In addition to death and taxes, you can add financial burden to the list of things certain in the life of someone with infertility. Even those with insurance coverage live in fear of reaching the cap and often need to fight for compensation regardless. Rachel at Henry Street is a case in point. She was recently denied coverage in her mandated state because regardless of the numerous miscarriages, failed IVF cycles, and balanced translocation diagnosis, they are not considered infertile by the state's definition.

This might beg the question, what is the definition of infertility if this couple does not belong inside the definition. But it's certainly food for thought for anyone who hasn't yet considered the enormous financial repercussions of infertility.

It's not a side of infertility that can easily be dismissed even though most people choose to focus on the emotional and physical aspects. One of the more frustrating misperceptions is that if you can't afford treatments or adoption, you can't afford a child. Yet how many couples would be able to pull together a full year of college tuition merely for the chance to parent BEFORE there is even a child in the picture? The costs associated with treatments and adoption are astronomical which means many infertile men and women end up paying the equivalent of college before and after they've had their child.

Money is on everyone's mind right now due to taxes and nothing brings out bitterness about infertility like taxation. It's impossible to mark no dependents without feeling a twinge of frustration or to see your medical spending listed out in print.

JJ from Reproductive Jeans wrote a post for the Redbook Infertility Diaries on this very situation:

We are one of the many couples who are not covered by our insurance to have fertility treatments. That has meant that the cost of each test, each blood draw, each injection has come directly out of our pockets. So as I sat down at our kitchen table last month to fill out forms to send to our tax preparer, I had a bit of a grin on my face anticipating the nice refund we would get for all the medical expenses incurred last year. What I wasn't prepared for, was how fast that grin changed into a frown. I had to rehash each one of those medical visits, and it brought back some painful memories. When I finally listed the last item, a tear rolled from my cheek onto the paper. We had spent all this money, with nothing to show for it; and the money coming back to us won't equal a baby either.

It's impossible to not think about next year as you fill out your forms, wondering how the taxation will fall, if all of the work you're doing will pay off and you'll be parenting.

Crying Over the Fish Sticks prepares taxes for a living and this is her third infertile tax season. As she prepares taxes, the constant chit-chat always returns to when she'll have children and this year, she decided to answer truthfully when this question is posed. Ever financially responsible, she is waiting until she has saved up the money before proceeding with IVF and mentions the debt that often comes hand-in-hand with new parenthood after infertility.

What Wuz I Saying, parenting after infertility and in the process of adoption, has a post this week about Oprah's Big Give and the philanthropy she wishes she had the funds to start.

I would love to set up a program that raises money for those who cannot afford infertility treatments. Oprah told the contestants to pick something that hit close to their hearts and that they felt passionate about. Got that covered! I have no idea how I would raise the money or start something like this, but it has my wheels a turnin'! I guess that once things got rolling, or I won the lottery, the hardest part would be choosing who was to receive the money. How in the world would anyone pick? Do you pick based upon the most financial need or the longest in treatment? Women without any children yet? Those that have been through loss? Or do you just give a little to as many women as you can? Ugh. Maybe this hits too close to home.

The other point Kim makes is the idea of paying money for a chance instead of paying money and actually walking away with the problem treated. It would be like going to buy a car, putting down $20,000 dollars, and then holding your breath to see if you get to drive off the lot with a new Volvo or getting a shrug of the shoulders from the salesperson and a "better luck next time."

Lastly, the deep-reaching effects of the financial side of infertility play out in Life, Love, and the Pursuit of Normalcy recent post about cost of reaching parenthood. With their best chance at parenthood in the $10,000-30,000 range, parenthood is priced beyond their means even though they have the financial capabilities to parent a child.

It is dismissive and offensive to ignore the emotional aspects of infertility simply to address the financial aspects and all solutions must take into account the three points of the triangle--financial, emotional, and physical--and attempt to balance them. Which is why it's impossible for anyone else to blaze another person's path to parenthood or even throw out suggestions--balancing those three points is a very personal thing.

How are you handling the financial side of infertility?

Melissa is the author of the infertility and pregnancy loss blog, Stirrup Queens and Sperm Palace Jesters. She keeps a categorized blogroll of over 1200 infertility blogs and writes the daily Lost and Found and Connections Abound, a news source for the infertility blogosphere. Her infertility book is forthcoming from Seal Press in Spring 2009.