(Click to See My Fertility Chart)

Sunday, May 30, 2010

The Post Where I Over-Analyze My Over-Analyzation, and Then Some

Slight change of plans. Our quote from Dr. Big Time's shared risk plan came in. Sheesh!

In my second to last post I mentioned that we are thinking about doing a refund (or "shared risk") plan. Out of the 3 IVF REs we've seen, 2 offer a shared risk plan: Dr. Big Time and Dr. Immunity. The details of the plans are different in ways, but at their most basic they are the same: you pay a large sum up front (does not include meds or anesthesia), and get up to 3 fresh and 3 frozen cycles, and a portion of your money back if at the end you don't get a baby.

Dr. Immunity's plan costs $19,050. The refund at the end (with no baby) would be $4475. The refund is small, but the initial cost is also, comparatively, small. However, Dr. Immunity's success rates are all over the place. For 2008, Percentage of Transfers Resulting in Live Births:
  • Under 35 - 54% (National Average - 47.3%)
  • 35-37 - 32% (National Average - 37.3%)
  • 38-40 - 10.7% (National Average - 28.2%)
  • 41-42 - 35% (National Average - 16.7%)
Dr. Big Time's plan costs $36, 772. The refund at the end (with no baby) would be $26,009. The refund, obviously, is rather large, but the initial cost is also rather large. And Dr. Big Time's success rates are pretty good. For 2008, Percentage of Transfers Resulting in Live Births:
  • Under 35 - 51.9% (National Average - 47.3%)
  • 35-37 - 44.4% (National Average - 37.3%)
  • 38-40 - 31.1% (National Average - 28.2%)
  • 41-42 - 18.2% (National Average - 16.7%)
Another thing to take into consideration is Dr. Immunity's total cycles for the year are 584, while Dr. Big Time's clinic did 2,028. This could be a partial explanation of why Dr. Immunity's success rates are all over the place.

So, how does this change our plans? Well, first of all, I don't think we can do Dr. Big Time's shared risk program. Here's the thing, the worst case scenario financially is that I do all six cycles (3 fresh, 3 frozen) before I get pregnant. In that scenario, we would not get a refund, plus we will have to have spent money each time on meds and anesthesia, which I guess could be about $14,000, in addition to the original $36, 772, for a grand total of $50,772.

I can't do it.

Spending $50,000 on a baby... I mean... I just don't think I can do it. Ugh. The thing is, we have the money. We don't have much more than that though, so pretty much we would be in a position that we have spent ALL OUR MONEY and are now pregnant. And maybe with twins (Dr. Big Time has a 32.3% twins rate). It feels irresponsible to do that. Of course, there are a lot of couples out there that get pregnant with twins and probably don't have a lot of savings and they make do. We could, too. I know we could. But we have a choice here. We don't have to do it that way.

The thing that I find so difficult to wrap my head around is that the very reason I qualify for these shared risk programs is that, based on my stats, I am likely to not end up having to get a refund. I am likely to get pregnant from IVF (again, based on my stats, not on my own feeling about it, which is that I'M BROKEN AND I'LL NEVER HAVE CHILDREN! WAAAAAH!!). I am (fairly) young, and so far no one had found anything wrong with me. I SHOULDN'T do the shared risk program for the same reason I am covered under the shared risk program: based on my stats I am likely to have success with IVF.

Okay, next (I feel like this post is scattered all over the place, but I'm gathering my thoughts on all this as I type, sorry!). What is our maximum budget for IVF? Hubs and I talked it over, and we think we'd like to try to not go much over $30,000. And although 3 fresh and 3 frozen cycles would give me a really really good chance of getting pregnant, I can't help but think it's a little overkill. (Oh boy do I hope those words don't come back to haunt me. Please please don't come back to haunt me, words...)

Okay, let's do a little exercise. Let's take 100 women between the ages of 35-37. Let's say they go to Dr. Big Time, and they are in it to win it: 3 fresh, 3 frozen, or until they're knocked up. Based on his stats here's how it would go:
  • 1st Fresh IVF: Out of 100, 44% (44 women) would get pregnant, leaving 56 women not pregnant
  • 1st Frozen: Out of 56, 30% (17 women) would get pregnant (btw, 30.2% is their success rate for FET), leaving 39 not preggers.
  • 2nd Fresh: Out of 39, 44% (17 women) would get pregnant, leaving 22.
  • 2nd Frozen: Out of 22, 30% (6.6, but lets round down and say 6 women) would get pregnant, leaving 16.
  • 3rd Fresh: Out of 16, 44% (7 women) would get pregnant, leaving 9.
  • 3rd Frozen: Out of 9, 30% (3 women) would get pregnant, leaving 6.
So, we have a 94% success rate. Not bad odds. BUT, if you look at the difference between the results of the 2nd frozen and the final 3rd frozen, they are only 10% different (i.e. 84% are pregnant after the 2nd frozen, while 94% are pregnant after the 3rd frozen).

If I paid for the cycles one by one, and it took 2 fresh and 2 frozen for me to get pregnant, I would pay:
  • $9,215 x 2 (for fresh IVF cycles)
  • $3,500 x2 (for frozen cycles, and I actually don't know how much their FETs cost, so this is just an undereducated guess)
  • $750 x 2 (anesthesia)
  • $4000 x 2 (meds, which I hope is an overestimation)
  • Total: $34,930
That number is more in the ballpark of what we would want to spend (not that I want to spend any of it, but you see what I'm saying).

Now, the final option would be to go with Dr. Immunity's 3 fresh/3 frozen shared risk plan. Total cost if it takes all 6 cycles to get knocked up: $32,550 (approximately, obviously). Of course, his success rates are lower, so my exercise above would look very different for him (I'm not going to show you that one, because I'm guessing you can't take much more of this!!).

Based on all of the above, we are now thinking we will either do a cycle by cycle with Dr. Big Time (up to 2 fresh and 2 frozen), or the shared risk with Dr. Immunity. And we have decided to wait until all of our immunity tests come back before we decide, which we found out could be up to a month (oh, yeah, they took 26 VIALS OF BLOOD FROM ME, HOLY SMOKES!). Which means we won't start our IVF next month as planned. We'll probably start in July.

And finally, I just want to say that I realize that all of our planning and figuring things out and all of my little "exercises" could add up to diddly-squat when we finally do an IVF. For example, we may find that my eggs SUCK, in which case if we didn't sign up for the shared risk, we may wish we had, as it would then be more likely (I would think) that we would need all the cycles, imagining that if my eggs are crap I might not be able to do the FETs at all.

So, that's it! If you've read this far, congratulations! You either: A) really care about my life (thank you! you are so sweet!), or B) are as obsessed with IVF costs and success rates as I am (you should really chill out about that. seriously.)


  1. Hey,
    I've enjoyed stumbling over your blog. I want to follow you and keep up, but I just wanted to encourage you to keeping going forward and don't give up. I have PCOS and have been trying to conceive for over two years now. So I can relate and understand how you feel. Feel free to check out my blog, I'd love to add you to my blog roll, and I hope you will follow me, and add me to your favorite sights. I'll be praying for you. Here's my blog. Follow me.


    God Bless,

  2. It is SO hard to decide. It's a little like involuntary gambling, because it leaves you figuring out your odds, thinking in terms of better and worse case scenarios. I don't have much to offer other than this: when we were looking around at places to do IVF we were pretty focused on the number of procedures done by any given clinic (important) and, especially, their labs. I can't stress this enough. Lab conditions, embryologists, etc., these are a very important part of the entire process (for example, different labs use different media to grow the embryos) and so I would research both doctors in terms of their labs, as well. Good luck with this.

  3. I think it's wise to wait until the immunology tests come back to make the decision. But to me it sounds like you have an excellent chance of conceiving with one IVF or FET. Since you have no known issues, you're on the favorable sides of the odds. Sounds like you really like Dr. Big Time and it would be worth a shot to try a cycle with him rather than committing to a shared risk somewhere else. Good luck! These decisions are not easy!

  4. Wow, well first let me applaud you for some serious number crunching!! I totally get how big of a call this is, so why not over analyze when you're about to drop $30K on something!! We didn't do the shared risk because we wanted to see how the first IVF went, would it work, would we have frozen and if so how many. I mean if you had a bunch of eggs to freeze you may only need to do one fresh cycle anyways, and if it doesn't work you just keep banging out frozen. Obviously these are all if statements and depend on the person, but I do think it would be worth trying one cycle with Dr. Big Time!

  5. I think you are wise to weigh your options before deciding and wish you good luck with whatever you decide to do. Hope whichever path you choose leads you to a baby.

  6. I really love the way you went through the percentages. It was interesting that you ended up with just 6 woman who did not end up preggers in the end. Do you know out of the woman who do NOT end up pregnant, are they dealing with unexplained infertility or were they diagnosed with something that could lower their odds?? I just ask because I'm wondering if ppl with unexplained fertility have better odds? either way a 94% success rate sounds mighty good to me.....
    I mean, If I knew a lottery ticket had a 95% success rate I would certainly buy it! The only problem is, this particular ticket costs SO MUCH MONEY, i think you are smart to really sit down, crunch the numbers, and decide which doctor can offer you the best odds. Is there a Doctor that you like better? that you connect with more? It seems as if Dr. Immunity does a lot of transfers in a year, do you know how organized the clinic is? have you talk to others who have gone through his doors? do you get lots of personal attention?
    Sorry, that was a lot of questions!!! I am really interested in your story and I really look forward to hearing about your success story!!!

  7. those are some serious numbers. What a frustrating decision, it's so upsetting that you have to do this! I have no advice, but I hope that everything works out in the end.

  8. You have some big decisions to make. We are so similar. I would have done the same thing in making this kind of a decision. I have no words of wisdom, because we chose not to do IVF because our percentages weren't too great. But, I'm praying that you just need one cycle!!

  9. Yah, I am seriously impressed by all your calculations!!! Working out the finances (limits, conditions, etc) is one of the hardest parts of IF. Praying that you'll receive guidance as to what path you should take!