My husband and I recently bought our first house (!!!) at age 37 – roughly seven years after I began wanting to own a home.  I wanted to be able to paint my walls whatever color I chose.  I wanted to purchase furniture that fit my space instead of making the furniture I owned work in the space I lived.  I wanted to think about light fixtures and bathroom tiles and countertops and even landscaping.  I’ve wanted this moment for a long time.  But I have also wanted a baby… and when you can’t have one, wanting a baby becomes an expensive endeavor.

Children are expensive no matter what. According to the US Department of Agriculture, the average cost of raising a child from birth through age 17 is $230,000 dollars.   Thinking about my own childhood and my private college tuition, I know I was much more expensive than that.  I knew being parents would cost money.  I just didn’t think it would cost so much to become parents.

Over the past five years my husband and I have paid more than $15,000 out of pocket on fertility treatments (not including mental healthcare) – and that was with really good insurance coverage.  A single round of in vitro fertilization (IVF) can cost $15,000 uncovered.  Surrogacy – which are doing through an agency in the US – will cost us roughly $100,000.  None of it will be covered.  Had we chosen adoption, the cost for a private agency adoption in the US is around $45,000.

I am not saying this not to complain.  I do feel unfortunate to have endured multiple miscarriages and years of fertility treatments.  But ironically, my ability to do so demonstrates how privileged I have been in this process.  My husband and I are financially secure.  We have good insurance.  We could make the choice to pursue IVF and now surrogacy.  Many other families are not as fortunate. 

According to the CDC roughly 12% of women (1 in 8) have difficulty getting or staying pregnant.  That’s about 6 million people.  Yet only 17 states – less than half – have fertility insurance coverage laws, and only one in five employers provide infertility treatment benefits to their employees (source: RESOLVE, the National Infertility Association).

Like so many things, discussions about family planning and assisted reproductive technologies (ART) touch on issues of equity. Access to fertility treatments favor the wealthy.  Adults making more than $75,000 annually are more likely to know someone who has used fertility treatments than adults making less money.  The same is true for adults with college and postdoc degrees compared to adults with a high school education or less.  (source: Pew Research Center)

Is this because women with more education wait longer to have children?  No.  A 2011 study in “Fertility and Sterility” (the premier journal for obstetricians, gynecologists and reproductive specialists) found that when controlling for age, demographics and fertility characteristics, women with higher household income and higher education levels were more likely to pursue fertility treatments and had higher odds of achieving pregnancy. 

For this and many other reasons, I’m participating in RESOLVE’s Annual Advocacy Day on Wednesday, May 20.  I will be talking to members of Congress about issues like access to infertility treatments, adoption affordability, and NIH funding for infertility research.  You can read about this year’s specific issues and if you’re interested, you can help by doing any or all of the following:

• Send a letter to your representatives.  It only takes 45 seconds to fill out this letter form and have your voice heard.
• Advocate on social media.  RESOLVE has put together sample tweets to create at Twitter storm on May 20. 
• Sign up to advocate in person.  You can register through May 15.  The meetings will all take place virtually, so no travel is required. 
• Tell your friends and family

Growing up, my mother would tell me her grandmother used to say, “if money can fix it, it’s not really a problem.” Her point was that money couldn’t buy the things that really matter in life. And in my great-grandmother’s defense, in her day assisted reproduction wasn’t an option; she would have considered infertility a problem that money couldn’t fix.  But that’s not the situation today.  Today, if you struggle to have kids, you might still be able to, but only if you can afford it.