Would you invest $100,000 of your life savings with a 50% to 75% chance of losing your money and receiving zero return?
Provinces will pay to investigate infertility and perform some surgeries; but few pay for treatments. What if the return was a life? How much would you spend for the chance to have a child? What is it worth to you to expand your family? Thousands of Canadian couples are faced with this dilemma — an estimated 11.5% to 15.7% of couples face infertility, notes a 2012 Vanier Institute of the Family report — and the compulsion to gamble everything is great, given the reward. Infertility doesn’t discriminate. It often arrives unannounced, leaving couples unprepared for the hefty financial implications. To pay for fertility treatments, people take out second mortgages on their homes. They clean out their savings.
Depending on where you live, a single course of IVF (in vitro fertilization) costs $4,500 to $8,000, plus $2,000 to $7,000 for required medication. (A portion of the fees may be covered by extended medical insurance or provincial health care plans.) Donor sperm costs $3,000 to $4,500 for six inseminations. It is illegal to pay for donor eggs in Canada; but to get one from the U.S. might be as much as $20,000. Commercial surrogacy is outlawed in Canada; but parents are willing to pay as much as $100,000 to have a baby via a surrogate in the U.S.
“It’s so scary. In my head, I was thinking, ‘I would spend any amount of money,’” said Amira Posner, a 36-year-old Toronto social worker. She and her husband spent $18,000 on IVF treatments and after two years, her twins were born in 2010.
“Because you’re so caught in it, it’s hard to think clearly. You want something so bad and it’s hard to put a money label on something that is so organic.”
It may be hard; but the fact remains that there is an associated price tag. And what if you don’t have the available funds? Do you wait until you’ve saved enough, knowing that with every year that passes, your chances of conceiving drop?
In the summer of 2011, Ashley and Jeff Coull visited a fertility specialist in Victoria. In an office, surrounded by photos of babies, Ashley was told that she had diminished ovarian reserve. “I have the eggs of the woman who is going through menopause,” Ms. Coull, 30, said.
To retrieve her eggs for in vitro fertilization, it would cost $5,500, not including medication, the doctor told her. “I was shocked. I thought, ‘Where the hell are we going to get this money?’ We had bought a house three years earlier and we were just making it.”
They borrowed money from her parents. They maxed out their credit cards and paid them off with their line of credit. They rented out their basement to international students. They cut back on spending. They spent six months driving together to and from work when Mr. Coull’s vehicle broke down. As a further burden, Ms. Coull took a two-month stress leave from her job at B.C.’s Ministry of Children and Family Development and received 75% of her wages.
“I remember thinking a lot of times, hearing friends say that they’re going on vacation, I would’ve loved to be on a nice beach with my husband and not dreading the first of the month when we had to pay the bills.”
After five rounds of IVF, medication, acupuncture, therapy and fees for freezing embryos, it cost the Coulls $23,000. At 1:15 a.m. on Jan. 20, 2013, their son, Jackson was born.
The Coulls are still about $10,000 in debt.
“I would do it a million times over. I’d find a way. I’d sell my house. I’d beg, plead, borrow, steal,” she said, her voice breaking.
“You’re going to feel like you can’t pour another cent into it. When you go to the doctor and you know you have to pay another $1,000 for medication and it’s going to leave your bank account at zero, and you’re not going to be able to buy dinner and you’re going to have to have macaroni again — we ate so much macaroni — it’s worth every penny.”
But is it worth every penny because the Coulls have Jackson? What if the treatments didn’t work? There is no guarantee. IVF has a success rate of 47% for women under 35 and drops to 25% for those 41 and 42, according to Mount Sinai Hospital in Toronto.
In Canada in 2010, there were 11,806 IVF and intra-cytoplasmic sperm injection of eggs cycles performed, and about 3,200 babies born as a result, said Dr. Timothy Rowe, head of the reproductive endocrinology and infertility division at the University of B.C.
“Everything about it makes you feel irresponsible,” Kyle Adamo, a 37-year-old project manager at a Toronto design firm, said.
Adamo and his wife Melissa Martin who is also 37, cleaned out $24,000 worth of savings on fertility treatments; they spent $13,500 for one cycle of IVF, including drug costs; but it was not successful and they decided not to repeat it. They then opted for six intrauterine insemination (IUI) treatments at a total cost of $2,400.
“It’s a vicious spiral. You could spend thousands upon thousands of dollars and still not have what you want,” Ms. Martin said. “That would be even more heartbreaking. You’d feel robbed and you’d feel empty.”
On a recent afternoon, the couple waited for the fertility clinic to call with the results of their last IUI treatment. She sat on the couch, checking her cellphone every few minutes.
The two are affable and easy-going; Mr. Adamo’s face at rest is serious, whereas, Ms. Martin’s is expressive, always grinning or laughing. In the dining area, a photo from their wedding three years ago shows Ms. Martin’s niece flashing the photographer in the middle of the ceremony.
“If it doesn’t happen in 2013, that’s it. We’ll be great aunts and uncles. We’ll spoil everyone we know,” she said. “I regret spending $13,500. I regret not getting pregnant. But at the same time, I had to try for my own peace of mind.
“What’s the cost of a family, a life, love? But you’ve got to think that there’s no guarantee. You can’t mess with your life financially for that.”
The nurse finally called at 3:49 p.m. Ms. Martin accepted the news, her eyes closed, her chin dimpled with emotion. She broke into a grin.
“This is awesome, thanks!” she said before hanging up. Mr. Adamo hugged her, tears in his eyes. They then separated and gave each other a high five.
Their baby is due in April 2014.
Melissa Martin and Kyle Adamo’s expenses from 27 months of trying to conceive
$13,500: IVF (including $6,500 cycle fee, $1,400 for intracytoplasmic sperm injection (ICSI) and drug costs)
$2,400: Six intrauterine insemination procedures
$300: Clomid (ovulation stimulating drug)
$3,000: Gonal F (injectable follicle stimulating drug)
$340: Ovidrel (a drug that assists with ovulation)
$160: Sperm friendly lubricant
$900: Ovulation predictor kits
$599.75: Home pregnancy test
$120: Books and education
$85: Anti-mullerian hormone fertility test to determine your ovarian reserve