Friday, April 30, 2010

What IF?

Or, How Infertility Affects Your Finances. . .

I am nearly 38 years old, and I just recently had my first child. I was only 34 when we started trying. Like so many women, I had a feeling that something was not quite right after a few months of trying. Neurotic, Type A person that I am, I started charting as soon as we started trying, and I discovered a very disturbing trend. I always ovulated much later than all of my books said I should. But my doctor, unfortunately like so many gynecologists out there, told me to keep trying. She said she wasn't concerned about my late ovulation. She still wasn't concerned when we got pregnant, then miscarried. My age didn't worry her at all. My rail thin frame didn't raise any eyebrows, either.

After my second unsuccessful pregnancy, I felt conflicted about what to do. I liked my doctor, and wanted to believe her reassurances. But, there was something eating away at me. It was one thing to deviate a little from the textbook Day 14 ovulation. But I couldn't find anything that said it was okay to regularly ovulation on CD 22 or later. I wanted a second opinion, so that at the very least, the nagging doubt would go away. I was reading a lot on my own, and I just felt like my doctor was missing something. I decided to consult a reproductive endocrinologist.

I was lucky, for two reasons. First, I have great health insurance through my employer for which I contribute a pittance. This insurance is so good that it provides full and apparently unlimited infertility coverage. Even better, it doesn't require a referral to see a specialist. Second, I had been researching on my own, and discovered that the source of my problems might be that my BMI was a tad too low, causing late ovulation, which was in turn resulting in rotten eggs (which was in turn causing the miscarriages). I began a campaign to gain some weight (a mere 10 pounds), and looked for an RE.

Had I needed a referral, I might not have ever seen the RE. I probably would have chickened out, rather than face the scorn of my doctor, who clearly didn't think there was anything wrong with me. Had I not had such great health insurance, I might not have been able to afford to ever see an RE. And had I not had the ability and tenacity to both research and advocate for myself, I might never have gotten to the bottom of my problem at all. If I'd left myself in the care of my old OB, I might have merely been subjected to endless rounds of Clomid, which was her knee jerk reaction to my problems, as it is for so many gynecologists.

Instead, I consulted with the RE, who confirmed that I was too thin. My weight gain campaign was already underway, and I got pregnant during what was supposed to be my "evaluation" cycle. I have a healthy baby girl now. Given how proactive I was with my own reseach, might all of that have happened without the RE? Sure. I was already trying to gain weight on my own. But would I have known what my IF problem truly was, and why it was happening, had I not seen the RE? No, I would not. After all, I was under my OB's care for a few years before I got to the bottom of it, and without that RE's confirmation, I would have had my suspicions about the cause of my miscarriages, my late ovulation and my wonky cycles, but I wouldn't have been confident in it. I would have been even more worried for the future than I am.

So it is with great trepidation that I leave my current job, and its gold standard health insurance. I know that it will be at least another year before I will be ready to make a decision on whether to build our family from here. At that point, I will be another year older, pushing 39. At that point, I will work somewhere else, with health coverage that sounds as though it may not measure up (and really, how many plans can measure up to my current health insurance? It's amazing coverage). If we decide we'd like to have another child, will my body cooperate? And more importantly, will my insurance?

Those are just two of my fears. Once I switch insurance, will I get the care I need? Should I stay where I am? By pursuing my career dreams, am I compromising my personal dreams regarding my family? What if that's the case? Will I have regrets? I can't know the answer now to any of those questions. I worry that I am making the wrong choice, that once again I am sacrificing personal happiness, and the happiness of my husband, at the feet of my career. This time, though, the angst is caused not by the job, but by the quality of the insurance coverage on offer.

To learn more about infertility during National Infertility Awareness Week? Visit Resolve. You can also read more What If's by visiting here. They will both inspire you and break your heart.

So, what if I am throwing away my opportunity to have another child? Ah, but what if I am not? I don't save the good china for holidays, and I won't give up this wonderful new job opportunity just because the health insurance isn't as good. I have to live my life, after all, insurance be damned. The RE consults gave me some confidence that I can handle my IF in the future. It feels scary, but I just have to hope that it will all work out in the end. But what if I didn't have to make a leap of faith on this one? What if health insurance treated infertility for what it is: a medical condition just like any other.


battynurse said...

Wow. That does sound like great insurance coverage. That said I also understand the need to follow a dream or your bliss or whatever. To have a job that is something you truly love to do isn't something many people manage to do and I hope that you are able to. I also hope the difference in insurance coverage won't make a difference.

Piccinigirl said...

your story sounds a lot like mine..because I stayed with my OB (they even do IVF in that office) for far too long, chasing clomid and IUIS...our first IVF was a success and I wonder what kept me at the OBs..loyalty I guess.

Insurance coverage is a big deal.I can only imagine how you agnonize over it and leaving that type of coverage...but as battynurse said, your bliss is your as important for your health and your next pregnancy, to say nothing of your sanity.

May your choice bring you even more happiness.