Knowing that "what we can do" depends a lot on "who has access to what resources" is a tremendous sense of frustration for both patients and providers. It is worthwhile to remember that this isn't just a problem related to infertility or the United States. In addition to being a reproductive endocrinologist, I have also been working in Haiti for the last 18 years and there is no question that fair isn't a word that describes how resources are distributed around the world. People in Haiti die every day from a lack of access to even rudimentary health care. I have seen women who died on the side of the road looking for help and done C-sections without the assistance of an anesthesiologist. In addition to providing basic health care, I have also helped a Haitian MD open an IVF program in Port-au-Prince. You might think that is crazy but we can use issues like these to help us to recognize where we are blessed and what our role we should try to play in the world during our very short stay on the earth. The Haitian people don't complain about what they don't have. It wouldn't do them any good & they don't expect help from anyone. They value the people in their lives and are grateful for the opportunities that they do have. After 250,000 people died in the earthquake, survivors were praising God that they had been given a 2nd chance. From a fertility standpoint, some of us become parents without much effort, others become parents through assisted reproduction, others adopt and some choose to live without children. I have yet to meet a patient in my practice who became a parent by any of these means who didn't feel blessed. The journey is hard sometimes & it isn't fair but sometimes it brings us together and helps us figure out what is most important. If you are unhappy about what insurance companies don't provide, are you doing anything personally to change that. Are you lobbying your congressman? Are you investigating money back programs that allow you to take some of the risk out of the process. Talking with your provider about these issues and getting actively engaged in something that matters to you may not benefit you personally tomorrow but you may be able to improve things for someone else down the road. I know that this may not be a popular response to a feeling of angst and frustration but we have to realize that the we live in a big world and that some things are positioned for our benefit and others are not. We would all be happier if we adopted the Haitian strategy of degaje (pr: day-gah-jay), which means do what you can with what you have where you are or make due. Included in my prayers ever day are the hopes and dreams of my patients. I wish you well in your personal pursuits and your efforts to help others in theirs. Blessings.