DOREE SHAFRIR: I think I had this misconception in my mid-30s when I started thinking that I did want to have kids, I was like, "Oh, well, it'll be fine. Like, I'll just do IVF. Like if I have to, I'll just do IVF," and - as though that were, you know, this sure thing.

This is Death, Sex & Money.

The show from WNYC about the things we think about a lot...

...and need to talk about more.

I'm Anna Sale.

Writer Doree Shafrir spent her 20s and 30s working her way up in journalism, to impressive jobs at Rolling Stone and BuzzFeed. 

But in a lot of ways, she felt left behind, like adulthood wasn’t clicking into place for her the way she’d expected. She writes about this in a new memoir with an excellent title: Thanks for Waiting: The Joy (& Weirdness) of Being a Late Bloomer.

DS: I feel like I only really started thinking about that term in my mid to late-30s, but I do feel like throughout my life, there were certain things where I was like, "Oh, I'm older!" [laughs] Or like, "I haven't done this thing yet that I feel like I should have done."

ANNA SALE: How much do you think was related to some idea of a biological clock?

DS: I think it was somewhat related for sure. I think I thought about it less in terms of like, "Oh, my clock is ticking," and more like, "Oh, wait, like, I should be doing these things too. I want kids, right?" [laughs] Um...

AS: So it was more like a fear, a sense of being left behind by your peer group?

DS: Yeah. I recently said to someone that my book is about having life FOMO.

AS: [laughs]

DS: And, I think that that's really what it felt like. It was, it was the fear of missing out on all these milestones that, to me, it felt like everyone around me was reaching.

AS: And for you, what were those milestones when you would think, like, really bluntly, like, what were the shame-y thoughts you had about the milestones you ought to be reaching?

DS: It was getting married, it was having a kid, it was buying a house, it was being in a place with my career that I felt confident and happy and fulfilled. Those were kind of the four pillars and it really seemed impossible for a while that I was going to reach any of them, and so I had to kind of reframe how I was thinking about the rest of my life.

Doree did that reframing, while making it the focus of her work, in not one, but two podcasts she now hosts. One, called Forever35, is about taking care of yourself, and being cool, for women, like yours truly, in middle age. 

The second podcast she started with her husband, about their efforts to get pregnant. It’s called Matt and Doree’s Eggcellent Adventure: An IVF Journey.

In her book, and on their podcast, Doree has been remarkably candid about their infertility treatments, which can be such a frustrating and isolating experience. And that’s what I wanted to focus on with her. 

Doree met her now-husband Matt, on Tinder, when she was in her mid-30s. They married when she was 38.

DS: I felt like I'd finally met someone who I could envision raising a child with and being a great dad. And, I was really ambivalent about having children for quite some time. Throughout my 20s, I, I didn't say I didn't want kids, but it wasn't a future that I, you know, fantasized about or necessarily saw myself doing. And I didn't see myself as very mothering or motherly. And I worried, I think, that I wouldn't be motherly, that I just didn't have that in me. And it wasn't really until when my nephew was born, and I remember just being so crazy about him. And the same thing happened when my sister had her child, and I kind of saw a side of myself come out that I hadn't really seen before. And that was when I was really like, "Okay, this is really something that I want." But at the same time, it was also another kind of reminder that I did not have a child. My husband and I, we'd been trying to get pregnant for a few months, we'd gotten married a few months earlier and nothing was happening. And I had to kind of hold both of those feelings at once, right? Like, being really happy for her, and so thrilled and so excited that this new person was in the world, and then also kind of feeling sorry for myself, and letting myself feel that.

AS: And how did you let yourself feel that? I think one of the things that is so... can be so tricky when we are in a moment in life when we want to be happy for someone we love, particularly a very close friend or a sibling, but it also points out the ways in which we feel some, you know, deficiencies in what we want our lives to look like and how to do both of those at the same time. Like was your, do you think your sister was aware of those mixed feelings you were having?

DS: I think she was to an extent because she knew that we were trying to get pregnant, um, and we had, you know, we talked about it. But I had had practice holding both of these feelings at once. I distinctly remember feeling that way at my sister's wedding. She got married when I was 34 and she was 27. Um, and I felt like, I was, here I was, you know, the older sister in her mid-30s, single, going to her younger sister's wedding. And I think what I felt was, I, I remember saying to myself, like, "You can't let this weekend be about you," you know? "You have to be happy for her. You have to just, you know, put on the game face and power through," even if what I was perceiving was, oh, oh, people were feeling sorry for me. And again, I don't know if that's true, but that was what was going through my mind. And so having to hold both of those things was something that I feel like I was, had gotten some practice in, um, [chuckles] by that time.

AS: Did you like the outfit that you wore to her wedding?

DS: [laughs] Um, I was a bridesmaid. She had us wear matching bridesmaids' dresses. They were purple, a lovely jewel-tone purple. But, you know, it, it was this strapless dress. It was not something that I would have picked out for myself, I'll put it that way. I didn't hate it. I didn't get into it and feel like, "Oh, my God. This is, like, horrible," but I, it was not what I would have necessarily picked to wear. The rest of her bridesmaids, they were her friends from growing up and college mostly, if I remember correctly. And all very lovely people, but all very petite. [laughter] And I'm not especially tall. I'm like 5'6", but they were all very small and very thin, and, um, I felt really awkward and, and big next to them in a way that made me uncomfortable. I felt like Barney. [laughter] You know, this kind of, like, big purple blob.

When Doree was single in her 30s, she had considered freezing her eggs, but eventually decided not to. So when she and Matt still hadn’t gotten pregnant after six months of trying, because of Doree’s age, her OB/GYN suggested they see a specialist.

DS: She told me that my husband would have to get a semen analysis, um, in addition to all the tests that I was doing.

AS: So you had to come home and say, "Sweetie, you need to do a semen analysis?"

DS: Yes, but, you know, I think he was expecting it. I mean, I know he was expecting it, because... as we had been trying to get pregnant and, you know, month after month, it wasn't working, he kept saying, "I know the problem is me. I know the problem is me. I know I have bad sperm." And I was like, "How do you know that? Have you ever had a semen analysis?" He was like, "No, but I just know." So, when I told him, "Okay, you have to take a semen analysis," he was like expecting it, um, and very kind of pessimistic about it. But then when they called him with the results, it turned out he did have a low sperm count. So, he was right.

AS: When you were just having those first conversations, or when that would first come up with your husband about his sperm count, and then when you got the results, like... did you know how to talk to your husband about sperm counts in a way that felt okay?

DS: So my husband has been a podcaster for a very long time, and is remarkably open about—

AS: It's a really funny way to start the answer to that question. [laughs]

DS: Well, because he's, he's, he's not like a politics podcaster, he talks about personal things on his podcast. And so, in a way, I think he's just—I think, especially when we met, he was definitely a more open person than I was about this stuff, and was just kind of fine talking about it. And so I never felt awkward talking with him about his sperm count, but it was, it was interesting in those early days because I still had a lot of confidence in the medical establishment. And I thought, "Okay, well, our only problem is that Matt has a low sperm count. Like, that's easily dealt with. I'll be pregnant in no time!" And it didn't really work out that way. But, at the time, I remember just thinking like, "Ugh. Like, if he didn't have bad sperm, like, we would just be, we'd be able to just have, have kids, you know, having sex! We'd be able to have free kids!" [laughter] That's the other thing, when you're, when you're doing IVF, it starts to seem completely bizarre that people just have sex and get pregnant.

AS: Yeah. So when you're doing those early tests, and you are beginning to have conversations with doctors, how did you begin—did, did you have conversations between the two of you about how much intervention you were willing to do physically and pay for?

DS: So, we were told when we got Matt's results that our—basically, our only option to get pregnant was IVF. And neither of us had insurance that covered IVF. But again, I think we thought it would work right away, so we... thought, "Okay, this is going to be a big financial hit, but we're going to do it." And I mean, these were kind of, very eye-popping numbers, like over $20,000. And we didn't have that money, which didn't feel great, going into a lot of debt to pay for IVF. But it felt like our only option, and, again, it felt like the clock was ticking because now, the biological clock was really becoming present in my life. I was 39, and, you know, egg quality starts to go down very quickly after that, um, and the numbers of eggs start to go down very quickly. And so, we knew, "Okay, it's kind of now or never. We gotta get going." And it just felt like there was this urgency to it that was stressful.

AS: That you almost like didn't even have time to spend to think about the decision. It was like, "Are we doing this or not? 'Cause we've gotta go."

DS: Exactly, yes. Once you're on the IVF train, it starts moving very quickly out of the station. Like, I was told, "Oh, you have a polyp. You have to have your polyp removed, that's surgery." So, okay, got it, gotta arrange that surgery, gotta find someone who's going to do it. Oh, insurance will pay for - great! I'll, you know, you're just consumed by everything. And then it was, you know, it was getting the medications and doing the shots. And everything just felt like we weren't in control of what was happening. We were just kind of going.

AS: What do you remember as the first moment once you were on, as you say, the IVF train when you were like, "Whoa, this is not the kind of quick intervention that I thought it was going to be?" Like, when did that first hit you?

DS: It was when we got the genetic testing results for our first round of embryos. So, the way it works is you do these shots for about two weeks and then your eggs get essentially harvested. And that, a, in the US, at least, they put you under for that, so that's like a surgery. And then they get fertilized with sperm, and then they grow in the lab for five to six days. And, on day five or six, they either turn into what's called blastocysts or they don't. And if they turn into blastocysts, then they are considered potentially viable. And at our clinic, at least, for women over 38, they recommended that you send, that you get them biopsied and tested for genetic abnormalities, for chromosomal abnormalities. And so, that first round, we had ended up with four blastocysts. And so I just thought, "Okay, we'll get four blastocysts. Like why would they be abnormal?" And then they came back with only one was normal. And that's when I was like, "Wait a second, one? Just one?" Like I had had, I forget exactly how many, but I had had, I think, about 15 eggs retrieved. And then, at the very end to get one, I just thought, "Oh, my God, what?" And at the time, I didn't know that, you know, a lot of people don't get any. But in my mind, I had just, again, naively assumed that... this would be fine! I would get multiple embryos, and get pregnant, and ride off into the sunset. [chuckles] So I think this first round of - this first egg retrieval when I only got one normal embryo was a real wake-up call in that regard too.

Doree and Matt transferred that one embryo that didn’t have any chromosomal abnormalities. But it didn’t implant. Doree didn’t get pregnant.

DS: I, I got a lot of people saying like, "Oh, I know, I know it'll work. I know you'll get pregnant soon." And I was like, "How do you know that? How could you know that? Like, that is not, that does not make me feel better." Um, and then, you know, I also got a lot of people who liked to tell me what I called "miracle baby stories."

AS: [chuckles]

DS: So, you know, "Oh, I have my cousin's friend. She was doing IVF for five years and then they decided to just stop because they couldn't take it anymore, and then she got pregnant!" And you're always like, "Okay, great. Great story." [laughter] And They tell you these stories with this eager look in their eye of like, "Oh, well, you know, this will give her hope," but it just made me feel worse actually.

AS: Did anyone say anything that was surprisingly comforting?

DS: I think the people who were just like, "I'm really sorry. I'm here if you want to talk about it," were the best responses. It actually taught me a lot about how to engage with people who were going through difficult things. I was, I was grieving in a way and, you know, sometimes I did want to talk about it. And other times, I really just didn't.

Coming up, Doree does finally gets pregnant. But not before racking up a lot of debt.

DS: It was so overwhelming that a lot of times, I just didn't want to know how much, how in debt we were, like I didn't want to add it all up because it was so much money. And it felt - I, I was ashamed that I wanted to keep going.

--

We have heard from many listeners over years about dealing with infertility. Many of you pointed out it is right in our sweet spot: there’s death, there’s sex, and oh, it takes money.

The average IVF cycle, including medication, embryo transfers, and one egg retrieval can rise to about $25,000. And that’s just for one cycle.

IVF insurance coverage in the U.S. is uneven. Fewer than 20 states in the US have laws mandating some kind of private insurance coverage for fertility treatments, and as of last year, no state's Medicaid programs covered IVF, so it is often not available for people without money to pay out of pocket.

And, of course, IVF is just one reason becoming a parent can be expensive, emotionally draining, or feel out of reach. Others of you might have needed other interventions because of your gender identity, or because you’re unpartnered, or you’re in a gay relationship.

If you’ve had to jump through medical or legal hoops to start a family, we want to hear from you. And tell us the moment you realized that becoming a parent was going to be more difficult than you expected. Write a note, or record a voice memo, and send it to us at deathsexmoney@wnyc.org. 

On the next episode:

RACHAEL CUSICK: You just want to get out of that feeling of grief when it's overwhelming and you feel stuck. And I think for many, many years I tried to move through versions of those stages.

The Kubler-Ross stages of grief are often presented like a road map through loss. But early on, Radiolab producer Rachael Cusick realized… her grief after losing her mom did not work that way. Look out next Friday for our collaboration with Radiolab—when Rachael talks with her grandmother about their shared grief together.

RC: Like it was always in the room—loss—but I don't know how often we talked about the word "grief." Grandma, do you remember ever, like, having a conversation about it? 

MARILYN: We, we didn't really talk about grief. We didn't. And, and, um, you know, that's probably a mistake, but we, it was just there. It was just so present.

--

This is Death, Sex & Money from WNYC.

I'm Anna Sale.

When Doree and Matt started the IVF process, they were still paying off their wedding. They knew IVF would be expensive, but as they went through round after round, and discovered that Doree needed surgery on her uterus, going deeper and deeper into debt felt like their only option.

DS: It was like once you kind of got one thing sorted, something else that you had never even known was a possibility cropped up. Like I didn't know that I, like, had a bad uterus. [chuckles] You know, no one had even told me that that was a thing. It felt like we were, I was Sisyphus pushing the rock up the hill, and we were just never going to get to a point where the rock would be fully up the hill.

AS: As these goalposts are shifting, how did you get billed?

DS: We got billed for, like, every appointment and it wasn't covered by insurance. So we were just charging everything to credit cards, and we started getting very adept at the 0% interest credit card game. So we would open new credit cards and transfer, you know, huge balances to these other cards, so that we could pay them off over time. Um—

AS: Who was in charge of that in your relationship? Who, who did the hunt for the 0% interest rate?

DS: It was mostly me, but Matt would also-- if he got an offer for a 0% card, he'd be like, "Oh, I just got an offer for an American Airlines card," you know, or whatever. Should we apply for it?" I'd be like, "Yes!" But I was mostly handling... mostly handling the transfers themselves.

AS: In your family, um, and in your husband's family, was asking for help an option?

DS: No. Um, it, it wasn't an option. My parents did at one point about, I don't know, a year or so into the process, they did give us $2,000, um, but that was the only help that we got from them.

AS: Did they ask how much money you were spending?

DS: They did not.

[CLIP FROM "MATT AND DOREE'S EGGCELLENT ADVENTURE"]

MATT MIRA: Hey everybody, welcome to Matt & Doree's Eggcellent Adventure, I'm Matt.

DS: I'm Doree.

MM: Um, leave your Apple Podcast reviews!

DS: Wow, you really just went right into it...

And then, after two and a half years, five egg retrieval, three embryo transfers, and 98 episodes of their weekly podcast… Doree finally got pregnant.

[CLIP]

DS: My phone rings and Dr. Kelly Beck—

MM: DKB.

DS: —says, "Congratulations!"

MM: "What?"

DS: I was like, "What? What? What?" I was like, "No! Wait, are you serious? Are you serious?"

AS: When you announced that you were pregnant in August of 2018, was it a scary thing to say out loud publicly?

DS: Oh, totally. I mean, I - we transferred our, our last genetically normal embryo. I was 41. It felt like our, you know, last shot really. Um, and I was very pessimistic up to the pregnancy test. I was like, "There's no way this worked," which really pissed Matt off. He was like, "Don't talk like that." And I was like, "Who cares? If I'm negative about it, that's not going to affect anything." You know, I was really kind of down on this whole power of positive thinking thing. I was like, "That doesn't matter. Who cares?" Uh, I was very pessimistic about it because, I think, when I had allowed myself to be hopeful, to be optimistic, I had just been disappointed. And so being optimistic didn't even feel like an option anymore. I had, I felt I was, like I had to protect myself. And so, I was really nervous about talking about it, even though I had to because we had the podcast. So everyone was expecting the news. But, I was so nervous about miscarriage, like, obsessively nervous about it, and I was constantly looking up like, "What are the statistics for miscarriage at five weeks? What about six weeks? What about for women over 35? What about for women over 40? What about for women who have done IVF? When does it go down?" Like, I just got consumed by this. And, you know, I couldn't stop reading, like, stories of people who had missed miscarriages, you know, when you don't know that you've had a miscarriage and you go to the doctor and there's no heartbeat, which is so devastating. I mean, it's all devastating, um, but I was like, "Oh, that's going to happen to me." I was really nervous, I think, until about 24, 25 weeks, which was when I was like, "Okay, if I have the baby now, it would be in the NICU for a long time, but it would, it would probably survive." But until then, it just felt like every doctor's appointment, every time that we, you know, that we checked anything, I was, I was bracing myself for bad news. 

AS: Did you enjoy parts of being pregnant?

DS: I enjoyed parts. I was really sick my first trimester. So, um, that was very difficult. But then in my second trimester, after I started feeling better, probably, uh, let's say two to three weeks into my second trimester, I started feeling better. And then I started feeling great. Like I started feeling really good and I felt like, "Oh! I'm getting that pregnancy glow that everyone talks about. Like, I'm liking being pregnant," which I wasn't really expecting. And then I had a kind of traumatic birth. I had to be induced on my due date because my amniotic fluid was low... but the baby hadn't dropped at all. I was like, I wasn't dilated, and they tried to get things moving and nothing happened, like really nothing happened. And this went on for two days. And then, finally, my doctor was like, "We have to do, um, a C-section." So we did a C-section, which was... hard. And I was shaking the whole time, which I didn't know was going to happen, and... then I kind of passed out right after from the drugs that they gave me. And then my milk didn't really come in, and I was in so much pain, and I couldn't pee. Like, it just was this sort of cascade of physical things. And then I had this baby, who I was so happy to have, and so excited for, and, you know, just in awe of, but I was also like, "Wait, what just happened?" I think I was kind of in shock, and I also felt really overwhelmed, like I don't know what to do. And I felt like the fact that my birth had been so chaotic that... we had kind of, like, gotten off on the wrong foot in a way. So that was tough.

AS: Do you still feel like that? Getting off on the wrong foot with your son?

DS: You know, I don't, I haven't thought about it in a while. But yeah, I mean, those memories of those first few hours, and that, the couple of days in the hospital after I had him are not, like, pleasant memories. Like, I remember being in recovery after the C-section, and they put him on me for like skin to skin, and they were trying to get him to nurse. And he was kind of like scrabbling around my breast and they were like, "Oh, you have flat nipples, so he can't really get a latch." I was like, "Who knew that was a thing that I would have to think about?" I didn't know I had flat nipples. [laughs] So, yeah, it did, it did feel like there kept being these things where I was like, "Oh, that's another thing that is like preventing me from kind of bonding with my child in the way that I thought I would."

AS: Hm. When you had your child and, all of a sudden, there's this human that you are parents to, um, did part of you feel like you were emotionally exhausted from the IVF and pregnancy process that depleted you in ways that you were sort of mad about as you were becoming parents?

DS: Definitely. I still resented the fact that I had done IVF, and felt like I would, you know, always be labeled an IVF mom.

AS: By whom?

DS: Who knows? The world, you know, the faceless masses. This was, this was, again, this was just in my head of like, "Oh, this is me now. I'll never be able to, like, move past having done IVF." And you know, to some extent, actually, I think that was true in a way in terms of what I was just talking about with like being so scared of miscarriage. I'm sure people that don't do IVF are also very scared of miscarriage. But for me, it felt like so many things had gone wrong with IVF that like, of course, they would go wrong during my pregnancy also.

AS: Are you trying for a second child?

DS: Sort of? So we... the, the round of IVF that we did, where we got Henry, we also got an embryo that we were told had a deletion on the arm of one chromosome. And we were told like, basically, we don't know what this means. It could be something that self-corrects, it could be meaningless, or, you know, it could be a birth defect, like we just don't know. So, I recently had a conversation with a genetic counselor about this embryo and she told me it was... that the nature of the deletion was such that I would either have a healthy birth, or it just wouldn't implant. And so I thought, “Okay, well, let's just go for it.” So we did the embryo transfer and it didn't work. And now, you know, I feel like we're at this crossroads where it's like, “How badly do I want to have a second child?” I think this is what IVF does in general. It makes you, it makes you really ask yourself, like, how badly do I want this? Because you have to want it pretty badly to put yourself through everything that you have to go through in IVF. And I think if I could have a free sex baby, I would take one, but that's not in the cards. And I want to just, you know, my son is two, I want to be able to enjoy him, and enjoy his childhood, and be a present mom, and not just be so fixated on the idea of having a second kid that I, like, neglect my only child.

AS: How much money have you paid, do you think, altogether?

DS: I think it's probably been around $100,000.

AS: How much of that is paid off?

DS: It's all paid off now.

AS: Congratulations!

DS: We paid it all off. Thank you.

AS: That's incredible. [chuckles]

DS: Yeah, thank you. We started working a, um, we started working with a financial coach a couple of years ago because we were in so much debt, and I was like, "I don't know how we get out of this," and he really helped us, um, figure out how to do that. So, thank you, Dylan. [laughs]

AS: Does Dylan have one hot tip that you can pass on to all of us?

DS: Oh, man. I think one thing that I've learned from Dylan is make things as, like, low touch as possible. If you're paying off debt, decide how much you're going to pay each month and make that payment automatic. And, if you're saving, make that savings automatic, and just try to do as much as you can that you don't have to think about it, which probably sounds obvious to a lot of people, but like wasn't that obvious to us, [chuckles] um, but it definitely helped us.

AS: You mentioned before that, that going through IVF, um, and all its various stages, kind of made you adopt a very pessimistic view of, of, uh, both—like, a skepticism about the power of positive thinking. I'm... do you feel like that has... has that carried over into other parts of your life, and how you think about what you're allowed to envision for your career, or for your family, or for your future, or have you found things that have been comforting, that have pushed back that sense of just... uh, just feeling out of control?

DS: So, I hadn't ever really thought about it until you just asked me this, but I actually think the opposite is true in most other aspects of my life because I feel more in control of them. Whereas with IVF, I felt so totally out of control that it felt like it didn't matter what I did. It, it was not in my control. Like, as long as I, if I followed my doctor's instructions and did everything within my power, beyond that, there was nothing I could do. Whereas I feel like in most other aspects of my life, there is usually something that is within my power to change. And I think that was... that has been one of the most important and difficult lessons of IVF. Is, you know, and I realized this is, again, like something that people learn in AA. This is a truism that people have to acknowledge, that there are, you know, that we have to accept the things we cannot change. And that was really hard for me, um, but I had to, I had to learn to do it. But, um, I think it's... I don't know. I hesitate to say like, "Well, this is what I learned from IVF," but I do think it has made me a little bit better at when I am faced with situations that are out of my control, or the results of which are out of my control, I'm able to accept them better.

That's Doree Shafrir. Her new book is called Thanks for Waiting: The Joy (& Weirdness) of Being a Late Bloomer. Check out her podcasts, Forever35, which she hosts with journalist and friend Kate Spencer, and Matt and Doree’s Eggcellent Adventure, which is still putting out new episodes.

Death, Sex & Money is a listener-supported production of WNYC Studios in New York. This episode was produced by Afi Yellow-Duke. The rest of our team includes Katie Bishop, Emily Botein, Yasmeen Khan, and Andrew Dunn. Our interns are Mardy Harding and Kristie Song. 

The Reverend John Delore and Steve Lewis wrote our theme music.

I'm on Instagram @annasalepics, that's P-I-C-S, and the show is @deathsexmoney on Twitter, Facebook, and Instagram.

Thank you to Samantha Wood in Narragansett, Rhode Island, who is a sustaining member of Death, Sex & Money. Join Samantha and support what we do here by going to deathsexmoney.org/donate.

Doree told me that she has now achieved three of those four pillars of adulthood: marriage, kid, job. But she still wonders if she'll ever own a home.

DS: It almost feels more important now, now that I have a child, because it represents this kind of stability to me. And, I want to feel settled in a way that I don't totally feel right now. And I think, ultimately, that has been a theme of my adulthood, my late bloomer-dom, um, has been, has been trying, "Where do I fit in the world? Where am I going to feel stability, and how is that going to happen?" And I think I've mostly figured that out, but not totally, and, you know, I think maybe we don't ever totally figure it out. I think that's the conclusion I'm coming to.

I'm Anna Sale and this is Death, Sex & Money from WNYC.

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