Fertility Treatment Options for Those With Lower Incomes

Key Takeaways From This Article:

• Fertility treatment can be cost-prohibitive to families with lower incomes. A single cycle of I.V.F. can cost as much as $25,000, with medication.
• Some insurance policies cover treatment and grants may be available.
• For some infertile couples with no underlying medical cause for their infertility, natural remedies, like sleeping well, quitting smoking, lowering coffee and alcohol intake, reducing stress, eating a healthy balanced diet, and certain wellness supplements can increase the chances of conception.

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Infertility is defined as having tried unsuccessfully to have a baby for one year if you are under age 35, or as having tried unsuccessfully to have a baby for six months if you are over 35. However, this doesn’t mean that you can’t have a baby. The fertility treatment options that follow from this will depend on the medical reasons for your infertility (infertility can be caused by medical factors like inability to ovulate or cancer treatments, or due lifestyle factors, like weight, nutrition, and substance use). For some women who need I.V.F. or I.U.I. treatments, the cost and road ahead can be full of challenges, financial challenges being often chief among them.

Fertility treatments like in-vitro fertilization (I.V.F.) and intrauterine insemination (I.U.I.) can be incredibly cost-prohibitive for low-income families. The New York Times reports that the average cost of a single I.V.F. cycle ranges anywhere from $12,000 to $17,000 (according to data the Times retrieved from the National Conference of State Legislatures), not including medication. And with medication, a single cycle can cost as much as $25,000. To make matters even worse for low-income families, the Times reports that women may need anywhere from 3 to 6 cycles to successfully conceive. With the costs being so high, there have been stories of middle class families refinancing their homes just to have the chance to have a baby. Lower-income families are often excluded entirely from even trying one cycle of I.V.F. due to the high costs of this procedure.

Yet, before you decide that assisted reproductive technology or fertility treatments are out of reach, there may be fertility treatment options available for families with lower incomes. Families should look closely into what their insurance covers. Other families may consider applying for grants that may cover fertility treatments. Some insurance policies may cover diagnostic testing that could give you better insight into the medical reasons why you may be struggling to conceive, so that you can make more informed choices about your next steps. For women with lifestyle factors or those with no clear medical reason for their infertility, trying natural remedies supported by scientific research could also be an option.  Let’s take a closer look at all these options:

Insurance Coverage and Grants

Insurance companies offer different levels of coverage for fertility treatments, diagnostic testing, medications, and more. Before going to the doctor for diagnostic testing, it might be a good idea to contact your insurance company to learn more about what is and isn’t covered. For example, some insurance policies might cover diagnostic testing, but may not cover I.V.F. or I.U.I. treatments. And some policies might cover I.V.F. and I.U.I., but may have limits on how much a family can spend on these treatments. Other policies may require that couples try I.U.I before starting I.V.F. Ultimately understanding what is covered and required by your insurance company can better help you understand your options and what you may be able to afford.

According to the National Conference of State Legislatures, 16 states have laws that require insurers cover infertility diagnosis or treatment, or offer coverage for infertility diagnosis and treatment. These states are: Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia. In New York and Texas, insurance companies are required to offer coverage for fertility treatment, but not all policies may cover it, so if you think you might need fertility treatment, this might be a discussion to have during enrollment periods and when discussing health insurance benefits with your employer. Of course, policies might have tons of fine print, so you may need to be an active advocate for yourself when it comes to learning about what is and isn’t covered by your insurance. Additionally, you can learn more about the policies and options available to you by speaking to insurance advocates when signing up for policies through the Affordable Care Act. This may mean making phone calls, getting informed, and looking over your policy closely.

Finally, low-income families may be able to apply for certain grants and scholarships that may offer financial assistance to cover the costs of I.V.F. and I.U.I. Verywell Family notes that some of these grants may have application fees, and others may require winners of the grants to appear publicly in promotional materials, so families may want to look closely at the different grants available and choose the ones that are best for them. Verywell Family offers a list of some national grants available here.

If you are having difficulty conceiving, diagnostic testing may be able to tell you why. Your doctor can better guide you on your options. For some couples, there might be no clear reason why they are struggling to conceive, while others might be offered a clearer diagnosis and roadmap forward. Having some answers can help you navigate the options available, which can include I.V.F., I.U.I, and even natural remedies, in some cases.

Natural Remedies

One of the benefits of natural fertility remedies is that many of them are low cost. And while there is research supporting the benefits of quitting smoking, getting good sleep, cutting back on the caffeine and alcohol, eating well, and losing weight, natural remedies won’t be able to help all infertile couples (particularly couples who have specific medical reasons underlying their infertility). Before trying any fertility remedy, it is also always a good idea to speak to your doctor. What are some natural remedies that low-income families can try? Here are a few things to keep in mind:

• Get Good Sleep. According to Sleep Medicine Reviews, research on shift workers found that insomnia and sleep disturbance could affect fertility, because fertility hormones are related to your circadian rhythm. Interrupted sleep patterns associated with shift work could also interfere with a woman’s menstrual cycle, which can affect fertility. While more research needs to be performed on the link between sleep and fertility, it can’t hurt to get a good night’s rest. While the average adult needs anywhere from seven to nine hours of sleep, according to Harvard Health Publishing, each individual will have their own unique sleep requirements, with some people needing more than nine hours and some needing less than seven. Listening to your body, reducing stress, and getting adequate sleep can’t hurt if you’re trying to conceive.

• Quit Smoking. According to the Cleveland Clinic, just quitting smoking can double your chances of getting pregnant if you are trying to conceive. Smoking can cause inflammation in the sperm in men and damage a woman’s eggs and ovaries. Researchers writing in the journal Human Reproduction concluded that as many as 13% of women suffering from infertility suffer because of smoking. Quitting smoking within one year of trying to conceive can return your fertility levels to those of a person who never smoked. Finally, quitting smoking while trying to conceive has added benefits because it gives your body time to clear out the toxins and carcinogens associated with cigarette smoke, making it less likely you’ll expose your developing baby to these chemicals.

• Coffee. While studies don’t show a link between infertility and caffeine consumption, the risk of spontaneous abortion during early pregnancy seems to increase with higher levels of caffeine consumption, according to the journal, Clinical Epidemiology. This is still an area where researchers need to do more work, but limiting your caffeine intake or cutting caffeine out of your diet altogether can’t hurt, especially if you’re struggling to conceive.

• Alcohol. While the jury is still out on whether moderate alcohol use can affect fertility, binge drinking in women and heavy alcohol use was associated with lower ovarian egg counts, according to Fertility Research and Practice. Men who drink heavily showed signs of testicular atrophy, decreased testosterone, and reduced sperm production, in addition to erectile and ejaculatory dysfunction. For couples undergoing I.V.F., even moderate alcohol use can reduce your chances of conceiving. The chances of not getting pregnant and miscarriage increased when women drank moderately during I.V.F. treatments. When men drank the week that sperm was collected, the chances of conceiving were also reduced.

• Mental Health. Staying calm and stress-free can also help. According to Dialogues in Clinical Neuroscience, infertility can lead to stress and depression. The researchers noted that the depression levels in those struggling with infertility were similar to those struggling with cancer. What isn’t clear is whether stress leads to infertility or whether infertility leads to stress. Researchers at the National Institutes of Health and University of Oxford found that women who had higher levels of alpha-amylase were less likely to become pregnant. Alpha-amylase is present in higher levels in the body when the body is experiencing stress. So, while it isn’t clear whether stress itself can lead to fertility issues, reducing stress while trying to conceive is a good idea. 

• Nutrition. One of the most important things to consider when trying to conceive is your diet. According to the journal, Frontiers in Public Health, diets high in saturated fat and sugar can reduce fertility. Being overweight or underweight can also reduce fertility. The journal, Obesity Reviews found that weight loss in obese and overweight women could increase the chances of pregnancy among women undergoing assisted reproductive technology treatments. Cutting down on sugar, red meat, saturated fats, and even soda could improve fertility as well. Folate has also been associated with better fertility. According to a National Institutes of Health fact sheet, foods high in folate include liver, spinach, black-eyed peas, asparagus, brussels sprouts, lettuce, and avocado. The American Journal of Obstetrics and Gynecology notes that diets high in seafood, poultry, whole grains, fruits, and vegetables are associated with better fertility rates in men and women. Finally, seafood, which is high in omega-3 fatty acids is associated with better fertility outcomes according to the Journal of Clinical Endocrinology & Metabolism. However, when eating certain foods like fish, the potential for contamination with mercury can also be a risk-factor, so women need to be cautious about where they are sourcing their ingredients. Finally, eating fruits and vegetables with high pesticide residue levels is also known to reduce fertility outcomes in women undergoing assisted reproductive technology, according to a study performed at the Harvard T.H. Chan School of Public Health. A list of fruits and vegetables known to have high pesticide levels can be found here . Women with lower incomes may have more difficulty accessing healthy foods, because fresh organic fruits and vegetables can be costly. Dietary supplements may be able to help, but nothing can replace a naturally healthy diet.

• Wellness Supplements. Because diet and nutrient intake can be so crucial to fertility, can taking a wellness supplement potentially improve fertility? According to research performed at Stanford University, women were given FertilityBlend, a nutritional supplement containing green tea extracts, vitamins (including folate), minerals, L-arginine, and chasteberry. Women who used FertilityBlend saw notably higher pregnancy rates. The researchers concluded that FertilityBlend could be an alternative to fertility treatment or serve as a complement to fertility treatment. For women who cannot afford the tens of thousands of dollar treatments of I.V.F., particularly those who do not have a physical or organic cause for their infertility, FertilityBlend may be a lower cost option. FertilityBlend also incorporates natural herbal fertility remedies that have been used for centuries. Learn more about these here.

For lower-income couples looking to conceive, understanding the underlying causes of your infertility is an important first step. If there is no underlying disease or medical cause, natural options like adjusting diet, losing weight, getting good rest, lowering alcohol intake, and considering wellness supplements like FertilityBlend may be options to discuss with your doctor or try on your own as you continue your family-building journey.

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