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!

Fertility Chronicles: Part 3

Alright, so here's what's going on...and my dilemmas (yes, that's plural!) Jeff got his test results back today and it was a thumbs up, but they said they would recommend that we still do ICSI. That's where they inject the sperm directly into the egg to fertilize it. My question is, if Jeff's little soldiers are fine..why do we need to do ICSI and incur the extra cost of doing it? Apparently the nurse told Jeff that if they just put the sperm in the dish w/ the eggs and hope for the best, there's only a 15% chance that it will work. Um..what??! How can it be that low when the sperm and eggs are all there together hanging out? Say..6 eggs..and 2 million sperm...and it's still only 15%??? Bollocks to that! I think she just wants us to spend the extra money. ICSI is for couples who have infertility issues with both partners. If Jeff's "boys" are A-OK....then I don't see a reason to pay the extra $1500-$1800 to have it done. Oh..and that's out of pocket..insurance doesn't cover that. So this dilemma is: do I pay the extra money to guarantee we have embryos..which still may not result in a viable pregnancy..or let the fertilization happen naturally?

Ok..on to the next dilemma. Jeff may lose his job in April when his contract runs out..which means the insurance goes with it. We're hoping they'll make his position permanent..but we have to plan otherwise. IBM's insurance is AWESOME! No copays and they cover 2 cycles of IVF. If we lose that April 30th, I have to go on NC's State Insurance..which is hideous! Ridiculous copay and co-insurance fees and they don't cover IVF...plus you have to wait a year for payment on preexisting conditions. I should also mention that I would have to cover Jeff too..and the Employee/Spouse plan..is something like $350 a month. The family plan is $450. We're paying $80 through IBM for both of us...and their family plan is only $110...or something close to that.

If the IVF works and I become pregnant and then have to switch insurance companies..wouldn't the pregnancy be considered a preexisting condition?? In that case, they would cover NONE of the birth expenses...or any of the work I have to have done relating to the pregnancy at all. I can't lie and say I didn't know b/c it's insurance fraud and they could check w/ IBM's insurance and find out we had IVF. Even if the birth goes the way it's supposed to, you're looking at probably $12,000 or more....and if it's complicated, it could be $50,000 or more. Plus..what if Jeff still doesn't have a job? I realize all this sounds like I'm being a Debbie Downer, but I have to plan for the worst even while hoping for the best. What do I do? Do I still go ahead w/ the IVF knowing that Jeff may not have a job and that insurance wouldn't cover any pregnancy expenses? I know our parents would help us out..but they're in a tight bind right now too. Dad may lose 3/4 of his retirement, Jeff's parents just built a new house and are still supporting his brother and his family...so I wouldn't want to be a burden. I rarely ask for help anyway.

I'm just unsure about a lot of stuff. Now that I'm ready to do this...it's the absolute worst time to be ready for it. Our economy will be in the hole for another few years...but I'm not getting any younger and really don't want to wait that long to have a baby. I feel like my window of opportunity to have one is closing on me in the next 5 years, so I don't feel like waiting is an option. I keep trying to remind myself that Jeff's parents lived off of Beanie Weanies for a month in order get by after having Jeff....and they made it. Do I look at all of these roadblocks as a sign that we shouldn't be doing this or do I look at them as trials from God that I have to get through? Maybe God's testing the strength of my desire to have children. Maybe this is when He wanted me to be ready, even though it makes no sense to me. I just know I could use a lot of prayers right now. If you have any ideas or words of advice for me, please email me!

Fertility Chronicles: Part 2

So Jeff and I had our Dr's appt on Feb. 4th. I really liked him and felt very comfortable with the staff. They scheduled Jeff for a semen analysis..which he wrote a blog about here and then told me to call back on day 1 of my cycle to schedule a 3D Sonogram. So..that should be in the next week or so. I have to take Provera monthly to even start a cycle since I don't ovulate and I'm halfway through my 10 days of it now. I also have to have blood drawn on day 3 to determine my hormone levels so they know how much meds to give me. We still have to talk to the financial counselor to find out what our out of pocket expense will be and get a loan. They don't allow payments to be made to them.

This process is sooo much more complicated than I thought it would be. A LOT of hoops to jump through...and they have to be timed just right. Some of it is a bit confusing. Here's the gist. We talk to the financial counselor to find out our price and then get a loan. During this time, at some point Jeff and I both have to have blood work done for HIV, Hep B & C, rubella, RPR, blood type and screen. Once all these results come back, we call to schedule the nurse med instruction session where I get my prescriptions and have them filled to the tune of around $2000. Then, they schedule my baseline ultrasound, I start the meds, they monitor me, I have the egg retrieval and within a few days, the embryo transfer. Sounds simple, right? Not quite. Somewhere in the paperwork it said that it's best to use a mail in pharmacy b/c they're cheaper and have more of the meds in stock. Ok..our pharmacy can take 2-3 weeks to get the medications. That time is VITAL and shouldn't be wasted on waiting for the meds....especially w/ Jeff's insurance running out in April...maybe sooner if he gets another job.

I just have a lot of questions about the exact order of a lot of this stuff. Do I call to schedule the baseline ultrasound or do they call me? Do I have to have the instruction session before my baseline ultrasound? Does it matter? Can we have all this done by April? If not, can we afford it? I feel guilty because I meant to call the financial counselor this week to find out how much our out of pocket expenses would be and what our insurance covers..and other options on how to pay for it. I was going to go ahead and get a loan for a little more than what they said we'd need...just to be sure. I was going to schedule an appt. to have all my blood work done and faxed to Duke. I didn't do any of that and as I said..time is vital. I just pissed away another week. It just totally slipped my mind. You know what I was doing instead? Watching movies, doing laundry, sleeping, doing dishes, and other random unimportant stuff. Calling Duke and getting my tests done should have been at the forefront of my mind. I set my cellphone reminder to go off Monday and remind me to call them...as well as set up a time for blood work..though I guess I could just have that done the same day as my 3D sono..but I'd feel better if I knew that I was moving closer to the goal, you know? Otherwise...I'm just waiting..and wasting time.

I need to get Jeff to have the blood work done too, but that's the only other thing he needs. I hate sitting around waiting for my period. What happens if it doesn't come? What if the flow isn't heavy enough to have the sonogram done? Why am I worrying about all this when I have no control over it? Sigh...I'm just stressed...and that's one of the worst things that can happen during an IVF cycle. I need to just calm down and realize that I can't make this happen before April. I was the one who kept putting it off b/c I wasn't ready..and now that under pressure and getting ready to lose the insurance, I decide to do it....then waste a week. I didn't know about the 3D sono...that's what's putting this off for awhile....b/c it has to be done during my cycle. When they told me I had to have it done, I had just finished my period a couple of weeks before...and I was disappointed to know I'd have to wait.

I just keep running into obstacles. Is this God's way of telling me not to do it? Am I reading too much into it? Sigh...I'm just getting frustrated with the delay and worried that this is never going to happen...or if it does..that it's not going to work. Or that we'll end up w/ massive bills and that Jeff can't find a job that pays what he's making now. It's not fair. Crack whores are out there getting pregnant left and right and don't want them..and I can't even get pregnant once. I"m really trying hard to be hopeful and positive, but sometimes, life just sucks.

Grover where are you?!

As a woman in my 30's, I was raised on Sesame Street, The Muppets, and The Electric Company. I hardly missed a show. When I was about 7, my babysitter had a yard sale. My good friend Celeste was my baby sitter's niece. So...she had a ton of her stuff over there to sell and I just had to have this Grover doll. He was about 15 or 16 inches long, well loved and kind of ratty looking...but I wanted it. Mom got it for me for $1. I carried him everywhere and talked to him as if he really understood me. Maybe he really did, who knows, but he was my friend. I slept with him. I ate with him. I danced with him. I watched TV with him so he could see his performances on Sesame Street..and I would tell him how great he did. I would even push him around the yard in a baby stroller. I would make sure he was tucked in safe and warm.

One very windy day I was out in the front yard throwing him into the air and watching the wind blow him a little to the left of me..then I'd catch him. I did this over and over until he landed on the branch of our maple tree. He looked so cute just hanging there with his sweet little smile. I climbed up to get him and when I got back to the bottom, I had a new game. How far up in the tree could I throw him...and how long would he stay there before the wind knocked him out? It turns out..pretty darn high and for a long time. I think the record was about 10 minutes. For an 8 year old, that's an eternity to wait. But at least he came back down because that would have been a very precarious climb on little limbs to get him out. After this game, I tucked him back into the stroller. This is my last memory of him.

Sometime after that day, he went missing. I never found him. Maybe Mom thought I was too old for Grover and secretly got rid of him at a yard sale. That's what she did with my lion when I was about 10, but that's another story for another time. Maybe he was stolen. I keep wondering if I accidentally left him in the stroller in the yard. I have a vague hazy thought that I left him safe in his stroller when I went in for dinner and when I came back out, he was gone. Never to be seen again. I even asked Dad if he would look on the roof to make sure he wasn't up there. There had been an incident that day where a gust blew him on the roof instead of into the tree. Luckily..another gust knocked him off. But, Dad looked for me. No Grover. He did find several tennis balls and a Koosh ball. Remember those? Kelly and I used to throw them over the house to each other and they didn't always make it.

Anyhow, I wonder what happened to him. I personally think he was stolen by a neighborhood kid, but maybe I'm trying to pacify myself and made that up in order to block the memory of Mom getting rid of him. I could understand the theft because Grover was awesome...but Mom betraying me..knowing I loved him...that's just too hard to swallow. Or maybe I simply misplaced him and find it easier to blame someone else than myself. I'll never know the truth of what happened, but today, the truth is that I wish I still had him. Jeff still has Stanley, his little green teddy bear from when he was 3...and I have none of my childhood toys..except Garfield..and he's at my parents house. Many of my toys are still there, but none of them had quite the meaning that Grover did.

Today, I can honestly say that when I have children, they can keep their toys for as long as they want. It's been more than 20 years since Mom got rid of my lion after I begged her not to and I still hold some resentment towards her. I may not have had it now, but it was mine..and my choice of when to give it up. It was sentimental...so what if I didn't play with it anymore. I don't blame her for Grover..I just think someone else wanted him as badly as I did. I hope whoever took him gave him a good home and loved him. I hope they still have it and gave it to their children for them to love. It just leaves me asking: where are you Grover? Are you thinking of me? I'm thinking of you.