Fertility Chronicles: Part 5

Sorry I didn't update this last week, but I was busy! Jeff and I had our IVF medication instruction class last Thursday. There were 4 other couples in the class and it lasted about 2 hours, but was filled with a LOT of information. She gave us the details of which meds to take and when and for how long and showed us how to draw the meds. She left very few questions unanswered. I'm really glad Jeff went with me b/c it was a lot of information to get in such a short amount of time. The progesterone needle was the only part that made me go.."hoollly crap". Two inches long..all the way in my hip..every day for 10 weeks after the embryo transfer. If the embryo's don't attach and I'm not pregnant, then I don't have to take it..otherwise, it's through most of the 1st trimester. OUCH.

So..where do we stand now? I got a letter from Duke telling me the amount I owed after insurance paid, which is $3518. I faxed that to ARC Sunday night and they called me back confirming that they got it and were just waiting on the clinic to fax the prescriptions. Duke faxed those to ARC today and she called telling me the price on those was $2328.48, for a total loan amount of $5846.48. She said she'd get the loan paperwork up and ready to go and fax them to me tonight...which I never received..but then I just sign them, fax them back, they order the drugs and have them overnighted to me..and away we go! I still have to go in for my baseline ultrasound before I can start the drugs, but hopefully I can start them the first of next week.

Jeff got me all freaked out the other night because he told me his contract expires on April 15th and I thought we had until April 30th. If I had started the drugs tomorrow, we'd be looking at an embryo transfer date of around April 13th. That's cutting it verrrrry close. The only way this is going to work now..is if Jeff gets the COBRA insurance through the end of the month. That's also really expensive, but still cheaper than paying full price for IVF. If his insurance hadn't covered any of it, we would've paid about $13,000 for everything. We're hoping that his insurance doesn't end the day of his contract, but at the end of the month during which his contract ends. We'll see. I can't stress over it b/c there's nothing I can do, you know?

The fact that this might not work hasn't even set in really. I'm just confident that it will work...I have to think that way. I'm trying not to get my hopes up, but at the same time, I'm thinking of names, who to pick for an OB, how I'll do the nursery and wondering how fat I'll get. My biggest concern is that Jeff can't get another job until this cycle is over with b/c of the insurance. So..he'll be technically without a job before we even have the embryo transfer and that scares me. I know we'll be ok because we always have been...it just works itself out...but that doesn't mean it'll be easy. Our first year was rough b/c he got laid off..and even if he gets another job, he may not be making as much...and we need to prepare for that. I'm putting away as much as I can to help cushion it a bit, but it's not going to be enough. The job market for IT people in this area has slowed to less than a crawl. It's kind of like a baby who's just lying on the floor, drooling, rocking back and forth but not going anywhere. He's looked for jobs outside of the Triangle and in other states, but the truth is that we don't want to move. Despite the strange weather and unbearable summers, we like it here. We're close to just about everything and there's never a shortage of anything to do..but...you have to do what you have to do. If we can't make it through the next 18 months and wait for the economy to turn around, we'll have no choice but to go elsewhere. That makes me sad.

I'm just so thankful to have a very supportive family who I know will help us out when and how they can. All I can do is pray. So, here's to a successful IVF cycle, a new job for Jeff, and strengthening our bond by extending our family!

Fertility Chronicles: Part 4

Seems like a lot has happened since last Thursday! I hope this isn't TMI, but it's kind of important..so just put on your big girl panties and deal w/ it. Late in the afternoon Friday, I got my period..which means day 1 of my cycle. I needed to have blood work done on Day 3 to determine my medication dosage. Day 3 was Sunday...and they're closed, and they closed at 3pm on Friday..so I couldn't call to ask what I needed to do. I decided to call the RE on call and after a short wait, she called me back. Dr. H was awesome and not upset that I had her paged for a fairly minor issue. She's there to handle emergencies after hours. Anyhow, she told me that I could have my blood work done Monday morning and it would still be valid. I was also supposed to call on Day 1 to schedule my 3D Sonogram..and they were closed..so that also had to wait.

I called Monday morning to schedule my lab work and thought since they were already going to be drawing blood for my hormone levels, I could also go ahead and get my IVF screening labs done as well. When I told them what I needed, they discovered they had an appt. opening that day for a 3D Sono and that I could just have everything done at one time. Wow..I wasn't expecting to have the 3D Sono done until later in the week. She told me it has to be done between days 3 and 11..so I guess day 4 was just perfect. The appt. time wasn't until 1:30, so I asked if the blood work for my hormones would be ok if put off until then and they said it was fine. So..at 1:30, I headed into the office where they filled 8 tubes of blood. Yep...I said 8. They have to test for FSH, TSH, and Prolactin...plus HIV, Hep B&C, Rubella, Blood Type & Screen, and um..something. I can't remember..I'll find it later. Jeff also had to go in Tuesday to have his blood work done and they only filled 4 tubes for him.

Anyway, so after my blood work by the very talented Lab Tech..who left no bruising...I headed into the ultrasound room. I'll admit I was nervous because I knew the 3D Sono was similar to an HSG..which was NOT pleasant in the least. I hurt for several hours after that one. The Dr. came in and told me they would push a catheter through my cervix and fill my uterus very slowly with saline and that if it hurt they would stop. The catheter didn't hurt...so if you ever have to have one done, do it as early in your cycle as you can. I had the HSG done around day 10, after my cycle was over and my cervix wasn't as open...thus the pain. Once she took the speculum out, I was fine. She put in the ultrasound wand..then the saline started...very uncomfortable. Not painful...but there was discomfort. I'm watching the screen as my uterus expands and I'm fascinated at how little it actually is. I started having some cramping because my uterus was rebelling at being filled so fast, but I was ok. According to the Dr., my uterus is perfect..no polyps or malformations of any kind and my lining was good.

She also looked at my ovaries and said they were perfect. Oh really?? I have PCOS..which means cysts on my ovaries...and she's telling me there are none?!? Then why can't I ovulate or get pregnant??? I found that interesting. I could see the follicles and they were a little larger than normal ones..but they looked like they're supposed to. After I cleaned up, She gave me a prescription for Doxycycline to prevent infection. I spoke to the nurse who gave me a prescription for birth control which I also started Monday and I scheduled my IVF Class for next Thursday. That day I should also get my medication dosage and prescription. After leaving and having paid my 25% to the tune of $460, my only issues for the rest of the day was the saline leaking back out and the headache and upset stomach from the birth control and Doxy.

When I got home from the Dr., I called ARC(Advanced Reproductive Care) and asked them about financing the IVF cycle. They gave me the rundown of what they needed and who they financed through. Our best option was Capital One and we got pre-approved for $9,000 at 9.9% for 60 months...which is the best you can get for that loan term for the amount we asked for. It shouldn't cost anywhere near that, but it gives us a bit of a cushion to work with. Now, I just have to have Duke fax my prescriptions to ARC, they find the cheapest pharmacy to provide the meds, let Capital One know what the total cost is going to be and then they send me the loan forms, I sign them, send them back..and then they pay Duke. Voila. My insurance will cover some of the costs of the medication if I go through their pharmacy..so they may be the cheapest route to go w/o having ARC find me a pharmacy. I just want the smallest out of pocket expense!

My next step after the class is my baseline ultrasound and medication start. My Dr. also called me Tuesday to go over Jeff's results from the semen analysis...which gave me a lot of answers to questions that I had in my last blog. Dr. W said that Jeff is normal but there's still a 1 in 6 chance that there could be no fertilization and that the the ICSI procedure is basically an insurance. With all we're putting into this procedure, why not guarantee that we're going to get an embryo? I hate knowing we have to pay the extra $1700..but our insurance covers it..so I don't think it'll really cost us that much out of pocket.

I don't know how they determine which sperm to inject into the egg though. I guess they just pick the one that has the best motility and morphology..and therefore the strongest to fertilize the egg. I still wish they'd just put it in the dish so that some of this is left to chance, you know? I guess technically..it's still chance b/c there's no way of knowing which sperm is going to be used..it's random. Anyway, if the timeline falls the way I've figured it, I should be having the embryos implanted in late March or early April..and know by mid-April if I'm pregnant or not. There's still a lot left to chance though. Just because we have embryos doesn't mean the embryos will attach or that I can sustain the pregnancy, so there's a lot of stress still ahead of me. I need to find a way to deal with it and not hang on to it...that could cause the whole thing not to work. Maybe weekly massages throughout this whole thing wouldn't be a bad investment. Eh..we'll see.

UPDATE: Here's Videos!

Here's one of Egg Retrieval: http://www.youtube.com/watch?v=ulFp3N6D4Oo
Another one better explaining the egg retrieval: http://www.youtube.com/watch?v=TC9UaNtpweE
I also found a video of ICSI! http://www.youtube.com/watch?v=nPBZ7jURBXg
And one of the embryo transfer: http://www.youtube.com/watch?v=CHCE3ale7sI
Hope this helps you guys better understand the process!