Well, why not try...?

The first thing that most anyone asks if they learn someone close to them is doing IVF is "why not....?" (Fill in the blank).  Why not try intrauterine insemination (IUI, aka "turkey baster")?  Why do anything (e.g. leave it up to God, if you so believe)?  Why don't you just adopt?  Some of these questions are more easily answered than others, but here is our view:

Why not try IUI?
For those that haven't researched every method of babymaking, IUI is the acronym for  intrauterine insemination, which is a type of a broader category of "artificial" insemination.  Essentially, the semen is "washed" to isolate the actual sperm.  The washed sperm is then injected directly into the uterus.   In general, IUI would be most people's preference over IVF, at least to start:

• It's quite a bit less expensive than a cycle of IVF.
• The drugs/injectables, depending on the situation, are normally quite a bit less daunting.  Some people can do without any drugs at all.
• It is not as invasive as IVF.
• It can potentially solve whatever infertility issue is out there, especially if the issue is the "motility" of the sperm.  If the sperm are just pretty dumb and can't swim in a straight line, IUI can help them out by depositing them closer to the party entrance.

Unfortunately, IUI isn't for everyone, and it wasn't feasible for us.  The count in washed sperm will be quite a bit lower than the starting count, so if count is your issue (as it is for us), then you're pretty much washing away all of your chances.  Also, the success rate of IUI isn't fantastic if you have issues, and the likely need for several cycles can make costs add up fairly quickly.   IUI is often used for anyone trying to get pregnant without male involvement (e.g. a single mom-to-be or two female partners).  Normally, these people don't necessarily have fertility issues; they just don't need a male outside of the "donation".

 Why not leave up to God (or fate, or Buddha, or Baal, the pagan god of fertility, or whoever you so choose)?
This one is a tough one.  My husband and I DO believe in God and do believe in an "everything happens for a reason" kind of doctrine.  So, it was definitely a consideration to just step back and live our lives and see what was around the corner.  But, in reality, infertility IS a disease.  It is likely that kind of disease that people can write off as not a "real" condition, like cancer.  But it is something that is not "right" with our bodies.  And if modern science can assist with that, similar to providing treatments for other diseases, why would God not want us to utilize the research and learning we as humans have accomplished?

As with anything, there is a spectrum.  I feel that couples desiring children, of any religion or belief, should absolutely have the right to attempt IVF or similar procedures without judgment from others.  However, this should be done in a responsible, credible, and moralistic fashion.  This does not give people the moral green light to genetically engineer perfect babies in a lab or stuff their uterus with as many embryos as possible (I'm looking at you, Octomom).  It is absolutely a slippery slope and one that should be managed with care.

Why not just adopt?
This is absolutely a valid question, and one I may have even phrased this way before seeing friends go through this process and learning more about myself.  The key here is that NO ONE can "just" adopt.  Adoption is an expensive, mentally exhausting, drawn-out process that can end in heartbreak.  It can also be an absolutely beautiful way to create a family.    In that regard, it is very similar to IVF, in that you devote yourself and your resources to this process without knowledge of the outcome.  I think the misconception is that babies are just sitting around waiting to be adopted, but the potential parents are just not there. 

IVF and adoption are two extremely independent paths that couples without children will potentially travel.  Some will do only one or the other, some both and in no particular order. 

For us particularly, we decided to start with IVF, and will likely consider adoption if we don't have luck here (or potentially even if we do).  We could have easily decided to try adoption first, and then consider IVF if we were unsuccessful.

Our decision came down to:

• Money:  Our cycle of IVF will likely cost around $15,000.  We are able to utilize flex spending for about $11,000 of that through both our employers.  This means we will not pay taxes on that $11,000 and will also have it available to us to use on January 1st, even though we'll be paying it throughout the year.  Think of it is an interest-free loan from our employers, and one that comes with tax benefits to boot.  Alternatively, adoption is often in the tens of thousands of dollars.  There are some tax credits and help available from my employer, but not nearly the same level.
• Time:  We'll know in an approximately 35 day period (starting early January) if the IVF worked or not.  Substitute "days" with "months", and you're more in line with adoption timelines.  And that time waiting for a child after you've spent 12 months or more trying to get pregnant naturally can be very mentally defeating all over again. 
• Ability:  If we do get to the point we'd like to adopt, we are actually disqualified from many potential sources, due to divorce history, age, the fact we have my stepdaughter, etc. 
• Desire:  I'd like to be pregnant.  I'd like to be fat and have stretch marks and puke my guts out for a trimester or more.  That is a miracle that only women can experience, and I'd like to have at least a chance to experience it myself.  We'd also like a biological child.  That is really only natural -- after all, if that desire to procreate wasn't innate in our systems as a human race, we'd have died out years ago.

That being said, I love the concept of adoption.  I always thought I'd like to adopt even without fertility issues.  So who knows where we end up with that?

I think it is important to remember that the IVF vs adoption vs other alternatives decision can be a tricky one, and you can be pretty assured that anyone going through any of it as carefully assessed each choice before committing to a decision.