$18K IVF Bill: Millennial Couple Breaks Down Insurance Coverage, HSA

Shiraine and Barrett McLeod love being parents. They live in western Connecticut with their toddler, Lejend, who asks them constant questions about spaceships, gravity, and the fish in “Finding Nemo.”

“This kid blows our mind every day, and he’s only two,” Shiraine said.

The couple, who are in their late 30s, experienced an increasingly common path to parenthood: in vitro fertilization. Over 86,000 infants were conceived through assistive reproductive technology like IVF in 2021, the latest data available from the US Department of Health and Human Services shows. The number of Americans using fertility treatments to conceive is rising, but the procedure is costly. One round of IVF without insurance can range from $15,000 to over $30,000.

This comes as reproductive healthcare access is caught in political crosshairs. Barrett said they were undergoing fertility treatments around the time that the Alabama Supreme Court declared that frozen embryos are people, a ruling that threatened IVF access nationwide: “It was scary,” he said.

President Donald Trump signed an executive order in February aimed at “aggressively reducing out-of-pocket” IVF costs for Americans, although the White House has not provided additional details on how the policy would work. Separately, the Trump administration has slashed women’s and maternal healthcare programs across the US. And, in April, the administration floated policies to encourage people to have more children, including a potential $5,000 baby bonus for every American at the time of delivery.

Even with the federal policy limbo, the McLeods said IVF is an important resource for millions of families like theirs.

“There’s a lot of people out there who really, really want kids, and they don’t believe that they’ll ever get to have them, because IVF is probably the only option and they believe that they can’t afford it,” Shiraine said.

The McLeods told BI about their experience navigating fertility treatments and their top tips for others. They recently found out that Shiraine is pregnant with their second baby via IVF — a little girl — and they couldn’t be more excited.

An HSA and insurance helped the McLeods pay for IVF

The McLeods knew fertility treatments would be expensive. Embryo implantation might not work on the first round, and the cost of doctor’s visits, blood screenings, genetic testing, and embryo storage quickly adds up.

Shiraine works for the New York state government and is their household’s primary source of health insurance. Barrett works remotely in management and consulting and takes care of Lejend when he isn’t at daycare. Together, the couple said they make a comfortable, six-figure income.

“We were just so excited about the possibility of having a child, we didn’t really think too long and hard about how much it would cost us at the end of the day after insurance,” Shiraine said.

While Shiraine said her insurance covered about 90% of their roughly $18,000 in medical bills to conceive Lejend, the couple had to add regular doctor and testing copays into their monthly budget. She added that some of the procedures she’s undergone this year to conceive their daughter have been noticeably more expensive than when she and Barrett first started IVF in 2021: “Initially it was $50 a month to continue freezing the eggs,” she said. “Fast forward to today, it’s now $75 a month.”

Shiraine would tell other Americans thinking about IVF to open a health savings account. Saving $266 a month of pre-tax money in an HSA has helped her cover out-of-pocket costs without stress, she said. She also encouraged others to ask both their insurer and fertility clinic for a potential price breakdown before beginning the IVF process.

“There’s certain general things that everyone does with IVF, and there’s things that are tailored to your situation,” Shiraine said. “If you can get a breakdown from both your insurer and clinic, it helps you plan out what could be covered and what might not be covered.”

Dr. Cynthia Murdock, a Connecticut-based reproductive endocrinologist, and the McLeods’ provider, added that many of her patients are surprised to learn that they have fertility coverage through their employer or state insurance. In Connecticut and New York, for example, insurers are required to cover some IVF treatments.

“We try to do as much as we can to help people navigate the insurance so they don’t have to be stressed about that in addition to being stressed about not getting pregnant,” Murdock said.

Beyond finances, Shiraine and Barrett told BI about the emotional impact of fertility treatments. As Caribbean Americans, the couple said they faced some stigma from family members about pursuing IVF because it is outside cultural norms. Shiraine said her mother was skeptical of them publicly talking about their “private” infertility experience. Between the ages 25 and 44, 15% of white women seek infertility treatment, compared to 8% of Black women, per the most recently available National Institute of Health data.

But, after seeing the positive reactions the McLeods were receiving from friends and on social media, Shiraine said her mom praised her for being so open about IVF, adding that it was a “beautiful” moment for their family. The couple said that they continue to share their story to help others experiencing infertility feel less alone, and they’re thrilled for Lejend to become a big brother later this year.

“As a woman, in terms of reproducing, I doubted my body a lot,” Shiraine said. “I’m so happy to finally have a kid. Going through this process gave me that opportunity.”

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