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One Thousand, One Hundred and Fifteen Days

Matthew (left), Emily (right), and Dr. Stanley Prough (center), their reproductive endocrinologist.
Matthew Moore
Matthew (left), Emily (right), and Dr. Stanley Prough (center), their reproductive endocrinologist.

One thousand, one hundred and fifteen days.

My wife and I had moved to Fayetteville in August of 2019, both trying something new. She launched her own business as a professional organizer, and I started graduate school with the plan of going into public radio. We felt hopeful. We’d been married just over a year, and decided we were ready to expand our family. And then a year passed.

We met with an OB/GYN to better understand what was causing the infertility. Turns out, it was me.

I’ve always felt a bit… let’s say underwhelmed, with my masculinity. I’m short. I shop for shoes in the “Big Kids” section of the Nike website. I didn’t grow leg hair until I was a senior in high school. And to find out that I was the reason we couldn’t expand our family was a real gut punch, to say the least.

My wife’s OB/GYN suggested that we do IUIs for several months before moving on to more intensive measures. An IUI, short for intrauterine insemination, is a procedure that is pretty much what it sounds like. We had three failed attempts. The fourth attempt resulted in a positive pregnancy test, but after just seven days, we spent hours in the emergency room while my wife experienced a miscarriage. We tried one more IUI after that, which failed as well.

There’s just one clinic that provides in-vitro fertilization services in the entire state of Arkansas, and it’s in Little Rock. For northwest Arkansans, the closest option is likely to go out of state to Tulsa, Oklahoma. And so we bought ourselves a Cherokee Pike Pass for the toll highway and started making our countless trips—two hours each way—to Tulsa, Oklahoma to begin the in-vitro fertilization process.

Our reproductive endocrinologist who refers to my wife and I as “kids,” was confident we could conceive. Further testing of our infertility determined the motility of the sperm was the issue, but now that we knew that, we could make it work.

My wife would begin an abundance of medications, including subcutaneous shots in her stomach, to help her grow her uterus and ovulate as much as possible. The first objective: grow as many eggs as possible and retrieve them. We would outpace the sunrise as we drove to Tulsa every other day for a month. Sign in, blood work, ultrasound, and back home. Four hours roundtrip for what was often a 10-minute visit.

It's worth noting, I am lucky enough that my insurance provided some coverage for infertility. That didn’t stop me from spending on some days 5 or 6 hours on the phone arguing with them over what should be covered, how it should be covered, and why their coverage was completely inadequate in some very important areas.

One of those being medication. My insurance plan offered a lifetime limited coverage of $7,500 for infertility medication. However, the only pharmacy that our insurance would cover charged $18,000. And that was just for the medications for my wife to prepare for the egg retrieval. This was just the first batch of many—MANY—medications she would be taking. And so after many battles and arguments with our insurance, we decided to use a different pharmacy, that only charged us $4,000.

During egg retrieval, they collected 5 eggs, 3 of those fertilized, and 2 became embryos. Those two embryos went through genetic testing to ensure there were no issues that would result in a miscarriage or still birth. Both tests came back poorly, which means we had to start the whole process over.

Sign in, blood work, ultrasound, home. Another egg retrieval. And this time, success.

One round of the waiting game was over, but then came, well, more waiting. We had planned on doing a transfer June, but a coding error from insurance led to them refusing to pay for the second egg retrieval because they said we had already had this procedure before and that it was a duplicate. When we tried to correct the issue, we kept running into toll free number purgatory, with a different person on the line each time we called and no one able to answer our questions. Eventually we got it worked out, but it was too late. We had missed the deadline. And so we waited some more.

In August came more medications, more shots, and more trips to Tulsa. In September, the first embryo was transferred. And after tens of thousands of dollars, and one thousand, one hundred and fifteen days, we finally got to expand our family.

There are two major points I learned through those 1,115 days.

The first is how inadequate the access and coverage is for people going through infertility in the state of Arkansas. Arkansas is one of the few states that mandate insurance coverage for infertility, but as you heard from my story, it’s deficient and doesn’t cover appointments and procedures appropriately. There is a major gap between what is actually involved in the IVF process and what employers and their insurance providers believe actually happens. And it’s not very helpful to mandate insurance coverage for a procedure that is unavailable to millions of Arkansans in their own state because they aren’t able to drive to Little Rock dozens of times for appointments.

The second point is the recognition that we so often have no idea the struggles that people are going through. Through that 1,115-day period, my wife and I were asked numerous times when we were going to have kids. When we were going to start growing our family. And every time we heard that from someone, it was just a dagger in our hearts. The pressure so many people struggling to get pregnant experience hearing these sorts of things from loved ones is one of the worst parts of the whole process. It’s never OK to assume you know where people are in their journeys. And for some, a family is a family even without children.

For the two of us, we finally got to expand ours. Coming June 8, 2023: a baby boy.

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Matthew Moore is senior producer for Ozarks at Large.