The true cost of IVF

I recently spoke to Mumbai Mirror about my IVF journey and its impact on my life (you can read the article here>>) and it got me revisiting the past 3 years. A roller coster journey that took away a lot while finally giving me my heart’s desire.

As the article rightly points out, many of us struggling with infertility tend to look at IVF as the ultimate solution. Something that’s surely going to set us on our way to parenthood. Even when the doctors caution about the low success rates, we feel that we are going to be the lucky ones. However, the dreams of taking home a bundle of joy after one cycle shatter in no time.

The true cost of IVF is not in the money you shell out at the clinics, it’s in the way the process takes over your entire life. Here’s how it will affect you:

The Physical Cost

The process is painful. Before you even begin the actual cycle you undergo a surgical procedure called Hysteroscopy to check the health of your uterus and ovaries. For me this was the first ever surgery and to be honest I was spooked at the thought of general anesthesia.

You take 2-3 oil based injections daily for 10-12 days per cycle. These are given on your abdomen or thigh and leave a trail of black and blue bruises. As the hormones get your follicles to grow (they can get as big as 2mm each) you start getting stabbing pains in your lower abdomen.Walking, driving, riding in a cab or sitting on a bike – everything hurts.

Then comes the egg retrieval under general anesthesia where they put a catheter inside you, insert a needle and suck out the eggs from your ovaries – waking up after is not nice. That’s still better than the embryo transfer. You lie wide awake and helpless with your legs in straps as the doctor inserts a metal clamp to open your cervix. A catheter goes in again to deposit the embryo. While this bit isn’t painful for many women, it’s supremely uncomfortable.

Finally, in case the normal route does not work, you’ll need to undergo several other tests and procedures. I had to get my endometrial receptivity tested to check if there is a reason why the embryos are not implanting. What it essentially does it scrapes off some tissue from your uterine wall with a metal object – NOT under anesthesia. And till date it’s the most painful thing i’ve ever encountered – this from someone who didn’t care that her hand was sliced open and needed 6 stitches.

If IVF itself wasn’t painful enough it otherwise takes a toll on your body too. The hormones make you gain weight. I put on 18 kgs in the 2.5 years I was under treatment. The Estrogen produced in the cycles also increases the bile saturation and can lead to gall stones. I had to have my gall bladder removed in an emergency procedure as the treatment had give me gall stones. Then there is the added complication of OHSS – ovarian hyperstimulation syndrome – which is painful swelling of the ovaries and can even lead to death. In the US almost 1000 women seek emergency care for OHSS every year. And finally, in the long term IVF treatments can also cause ovarian cancer.

The Emotional Cost

Of course as you battle with the physical pain, there is a massive emotional cost you pay. The hormones make you overly emotional – it’s like an extended PMS.  I would cry at the drop of a hat. My cab is late – there are tears. My coffee is lukewarm – more tears. My phone battery is low – tears. Anything and everything can and will trigger an overly emotional response.

Even as the hormones make your emotional state fragile, there is a chance that it won’t work. You pin your hopes and dreams on the success of the treatment and it fails. You nurture an embryo inside your body for 15 days and it fails to implant. You feel pregnant for those 2 weeks, but you aren’t. You invest yourself in another cycle, you spend days, hours, and agonizing minutes at the clinic. You cut yourself from your social circle, you take many a step back from work, and you focus your entire being on trying to become a mother – and it fails.

I cannot put in words the disappointment that crushes you every time you see the negative BHCG results. Going through such an emotional roller coaster could also lead to depression.

Did you know the success rates for IVF are only 30-40%? Your doctor tells you that, but you feel you’ll be the lucky one, it’ll work for you the first time. When that doesn’t work, you feel the next one definitely will. It’s a gamblers mindset. You’ve put your chips in, and you can’t quit now.  But I have heard from several women on my blogging journey, where even after multiple attempts they were not able to have a child via IVF. I am one of them in fact. If not for surrogacy, I probably would not have had my baby boy.

To top it all there is that constant social pressure. If you haven’t told anyone, there is the pressure to hide it. If you have, then the constant questions and advice on what could be wrong and how to make it work. It’s enough to drive one mad.

The Financial Cost

The final straw that could break the proverbial camel’s back is the money involved in the process. Most of the people I have heard from have dropped off after trying a few cycles simply because they cannot afford it. While IVF in India is way cheaper than in the US, it is still a daunting investment for the middle class income here.

You need to shell out 2-5 lakh rupees for each cycle depending on your city, doctor, and treatment plan. The worst bit is the hidden costs that sometimes take the first timers by surprise. You hear that an IVF cycle will cost you 1.5-2.0L, then you go an realize that you need to pay another 40K for a hysteroscopy, then there are the daily blood tests that can be around 1000-1200 rupees a day.  Add the medicines you need to take pre and post transfer and that’s a few more thousand rupees gone. If you need more tests or procedures for instance ERA or cyst removal that come at additional costs.

Then there is the question of egg/embryo freezing – after the cycle you may have leftover eggs/ embryos that you need to preserve. Cost for freezing one tube that can store 3-4 eggs/ embryos is around INR20K. If you use the frozen embryos for another transfer that could be around 50-80K. If you are traveling to another city to do the procedure then you need to add the travel, stay and food costs as well. If you are switching doctors or hospitals you’ll need to pay for cryo-transport to shift your eggs/ embryos to another facility.  So overall the IVF budget turns out to be more than what you initially thought it would be.

Even after this, there is no guarantee that there will be a baby.

So if you are planning to go for IVF, think carefully before you start the journey.

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