Tina and James Nessl adore their 7-month-old daughter, Victoria Giselle. She’s outgoing like her parents and they rush home from work to see her every day.
Their bubbly baby is very different from how they first met their child: a cluster of cells, an embryo about to be implanted in Tina’s body. In 2009, Tina was 35 and having difficulty getting pregnant when she sought infertility help.
About one-third of couples in which the woman is older than 35 years have fertility problems, and are turning to infertility treatments, according to the Centers for Disease Control and Prevention. The treatments vary in cost, invasiveness and success in becoming pregnant and having a child.
“At the end of the day it’s the best money you’ll ever spend because having a child is the most wonderful thing a couple can do. It’s bringing your love to life,” she said.
The couple wanted to have a family together and tried for four years, after they married in 2005. But medical complications got in the way, as Tina takes medications to combat multiple sclerosis. In 2009, at 35, Tina visited an infertility clinic. “We were realizing we were getting older and we had to do something. We didn’t have time on our side and we really wanted to have a child,” she said.
At the Fertility & IVF Center of Miami, they tried two unsuccessful rounds of intrauterine insemination, costing $1,500 each round. Then they turned to the more aggressive and more expensive in vitro fertilization. Their plan, including medications, cost about $17,640. The doctors couldn’t diagnose why the couple couldn’t get pregnant on their own.
Dr. Bernard Cantor, a professor and infertility expert at Florida International University College of Medicine, said the most common cause of infertility is the woman is not ovulating regularly, or at all. In an infertility evaluation, Cantor will review the three things needed for pregnancy: sperm quality, egg quality and any impediment for the sperm and egg to meet in the fallopian tube, like blockage from a prior infection. He will also look for medical conditions that can impact ovulation, like a thyroid problem or polycystic ovarian syndrome with associated insulin resistance and possible diabetes. Other factors, like being overweight and smoking, can reduce a woman’s chances of conceiving.
Most insurance companies will cover diagnostic testing for infertility but will generally not cover the infertility treatment. In Florida, unlike states like Massachusetts, insurance companies are not mandated to cover IVF.
There are five main options that are usually recommended to couples, depending on what doctors believe is causing their infertility:
• Oral medication, such as clomid and serophene, to improve ovulation. This can cost about $300 per cycle.
• Injections of hormones — gonadotropins — that can stimulate eggs to grow in the ovary and ovulate.
• Surgery to remove scar tissue in the woman’s fallopian tubes, where eggs must travel, but which can become blocked or scarred by pelvic infections, previous surgeries or endometriosis, an overgrowth of the tissue lining the uterus.
• Intrauterine insemination, in which the sperm is placed in the uterus during ovulation. This reduces the distance the sperm has to travel.