it's like $35,000 if you pay out of pocket for one round. Welcome to NerdWallet's Smart Money Podcast. I'm Sean Piles. And I'm Ronita Chaudhry-Wade.

We're on to the final episode of our nerdy deep dive into the cost of parenthood. We've explored adoption and egg freezing, and today we go full implantation. You got that right, Sean. We are bringing it home with in vitro fertilization or IVF. All right. How common is IVF in this country? So according to the most recent numbers from the Society for Assisted Reproductive Technology, more than 73,000 babies were born via IVF in 2020. And those 73,000 were out of just over 300,000 implantation cycles. Okay. And that's out of just over 300,000 implantation cycles. Okay. And that's out of how many overall births?

So according to the CDC, about 3.6 million. So a small percentage of that, but still a lot of people turning to IVF to have a child. Definitely. And the IVF figures for 2020 were down from the year before. As we've noted in previous episodes, that's likely due to the pandemic. So we're going to take a look at what this process looks like and what it does to your bank account. And speaking of, is there an average cost for this treatment? Honestly, it's almost impossible to find an average.

It's different from state to state. It's different depending on your insurance. It's different depending on the medications you take. And it's different depending on how many cycles you go through. But we'll try to give folks an idea of how much they might need to save for it if they choose this option. All right. And listener, we want to hear what you think, too.

We'd love to get your stories around the decision to have a kid, especially around your finances. Leave us a voicemail or text the Nerd Hotline at 901-730-6373. That's 901-730-NERD or email a voice memo to podcast at nerdwallet.com. And Renita, where do we start today? Well, so last week we heard from Alexa, who had decided to freeze her eggs. And today we're going to hear from someone who's undergone IVF treatment. Her name is Tess. She's 33 and she lives in New York. She's also asked that we not use her last name for privacy reasons. Tess actually has a really interesting history with IVF. I'll let her tell her story. Tess, welcome to Smart Money. Thank you. I'm happy to be here.

We'll kick off the conversation with just asking, you know, when did you know you wanted to be a parent? I think I've always known. I never even considered that to be something I had to decide because it was just like, obviously, I want to have kids. I'm also a teacher. And I kind of knew early on that I'd want to work with children. And that stems from just a lot of kids. And it seems like while there are many teachers that obviously don't have kids, for me, that was one of the reasons I wanted to be a teacher. I just like being around children. Even when I met my husband, it wasn't like, oh, are you someone that wants to have kids? I think he was kind of in the same boat. It was just obviously one of that.

And can you tell us a little bit more about that journey to parenthood? I'm 33 and my parents actually had me through IVF. I didn't sign that out until I was in college. I have an older sister as well. She's two years older, also born through IVF. And it was not done a lot here at the time. And I guess my parents wanted to wait to tell us until we could really understand, you know, in their words, what a miracle it was. I knew that it took my parents a very long time to have kids. It took them 10 years.

But I just didn't know the details or how it ended up working. So I had that information. I knew that it was possible that it could be hard to have kids. I didn't think that I would have that experience. And then my sister, when she was ready to get pregnant, it happened immediately. And I was like, great, this isn't something genetic. I'll get pregnant immediately too and then my husband and I started trying like it was about a year maybe six months before the pandemic started and then like once you know we were not getting pregnant and then everything shut down and it was kind of like okay that we weren't getting pregnant because the thought of getting pregnant during

that time seemed terrifying but also it was a little bit strange that we weren't, I thought. So we went to a doctor and did some tests and they didn't get that much information. They said that I had like a slightly low egg count, but that wouldn't necessarily mean I couldn't get pregnant. And we did a bunch of rounds of IUI. I did get pregnant after the fourth one and had a very early miscarriage. We switched to another doctor. I did more rounds of IUI and then What is IUI? IUI, they basically inject sperm into you. So they kind of like monitor you. It's much less invasive than IVF. Like I had to do one

injection each round rather than like a thousand. And like in retrospect, I should have just probably gone to IVF, but I actually think, I mean, IUI was free for me. It was fully covered. And I think you actually have to do a certain number of them in order to even qualify to do IVF covered by insurance unless you have some glaring diagnosis. I didn't think I would have to do IVF, so I wasn't rushing towards it until our third doctor. She was just like, you should absolutely do IVF. Otherwise, this could take a very long time. And particularly if you want more than one child, which we do, you should start right now with this process. And we started the next month. Okay. Yeah. So what were those factors that went into that decision?

Was that a conversation between you and your husband? After seeing the third doctor, was it something that had already been in your mind? I was learning more about IVF. And also, like I learned, my parents' experience was so different because it was early on. And my mom, you know, they lived in New York. My mom had to like live in Virginia for a few weeks so doctors could do her injections and everything. So I got like an updated lesson about what IVF was. And it seemed, you know, much more manageable than that. And i was eager to just kind of i wanted to do something that you know not only would have a higher chance of getting me pregnant

but also ivf is sort of diagnostic you know they're analyzing like i know exactly how many eggs they took from me i know which ones were good and bad and which ones fertilized. And then they were able to do genetic testing on the embryos. You get so much more information. And then it worked. So what were the other factors that played into that decision? I mean, was the financial, the emotional cost of going through it as well? Yeah, I'm a public school teacher in New York City. My insurance covers three rounds of IVF. And when it says a round, that could be like a retrieval where they take the eggs out and a transfer where they put the embryo back in.

Or that could like just be a retrieval if the transfer doesn't work. I knew I had three chances where I would only be paying a co-pay and I had in-network coverage. I couldn't just pick the doctor that was available or nicest or that I felt most comfortable with. It had to be someone on my insurance because otherwise it's like $35,000 if you pay out of pocket for one round. That's a lot of money. It's a ton of money. And I guess we were lucky. We found a doctor on our insurance. And there are still parts of it that you pay for, like the co-pays or certain... The anesthesia

when I did my retrieval was not covered. And I think that was a couple hundred dollars. But going into it, I didn't know exactly how much it would cost, but I knew that enough was covered that it wouldn't be a massive financial burden. How long was this entire process for you? I think we had our first appointment in February 2021. And then my son was born March 9th, 2022. It was quick because like nine months of that was also a pregnancy. For us, it was once we started IVF, it was like a month of monitoring. And then I had two weeks of injections where I was making all the eggs that they were going to take out. And then they took them out in like,

I think mid-May or something. And then there's this really agonizing process where you're waiting to see like how many of them will fertilize. And then the ones that do fertilize, which will develop into like five-day embryos or six-day or seven days. And then once they have a good number of embryos or like a group of strong embryos or six day or seven days. And then once they have a good number of embryos or like a group of strong embryos, they send them out to a lab for genetic testing. And that took weeks to find out because they won't implant it if it's not genetically strong. So then actually, I remember it was on June 1st, which was our anniversary, is when I got the call from my doctor that like we had some good, viable, genetically strong

embryos. And then I had my transfer where they put one in me on June 21st. Yeah, like two weeks after that is when they were able to determine that I was pregnant. And just to clarify, so you did one round? I did one round of IVF, yes. And in that round, we still have a couple of embryos that we pay for them to be stored frozen. And that's not covered. And that's, you know, it's not cheap. I think it's like $700 a year. And, you know, we're now sort of thinking about another round. How did it affect your work and career? The fact that I was teaching remote and I was able to have my appointments really early in the morning and like sit on a heating pad if I needed to or like take a minute. In the classroom at my job, like you can't just go to the bathroom. You have to find coverage to go to the bathroom or like and you can't just be like, wow, I'm really emotional or like hormonal or in pain from these injections. I need to go cry or ice it or something. But remotely, you can. I was online with my students all day, but there was plenty of time where I could be like, okay, you're going to go do these math problems and we're going to check in in 10 minutes. And then I have time to myself. And I might be in a situation in our next round

where I'm teaching in person and doing this and I'll make it work. And I think I'll be a little less emotional about it because I've done it before. But I mean, I don't know how people do it because you're also like in pain. I mean, I had like a horrible stomach ache for weeks. Also, like I didn't want to go to like baby showers and celebrations of friends pregnancies. I wasn't up for it. And I didn't have to because everything was shut down and no one was doing that. So in some ways, the pandemic made it easier for me.

Right. But, you know, I'm so happy to hear the kind of happy ending that we have. So, yeah. tell us a little bit about your firstborn. Yeah, well, his name is Noah, after my mom's father. I have a picture of the embryo. It's like in my favorites on my phone every now and then we'll look at it. And we're like, how is this the baby that we like made with the doctors? And it was, I think, because I had a hard time getting pregnant, like all through my pregnancy, I like didn't quite believe that I would actually have the baby. And then, you know, of course, I ended up having like an emergency

C-section and everything was fine afterwards. But when that was happening, I was like, yeah, of course, this wasn't going to work like this. This is too good to be true. And then he came out on March 9. And he's wonderful. And I think it is like the absolute best change becoming a parent for us. And it comes with like, we're exhausted. And, you know, after this, I'll go to bed because who knows when he'll wake up. But it's like a dream come true. And I'm just so glad that we had the means and the access and the resources to make him. And Noah is how old now? 14 months old. Lastly, just what advice would you give to someone who's considering IVF? If you think that there's a problem, get to a doctor and do it because it's hard, but it's worth it. And the other thing, and I actually like,

I've been talking to a friend of mine who's going through it now, I think just allowing yourself to feel miserable. It's really hard. It's grueling on your body. And it's terribly depressing when you think you might not be allowed to have a baby. And I think you can skip those baby showers and you can be happy for the people in your lives that are having babies without spending all your time with them because you do need to protect yourself you're very vulnerable and then

to just like believe that it'll work because you know I don't want to sound naive because I'm sure there are situations where it doesn't but like it's an amazing science and very smart people are still working on it and you have to have faith in the science and in your body, you know, and then I guess if it's, if it takes a toll and you need a break, give yourself a break too. That's amazing. I feel like I've learned so much. Thank you so much for sharing your story with us. Thank you for giving me the opportunity to, I'm honored to share it. So Tessa's story is the fourth that we've heard from folks who are working to have children in whatever way is best for them. One through line that I'm hearing from all these experiences, including your own, Renita, is how much the

process of becoming a parent can require folks to be really vulnerable and also ready for a long, complicated journey. But in the end, the trials and heartaches and medical bills are all worth it when folks are finally able to have a kid. And how cool is it that this technology is no longer new, that we're now in our second or third generation of IVF, and that finally the costs and the way to get it done is getting easier? Yeah. So I feel like one of the lessons to take out of Tessa's story is to really know your insurance coverage. It's almost like you're under the gun there. You're covered for three rounds, and beyond that, you're on your own. That's exactly right. And again, it really varies depending on your situation.

So I asked Melissa Ellis to join us again. Listeners may remember we spoke with her last episode about the cost of egg freezing. So we brought her back. Melissa is a founder of Sapphire Wealth Planning in Overland Park, Kansas, and she has numerous clients who have gone through this process. Melissa, thanks for joining us again. Well, thank you for having me. I appreciate it. So last episode, we talked with you about egg freezing, And this episode, we're going to explore IVF. First off, are the costs similar or different between egg freezing and IVF? The procedures and the costs are very, very similar. The added cost to IVF is actually fertilizing the egg, right? So if you are just freezing your eggs, that's a single person can do that on their own without having

a partner. With IVF, you obviously need a partner of some sort, whether it's a sperm donor from a bank or your own partner. So that would be the added cost, but you're right, the procedure is about the same. And so how does it actually work? So there is initial testing. And of course, I'm not a medical professional. I'm a certified financial planner. But I have several different clients who have looked into either egg freezing or IVF to get their family started. We've really explored the whole procedure. And what they have to do first is they do have to take some medications to prepare them for the egg harvesting. Fertility testing has to

be done so that they know that it will be a good viable procedure once it's completed and that they will have viable embryos to implant. And then, of course, there's the actual procedure to implant the eggs to actually get it completed. Let's get to the cost aspect here. What are you typically going to pay for an IVF cycle and what exactly are you paying for? The initial cost, of course, is that testing and medications that might be needed, which will vary from patient to patient, but that's about $5,000 on the preparation side. And then the actual procedure for one cycle, meaning that would be the one collection time of collecting eggs and fertilizing them, that cycle is going to cost around $11,000. If it's being implanted at that point in time,

you have your medical costs ongoing for that pregnancy and childbirth. So that's what you're looking at in total. I know that some couples also do look at IVF plus surrogacy as well, right? Right. And that is going to be a lot more expensive because you have to pay the surrogate and that price is going to vary, right? Depending on the person that you hire to be your surrogate. Right. And so if we do, you know, look at IVF on its own, can we expect insurance coverage? Yeah, that's a great question. I have seen where some companies are helping their people either through IVF or for adoption that they will help subsidize that cost because they want them to be able to have a family. They don't necessarily cover for egg freezing though,

which we talked about last week. And I think that's a really nice thing that they've added in the IBF along with adoption. Are there any other financing options available for patients who can't afford the upfront cost of IVF and they don't have insurance coverage? Right. Of course, you can save money for it. If you have high income, it might be easy to save that pretty quickly. If income is a little bit lower, that might not be possible, right? So then you're looking at different ways to finance. You can always use a home equity line of credit, not the best option because you're putting your house at risk. You could use a personal loan. The interest rate's going to be quite a bit higher, especially now with our current interest rates. And if someone is doing IVF, it's not even just

about doing it once. Often people do more than one cycle of it, correct? Correct. And so you have that added cost each time. A lot of times when the egg is implanted, it's not a viable egg. Well, really it's beyond an egg. At that point, it's an embryo. And if it's not a viable pregnancy, then you have to go through this however many cycles. So you have that added cost for each cycle. Plus there's the emotional toll it takes each time as well. So if you have two treatments, you're paying that full amount twice. Right. And I've talked to people, they've gone three or four cycles. It's taken them that long to end up having a viable pregnancy. That's a lot of money.

I can't help but think, is it a luxury treatment? I would say so, yes, because it's not readily available to someone who doesn't have money, simply because insurance doesn't usually cover the costs. And that's a major decision to go through everything that it takes to complete one IVF cycle, if you think about it. So yeah, I've considered that a luxury purchase. It's something that you really need to consider deeply. I think it needs to go into your financial plan, obviously, so that you plan for at least two cycles, because from what I hear, one cycle isn't usually enough. So you want to plan for two or more just for that extra added dollar cost into your plan

and know that you're able to do everything else you want to do and prioritize it. If having a family is priority, then maybe that takes precedence over purchasing a home or a bigger home, perhaps. And just consider what your life is like with all of that in it. Are you able to do everything that you want to do by adding this large cost into your plan? But I think that's the important key is to have it in your financial plan. Any final advice for patients who are considering IVF? What's the best way to prepare as an individual or as a couple? I think that's something that a couple really needs to have that discussion. Make sure that this is what you want to do, that you've considered the cost, you've considered the emotional risk of it, because what if it

doesn't work and you've put the money into it and it doesn't work for you? That's an emotional side that you have to be able to address. But if you're preparing in advance financially for it, and I think that takes a lot of the stress off, which is probably going to help you have a more successful IVF experience. Melissa Ellis, thank you so much for your help, both this episode and the last. Thanks for being on Smart Money. Well, thank you so much for having me. I appreciate it. This has been quite a journey, Renita, Going through all the various ways to become a parent and all of the associated expenses

makes me think of that cliche, personal finance is personal, but that has really never felt more real to me. Or maybe it's that this whole process is so personal that involving money at all seems almost crass. But for many parents, having cash, good insurance, a generous benefits package from their employer can mean the difference between becoming a parent or not. And it's all really heavy. It absolutely is. I think one thing that became clear through doing this podcast and talking to everyone is that becoming a parent

isn't something that people nowadays take lightly. Everyone we spoke to, whether it was Edgar, Alexa, and Tess, really had deep thoughts on when and how and what kind of parent they wanted to be. And for me, I think that's really special. I mean, we did talk a lot about money and the amount is staggering that you can pay. But for like women in my family, going back to the start of time, no one ever had a choice about when they were going to have kids. Or I had a friend, you know, in high school in the 90s, who identified as LGBTQ, who never thought that he could be in a relationship that was out in the public and consider being a parent. And of course,

things are not perfect in this world and you still require a lot of money and having and raising kids is not easy. But I have to say it does soothe my soul that people are having options that they've never could have considered before. Yeah. Well, I want to thank you, Renita, for putting this series together for us. I really appreciated hearing you and your husband, Jeremy, share your story back in episode one. And I wish you much good luck in your quest to become parents. Thank you.

We'll let Uncle Sean know when we have some news to share. I'm looking forward to it. Until then, we have Mo. Yes. For now, that's all we have for this episode. Do you have a money question of your own? Turn to the nerds and call or text us your questions at 901-730-6373. That's 901-730-NERD.

You can also email us at podcast at nerdwallet.com. Also visit nerdwallet.com slash podcast for more info on this episode. And remember to follow, rate, and review us wherever you're getting this podcast. This episode was produced by Tess Figland and myself, Sean Piles helped with editing, Kim Lowe helped with fact checking, Kaylee Monaghan mixed our audio, and a big thank you to the folks on the NerdWallet copy desk for all their help. Here's our brief disclaimer. We are not financial or investment advisors. This nerdy info is provided for general educational and entertainment purposes and

may not apply to your specific circumstances. And with that said, until next time, turn to the nerds.