For the one in eight couples who struggle with infertility, finances can be a huge roadblock.
Whether they're pursuing in-vitro fertilization, adoption or surrogacy, the associated fees can reach well into five figures. The average cost for a single cycle of IVF is around $25,000, for example — and people often need multiple rounds to get pregnant.
"Physically, emotionally and financially, (it's) the hardest thing that we've gone through," said Katie Berlin, who struggled with infertility for five years before she and her husband decided to adopt.
And yet, as Berlin and others told Weekend TODAY, many are willing to do whatever it takes to have the families they always dreamed about. They opened up to NBC's Kristen Welker, who recently announced she is expecting her first child via surrogate, about the lengths they went to get there.
IVF is 'very expensive'
In Denver, Abby and Sean Mercado are the parents of twins Max and Annie, who were born via IVF.
"It's very expensive, but you know, it's definitely what we wanted," Sean Mercado said. "We wanted to start a family, and we prioritize that over the dollar."
For them, that meant taking out a second mortgage on their home, which may have been a difficult decision for some — but not for Abby Mercado. "It wasn't, because this is what we wanted," she said.
Yet her journey wasn't so straightforward. At one point, she overdosed on her fertility medication and had a miscarriage as a result. When she was pregnant with the twins, she had preeclampsia and had to have an emergency Caesarean section and three blood transfusions. The babies spent 19 days in the neonatal intensive care unit. The Mercados believe that if their health insurance covered IVF treatments, they wouldn't have taken the risks to have twins and therefore wouldn't have had such a complicated pregnancy.
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Abby Mercado has since started a company called Rescripted to help people figure out fertility financing and medicines, and to help people who need it get counseling.
Making the decision to adopt
Thomas and Katie Berlin of Michigan are another couple who struggled with the price of IVF treatments.
"Everybody wants the white picket fence, the perfect family," Thomas Berlin said. "And so, you know, you never think that it's going to be a struggle. You've just reached a point where it's like, we can't keep spending this money. We're going to go under."
Ultimately they decided to adopt, a cost that's comparable to about one round of IVF. Katie Berlin was herself adopted from South Korea, so when IVF wasn't working for them, the decision to pivot to adoption was an easy one. They made plans to adopt a baby girl named Lily — and then they got a surprise phone call telling them that Lily had a new biological sister, Maya.
"There was not a hesitation, we knew we were going to adopt Maya," Katie Berlin said. "But there was also this short panic — OK, financially, are we going to be able to afford another adoption?"
They wound up getting a grant from the nonprofit Gift of Adoption to help pay the fees to adopt both girls.
"It may not have been that family that you envision, but this is my family," Thomas Berlin said. "These girls are our daughters."
Pursuing surrogacy as a single man
The journey to parenthood can be especially challenging for those without partners, as was the case for Julien Zeitouni of Brooklyn, New York. He told TODAY he knew he would need a community of support as he navigated the surrogacy process as a single man.
Having a baby via surrogate can cost more than $100,000. Zeitouni told TODAY he saved for 10 years and then found a nonprofit called Baby Quest that provides surrogacy grants. He applied and was accepted.
He's now the proud father of a baby girl born via surrogate.
"Everything vanished right away," he said of the moment his daughter arrived. "As soon as she was born, all the heartache as well as the anxieties that I had to endure were worth it."
Yet Zeitouni and the other parents who spoke to Weekend TODAY said they wish there were more resources for people who are struggling with the costs of starting a family.
"Hopefully in the future people will not have to sacrifice so much to become parents," Zeitouni said.
As Sean Mercado put it, "I feel like everyone should have the choice to start a family."
Here are some resources:
Growing Generations: Full service surrogacy agency offering grants of up to $50,000 for qualified intended parents
Children's book about surrogacy: "You Began As a Wish"
Book for adults about assisted reproduction: "Your Future Family: The Essential Guide to Assisted Reproduction (What You Need to Know About Surrogacy, Egg Donation, and Sperm Donation"
American Society for Reproductive Medicine: Resources for prospective parents going through fertility care
Future Family: Provider of flexible fertility financing plans
Family Equality: Resources for LGBTQ families, parents and parents-to-be
Resolve: Resources for anyone challenged in their family building process
Society for Assisted Reproductive Technology: Organization for assisted reproductive technology professionals
Men Having Babies: Financial assistance and resources for gay men pursuing parenthood