The Question: How much is it?

How much is it? This is one of the most popular questions we receive regarding our fertility treatment. The ranges in prices and options is quite vast for numerous reasons: insurance, location, type of fertility treatment, which cyrobank, etcetera. While we cannot tell you all the different pricing scenarios, we can share about our own.

Here are the factors that influenced our scenario. We elected to do our fertility treatments with Columbia Fertility Associates (CFA), located in Washington, D.C., so we were charged based on the costs they set there. We bought our sperm vials from Fairfax Cyrobank located in Fairfax, Virginia, so again, the costs were based on their prices. We carry federal insurance through Blue Cross Blue Shield. This is as of right now in 2021. Things can change in the future. We will see about that.

What about insurance? Our medical insurance does not qualify fertility treatments and sperm vials as a medical cost to cover. Therefore, we paid for our fertility treatments and sperm vials out of pocket. What insurance did cover was what they considered a qualified medical expense such as: bloodwork, urine tests, HSG (x-ray) testing, and the doctor’s visits (consultation) other than co-pays.

We are sharing an overall summary of CFA’s Ovulation Induction, Intrauterine Insemination (IUI), and Invitro Fertilization global fees. Keep in mind that these costs do not include the cost of the sperm vials. These prices may give you a good understanding of what the costs could look like for you or others. They may slightly differ now since we did our fertility treatments back in Fall 2020.

Type of Fertility TreatmentCost per cycleDetails
Natural Cycle IUI without in-office monitoring$540Unmedicated
Natural Cycle IUI with in-office monitoring$1,080Unmedicated
Medicated IUI Cycle (Option 1)$1,620Medicated with clomiphene citrate (oral tablets) /letrozole
Medicated IUI Cycle (Option 2)$2,160Medicated with clomiphene citrate + FSH with IUI
Medicated IUI Cycle (Option 3)$2,700FSH with IUI (injectables)
In-Vitro Fertilization (IVF) Cycle$18,954Various things are included in this fee such as the egg retrieval, preparation of embryos for transfer, and the transfer itself; however, the cost of the medications and genetic testing are not included in this cost
Fertility Medications for IVF$2,000-6,500These medications are billed directly from the pharmacy of your choice
Approximate Costs of Fertility Treatment

Keep in mind that the summary of costs I shared above does not include all the additional costs such as sperm vials, an orientation (if applicable), anesthesia (if applicable), storage of sperm, freezing of eggs, sperm thaw, lab services, etcetera. These details are provided by your or another person’s respective fertility clinic.

The costs don’t end there; onto the sperm vials! The little “spermies” are an expensive price tag unless one has arranged for a known sperm donor who is donating for free! We purchased our sperm vials from our selected sperm donor via Fairfax Cyrobank.

Maya and I purchased multiple sperm vials for a mind-boggling $1,100 dollars each. We purchased multiple vials because we wished to take our chances on trying to conceive with the same sperm donor. We also wanted to have the possibility of having a same-donor sibling if we had sperm vials leftover.

The costs don’t end there… There are other costs to consider which we listed below with the prices we paid out of pocket. Again, this may vary depending on one’s factors.

WhatCost
Prenatal Vitamins – 2 Bottles$55.78
Ovulation Predictor Kit – 1 Box$67.20
Basal Body Thermometer $11.99
At-home Pregnancy Test – 1 Box$27.99
Insurance Co-pays – Multiple$130 (varies)
Sperm Thaw $108 (for each vial used)
Storage of Sperm$369 (annual fee)

At full disclosure, we spent a total of $18,100.23 until we successfully conceived our first child. This included three fertility treatment cycles we underwent. We’ll share more about that process further along in this ASL TTC Series.

We recognize and empathize how discouraging and intimidating it can feel when one is faced with the costs (and unknown emergent costs) of doing fertility treatment whether that is ICI, IUI, or IVF. There is no other way to say it but share the reality of such costs. Nevertheless, the cost doesn’t even equate to the joy you’ll feel when you learn you’re pregnant. It will be worth it. We also acknowledge that not everyone is able to conceive or carry a child. We honor you and your journey and hold you close when it gets hard. We support you.

Have at it.

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The Mighty Fertility Checklist

The first time we step into the place that would hopefully help us in procreating our first child was on July 10th 2020. We were barely married having done an at-home officiation of our own little ceremony with family on Zoom just weeks earlier! With giddy nerves, we drove up to Columbia Fertility Associates (CFA) and met our reproductive endocrinologist, Dr. Preston Sacks, who approached us in a gentle manner and welcomed us into his office. Sitting in two seats across from his desk, Maya and I locked hands between our seats, eager to learn what options we had with fertility treatments and next steps. I kept reciting in my head, “go with an open mind and expect the unexpected.”

During our initial consultation with Dr. Sacks, Maya and I had a chance to share about our background, our relationship, and hopes to become parents. Dr. Sacks asked Maya a bit about her background such as her age, period regularities, general health, and if she’s been pregnant before. After getting to know about our options and Dr. Sacks answering our (million!) questions, we were provided with a Donor Sperm Recipient Cycling Checklist. This checklist included the different components we would need to check off before beginning Maya’s first artificial insemination treatment cycle. This checklist may be similar to what you could anticipate from other fertility clinics in preparing you for starting an artificial insemination procedure. As we expected, there were parts of this process that we didn’t know about yet that were on the checklist in progressing with fertility treatment.

  1. Schedule a financial consult with CFA’s billing counselors. We were required to have financial clearance before beginning the treatment cycle. This may also be the case for other fertility clinics. Our billing consultation was on August 3rd, about three weeks after our initial consultation.
  2. Submit Pap smear results (within three years), current cultures for gonorrhea and chlamydia (within one year), and provide immunity status of rubella and varicella. She worked with her primary care physician to obtain this information. If you don’t have a recent Pap smear, you can make an appointment with your gynecologist to get new results.
  3. Go through bloodwork to provide information regarding Blood Group/Rh, HIV, Hepatitis B, and C, and VDRL, and CMV (within one year). Sometimes, a clinic will ask for you to come in to provide more bloodwork during the fertility treatment process to continue to assess one’s health and levels.
  4. If it was recommended by our physician (which it was), we needed to schedule for a Hysterosalpingogram (HSG X-ray test). We called CFA on Day 1 of Maya’s period to schedule this procedure, which was done during the first half of her cycle. This is an x-ray procedure that evaluates your uterus and Fallopian tubes. Basically, dye is injected into your uterus so it can be visualized through x-ray technology as it fills the uterus and travels through the Fallopian tubes and spills freely into the abdominal cavity. This procedure allows for a doctor to evaluate the shape of one’s uterine activity and to identify any potential abnormalities such as polyps, fibroid tumors, scar tissue, or congenital defects. The HSG also evaluates the shape of the Fallopian tubes and whether or not they are open. All of this information from an HSG can help your RE determine your fertility along with the bloodwork that is done so to communicate the likelihood the patient has of conceiving successfully. Fun stuff. It is uncomfortable or even painful for some people. Maya says it went well for her.
  5. Sign all consent forms which included one for which fertility treatment we chose to try first, Guidelines for Therapeutic Donor Insemination (TDI) Program, Donor Sperm Recipient, IUI/IVF Semen Thaw Consent, and HIV Consent (if applicable).
  6. Finally, we were instructed by the checklist to call the office’s recommended counselor to schedule for a psychological consult. We won’t get into this part today, but this is one of the most controversial, most talked about components to a queer person’s fertility treatments. Our checklist did not specify that this is only a recommendation for our clinic.

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Which Insurance, Fertility Clinic and Doctor???

This part of the process was our least favorite part. Nevertheless, it is one of the most important components to putting together your plan for trying to conceive via assistive medical procedures.

What insurance do we pick?

What fertility clinic should we go to?

Which doctor do we want?

  1. Selecting Your Insurance. Maya and I created a spreadsheet for organizing information we gathered from select insurances. At the bottom of this post, you’ll find an example of the format we used to organize our intel. For this part of the process, Maya did all the phone calls since I’m not a fan of that type of task. After she filled in the spreadsheet, we compared each option. Prior to doing this research, Maya and I anticipated that we wouldn’t find much coverage if any at all for doing IUI/IVF so we prepared ourselves in learning of such answers. Even then, Maya also asked each insurance about their coverage and support for maternal (parental) care. This is an area where most insurances are good about providing coverage. Hopefully you can find an insurance that covers everything!
  2. Picking Your Fertility Clinic. We chose Columbia Fertility Associates (CFA) which was a 20-minute drive away for us at the time of TTC. How I came upon CFA, I utilized a service through my federal agency called the Employee Assistance Program. They helped me gather information for different fertility clinics so I could narrow down our choices. It came down to Dominion Fertility in Arlington, Virginia, Shady Grove Fertility in Fairfax, Virginia, and CFA in Washington, D.C. The answer as to why we decided to go with Columbia Fertility Associates is in the next section we’ll talk about. For you, we’d recommend that if you feel good about a nearby clinic, the closer, the better. During the TTC process, you may find yourself going to appointment after appointment, even in the same week. We get the general sense from our experience that these clinics are queer-affirming, but this would be something to look into also. Additionally, it always helps when you can learn of other’s personal experiences and recommendations as former or current patients.
  3. Choosing Your Reproductive Endocrinologist. Choosing our reproductive endocrinologist (RE) was a lucky coincidence for us. At separate times Maya and I each had conversations with a colleague at work and a good friend, respectively. Each of them shared recommendations of the same RE! When we both learned that we received the same recommendation, we were delighted. We looked up the reviews of this RE and took a gamble. With choosing our RE, we chose our fertility clinic. We are fortunate that the recommendations we chose to listen to, led to a very comfortable and affirming process during our TTC journey. Our RE has decades of experience and has been working with CFA since they first started their medical training back in 1992. Our RE provided the accommodations we requested. They provided consistent reassurance when we were discouraged. I’ll always especially appreciate how they communicated with Maya each and every step of the way before doing something with her body so that she could anticipate what was about to be done. As little as it is, we’ll always remember that our RE always wore a Pride band for their Apple watch.

Ultimately, the best place to begin with this process is to ask around. Look into the leads you’re given, ask plenty of questions, and remind yourself that it will all work out. Regardless of what you choose, we hope you advocate for yourself by considering the preferences and needs you have.

In the next week or two, we will talk about our first visit to the fertility clinic and the price tag we were faced with.

Have at it!

Insurance CompanyPhone #Insurance PlanPlan’s PremiumMy partner and I are a same sex couple. We are looking to get pregnant via intrauterine insemination (IUI)? What coverage does your insurance provide for this procedure?We are looking to get pregnant via in vitro fertilization (IVF). What coverage does your insurance provide for this procedure?
Blue Cross Blue Shield(800) xxx-xxxxStandard$—.–
Aetna(866) xxx-xxxxValue$—.–
Kaiser(877) xxx-xxxxHigh$—.–
Example Template of Insurance Research

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1st Things 1st BEFORE Trying to Conceive via Artificial Insemination

In early 2019, the year Maya and I got engaged, we began having serious conversations about our wishes in creating a family together. It was clear from the beginning that Maya wished to attempt in becoming pregnant and wanted to do so as soon as it was the right time for us. We have other plans for more children and how we hope to have those children, but as they say, one thing at a time!

There are multiple things we did in preparing ourselves for the process of trying to conceive (TTC). The following lists all of the things we did, of which some you may find relevant to you or would like to consider. Even if you’re merely thinking about having kids, it wouldn’t hurt to get started early. Much of this process may not fit your timeline once you deem yourself “ready” to begin. The list is in the order we conducted after we decided Maya would try to conceive via artificial insemination.

  1. Start Having Conversations: Simply that. In spaces which you feel safe and comfortable, consider opening up about your hopes in becoming a parent through conception. Even though you may be subject to criticism (those stinkers can mind their own business), you are potentially gaining insight as you navigate this journey. This is a journey that you don’t have to do alone. If you have a billion questions, that’s okay! Talk about your fears. Talk about your concerns. Talk about your excitement. Break the silence and connect. After initial conversations, you can continue the conversations you wish to continue.
  2. Seek a Mentor: Before you think this is something formal or requires a financial investment, it doesn’t. The way I see it, this can be much more organic. If you know of someone who has gone through assisted medical procedures in trying to conceive, you could consider asking them to be your mentor. A mentor can be someone you already know well. Now, you don’t have to use this title – mentor – if it doesn’t fit you. A mentor (or otherwise) can be someone who provides emotional support. They could provide mutual understanding with this process. Our mentor is a dear friend of mine with whom I consider to be part of my chosen family. I’ve known this person since I was 18. They witnessed me through many trials and tribulations in my young adult years. They also are in my shoes as the non-bio parent to two children so they’ve been able to provide moral support throughout this journey.
  3. Ask Your Employer: Your employer/company/agency may have some family building benefits that may be useful to you. These are not usually advertised or provided to employees voluntarily so it would be good to double-check with your Human Resources office or employer. Meanwhile, learn about your place of work’s parental leave policy to prepare.
  4. Track Aunt Flo: Maya downloaded an app called P.C. (Period Calendar) which has a pink background and a white flower icon. It looks like a cute little diary! There are various apps like this one so you can choose which one you prefer. While you track your period, be aware about the patterns in your ovulation cycle. The further in advance you do this, the better. This information will help you and your doctor to determine your reproductive health and knowing when you’ll ovulate.
  5. Join a Facebook Group: We joined two private groups: (1) TTC LGBT IUI IVF RE ONLY & (2) LGBTQ+ Moms. We found these groups to be incredibly empowering. The members of these groups are open and willing to share about their experiences as well as discussing any concerns/challenges others have in the process of TTC. You can ask any questions you have. You’re bound to get a plethora of answers. These groups helped us not feel so alone in this journey.
  6. Schedule to Meet with Your Physician: Inform your primary care physician (PCP) that you’d like to talk about your general health and reproductive health. They can help you confirm that all vaccines are updated. Additionally, you can discuss any health concerns and/or what treatment plan could be best for you to consider prior to initiating the process with a fertility clinic. Your PCP also can provide recommendations in improving your health lifestyle in regard to your diet and exercise routine.
  7. Begin Prenatal Vitamins: It is widely recommended to begin taking prenatal vitamins a few months before you plan on trying to conceive. Because my sister-in-law was pregnant during the start of our journey in exploring our options, we asked what brand she took. She took “Nature Made” prenatal vitamins so we did too. They’re usually available at a grocery store or pharmacy.
  8. Save Now: Even if you’re not ready to officially begin the process of TTC, save your money now. There is no way of telling how much the how process may cost in accumulation. Be prepared for insurance to NOT cover your procedures. If they do, that’s phenomenal! Share your insurance in the comments for others to know about. Even with insurance, costs will emerge in places you aren’t told about or don’t anticipate. The bills will come. Have a stash prepared.

With these tips in mind of preparing yourself for TTC, next week we will share the next stage in our journey: the research in picking insurance, a fertility clinic, and a reproductive endocrinologist.

Have at it!

Part I: Preparing for Trying to Conceive via Artificial Insemination (in ASL!)

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A Queer and Deaf Pregnancy Journey? We got you!

Hello! For any new followers/readers/viewers, I am Maya. I am C3. As of last August, we’ve added an Instagram platform @thearielseries, to expand our endeavor with this blog, The Ariel Series. As of late, we have been collaborating on putting together a new blog/video series called “American Sign Language (ASL) Trying to Conceive (TTC) via Artificial Insemination” or “ASL TTC“.

We are collaborating on this series for a reason we feel is important for our Deaf and signing community. When we began the TTC journey, we were hoping to come across accessible, visual, and useful resources. We especially sought out formats that share information and stories via American Sign Language (ASL). ASL is our primary mode of communication.

As it turns out, there weren’t many resources specific to this journey that suited our needs. We only came across one channel we felt pretty good about which is called “ASL Stew”. Thank you Jill and Jenna for sharing parts of your journey! They have two beautiful children. While we had some information to gather from one Youtube channel, we wished for more because one story does not represent all stories.

So it had been decided. We committed ourselves to sharing our story with hopes that Deaf couples (or singles!) new to this process have more information out there to choose from, learn from, and relate to. Now even though you are reading this from a blog, we have a visual version which couples each blog post with a vlog produced in ASL. If you’d like to switch over to the vlog, you can view below!

Introduction to American Sign Language: Trying to Conceive via Artificial Insemination

So for starters…Whether you’re a couple with infertility issues, a single parent wishing to conceive on your own, or a same-sex or queer couple hoping to have a child biologically by way of assisted medical procedures, what we share in this blog series may be relevant or of interest to you. Of course, if you are none of these people, you’re more than welcome to join us in this journey because you know Maya and me, wish to support us, or just have happenstance curiosity.

Before we dive in, Maya and I want to emphasize that this blog series is only based on our personal experience and gathered knowledge from select resources. We are only sharing our experience of trying to conceive through artificial insemination, which is the path we’ve chosen with the hopes to have our first child. We also ask that you respect the choices we make as prospective parents. We recognize that everything we choose to do may not be what you agree with. Therefore, let’s share mutual respect!

Let’s get started…Next week!

Next week we will share multiple things we did in preparing ourselves for the process of trying to conceive.

Have at it!

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