So, you've got a lot moving pieces. You're doing the very expensive route of IVF. I'm sorry that it's necessary. But it also creates a potentially very tough decision: what do you do if it doesn't work? Because that happens. I hope you're talking honestly, about all of it - the stress, the worry, the heartache, the fear it won't work, the fear it works but the pregnancy isn't viable. ALL of it. If marriage counseling or individual therapy is needed, then do it.
If you do have children, yes you end up spending money on them (clothes, food, medical, toys, etc), but there are pretty simple ways to cut costs. If your wife isn't on board with frugality re children, then she's not on board in general and you've got a much bigger problem to address. Plus, it's often much better for the kid to be frugal than to buy everything in sight, so there's angle to work as well.
Job: Right now, you're burned out and dealing with (non-drug) addiction stuff. That doesn't get better without fixing the underlying problems, and the longer it goes the worse it gets. You need to seriously consider a new job/career shift. Which may in turn have income ramifications. Plus, if you are able to have a baby, do you really want to only see that baby for a few minutes a day?
Family: why would you need to support parents? Do they have savings, pension, social security? If they're living beyond their means, that's not something you have to fix. As for the medical costs, I get it. But before you kick in money, they need to be getting whatever benefits they're entitled to. Medicare, Medicare, private insurance, etc. It often just takes time to organize that and deal with the paperwork, and right now, it sounds like you have no time. Which is why you're defaulting towards potentially throwing money at the problem.
House: You're cash poor. Whatever the situation is that has prompted you to buy the house you're currently in, it's locked up a ton of your net worth. You can't FIRE right now, not without selling and dramatically reducing your housing costs. You say people would be upset if you sold/rented: well, unless those people are you or your wife, they don't get a voice. You and your wife live there, you pay the bills, thus you make the decisions. Not these other people. If other people are going to get so upset if you chose to rent/sell, then they're welcome to buy it from you. It doesn't really matter what the situation IS - either they can shut up, or they can buy the place from you so they can do whatever they want with it.
Expenses: you're spending $50k a year for 2 people. Unless that includes $20k of IVF, your budget has a ton of fat in it.
Bottom line:
You have some pretty serious LIFE decisions to make. What do you want? Because right now, you're bringing in a lot of money and destroying your physical and mental health in the process. You're locking the majority of your networth into real estate that you're not necessarily willing to change. At some point, the wheels are going to fall off the bus. This isn't a how do I FIRE question, it's a "how do I build a life that I'm happy with and can sustain" question. Good luck.
