Life advice: Mid 30's hoping for family, IVF, Graduate school, transitions

[MountainTown]

Recently I was accepted into graduate school. I would potentially be accepting a lower salary, certainly giving up a salary while going to school, etc. But it's a career path that I have always wanted to do and had in the back of my mind. My path lead me a different direction ten years ago and I have had a pretty successful Federal career so far. A transition in management has made work pretty unbearable for most of the people in my work group in the last 2-3 years. I won't go into great detail on that but let's just say it was a push for me. I'm still highly rated, well compensated, and get along with everyone but the manager is really tough to work for. It was too bad because I liked the job but...I thought well hey I always wanted to goto Grad school so now is the time.

I have wrung my hands about it all summer because it sure will put a dent in my FI plans...it's scary to give up the career...and my wife doesn't make a whole lot so it's giving up our "breadwinner" money. I decided to go for it but was having second thoughts for sure. I tend to struggle with these big risks and life decision.

Then on top of that, we got some really bad news. We have been trying to get pregnant for 17 months and finally saw a fertility specialist. Given our condition, we have a less than 1% chance of conceiving naturally. We just found out in the last week that we have a good shot, but only if we do IVF. Natural conception, IUI, etc has very little statistical chance for us. But if we jump on it, my wife is young enough where our chances in IVF are as good as they get in that world.

Of course, I wasn't planning on this added expense or time complication right now. We have just started formulating a plan but haven't nailed down where yet. We don't have great options in our area so likely we would either travel abroad to Prague as it is cheaper there or my wife's hometown as it is also cheaper there(not as cheap as Prague) and would have the added benefit of free shelter, transportation, family support etc. Long story short we will likely spend $18,000 to $25,000. If we do the Prague route, we may get it down to more like $10,000 but that would just be one round of IVF.

I'm pretty insecure about money but I gotta say I didn't think twice about this. I question almost every expense but this just seemed worth it to me. I would rather not get into that debate with anyone--FYI.

My problem is....I am having trouble fathoming going back to school AND doing this. I hate to give up on this dream I had, or defer it another year, but I'm just having a lot of anxiety about it. I also feel like I don't know how long this will take or how long I may need to be out of country to support my wife. So I'm concerned that I could miss a lot of school which is kind of a no-no when it comes to graduate school.

So I need some life advice. Am I wussing out here if I withdraw from school? Am I having one more year syndrome? Or is this reasonable?

I should mention I requested deferment and the current school was very strict on the no deferment policy they have in place. They were sympathetic but ultimately it just is not something they ever allow. I was offered a deferred admission at another school but this would require a move across the country. It's an option but perhaps not ideal.

At this point, all things being equal, I wish I could just wait one more year and cash flow through this IVF thing. I have a lot of annual leave, could invoke FMLA, and could pay cash for it all. It would hurt my FI plan but like I said it's worth it to me to have our own kids with our own genes. I'm concerned that I may not get back into the school next year or that I'm damning myself. Maybe they won't think I am serious?

Any thoughts on this ? I would be curious what people think if they have had to go through IVF and the whole process. Part of what I am struggling with is just the unknown. I imagine it may not be as time consuming and maybe even expensive as I am estimating...but so far the expenses just for diagnosing have been staggering.

Oh and on top of that my friggin transmission just went out!! LOL. Life really is not going my way right now. At the risk of making this post too long, let me conclude with a few numbers:

NW: $410,000, of $50,000 allocated to cash which we can access easily. The rest is mostly in tax deferred retirement accounts.
My salary: 85,000
Wife salary: 44,000
Savings per year: We save roughly $50k to $60k a year
Health insurance: Good but doesn't cover IVF or any procreative treatment
School cost: about $20k a year for everything. It's a two year program that requires low paid practicum/internship hours after(for 2 years).
Financial aid: I was granted unsubsidized loans for the cost. The interest rate isn't super low and starts accruing right away. I am averse to debt and didn't plan on taking out loans. Kinda freaks me out to go back into debt, especially for a high amount
Age I am mid 30's and wife is lower 30's
IVF cost $10,000 to $25,000 for 1-3 "rounds"

PS:

One other twist in all this is things have been changing pretty fast at my workplace. We have taken on 4 new people, will be getting secretarially support, and I will likely be taking on a collateral duty role which may excuse me from some routine duties(halftime) as I will be occupied with the collateral role. I just mention this because I anticipate a lot of things changing at work this year--perhaps for the better.

[mozar]

This is a values question not a money question. What do you value in life? I recommend you go to school and do the ivf. I would assume you will have to do the 3 rounds.

[MrThatsDifferent]

If this is what you both want, do IVF as soon as possible and prepare your hearts for all the possible outcomes. The younger her eggs are the better chances for success and for what you’re spending, you need to maximize the odds. You’ve got a good net worth, and make good money and you’re still relatively young. Don’t freak out about the money, it won’t mean a thing if you start your family. Most it could mean is you work a couple extra years, that’s ok. If you want to study, do that to but really know if it will advance your career and you can’t get that anywhere else. Best of luck!

[Zamboni]

First of all, thank you for writing out so many details. It makes it pretty easy to tell where you are and write something cogent in response.

I second the suggestion to plan to need 3 rounds of IVF . . . that way, if it takes less, it will be a pleasant surprise. While they don't tell you this, the first round may end up being used for them to figure out exact dosing for the medicines. People just respond to the hormones in different ways, so they start with an average and it might not be ideal. In a way, the first round is a bit of an experiment and by the second round they will have things more optimized for your wife if it is a good IVF center.

Based upon reading your entire post, and as someone who went through IVF, I think you should stay at work for the benefits and paid family leave while you do the IVF. Infertility treatment has a good chance of being one of the most difficult things you will face as a couple. It is WAY WAY more stressful that you think, especially for your wife, who will be giving herself a bunch of shots. A major change in another area of your life is probably a bad idea right now. Focus on this one thing, bringing home a baby, which is clearly a priority for you. Everything else can wait. Seriously. School will still be there one-three years from now. And, truth be told, going to school while you have a baby or small children is actually great timing, so consider a full effort on bringing home a baby as step one and school as step two.

Also, the aid you are being offered for school sounds really crappy. No grants at all? They must basing it on you making $85K and your wife $44K, none of which will happen if you start this program and IVF at the same time. I wouldn't even call it aid. It is also an odd policy for them not to allow you to defer admission. You don't say which school it is, but I am quite skeptical about what is happening along that front. Just what you write about the education program alone makes me think it is not a great deal for you at this time.

Good luck with everything!

[koshtra]

Whether grad school or staying on at your job would be the more stressful option right now, I dunno, that's your call. But I agree with Zamboni that while you're doing the IVF, and potentially first birth and child, you want to minimize the other stresses of your life. You're in for an emotional roller coaster, whatever the outcome.

The money questions are actually pretty trivial here compared to "making my life work for the next couple years." You clearly know how to make and save money, and you have a bunch put by. Go ahead and spend what you need to spend. Including fixing the transmission :-)

[Scotland2016]

I would stay at your job until your first child is born. School will be there when you are through this stressful and expensive period. Also, if there is a reputable IVF clinic in your area, I would just go there. No Prague, no hometown. Just take everything easy.

One thing to consider though - is your wife going to want to stay at home after the baby is born? That could throw a wrench in your plans to go back to school.

[Zamboni]

^I agree that you should look very closely at what is available in your area. It is possible that there is really no decent option . . . some rural areas probably don't have a decent clinic. But, if there is a clinic near where your wife works with decent success rates, then it would make the most sense to have IVF there instead of traveling.

It might seem like having "supportive family" around would be helpful in a hometown, and I hope that is true for you. But, then again, this might add to the stress. Online  and in-person support groups were helpful to us, but we would have gone nuts dealing with our mothers if they had known. For one thing I think they both would have made some insensitive remarks. They certainly made plenty of insensitive remarks to my brother and his wife when they were adopting their children, and they were so clueless that they didn't even know they were being insensitive. That's why support groups of other people who are going through the exact same things are best, I think.

Going to Prague seems really over the top unless you both speak Czech. If you both speak Czech and they have excellent results for lower prices there, then by all means do it if you can afford the time away from work. Remember, this is a process that takes weeks and weeks for just one cycle, and your wife will be going to the clinic many times for bloodwork, ultrasounds, etc.

It sounds like your job situation might get better soon. One of the things I learned from the older engineers at my first job out of school was to just stay calm and let any current bullshit climate sail by. It might take awhile, but their outwit/outlast strategy comes in handy, especially when dealing with a highly dysfunctional manager or colleague . . . often those folks either leave on their own or get sent packing. Enforce your boundaries on their bullshit in the meantime, knowing that they will be gone soon.

Regardless of the route you decide upon, good luck to you! Happy thoughts!

[MountainTown]

Thanks everyone. I had worried my post was too long and would bore people with details. It's validating to hear that this is probably going to be a tough, long, somewhat arduous process--not to mention expensive. Honestly I wasn't sure if I was being overly cautious or just freaking out. I suppose in a way I feel like I am chickening out with school and I worry that it might not be there for me later but...I must say it does feel overwhelming to handle both at this time, financially and emotionally. I'm someone who likes to have my ducks in a row--though I am working on that.

As for the treatment options....here they are pretty rough. The closest option is a 3 hour drive through the mountains with no friends/relatives. The cost is around $20,000 and I think there is a 3 round option that is 25k with a 50% refund if you don't get any luck.

The hometown option we explored is a flight away. However lots of family, friends, free place to stay, and probably a car we can borrow. It's familiar. I agree that doing it here would be better but it's just not possible to do it here so it seemed like what's the difference between a flight and a 3 hour drive other than some time off and money. And on the money front, the hometown option -is- quite a bit cheaper. For example, we can get two rounds, with costs of various flights, for about $12,000. I dunno to me it seemed like a no brainer but maybe I'm missing something.

The Prague or Mexico options are tougher for me. They seem to be tailored for english speakers and international customers. I see good reviews. I estimate with flights, food, lodging, we would save roughly $4000 on various different treatment options--maybe more if we had success sooner. It's hard to put a price tag on the comfort, convenience, knowledge of your home country--especially when it comes to this. I reminded my wife today that while people may speak english, it may not be well---and we aren't ordering a hamburger or just getting on a train we are entrusting people with almost $10,000 and all our hopes conservatively. It may all go smoothly but I'm not sure it's worth the stress of $4,000. Would love to hear about anyone's experiences.

What do people think about our options? Now that I have laid out the prices/locations...do people still think we should drive three hours locally? I just felt like saving the $10k was pretty significant, especially since that option involves a trip home to see friends, family, etc.

Also: I appreciate the words on how unsupportive family/friends can be. Honestly we have been a little shocked by both of our mothers lack of support. They both have been supportive in other ways but there seems to be a major disconnect with this one. I'm not sure why. My mother just kept saying how she couldn't believe how expensive it was and I'm like "yea no shit i know." Her mom has already advised us adoption is an option (Thanks--didn't know that lol!).

Oh and one other thing about all our treatment options...we do have someone in town who can at least do the ultrasounds. This will vary on how well this can be coordinated but at least it will minimize how long we have to stay somewhere else. We may be able to get one or two done locally before we have to go elsewhere. And...like I said either we would be getting on a plane or driving three hours and staying in a hotel.

[insufFIcientfunds]

You might consider, given age and job situation, to go the shortest route from now to baby. If that costs more, it might be worth it. If you go overseas and it doesn't work out, it puts one more year on your bodies.

I can for sure relate to the job situation. If you think it will get better, then stay. If you are a federal employee on the GS scale, and you are a supervisor, you can also consider taking another position at another office and giving up a grade. Your pay might be marginally effected, but it will free up time for school and family until you decide with you REALLY want to do.

Had a friend give up a 13 for a 12 because of a "soul-sucking" job and it was the best decision he made.

[mistymoney]

I would prioritize the family over grad school for now. Would you and DW want more than 1 child?

But - definitely talk with the school about deferring enrollment. If you ghost them, that would maybe be a black mark, but if you talk with the admissions and ask to defer enrollment for 1 or so years, that would be much better.

Are you in a house? Any housing changes planned for if/when you have 1, or 2, more in the family?

[Jacinle]

There is a book Conquering Infertility which talks about logistics and other things that might help .

[HerselftheElf]

I think it's smart to assume that it may take more than one round of IVF to start your family.  I was devastated when our first STIM round of IVF yielded 0 viable embryos but thankfully STIM round 2 yield a healthy embryo that is now our 6 month old baby boy!  I would absolutely stay working if I were you and use every benefit available to you (insurance, FMLA, etc).  One thing to consider is if you're facility recommends fresh or frozen transfers.  Fresh cycles are a little faster from start to finish, frozen have periods of time where you aren't actively doing something.  Your wife will also have lots and lots of checkpoint appts to check hormones, do ultrasounds, etc so factor that into it.  I used a facility an hour away and it was lots of driving back and forth multiple times per week, especially during the transfer phase. 

Lastly, take into consideration that this will likely be physically hard on your wife.  She will be pumped full of hormones (far, far more than normal pregnancy would induce), she will be poked and prodded with more needles than she'd ever thought possible, and her body will not feel like her own.  That said, every single thing I had to do for my son was worth it and I would do it again 10x over.  Good luck to you both OP!

[Bracken_Joy]

Jumping in to send support. IVF is definitely a rough road. And it's terrifying to do all of it, and spend all of that money, with no guarantee of success.

To your current specific questions- one of the reasons foreign clinics have really good stats is because they exclude own egg cycles in the stats they advertise. I know this is specifically very true of the 2 main czech republic clinics. They push donor eggs a LOT. So, be sure you're comparing apples to apples. With my low AMH but young age (28 at the time of my first cycle) I didn't want to risk being pushed into donor eggs prematurely. Also, the laws around embryo storage and rights freaked me out going international- in many cases you can ONLY bring embryos back into your own country if they share BOTH your genetic materials. Mexico doesn't allow you to transport embryos with donor material apparently back to the US. So if you made/banked embryos and decided you wanted them back home, for personal or political reasons, you might be SOL. All in all, it stressed me out way too much for a few thousand bucks and we went local.

You're probably seen but there are success data by diagnosis and age through both CDC and SART. They use different data pools, so check them both before you decide what clinic to use. Weirdly, with your wife being YOUNG, it may actually be worse- the first clinic we went to saw 'bad AMH' and way over-stimmed me relative to my age. Resulted in poor embryo outcomes. Protocol matters, for sure. IVF isn't all the same everywhere.

If you haven't run across the option too, while you're still as young as you'll ever be, consider the prospect of "banking" if you want the chance at more than one kid. That's where you go through one or more freeze-all PGS-tested cycles and build up a store of embryos for future use, before starting transfers to try for a current kid.

If you haven't run across it, reddit.com/r/infertility is an incredibly knowledgeable place. It can be a bit... tetchy... understandably. So look around before posting anything. But it is an absolute wealth of knowledge, community, and experience. Searching for specific countries for IVF will get you a ton of info there, too. 

Also, feel free to join us in the journals section on the Fertility, Baby, and Pregnancy Chat. More than a few of us there have gone through or are going through IVF. I'm also more than happy to answer questions directly if you ever want to reach out.

[Zamboni]

Yes, 3 hours is a long way to drive each way, especially through the mountains. That is not a drive I would want to make for every single visit needed for IVF. At the same time, since you don't have any ties to Mexico or the Czech Republic, my feeling is that saving $4K to go internationally for this is absolutely not worth it. Personally I would not even consider that. Near family is fine, and a familiar neighborhood is great, but I think you should forgo the free place to stay and book a hotel room. Flex your hotel points accrual muscles. As I said, family can add to the stress.

Looking at the databases suggested above for IVF success rates is waaaay more important than cost in my opinion. Success rates for the particular method you will be using is the ONLY thing that really matters for this. Do ask about how many embryos they would recommend transferring. Many places only transfer one at a time now, especially for a younger woman. But, if they are transferring 3 at a time, then their stats will go up because all they need to "count" it is a positive pregnancy test. But, you want to have a baby, maybe twins (twins are fine), but probably not triplets (and the odds of a massive problem with the pregnancy is great with 3+ fetuses.)

We did the "three tries or your money back" option . . . they don't really give you half of your money back, btw. For example, you don't get any of the money back for the medicines, which is a substantial part of the costs. Just want to make sure you know that. Psychologically, though, that option worked the best for us. It made the sting of the first cycle not working feel like much less of a big deal.

Also, you are in the driver's seat . . . remember that. The technician at our second cycle suggested transferring 5 embryos at once. Remember, all they need is a positive pregnancy test to "count it" in their success rate, so the more they transfer the more likely that is to happen, but what really matters to you is bringing a healthy baby to term. We were like "absolutely not!" because we did not want to be faced with a selective reduction decision, and we had already decided that twins were the maximum we could handle. In our case, with higher maternal age, we let them transfer three and ended up with twins because 2 out of 3 implanted. Again, your wife is young and you want to look for places that are transferring one embryo at a time with relatively high pregnancy rates.

Good luck with it all! And remember that self care is the most important thing.

[MountainTown]

Thanks everyone. My wife and I have been absorbing all this advice and will have some more questions on details. For now I am pretty  relieved to hear people don't think I am copping out by not going to graduate school. I guess it brought me a sense of relief and the more I think about it, I would also probably not do that well in graduate school if I was so focused on this.

Now comes all the other decisions...about whether we go international or local or to New York (wife's hometown). We were surprised by the amount of people recommending against her hometown vs our local option (3 hour drive). We are still leaning towards the hometown options as it's still about $10k cheaper (depending on the option).

I also am wondering...and maybe this is a stupid question...do these services usually  take credit cards? If so any recommendations for a good credit card to maximize points?

Also, given that we have about $55k in cash, do you think we should stop maxing out our deferred retirement contributions? Right now we aim to max out her 457, my TSP, and also in the next year(2020) we would do $11000 in IRA contributions. We already did the $11000 for this year(roth).

Thanks for your advice. As I move forward with this decision I must admit I am relieved to just focus on this, not worry about money, and move forward with other tough decisions. However I couldn't help but be a little pained seeing new students on campus and just thinking how I could be starting this new exciting career life.  Lately my job has definitely felt like a bit of drudgery and management just seems to expect more and more out of us.

[bogart]

Just wanted to chime in and wish you success with the IVF -- and say that it is often a hard row to hoe.  IVF mom here, took  a bunch of cycles (and a bunch of money) for me. 

It may be dated now, but I found Melissa Ford's book Navigating the Land of If: Understanding Infertility and Exploring Your Options helpful.  Sounds like you've got a diagnosis and a plan but she still has a lot of useful information both about what treatment involves and about the emotional angles (including things like dealing with people who say, "Well, you can adopt" when that's not the option you're wanting to pursue at that point.).

Given what you describe about treatment options, transport, and such, I'd choose NY.  I did cycles locally and one in NY (no connections, just had a clinic I wanted to try) and honestly found being away from home (though for me as I say it really was away from home, and friends, and family except DH) and found cycling away no more difficult than doing it at home.  Indeed, in one way it was easier, as I wasn't trying to squeeze all the medical appointments into my work schedule. 

For whatever it's worth, the question that I found the most useful as I went through treatment was, "If I try this and it doesn't work, will I regret having tried it?"  Of course it's hard to be totally sure -- hindsight and all that -- but it worked pretty well for me as a guide. 

Again, GL to you.

[marble_faun]

Definitely agree that you should prioritize IVF if having children is very important to you.  It will only get harder and harder as months and years pass. 

Could you or your wife get a part-time job at Starbucks?  They will cover up to $20K for IVF.  You would have to look into how it might interact with your current coverage, but it's worth exploring the idea.

The process will be incredibly stressful. In your shoes I would want to keep everything else a constant and rock-solid just to get through it.

Not sure what your grad school field would be, but you could take the extra year to explore other programs that will offer a better financial package.  I would recommend going down a list of all the programs you can find (US News & World Report might have a good list) and checking each department's web site to see if they offer tuition waivers or assistantships to masters students. Then include those in your next round of applications.  (Also, people who work for universities often have tuition benefits and can do masters degrees for free on a part-time basis.  Another idea to explore.)

If all goes well, you could be a grad student and new parent at the same time!  It's actually not a bad combo, as your schedule will be more open and flexible than in a regular 9-5.

Good luck with all of this!

[Bracken_Joy]

For funding:
-part time jobs like already mentioned at starbucks are an option
-apply for grants like Baby Quest
-for credit cards, we opted for the Chase Sapphire Preferred travel card, but it depends on your goal. Look up credit card churning sites! We also lucked out on one FET that the Freedom card had pharmacies on it's rotating 5% categories, so we put meds through that.
-shop around for meds. If your clinic allows you, you can go through a foreign pharmacy- we did IVFpharmacy in Israel. It feels sketchy, but it's fully legit, you can read lots of people's experiences on reddit. My first clinic that was actually who they sent people to without insurance!
-I don't know what's going on with the medical deduction right now, but when had our big claim year for last year, we tracked all the medical expenses, associated travel, etc that we could deduct. That definitely adds up!

[Car Jack]

Sorry, but I'm going to point out downsides.

If the IVF is successful, having a baby costs money for a long time.
If not successful, adoption is an option and this can cost a lot of money.
Going back to school will cost you salary money, of course.

My wife and I went through 3 rounds of IVF with no success and with one procedure causing an infection for my wife, spreading to me which was horrible.  It's one of the risks you don't plan for.  Adoption is very location dependent.  In the US, each state has its own requirements.  Our state is especially expensive but the protections that the agency we used has in place were very worthwhile. In our state, IVF was a required coverage for all insurance, so we paid only co-pays.  The adoption costs were far, far more than if we paid full boat for IVF.

[Jon Bon]

I know nothing about IVF.

I do however know a lot about grad school while being in the employ of the the federal government. Unless they have drastically changed the rules and or you are completely changing what you do like a chemist studying English literature. I think the government will pick up a larger portion of the tab.

I got my MBA in about 2.5 years with my job picking up about 75% of the cost. They also covered books which was nice. I was able game the system a little. Basically if you went through hell for a semester you could get double the credits for the same cost. I did it all while working, honestly it was not that hard. Especially since you dont have kids yet.

Look around, ask around. Because the government already provides most of the funding for public colleges they usually have a nice little agreement worked out.

Also if I remember correctly in federal they dont care if you have a grad degree from Harvard or a degree mill, as long as you have one you are awarded the same number of "points" when looking at your qualifications. So if you plan to stay federal where you go matters.

Lastly almost no one does "degree handcuffs" anymore. So they might SAY they require you to stay for X number of years after classes but I have never heard of a company going after someone for it.  They might have been able to collect something from me, but they did not try.

[HerselftheElf]

Yes!  Most physician offices, medical facilities and the pharmacies we worked with take credit cards so definitely maximize your points/miles/cash back.  I second the recommendation to call around for the pharmacies...many physician offices do have discounted contracts set up with a specific pharmacy but will send her scripts to another pharmacy if you request it.  Lastly, don't forget to also check out the drug company websites...I found that several (like follistim) actually have discounted programs in place if you qualify).  Your physician may use generics (like for the progesterone) but it's worth a look!

[MountainTown]

THanks. I am just catching up on posts.

Graduate school: I put in the cancellation. It was a hard decision but after talking to some other people about the IVF process and reading these posts, I am pretty at peace with it. It sucks but I just think with who I am, someone who likes to have their ducks in a row, it would have really sucked to be focusing on two gigantic things at once. There was a question as to whether the Fed pays for school anymore. NO--they don't. The program pretty much ended 7 years ago. They may support it better in some functions--depending on how valuable it is to them. In my case, the degree would have no value to my group.

I'm not sure if I should start a new thread but now we are wondering...about our options. I have some questions and of course we are contacting doctors and experts to get advice too. Basically we live in Montana and the options are pretty bad here. We would have to drive 3-4 hours just to get IVF. The procedure would cost about $18k for one round. We can do 3 rounds for around $33k with a 100% refund. There are options in between but you get the idea. My wife is from Buffalo, NY. We have done the math with travel, staying in an airbnb(family owned so no cost), and most of the food/transportation covered by family...would be around $11,000 so substantially cheaper--and that's for two rounds(2 fresh, 2 frozen). Just doing one would be even cheaper, I think around 8000.

Anyways, I think that Buffalo is substantially cheaper and since she is from there it would offer a comfortable, homey, supportive environment with friends, family, cousins, familiar surroundings, borrowed car, etc. We are leaning towards that option.

We consider Puerto Vallarta Mexico also because the flights would be not so bad from here on the western side. However ultimately the costs saved are only around $1500 to $2000. While a sunny vacation would be nice...some of the advice we go is that we want to make sure we feel we can trust whatever option we choose. So if we goto a cheaper option and it doesn't work...we may always wonder if we made the right choice. Of course we may feel the same way about Buffalo but I guess we both have a little more comfort with the US medical system. I am totally open to questioning that but it's my gut feeling. Would love to hear about anyone else's experience with IVF or IVF abroad to temper our thoughts on that.

Finally one more specific question...for those that have done IVF...have you gotten meds abroad? We heard it can be cheaper. Is it possible to get them from Canada cheaper? Obviously since we may goto buffalo we could maybe cross the border real quick...but not even sure it's cheaper there.

May ask some more specific questions later. But I'll stop for now. Another big decision we will have to make is whether just shoot for one round first or double down and get a deal on two rounds. We have been told that our chances are really good...the best case scenario for IVF(which is about 55%). However for two rounds it would only be about $2500 more so I'm inclined to lock it in.

Thanks for any help and support. This really sucks but you guys have been really helpful so far :)

[Zamboni]

Thank you for checking back in, and it sounds like you have made quite a bit of progress in planning your path.

Mentally I think it's better to just plan for multiple rounds. If it works on the first try, then you really won't care about the cost difference between $8000 and $11000, for example. It's sort of irrelevant in the scheme of things to have paid the extra money that you don't use if you are very lucky on the first try. Seriously. Would they let you use the frozen ones to try for a second baby later if the first round works? Probably. Things to ask about.

Remember: self care, happy thoughts, wellness.

[MountainTown]

Thanks Zamboni. Good question on the frozen...do you mean like for  a year later? I would think so but probably would cost extra to store. I don't think they would allow it to be a part of the package deal for transfer though. I think I have seen fine print on that.

[SunnyDays]

I know nothing about IVF, but many Americans have been coming to Windsor lately for insulin, which is 1/10th the cost compared to the US.  ($30 a vial vs $300).I can certainly understand why they do this, since this isn't exactly an optional drug!  So you could probably just call up a pharmacy and ask about prices if you know the exact name and dosage of your meds. 

[Scotland2016]

It sounds like Buffalo has some positives, but look into Las Vegas if there are direct flights. There is an international IVF expert here. I don't have personal experience, but I know couples travel from other countries to see him.

[fuzzy math]

THanks. I am just catching up on posts.

Graduate school: I put in the cancellation. It was a hard decision but after talking to some other people about the IVF process and reading these posts, I am pretty at peace with it. It sucks but I just think with who I am, someone who likes to have their ducks in a row, it would have really sucked to be focusing on two gigantic things at once. There was a question as to whether the Fed pays for school anymore. NO--they don't. The program pretty much ended 7 years ago. They may support it better in some functions--depending on how valuable it is to them. In my case, the degree would have no value to my group.

I'm not sure if I should start a new thread but now we are wondering...about our options. I have some questions and of course we are contacting doctors and experts to get advice too. Basically we live in Montana and the options are pretty bad here. We would have to drive 3-4 hours just to get IVF. The procedure would cost about $18k for one round. We can do 3 rounds for around $33k with a 100% refund. There are options in between but you get the idea. My wife is from Buffalo, NY. We have done the math with travel, staying in an airbnb(family owned so no cost), and most of the food/transportation covered by family...would be around $11,000 so substantially cheaper--and that's for two rounds(2 fresh, 2 frozen). Just doing one would be even cheaper, I think around 8000.

Anyways, I think that Buffalo is substantially cheaper and since she is from there it would offer a comfortable, homey, supportive environment with friends, family, cousins, familiar surroundings, borrowed car, etc. We are leaning towards that option.

We consider Puerto Vallarta Mexico also because the flights would be not so bad from here on the western side. However ultimately the costs saved are only around $1500 to $2000. While a sunny vacation would be nice...some of the advice we go is that we want to make sure we feel we can trust whatever option we choose. So if we goto a cheaper option and it doesn't work...we may always wonder if we made the right choice. Of course we may feel the same way about Buffalo but I guess we both have a little more comfort with the US medical system. I am totally open to questioning that but it's my gut feeling. Would love to hear about anyone else's experience with IVF or IVF abroad to temper our thoughts on that.

Finally one more specific question...for those that have done IVF...have you gotten meds abroad? We heard it can be cheaper. Is it possible to get them from Canada cheaper? Obviously since we may goto buffalo we could maybe cross the border real quick...but not even sure it's cheaper there.

May ask some more specific questions later. But I'll stop for now. Another big decision we will have to make is whether just shoot for one round first or double down and get a deal on two rounds. We have been told that our chances are really good...the best case scenario for IVF(which is about 55%). However for two rounds it would only be about $2500 more so I'm inclined to lock it in.

Thanks for any help and support. This really sucks but you guys have been really helpful so far :)

Regarding IVF and travel... my sister travels 4 hrs to a better clinic for her IVF. Keep in mind that things change when they schedule your cycle based off how your body responds. So a retrieval might be scheduled for Thursday tentatively based off what they would expect on a calendar and a dose of meds, but then based off test results it might be pushed out up to a week. Same thing for an implant. So when you consider having to change flights or buy last minute flights and park it in NY for 3 weeks here and 3 weeks there (because you might not be able to find a local provider willing to do your ultrasounds), I'm not really sure you come out ahead vs using the clinic 3 hours away where you can just take a day or 2 off, and the local clinics likely have a relationship with 3 hour away IVF clinic.  You and your DW might end up burning huge amounts of your vacation / sick time that you will want to have for when the baby arrives.

Also, clinics publish their stats. Look into the different clinics and see what you feel comfortable with. They do get a lot of out of town people so both places should be able to talk about their processes for making travel easier

[bogart]

Would they let you use the frozen ones to try for a second baby later if the first round works? Probably. Things to ask about.

Just to pick up on this point and as someone who's just a generally interested citizen and former IVF patient (no legal expertise, etc.), do be aware (for the OP, not Zamboni specifically, but since Zamboni's post touches on this) that any embryos created in a cycle are the couples', not the clinics'.  Yes, the clinic will store those suitable for freezing that you want to freeze, and yes, they will charge you for that (typically yearly IIRC), but also, you can get them moved (generally shipped via Fedex or similar, while still frozen) and have transfers (i.e. impregnation attempts) done at other clinics, etc. -- totally your call. 

How the package pricing deals with transfers versus continuing with fresh cycles, etc., is of course something to ask about as you are considering your options.  Medically, your best bet is to do all your fresh cycles first (of course, not knowing how many that will be) and saving any frozen embryos for later, as the determining factor about what "maternal age" actually is -- with likelihood of a healthy pregnancy declining as that goes up -- is the genetic mom's age at the point the egg was harvested.  But financially, transferring frozen is less expensive (and less likely to be successful) than starting again from scratch.  And emotionally -- well, that really depends on you and your wife, and how you experience and feel about all this.  I personally didn't want to have any frozen embryos sitting around while I proceeded with fresh cycles, not because of financial concerns but because I wasn't sure I'd be able to sleep at night knowing I had frozen embryos stored that I didn't want to use (as things worked out for me this became a non-issue, but it can of course be an issue for couples who e.g. get 10 embryos, freeze 8, but then have a successful twin pregnancy, or whatever -- obviously, depends a lot on what your hopes are and what happens, and those things vary a lot from couple to couple). 

So -- what's right for you is for you to figure out (as a couple), but do check on how much flexibility the package pricing options give you and be (as) sure (as you can) that they are right for you not just medically/financially but in terms of how you think you will likely want to proceed.

[MountainTown]

Thanks everyone....yes the travel is a tough call. We are definitely on the fence. My wife has quite a bit of leave--so do I. While I hate to burn up too much of mine again it does seem worth it because it would save about $10k and we would actually get more bang for our buck(2 treatments vs one but no refunds if success early). Again I don't think we would consider this if it weren't for the fact that my wife can easily stay in Buffalo for 2-3 weeks and maybe even work there. I will probably just fly in for 5 days or something.

I'm definitely a little concerned about the travel and I'm glad everyone is reminding me how big of a deal that is. It's helped me rule out the international options as it just doesn't seem worth a couple thousand. Again I am pretty on the fence about the local option because we don't really have anyone in that area so we would burn up so much time either traveling back and forth or money hoteling. Yea we have some points...but I dunno, again it's not just a difference of a couple grand it's easily $10,000 and much less value from what I can tell.

I have also considered how much trust we want to have in the place. For what it's worth we have spoken to two relatives/friends who have had success at the Buffalo place. They both spoke highly and had good things to say...

I'm going to show this thread to my wife! I think it will be useful for her and she understands some of the more technical aspects better.

[MountainTown]

Here is our excel...

[MountainTown]

One other note on travel/vacation....

1.) We probably have enough miles to buy at least one round of tickets free. Depending the value I could exercise this. I don't anticipate it to be a great use of the miles though(typically it's 1 for 1).

2.) Both of us have pretty good balances on vacation time. My wife thinks she could use SL. I have 3-4 weeks of use-or-lose. She also has paid parental leave so it's nice that even if she burns a lot she still should have plenty of time to be home. I think she is also hoping she can work remotely.

3.) She has talked to the clinic about travel concerns. Again it's a really good point how things can change on a dime. The plan is for her to be there 2 1/2 weeks so more of that is minimized. They also expressed little concern as she is younger at 30--they anticipate that they will have less issues with hormones.

[historienne]

For Buffalo, would you be going through CNY Fertility?  If so, they are definitely used to working with people who are traveling there.  It's so cheap in comparison to most other US options, they get people flying in from all over.  Especially since she has family there, I think it sounds doable.  Even more so if she can work remotely. 

I used to live in the general area, and know several CNY IVF babies.