I have to say that I agree with speaking to your husband and making that decision together. My insurance covered most of the procedure, but I still had the 20% I had to pay up front. It was tough just getting that money together. This is my first week, and with some of the pain I am experiencing and trying to still keep up with 2 small children, I am thinking right now, "What have I done???" But I am losing weight which I have not done in many years almost daily. I think you will still feel a bit of the guilt (I have tons of it still thinking that I spent so much on myself and a little for my own vanity), I think the recuperation will make it a little more difficult. I can not wait to be as excited as all those others out there who are enjoying the weight loss without the "right after surgery" pain. This will obviously have to be your own decision. If what I read was correct, you are wanting to start a family. Children were very important to me and they are actually the reason for being at my present weight since I was slim and trim before then. Even if you get pregnant now, there is some torture in getting back down to your pre-pregnancy weight. If you are already overweight, chances are you will not even lose that baby weight and you will not get to enjoy your child as much once those kids start walking and running, etc...If there is only the two of you, this might be a good idea to go for the surgery and get by on less for a little while to invest in your happiness...or you might start blaming him for your condition due to his job loss, resulting in marriage conflicts (been there, done that). I think a good heart to heart would be good, and I would suggest looking into other doctors in your area. The $18 K sounds kinda high depending on what is included. Ok, thought I would put in a few thoughts. Not sure if it will help.