Infertile couples who are trying to start families often deal with incredible emotional stress, but it doesn't stop there – the financial strain from trying to become parents can be draining, too.

Only 15 states have laws that require insurance coverage for infertility treatments, and North Carolina is not one of them.

The average cost of an in vitro treatment cycle is $12,000. Medications women must take can cost another $3,000 to $5,000.

The overwhelming emotional and financial stress is something Mark and Kelly LeSage know well. The Holly Springs couple found out just how difficult infertility can be when they started trying to conceive.

"When we first tried to get pregnant, we never even considered it wouldn't happen right away. We were both healthy," Kelly LeSage said.

"We thought a couple of months or something like that, and as time passed, it was so frustrating," Mark LeSage said of the couple's struggles.

Months turned into three years. The couple had two miscarriages and spent thousands of dollars on fertility treatments.

"It's been almost all-consuming, for sure," Kelly LeSage said.

The LeSages did not try in vitro fertilization, but it's a path about 85,000 couples trying to conceive take each year in the United States.

Insurance coverage for such treatment can vary widely. Eight states have laws that require insurers to cover at least one cycle of in vitro fertilization. In Maryland, up to three cycles must be covered.

Katie Lelito, a Triangle-based advocate for Resolve, the National Infertility Association, says lawmakers need to be made aware of the lack of coverage. She also said policy makers need to understand that one in vitro fertilization cycle may not be enough to help struggling couples conceive.

"We just have to show the lawmakers here in North Carolina that one in eight couples is suffering from infertility," Lelito said. "That's a lot of their consituents."

Lelito also says private companies should make fertility treatments an essential health benefit. Self-insured plans, often offered by private employers, don't have to follow state law.

"It shows a company values an employee's family life and shows that they're including women and supporting women, their family and their work life," Lelito said.

Lelito and others working with Resolve have been reaching out to local lawmakers, hoping to start a conversation about the lack of required coverage in North Carolina.

"Fifty percent of people in North Carolina are on the state health plans," Lelito said. "They would be affected by a state mandate if we were ever able to have coverage."

Lelito said Resolve's two-pronged approach involves talking to lawmakers and companies. Resolve wants people to ask their employers for coverage.

"It's a financial roller coaster, it's an emotional one, a physical one," Lelito said. "You're giving yourself your own injections. You're your own pharmacist, mixing medications, and then (you do) all of that work and (spend all of that) money and time for nothing. What really helped me was to be involved in fertility advocacy, which was trying to do something about this – to get coverage for people who don't have coverage."

Lelito and her husband, John, tried to get pregnant for about four years. After multiple in vitro fertilization cycles, they finally had success. Their first child is due in October.

"I had no more hope left, and I couldn't believe it, but we are expecting a baby," Katie Lelito said. "Every day, we're like, 'I can't believe we're pregnant!' It's just like what we've been working for for so long. We're just both really excited."

There is good news for the LeSages, too. Kelly LeSage is about 12 weeks pregnant after choosing to undergo intrauterine insemination.

"We're waiting for each doctor's appointment to make sure things are still going OK," Kelly LeSage said.

People who are struggling to get infertility treatments covered should take to the human resources department where they work to see if they can get assisted reproduction insurance added to their employer's group insurance plan. Couples should also ask fertility clinics about financing programs or special loans that can help pay for expensive treatments.