My husband and I just got married — I’m 41 and he’s 47. We’ve been talking about starting a family since we got engaged, and when we were on our honeymoon, we decided to start trying as soon as we got home. To our surprise, we get pregnant naturally just five weeks after having my IUD removed.
Cost: $0. Removing my IUD was covered by my insurance.
August 16, 2018 My first miscarriage
At 11 weeks and five days, I start spotting. I immediately call my OB/GYN and the clinic tells me I’m probably fine, but has me come in for an ultrasound. We’re heartbroken to learn that our baby’s heart has stopped beating. A few hours later, I have an onset of extreme cramping and excessive bleeding. It’s so intense that I just sit on the toilet with red gushing out of me for an hour. Just when I think it’s subsided and I go to lie down, I realize I’ve bled through a pad in under five minutes. This continues for two more hours before my husband rushes me to the ER.
The on-call OB there confirms that I’ve undergone major trauma and have lost an extreme amount of blood — my iron and hemoglobin levels have dropped to half of what they were in my prenatal blood work. After eight hours at the hospital, there’s still some fetal tissue remaining in my uterus. They send me home with a prescription of misoprostol — a drug that’s commonly used to help manage miscarriages — to hopefully pass the tissue. I end up needing a second dose of the same drug a few days later to fully empty my uterus. It’s a horrifyingly traumatic experience.
Cost: $1,000. Most of the costs are for the ER visit, tests, and lab work from my night in the hospital and the weeks following. The misoprostol was not expensive; on average, it’s about $30. After it happens, I keep receiving bills in the mail. This is my first ER experience, and I’m not originally from this country, so it’s all very foreign to me to receive so many bills I’m not expecting. I knew from the get-go I’d have a $250 copay for the ER, but the buck didn’t stop there.
February 2019 First appointment with a reproductive endocrinologist
After five months of trying to conceive without success after the miscarriage, my OB sends me for every test in the fertility handbook and refers us to a reproductive endocrinologist (RE). We test my Follicle Stimulating Hormone (FSH), a hormone that stimulates an ovary to release an egg so I’ll ovulate, and Anti-Mullerian Hormone, which may predict my egg count. While they’re not ideal, they’re also not horrible given my age. At our first and only appointment with this RE, he tells us that our numbers don’t look too bad and recommends we try Intrauterine Insemination (IUI) — the so-called turkey baster method. He says with certainty, “We’ll get you pregnant.” He then turns us over to the staff of nurse practitioners to help me with everything from prescribing drugs to inseminating me.
Our nurse recommends that we also get on the In Vitro-Fertilization (IVF) waiting list since it’s several months long. I don’t think I need IVF, but she tells me it’s better to be put on the list now and not to need it than to need it and have to wait longer. We’re feeling very hopeful when we began with IUI.
We do two rounds with Femara, a fertility drug that stimulates the follicles (the fluid-filled sacs on your ovaries that contain immature eggs). For the second, they increased my dosage. We have three follicles and my husband’s sperm are in abundance. The nurse tells us we have a really high probability of twins.
We get pregnant with one baby from the second IUI, but at my eight-week appointment, during our second ultrasound, we learn that the baby’s heart has stopped beating. I can’t believe this is happening. We had a strong heartbeat last week.
My doctor gives me two options: Having a dilation and curettage (D&C) — a medical procedure where they’d remove the tissue from inside my uterus — or taking misoprostol. I initially ask for the D&C, but my doctor’s schedule can’t accommodate it for over a week, so I opt for the misoprostol. This time, after taking the drug, I have some bad cramping and heavy bleeding for about six hours.
The week between learning the heartbeat has stopped and finally taking the misoprostol is one of the hardest, knowing I’m walking around with a dead baby inside of me and there’s nothing I can do. This makes me feel even more heartbroken, but also frustrated. Why does this keep happening to us? What can we do now?
Cost: $2,000 for the two IUIs, with the diagnostic tests and follow-up appointments. It could have been more; our insurance has some coverage for fertility assessment and IUIs.