This is a worry for me right now because we are trying for our second child and I'm older now. We are going to see a fertility specialist but I have already told my husband I can't justify spending a lot of money on this. We already have one child and while we both want another child we make less than the couple profiled here and live in a higher COL area. I admit I have a very hard time sympathizing with people who spend so much trying to have a child. I truly don't understand the urge to have your own being that big a motivator. I would turn to adoption.
People who say "I would adopt" or "you/they should just adopt" are usually well meaning, as I'm sure you are, but frankly it's an utterly clueless thing to say. When you are talking with people who are dealing with infertility, it is also anywhere from mildly offensive to hurtful, because OBVIOUSLY adoption has crossed their minds and they are almost certainly better informed about it than you are, so if they're not pursuing it there is probably a good reason.
And here are some reasons, just FYI.
First off, there are more than 7 million infertile people in this country (and it only takes one infertile person to make an infertile couple), but only 20,000-30,000 women place their babies for adoption in the US each year.
Second, adoption is more expensive than fertility treatments. Whether you adopt domestically or abroad, these days it can be upwards of $30-$40k per adoption (i.e., usually--unless the birth mom has twins--per child), plus legal fees and travel expenses. Compare that to $12k-$25k for IVF, $20k-$50k for IVF with donor eggs (which can produce your entire family--I know people who've had 3 or 4 kids from one round of donor-egg IVF), or for those who are willing/able to travel for IVF, you can do IVF in Europe for $5000 or donor-egg IVF for $8000.
The only way to adopt cheaply is to adopt from the foster care system, and if you want we can discuss why foster-adopt is legitimately not the right path for a lot of people, but even for those who do want to pursue it, there are only a hair over 100,000 foster kids of ANY age available for adoption in the ENTIRE US, and you can only adopt from foster care in the state where you live so far fewer than 100,000 kids are potentially available for you personally. (You can look up the numbers for your state, or just ballpark by noting what fraction of the US population lives in your state and then applying that fraction to the 100k number to guesstimate how many foster kids are available for adoption in your state).
Also, when foster kids are made available for adoption there is an automatic preference for them to be adopted by relatives, however distant, rather than strangers. You can be right on the verge of adopting the kid, after years of waiting and caring and paperwork, but if their second cousin shows up wanting to adopt them, generally speaking you are out of luck.
Third, the adoption process is incredibly invasive (you have to share thorough financial and health records with adoption agencies, and submit to home studies), and it has no guarantees--in most domestic and some foreign adoptions the birth moms choose the adoptive parents, so after spending thousands and opening up your life to some agency you might wait years without being chosen, and/or it might turn out that your age, your religion or ethnicity or non-heterosexuality, your asthma or overweight, or whatever other health factor--including minor ones--disqualifies you under a given country's adoption laws.
Fourth, in the US birth moms obviously and very legitimately have the right to change their minds, so you could spend $20k+ on a birth mom's medical expenses and then have her back out, even weeks after giving you the baby. There's a good recipe for complete heartbreak and massive financial loss (no, you can't get back the money you spent on her medical expenses). By the same token, birth fathers sometimes come after adopted children even years later--I'm sure you've seen the occasional news headline on that--and they not infrequently win. Even when they don't win, i.e. the child stays with you, you are still out tens of thousands in legal bills, not to mention therapy bills for the poor kid.
Fifth, adopting internationally can be an ethical minefield and is sometimes catastrophically unpredictable (just ask all the people who were right about to bring their adopted Russian kids home when Putin decreed that no more Russian kids could be adopted to the US). Even when it goes smoothly, it takes an incredibly long time. The part I understand the least is that even after you've waited it out and finally been matched with a child--they send you photos and info--you can still wait another year before they actually let you go GET the child. So your kid is sitting there in a third-world orphanage for NO REASON, risking malnutrition and exposure to disease, not getting the love you want to pour into it... for NO REASON other than that some third-world bureaucrat hasn't signed certain documents yet. It's absolutely maddening. We have friends going through this right now.