Carra discusses the common misconceptions many people have about adoption. An adoptee herself, Carra is an expert in the field with a unique perspective and has great resources for families to help guide you through the adoption process at any stage.
Adoption Insiders! Latest blog from the founder of Fertility Allies
Difficult topic, open forum. Let us know what you think by commenting below.
I’ve been meaning to start a blog in order to provide folks with some free, tactical information about paths to family building. After listening to Donald Trump speak about abortion at the third presidential debate, I was compelled to begin on this topic.
I should begin by saying that, for myself, I do not believe in abortion. Having started out as a radical feminist in college, I come to that decision after three life-changing experiences.
First, I had two abortions. They were necessary (the fetuses has lost heartbeat) and early (both under 10 weeks). They were also crushing. I’ll never forget the room. I’ll never forget the sound. I’ll never forget that hope was vacuumed out of me.
Second, I had two children. They are beautiful and joyous; they are infuriating and unnerving. I can't remember a time in my life when it was any other way. I can’t imagine a non-health related scenario where I wouldn’t be inclined to bring another package of glory & pain into the world, if not for me than for someone else. Why?
Because, third, I’ve spent years working with women and seeing the agony that goes along with even the smallest blip in trying to grow your family. How could I take that away from someone? It is my life’s passion to help families bring the joy of a child into their lives. So many people work so hard at building a family, only to endure so many failures. We live in a global economy; if you have an unwanted pregnancy, there are literally thousands of ways to get connected with an adopting family, often with financial reimbursement for the birth mother's living expenses in the process.
So that’s me. If a healthy, immaculate conception came along, I would not abort. But one thing is so eminently clear after listening to Donald Trump's uneducated rant on abortion - a man who was inches away from being the leader of the free world - and that is: women MUST have the right to choose for themselves. Government does not belong in these decisions. Hillary Clinton put it exactly right when she said this is a personal decision between a woman, her doctor, and her faith.
If you’d like to see an alternative to the alarmist rhetoric that is often trumpeted by the right-to-life crowd, a cogent description of the kinds of things that really happen around a late term abortion can be found here:
Peace and Progress,
(no one will tell you about!)
Freezing your eggs can be an overwhelming and confusing process. It is emotional, intense and time-sensitive. All these elements can make it hard to understand the details and even harder to complete the process without a mistake that ends up costing you some serious cash.
This article offers some simple ways that you can save time and money – and some sanity – while freezing your eggs. Here are tips that I wish someone had shared with me before I ventured into this process.
1. Choose your method: Traditional v. Minimal Stimulation
The goal of traditional egg freezing is to yield as many eggs as possible so that a woman has as many chances as possible for a successful pregnancy. The goal of minimal stimulation – a less publicized and less costly option – is lower egg yield with lower doses of hormones.
A few clinics across the country specialize in minimal stimulation, but it can be hard to save cash because most charge a “consultation fee” of at least $150. The good news is that some clinics offer free 10-minute consultations with Doctors. Sign up for a couple of these before you pay any fees, you may be able to quickly figure out if you are a good candidate for minimal stimulation.
To get the most value from these free consultations, make sure you have your vital personal fertility information available which includes your age, number of children you ideally would like to have, and your hormone fertility panel results (which are 3 numbers that you can get from a simple blood test from your gynecologist -- these are your AMH, FSH and Estradial numbers.
From there, it’s a numbers game. The best fit for you will depend on your ultimate goals. Example: You want two children. A doctor I spoke stated that generally one successful singular pregnancy takes 6-8 eggs. If you want two children, you would need 12-20 eggs. Minimal stimulation generally yields 5-8 eggs, give or take, while traditional stimulation aims for much higher numbers. A woman would need two cycles of minimal stimulation to retrieve the number of eggs likely to ensure two successful pregnancies, and probably one traditional stimulation cycle. If two minimal cycles costs more than one traditional cycle, in this example, a traditional cycle makes sense for you. You get the picture.. !
Conversely, if you just want one child and your panel results meet the necessary requirements, you could save thousands by going the minimal stimulation route.
To get super practical about this, this is what my conversation sounded like:
HOPEFUL ME: Hi Dr. X, thank you so much for taking the time to speak with me. I am a 38-year-old female, I would like to have 2 children and am considering minimal stimulation as an alternative to traditional egg freezing methods both because I am financially minded and because I want the minimal amount of hormone stimulation possible. That said, I am also looking at the big picture and want to ensure I am making the right decision considering my ultimate outcome – which right now for me is 2 littles!
Dr. X: Do you have your fertility panel numbers?
HOPEFUL ME: Why yes, yes I do. They are x,y and z. Can you tell me if you think I would be a good candidate for this method?
BOOM. There it is. You will get an assessment from this Dr. Of course it’s always great to get more than one opinion and of course every professional will have a slightly different opinion. But the point is you can get a lot of information by doing your due diligence at this stage. Take the time, do it, it’s worth it!
2. Get Insured Before You Get Tested (or Pre-Tested)
Find out at your initial consult with the fertility specialist which blood tests are required (this is often called pre-testing), and contact your gynecologist to determine which of these can be done as part of your annual check-up covered by insurance.
Here are some of the most common tests:
1. Hormone Panel. The first step in deciding whether you are a candidate for a successful egg freezing is looking at your hormone panel. This is a test that measures three different indicators of fertility: FSH, AMH and Estradial. Together, they give doctors an idea of how successful the egg-freezing procedure could be and the personalized hormone regiment you may require.
The hormone panel is a simple blood test performed by a gynecologist that is often covered by insurance. Fertility clinics can charge a significant amount for this test, even though they offer the testing there on the spot. Don’t feel pressure! Take your time and assess your options.
2. Genetic Testing. Doctors need blood work for a full genetic testing panel to determine if any genetic abnormalities are present. I was able to get a Circuit Panel test done through my gynecologist at a cost of $99 as part of my regular visit. This test covered everything the fertility Dr. was requesting. The clinic will again probably offer to give you the test right there. I know it is tempting but it will cost you a LOT more money to do it this way.
You can never ask too many questions! Ask the fertility Dr. which genetic tests they need to see and write them down. Then make you’re your gynecologist knows which ones they are and that they are accounted for in the panel. Don’t be afraid to look like an idiot!
3. STD Panel. STD tests are legally required as part of your blood work to proceed with fertility treatments. Many gynecologists conduct these tests annually. The fertility clinics will only accept STD panels that have been done within a year. If you don’t have a recent STD panel, ask your fertility clinic which specific STDs the panel needs to include (as in, literally sit there and make a list in the office), and try to get this testing as part of your regular care through your doctor or through a clinic. Fertility clinics will charge you a fee per STD that’s much more than you would spend at your doctor or a clinic like Planned Parenthood. The fertility clinic that I used charged over $400 for an STD panel, but with a bit of research and preparation, I avoided this cost completely by requesting an updated STD panel with all the required testing.
Two quick notes here:
If the fertility doctor doesn’t know the answer to something – whether it’s which STDs need to be on the panel or which genetic tests they require – ask someone who does know. I was surprised by how much the doctor DID NOT KNOW. But there’s always someone in the office who does know. Don’t be shy about asking to speak with them directly after you talk to the doctor. Also remember that you are the client here and have a right to get all the information you need to make informed decisions.
Finally, always double-check your medical records to ensure everything was sent and received between your Dr.’s. There were several occasions where the staff at the fertility clinic couldn’t find paperwork and thought I didn’t have some of the required testing. When I double-checked my medical records, I found that they had missed the paperwork somehow. Ultimately I hand-delivered my medical records from my gynecologist’s office to the fertility clinic. It was worth it! Before you spend the money getting tests that are "missing," review your records to make sure they are in fact missing.
3. Time Is Money!
The reality of freezing your eggs is that it can be a lengthy process. You have research to do, appointments to make, schedules to consider, tests to have done, money to secure, and on and on. But all that time comes at a cost: as the demand for fertility treatment continues to rise, clinics keep raising their prices. Over the course of a couple of years at the clinic I chose, the price for an egg freezing cycle rose almost $2,000 between my initial consultation and the time I was ready to move forward.
I was able to secure the lower price by requesting—and later demanding—that the clinic honor their initial quote. And I got it in writing. Often, by the time you end up deciding to move forward with this process, it can be months or years. And the price can go up. At your initial consult, try to ensure the fee schedule you get that day will be honored whenever you decide to move forward. Ask a financial or business coordinator at the clinic for a fee schedule on your first visit. Keep in mind that often an “initial consult” is more expensive than a second “office visit,” but if you wait long enough, your second visit will again be considered an initial consult. These timelines are arbitrary and not publicized. Be clear with some good questions, such as:
- How long is this fee schedule good for?
- Do you have any plans to change it in the near future?
- Will you honor this fee schedule that I received today no matter when I end up deciding to move forward or is this subject to change? And if so, when?
- How long do I have to follow up with the doctor after my initial consult before you consider my follow-up meeting another initial consult?
- Does the doctor offer a phone/Skype meeting as an alternative to an in-person meeting that is less expensive for either the initial consult or follow-up visit?
4. Fertility Medications
There are a few good ways to save money here. Since insurance doesn’t cover any of the medications, which are really different varieties of hormones, and they are VERY expensive, it’s helpful to do your due diligence. The first thing you can do is apply for a program that offers discounted medication by up to 30% through pharmacies. IVF Greenlight is an example. (Google it!). Your clinic should give you the paperwork necessary to apply for this program. If they don’t, request it. And if they don’t know about it, tell them about it!
When it comes to your hormone regiment make sure that you request the doctor ONLY PRESCRIBE MEDICATION ON AN AS-NEEDED BASIS. The amount and dosage of your medications will depend on how you react to the hormones among other things. Often it’s unclear at the start how much you will need of each drug. Some doctors prescribe enough of each hormone to cover the entire length of the entire egg freezing process at the beginning. But often women don’t need all the medication they were prescribed, and then are stuck with leftovers. These hormones run $100/mg, so 5-7 units of leftover hormones is a lot of money. You can request that the doctor only prescribe the medication you need as you go along (maybe for the first 5 days, etc.) Remember, you will be monitored every other day with ultrasounds and blood work. There’s ample time for the doctor to amend your medication prescriptions, lower your hormone dose (the less hormones you need, the less money you spend) or prescribe more if needed. There is no shame in letting them know that you are on a budget and want to minimize the chance that you will spend money on doses that you do not need. You cannot return unused medications to the pharmacy for a refund and there is no official program for donating extra meds to those in need either for a fee or for free.
And one quick word on supplements; many fertility clinics prescribe very expensive prenatal supplements to start taking after the initial consult, and during all your “child-bearing years.” These supplements are costly and are essentially the same as over-the-counter prenatal vitamins that can be found at any pharmacy for significantly less. The prescription version can run about $100/bottle, while regular ones run closer to $20. As long as the over-the-counter supplements have the important ingredients, the difference is minimal. Ask your doctor what the most important ingredients are in the prenatal vitamins at your consult (again, sit there with a paper and pen and make a list), do the research, and find a reasonable substitute if you can’t afford the ongoing expense for the many months you should be taking the supplements.
5. ALWAYS Question Billing
PLEASE PLEASE PLEASE question every single bill that you receive from your fertility clinic. After my egg retrieval, I received 3 invoices from the clinic; one for $75, one for $2,100 and one for $150. The invoices were difficult to read and official looking, and they had a time stamp on them, meaning that if I didn’t pay within a certain period of time, I would accrue late penalties. I called the financial department to inquire about the bill and on every single occasion, it was a mistake. I made sure it was noted on my account and documented. Be diligent about the fee schedule and ask questions! You can never be too careful.
Good luck on your egg-freezing journey ladies!!!
Note: The information, content and/or data contained herein is for informational purposes only. The Author does not purport to provide any medical advice on the Site, and the Information should not be so construed or used. Always consult a physician licensed in your state who specializes in fertility treatment before making any medical decisions.