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