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Common Questions about Reproductive Assistance

Updated: Nov 16, 2023

**Disclaimer: Any advice and information is from our experience or research, not medical advice.

Colorful mountains with a small journeyer and rainbow in the sky.

You want to expand your family - YAY! Congratulations on making one of your life's most significant and rewarding decisions. What's next? You may try several traditional and non-conventional methods and still find the intended parenting journey arduous. We did as well, and it's one of the main reasons we launched The Q Family Way. After years of research and maneuvering through our extensive process, friends, family, and colleagues continually peppered us with questions for their own curiosity since the subject is not commonly discussed or for personal considerations. In this post, I will highlight their top questions and provide answers from our experience and thoughtful resources. Let's dive in.

Q: How much did the process cost?

It is such a common question, but highly personal and so nuanced. The cost of family building greatly depends on your needs, the country or state in which you live, and your insurance plan. Since we live in the U.S., we will be focused on those statistics and numbers. Only 19 states mandate insurers to cover or offer "fertility" services. Most insurers still focus on infertility, use narrow definitions and language around sexual methods for procreation, and unnecessary timelines for "trying" that exclude the LGBTQ+ population and single parents. Luckily, the policies are becoming more inclusive, like using reproduction instead of fertility, removing timelines, and adding surrogate and adoption support.

Still, insurance is limited, and most of us seek reproductive assistance by paying out-of-pocket or finding non-clinical means for family building. Out-of-pocket costs can vary widely - think donor egg or sperm, fertility/hormone medications, surgeries or procedures (like IUI or IVF), or the number of rounds until success. To give a ballpark number, the costs can be between $8,000 to $80,000 and rise year after year.

Graph of 2011 Average Cost of Fertility treatment over 18 months in Northern California.

Yes, ouch! During our family's journey, with insurance services covering some of our processes, we still spent over $15,000 out-of-pocket. We prioritized savings, hunkered down spending for three years, and could pay our portion outright. But there are also grants, medicine discounts, IVF-specific loans, and other ways to help cover the costs, as highlighted in a 2023 Forbes Health article.

Q: How did you know where to start the process?

We didn’t at first! I tried asking my Primary Care doctor at the time, and she was a bit rude about the question - just stating that once we got pregnant, come back for care. She added, “We have even had a trans patient give birth here before.” Okay, so I’m supposed to feel more comfortable with your care now when you haven't answered my questions honestly. “How do we go about getting pregnant with Kaiser?!!?” It was unexpected based on previous discussions I had with her. After the fact, I found that since the Kaiser insurance in my State didn’t cover all ART, just the basics of infertility medications at best, her hands were tied. Couldn’t she just have said that? OR perhaps she was uncomfortable or didn't have the training to discuss same-sex options. I quickly switched to Danielle’s insurance during the next open enrollment period to provide more options. We were nervous about choosing a traditional reproductive endocrinological clinic due to my experience with Kaiser. Luckily, there were other clinics with a personable approach in our area, and we received the answers we needed to make the best decision for our family to move forward.

I hope you had a smoother experience than us if you have already started your family-building journey, but I learned that you must advocate for your health and goals. Do a bit of outreach and find the best birthing clinic, midwifery practice, or reproductive endocrinologist to answer your situational questions. A place where being your authentic self isn't challenged, or at least not beyond your comfort level. Your comfort should be prioritized regardless of the size or type of provider. Kindly speak up or make a change as needed.

Q: How did you choose the sperm donor?

Like many aspects of this process, finding a donor is personal. We have had friends who only cared about physical characteristics (race, hair, or eye color) or medical history (potential for genetic disorders). While others have many criteria, we were one of those, well, me mostly. Since we had decided that I would carry and use my eggs, I wanted the donor to have physical features and ancestry similar to Danielle's. Educationally and athletically driven, a family medical history we were comfortable with, and donor anonymity were vital factors as well. We both wanted them to be kind.

Once we knew what to look for, choosing a donor bank was next. Going with a bank and using an anonymous donor made the most legal and logistical sense, mainly due to the State in which we resided. Living in the South, we naturally started to search for banks here but found donor pictures closer to Tinder profiles than a clinical bank. We still laugh about that to this day. This led us to two reputable banks with user-friendly websites - California Cryo and Seattle Sperm Banks. When we started a decade ago, we had fewer options and less easily digestible information. The credibility and success of donor banks have increased viable options in the US and abroad. Each State has its own laws surrounding parental rights, so tread wisely however you choose to access sperm.

Q: Any other interesting tidbits?

Depending on your clinic or provider, you may have to complete and sign an informed consent letter, which is an agreement that informs the allocation of sperm, eggs, and embryos in the event of death, divorce, or other unforeseeable circumstances. This was something I wish we had known ahead of time and were able to dedicate more time to legal advice. It also has become more mainstream due to the Roe vs Wade reversal. Another is we had a Fertility Psychologist review required by anyone seeking care with our chosen clinic. Danielle and I found it to be a welcome pre-parental therapy session that would probably benefit ANY person before becoming a caregiver.

With such a big decision comes a lot of responsibility, but every year more and more options are available to LGBTQ+ couples, single persons, and any looking to expand their family through the support of others. If you want to advocate for better policies in your state and federal government, check out the excellent work at Resolve. If you are looking for clinics near you, SART is a good start. And, always remember you are your own advocate but never alone in the journey. Together, we can make anything possible.

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