As a Psychologist, Academic, and Advocate, I believe in the importance of insurance coverage so that financial barriers and coverage should never be a reason for not pursuing fertility treatment. I hope that through telling our story, we can add to the growing list of voices advocating for change in the state of Tennessee.
My partner Marc and I met in our late teens, have been together for 12 years, and married for 6! For the first 3 years of our marriage, I was finishing up my doctoral program (I have a Ph.D. in Counseling Psychology) and working to become licensed as a psychologist. The first year of marriage, I was initially pretty naïve and fretted over getting pregnant while finishing up my Ph.D. program. No one in my family had ever struggled to get pregnant (in fact all of my extended family members had a pretty easy time of getting pregnant) so I was worried about becoming pregnant while still finishing my program. Little did I know how long that journey would take.
I had completed my doctoral and post-doctoral training in August of 2017. Marc and I found our dream jobs and settled in Knoxville, Tennessee in August of 2017. Shortly after moving, we began earnestly trying to get pregnant. The first few months, I remember feeling so confused. I asked myself, “Why wasn’t it working?” I remember telling myself, “maybe it takes a little bit of time after getting off birth control.” I remember being so strict about drinking and eating, sure that I was pregnant each month. Each month, I was disappointed.
In doing my research, everything I read suggested that we should try “naturally” for 1 year before pursuing help, but I turned 30 in July of 2017 so I didn’t want to wait a year before talking to my doctor. I made an appointment with my gynecologist in early 2018 who encouraged me to keep trying naturally for 6 more months and come back if I still wasn’t pregnant. So, we kept trying.
We had a chemical pregnancy (or really early miscarriage) in October of 2018. I remember feeling so sad but also hopeful that if I was able to get pregnant once, I could do it again. So, we continued trying. I went back to my gynecologist who started doing blood work and Marc did a semen analysis in November of 2018, all of which came back normal. I had an HSG done by my gynecologist in January of 2019 where I found out that I had a blocked right fallopian tube. My doctor assured me that people got pregnant all the time with one “good” tube so we moved into several rounds of medicated cycles without any success.
In May of 2019, I decided to seek out a reproductive endocrinologist as I felt like we needed more help. We did three rounds of medicated cycles with a different medication. After none of those were successful, my RE suggested we do surgery so that she could go in there and look around. I had my first laparoscopy and hysteroscopy in August of 2019. My RE found a uterine septum that she corrected, some endometriosis that she cleaned up, and she was able to open up my right tube. I was hopeful for the first time in so long after the surgery and the next month we were able to try again. We had one more medicated cycle before she found a very large ovarian cyst and I went on birth control for 3 months to get rid of it. At this point, Marc and I were both pretty frustrated, sad, and hopeless. We were able to begin trying again in January of 2020 and did our first IUI. My numbers were great, Marc’s numbers were great and the cycle looked great! I was sure it would work! Then, it didn’t. We tried two more IUIs after that. Both cycles looked great. Neither of them worked. At that point in time, my RE told me that she did not recommend more IUIs and that her recommendation was to pursue IVF. I was devastated but also resigned in our plan. We would have to pursue IVF. In some ways, this news was a relief because deep down I already knew that IVF would likely be our only option.
Preparing for IVF was no easy task (and we haven’t even started yet!). The first major issue we faced was where to go for IVF. Our RE did not do IVF and so we knew we would have to find someone else. I did a lot of research about the various facilities and clinics that offered/specialized in IVF that were within driving distance, and ultimately decided on a clinic in Chattanooga (a 1.5-hour drive from Knoxville). We scheduled our first consult during the height of Covid-19 and were able to go for our first baseline appointment in May of 2020. Our new doctor wanted to do another HSG to make sure my opened tube was still open from my surgery in 2019 and I was lucky that I was able to do that the same month. I did a second HSG and my doctor was concerned that my right tube had closed again based on the scans. So, I underwent a second laparoscopy and hysteroscopy in July of 2020 where my doctor found that my tube was not blocked and that everything looked good (he did remove some mild endometriosis). We tried one more IUI after surgery to take advantage of the surgery and that was not successful. At this point in time, we decided to stop trying other things and focus on IVF.
I called my insurance and quickly learned that IVF was not covered through my insurance, which meant that any cost would be completely out of pocket. Marc and I talked for a long time about how we would pay for IVF and ultimately decided to sell our house and use the money we made to pay for IVF. We knew we did not want to take out a loan, and couldn’t/wouldn’t ask to borrow money from family -selling our house was the only option. So, we sold our house, and used the money to pay for IVF. We reserved our cycle for the earliest month possible, which means we will hopefully do our first retrieval in January. Now we wait.
We feel grateful to be able to sell our house and use the funds to pay for IVF. We also feel angry and frustrated that we do not live in a state that requires insurance coverage for IVF. I tell our story in hopes that it will: 1) normalize infertility struggles and provide insight into the vast amount of time, energy, money, and effort that goes into infertility treatment, and 2) add to the voices of people advocating for fertility and infertility insurance coverage in the state of Tennessee. We are one of the lucky ones to be able to make this happen and we have hope that all of the time, emotional energy, money, and waiting will ultimately result in a biological child. However, there are no guarantees. So, we stay content in our hopefulness and try to take it one step at a time!
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