Nikol Flowers feels lucky. She’s a few weeks pregnant for the first time, and all it took was one IVF cycle — well, that and a whole lot of perseverance and coordinated effort between her and the whole treatment team at Shady Grove Fertility in Annapolis.

As is the case for all Shady Grove Fertility patients, her team included a financial counselor at the ready.

“We started trying to get pregnant in July, and I had a blocked fallopian tube and PCOS,” recounts Nikol, who is 37. Her husband is 47, and neither have had children. Because of her pre-existing conditions and age, the couple only tried to conceive on their own for a couple of months before seeing a fertility specialist.

Even though they knew enough about infertility to not wait longer for treatment, Nikol and her husband learned that sometimes things can work almost ‘too’ right.

The first attempt, an intrauterine insemination (or IUI), did not result in pregnancy. A later try at IUI wound up steering the couple into unplanned territory.

“My body produced too many eggs to safely do an IUI,” says Nikol, “so Dr. (Jeff) McKeeby recommended IVF at that point. It all happened so fast, I just learned as I went.”

Even with the best fertility experts and facilities, nature will try to take its own course. Fortunately, most patients have a number of options for Plan B or even Plan C. As always with fertility treatment, the key is timing — nobody wants to completely cancel a successful super ovulation cycle. But there’s the firm reality of affording these unforeseen changes in plan.

Nikol had already been advised by her assigned financial counselor, Darlene Sine, from the very first appointment, that her current insurance plan covered no infertility treatment, but that the upgraded plan would handle 50 percent of her infertility costs. Because of her company’s policy, upgrading her insurance would mean that she would have to delay treatment until January 2009.

“I just didn’t want to wait,” she says. “I’ll be 38 in January. We‘d already had gone through a bunch of tests and had made our decision to try IVF. I just wanted to move forward instead of putting it off.”

Nikol recalls how steadying it felt to know where she stood financially from the very beginning. “Our financial counselor had all the details on that first day, and it was great. You understand what you’re dealing with. You don’t make these big emotional decisions and then find out later that your insurance won’t cover it. The decision was ours and we knew up front.”

As is often the case, Nikol’s EPO insurance deems all infertility treatment as elective surgery, a fact she finds ridiculous. “It’s not like this is a ‘fun’ thing to choose,” she says.

Adding more stress to the situation was the fact that her insurer denied coverage to the medication she needed for her IVF cycle. Her financial counselor and her pharmacist pursued medication reimbursement tirelessly, but the insurer continued to deny coverage. In the end, Shady Grove Fertility helped her obtain the medication she needed for her cycle.

In deciding how important having a baby was, Nikol and her husband took a number of steps to afford their fertility treatment. They cut back on dining out, canceled a planned trip to Key West, and sold an extra vehicle to finance their IVF cycle.

It took only one cycle for Nikol to conceive and she’s excited to be pregnant. “I’m tired, but other than that, no problems. I’m feeling great!”

To survive the experience emotionally, and with your marriage intact, Nikol recommends talking to others who are going through the same thing. “Your friends and family might get a little tired of hearing you talk about the injections and appointments, even though they support you wholeheartedly. Another woman who is going through the same thing is going to want to talk about it just as much as you do.”

On surviving financially and regarding the lifestyle changes she and her husband made to afford getting to this point, Nikol clearly kept a long-range perspective. “We said, hey, we have the rest of our lives together, and we can do these things — like taking vacations — some other time.”

She even credits the little things, like playing board games at home with friends instead of going out and spending money, with enabling them to get this close to having a baby. Besides, she adds with a laugh, it’s good training for when the baby’s arrived. “We think IVF is expensive, but our friends with kids have said ‘that’s nothing compared to how much kids cost for 18 years!’”