Josie, a 42-year-old from Virginia Beach, Va., and her husband have visited several clinics to inquire about IVF. Some charge as much as $17,000 for just one try.
"In vitro is our only option but we cannot afford this and our insurance doesn't cover it," said Josie, who didn't want to share her last name.
"We also have tried to purchase health insurance on our own but couldn't find one to cover fertility," she said. "Financing such a dream is impossible as both my husband and I don't have the best credit. Our dream is fading."
Susan Mazzoni, 42, of Bala Cynwyd, Penn., paid more than $50,000 for her fertility treatments, conceiving within 15 months. Her insurance company covered ultrasounds and blood tests, but all else was paid out of pocket.
Mazzoni worked as a health care project manager and her husband Claudio owned his own plumbing business, but the couple had to take out a home equity line of credit to pay for inseminations and IVF.
"My son is 4 years old and we are still paying for the treatment to have him," she said.
In September 2009, RESOLVE conducted an online survey with over 400 respondents, 50 percent of whom were in medical treatment at the time they took the survey. About 37 percent said they either had to slow down or stop their treatment due to the economy; 11 percent were considering going out of the country to find less-expensive treatment; and 40 percent needed help to pay for treatment in order to continue.
When Keely Webb, 35, learned that her only possibility for getting pregnant would be through in-vitro fertilization, she said it was a "devastating blow."
But she lived in Maryland then, where insurance companies are required to cover up to three attempts at IVF.
"This mandate has been the biggest blessing in our lives," said Webb, who gave birth to a daughter six years ago and now works for the federal government.
Now, because her husband is on active duty with the military, which does not provide fertility benefits, the couple will adopt an American foster child.
Only 14 states, including Maryland, have minimum mandates regarding fertility procedures for insurance companies.
In New Jersey, IVF is allowed, but not for women older than 46. Hawaii limits women to one try, but in Massachusetts, there are no limits in the number of treatment cycles. In Arkansas, payments are capped at $15,000.
But, those so-called mandates are deceiving, according to Resolve. Massachusetts, for example, has the oldest and strongest mandate, but large companies with self-insured plans and small employers are exempt.
"In some states, it's not even a full mandate, and in some there is really no coverage at all," said Collura. "It's a relatively large number of people who do not have access to care. As high as 50 percent of those diagnosed with infertility would benefit from medical intervention and are not getting the care that they need."
In states like California and New York, insurance companies specifically don't have to offer coverage.
According to America's Health Insurance Plans (AHIP)., employers, not insurance companies determine who gets benefits. They can purchase a package of services or specific diagnostic procedures or treatments.