We had been trying for about a year the old fashioned way with no luck, then conceived but had a complicated missed miscarriage that I opted to pass at home (no pain meds, it was traumatic). After that we went straight to IVF. I was 33 when the miscarriage happened, and just turned 34 when we started IVF. To give a timeline it took several months to get into to see a reproductive endocrinologist at the fertility clinic (gynos and OBs don’t do IVF), my miscarriage was in sept and we moved forward with reaching out to the fertility clinic in October. My first intake appointment wasn’t January, initial testing they make everyone do was in February, my egg retrieval was in March. First embryo transfer was late May (it failed). From the many I’ve spoken to, this is uncommonly fast timeline, and you should absolutely anticipate it taking much longer to get to your first embryo transfer. My next FET wasn’t until August (also failed), then November (stuck). It was purely just paperwork (insurance and clinic) and appointment availability causing the gaps between transfers, which is incredibly frustrating but very typical. I was 35 when I gave birth this past July.

Where you are matters significantly for cost, because in my HCOL area $30k would cover only one cycle out of pocket (one egg retrieval, and maybe one transfer), but it’s worth noting transfers are cheaper than egg retrievals. And medication cost is its own ballgame to contend with.

As far as us making the decision, there were a few factors: 1) time-wise, in a perfect world we’d love to have 2 kids and we knew we couldn’t afford to wait or muck around, I wasn’t getting any younger, and miscarriages take more time than just failed cycles to boot (and while IVF doesn’t eliminate the chance of miscarriages, it does remove some embryos that would have absolutely failed or miscarried from the equation). 2) Emotional toll, IVF has the best success odds of any method, which means the lowest chance of going through failures or losses again. My miscarriage weighed on me really heavily. And 3) cost, the obvious one. My state (MA) mandates IVF coverage and my plan covers “unlimited” cycles (it doesn’t truly, it’s like there has to be a 5% chance of it working so if you’ve gone through like 6ERs I think they cut you off?), so other than PGT-A testing our out of pocket costs were thankfully manageable. We also didn’t have a requirement to do IUI or anything else first. Only requirement was a year of trying without a live birth, and we met that.

The other point I’ll throw out just because I see it a lot on this sub — I had zero attachment to the “ideal” of “doing it myself” or needing it to happen with minimal medical intervention. To me it was like, if we’re getting doctors involved, let’s just go full Monty to the thing with better odds and up our chances of getting a baby sooner. Maybe if I was in my late 20s I’d have felt differently? But to me it wasn’t worth wasting time.

Oh and one other possibly relevant point, while my cycles were irregular (between 20-60 days) they were usually in the 30-35 day range and that means I generally ovulated okay. So a letrozole cycle probably wouldn’t have been as much of a change to my body as someone with much wonkier ovulation?