At Any Price

As some of you might be aware, this year has already shown itself to be a challenge for us. In January I was hospitalized with near liver failure due to an adverse reaction to a medication. The reason behind my change in medication some of you may not however know.

Since our marriage in 2009, my husband and I have been trying to conceive. For over two and a half years we tried and last November when I saw my nephrologist (my doctor who oversees the care of my Lupus) he stressed to me that time was at a premium and that my opportunity to carry a baby to term was severely limited due to my age and the poor state of my kidneys. He repeatedly stressed to us that pregnancy for even the healthiest women is very strenuous on the body, the kidneys in particular, and that as someone with essentially only 80% of one kidney function, it would be extremely difficult for me. Compounded with my age, the Lupus would make any pregnancy I had very high risk and (as my OB/GYN explained) would likely mean strict bed-rest for the greater majority.

But this news was moot to us! All my life, the one thing I wished for more than anything else was to be a mommy. Twelve years of searching for the man of my dreams, eighteen years of babysitting, and three nanny jobs later, I came to the point where babies were surely in my future. But, for some reason, it just wasn't happening. Discouraged at another "nope, not this month" and pressured by my nephrologist's repeated stress on the "this year or no year at all" point, I sank into dark depression. I didn't understand why the one thing I had wanted above everything else in my life was seemingly beyond my reach.

We contacted our primary care physician who made us wait four months for a referral to see even a basic OB/GYN -- other than my Lupus, the OB/GYN couldn't see why we were having trouble, everything seemed fine. So we were ushered back to the GP just to find out that our insurace denied our request for infertility treatment because we were told I needed to consult a perinatalist first and get an evaluation and genetic screening. At this news I was not only insulted (why should I have to get an evaluation and screening just to determine if I was worthy of fertility treatment?) but angered that yet another two months of my very short time had been wasted by our HMO and poor office practices of our family doctor. It was at this time that my blood pressure medication was switched to a gentler, pregnancy-safe version in the hopes of conception. Ironically, it turns out that although Methyldopa and Nifedipine may be safe for pregnancy they are not safe for Sara and thus I ended up in the hospital with extreme jaundice and near liver failure (I went into the hospital on Methyldopa, was switched to Nifedipine while there, only to find I was highly allergic to both).

Due to the poor care both my husband and I received at the hands of our terrible GP, we switched and found a much better doctor (we now only wait 1 -3 days for a referral as opposed to 6 - 7 months when the office staff feels like getting around to it after the twentieth time we called to complain; HOORAY for good customer service!). When we consulted our new GP about our desire for infertility treatment the FIRST thing he did was turn to my husband and ask "Have you ever been examined for infertility?" It's not that we hadn't considered this but everyone along our long, lonnng, LOOOONNNNNGGG road of medical hoops thus far kept dismissing it due to my medical history. Moments later we left our new doctor's office with lab orders.

Nearly two months down this long road and we were FINALLY sitting across a desk from an infertility doctor. We now have a diagnosis, we now have some idea where we can go from here, yet with every door that opens, it seems more closed doors appear (temporary as we hope them to be). Without too many details, we now know that conceiving naturally is absolutely impossible. We have investigated adoption - with my medical history we could not adopt in the US even if we could afford the fees. Foreign adoption is also seemingly out of reach as again the price is hefty.

So there we stood, at cross-roads unsure which path to pursue. My prayers have been consumed with pleas for guidance, for patience, for a miracle, for a family of our own. I feel I am constantly in a state of prayer. My husband councils me not to "obsess" as he says I am prone to do but this is perhaps the most important choice of our lives, the one thing I have wanted all my life more than any other, and I feel so helpless. I am a pro-active person, I always have to have a plan. I need it to feel safe so I can say "ok, well then if this happens then we will do that." Call it obsessive if you like but it's who I am. But with infertility and our lack of other options (primarily due to monetary reasons), there doesn't seem to be a this or that.

To choose infertility treatment means we will accumulate approximately $20,000 worth of additional debt. Beyond the monetary risks there are several other factors. 1 - The treatments for my husband alone are estimated to START at $5,500. That is merely for treatment, that is not sperm accumulation and preparation, not for doctor's visits or lab work, just the meds. 2 - If the treatment doesn't work, where do we go from there? The idea of using a donor feels...wrong to me (at least right now), maybe when I am out of other options it won't but I somehow doubt it. Our HMO covers pretty much nothing and that is only if they feel the diagnosis fits their incredibly narrow criteria.  3 - If viable sperm is retrieved it will mean automatic IVF (In Vitro Fertilization) because their motility and longevity will be severely compromised and thus "test tube fertilization" will be required. In order to do IVF, I will also have to go through two months or more of pre-treatment that also ranges in the thousands before any attempts at egg retrieval can be made. 4 - The process of egg retrieval (if any viable ova are found), up to two and possibly three cycles of implantation, and (if chemical pregnancy and then true pregnancy occur) through the first six weeks of pregnancy comes with the substantial price tag of just under $14,000. 5 - According to my infertility clinic, I am in the optimal range for infertility treatment. From ages 21 - 35 (I am 33, only a few weeks from my 34th birthday) I have a whopping 66% chance of becoming chemically pregnant and a 52% of IVF translating into a live birth. At the next range (35-40), the odds for chemical pregnancy decline to 35% and live birth to 22%.

With the exception of occasional babysitting, I am unemployed and although I have now applied for several hundreds of jobs in one of the worst areas of one of the worst states in the nation (economically speaking) I cannot find employment. I live in an area where an average of 250 applications is received per position posted, according to a conversation I had with a local head hunter. The term "over qualified" should be outlawed, if you want to work and you meet the requirements for the position it shouldn't matter. My husband is a teacher. We (like so many Americans) are upside-down in our mortgage. We have two car payments (on the bright side, both will be paid off in the next year). We have massive student loan debt from our undergrads to three master’s degrees (collectively). And like nearly all Americans, we are struggling to make it through this modern depression. But I can't wait for the economy to improve; I have less than a year according to my doctors. And so I stand at the end of one path and the verge of another...

And yet, even with statistics and odds fighting against us, I have to try. I must try! As I said, I am a pro-active person and I must feel I have a hand in my own fate even if it is just in that I have exhausted my options. We have chosen to go through with treatment. If it drives us to bankruptcy and yet we still don't get to experience the moment of breathless, overwhelming joy as we hold our own child for the first time at least we will know we tried, that we did everything in our power to do what we could in this modern age of medicine to make our ultimate dream a reality.

I am trying to stay positive. I fight for it every day. I avoid the empty bedrooms in our house, afraid that hopes that they'll one day be occupied by our children will somehow jinx it. As yet another Mother's Day approaches I try to focus on the wonderful mother I was blessed with rather than the fact that I may never be one. I have been pouring over the scriptures, praying for help and guidance, and doing my best to stay focused on the tasks and logistics related to our upcoming treatment. So far this week I have only succumbed to tears three times (the news that I was to be an auntie again didn't really help matters even though I am happy to be). Next week I have promised myself it will be less. Crying will not get me pregnant. Pity will not fill those bedrooms. And, fear and doubt will not slow down our ever-shrinking timeline.

To anyone who is a mom, to anyone who is a dad, to anyone who hopes one day to be either, to anyone who (like us) has wanted more than anything to hold their own child please keep us in your prayers and thoughts.