Telling 'Mom'

It's been a few days since my last post so here's what I've been up to:
Saturday May 24th, my mother-in-law(MIL) arrived for a week-long visit and my husband and I are about to celebrate our 3rd wedding anniversary. I recently posted about our timeline on who we would share our IVF news with. You can find that post here.
After further discussion we thought it best to tell my MIL while she was here visiting.


We decided we would do it after breakfast this past Sunday morning.  I was a little nervous before we told her. I started it off by saying that no we weren't pregnant and here's why. I gave her the gist of the story and there were some tears. Overall, she was happy that we shared this news with her and is here for us. I told her I know it's a lot to take in and if she had questions while she was here to just ask them, but when she leaves, we need to set boundaries. Boundaries for us and for her. You see, she's a worrier. Big Time! Her son is her only child and only focus. We asked her to trust us when we say we will come to her with updates and we understand that sharing this crazy time in our lives means that she's now a part of this process.

I think it's important to set boundaries. I don't want every conversation centered around our infertility. It's already something I think about every minute of every day, and we will make sure that we provide updates as we progress with everything.


The material that the clinic gave us on Assisted Reproductive Technology (ART) has come in handy. I gave my MIL the packet on IVF w/ ICSI and she's been reading it. I have been asking her if she has any questions. Kind of opening the door for conversations.


It's been really nice to be able to speak openly about it at home.
We're going to be telling just a few of our closest friends soon.


Side note: STILL waiting for AF to get here. I'm looking forward to moving forward with everything.


I'll post again when I have something more substantial to report on. Hope you have a great week. :)

Financial Assistance and Grants for IVF Medications

Hello Again!


I recently posted about the cost of IVF here. My husband and I applied for the discount medication programs First Steps by Design Rx and EMD Serono's Compassionate Care program. We were notified via e-mail from First Steps that we did not qualify financially to receive any assistance, but we received a membership card that gives us access to 'up to 30% the cost of retail IVF medications.' I'm always leery of the word 'up-to' because that usually indicates it's much lower than 30%.

I then had to call Compassionate Care as it was going on a week (we were told they have fast response times) and the nice woman on the phone told me that our application had been rejected because our income fell outside the limits of those who qualify. I of course asked her, well what level of income would I have needed to qualify and she said that they don't provide that information.

I'm sorry, but to apply for these programs I had to provide our most recent tax return. You're telling me I showed you my cards, and you won't show me yours?
This leads me to believe that the income level for these programs must be low if they won't share with me. Maybe these programs are some sort of PR stunt for the big pharma companies to be like, "look at our wonderful program we have to help those in need." A$$holes.

Anyway, Compassionate Care (ironic name right?) said they mailed our rejection letter and included a code in there for us to receive 'UP-TO' a 10% MAIL-IN rebate after we make our purchases. At least First Steps gives us the illusion that it could possibly be 30%. And who likes a mail-in rebate? I think they're bull$hit.

So that's where we are with our pharmaceutical discounts.


Just to break it down, here is a list of medications that a Frist Steps Discount will help you buy:

• Follistim^® (follitropin beta for injection)
• Ganirelix^® (ganirelix acetate for injection)
• Pregynl

For Compassionate Care:

• Gonal-f^® (follitropin alfa for injection)
• Ovidrel^® PreFilled Syringe (choriogonadotropin alfa injection)
• Cetrotide^® (cetrorelix acetate for injection)

I looked into grants for treatment, and there are some out there, but they have very specific criteria. Still, you may want to look into them because you may qualify.

WTF Aunt Flow!!!

My GYN visit went well and we had a nice talk and she apologized for what the nurse said, which surprised me, and said if I'm ever nervous or don't feel comfortable with the nurses response, to ask to speak to a doctor. I think I really like my OB/GYN. 

Now I'm patiently waiting for Aunt Flow (AF) to get here so I can call my RE and get on the schedule to have this darn polyp removed. 

Work has been busy and I only thought about my infertility a few times today which meant I was especially busy. 

Side Note: One of my girlfriends is very pregnant and today was her last day at work. Amazingly, I'm not jealous of her like I am most pregnant women. She struggled for such a long time to get where she is today and I'm truly happy for her. 

Try and have a good weekend! :)

Mother's Day

This Sunday is Mother's Day, A holiday that has never bothered me until recently. Don't get me wrong, I love my mom, and all the moms in this world, it's just hard right now.


I would love to come in late to work because it was Mommy Tea Time at my child's school. That was the gem I heard this morning while in the kitchen at work. My tolerance has gotten pretty low for these kinds of stories, and it's because I suffer from an super unattractive personality trait right now: Jealously. It's not a feeling I often have and I wish I didn't feel this way.(And obviously I didn't let this emotion get the best of me.  I said 'awwwwww' like a champ and quickly dashed out of the kitchen). 


I truly am happy for those out there who are fortunate enough to become parents. I just wish I was one of you...getting the macaroni necklace or the cutely decorated potted plant for Mother's Day or even nothing at all, but just spending time with my child on a workday morning.


My jealously comes and goes in waves, and I'm not consumed by it, but it's there.


And of course I'm still very hopeful right now...but what if our IVF doesn't work? I read a lot of stories of women whose first IVF cycle failed. I know that's a real possibility but I can't think about that right now. I don't need to mix my fear with my jealousy.


I hope I'm not alone with these feelings.


I pray that I'm filled with another feeling next Mother's Day: Joy.

GYN Visit: Words of Wisdom

Back in September 2013, I called my Gynecologist's office because I was having mid-cycle bleeding. The nurse told me this was normal and not to worry.


I come to find out many months later that it's a polyp that is causing this bleeding. If I had this addressed back in September I wouldn't be in this torture chamber called: WAITING TO GET THIS SHOW ON THE ROAD!


I've never had spotting until about a year ago. Sometimes it would be so bad that I needed to bust into my monthly lady supplies just to deal with it.


Looking back I wish I had been more persistent. My words of wisdom to myself and every woman out there is this:


You know your body, if something doesn't feel right, get it checked out. Who cares if there are guidelines that doctors follow. You know what is and isn't right. Go with your GUT!


I'm scheduled to have my annual exam tomorrow, and we're going to have a nice long chat. More to follow :)

Drugs!

The above picture is the response I got from my husband when I sent him the list of drugs that I will have to take when we are ready to begin our cycle.

Below is said list:

Ganarelix 250 mcp OR Cetrotide .25mp

HCG (trigger shot) 10,000 units

Menopur 1 or 2 vials daily for 10 days

Follistim OR Bravelle OR Gonal-F 225 units daily for 10 days

Crinone 8% progesterone gel

 

The good news is that I can choose which versions of each drug I would like. This is good news considering we will be out of pocket on the medication costs.

If you have gone through an IVF cycle, can you please tell me if there is one that you preferred over another? I also hear that some are harder to take/inject than others. Sweet!

 



To Tell or Not to Tell? Who to inform.

After our May Day appointment, I told my mom. I'm very fortunate to have a wonderful relationship with my mother. My mom is the least obtrusive, inquisitive person you will ever meet. She may be the epitome of social etiquette.  I know she is there for anything I need. As I've mentioned in a previous post, I come from a large family, lots of brothers and I'm the only girl.

We had some struggles in my late teens, mostly me growing up. But I really feel like she's one of the most amazing people that I've ever had the fortune of knowing, and to have her as my mom, what more could anyone ask for?

I called her the afternoon of the appointment. I told her what we know right now. She hasn't told my Dad yet. We finally agreed to bring him in when we had a more full diagnosis. 

This weekend, I spoke with my husband about the possibility of speaking with his mom and telling her. After many broken conversations (where you start a conversation and discuss it here and there) we decided to tell her after we had the results of the hysteroscopy and the removal of the polyp. 

My husband is an only child and he is his mother's whole world. When you are thinking of telling someone, you have to remember that you will be bringing them into your world. They become a part of this journey. They are invested. Updates need to be made and you have to worry how they are handling everything. Telling her is a big deal because she worries so much. I love her so much and we have a great relationship and I don't want to make her worry.

I've been married to my husband for almost 3 years and so much has happened in these past 3 years. Sometimes I think about our ten year anniversary and imagine renewing our vows. Mine would go something like this:
You are my best friend. We've had a tumultuous first 10 years, so many ups and downs and I want the next 30 years to be some of the most boring years. I want time to creep by, and to enjoy our lives in the mundane happiness of every day.

But I digress...We decided to tell her after I have my diagnostic testing and after we have all the facts. 

The issue now is that she's visiting us in the next few weeks. I'm supposed to call the clinic when I get my next period so we can figure out when to schedule the surgery. I'm expected to get my period around the time of her visit, which is also our 3rd year anniversary. Should be an interesting time!

We decided not to tell our closest friends until we tell my husband's mom. We figure the less people know, the less questions we'll be asked. We need to figure out our game plan. 

We're not making any plans for the summer, and are almost being hermits. 
Thinking about our infertility, the treatment, and outcomes, we've got enough on our plates. Deciding on who to tell is an important decision. You will need to do what's right for your personalities. Do you need a constant influx of concern and questions, or do you want to figure things out first, and then bring people up to speed? I think we're somewhere in the middle. 

More to come. God Bless, and have a good week! :)

Show Me the Money!

We met with our Financial Counselor Cathy. Woman knows her stuff! She went over our options, and apparently there are tons of them. Treatment costs will vary depending on your insurance coverage, and area you live in. 

We will be spending our own, hard earned cash to pay for this process as our insurance only pays for the diagnosis and not the treatment of infertility.

Cathy first went through the cost of a treatment cycle. Between ultrasounds, blood work, and embryology lab fees, our cost would be $9,000.00. This does not include medication. Medication ranges from $4,000-$6,000. We were presented with two medication discount programs that offer a percentage off of the medications. (anywhere from 15-75% off depending on our financial need) I'm always skeptical when presented with discount programs. I went online after our appointment to see what other kind of discounts were out there for us. I confirmed that these were our best options. 
But don't be afraid to do your own digging. 

Cathy then spoke about their treatment packages. Their 'most popular' included an entire fresh cycle, and then a frozen cycle if the the fresh cycle didn't work. This was $11,700 (no meds included)

The doctor asked her to speak about their other option which was 6 cycles for $20,000. This is a refund guarantee program. If we don't get pregnant after 6 cycles, we get our money back. If we are successful after one cycle, the package is deemed complete. 

My husband, ever the comic says, "I'd like to see something in a leather interior with maple wood accents." Love this man!

There were a lot of other packages available to us, but those two seemed to be the big contenders. We aren't able to make a decision at this moment because we won't have our full diagnosis until after my hysteroscopy and polyp removal. 

The clinic also offers a discount program to those who qualify. You can't combine the discount program to the guarantee program. I knew to ask about that because I saw it on their website. Couples have to qualify financially which means that you have to provide two years of tax returns. 

Also, there are grants available to those who qualify. They are very specific and may be available to you if you qualify. 

Stay tuned for more! 

WTF!?! IVF!?! aka Our First Fertility Appointment

Thursday May 1^st, 2014 – WTF!?! IVF!?!  aka Our First Fertility Appointment!

Ever the planner, I was focused on all aspects of our appointment, down to the most frequent question all women ask themselves when preparing for an important meeting…What will I wear? My mother always said when you are feeling down, or unsure of yourself, at least look fabulous! I think there is some truth in that. I’ve had several days were I felt like crap inside, but I looked good on the outside.

With the printed New Patient paperwork in our hands and having decided on my newly dry-cleaned favorite maroon ankle pants, cream blouse and blue cardigan, we set out for our appointment.

I don’t think I've ever been as nervous for anything in my life as I was for this appointment.  My husband and I were driving separately because I had to go into work after the appointment for an important work meeting.

As we walked into the office, the front desk ladies knew who I was when we walked in. They were very welcoming. There goes those warm and fuzzies!

Because we live in one of the many states in these United States that does not offer coverage for Infertility treatment, I knew what we were in for. 
On a positive note, my insurance and my husbands covers the diagnosis of infertility. So many tests and procedures leading up to treatment are covered. Check your medical benefits policy to see if this is covered. If you have any questions about this topic, please e-mail me!

Our wait was very short, and a very pleasant nurse brought us in to take my blood pressure, height and weight, (she let me write it down because don't most women know their weight?) She then went over how the appointment would unfold. We would meet with Dr. C for about 20-30 minutes, then he would perform a baseline ultrasound and then another nurse would do our blood draws and collect urine sample, and we would meet with the financial counselor, and then the physician again if we had any additional questions.

Blood pressure was perfect: 120/80. I thought for sure it would be high because my nerves were going insane. Thank you empty stomach and 1/2 cup of coffee!
Suppose now is the time to tell you a little about me and my husband. We're both 33 years old and carry a little 'happy to be married' weight. My husband is 6'1" and built like a football player. And he has the most amazing hazel eyes. In the past few weeks we've really started to take our weight seriously, knowing what could lie ahead for us. Last year we both lost a bunch of weight, and over Christmas, Santa gave us a few extra LB's. I come from a large family and I always knew I wanted to be a mom. My husband is an only child and always wanted a large family. Win-Win!

The nurse then brought us into Dr. C's office and he was very calming. He got right into it. I was worried he would suggest trying to bring up my husbands sperm count and then several rounds of IUI before suggesting IVF. 

When I say I was worried, it's because we only have a certain amount of money to work with. Remember that retched job I mentioned? Yes, it was awful, but when I walked away from it, I left with enough stock for a rainy day or some fertility treatments. Dr. C said, 

"I like seeing patients like you. Young, with male factor. We'll see what's what with you and if everything looks good, we'll get you pregnant."

 I like this guy. He goes through our potential treatment plan and then gets into some science. Having done my fair share of research, I knew a lot about what he was speaking about. My husband was following because I gave him the Cliffnotes version of my findings. 

He said that IUI wouldn't work for us because we don't have much sperm to work with and our only option would be IVF using ICSI, which is Intra-cytoplasmic sperm injection. They can take a single sperm and inject it directly into the egg to fertilize it. Traditional IVF would have an egg in the petri-dish and then sperm would be added and one of the millions of normal sperm would make its way into the egg. ICSI does the fertilization for you. Science!

Next, we had the baseline vaginal ultrasound (u/s). I also have to mention that I've never had a male doctor as my lady doctor. So, there is a whole other layer to my nerves. But he's very professional, and makes me feel at ease. 

If you don't know what this kind of ultrasound is, please look it up. Be prepared.

After a quick peek around, Dr. C. immediately said that I had a polyp in my uterus. A uterine polyp can make it hard for an embryo to implant into the uterine wall, and should be removed. If we don't remove it, an embryo could attach to the polyp, and miscarriage is very likely. If my husband didn't have his issue, my issue would be a serious hindrance in achieving/maintaining pregnancy because of it's location. Right ovary looked good, and left ovary, 'looks even better!'

Doctor said we still had to check out my fallopian tubes. We would need to schedule surgery to remove the polyp and could do all of the other diagnostic tests at the time of the surgery.  

We then met with the nurse who told us about screening for cerebral palsy and an optional genetic test we could request by a company called counsyl. https://www.counsyl.com/ We decided to get this additional testing done because we have already come this far. I asked the nurse how many patients get this genetic testing done and she said, about 50/50.

The nurse only took one vial for the counsyl testing, and about a million other for the diagnostic testing, (ok, maybe 7 or 8) and just one tube for my husband. 

Dr. C. stopped in to check-in on us, and I asked him about the spotting I've been having between cycles. He said, it's most likely because of the polyp. 

Next came the Financial Counselor...dun dun dun!

Our financial counselor was very knowledgeable and she was able to explain our options in a clear and concise way. I know she talks about this subject multiple times a day and still she had enthusiasm and took her time making sure we understood everything. I'm going to create another post just to talk about affording IVF.

The Beginning

I’d like to start at the beginning so I’ll try to bring you to present day as quickly as I can:

It was 2009, while working at the most retched job ever that I met my future husband. We have since moved on to better careers that offer excellent work-life balance and we’re better people for it.  I’ve never been one to like taking birth-control pills, so shortly after we were married in 2011, I said: Birth-Control, meet Trash-Can, Trash-Can, meet Birth-Control.

For the next few years, we were ‘sort-of’ careful.  It wouldn’t have been terrible if we got pregnant so we weren’t very concerned.

In May 2013 we decided we were ready to really have a go at it. Let’s get pregnant! I knew I would need to start by taking a prenatal vitamin well before getting pregnant. Vitamins are my sworn enemy, and most make me nauseated, so I had to find one that wouldn’t hurt my delicate stomach.
After consulting with one of my best girlfriends/new mom, I found that I like Rainbow Light Prenatal Vitamins. They are food-based, so gentler on my finicky tummy.

Prenatal Vitamin, Check! Now, for the neurotic/impatient woman’s tools for conception:

Period Tracker App
Fertility Friend App
Clear Blue Easy Fertility Monitor
Refills for Monitor
Basal Thermometer
Lots of Pregnancy Tests

Before you think I’m crazy, hear me out. I am a person who likes control. Need as much information available to me as possible.  When I’m interested in a subject, I like to know as much about that topic as possible. I’ll research the heck out of it. I’ve always been this way, and you may think I’m a little coo-coo but this is often a silent personality trait, and only those closest to me see this side, so please reserve your judgments J And if you’re just like me, nice to see you again my friend!

People that say, ‘Relax, it will happen’ may have had an easy time getting pregnant. Or, they think you really ARE crazy and they want you to relax. Either way, this path I headed down was going to change significantly over the next few months.

In my first few months of trying, it was exciting and new. In my research, I knew that it may take about a year, but odds were better if I knew more about my body and my cycles.

I only used the Fertility monitor for two months. I’m still hearing about that purchase from my husband. It was NOT cheap, and I never got the ‘Peak’ day that I was expecting to get. I later discovered that I should have been testing later in the morning at 11 or 12, or later afternoon at 3 or 4. NOWHERE in the directions did it mention that the best time to test is late morning. I liked the simplicity of it, but what I came to discover, you’re at the mercy of the monitor. So if you have a longer cycle, say 32 days or more, you will definitely feel like you are pissing away money by having to test on day 9.

After two mildly disappointing months, I moved on to another tool: Internet Cheapie Ovulation Predictor Kits (OPK’s). I could test when I wanted, and even twice a day. You have to read the lines and know when you have a positive reading, but they are pretty easy to use, and very affordable.  (I ordered almost all my conception ‘tools’ from Amazon.)

It was during this time that I was also charting. For some people charting is easy and becomes a part of their daily life.  For me, it was something I had to be mindful of. I would get so mad at myself if I got up out of bed in the morning and forgot to get my temp, or missed getting it at the same time every morning. Charting is also difficult if you travel a lot for work, or spend weekends away from home, which was our case, when we visited friends.

Looking back at my charting, I think it came and went in spurts. I was good one month, and then have an incomplete month the next month. Once I had a few months of ovulation certainty, I was able to start testing a few days before I thought I would ovulate and catch it every month.

The one method of tracking ovulation that I never got into was observing my cervix position. For any woman who does that, you’re a better woman than me.

I have to also mention that for about the last year and a ½ I began spotting between cycles. I’ll get into that more later.

As for my emotions, I never really broke down and cried until we were about six months in. I think I held myself together because my two closest friends each struggled to get pregnant and it took them a while, with one of them taking almost 3 years to get pregnant.

I don’t know what it was, but the despair hit me hard, and I was a wreck. Every woman who has been trying for a while will know what I mean and understand. It’s our secret society where our ritual is to cry in the bathroom while reaching for a tampon/pad with general lethargy to follow. I ruined an entire weekend by wallowing in sadness.

As women, we’re taught at a young age that getting pregnant is very easy. A boy can look at you the wrong way and BAM you’re pregnant. Obviously, that isn't true, but it sets you up with unreasonable expectations when you ARE trying to get pregnant.

It was also around this time, that my dear husband started to take this whole process more seriously and was on-board with Operation: Get me pregnant! It really helps that I married an amazing man.

After about 10 months of working hard I began thinking about next steps. I know that checking out the woman is a much more complicated process, but having your husband checked is easier.

Much to my surprise, my husband bought one of those test at-home kits.  He didn't tell me he purchased it because I would probably ask too many questions. He tested a few days later and it came up negative.  I know that other reviewers state that even if it’s a faint line, it’s a positive. There was no line.

I don’t hold much stock in those tests but knew we should go ahead and get a real semen analysis (S.A.).
Most people might wonder where to get this kind of test done, do I go to my regular doctor first, or a urologist? I work in the insurance business and sometimes my knowledge base helps when it comes to personal matters. You have to be careful about scheduling a urology appointment for your significant other. Some don’t do semen analysis. Or you may have to do a consult first, then go to some lab, then go see doctor again for results. I.Don’t.Think.So!

Thankfully, we both have PPO plans, and do not need referrals for services. I suggested that my husband go to his primary doctor and have him write a script for the S.A. We live in a major metropolis and so I took a look at the large hospitals because most have labs on site. After a phone call, I scheduled an appointment at the andrology lab and hubby just had to bring the script with him. (Insurance covered the test. I’ll get into that fun topic in a later post.)

Script in hand, my husband made his deposit one rainy day in April 2014. Within 24 hours we got the preliminary results, with a detailed report being sent to the family physician within 10 days. We didn’t get a detailed report 10 days later. The preliminary report was all we were going to get. In the box where it read ‘Sperm Count (>15 X 10-6/mL)’ the technician wrote: ‘See Comment’:

Severe Oligospermia, 4/4 non-motile sperm seen in fresh sample.

WTF? Aren’t there supposed to millions of those little guys? 4!?! FOUR? 4.0.

OK. Now we’re getting serious. I was coming up on 12 months of trying, and my annual gynecologist appointment was coming up where I would tell her we tried for a year, and now what?

My gynecologist, or my lady doctor, as my husband calls her, is part of large network of physicians and hospitals. After doing my research, I knew I didn't want to go to the fertility clinic associated with that network. I’m sure she would refer me to them.

Sometimes, I need to be reigned in, as I can get ahead of myself, and for that, my awesome husband allows me to bounce ideas off of him. My lady doctor appointment is scheduled for May 8, 2014. It was after his fateful results that I started looking into fertility doctors. I didn’t want to wait when I knew we needed more information.

Where does one start? Well, I ended up here: http://www.sart.org/find_frm.html

Here, you can see fertility clinic outcomes for IVF in your area. They don’t report things like IUI or other techniques, just IVF results. It’s a good jumping off point. A word of warning though: take the results with a grain of salt. With any statistical reporting, outcomes can be manipulated.  For example, some clinics might have high live birth rates because they may only work with couples that they know they can help make a baby.

Another thing I did was look up each clinic I was interested in. View the website, check for reviews. Again, take reviews at face value. What prompts someone to post a review? Either a very negative experience, or a very positive one. There are many in-between experiences that we never hear from.

I researched the doctors in the practice. I also looked up where they were located. If you end up in the IVF boat, you will need to determine if its location will work for you. Can you get to your appointments and then head into work within a reasonable amount of time? Check out the clinics operating hours, do they have early morning appointments and evening appointments? Do they have multiple locations? Will you been seen by a physician at your visits or by a nurse?

I decided on a clinic that has several experts in Reproductive Endocrinology (RE), has a lot of face time with the physician, was close to my work, and had great hours. I also got the warm and fuzzies when researching the provider. You will need to do what’s right for you, especially if you are paying out of pocket. 

Welcome!

Welcome to my blog! After much deliberation, I decided it was important for me to journal my experience with Infertility. God knows I’ve spent a lot of time trolling the internet for information on everything from Pre-Conception, Diet & Exercise, Recipes, Charting, Ovulation, to Infertility that I felt the need to share my journey so if there is someone out there like me - it might help! Plus, I sort of like being held accountable to document this time in my life and what better way to be held accountable than to put it on the internet!

My personal disclaimer: Any recipe or products I share with you are because I’ve tried them and loved them (or hated) and I’m not being paid to promote anything.