Do we want to have a child? We discussed this topic many times over the years. For a long time we both thought the answer was no, but… then things like maturity, love, and a strong relationship happened
Like most people, we knew how to make a baby the old fashioned way. But no matter how hard we tried (or how many times), it just wasn’t happening. Perhaps this had something to do with the vasectomy I had about 12 years ago?
Determined to extend our family, we explored our options, comparing costs, success rates, and convenience factors.
Although we had health insurance at the beginning of our journey, it seldom (or never) covers the costs of infertility treatment, so cost efficiency was important. Why pay more than we had to?
Here are the results of our path to pregnancy
While we were still in Seattle, we looked into vasectomy reversal. I wanted to know about costs and success rates for the procedure, but the internet was quite useless in this regard. There were many paid ads and websites promoting “Doctors” that reminded me of Dr. Nick Riviera, the quack doc from the Simpsons.
I asked around and was referred to an ex-army Doctor that had performed thousands of vasectomy reversals (“back when the military paid for this procedure, I did a lot of them”)
This is what it cost me $300 and 5 minutes to learn:
A vasectomy reversal microsurgery has a 95% success rate, at least when it comes to connecting the tubes back together. This success is temporary though, as eventually scar tissue will result in complete blockage of your little swimmers’ escape route. This means after the procedure you have 6 months to 1 Year of fertility, plus or minus (but also leaves the possibility of an “oops” even years later)
Somewhere between 7 and 10 years after a vasectomy, your body will recognize that it is pointless to make more sperm. What little sperm it does create, while being completely normal and healthy in terms of DNA, will be stunted and unlikely to have the strength to swim the distance, if you know what I mean
Thus what the doc told me: “I give you a 95% chance that I can connect the tubes successfully, but a 5% chance at fertility.”
The cost of this procedure was estimated at $6,000 (or more if there are “complications”), which included his fee of ~$2,000 and about $3,500 for use of the “cheapest operating room in the Seattle area.”
Spending $6,000 for a 5% chance at fertility didn’t seem like a great choice.
The old fashioned way was out of the question
In Vitro Fertilization
Our next best option was In Vitro Fertilization (IVF.)
IVF is a process whereby an egg is fertilized outside the body, the so-called test tube baby. This requires stimulating ovation in the woman, surgically removing the released eggs, fertilizing the eggs with sperm in a petri dish, cultivating the eggs for a few days, and then implanting the resulting embryos into the woman’s uterus. An explanation in great detail can be found here.
Because of the vasectomy, sperm extraction was also required, whereby sperm is removed directly from the testes while under anesthesia. Unless you like getting a needle into your nether regions, having some sperm frozen at this time is a good idea, providing future options
Because of the long period of time since the vasectomy (over a decade) assisted fertilization is also required, whereby a single sperm is manually injected into the target egg.
I was able to find a great online IVF cost estimate tool. Our estimate is shared below (this does not include the cost of obtaining sperm, but does include the manual fertilization process aka ICSI)
In addition, the cost of sperm extraction would be several thousand dollars, pushing our total towards $35k
Medical Tourism to Taiwan
For perspective, last year we spent less than $35k on our permatravel lifestyle. That seems like a steep price to pay as a down payment on a GCCjr
But with time and freedom on our hands, we didn’t have to stay in the US.
Taiwan had several benefits. Costs were substantially lower than the US and it had a booming IVF industry with a strong track record. Being in Taiwan also served double duty, allowing us to visit Winnie’s family while we went through the IVF process
(As an added bonus, Winnie is a citizen of Taiwan which means she is eligible for the single payer National Healthcare system after being in the country for 6 months. This doesn’t impact any of our IVF costs, but might affect the cost of childbirth if we choose to do that in Taiwan.)
Our IVF Experience
We interviewed two doctors before selecting the second, working out of a hospital affiliated with a medical university. We worked with a Urologist in the same hospital
The IVF regime is lengthy and intensive. Daily injections in the stomach are required to induce hyper ovulation, a painful process. In total this produced 15 eggs. 8 were extracted during surgery, of which 6 were manually fertilized (ICSI.)
Obtaining sperm was relatively easy. I went under anesthesia and woke up with only mild discomfort, so my contribution was done within a day. We even froze sperm for potential future use. By comparison, Winnie’s process was nearly 6 months, and of course that is just the beginning
An overview of timing and cost is shared in the table below
|Feb 17||$40||$47||W: Doctor interview, general health check, blood test|
J: Urologist visit, blood test (is body still producing sperm?)
|Mar 6||$13||W: Dr visit, see results of blood tests (determines drug regime)|
|Apr 1||$163||W: Dr visit, shots to excite ovulation: $13|
W: Supply of ovulation drugs: $150
|Apr 3||$152||W: More ovulation drugs|
|Apr 7||$151||$40||J,W: HIV Tests|
W: More ovulation drugs
|Apr 9||$164||$71||W: Dr visit, blood test (are drugs having desired result?), more drugs|
J: Urologist visit, Chest X-ray, EKG (evaluate risk of anesthesia)
|Apr 11||$680||J: Surgery for sperm retrieval|
|Apr 12||$1740||$18||W: Surgery for egg collection (8 total)|
J: Urologist visit, change bandages
|Apr 15||$1953||W: Freeze embryos, sperm, ICSI (6 eggs total): $1233|
Embryo implant (3): $500
Drugs / misc: $220
|Apr 29||$13||W: pregnancy test and Dr consult (not pregnant)|
|Jun 20||$12||W: Dr consult Re: round 2|
|Jul 11||$18||W: Dr consult, estrogen free sample|
|Jul 22||$60||W: more estrogen|
|Jul 26||$682||W: embryo implant (3)|
|Aug 8||$165||W: pregnancy test (yes!)|
|Aug 22||$176||W: Dr consult, ultrasound (heart beat!), more estrogen|
Total expenses through the hospital were ~$6,357
This doesn’t include the seemingly daily supply of home pregnancy tests that were used by a certain curious someone throughout the process :)
Also not included is a regime of Chinese Medicine that we undertook after the first failed attempt. There is a Doctor in Taiwan, trained as an MD and in CM, that specializes in pregnancy. I’m a skeptic on CM in general, since it has little (if any) evidence based credibility, but there are things you don’t argue about :) This supply of herbs set us back about $97 a week, for a total of $723
The majority of the hospital expenses were paid for with a cash back credit card, reducing our total costs by ~$95.
Overall, we are very pleased with the results
By pursuing fertility treatment outside the US, we saved 80% off the estimated US price, have a child on the way, and are still guaranteed free birth control in the future
In terms of cost efficiency, it doesn’t get much better than that. $6,357 for 12 years (so far) of 100% effective birth control is also quite reasonable as well, less than $1.50 per day
And better than expected, we are expecting :)