Maybe I'm overly cynical, but if they could, I'm sure firms would try to limit this insurance to their male associates. Children make men stay at the firm, while they make women eventually leave. It's a bold move for a firm to shoulder more of the insurance cost of this when it could lead to another female associate leaving the firm.

In addition to shopping for firms that offer this insurance coverage, people should check the insurance coverage of their spouse's employer. I know the federal government offers better (and far more) insurance options than my firm does.

I chose my firm based on their beard and mustache-related expense account. The muttonchops co-pay is only a quarter-dollar!

Lat, what about coverage for adoption benefits? Adopting a child can be very expensive, and only a handful of firms offer financial assistance.

I imagine it would make much more financial sense for firms to offer free sterilization.

No kids = More Hours Billed :-)

I bet my friend $100 the other day that ATL was about to jump the shark. Oh man, I can't wait to spend that $100.

ATL = Pets.com

4:11 - don't drink the Flavia or from the water fountains...

FYI - just because your state has mandated infertility coverage, and you work in an office in that state, it doesn't mean infertility treatments like IVF will be covered by your firm's policy. I am in an insurance-mandated state, and I had to pay out of pocket b/c my firm's policy was written in another state that excluded benefits (or capped them at some ridiculously low #).

It is also worth mentioning that my firm offers no adoption benefits either.

this came up at one of my oci interviews (i do not remember why). my skadden interviewer informed me her over $250,000 in medical bills re: to her in vitro were covered by her insurance policy.

Are you taking the piss? Few topics are sexier than fertility, ipso facto.

If you have to undergo a purely elective and highly expensive medical procedure just for your own gratification and biological urge to procreate, when other cheaper alternatives (adoption) are available, why don't you spend the money out of your own pocket, instead of trying to spread the cost to other hardworking people who are now paying higher insurance premiums.

I fail to see how this medical treatment require medical "insurance" in the classical sense of the term, unlike a bike injury or a workplace accident, especially when society accrues very minimal benefit when the breeding population just went up by one.

"If you're lucky enough to be blessed with children..."

So which is it, chief? Lucky or blessed?

Can't be both.

4:14 - generally correct, however, in Massachusetts it doesn't matter where the policy is written, it's where the coverage is. As long as the insurance policy covers a Massachusetts resident (and the mandate isn't preempted by ERISA) the mandate applies.

4:22 is exactly right. The point of insurance is to spread risk, not to have others pay for electives. Asking an insurance policy to cover in vitro is similar in kind to asking it to cover the cost of turning a guest room into a nursery. Both are added expenses due to a child, but it would be a bit silly (and morally indefensible to boot) to ask you co-workers, other citizens, and indeed, those who can no longer afford health insurance, to cover the cost of basinets and animal-covered wall paper.

Adoption isn't necessarily cheaper than fertility treatments (which, btw, include much more than IVF), but otherwise I agree with 4:22. This is not a cost that should be spread across all members of the firm via insurance premiums.

It's not that I fail to recognize the stress and crappiness of infertility and its various treatment options. I just fail to see how it's a cost that should be borne by the group. Sometimes bad things are just going to happen to you, and you alone. It sucks, but it's pretty pathetic that our culture has become one in which our response to individual hardship is to turn around and see who else can share some of the cost/responsibility.

Yeah, I want to know which firms DON'T offer coverage for IVF treatments so that I can go there, since I don't want my health insurance contributions to subsidize someone who wants to spend $200k to squirt out a baby instead of adopting some child from the orphanage.

Baker & McKenzie and Skadden, I'm not going there.

At least with adoptions there is a colorable argument for a group subsidy since the new parents are improving society by reducing the number of presumably miserable children by one.

Not so much with fertility treatments.

Turn around is fair play -- not everyone wants a child, yet the cost of having one is borne is spread out amongst the group and factored into the rising health care contributions

Why do I get the feeling that if a guy's parts don't work optimally (or even for recreational purposes), it is always covered by insurance.

4:22 - you're a moron. Infertility is a medical condition. The treatment is so expensive because it is highly specialized, just like the treatments your cardiac surgeon will be providing to you in the not-so-distant future. Procreation is every person's right - a FUNDAMENTAL right - and if you don't believe this go back to your Con Law class and reread the 14th Amendment cases. Instead of blaming the high cost of health care on the extremely small group of people seeking treatment for this valid medical condition, try blaming the real causes - smokers and fatties. And before you start responding that smoking and eating all you can at the Country Kitchen Buffet are also fundamental rights - go screw.

4:22,

I was in the middle of crafting a thorough and intelligent response, but overcome by a sense that you are a repugnant piece of shit, I deleted it and wrote this instead.

Does anyone know Latham's policy on this?

4:43, I believe that you are the moron. Procreation is a fundamental right that the state can't take away. It is not a privilege that the state/private sector has to subsidize. Please go back to your Con Law class at Cooley and reread the 14th Amendment cases, and learn some better ad hominem attacks.

I have a fundamental right to travel across state lines, but that doesn't mean that the firm or the government must pay for all my expensive vacations. In fact, most people would find that pretty ridiculous, but obviously not you since that's a fundamental right.

You go into some of these law firms in New York, and like a lot of law firms, the jobs have been gone now for six months and nothing's replaced them. And it's not surprising then the associates get bitter, they cling to antipathy to people who want to have babies or anti-infertility treatment sentiment as a way to explain their frustrations.

I say the term "jump the shark" has jumped the shark. Fools!

4:43 - it's not my obligation to subsidize your fundamental right. I can't prevent you from exercising it, but I don't have to pay for it. Go back to con law yourself.

(This isn't 4:22, I just think your argument is poorly reasoned.)

This will surely be ignored, but I'll toss it out there anyway as a preemptive strike. Can everyone who is having/has had infertility issues *please* not view every post here as a referendum on their individual case? Please? There's a legitimate policy issue at play here.

4:43 needs to reread the Constitution I think.

Please please tell me where in the text it says that you have a right to procreate. I must have missed that since I didn't go to Ava Maria. Curse my Ivy league education again!

I will support 4:22 - this is complete bullshit to be concerned with this. I mean really.... there are plenty of kids to be adopted out there. The fact that people are using outrageously expensive treatments is a waste of resources....
THe real problem is that everyone who does this wants to have "their own kids" like its a fucking pet. Worse still a pet which they then try and get into the best Pre-K, then K, then a good high school, and then Ivy league... thats why everybody wants IVF - they think thier genes are so good that their kid must have them to succeed. Its sort of sickening.

Plus maybe before these treatments people should just try to shag more - probably cant because they are hideous and work all the time - sounds like a lot of girls at my law school. I certainly dont want to f-ck them

"Procreation is every person's right - a FUNDAMENTAL right" But it cannot simply follow from this that you can force others to pay for IVF. At most, it means the government cannot stop you from having IVF. Owning a gun, for example, is also a fundamental right (by they way, are we writing fundamental in all caps now?) but I cannot just march into my managing partners office and demand he chip in on my sidearm.

4:43 - your right to procreate does not mean that others should have to pay for you to do it. No one is arguing that your firm should be allowed to stop you from doing in vitro, just that your co-workers shouldn't have to pay for it.

3:54: This Is The Shrewd Response (though it could be a cheap way to drive out unproductive female associates).

4:45 - I just looked at the 2008 coverage brochure for Latham's PPO insurance (in CA, not sure how other offices compare). Fertility treatments are specifically excluded.

(However, I know someone who was able to get around such an exclusion on her insurance by going to an endocrinologist, who processed her treatments as such. She didn't need IVF, though, which is the grand pearl in the infertility cost oyster.)

i dont want my firm paying 15k to cover this kind of thing.

that picture's grossing me out lat

For all of those suggesting adoption as an alternative to expensive treatments, the two are roughly on par (generally $15K plus). Thus, those who choose IVF are not foregoing a cheaper alternative. (In addition to the many complications that adoption can bring, including a stringent qualification process, lengthy wait times, potential complications with the birth mother, etc.).

Dear 4:43, here are a list of other FUNDAMENTAL rights that I would like to exercise, and since you think that I should subsidize your FUNDAMENTAL right to procreate, please send me a check so that I can exercise my FUNDAMENTAL rights.

- getting married
- owning a gun
- interstate travel
- buying some condoms
- getting an abortion
- burning the flag

Forget infertility - I shouldn't have to pay for any type of cancer treatments for smokers. I also shouldn't have to pay for treatments related to diabetes, heart disease, hypertension or any other disease caused by obesity. These are the real causes for inflated insurance premiums - well, these, and a poorly run system in general.

5:01, the difference is that without infertility treatments, the wannabe parent is still alive and well. Without cancer treatments and those other treatments, the person (however culpable) is going to die. For most people, there is a difference between not having a kid and dying. Usually people want to stop deaths.

Furthermore, smokers do pay more in insurance premiums so their costs are not so externalized like the IVF subsidy.

Also, overall health costs will be driven up as the cancer/heart attack patient goes to the expensive emergency room instead, while obviously the infertile woman won't do that.

I am guessing that will be the last time captain 1L, aka 4:43 jumps in with a retarded response.

Also, its not as if they have this "medicine" down pat. I know three people who have used IVF. Two had twins, the other had triplets. Nice work doc. The later of the three had to mortgage his house to pay all the damned bills.

The only socialized medicine I will ever support is free birth control to any girl who wants it. This would solve social security, the deficit, welfare, food stamps, the Spears family. There would be not "cost" to the country for that little program. Not spending a trillion dollars in Iraq would have helped too.

5:01, I disagree with the statement about costs not being driven up by infertile women. That's not always the case. If a workplace does not cover IVF, the woman will often undergo "lower tech" (read: cheaper) procedures. Some of these procedures involve MUCH higher risks of multiples (although IVF can lead to multiples, the high-order multiples you often hear about are generally from the lower tech procedures). So by not covering IVF, you now have a heightened the risk of pre-term births (and very costly NICU expenses) and potential complications to the mother.

Food for thought... In my observations, infertility seems to be more prevalent among attorneys and their wives (who are often professionals as well). My thoughts on this trend being that (1) attorneys tend to delay having children in the interest of their careers and (2) attorneys tend to experience a higher degree of stress on the job, which certainly does not help with infertility. So if infertility is in many cases related to work at a law firm, why shouldn't the law firm cover at least part of the treatments?

I agree with 4:22 (no matter how obnoxious it came out) even though it is a bad situation to be in - but when you have people who cant even afford to get extremely basic care that would actually mitigate more serious medical concerns the idea of having to pay more becasue someone thinks they have the right to have their own children even though they naturally cant and want to have that right subsidized by everyone else is really wrong....How about we try subsidizing basic health care for everyone before we even jump to purely elective IVF.....?

Lastly, I think its pretty ridiculous what folks, who add very little value to law firm other than their IVY league diplomas, think a firm should have to give them. Lets see - 160K plus bonus, plus meals after a certain hour, plus free car rides after a certain hour, plus months of parental leave, 4 weeks vacation, plus bar expenses, plus relocation expenses, plus my baby's mama child support...i kid i kid...but seriously a lot of you have no idea good a deal you are getting - sure your lives suck but its the trade off you made for 160K without adding very little value. Bottom 1 percent of any tier 1 or 2 school could do what you guys do without anyone noticing the difference....you are a bunch of document reviewers, paper editers, and empty suits - talk to me about extra benefits when you can actually drum up business or create a unique new value added service to charge clients for....

With the massive carbon footprint that every new child leaves on this fragile planet, it's amazing that anyone would go to such lengths to cause such destruction for their own selfish purposes.

5:16 - go play in traffic.

4:43 got pwned

5:16 - that's not the dumbest thing I've heard in the last week, but it's definitely in the top 5. Have you looked at any kind of meaningful sample? Or are you just aware of infertility among your friends, most of whom are attorneys? Even if there is a higher incidence of infertility among attorneys, how can you say it's "related to work at a law firm" with a straight face? Hyperbolic extrapolation much?

4:45, why is someone "repugnant" just because s/he doesn't give a shit whether someone who wants to have a baby can have one? I sure don't give a shit, and I sure as hell don't want those costs spread to me.

4:43, you're too stupid to live. Forget your mutilation of Con law, infirtility isn't a medical condition that impairs one's health, so it doesn't need to be fixed.

4:48: Thanks for the info!

Wow. The comments above reflect complete ignorance as to how difficult it can be to have a child nowadays. Infertility can be one of the most difficult and isolating experiences a couple can go through. You brats who think you can just conceive when and where you want, go ahead and be my guest. And it is a medical condition. You can deduct infertility treatments as a medical expense on your tax return. To answer one of the questions in the post, I know that Alston and Bird is also known for providing for one full IVF course in their insurance plan.

5:19: good to see you went straight from law school to being a rain-making, value adding genius partner. If there is one thing that is worse than a newby bitching about how "bad" they have it, it is a older attorney pretending they were never that "newby." The definition of the term asshole.

My advice for you....see comment @ 5:22.

How about Cooley?

To all female associates experiencing difficulty conceiving: Pls send height, weight, and headshot to my attention at Orrick.

Guaranteed results.

5:26 - thanks, I didn't know that the IRS was the authority on defining what is or is not a medical condition.

Also, no one here is claiming that is it easy to have a child, but saying a situation is "difficult and isolating" doesn't mean that other people should have to pay to fix it for you.

5:26 - not so much. No one here seems to be saying they don't get that infertility is hard. Just that they don't want to pay for it. Tax deductibility isn't an indicator of something that should be covered by group insurance - the point of medical deductions is to remove those expenses from your AGI, not to give a treatment an official "this should have been covered by your insurance" seal.

5:26, I don't think anyone doubts that infertility can totally suck for the person who wants a child, and that conceiving can be difficult. The point is that I (and the people who don't want IVF costs included in insurance) don't don't give a shit whether any given couple/person can conceive. I just don't care. Unlike medical conditions that can, you know, kill you, infertility just means you can't have a baby. I don't care whether you can have a baby and don't want to share the costs of fixing that "problem."

The medical expenses tax deduction is a completely different issue from whether others should subsidize your elective care.

According to the IRS, you can deduct fees paid to Christian Science practitioners for "medical care", which basically means all prayer and no medicine. That's fine with me if they want to do that, but don't ask me to subsidize that.

to 5:27pm from 5:19pm

another over coddled whiny gimme gimme brat...when did earning your stripes mean being pampered the entire way through. I would personally love for law firms to actually stop this overentitlement - it would cut off a lot of the dead weight especially considering most of you will bolt after only putting in 2-3 years to do something you actually "enjoy." Really its a losing model - for the firm, for the client, for the kids who do it just to pay off their loans, and for the folks who decide to stay and lose out on actual professional development.

Actually, 5:24, female law firm lawyers experience a higher incidence of miscarriages compared to the general population. See, http://www.ncbi.nlm.nih.gov/pubmed/9211214 . It would make sense to think that infertility also is affected by occupation (although that doesn't support 5:16's logic regarding insurance).

yay, liberals arguing against the laws of nature. come down off your pedestal...there are plenty of children here in the US without basic healthcare and still more without homes. Corporate lawyers complain about not being able to make a difference...well how about you donate some of your big moeny paychecks to a worthwhile childrens charity or donate your time to a big brother/big sister group. On the other hand I guess you are helping the economy as the nanny who will undoubtedly raise your child will appreciate your efforts as will the private schools they are placed in as a right of entitlement, just like their parents.

5:27/5:43, can you tell us about the time you walked 5 miles in the snow, uphill, with no shoes to do due diligence? Or how about the time the people actually running your (and every other biglaw) firm decided to ignore your sage management advice?

People much smarter than you--a low threshold, I know--decided long ago that law students were not fungible. The best assistance you could ever provide to a young attorney is your name so that we can make sure to avoid ever working with you.

5:47 - Are you referencing something in the larger article, or the abstract? I don't see anything in the abstract to support your statement that "female law firm lawyers experience a higher incidence of miscarriages compared to the general population." The abstract states the data showed that "weekly job hours during the first trimester of pregnancy showed a strong independent association with spontaneous abortion risk" and that "self-reported stress during pregnancy was positively but not statistically significantly associated with spontaneous abortion." So working a lot and being stressed during first trimester leads to a higher incidence of miscarriage, but lawyers certainly don't own the market on high stress or excess hours. My read of the abstract also leads me to believe this study wasn't comparing female lawyers to the general population, but among each other (see, e.g., the fact that the study population only included lawyers).

A few points:

(1) It can be remarkably difficult to find out whether or not IVF is covered prior to joining a firm. Persist. When I was considering my lateral choices a while back, IVF was a big factor, and I was ultimately able to find out whether it was covered, but it wasn't easy.

(2) Most firms offer at least an "expensive" and a "cheap" plan. My current firm's expensive plan covers IVF, the cheap plan does not. This should address the "oh, I don't want to subsidize anyone" argument. That's great -- take the cheap plan, and I won't subsidize your bypass being performed by a top surgeon and you won't subsidize our IVF.

(3) If you or your spouse are self employed, take a look at 105 plans. These can save you a ton of money if you know that IVF is coming up. Even when covered, IVF means you're going to have a lot of out pocket expenses. Also, no insurance I'm aware of covers egg donor fees or medical expenses.

As much as I agree with 4:22, I think s/he's missing the point. The point isn't to debate about whether law firms *should* cover IVF, it's to determine which law firms *do*. Putting aside whether or not it's fair for everyone to subsidize IVF (and again, I agree with 4:22 that it isn't), such a subsidy does add a significant benefit to a compensation package, and I can't blame anyone who needs fertility treatments for going to a firm that will provide that coverage.

If you can't shit out a kid on your own, you shouldn't have one. Isn't that how nature is supposed to work?

People who have children are selfish. We all soon struggle to gain access to valuable resources.

Good point, 6:10 (the first one). According to http://www.conceiveonline.com/index.php?option=com_content&task=view&id=9&Itemid=147, a few firms that cover IVF include Alson & Bird, Arnold & Porter, and Baker & McKenzie. A number of accounting firms also cover it. Anyone know of others?

Dewey & LeBoeuf's "expensive" plan (two plans are available) covers IVF up to three cycles. I assume the "cheap" plan does not cover it.

In response to 5:32-5:39, I'd be interested in seeing how much adding infertility to an insurance plan actually increases your insurance premium. If it costs an additional $100 bucks a month for everybody, yeah I can see your point, but if it's like $5 or even $10 a month, well your point is not so well taken. I think it's pretty easy to say, "I don't give a sh*t about people who want kids," because it's pretty clear none of you have or want kids. But until you do, you'll never understand the benefit. BTW, besides the firms already mentioned (Baker McKenzie and Alston Bird) there are pretty much no other firms who offer this benefit so no need to freak out O greedy, self-involved associates of the blogosphere.

Anyways, if you guys take so much offense to ponying up some nominal cash to help your co-workers have children, you guys must be absolutely apoplectic at what your hard earned tax dollars are paying for. Damn, if working at biglaw doesn't make you one heartless SOB.

Everyone's selfish. Some people have kids because they want them. Others don't because they don't. Neither is an act of charity. Besides, our economy actually faces a dearth of skilled workers thanks to the retirement of the baby boomers and lower birthrates among the educated .

6:06, by definition, even the "expensive" health insurance plan has a form of subsidy by other people who pay more in costs than they get out in benefits. If there was no subsidy, then the fertility treatment would cost the same as if you paid everything out of pocket (with tax deduction), so you wouldn't even be needing that "expensive" plan at all.

So yes, that "expensive" plan involves less subsidy by other people, but don't kid yourself that the out-of-pocket savings that you received from that plan came magically from thin air. Someone else out there paid for the share of your purely elective treatment expenses that you did not pay personally.

6:06, actually, the cheap/expensive plan argument doesn't address the "have babies on your own dime" concern at all. Getting a top surgeon improves one's health, having babies is a lifestyle choice.

Pay for my plastic surgery! Being ugly is a medical condition!

One website I found gave a range of less than $3 -$20 / year for premium increases:

"Advocacy groups, such as the infertility support group Resolve, refer to studies showing that adding infertility coverage raises premiums by less than $3 per employee a year. Critics of the laws say other studies show higher costs, possibly $20 a year or more per employee."

Wow, it took several hours for someone to bring up the beloved saw equating disinterest in paying for others' entitlements with heartlessness. Hooray. We can now retire the thread.

Seriously, every time someone posts something like 6:20's last paragraph, I just want to give them a good, old-fashioned cockpunch. I don't make value/moral judgments about you based on the way you choose to spend your money; please don't do the same for the ways I choose to spend mine.

The way these corporate health insurance plans seem to be structured it seems you can basically go and shop around for plans that cover IVF that are either firm-based or "expensive"-"cheap" based as 6:06 states. But think about it - if that treatment costs $20k and you're paying the same premium as everyone else (or however much more you're paying for the "expensive" plan), then you're essentially going around looking to see who will subsidize your elective IVF treatment and making other share the cost with you. Yeah, its the firm's stupidity ,or generosity by the partners, which then makes other associates share in this generosity, for having this option available in the first place, but YOU ARE SHOPPING AROUND LOOKING FOR SOMEONE TO SUBSIDIZE YOUR ELECTIVE PROCEDURE. Don't act indignant when those others who are forced to help you pay for your treatment tell you that you're ripping them off. If I were looking and i knew that I could take advantage of some aspect of a firm's health plan coverage, then I'd take full advantage of it too because you'd be stupid not to, but don't pretend that you're somehow morally right while those who complain are morally wrong. It is what it is so use the system, take the benefit, and shut up.

This is a sweet benefit for people who need it.

I'm not really sure what the debate here is about: if you don't support a firm spending money on this, don't work there. Compiling this list can help everybody in that respect.

My breasts are too small. Which firms have insurance that pay for elective breast enhancement surgery?

If I have big breasts, that will help me get a man, and we'll procreate to have a baby which is our FUNDAMENTAL right (thanks 4:43) that requires a subsidy from others.

And i bet that firm would be popular with a lot of people who can't use breast implants themselves. Everyone wins.

Just kidding.

I wish infertility upon you 22-year-old assholes who have no idea what it means to want to have a child and be unable to. I also wish the "ease" of domestic adoption on all of you. People have absolutely no clue how difficult it is to adopt a child of any age. It's astonishing given the confidence with which you people throw it out as the easiest option in the world. Sure, just run down to the orphanage (those haven't existed since when?) and pick yourself up a child!

Adopting abroad is similarly no joke and certainly not inexpensive.

Really, 6:35? I would think firms that paid for breast implants might actually become very popular.

Why is everyone talking about fundamental rights and public policy? This is a simple contract issue. Either the firms think that the hiring benefits of offering IVF coverage outweigh its costs, or they do not. It's not like we're discussing natural law here, just a business decision made by private partnerships.

6:36, here is a list of American orphanages today:
http://www.missionfinder.org/orphanages.htm

Also, please look up "foster adoption" and so-called "foreign countries" that have orphanages.

If you're so motivated to get a baby that you're willing to take money from others, you should be even more willing to spend your OWN money for IVF or adoption.

Of course I will have myself cloned as soon as I can; of course everyone will get themselves cloned as soon as they can. I will go to the Bahamas, New Zealand or the Canaries; I will pay the asking price (moral and financial demands have always counted for little next to the demand for reproduction). I will probably have two or three clones, as you have two or three children; between their births, I will allow for an adequate gap (not too narrow, not too wide); as an already mature man, I will behave like a responsible father. I will make sure my clones have a good education; then I will die. I will die without pleasure, because I do not wish for death. Through my clones, I will have reached a certain form of survival - not completely satisfying, but superior to the one which ordinary children would have brought me. For the time being, it is the most that western technology can offer.

Can an obnoxious 2L at Vandy tell me which firms cover this under their "healthplan"?
Merci.

Cripes. Can we please get something straight? Stating that one doesn't feel infertility treatment should be covered by group insurance IS NOT the same thing as stating that one doesn't appreciate what it means to want to have a child and be unable to. 6:36, you should be ashamed of yourself for wishing infertility on anyone. Read the posts carefully - there are several that *explicitly* state the author's appreciation for how painful and agonizing it is to experience infertility.

Have people thrown out flippant "just go adopt" comments? Yes, but several posters have noted that adoption is neither easy nor cheap.

In short, there are a lot of people here who empathize with your ordeal. Maybe cool it on the name-calling and spite.

6:43: Do you mean this statement from the website you attached?

"Orphanages were the primary way of caring for indigent children in the USA from the mid-19th century to the mid-20th century. After that, foster homes and small institutions like group homes replaced orphanages."

Employers always have a couple plans to pick from. Just pick the one that doesn't cover stuff you don't need/want. That's not so hard, is it?

Though I wonder how many people here would consider E.D. or any male genital malfunction whatsoever "elective" and therefore uncoverable.

What about reconstructive surgery? What about replacing a lost thumb with a toe? What about rehabilitation after accidents or for C.P? What about mental health? What about the thousands of other things that good insurance pays for that greatly increase quality of life but aren't strictly speaking "necessary" because you won't die without them?

6:47: See, I think lots of people maintain that they "understand" how tough something is when, in fact, they have no fucking idea how tough it is.

6:36 - I'm not a 22-year old assh0le. I'm a 30 year old, married woman who has no idea whether or not she's fertile. However, as much as I wouldn't be surprised if I didn't have heart disease from the long hours, stress, poor diet, lack of exercise and insufficient sleep, and I certainly wouldn't be surprised if I didn't have difficulty in trying to conceive. The stresses of law firm life certainly aren't optimal for easy conception.

Here's the thing, though. I knew going in what I was getting into. Biologically, it's easier for women to get pregnant in their 20's, but I made a choice to get settled in my career first. I'm an adult, and I'll live with the consequences of that decision.

Here's the other thing. People should get over their narcissism and selfishness and start adopting more children instead of using expensive technology to help them have their own. People are too hung up on having kids that look like them. I'm sure that you and your spouse are perfect and the world deserves to have the blessing of the fruit of your loins. Everyone wants a healthy white baby from this country, so they complain when they can't have one on their own or adopt one with ease. Meanwhile, kids of different races and ages are still waiting to be adopted. And there are kids the world over, esp. older ones, who'd love to have a home. Those adoptions, if you meet the age and income requirements (easy for a lawyer) are almost guaranteed, given a willingness to wait the 2 years.

And there are still orphanages - but you are correct, in the U.S., they often aren't used to adopt out kids. That's what the foster system is for, but I am sure that most people who are interested in IVF aren't interested in kids in the foster care system.

IF YOU'RE NOT A BITTER, BARREN BIGLAW LADY LAWYER WITH TWIGS IN HER SNATCH, YOU HAVE NO RIGHT COMMENTING ON THIS TOPIC.

6:49: I think there is a general sense in society of what is "necessary" and what is not. I think most would agree that reconstructive surgery for horrible disfigurements or rehabilitation after accidents are much more "necessary" than "IVF" treatments. You can judge for yourself by the comments on this thread. I don't think you'd see many comments talking about how health plans shouldn't cover physical therapy for paralysis or stroke if such an issue were posted here so its not a valid argument to lump those conditions with IVF. I'm sure IVF is a very difficult situation, but it is an elective decision that many do not equate with a serious medical that affects the health insurance policy-holders own health.

6:49 - you are seeing opposition and affront that isn't there. How much proof do you want that someone has an idea of how hard this is for you? A blood oath? You are going through a really hard process, one that surely can't be fully comprehended without personal experience. But that doesn't mean that people can't show empathy without having been there, and it really doesn't mean that people who don't want to help you pay for it are somehow less understanding.

i'm continually surprised by the fact that some people are still shocked--SHOCKED!--and insulted by the callousness, selfishness, and immaturity of some of the posters on here. do you really think more than 1 in 10 of these people would be making the same comments if they weren't anonymous?

if things like IVF are tax-deductible, we're all subsidizing them anyway through reduced tax revenue. so isn't all this outrage overblown, since it's really just a matter of degree? if a firm wants to adopt a plan that covers IVF, good on 'em. if not, cool. if i knew my spouse and i would likely need IVF to conceive, you bet your ass i'd be picking a firm whose plan covered it, and so would you. anyone who suggests they'd act otherwise is either a liar or a fool.

i'm outraged that some firms' plans cover ED treatment. i don't need it, and no one is dying from it, so why should others have to subsidize some old guy's bedroom life?

and contact lenses...really? glasses aren't good enough? now i have to subsidize your vanity?

i thought i was infertile until i knocked-up my girlfriend.

my wife was pissed.

7:17 - your tax argument doesn't really hold water. Since any medical expense that exceeds 7-1/2% of your AGI is deductible, you're effectively arguing that anything the IRS views as a medical expense shouldn't be objectionable when included under a given health plan.

ED treatment?!? Covered in my healthcare coverage! I refuse to pay to help bonerless colleagues get their jollies. Obviously, nature did not intend for them to have boners.

Bonerful associate

To 7:17, even if you're argument were IVF-specific, you're basically saying that for those that didn't realize it was tax-deductible (because for some horrendous reason, they weren't totally versed in the IRC), you're saying that they can't say anything now because they didn't say anything about something they didn't realize earlier. So if I just realized that politicians spout BS to get elected and stay in office, am I not allowed to complain because its been going on since the start of mankind?

Unfortunately, thanks to genetics, a lot of infertility problems are passed on to (guess who!) your children! So the more infertile people there are having children through IVF, the more there will be! Yay!

I have a number of friends who have struggled with infertility and, from my outsider's perspective, it can be even more agonizing and demoralizing than your first "C" in law school. I care deeply for my friends. Strangely enough, I have not offered to pay for their infertility treatments. Perhaps it is time for them to re-evaluate the friendship and surround themselves with more caring and compassionate people.

As for infertility versus adoption, spending thousands on fertility treatments is your choice and your right, legally speaking. But you would do well to remember that while you are spending thousands fiddling with your hormones so that Johnny or Sally will have your eyes, Bao-zhi and Habika don't get supper every night before they go to bed. It's no more cruel or unfair to remind you of this fact than it is cruel or unfair for you to choose to continue the planet's trend toward overpopulation while others languish in poverty and illness. People who conceive easily are certainly no less selfish than you, but their selfishness requires less active and continued effort.

6:36, clearly *you* do not understand the difficulty of infertility if you would so carelessly wish it on anyone else. Either that, or you're a heartless psychopath.

7:18, contact lenses are appreciably different from glasses, as they give you a fuller range of sight and don't get in the way with things like sunglasses/ski goggles/difficult yoga poses/etc.

The adoption point is, frankly, stupid. The same arguments hold true FOR EVERYONE who has kids of their own genetics. This is not unique to infertile couples...

Amein, 8:01. To every person who beats the "hey, just adopt" drum, I am always curious as to where they are hiding their stack of adoption apps. 7:57 - if you decide to have children, are you going to try to conceive your own, or are you going to go straight to adoption? Remember, Bao-zhi and Habika don't get supper every night before they go to bed. Are you going to take them home?

It's crummy to presume that you can tell someone else how or when to procreate. Saying you don't want to pay for the means is different from telling someone not to do it at all, or to do it a different way. I hate it when people confuse the two.

8:14, didn't you notice that I explicitly stated that fertile couples who conceive naturally are equally selfish?

I am perfectly comfortable facing the consequences of my choices, be they acknowledging that I could, but won't, save a starving child instead of gratifying my narcissism, or actually saving the kid and feeling superior to everyone else. If you're comfortable with acknowledging the consequences of your actions, then I have no beef with you.

7:01 here, 8:14.
I'm all for walking the walk. My adoption applications are in my basement for when I need them. I'd love to have Bao-Zhi, Habika, Consuela or Lakshmi. Did you know that they bring older kids from another country to the DC area every summer to go to camp and to simultaneously see if they can find an adoptive family? Thinking about that gets me every f'in time. Especially when I think about all the kids at Langley High School who are mortified to be seen driving to school in a 5 year old car or with last year's handbag.

And I disagree with you - I think that people can tell other people how and when to procreate. They don't have to listen, but if people can tell other people not to drive SUVs or not to commute long distances or to give to charity, I think they can strongly tell people to consider an adopted child instead of their second or third biological child. We can certainly tell teenagers not to get pregnant. It's up to each individual as to whether or not he or she listens. Have the strength of your convictions - if you've decided to do something, you should have the strength to defend your decision.

8:14 here - yep, I noticed that you pronounced the selfishness of fertile couples, and I noticed that you did it in the same breath as you launched a big load of sanctimonious judgment on infertile couples who choose to spend their money on trying to conceive rather than adopt. My point here is that it's quite lamentable that people like you think it's fine to pipe up about the morality/validity/selfishness of someone else's reproduction decision. Fertility shit is tough enough, but for some reason there are a LOT of people who feel like someone else's fertility issues signal a call for input on the propriety of their actions. It isn't. Not to be blunt, but keep your eyes on your own paper.

To be clear - I am not experiencing infertility, nor have I ever undergone any such treatment; I'm not defending any choice of my own here. I just really, really hate the way certain topics make people feel like their input has been solicited. There are two conversations here - one about the inclusion/exclusion of infertility treatments to firm insurance plans, and one about the relative selfishness/moral propriety of pursuing infertility treatment over adoption. Two completely different topics. Yet there seems to be a persistent confusion and comingling between them.

Frankly, I don't care if you have a beef with my actions or my acknowledgement of the consequences thereof - how, when, and if I decide to have kids isn't any of your business.

7:01 - and see, I think the people who tell others not to drive SUVs, not to commute long distances and to donate to charity can also go piss up a rope. Our society has gotten unbelievably overindulgent towards people's opinions. It's the most distasteful part of liberals' beliefs: I can tell you how to live your life because I know what's best for you and all of us. That's a lot of nerve. I am quite happy to stand behind my decisions, but I don't believe that I answer to you or anyone else on this board.

I sired a baseball team. An orchestra if you count the bastards!

-Bill Brassky

Thankfully, conservatives never pass judgment on private affairs or tell others how to conduct their lives...

Sorry. I know a few too many female lawyers who are having trouble getting pregnant. Me thinks it isn't an accident.

About the point about adoption and fertile couples who still choose to have kids (and thus are supposedly hypocrites), the difference is that:
A. fertile couples aren't making other people subsidize their procreation through so-called health "insurance"
B. fertile couples aren't acting sanctimonious and morally offended when other people say that they would rather not pay for their procreation
C. fertile couple don't wish bad things would happen to those other people or call them heartless monsters for having such a differing viewpoint.

You can do whatever you want on your own money, making kids the regular way or in vitro. But when you start asking for a subsidy from society, I have the right to ask you to do a cheaper alternative (foster adoption) that actually benefits society.

Even if adoption costs the same as fertility treatment, the state obviously saves hundreds of thousands of dollars in the first case when they don't have to support a foster child for 18 years. Thus, even if adoption and fertility treatment both cost $20k, society is better off with the first choice.

But the infertile people who are asking society to cough up money to support their infertility treatments, are ironically unable to comprehend that others might kindly want them to contribute a bit to society instead. All they want is their own genetic (and possibly infertile too) trophy baby, instead of some foster kid who might be black (the horror) and the son of some irresponsible teenager who chose not to get an abortion.

Those making the voluntary/involuntary distinction are idiots. I don't want to subsidize smokers' cancer treatment. Or treatment for the various diseases the the promiscuous may contract. Or people who don't wear seatbelts. Anyone who rides a motorcycle. Out of shape attorneys who play basketball on the weekends. There is no sound reason to distinguish any of these expenses from IVF. Fucktards.

9:51 - not to mention the stupid massage treatment, weight watchers classes, acupuncture subsidies, "wellness" seminars and other ridiculous benefits that my firm offers (while not offering any IVF benefits...)

1) 4.43 experienced major OWNAGE;
2) pay for your own fertility treatment; and
3) did I mention that 4. 43 got owned.

PS Are Penn and Penn State the same? Thanks

6:29 and 6:42 have it right.

This is a perk that only some firms give. Not everyone is paying for this. Make your job choice appropriately.

9:51/9:59 - all those medical treatments directly benefit your fellow employee so that he doesn't get sick. You have a direct interest in making sure your fellow employees don't get sick, because you'll have to pick up his slack and cover for his loss of productivity. Furthermore, for _preventive_ care, the costs are minimal compared to the health benefits and expected cost savings. That's why you have employer-provided health care.

Fertility treatment does not dramatically reduce the number of sick days that your fellow employee gets. The person is completely able to work without the expensive treatment. Almost the entire benefit accrues to that person. And it's not very cost effective at saving future health costs.

PSA from mother nature.

I

WILL

ALWAYS

WIN.

tick tock

I'll bet you were the one that sneered at women in their mid-20s that had children. I'll bet you snickered and said "they're throwing away their life." You were going to make something of your life. And now?

They drive used cars and have beautiful children. You drive new cars and scream about your coworkers not wanting to pay for you to try and turn back time.

Enjoy your Mercedes.

As someone who is now starting her second IVF cycle (first one didn't work), I have found this topic interesting. Here are some facts:
1) My firm (Vault 100) offers 2 insurance plans. 1 is a PPO which covers certain testing and a finite number of inseminations, but pretty much nothing else, including the frequent monitoring that is necessary with IUIs (intrauterine inseminations). The other is an HMO, and since I am in a state with mandated coverage and the plan is written in this state, infertility treatment (up to 4 IVF cycles) is covered. However, you have to go through less invasive procedures up until the point the insurance company ultimately deems you worthy of IVF. When I first started at the firm, I signed up for the PPO, started incurring massive bills when I realized I had a problem, and then switched to the HMO. Now I'm stuck in a network but I have infertility coverage.
2) I personally think it is in a firm's interest to offer the best insurance possible, preferably with infertility coverage. The only thing more depressing than not being able to have children is having to pay thousands of dollars to try and figure out what the problem is. Lawyers are depressed enough. Having the coverage means I don't have to stress about one more thing.
3) Infertility can be a symptom of other, more severe health problems. A normal body is able to procreate. If you can't, there is something medically wrong. Insurance should cover the testing. Often you don't learn what is wrong until you go through an IVF cycle and the lab can see what's happening in the petri dish.
4) I expect that I will move on to adoption once I am confident that the doctors have done what they can to fix my husband's and my medical condition(s), which are still undiagnosed. If we adopt, that means I have to have social workers examine my home (and career) to determine if I'm a worthy parent, take psychiatric evaluations, go to classes, spend thousands of dollars on fees, yank a child out of his or her culture or risk a domestic birth mother changing her mind at the last minute, never experience pregnancy, miss my child's infancy, have no idea what physical, emotional or mental trauma my child has been through, and only get 4 weeks paid vacation after I bring the child home. So, yeah, either way pretty much sucks.

I do appreciate that my firm offers one insurance option that has coverage. I would rather not be stuck in an HMO, but it is a smarter choice for me at the moment.

"A normal body is able to procreate. If you can't, there is something medically wrong."

Yes, of course, within a particular age group, a normal body is able to procreate....beyond that (and we are talking late 30's, 40's) Mother Nature takes over, and it is not normal (or very difficult) to procreate, due to the way our bodies are hardwired. It has nothing to do with having something medically wrong; it has to do with the biological fact that women's most fertile periods are much earlier, in their twenties.

Look, I am extremely sympathetic to women who have sacrificed greatly for their careers, and find themselves in their late thirties and forties struggling to have children...but the cold hard facts of human biology is that nature fights against women in that same age group conceiving....and there is nothing "unnatural" or "medically wrong" about it.

I have seen too many women being told that they could conceive well into their thirties and early forties, when the stark reality of biology is that this is just not the case for most individuals...and fertility treatments are futile in far too many cases....regardless of who pays the bills, tens of thousands of dollars are down the drain. This is the harsh reality that very few are willing to face.

11:04 says of IVF and adoption, "So, yeah, either way pretty much sucks."

Um, then don't have kids.

And I'm so sorry you "only get 4 weeks paid vacation after [you] bring the child home." I'm sorry that new parents get any paid leave at all, because I sure don't get an automatic, paid vacation for my lifestyle decisions.

Wiley Rein's PPO plan covers up to $50K in fertility treatments.

Also, some of the fertility treatments offered result in the creation of embryos, many of which are destroyed or aborted early in the process. I'm not sure that an entire firm should be asked to pay up for treatments which destroy human life for the purposes of creating it. I'm not saying you can't do it if that's your thing, but you shouldn't ask the rest of us to pay for those kinds of choices.

OK, so you decide to have kids. So why is your firm--other people--supposed to cover some of he cost? And what of clients who count on you? I have three kids and never had the idea that this obligates anyone but me and my partner to look out for their well being. This entitlement-out-of-the-blue is weird.

2:25 - Um, plans that cover abortion? Plans that cover the morning after pill?

7:57, I don't think any of your friends would expect you to pay to help for their treatments. The difference being that when you're part of an insurance plan, the whole purpose is to share the risk. I might think it's incredibly stupid that a coworker decided to go down a risky ski slope and is now immobilized with broken everything in the hospital, but my premiums are still going towards that, or I may prefer that a coworker try lifestyle changes to get her cholesterol down, rather than skipping immediately to drugs, but my premiums are still going to that. Fine, it's insurance, and by signing up for it, I agree to chip in towards things that I myself may never face. Same goes for infertility. The root causes of infertility are medical issues -- whether it be male factor, polycystic ovarian syndrome, endometriosis, etc. I would have no problem paying towards that because most of us who participate in insurance are eventually going to have "our issue" that not everyone else experiences, but that we need covered.

Come on people, let's be realistic, you know that those people who try fertility treatment aren't going to adopt. Why should these white upper-middle-class couples get a black or brown baby from foster care into their home and embarrass their parents/sorority sisters, when they can spend five or six figures to create their own baby (and act entitled and wish infertility upon those who disagree with them).

It's obvious they didn't research adoption seriously when they say that adoption costs the same and requires a few more interviews. You get a $10,000 tax credit for adoption. Boohoo, 11:04, you only get 4 weeks vacation off if you adopt instead of give birth. If you make enough that the credit phases out (over $210,000), cry me a river if you can't "afford" IVF treatment.

If you can't have children, then god didn't want you to have them. Just like if he gave you small breasts or a big nose. No firms pay for breast enhancement (unless you consider a partner paying for a set for his assistant) or nose jobs. Stop playing around with mother nature.

For those that go through with IVF, I am guessing you want us all to contribute $10 per paycheck to care for the quadruplets, even though you will undoubtedly leave the firm once we pay you not to work for 12-18 weeks. Sounds like a really solid financial plan.

Wow, 52 minutes before the namecalling started. What remarkable restraint!

Some of the logic being used here would justify a lot of really bizarre things. Hospital bills for prenatal care, labor, and delivery are quite significant, almost certainly more in a year than the woman is paying in premiums. Therefore, everyone else at the firm is "subsidizing" her selfish choice to procreate naturally. Maybe we're happy to chip in for two kids, but what about my co-worker down the hall whose wife is about to pop out #5? I'm willing to bet that my "subsidy" for his "selfishness" is a lot more $$ than one IVF cycle.

And don't even get me started on gastric bypass surgery for the overweight secretaries.

The bottom line is that insurance equals risk-spreading, and yes, "subsidies." Some plans subsidize more than others. All plans cover expenses that are directly attributable to people's "lifestyle choices," whether it's smoking, eating yourself into diabetes, or having kids even if you need some medical assistance to do it.

9:39: Exactly. I don't think anybody wants that kind of scrutiny into the habits they have that lead to medical intervention and being "subsidized" by everybody else's premiums. It's the nature of insurance - it's there when you need it and when you don't. Waive your firm's insurance plan and pay as you go if it bothers you that much.

If you don't have kids or have not experienced fertility problems (and especially if you don't want kids), you don't have the right to comment on the issue of whether going to extreme measures to have a child that represents the joinder of you and your spouse in the most intimate way is right in a moral or ethical sense. You can comment that you don't want to pay for medical treatment, but that was not the point of the thread. The point is whether various firms offer insurance coverage for fertility treatment, not whether they should or shouldn't.

I have been through 6 IVF cycles and struggling with infertility for 3 years. It is the most difficult thing I have ever been through and many of the people posting on this issue do not have a clue. One clarification, even if you lie in a mandated stated (like MA) your insurance will not necessarily cover you (if your firm has a national policy written in another state). I am lucky that my husband's coverage paid for IVF treatment. I think that if a firm has an office in a state where coverage is mandated they shold be forced to comply.

Several of you idiots are pointing out that if nature intended for infertiles to procreate, infertile they would not be, and they should simply accept their lot.

Nature has also occasionally intended that some people get pneumonia, cancer and Lou mother-truckin' Gehrig's disease. Should we just flush modern medicine down the pooper? While we are it, let's stop breeding altogether and deliver the planet back to itself. Mother Earth would be well-pleased.*

* Disclaimer: Mother Earth is an inanimate object with no soul or conscience. To worship it is very dumb.

I think there's been a lot less discussion of which firms are covering infertility benefits and a lot more of random rambling. Anyone else know which firms do or don't cover IVF?

11:22 PM is right. A normal body is able to procreate -- with a high rate of success at a certain age. There are numerous statistics about how long it will take the average 20, 25, 30, 35, 40, etc. year old to conceive based on average "trying". That number starts to drop at 30. It's not sexist or classist or liberal or conservative. It just is, and if you want kids later on, then it sucks. Professional women have been lied to, because reproductive science really hasn't come far enough to allow any older woman to have a baby at any time.

And 10:03 AM? Seriously? "If you don't have kids or have not experienced fertility problems (and especially if you don't want kids), you don't have the right to comment on the issue of whether going to extreme measures to have a child that represents the joinder of you and your spouse in the most intimate way is right in a moral or ethical sense." In a society, yes, I get to comment - because your kid affects all of us. I'm sure you commented on Britney Spears and K-Fed having kids. I'm sure you don't like it when welfare mothers have unplanned pregnancies. Just because you are upper class (and presumably white), your "child" is no more an expression of your joinder as man and wife than anyone else's. How completely and utterly freakin' narcissistic. How are you going to explain the twin or the triplets? Are they extra expressions of your love? God chose you to have more?

I think this thread is teaching us that the parents who are trying fertility treatments are precisely the type of blindly self-righteous and narcissistic people that we don't want polluting our gene pool.
God/nature made you infertile. Take a hint.

And analogy to other diseases is irrelevant. Fertility treatment is purely elective and nothing worse will happen to your body if you don't get the treatment.

10:22: Prepare for the crazies to tell you how selfish you are and how you should, on top of struggling with infertility, bear the weight of the world on your shoulders and adopt from our organized, totally non-political and bureaucratic foster care system.

um, 11:07, 10:22 isn't struggling with infertility. S/he was mocking the ignorance of 10:03, who is.

You are stupid.

Well, 10:22(1), *I* think you shouldn't be a selfish whore with your IVF treatments. So I guess we each have our opinions.

10:22, 11:07, all other IVF nut-jobs:

Please just get a dog or a cat. From some of your comments, I don't think you should have children whether you are fertile or not. On second thought, I don't want you to get a pet either, I like animals.

MoFo's basic HMO policy (at least in California--I don't know if their other offices have the same health care options) covers upto $30K in IVF benefits. Also, this basic plan is fully covered by MoFo--I don't contribute anything besides the office visit cost, etc.

11:20, I think you just hit the bottom. Entirely unnecessary for someone who was just trying to share her experiences. And to think they call attorneys "professionals".

"There are numerous statistics about how long it will take the average 20, 25, 30, 35, 40, etc. year old to conceive based on average "trying". That number starts to drop at 30."

Actually, that number starts to drop as you age, period--the optimum (physical) age for procreation is approximately 15-24. So, presumably, women should be doing most of procreating during their teen-age years.

As for firms paying for IVF, infertility is not an illness--unlike pneumonia, cancer or Lou Gehrig's Disease, you will not either die or suffer long-term physical incapacity from infertility--infertile people are perfectly capable of performing as attorneys, so the entire practical rationale behind employer-provided health insurance (to insure the capacity of the workforce to perform its duties) is not implicated by not paying for infertility treatment.

Anyone know whether McDermott covers IVF?

Procreation is not a right. It is a biological capability. It is neither necessary to an individual's survival, nor is it fundamentally necessary for the betterment of humankind or society. To make a general demographic share the burden for a specific individual's personal need is inappropriate and can be considered tyranny of the minority. (I am one half of a couple that can not have children due to biological/plumbing problems.)

Weil's expensive insurance plan covers infertility treatments, including in vitro, but has a $10,000 lifetime maximum benefit.

Are all lifestyle choices the same? You want to equate IVF treatments with heart disease and cancer from obesity? Fine, and if your co-worker's lifestyle choice is to become a hermaphrodite with bigger breasts and a bigger penis, then you want to help pay for that?

Some things are more accepted in this society and some aren't - to equate everything under "lifestyle choice" is ludicrous. Aren't we lawyers supposed to have this "thinking" thing down pretty well?

"You want to equate IVF treatments with heart disease and cancer from obesity?"

So don't equate it with a terminal disease - even though some of those can be prevented by personal decisions and choices - and even though infertility has been shown to cause depression of equal or greater severity and occurence than terminal diseases. Which means that even if there is no IF coverage, it's still being paid for in some indirect way. A friend of mine had over $10K in psych and med bills from IF related depression. She eventually got pregnant and has been "cured" of her depression - even at diagnosis she was diagnosed as situational.
But now I'm off track - don't liken it to cancer, liken it to a broken arm, something that's not terminal. Should employers choose not to pay for the treatment of a broken arm, especially if it's because someone did something stupid to cause it? That's ridiculous. Infertility is a medical condition abd it's been shown that for 91% of the employers offering IF coverage it does not raise costs. Why wouldn't it be offered?!

If each employer offers a program that pays me, JT, personally $1 million, I can show you that for 99.999% of employers it does not raise their costs. Why wouldn't they offer it?

If you have a broken arm, it directly hinders your work. The employer has a huge interest in ameliorating that change in status. The broken arm is also temporary and accidental (thus the idea of spreading risk). If you can't have a kid and get depressed, who cares. Your status, no children, is exactly the same as it was before, and you were plenty productive as a childless 20s person. There is no equivalence between a broken arm and a barren womb.

I can't believe these people are lawyers. Firms should fire everyone who uses IVF treatment, not because of the cost, but because the lawyer users are dumb as rocks.

Infertility coverage is VERY expensive. My wife's company has it and we have used it. It is rare for any company, let alone a law firm, to offer it.

12:33 - Did you read the entire thread before responding to me? I was responding to someone before (9:39) who equated "lifestyle choices" with insurance coverage.

My argument is that there are some things that are accepted as conditions that should be covered by insurance and others that are not nearly so universally viewed. Cancer, broken arm, etc. are obviously conditions that most people will agree should be covered by insurance regardless of whether "lifestyle choices" are a but-for and proximate cause of the condition. IVF, on the other hand, is not and those who protest its inclusion in their insurance policy have every right to tell those people who receive IVF treatment that they don't agree. It is those self-righteous "I have a right to procreate artificially at your expense and you can't tell me that I can't make you help me pay for it" idiots to whom I am responding.

As an example, in terms of acceptance by society for covering through insurance:
broken bones >> IVF >> sex-change operation

Many people think that others shouldn't get IVF through a corporate health plan because it raises premiums for everybody. If your firm offers it, then good for you. You should take advantage of it just like any rational person, but no one should pretend that they have such an absolute right to it that others can't tell them that the system is flawed.

12:09

11:19: What are you talking about? 10:22(1) clearly stated that she is struggling with infertility. Thanks, though, for contributing to my theory that people who introduce statements with "um" are absolute douchebags.

12:53: "no one should pretend that they have such an absolute right to it that others can't tell them that the system is flawed."

Setting up a bit of a straw man, aren't we?

And how does your statement that "If your firm offers it, then good for you" fit with your claim that "the system is flawed"?

I sense that you are bitter because your firm won't pay for your sex change operation.

I would actually put broken bones >> sex-change operation >> IVF because having a baby is a clear lifestyle choice, while many people have serious hormonal and physiological problems that are effectively treated by sex change therapy.

But I have the right to complain that neither should be paid by my insurance.

I love it - having children, a biological imperative for the human race, is a "lifestyle choice." No, being a vegetarian is a "lifestyle choice." Give me a break.

1:17, you are a moron. Procreation is a biological imperative for the entire human RACE. Whether each individual person does it or not, is a lifestyle choice. Plenty of people have the lifestyle choice of not having kids.

Securing food is a biological imperative for the human race. But if I become a farmer or a hunter, that's a lifestyle choice. Many people leave the mandate to get food or make babies to others.

Here's your break and you can put it where the sun doesn't shine.

1:14 - Hypothetically, if you think Social Security and Medicare are a complete mess and currently wasting massive amounts of resource, then will you decline to receive benefits if you become eligible? If you think the reduced capital gains tax is just an outrageous tax break for the rich, are you going to pay your own capital gains rates at 35%? You can protest a system all you want and actually want the system to change, but very few people actually refrain from the benefit when they are entitled to it. And I don't expect people to refrain as such. You shouldn't be under any obligation to suffer when everyone else is taking advantage of the what you detest. If you do so, great, if not, then I'm not one to judge you for it.

Someone can't find any way to argue other than try to make sly insults.

"Procreation is a biological imperative for the entire human RACE."

But that doesn't make it a biological imperative for any particular individual, nor does it mean that your employer is obligated to finance it. Food, clothing, and shelter are also biological imperatives for the entire human RACE, and much more immediate ones for each individual than reproduction, but most employers do not subsidize the costs of these expenses for employees. They pay you a salary which you are free to spend as you wish. If you wish to spend your salary on IVF, so be it--it should not be an employment benefit.

These anti-IVF posters are just trolls. Ignore them. It might just be Lat moonlighting to raise his hits.

"These anti-IVF posters are just trolls."

Whatever makes you feel better, dear.

First I want to say that I haven't done IVF but I am in favor of coverage - I think a few key things are missing in the above points (all of which sound good until you really think about them). For the poster that said a broken arm affects work performance, so does infertility. For example, some women have a thyroid problem that is the cause of their IF. Other symptoms would include weight gain, fatigue, insomnia, constipation, depression, poor memory/forgetfulnees, heavy periods - all of which can affect work performance. You can't get much work done if you're in the bathroom every 15 minutes changing your tampon, can you? And how much more productive are you on a full 8 hours of sleep vs. 5-6? I take about twice as long to do something when I'm exhausted. But testing and treatment can make these problems temporary, just as you describe a broken arm. So by your own logic IF should be covered similarly to a broken arm. The ER bill alone for a broken arm could top an IVF cycle. Then let's think about this - someone who has to pay IVF out of pocket is much more willing to put all of their eggs in one basket, quite literally. Jane Doe has saved up $15K to do her first IVF cycle but hey, she's already lost $50K to failed adoption attempts so this is really the end of the road for her - they just can't afford any more treatments or other pursuits toward parenthood. She has 3 embryos that look good. Since it's her last chance, she's going to put all 3 back. Then one of them splits into identical twins which means all of a sudden she is carrying 4 babies. Quadruplets are typically born 2-3 months early which means on average they'll need at least that long in the hospital. Do you know how much NICU stays for 4 babies costs? Insurance is absolutely covering that stay and it's at least 10x more than an IVF cycle. But same Jane Doe that has IF coverage may actually listen to her dr. when he says they have a great quality embryo and he thinks she should just transfer 1 b/c if that cycle doesn't work she can still try again (and a frozen IVF cycle will cost much less than a full cycle - only $2K or so on average). Oh, an dbefore you go saying she should have to terminate if there are 4 babies you have to remember that quadruplets do actually occur spontanesously and you really can't go placing restrictions on who should and shouldn't terminate pregnancies.
Oh, and JT - the study was among employers who had all opted to offer coverage - and yes, I guarantee you that if your firm went from paying you $175K to $1M it would raise their costs - and if there was a JT at every firm and they raise his pay it would raise their costs.

2:42, great point about the eggs in one basket. Many doctors are advocating for single embryo transfers as a means of cutting down on multiples, but many patients are rejecting those recommendations because they want to increase their odds since they may only be able to afford one round of IVF.

Sidestepping the acrimonious commentary above, here's the list of firms so far who provide infertility coverage in some form:

In no particular order

Alston Bird
Arnold Porter
Baker McKenzie
Dewey LeBoeuf
MoFo
Skadden
Weil Gotshal

Feel free to add to this list...

2:42 - This is your justification scenario for IVF, but to view things solely in terms a worst-case scenario without supported (or at least likely) probabilities is basically sensationalism based on nothing better than your best guess.

But I respect that your opinion may have merit and that you're fully entitled to voice it. However, the complaints that I and other people have with our having to subsidize IVF are also not without merit (we could also give our own versions of worst-case cost scenarios) and we are fully entitled to voice them.

4:58- Latham actually has a separate fertility rider in addition to the EPO and PPO plans (ask you rlocal HR person for it)- they cover infertility treatments and will cover IVF in *some* cases (I think one of my friends said not for gays or lesbians or other people who need donor eggs or donor sperm)

When Hillary is elected and gets her state controlled healthcare pkan passed you will all get your fertility treaetments and we will all have to pay for it, so stop whining. Of course, you may have to get on a ten-year waiting list.

Thanks for the list, 3:17. You can add King & Spalding to the list, too.

While 2:42 may have thrown out a worst-case scenario, I think she's right on about the "eggs in one basket" - even if it's not the end of the road, most people are much less willing to put one back if it's coming directly out of their pocket - risk vs. reward.

1:56, you're probably right. I think they're coming from here. See the IVF coverage post.

http://www.refugees.bratfree.com/list.php?2

Updated list:

Alston & Bird
Arnold & Porter
Baker McKenzie
Dewey LeBoeuf
King & Spalding
Latham Watkins
MoFo
Skadden
Weil Gotshal

If IVF should not be covered because it is elective and procreation is not a right, then why should maternity expenses be covered? Isn't it the same logic that you are all having to bear the burden of someone's selfish desire to procreate?

If you get lung cancer because you refuse to stop smoking why should I pay for that? In any scenario where insurance is provided there is shared risk and you will always end up incurring the cost for health choices made by someone else. That is the fundamental basis of insurance.

No one has bothered to note that infertility treatment makes up less than 1% of all medical costs in the US.

If IVF should not be covered because it is elective and procreation is not a right, then why should maternity expenses be covered? . . . If you get lung cancer because you refuse to stop smoking why should I pay for that?

Because a pregnant woman giving birth is not engaging in an elective procedure, anymore than someone suffering from a metastizing cancer can "elect" to go without treatment. The better analogy is, again, asking insurance to cover the costs of your fertility treatments so that you can become pregnant and give birth, or to cover the costs of your cigarettes so that you can smoke and thus develop a cancer. The issue is whether the treatment involved is one you can choose or decline without risk to your life or continued health. Someone who is ALREADY pregnant has no choice but to give birth or abort, and someone who ALREADY has cancer has no choice but to treat it or die.

Someone who is infertile will neither die nor suffer physical illness due to their inability to conceive; treatment of infertility is thus ENTIRELY elective, and something that should be paid for out of the infertile party's own compensation.

"If you can't have children, then god didn't want you to have them..."?

Really? So if you get cancer, that's what god wanted you to have so you shouldn't seek treatment, which is "elective" since there's no guarantee that it cures anything. It'll just extend your life, if "god wants to..."

Infertility is a medically recognized problem in both men and women by the Centers for Disease Control and Prevention.

For those anti-fertility treatment commenters, would you pass the same judgement onto men who have erectile disfunction? I know for a fact that Medicare (e.g.) will pay for penile prosthetics in Medicare eligible beneficiaries at $70,000 - $125,000. Isn't sex an "elective" choice? If you can't get it up, then god didn't want you to have sex. At 65, 70, 80 years of age, is this what I think a tax dollar should be spent on? Again, the argument about what god wants and doesn't want is laughable.

My health insurance pays for smoking cessation, alcohol addiction, diabetic education, vaccinations and yes, even maternity coverage. Elective services.

When one of the above talked of paying for 4 preemies, you need to check over your stats and information and get facts straight: IVF has a much LOWER chance of multiples in comparison to IUIs/or oral fertility drugs (which many insurances do provide limited coverage for while at the same time exclude IVF treatments).

Also, adoption is not a cheaper option than infertility treatments. Fees (strangely because of all the "legalities") can be anywhere from $20K - $40K for domestic adoptions. International may be a little less expensive, but that's just in fees. Count up the loss in wages and travel expenses and they are almost equal.

And yes, I am someone who has gone through infertility treatments, out of my pocket and I take great offense to the ignorance that is being displayed through many of these comments.

Here's some recommended reading for those who seriously want to make an educated decision about the impact of infertility on nation's pocketbook: http://www.uhmc.sunysb.edu/prevmed/mns/mcs/2/sched/ART_SG/ART_RS/Katz_economic_ncb-nm-fertilityS29.pdf

Signed,

Fertility Challenged

"My health insurance pays for smoking cessation, alcohol addiction, diabetic education, vaccinations and yes, even maternity coverage. Elective services."

That all help either treat or prevent expensive, non-elective medical conditions. Infertility treatments neither prevent nor treat non-elective medical conditions. And just to clarify, opposing the extension of insurance coverage to IVF is not the same as being "anti-IVF." I say get all the IVF you want--just don't ask me to share in the cost.

Everyone needs to get your head out of the ass that is called "entitlement". Stop trying to justify your abuse of the corporate health care plan as something that is "right". You are making your co-workers share in the cost of your elective procedure which is no more mandatory than a stripper's boob job. Yeah, the chain-smoker is electing to smoke, the mcdonalds regular is choosing to clog their arteries, but there isn't as much complaint about those conditions in this society because society has come to accept those as inevitable, unfair though it may be to those with a healthy lifestyle. But society, including many on this board, still views inferitility treatment as something purely elective along the lines of plastic surgery - although admittedly not as harshly given that there are some health plans that cover this. YOU HAVE A RIGHT TO PROCREATE BUT YOU DON'T HAVE A RIGHT TO FORCE OTHERS TO PAY FOR YOUR ARTIFICIAL PROCREATION. And don't tell the crap about how naturally pregnant mothers create high medical costs. You have those same costs (which I doubt many people would object to paying) in addition to having the 20k cost for infertility treatment.

And so what if IVF makes up less than 1% of the medical costs in the US? What matters is if it makes up 10% of the firm's medical costs.

Your arguments are very politically correct, but you're just like the stupid politician who preaches "everything for everyone" but doesn't see the economic costs to achieving the objective. In this case, the economic cost is your co-workers money.

Updated list:

Alston & Bird
Arnold & Porter
Baker McKenzie
Dewey LeBoeuf
King & Spalding
Latham Watkins
MoFo
Pillsbury
Skadden
Weil Gotshal

The self-righteous and money-grubbing idiots who equate subsidizing IVF treatments with treating broken arms or providing vaccination are hilarious.

Just pay the $20-40k (which is how much the supposedly "equally expensive" adoption option costs) out of pocket and stop whining. If it costs more than $40k, try adopting instead. You can afford $40k to buy a car but can't afford to pay for your own child in a once-in-a-lifetime need?

To "guest" 4/23/08 at 1:31 p.m.

For people who ELECT to smoke, they take on the high odds of cancer. For people who ELECT to eat poorly and not excercise, they take on the high odds of diabetes. For people who drink, they ELECT to take on the odds of liver failure.

For those of you incensed by the idea of paying pennies for insurance coverage for infertility treatment, the odds are much higher that you would pay for someone's gastric bypass surgery, which is so much more expensive and undoubtably "elective" and questionably, a "treatment". Now factor in that your insurance dollar will probably also be used to cover that patient's cosmetic surgery in a year. Are you as outraged about that as you are about infertility treatments?

Infertilty is not an ELECTIVE medical condition. My infertility was not a result of lifestyle activities.

The treatments for infertility are ELECTIVE, yes. But ALL TREATMENTS for ALL medical conditions are elective.

The odds are higher that you will have a co-worker who chooses to get shit-faced drunk, wrap his car around a tree and pay for not only his immediate medical coverage, but ultimiately a life-time of rehab, but still you give a "woe is the pocket book of me and my fellow co-worker" when even the slight possiblitiy may come to treat a medical condition that was neither brought on by lifestyle, nor expected.

The next time you are presented with the possibility of treatment for whatever medical condition you may have, why don't you look out for the better interest of your company and your co-workers and decline treatment. And I honestly hope that your condition will never be infertility.

Infertility Challenged

Dude, 10:18 - have you ever actually read a summary of benefits manual? Gastric bypass and cosmetic surgery are usually clear exclusions.

I think the point people are making when they identify infertility treatment as elective is there aren't any ill health effects that will come as the result of not being able to conceive. There's "I don't have a baby" and there's "my cancer is going to metastasize soon," and they don't begin to compare in terms of medical necessity.

No wonder lawyers have a bad rap! Really, I cannot even believe that I would look to some of you slimeballs (and I am sure they are tiny ones at that) to support any of my inalienlable rights. I hope for your sake that you never have to endure any medical condition that alters your life since if you think about it, it truly is all elective. So, would you deny your own child of a life saving bone marrow transplant or your sibling from a breast implant after breast cancer? You better hope you don't find yourself in those shoes. Just remember, karma is a real bitch.
I am not even sure why I wasted my time here.

Of course, with all this in-vitro and 'helping fertility', in the long run we are breeding FOR infertility. (which perhaps might not be a bad thing...)
It is to the point that some medical journal in England commented that, in a few years instead of 1 in 10 having a problem it will increase to 1 in 5 (or some similar figures.. the point was the problem of infertility is going to increase).
This, among many other indicators proves my contention that people (especially women) do NOT give a holy hoot about what they inrflict on kids.
The genetic narcissim imo is atrocious.

two cents ¢¢

Updated list:

Alston & Bird
Arnold & Porter (30K limit?)
Baker McKenzie (4 tries ?)
Cleary Gottlieb (15K limit?)
Dewey LeBoeuf
King & Spalding
Latham Watkins
MoFo
Pillsbury
Skadden (4 tries IVF?)
Weil Gotshal

Any information on limits would be helpful. Put in the few I've heard about.

For the poster that argued that we are "breeding FOR infertility," isn't that true for things like leukemia and breast cancer? The child or person that gets successful treatment for these conditions and then goes on to have children is breeding FOR cancer, correct?

For the poster that argued that we are "breeding FOR infertility," isn't that true for things like leukemia and breast cancer? The child or adult that gets successful treatment for these conditions and then goes on to have children is breeding FOR cancer, correct?

For the poster that argued that we are "breeding FOR infertility," isn't that true for things like leukemia and breast cancer? The child or adult that gets successful treatment for these conditions and then goes on to have children is breeding FOR cancer, correct?

I love how so many of you think infertility is only related to a few causes, some of which are tied to "free will" (advanced maternal age from choosing to delay reproduction, for example) and have engaged in a brainless armchair debate with a scant picking of facts. I for one am a carrier for a genetic disease that is not immediately fatal to the child, no, it merely costs hundreds of thousands of dollars of law firm insurance money to give the baby multiple surgeries including heart reconstruction, possibly organ transplants, frequent resuscitations, almost permanent NICU stay.

It costs just $15,000 to pay for IVF with PGD (preimplantation genetic diagnosis) to make sure that this embryo is never implanted.

My law firm was so "smart" to save money by not paying for IVF. Unfortunately for their bottom line, this sick baby can make a good dent into their 1 Million benefits limit.

And to all those people who think adoption is the answer. Why is it only the answer to people with a disorder already. YOU adopt. NOW. Go. Every second you are wasting is selfish. Oh, by the way, it's a several year wait actually, and it's really expensive (more so than IVF). And I have looked at the children on the waiting list that are "available immediately". Clearly you haven't checked very carefully other than by logging on the website and shooting off your opinion. I called. You need homestudy ($). "Immediately" available children are actually often not available because parental rights still need to be terminated. Get ready to wait around and have your heart broken by endless court dates, not to mention having to deal with an anxious, disoriented, sometimes abused child that is getting jerked around waiting for court decisions. Otherwise the children have disabilities that a busy law firm associate can hardly be the best person to deal with. Or the children come in groups of 3 siblings that cannot be separated. I only wanted to adopt 1, but since all the single children were sick or unavailable, I bit the bullet and called about the only such group of 3 kids that was not disabled, figuring G-d will grant me the strength to handle them. But when I called, they were already unavailable.

Don't need my genetics to be part of the equation. If anyone has free eggs, embryos babies, or children to donate, I would be very willing to accept. Haven't found a donor yet.

(in case you were wondering. Cost of donor eggs is around $15-30K; donor embryos $6K to implant each time, may take several tries; adoption $15K-45K maybe some people can do it for cheaper, but I haven't figured out how).

(Continued from 185) And for those people who think if IVF means so much to me, I should be willing to pay for it out of pocket, why don't you put your money where your big nazi eugenics-worshiping mouth is and opt out of your group health insurance. That way, you'll save a few hundred dollars a month and, hey, when you get hit by a car and need surgery, I'm sure you'll decide that it means enough to you that you'd pay for it out of pocket. So why do you need health insurance?