For the one in six couples blindsided by impaired fertility, the quest to achieve pregnancy can become all-consuming—battering emotions, body, and pocketbook. How much are you willing to pay for a pregnancy? Jeff Opdyke addressed this issue in a column for The Wall Street Journal.

Certainly, there are many who will immediately say that no price is too dear to experience the joys of parenthood and to bring into this world a life that is of your flesh and blood,” writes Opdyke.

But when couples learn that a natural pregnancy is unlikely, they’re faced with immediate, very difficult decisions:

• If at first we don’t succeed, how many times should we try, try again?
• If medical treatment doesn’t work, do we have a Plan B, such as adoption or remaining child free?
• Just how much money are we willing to spend on treatment that may not work?
• Should we reserve funds for pursuing other paths to parenthood?

“Money often takes a back seat in the initial discussions—lost in the emotion of the moment,” writes Opdyke. He adds, “It doesn’t do any good to ignore the financial component, even if it seems crude to put a price on childbirth.”

I agree. In my volunteer work with couples facing fertility challenges, I have met couples who spent upwards of $100,000 in their quest to become pregnant. Some have refinanced their homes; others have moved cross country to find jobs that offer excellent fertility treatment benefits. Most, unfortunately, have gone heavily into debt and even into bankruptcy.

One friend told me, “There’s always the hope that next time, the treatment will work. Next time, they will have invented some new drug or new procedure that I just have to try.”

Next time…next time. The kernel of hope remains through seemingly endless cycles of hope and anticipation followed by defeat and intense grief.

With the fixation of conceiving or carrying a child to term always before you, it’s hard to set limits. Opdyke writes that “money and motherhood…become so entangled that rational thought will disappear.”

And yet, rational thought is critical when a couple considers treatment. Limits must be set. You and your spouse must sit down and closely examine your finances, preferably BEFORE you begin treatment.

• How much do you have in savings?
• In home equity?
• In workplace health benefits?
• Are you willing to take out a loan? If so, for how much?
• Are you willing to move to another state, to a job that offers better fertility benefits?
• Are you willing to sell your nice new car and drive a used model?
• Are you willing to downsize?
• Should you get pregnant and give birth, how much money will you need to pay for your child’s basic needs, for daycare, or for potential medical issues the child may experience?

Harsh as it may sound, taking an honest look at your finances will save you potential heartache. If you determine that you can afford $40,000 in your quest for a child, you might decide to budget $20,000 for one cycle of IVF (in vitro fertilization) and the remaining $20,000 for adoption.

Or you may elect to try two or three IVF cycles. Whatever you decide, it’s imperative to be emotionally prepared to walk away from treatment when you’ve reached your financial limits.

Yes, it’s excruciating to walk away – I’ve done so myself. But when my husband and I worked up the courage to walk away from fertility treatment, we had something to walk toward. That “something” was the two delightful babies whom we adopted.

What about you? If you’ve experienced fertility challenges, what boundary-setting have you done that works for you? What do you wish you’d done differently?

There’s an interesting article in today’s Cincinnati Enquirer called "$10,000 babies." The article, by Tim Bonfield, introduces couples who go to extremes to pay for fertility treatment:

• The woman who loved her job, but elected to change jobs because her new employer offered fertility benefits.
• The couples who go to Mexico, Canada or Europe for fertility drugs, and those who trade medications over the Internet with other infertile couples.
• Those who take out huge loans or borrow against their credit cards.

Some of the stats that Bonfield mentions in his article include:

• An estimated 6 million couples per year — 10 percent of all married people, experience fertility challenges.
• Success rates for first-time in-vitro fertilization (IVF) are going up. Ten years ago, the success rates were 20 percent; now they are 50 percent in women younger than 35.
• Since 1978, when the first "test tube baby" was born in England, over 250,000 children have been born in the United States as a result of fertility treatment.
• Most states do not require health insurers to offer infertility coverage. Only 15 states require at least some fertility coverage (with many restrictions attached).
• Insurers assert that infertility benefits are not medically necessary, saying that offering full benefits would drive up insurance costs for everyone. A spokesman for one insurance company estimated that providing such benefits would increase costs for all employers by 2-3 percent.
• Many employers cover adoption costs but not fertility treatment.

An article I wrote, entitled, "Four Steps to Financing Fertility," was published at www.preconception.com.

The article explains how to budget for fertility treatment and why to seek a specialist early on. You’ll learn about the importance of medical insurance to cover the costs of fertility treatment, and you’ll get some tips for how to connect with others who can help you along your journey.

Here are some "bonus" tips for financing fertility that didn’t make it into the published article:

• Comparison shop for pharmacies (including online pharmacies) that provide low-cost fertility medications. Visit www.sharedjourney.com/phar.html.
• Search the online classifieds for low-cost meds at www.FreeGarageSale.com/cls.htm. Ask whether local universities or research facilities are conducting clinical trials in which you may be eligible to participate.

Part 2 of the series: "Financing Adoption" — is also available at preconception.com. An outline of that story and some additional financing tips is in my two January 15, 2005 blogs.