Episode 148: Season 5 Year End Recap

Dan Bulger: In Episode 145: Infertility in the Military From a Male’s POV, we heard from my colleague and friend Justin Smith, who talked about a lack of choice that is afforded to those in the military when it comes to IVF.  

Justin Smith: The military doesn’t necessarily have any coverage for fertility treatment. So, you can get coverage for diagnostics from the military, you can get some of the lab work done. However, egg retrieval and embryo transfer are not covered by the military. 

In some military facilities, they have programs and they’re very geographically isolated to certain areas, San Antonio, Washington, DC, I believe, Washington State, they have large health facility health care facilities, but they partner with external embryology labs to do their cycles. And they do what’s called batching cycles, where they bring in everybody who has been accepted into the program, and each of these clinics only accepts 100 to 150 per batching cycle. So, if you don’t get accepted into the program, you’re kind of waiting in a holding pattern.  

You’re coming out of pocket six or seven thousand dollars for this but what you get with that is you’re not getting any genetic testing or PGT-A, you’re not getting any of that done. You’re just pretty much a part of the batch. It took us over two years to actually get into the program which in infertility years is a killer.

Dan Bulger: We’re going to hear from Delaine, who shared her story with us in Episode 126: Unexpected Detours of Black Woman on the Journey to Parenthood. And we’re going to hear from Caitlin who shared her story in Episode 138: From “That’s Not Good Enough” to Parenthood. Both episodes deal with the choice of provider that many must make as they embark on their journey.

Delaine Williams: I had a Black OB-GYN, and I had to see someone else in her practice. And I explained to him the situation and that I was ovulating on time, but I wasn’t sure what was going on and explained the symptoms I was having on my cycle. And he looked at me and he said, well, how do you know when you’re ovulating? And I remember feeling like, just horrible. It’s just so upsetting. And I said, why wouldn’t I know when my body is ovulating? I just remember being so offended that he did not understand why I would know. I mean, he didn’t understand, he just didn’t think I was smart enough to know. I remember, you know, issuing complaints and listing that I no longer wanted to see this doctor at this specific practice. 

The day before my surgery, I went in for my appointment with my doctor who I’d been transferred to from that first doctor. He said, “All this work to get pregnant? Why do you care how the baby gets here?” And I said, “do you know the maternal mortality rate for Black woman?” And I remember being so devastated. Another moment when I’m inconsolable. And I’m like wow. I felt really dismissed. It’s interesting to me, because people are like, how does this literally happen? And it really is, like perception, like the way people perceive the complaint of Black women or the care of Black women.

There are not a lot of Black doctors and even the Black doctors that we have, they’re still taught by the same system, right? So, it takes an extra layer of mindfulness, to make sure that you are not subjecting your people to those same protocols and that same system.

Caitlin Day: He had given me a range where women my age would normally be, and I was significantly below the lowest end of that range. And he said on the call, you know that if we did want to have a family that IVF was really our only option.

He said it  would be a tough journey ahead of us just based on what my numbers were, you know, as a baseline, took a look to my blood work and essentially said, if I was planning on being a parent not to quit my day job, because our numbers were just, you know, that low.  

We started five cycles with this particular doctor, some of which were cancelled because I wasn’t responsive to the medication, some of which did result in an egg retrieval. And we did get one viable embryo through this doctor. I remember, you know, my husband and I just looked at each other. This was after one of the cycles that I wasn’t responding to, and we were like, this isn’t good enough. We need to find somebody who’s specialized and who at least is willing to customize treatment plans or adjust treatment plans, if they’re not working so that we’re doing everything that we can to try and optimize our outcome.

Dan Bulger: It wasn’t until Caitlin’s employer added Progyny that Caitlin was paired with a doctor who specialized in her specific diagnosis. And it made all the difference.  

Caitlin Day: It allowed us to change the conversation that we had with our doctor from one that was financially driven to one that was driven based on science, and what would work best for us in our family planning process. We had one more embryo left. And we transferred that embryo, which then did result in a pregnancy.  

Dan Bulger: When people get coverage for fertility treatment, the coverage needs to be designed in a way that encourages choice that allows for people to access the doctor that will work for them. If a fertility benefit or coverage only funnels patients to a specific clinic, or limits patients financially from being able to do what would work best for them, then that coverage is not actually empowering people to choose, but it’s limiting them with restrictions.

Dan Bulger: Most of us get our coverage from our employers. And we don’t exactly get to vote on what they offer. Well, in Episode 130: Fighting for Fertility Coverage: Advocating from Within, we heard from Chrissy who proved otherwise. 

Chrissy Hogie: We had just opened a daycare on corporate grounds, state of the art, brand new, run by KinderCare. Incredible. The women’s networks fought for that and partnered with HR to make that happen. The retain pillar had fertility on their roadmap of things they wanted to accomplish the following year. And I wasn’t in a large group of people ready to be like, Sign me up. I care about that. But I found the pillar leads and I talked to them and I said “Hey, listen, I’m currently an IVF employee. I know what it’s like, I know what it’s like to not have coverage. I know how prominent this fertility journey is for many, and I’m willing to fight to make that happen.”  

RFP processed the request for proposal for all these companies that offered fertility benefits to come to our headquarters and to pitch their products and their services and pricing and everything. And a PCA came in and pitched the spiel about Progyny.

There are many different ways to slice the cat, but Progyny’s program is the best. It has everything that you would need. And it cuts out financial stress and the picking and choosing of what you need to do to increase your chances of having a successful pregnancy.

Dan Bulger: If you don’t currently have Progyny, I could see this kind of episode feeling discouraging to you. But I do think it’s important to remember that it’s possible. Chrissy and her colleagues didn’t have access to the Progyny benefit until they advocated for it.