Gabe and Miranda IVF Fund

Gabe and I have been married for a little over two years, but together for almost 10 years.  We have always wanted a family.  Through this process, I have been diagnosed with Poly-Cystic Ovarian Syndrome, or PCOS.  We have struggled with infertility and multiple cycles of infertility treatments over the last year.  We want to start a family so much.  We are at the point where the best, remaining option is IVF (In Vitro Fertilization).  This is a very costly procedure.  But hopefully at the end of this long emotional roller coaster, with IVF, we can bring home a baby.  IVF is a very costly procedure that insurance pays absolutely $0 for.  With Gabe’s disability, we have been a single income family for the last several years, and don’t have any savings to be able to pay for IVF on our own, nor are we at the point where we can afford the payments if we financed the costs.  It is heartbreaking to know that we tried so much to reach our goal, but that money is the only hurdle to get us there.  So, we are reaching out to you, our friends, family, friends of friends and compassionate strangers to help us.  We have nothing to lose at this point except the dream of having a family, and we are not ready to give up on that dream.  Gabe and I invite you to read below about the costs of IVF as they have been quoted to us by our doctor.  We have provided additional links so you can learn more about my condition, PCOS, and the IVF procedure.  We have put together some fun incentives that you can receive with certain levels of donation.  And each of us has also written a personal essay as to what last few years has been like struggling with infertility. 

We hope that you can donate any amount of money, no matter how small or large.  We understand that not everyone will be able or willing to donate, and from you, all that we ask is for your prayers and support, and to pass our message and dream along to your friends and family.  If we are successful in our goal to bring home a baby, Gabe and I are committed to taking our success and paying it forward.  We will donate any remaining embryos to other couples in need and struggling with infertility.  Infertility doesn’t have to be the silent agony that couple struggle with alone anymore. 

Gabe and Miranda IVF Fund Donation Incentives
There is no minimum to donate.  We welcome even the smallest donation, and if you cannot donate, we gladly accept your prayers and well-wishes.

$50 – first sonogram sent to your email           
$100 – monthly picture of child for first year mailed to your address (plus $50 incentive)
$250 – baby footprint keepsake (plus all previous incentives)
$500 – yearly picture of child through 18th birthday mailed to your address (plus previous incentives)
$1000 – middle name of your choice and copy of birth certificate showing your name selection (plus all previous incentives)  ** Don’t worry, if more than one person donates $1000, we will have multiple middle names for the child, and we will always have the story behind all the names.
$5000 – Godparent status (plus all previous incentives)
Full Amount – Full Name Consideration (plus all previous incentives).  We would like to name our child after you, but we get final say. 

If we are successful, we plan to donate our remaining genetic materials to other couple(s) that are not able to conceive with methods other than IVF.  We do consider ourselves lucky that we do have the opportunity to conceive a child with our own genetic materials.  I have a good egg supply and Gabe has a good sperm count with good quality swimmers.  As we have gone through this process, we have come to realize there are a lot of other couples out there that cannot even get to the IVF phase because they do not have their own genetic materials available, and they must come up with funding to and find donors to secure eggs or embryos.  We are taking a leap putting our story out there.  We do have the bittersweet mix of emotions to not be able to conceive but to be able to hopefully do so with IVF with our own genetic materials.  We want to pay it forward for another couple that has more difficulties than we do.  We will donate any unused, remaining embryos to couples who need it.
 
Total Costs for IVF
Pre-Cycle Evaluation Costs
 Blood Tests (AMH & Hormones) $238
 Antral Follicle Count Ultrasound $320
 Hysteroscopy $650
 3D Rendering $150
 Uterine Sounding (trial transfer) $135
 Genetic Testing $100
 Disease Screening (male & female) $445
 Semen Analysis $125
                                           Pre-Cycle Evaluation Total $2,163
  
Costs per IVF Cycle

Medication per Cycle Total $5,000
  
Patent Monitoring Costs
 Ultrasound $1,600
 Estradiol $425
 Venipuncture $75
 
Patient Retrieval
 Anesthesia $745
 Aspiration ova $336
 Follicular puncture $1,830
 Insemination of Oocyte $785
 Oocyte ID $850
 Culture and fertilization $1,990
 Sperm prep IVF $335
  
Patient Transfer
 Ultrasound guidance $335
 Embryo prep $610
 Embryo transfer $990
 Extended Culture $650
 Cryopreservation $900
 ICSI $1,415
 Assisted Hatching $650
                                            IVF Costs per Cycle Total $14,521
 
 Additional Costs
  6 months Frozen Storage of Embryos $240
 
 Pre-Cycle Total $2,163
 Medication Total $5,000
 1 IVF Cycle $14,521
 
Grand Total for 1 IVF Cycle*                                      $21,924
Grand Total for 2 IVF Cycle**                                    $41,445
 
*Grand Total for 1 IVF Cycle includes 1 set of Pre-Cycle costs, 1 round of medication costs, 1 round of IVF costs, and 6 months of frozen embryo storage
**Grand Total for 2 IVF Cycle includes 1 set of Pre-Cycle costs, 2 rounds of medication costs, 2 rounds of IVF costs, and 6 months of frozen embryo storage
 
Individual IVF Costs vs Attain Program

Individual IVF Costs
Fee-for-service (one IVF cycle)
Total Cost of Plan $21,924
Pre-Cycle Evaluation $2,163
Medications $5,000
IVF cycle / Attain Program $14,521
6 mo Embryo Storage $240

Included in Cost
Egg Retrievals 1
Fresh Embryo Transfers 1
Frozen Embryo Transfers 0
Refund Eligibility none
"Attain IVF Savings vs Fee-for-service" $0 / 0%

Fee-for-service (two IVF cycles)
Total Cost of Plan $41,445
Pre-Cycle Evaluation $2,163
Medications $10,000
IVF cycle / Attain Program $29,042
6 mo Embryo Storage $240

Included in Cost
Egg Retrievals 2
Fresh Embryo Transfers 2
Frozen Embryo Transfers 0
Refund Eligibility none
"Attain IVF Savings vs Fee-for-service" $0 / 0%

Attain IVF Flex Plans
"Attain IVF Multi-Cycle (core)"
Total Cost of Plan $37,153
Pre-Cycle Evaluation $2,163
Medications $10,000
IVF cycle / Attain Program $24,750
6 mo Embryo Storage $240

Included in Cost
Egg Retrievals Up to 2
Fresh Embryo Transfers Up to 2
Frozen Embryo Transfers Unlimited
Refund Eligibility 0%
"Attain IVF Savings vs Fee-for-service"
 up to $8,798 / up to 26.2%

"Attain IVF Multi-Cycle 2+ Program"
Total Cost of Plan $39,803
Pre-Cycle Evaluation $2,163
Medications $10,000
IVF cycle / Attain Program $27,400
6 mo Embryo Storage $240

Included in Cost
Egg Retrievals Up to 2
Fresh Embryo Transfers Up to 2
Frozen Embryo Transfers Unlimited
Refund Eligibility up to 50%
"Attain IVF Savings vs Fee-for-service"
up to $6,148 / up to 18.3%

"Attain IVF Multi-Cycle 3+ Program"
Total Cost of Plan $49,403
Pre-Cycle Evaluation $2,163
Medications $15,000
IVF cycle / Attain Program $32,000
6 mo Embryo Storage $240

Included in Cost
Egg Retrievals up to 3
Fresh Embryo Transfers up to 3
Frozen Embryo Transfers Unlimited
Refund Eligibility up to 100%
"Attain IVF Savings vs Fee-for-service"
up to $18,322 / up to 36.4%

*Savings will vary depending on the number of services used.  The more services used, the greater the savings.  Patients who have a baby after one transfer will not incur a savings.  Savings estimates for Flex Plans that include up to 2 Egg Retrievals and 2 Fresh Transfers assume 2 FET cycles, and savings estimates for Flex Plans that include up to 3 Egg Retrievals and 3 Fresh Transfers assume 3 FET cycles, although there is no limit on the actual number of FETs covered.
 
All of these costs are, of course, the best estimates given to us by our doctor's office.  The costs of medications will vary and the doctor's disclaimer is that prices may change at any time.
 

Informative Links
·      More about PCOS from Seattle Reproductive Medicine – http://seattlefertility.com/polycystic-ovarian-syndrome

·      A good video segment from New Day Northwest explaining PCOS - https://www.youtube.com/embed/Fbyqme_Xv_I

·      Also the US Dept of Health ePublication about PCOS – http://womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html#a

·      IVF Overview - http://seattlefertility.com/in-vitro-fertilization

·      IVF Start to Finish - http://seattlefertility.com/ivf-start-to-finish

·      Info about the Attain Program - http://seattlefertility.com/attain-ivf-programs/ 

·      Understanding Success Rates – http://seattlefertility.com/success-rates

·      Seattle Reproductive Medicine Stats - https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=2393

Our Baby Story – The Struggles of Infertility
By Miranda Boettger

Not everyone can say they have been together from the moment they met.  Gabe and I, however, we can.  We have been nearly inseparable since we met, and that was almost 10 years ago.  From early in our relationship, we knew we wanted to have a family, and that it would happen when the time was right.  Years went by without any pregnancy.  There were always plenty of life’s hurdles, so we concentrated on getting through those obstacles first: both of us losing jobs, Gabe getting sick and going on disability, Paula – Gabe’s mom – moving in with us.  These obstacles, to some extent, kept us from realizing that the family we were trying for. 

With the help of our friends and family, we got married in 2012.  12-12-12 in Las Vegas.  It was wonderful.  We thought, well, maybe now that we’re married, that will do the trick.  Being married changed our relationship for the better in every way.  It made us stronger as a team, and it made us realize that much more that we wanted to be parents together.  We put renewed efforts into starting our family.  As I do with everything, I started researching.  I started charting my cycles and my basal body temperature.  We started eating healthier and exercising together.  We were trying, and we still had hope, even though every time we saw friends or went to family functions, the little questions and comments were unavoidable.  “Soooo, when are you guys going to have a baby?”  “I can’t wait until I’m a grandparent”.  We saw almost all of our friends and relatives have babies and in many cases, baby #2 or 3.  The well-meaning comments like “you just need to relax, and it will happen” or “maybe you just need to go on vacation” never made me feel better.  When after a couple years of charting and trying, we went to see our doctors.  They start with basic tests, and I had longer than normal cycles, and Gabe was on medication that lowered his count, so our doctors referred us to specialist to get us more tests.  Gabe’s prognosis was good, he would need to switch meds, and monitor his counts until the numbers went up within a few months.  My tests, weren’t terrible, but showed I had PCOS, Polycystic Ovarian Syndrome.  Amongst other symptoms, there are fertility challenges relating to irregular or absent ovulation.  I had all the other tests to check my hormones, tubes, and uterus.  Good news, I have eggs, my basket looks good and my tubes are open.  With medication, the doctor says, we should be able to get you to ovulate.  It’s not surprising that we were having difficulties on our own, given my diagnosis, but we’re still relatively young and in a good position to try. 

So, I start Clomid cycle one.  I was so excited that this is going to be it.  This month, I’m going to get pregnant.  You can’t help but think what our lives are going to look like 9 months from now.  Every fiber of my heart and soul wants it, so why wouldn’t it work?  We’d time our BD’ing (baby dancing to the TTC-trying-to-conceive crowd) to my cycle and go at it every other day for 10 days.  I keep peeing on my ovulation predictor twice a day, every day for two weeks.  No ovulation.  My new cycle starts, and I cry for about two days straight.  Ok, so, we knew that the chances for pregnancy on one Clomid cycle are only about 8%, with a 15% success rate overall.  That about brings me up to a normal couple’s chances in any given month is only about 15% chance of pregnancy for our age.  I knew it might take a couple times.  I pick myself up, force myself to be positive.  The stress and negativity aren’t going to help my body cooperate.  I did everything I could to make sure my body cooperates.  I had already stopped drinking any alcohol.  I also gave up coffee completely and most sugar.  I stopped eating dairy.  And really tried to eat clean and stick with a low-impact workout routine (yoga, swimming and walking).  

Clomid cycle two.  I want to be and stay positive.  Every cycle means going to the doctor for a couple ultrasounds to check for follicle development.  And these aren’t the made-for-TV over the stomach kind of ultrasounds.  Good news, I have two good looking follicles, one for sure.  “Are you ready for twins?”  They give me the shot to trigger ovulation, and we make our plans to catch that egg.  We hit our window, and now all we can do is wait.  The dreaded two week wait. . . and again, nothing. 

My doctor switches to Letrazole, so she can give me a stronger dose.  We do that whole process over again for a few more cycles.  The new cycle starts with a couple depressed days when you get a negative and realize you’re going to do this all over again.  A few days of emotional roller coaster meds followed by mandatory BD’ing and constant peeing on ovulation test strips, then two weeks trying to ignore the anxiety building inside me. Over the next six months, we get one triggered ovulation, one positive ovulation, several months with no ovulation, and obviously no pregnancy. 

This trying to conceive cycle has this powerful ebb and flow of emotions all of its own.  It never helps to be a Negative Nancy, no matter how much I want to.  Fake it until you make.  Stay positive.  Think baby thoughts.  But the contrast between staying upbeat and positive, and trying to prepare yourself for what could be another negative, is the most unrelenting, powerful swing of emotions.  I don’t want to see my friends and family because the wrong question or comment will have me instantly bursting into tears.  Each day is a tossup of whether I keep it bottled up for everyone but Gabe, have some curt, smart remark back or go ahead and burst into tears when they say the wrong thing.  I start sharing my journey with a few close friends and family members, but the things they say with the best of intentions still cut.  Even the friends that have had their own fertility struggles don’t know what to say because, I now know, they know there is nothing they can say that won’t make you cry. 

We have entered the medical no-man’s land.  As far as I can tell, this is the only condition where the doctors satisfied with diagnosing you with “unexplained infertility”.  Seriously, look it up.  That is a medical condition.  All the parts are there, and seem to be working, but they have no idea why.  They have no idea how or why women get PCOS and why they are able to get some women to ovulate and others, like me still don’t.  The doctors and websites are always positive and make it sound like with medications and healthy life, you’ll get pregnant.  Like if you’re healthy enough, poof, your fairy godmother will give you a baby.  This isn’t House or something rare that the JAMA is going to study you for.  And worse, as soon as you are diagnosed with infertility, insurance stops. This isn’t just my insurance or that unusual, but insurance pays for absolutely nothing to do with infertility; no medications, no doctor visits that you have to have three times a month, no ultrasounds, no tests, no lab work.  NOTHING. 

Infertility is the most isolating thing I have ever had to endure.  I have moved halfway around the world with nothing but a suitcase and the promise of a student loan.  I have been unemployed and unemployed at the same time as my husband.  We have dealt with Gabe’s prolonged illness and subsequent disability.  My mother-in-law moved in with us.  Now I find myself not even wanting to leave the house.  The times I may go out, I struggle to keep my emotions in check for one evening, but I can’t stop thinking about the baby we can’t have.  I don’t feel like answering the questions why I’m not having a glass of wine, only to reply, “NO, I’m not pregnant”.  And with the doctor’s bills, I can’t afford to go out, even if I wanted to. 

So that brings us to the present.  Last week, Gabe and I had a very hard appointment with my fertility doctor.  The medications aren’t working, and you can’t take them forever.  So it’s time to play hardball.  We have two options.

Option 1: more aggressive medication and monitoring with IUI.  Intra-uterine injection is pretty much what it sounds like.  They get my ovaries working overtime with the meds, get a sample from Gabe, trigger ovulation, and with a small tube, inject Gabe’s genetic material into my uterus at just the right time with ovation.   Ok, big picture, not terrible sounding or the most aggressive of medical procedures.  I can give myself shots.  But the bad news is, there is only about a 10% success rate each month, which is about the same as the average success rate on Clomid/Letrozol.  Each cycle of medication, tests and procedures is about $1,200 and it could take six cycles or not work at all.  If it doesn’t work, we’ve spent all that money (that we don’t have), continued with the debilitating, emotional TTC roller coaster, and still have to spend more money on IVF to reach our goal. 

That brings us to Option 2: IVF.  In Vitro Fertilization is probably what you think it is.  They pump me full of meds to get my ovaries working overtime, then instead of triggering ovulation, they go in and harvest as many eggs as they can.  They take Gabe’s sample and mine, and combine them to create embryos.  I go back about 3 days later, and they implant 1-2 embryos in my uterus.  We all say a prayer and cross our fingers and hope it results in a pregnancy.  You have another dreaded two week wait before you can test for pregnancy.  The good news is, the average success rate for one round of IVF is about 45%.  So we’re finally starting to get to some promising success rates.  But there is always the chance that it may take more than one round of IVF; my doctor says the average IVF cycles needed for pregnancy is 1.8 IVF cycles.  My doctor’s office offers a program called Attain.  In layman’s terms, it offers a savings program if you buy into the program for more than one cycle of IVF.  It also offers a refund program if you do not take home a baby.  So the Attain Program cost is more than one cycle alone, but much less than two.  It offers unlimited frozen embryo transfers which are not included in the typical, one cycle only program. 

The good news, my doctor’s office is one of the most well-respected fertility centers in Washington, so we have that in our favor.  Now we just need your help and support to reach our goal of having a family.  If we are successful, we want to pay it forward and donate our remaining embryos to other couple(s) in need that have infertility struggles. 


Our path to parenthood
By Gabe Boettger

 This is a letter to my friends, family, associates, and anyone who’s has had to endure the emotional trials and struggles of infertility. Currently I am 34, partially disabled and back in school to receive my Associates Degree in Construction Management. Like many construction workers I feel I am a “man’s man”, I take care of business and do what needs to be done. This is especially true of our home lives, our wives and families look to us to be leaders, protectors, and providers. I won’t lie as stressful as it can be we enjoy the responsibility. It helps us to feel useful, and like we are doing good at taking care of our families. When my ability to perform my previous career was taken, I felt a large part of my identity was also taken.

After about two years of being depressed and angry at the word, I realized I was not being the husband my wife deserved. So I started looking into state sponsored programs that help in career retraining for people who are maybe not fully disabled but enough that they cannot perform their previous job. I filled out applications and got approved for a service called DVR. That is the Department of Vocational Rehabilitation. With this acceptance into DVR, I now had the opportunity to be a provider for my wife again. Furthermore, school has given me something to focus on, and a goal to strive for. With this part of my life back on track, things are starting to look up. It’s around this time that we also start to address the Massive elephant in the room, and that is, we are a married couple in our early thirties with no kids.

I cannot begin to describe the feeling of leaving a family function, where everyone feels like it’s their responsibility to remind us we need to start a family. My wife can barely make it to the car before she is in tears. As a husband I want to march back in the house and tell them to keep their comments to themselves. They really have no clue what it’s like inside the heads of a married couple who are having problems conceiving. It is an emotional rollercoaster every month waiting for “the seed to germinate” per say. As a husband you feel like a failure, less of a man. I know people are not intentionally trying to be hurtful, but they don’t understand how sensitive of a subject it really is. Most all our friends and family have children, and pretty much all our friends and family also ask when we are going to have kids. The worst for me is having to see the pained look in my wife’s eyes as her friends talk about their kids. We truly love our friends and family, and know they really do mean well.

  As a couple we decided that enough time had passed and we needed professional help. At this point I am 33, back in school and I too am beginning to hear some of the ticking biological clock so many of you ladies speak of. The first stage in this long journey is going to be some testing and the first tentative steps into the infertility treatment system. We have to establish what the problem is right? I get a referral to go to the UW men’s health center and get to leave a “Deposit”. This is so we can establish a baseline count and all that fun stuff. On the other side Miranda is starting some of her own testing. We also get to start our second round of infertility treatment. This consists of tracking her womanly cycles and trying to hit that opportune moment. We rode this roller coaster for the better part of a year to no avail. It is truly a test of the strength of your relationship. Having to endure the letdown of not conceiving month after month is a trial I wish I could have avoided. Not to mention how much the medical costs are already piling up.

February 18th 2015, Miranda is flying out to Denver today for work and we have a consultation appointment with our Infertility doctor, Dr. Barker.  Our goal for this meeting is to find out where we are after a year of being guided thru the process. We are a couple in our mid-thirties who have just spent another year without conception. We tell the Dr., as a middle age couple we want to try more aggressive measures. She thankfully agrees we are good candidates to move to a more assertive treatment plan. She explains the procedure, and an estimate of costs connected to the different options ($15,000-32,000 medication not included). All and all we left the meeting feeling, ok. Not really on top of the world but still feeling hopeful.

Our financial position is not the greatest. I am in school and have a small fixed income I receive from Soc.Sec. and my wife is the primary bread winner. We got married in Dec of 2012 and wanted to start with a clean slate. We filed for bankruptcy and have been discharged for a couple years now. With Miranda in Denver I decide to call the financing agency that specializes in funding these type of medical procedure. The first thing they ask for is our credit rating. I inform them we had a Bankruptcy and have been diligent about paying bills on time and living on a budget. Unfortunately, the financing company will not even consider anyone with a credit rating under 650. However, the last time we pulled our credit, I was 630 and some change and Mirada was only 2-3 points below me. That was 6-8 months ago and we have not missed or been late on anything so our score could be better by now. The second issue is the payment for that loan would be somewhere in the ball park of 640-700 dollars a month. With our current financial position we cannot afford that kind of payment. So even if our credit has improved as such that we could get financing we still cannot afford the process. This is a major issue, how do I tell my wife we can’t afford to have a family.

 I will not tell her that, I will think of a solution. I will figure it out. But truth be told, as soon as I hung up I started to cry. I felt sick to my stomach. I wanted to scream, I wanted to yell, I wanted to hold my wife. I felt like a complete failure as a husband and a man. After a few minutes of frustrated crying I began to realize that unless I came up with something. That is exactly what I would be telling her we can’t afford to start a family. This got me thinking, who can I contact for advice? I reached out to my dad and set up a little private meeting for me to unload my grievances, throw out some ideas, and seek some guidance.  Even if he could to co-sign on the loan, we still can’t afford over 600.oo dollar a month payment. One of my goals was to put our story out in social media, Facebook, Twitter etc., but the best idea was a Crowd Sourcing site. Basically we tell our story and ask friends family and strangers for donations. This was the best plan I could come up with that actually sounds feasible. With a plan in place I need to tell Miranda what I learned on the phone call to the Lending institution.

I arrive home from my meeting with my dad and it’s time to let the cat out of the bag. We sit down and talk it over. We cry a little bit and we decide to dig in our heels and open up to our friends and family and ask for help. But we need a platform, something people who are going through a similar situation can relate too. We understand as hard of a time as we are having, some couples may have it much worse. Miranda came up with this fantastic idea, after we conceive, we will donate eggs we don’t use to a couple who need them. I thought this was a great idea, the cost would be considerably more if we had to go down that road, for that I feel blessed. We also want to draw some attention to the cost not only financially but emotionally to the couples who struggle through this process. I think we have a rock solid plan.  But there is one other person I would like the opinion of, that’s my uncle Jim.

 I deeply respect and admire my uncle Jim. He came from a poor economic background, recognized education was the ticket and went on to become an amazingly intelligent individual who has seen and accomplished much more than most. He would be able to tell us if we really were on to something or maybe offer another suggestion. As it went, he did like our ideas and supported us fully. He recommended we buckle down and put together a plan and start to execute it. So that is what we are doing.

I watched and still see commercials and little news stories here and there talking about infertility. And while they may sometimes bring up the high financial cost. Very little is mentioned about the emotional price paid by both partners involved. Feelings of doubt and insecurity, and how do I make this right for Miranda. I think we have a sound plan, and I think couples going through this can identify with these daily struggles. It’s hard to watch someone you love want something so bad, and know you can’t provide it for them. I wouldn’t wish this on anyone, but if you are going through it or know someone who has gone through please, donate, contact us, share your story with us. Our goal is to collect enough money to pay for the procedure and cover medications. If we don’t reach or goal, its ok. It will be that much less we will have to try to finance. If we do reach our goal we will use any extra money to cover the cost of medicines and if we really do better than expected, along with the eggs, we will donate extra money to another couple in the same situation.

Regards,
Gabe Boettger
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Organizer

Miranda Boettger 
Organizer
Puyallup, WA
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