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Past Article of the Month Originally Published 09/03/2008
The Financial Challenges of Infertility: How to Understand and Cope

Infertility treatment entails many challenges, all of which add to the trauma of the experience. A major stressor that many couples describe is the financial burden that treatment demands. There are several difficult aspects to this issue, which will be discussed in this article: 1) For many couples, the financial demands of using assisted reproductive technology can be deal-breakers. Even those who can afford it may balk at the enormous expense that is coupled with an uncertain outcome. 2) Couples dont always agree on how much money should be spent, or on what. 3) Infertility treatment forces couples to confront what they may perceive as ethical or moral dilemmas associated with the exchange of money for donor eggs or sperm, or for adoption. Even if such arrangements are clearly fees for the service provided by the agency, many people still experience it as buying a baby, or they worry that others will view it that way. Lets look at these issues more closely. The cost of infertility treatment can go into the tens of thousands of dollars. People who undergo multiple procedures may spend well over $100,000 trying to become pregnant. Couples often put off making important purchases, such as buying a house or car because they feel they must save all of their money for treatment. This adds to the sense that they are suspending their lives, or are perpetually on hold. Further, the financial burden can actually shape treatment planning. Couples often spend so much on medical treatment, that they are then unable to afford donors or surrogates or adoption. It can be heartbreaking to be forced to make such decisions, especially to have to stop treatment or be unable to afford adoption, due to economic limitations. It only adds to the sense of deprivation and the unfairness of it all. If a couple must stop treatment or be unable to pursue other avenues due to financial constraints, this is another major loss that must be grieved, in addition to the many other losses that make infertility so traumatic. Finally, couples do not always agree on how much money to spend in the quest to become parents. Often, resentment builds when one spouse claims they cannot afford a procedure, but then is willing to spend money on something else. Control struggles often erupt, perhaps focused on small decisions (what dining room chairs to buy, or where to go for dinner), which can be very confusing to couples who previously felt quite compatible. It is important to understand that these control struggles over everyday decisions often mask or represent the larger and deeper disagreement about the cost of treatment or how to proceed with treatment. All of these issues add to the trauma of infertility and make the rewriting of the reproductive story more difficult. But it is important for couples to understand that these are issues that can be discussed and resolved. One thing they should be aware of is that couples often have different attitudes and feelings about money. When infertility hits, it intensifies the differences. For example, some people view money as a finite entity; even if they have an income, it might run out. Perhaps they grew up poor, or had parents who worried a lot about finances. Others may feel more generally confident about money, that somehow well have the money when we need it. They spend more freely, with less anxiety. If couples can understand each others attitudes and where they come from, they can address their concerns with empathy rather than viewing them as obstacles. It is also important to put the treatment expenses in a context. Infertility treatment is not unlike other investments, with a certain degree of risk. At the milder end, for example, a person may choose to spend money on an expensive vacation, taking a risk on whether they will like the place they choose. As another example, people often go to college, spend several years in a major and then decide to change majors. Does that mean that the courses they took earlier were a waste? Does it make the extra tuition needed to pursue ones dreams, not worthwhile? No, of course not, it is all part of lifes journey. There are many financial decisions people make that involve some risk, but the risk is considered worth it. Infertility treatment may be viewed in a similar context. It is an investment in your future, and any investment involves risk. It is up to each couple to determine their risk tolerance and make their decisions in part based on that. The moral and ethical meaning that some people associate with treatment must also be addressed when making financial decisions. Although people may know intellectually that medical treatment, including donor or surrogate technology, costs money, emotionally, it can be hard not to view it as buying a baby. Adoption, which used to evoke feelings of altruism and humanitarianism, has become so expensive, that it too, takes on a different quality; having to use an attorney, and pay large amounts of money, being chosen by a birth mother, all of it can lend an uncomfortable mercenary feel to the process. It is important to reflect deeply on where these attitudes come from. Sometimes, they reflect a sense of shame and guilt. People may feel that they dont deserve a baby, or that they should adopt, when what they really want to do is use a donor. It is essential that people work these issues through so that they can make the very best reproductive decisions that they can. * Back
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