I apologize in advance for the novel. I have never been concise.

Background: I had no trouble conceiving LO #1 (3 cycles), but developed pre-e that got severe and had PPROM and premature labor & delivery at 33+5 with post-partum hemorrhaging & huge clots.

TTC#2: We've been trying since May 2013 with no luck. I had a chemical in Oct 2013, but that's it.

I'm 37 now (will be 38 in Sept), and DH is 33 now (will be 34 in Sept). My day 3 labs were all fantastic numbers, but my antral follicle count was very low (5-6). DH's SA was great in count (180 million), good motility, but poor morphology (half of what they like to see).

They had us see MFM (high risk OB) for a pre-conception consult, and MFM stressed that because I'm already at an elevated risk of a pre-e & PPROM recurrence, and because multiples increase those risks, we have to avoid the possibility of multiples at all cost. My age is already a risk factor for multiples, so the MFM & RE said that I absolutely cannot do super-ovulation + IUI or any fertility meds of that nature.

Given the need to avoid multiples at all costs, the only intervention that the RE & MFM are comfortable doing for us is single embryo IVF + ICSI (where they inject 1 sperm directly into each egg).

Here's the dilemma: My DH's insurance doesn't cover IVF (he works for a very small business, and small business are not required to cover IVF). My insurance covers it 90%, open enrollment isn't until Nov, and the insurance wouldn't kick in until Jan 2016! So we can pay out of pocket, or we can wait. The RE said he strongly urges us not to wait because he is concerned about my egg quality (even though my hormone levels are all excellent, the low antral follicle count is concerning).

Out of pocket will cost us between $23,500 for 2 retrievals and unlimited FET ($17,500 for the 2 retrievals and $6k for the meds) or if I qualify for shared risk, $28,000 ($22,000 for up to 6 retrievals and unlimited FET and cryopreservation + $6K for meds). The shared risk is 100% reimbursable if all cycles fail (including all FET or destruction of remaining embryos). If we wait for my insurance, we're looking at $800-1000 per retrieval + co-pays for meds & cryopreservation.

My DH is talking to his HR to see if there's anything the company can do to defray the cost since they choose not to cover it, but I'm guessing the answer there will be no. I can't think of any way to get on my company's insurance outside of open enrollment for next year. We even joked about divorcing & remarrying to trigger a life event, but our state requires a 1 yr legal separation prior to divorce. Ha.

I really don't know what to do. We're trying the old fashioned way this month (I'm CD 13 today, so we couldn't start BCP for IVF until AF comes anyhow), but if this cycle is another bust, we have to decide what we're going to do.

I know this is a personal decision, but I needed to vent my frustration and also wonder what other people would do in our shoes. If you read all of this and want to share your opinions, I would be grateful for them!