The cost of IUI and IVF

Apart from wanting to connect with and update family and friends around the world, the main purpose of this website is to connect with LGBTQ+ families who are trying to conceive, and families who are struggling with infertility. Having gone through both intrauterine insemination (IUI) and in vitro fertilisation (IVF) to conceive our little one currently growing in G’s uterus, we know a lot about the process and procedure in Germany. We want to be completely transparent about the process, and more importantly about the costs, because trying to conceive with additional help is expensive! Hopefully this post opens your eyes to our world a little more, and you gain some insight into how much it can cost to conceive a child through IUI and IVF, particularly with no support from the government and health insurance agencies.

Disclaimer: This is our journey, and what you are about to read is what we went through in Berlin, Germany. Other couples in other cities and countries around the world, at different fertility clinics, at home, etc. may go through a similar or completely different process. We hope this post simply helps others to understand what costs might be involved in their process, should they find themselves identifying with two women trying to conceive a baby the unconventional way.

Administration costs: €1800 (plus tax)

We wrongly assumed that the upfront administration costs would cover a lot more than it actually did. We thought the ultrasounds, insemination procedure(s) and use of the equipment were covered in this section, but don’t be fooled by this upfront fee, because it didn’t cover a damn thing. We essentially paid this fee to register with the fertility clinic. It took a huge chunk out of our savings, but without it, we wouldn’t have been able to start the trying to conceive process.

Medical tests: €145.72

These costs were partly covered by our health insurance provider and were necessary before any treatment could begin. They tested for infections, blood type and risk factors, in addition to other important medical type things that I don’t know the translation for!

Sperm and sperm preparation for IUI treatment: €398.65 for the first three tries, and €410.55 for the following four tries. A total of €2838.15 was spent on sperm!

Doing the calculations now, I can’t believe we spent this much on sperm. And this was only for the IUI treatment!

Fertility clinic services for IUI treatment: €1982.10 for all seven tries

The cost of the services included each and every ultrasound, phone call, piece of advice given, check-up, vaginal treatment, insemination procedure, test tube used, blood test, acupuncture treatment, and the list goes on. Basically, every time they touch, talk or look at you, you have to pay. This was difficult to get used to at first, because we really couldn’t believe a lot of this wasn’t included in the administration fees, but in the end, it mostly made sense. The staff at our fertility clinic were always wiling to explain each invoice and what each part of the invoice meant.

Medication for IUI treatment: Approximately €355.65

The medication for the IUI treatment included many rounds of the injection that initiates ovulation (Brevactid), and hormone tablets such as progesterone and oestrogen. It’s hard to say exactly how much we spent, as we didn’t keep all the receipts.

Medication for IVF treatment: €619.73

Before the egg retrieval procedure could take place, G had to be injected with a fertility drug every day for 10 days in a row, which then allowed her body to produce more follicles and therefore eggs before ovulation. In addition, to ensure that her body didn’t dispose of those extra eggs, she had to use a nasal spray to counteract the use of the fertility drug. Brevactid was also necessary again, as was the use of hormone tablets.

Anaesthesia for egg retrieval procedure: €294.47

This basically covered the costs of having an anaesthesiologist present and working during G’s egg retrieval procedure.

Sperm for IVF treatment: €410.55

We had to fertilise those eggs somehow!

IVF treatment: €2462.02 for two cycles

The cost of the IVF treatment was steep. It included monitoring of G’s eggs through to fertilisation, follicle treatment, sperm preparation for IVF, acupuncture and the embryo transfers. Again, basically everything was billed to our invoice!

Cryopreservation: €600

After the egg retrieval procedure, we were able to freeze one fertilised egg ready for G’s second cycle should the first one be unsuccessful. This fee covered the cost of freezing that last fertilised egg (which would go on to be our little one currently in G’s uterus) for 6 months.

Sperm reservation for P: €297.50

With G now pregnant, we had to look to the future and reserve the same sperm for when I finally start trying to conceive. We want our children to be biologically related, so in case our sperm donor stops donating sperm, we had to reserve a batch for then.

FINAL TOTAL OF ALL COSTS: Approximately €11,805.89

We could not have afforded this without the support of our wonderful parents. G’s parents lent us money, and my parents paid for part of our holiday to the Philippines. We are so grateful to them.

Hopefully this post has given you some insight into the financial costs of trying to conceive a child in a same-sex family. This is actually the first time we calculated all the costs, and to be honest, it is quite overwhelming to think we spent so much money on this process. It wasn’t easy, and we did have struggles along the way, but we were both determined and stubborn as hell. We were not willing to give up on starting a family.

Thank you for all your love and support.

Decision to do IVF

A lot of people ask us how we got pregnant (because, you know, two women can’t make a baby without some form of help just yet), and I am always incredibly proud to say that it was through IVF. Unfortunately, there is still a lot of stigma attached to IVF and I honestly don’t know why. Is it because of ignorance? Religion? Cost? The process is absolutely amazing, and allows women to fulfil their dream of carrying a child. It puzzles me how often women are quick to judge and comment on another woman’s choice to do whatever the heck she wants. Why aren’t we praising each other and lifting each other up? Aren’t there already enough people out there who want to put us down? Why do we go and do that to our fellow sisters?

The view from our Fertility Clinic

But… I digress. Our decision to undergo IVF was an easy, yet difficult one to make. There were many factors in the decision-making process, but ultimately, it was the next (and last) option for us.

During our Summer holidays in 2016, we tried three cycles of IUI. It was the perfect time to just try as often as possible, because “G” was super relaxed and we didn’t have to worry about taking time off work or stressing about how to ovulate at the right time outside of working hours. During our sixth unsuccessful insemination, our regular fertility doctor was on holidays, so “G” met with his colleague. She immediately asked “G” why we were still trying with the IUI process and not taking the IVF route or even switching utero to ME! We were actually quite shocked by this, as despite “G” being 37,  she has always been really healthy and way above average, medically speaking. IVF simply wasn’t on our radar, and the later thought was downright rude.

** Quick side note on why we both think the switching uterus comment is rude. Quite a lot of people asked us why we didn’t switch to me, or when we would decide to switch to me, or even simply suggested switching to me, because clearly everyone else knows best. I know our friends and family were not intending to be rude, and probably didn’t think twice about the comments, but for us, these comments really hurt. If it was a heterosexual couple, would you suggest switching to someone else’s uterus so quickly? “G” wanted to get pregnant first, and I totally and 100% supported her in this. My time will definitely come. We weren’t going to give up so quickly, especially since we hadn’t tried everything.

After our seventh unsuccessful insemination attempt, we decided to weigh up our options and talk more about IVF. “G” and I weren’t in a good place, and our relationship was under strain. I certainly didn’t feel like we were connecting, and “G” was feeling 10 times worse than me. Imagine feeling like your uterus is failing every time a big fat negative appears on a test, or when your period comes. On the outside, we projected the image of a happy couple, but deep down, we were devastated. We both hated the thought of going out, so we’d spend days at home, wallowing in our despair. This probably wasn’t the best thing to do, but at the time, it felt like it was the only thing we could do to cope.

Our regular fertility doctor supported our decision to try something new, so we continued down this path. Up until this point, we had done everything naturally, with no additional hormones or medication. “G” was physically fit, so our fertility doctor didn’t suggest anything different. In fact, he was always super positive and happy. Seriously, the guy whistled every time “G” opened her legs.

The stirrups

Although we were both extremely crushed at the time, we had to keep thinking about the fact that seven failed cycles was actually not a bad statistic at all. It can take couples years to conceive a child without any assistance, so we needed to stay positive. Easier said than done.

We had a few things going against us that required us to speed up the trying to conceive process. The biggest factor that we had to consider was finances. IUI and IVF aren’t cheap options; sperm costs money, the procedures cost money. Everything that touches and doesn’t touch you, costs money. We are extremely grateful and fortunate to live in Germany, as the costs are much cheaper than in the UK, US and Australia, but they are still steep. We had to budget and save constantly.

We didn’t want to keep paying for IUI attempts when the probability of getting pregnant was much lower than the success rate of IVF treatment. Each IUI had a 13% chance of success as opposed to 40-50% with IVF. The switch to IVF was a no-brainer at this point.

So, after that Summer, we took a couple of months to regroup and get back on our feet before starting the IVF process. It wasn’t always easy, and we fought and cried and hugged each other a lot, but ultimately, we both wanted the same thing, so we kept going.

 

TWW

 

TWW. What does it stand for? What could it possibly mean? How can this short, three letter abbreviation make a period of our lives feel so endless. Three words.

Two. Week. Wait.

It’s that period after G has ovulated (and for us, after the insemination actually takes place), and before we can actually take a pregnancy test to find out if it worked.

The waiting game is the hardest. It feels like we are constantly waiting. We wait for the beginning of G’s menstruation and start counting the days. We wait for the ultrasound appointment to check G’s follicles. We inject. We wait 32 hours for G’s ovulation and she gets inseminated. We wait a day before G starts taking hormone pills. And if there hasn’t been any sign of blood by the time we’ve waited 14 days since the insemination, we can take a pregnancy test. If it’s a BFN (big fat negative), we start the waiting game again.

I will be thrilled when this waiting game ends, and the 8 month waiting game begins.

Vulnerability

Blood. A thin layer of blood on her underpants was all it took to know that another unsuccessful month passed by.

The waiting was slow and painful. We questioned every symptom and change in her body and mood, wishing and hoping that this was the month it was going to work. Two weeks isn’t really a long time, but when you spend two weeks of every month just waiting for a sign of blood, or better yet, no sign of blood, it can feel like an eternity.

We started the process of intrauterine insemination 8 months ago, and it has been an exhilarating, but completely gut-wrenching journey. The worst part of it all is that it still isn’t over, and we have no idea when this emotional rollercoaster is going to end.

The process is meticulous and always timed to perfection. If it isn’t timed and controlled, we would be disadvantaging ourselves, and we want to give ourselves the best possible outcome.

Intrauterine insemination is relatively simple. It’s like having sex without the thrill and excitement of actually having sex. The simplified version goes like this – each month, my wife sits in a chair, and sperm is released into her uterus through a catheter. In order for our doctor to know exactly when to do this, and to leave no room for error, we have to control the release of my wife’s eggs. To do this, I inject my wife in the stomach with a drug that stimulates the ovulation. The doctor, now knowing the exact time of ovulation, is then able to perform the insemination at a specific time.

Our last try was particularly difficult for us. As two full-time employees, it’s rare that we are able to get an appointment outside of working hours, and rarer that we are both able get time off work to be at the “having sex without really having sex” appointment. This time was different. We were given an appointment after working-hours and I could actually be there in the room.

On insemination day, we walked into the medical room together, and made ourselves comfortable – my wife in the stirrups, with me beside her, an arms-length distance separating us. Our doctor followed shortly afterwards with a nurse, and they began preparing for the procedure. My wife was so nervous even though she had been through this process before, but I couldn’t contain my excitement. An awkward silence filled the room as the long catheter became visible.

Our doctor inserted the catheter, and I looked towards my wife to see the expression on her face. She describes the feeling as being uncomfortable, but not painful. I guess it’s nothing like having sex after all.

Suddenly, our doctor starts talking and I’m too busy looking at my wife to notice what he’s saying. I ask him to repeat what he just said, and he asks if I would like to do the honour of releasing the sperm into my wife’s uterus. I am so surprised and excited about actually being part of the process that I immediately jump up to push the syringe before my wife can utter a word.

After the short procedure, we are given some time alone in the room, and my wife sits in the same position for 15 minutes. During these 15 minutes, we laugh about the whole experience, and this positive feeling overwhelms me and I truly believe that this time it’s going to work.

Two-weeks of wishing and hoping later, and blood appears.

At this moment in time, my heart is breaking. It’s breaking for my wife who puts her body through this every month and has to face disappoint each and every time. It’s breaking for our future baby who hasn’t even been conceived yet. But more selfishly, my heart is breaking because I honestly don’t know what to do or how I can help anymore. My hopes that have been building up for two weeks, imagining what it would be like for us to be expecting our first child, come crashing down in an instant.

I try to understand, but I really can’t understand what it’s like for my wife to go through this every month. It’s her body and her emotions that are constantly under pressure. Is it selfish for me to also feel sorry for myself?

Where do we go from here? Do we just move forward and forget the past disappointments? It’s so cliché, but what other choice do we have?

Taking the plunge

I live in Berlin, the capital city of Germany. It’s a city rich full of culture, politics, media and science, and I love it. Berlin is a place where history meets the modern world in such a cool and diverse way, making it a sought-after living and holiday destination for many in the LGBTQ+ community. This past vs. present discord complements the city and is one of the reasons that drew my wife and I to live here; however trying to start a family in this big cosmopolitan has its difficulties and is certainly testing my ability to live in a bureaucratic society.

Over a year ago, my wife and I decided to make this baby thing real. We booked an appointment at one of the bilingual fertility clinics in Berlin Mitte to talk about our options and the process of how two women can make a baby. Now, we’re not stupid, and we know that science hasn’t progressed far enough for two women to make a baby without the help of a man yet (I’m not-so-secretly waiting for that day to hurry up and happen though!), but we just wanted to hear about intrauterine insemination from a professional, rather than read through the copious amounts of literature that is available on the Internet. Sometimes, there can be an excessive amount of information that it is simply too overwhelming to digest.

At the appointment, the doctor explained the process of insemination and how to proceed from here, but before anything could begin, there were a number of hurdles we had to overcome to get to that point. Germany can be very bureaucratic at the best of times, but finding out that we had to be married before we could begin insemination really slowed the process down and got me thinking about the many things the LGBTQ+ community have to overcome to just live their lives as normal citizens of the world. Straight couples don’t need to prove that they are married before they try to conceive a baby. Heck, it happens by accident a lot of the time! Why should we, two women in a committed relationship, be asked to sign a paper so that our relationship is formally and legally recognised by the government before we have a baby? At the time of our initial appointment, my wife and I weren’t married, but we had discussed getting married in a couple of years or so. This was something we wanted to do on our terms though, not because it was an “obstacle” in the way to starting a family.

Of course there may be legal disputes and issues should two people of the same sex who aren’t married and who have a baby split up, but is it really any different to two people of the opposite sex doing the same thing? Aren’t there just as many difficulties? Although our future child may not have my DNA, of course I am going to love him or her just as much as my wife, who will be biologically related to them, will.

If two people who are committed to one another bring up and nurture a child from birth, or at any age for that matter, even if they aren’t the biological parents, isn’t that all that matters? As a parent, you take on one of the toughest jobs in the world. You are responsible for another human being 24/7 until the day you die, and it’s essentially unpaid, but at the end of the day there is this earth-shattering and all-consuming love that makes it all worthwhile. Should two people in a relationship decide to part ways, I would hope that as human beings, we are compassionate enough to realise that love trumps biology, no matter how hard the separation might be on the two adults. It isn’t a piece of paper and marriage that defines parenting and love!

Despite this, my wife and I decided to tie the knot shortly after this revelation, but in a very discrete and low key way, with just the two of us, a celebrant and a translator (because my German is still shocking despite the fact that I am now married to one). We still want to have a celebration and a wedding one day, but we didn’t want this piece of paper to stop us from trying to start a family.

It dawns on me now that governments, and even everyday people, don’t realise the struggles of the LGBTQ+ community very well, and that often we have to go through a very obsolete process for the sake of being able to carry out something that appears to be menial and basic to others. I hope that equality comes in the form of something more than same-sex marriage soon, because it simply isn’t enough.