Day 5: Undecided

We got our packet of information from the clinic this weekend. It is a folder which contains a slew of instructions, consent forms and details about our upcoming IVF cycle. We are suppose to read it and be prepared to sign the various release forms in front of a witness (the Dr.) during our Informed Consent meeting on the 17th.

The packet contains a consent form that is 6 pages in length titled "Authorization For Embryo Cryopreservation." Basically, it is all what we want to do with any extra embryos that are created during our IVF cycle. In all of our meetings with the Dr. thus far, he has been very optimistic about the ability for me to stimulate well and therefore generate lots of eggs for fertilization. At one point he quoted 10-15 eggs as what he might expect. Now, not all of those eggs will probably fertilize and become viable embryos, but there is a very good chance that we'll end up with more embryos than than the 1 we plan to put back. Therefore the question is, what do we want to do with those extra embryos?

In the short-term, the answer is simple. We want to save them in case the cycle doesn't work (although we all know that won't be the case) or when the time comes for us to further extend our family.

It is the long-term that raises questions. There may come a time when our family is complete and we may still have frozen embryos in storage. Additionally, the form asks us to provide instructions on the future of our embryos in the event of "special situations" such as divorce, death of a spouse, death of both of us, etc. We're essentially given 4 options for consideration:

1. thawing and discarding the embryos according to clinic protocol
2. cryopreserving and donating the embryos for research purposes
3. cryopreserving and making them available for use by X and X.
4. cryopreserving and donating the embryos for anonymous use by another person or couple

I brought this topic up during dinner tonight with the Husband. He was quick with an opinion. Anything other than option 1 (thaw and discard) didn't seem right to him. He didn't like the idea of an embryo with our genetic make-up out in the world without us.

I, on the other hand, am undecided. The "discarding" language of the first option upsets me slightly and I can't help but hear a flushing noise when I think about it.

Part of me is also very uncomfortable with the idea of donation. The idea that our embryo, with our DNA, could come into this world as part of another family. But at the same time, I know the extreme pain, heartache and yearning that comes from infertility and there is something about the possibility of us helping another couple recognize their dream of a child that I think warrants some thought.

The research option also interests me as I understand that research on embryos has the potential to produce many major medical discovers such as cures for previously untreatable diseases and disorders. However, I am aware of the ethical and religious views on these types of experiments.

So, I am undecided.

I think we'll both sleep on it for a few nights and see where we end up as we know there is really no right or wrong answer. We just need to determine what feels right to us.



Total Pill Count: 6 Total Shot Count: 0

Day 4: Bye Bye Happy Pulse

I had an acupuncture appointment this morning. I started going in October so I am going on my 4th month of treatment. Overall I like it, but honestly if it wasn't covered by our insurance I am not sure I would pay $85 per treatment. But research shows that it can help with infertility and conception so I am giving it my best shot and keeping an open mind.

When I first started going back in October, I am pretty sure I had some really bad Qi going on. The acupuncturist didn't come right out and say that at the time, but I hear it in her comments now that things are flowing more smoothly.

A typical appt goes as follows: she welcomes me in, we sit and talk for about 10 minutes. This is my chance to talk about where I am at with my cycle, and how my body feels in general (pain here, bloating there, etc). She then decides on my treatment plan for the day (which acupuncture points need attention) based on what I tell her in those first 10 minutes as well as an examination of my pulse and my tongue. She inserts the needles, sets up the heat lamp on my feet, puts on the calming music, turns down the lights and lets me rest for 45-60 minutes.

In Traditional Chinese Medicine, pulse diagnosis is important for two reasons - it can give very detailed information on the state of the internal organs and it reflects the whole complex of Qi, Blood Yin, Yang and every part of the body.

Over the past couple of months she says has seen a noticeable improvement in my pulse. In fact, last week she was thrilled with my pulse. "It's a happy pulse" she exclaimed! This week, the happy pulse was gone and while it was still relatively relaxed, there was a 'tenseness' in it. She described it like taunt string. She thought could be from the disruptive sleep I got this week (something I told her during our discussion).

This diagnosis led to a few new acupuncture points today including a few at the top of my head to "calm the brain." Ironically, today was one of the few occasions that I didn't sleep during treatment as my mind was racing. I guess my brain wasn't in the mood to be 'calmed.'

Pill Count: 6 | Shot Count: 0

Day 3: Plan B

While I was sitting at Walgreens last night waiting for my birth control prescription, two teenage girls came up to the pharmacy counter and told the guy very casually, "we need a Plan B." He checked their ID, they handed him a pack of candy to add to the transaction and $37.98 later, the transaction was done. They had their Plan B in hand and were on their way to "preventing pregnancy after known or suspected contraceptive failure or unprotected intercourse."

I've always considered myself pro-choice, but I must admit witnessing this transaction made me very sad. Here I sit wanting desperately for a baby after 2 years of trying about to spend $15k in an attempt to have one. These girls want desperately not to have one and hand over their $36 to ensure they don't.

Day 2: Baseline & Bloodwork

Big day today with our first visit to the Dr. since our official IVF start. Got a lot accomplished today at the clinic, so brace yourself for a long update. So far everything is going according to plan and I am happy to finally be 'in progress.'

Here is an overview of the various appts we had at the clinic. The only inaccuracy was that we didn't get all four things done in 15 minutes. We were there for over an hour.


First up when we arrived was a slew of blood work for both of us. They took 6 vials of blood from me. I sat there and watched the blood flow out, vial after vial getting filled up for testing. The Husband got off a bit a bit easier and just had to give up a measly 3 vials. The lab work included infectious disease screening for both me and the Husband, as required by IVF laboratories. Preconception screening is added for me (hence the 3 extra vials), which includes: my blood type, immunity to varicella (chicken pox) and rubella, a complete blood count (testing for anemia), prolactin and thyroid levels.

Next, we moved on to what they call a follicular ultrasound which is basically a vaginal ultrasound that looks at the uterus, ovaries and follicles. Purpose of today's ultrasound was to get a baseline count of how many antral follicles I had developing. Ultrasound counts of ovarian antral follicles are a good predictor of ovarian reserve, egg supply and the expected response to ovarian stimulation with medications. The doctor described looking at your follicles sort of looking at a chocolate chip cookie. The dark areas (the chocolate chips) are the follicles within the cookie (ovary). Well, I am happy to report this girl makes a mean chocolate chip cookie! My follicle count was very high. 25+ on one side and 15+ on the other. This is a positive sign and means that I should stimulate well and generate a good quantity of eggs. In IVF cycles a good quantity of eggs is a good thing! The only negative, is that because I had so many follicles already (without the help of meds) they need to be careful not to overstimulate me which can lead to a serious medical condition called hyperstimulation ovarian stimulation and could put me in the hospital. So to avoid this, the Dr. has decided to extend the suppression phase of the cycle...more about that later.

Final stop at the clinic was a meeting with our nurse to go through the schedule in more detail, get upcoming appts set and get meds ordered.

Got a call this afternoon from the nurse once the Dr had a chance to review my blood work and the ultrasound results. And the good news is that everything looks good (no cysts or concerns) and I am approved to move onto the next phase of treatment which is the "Suppression" stage. This phase will last about 4 weeks and the purpose of this stage is to use birth control and a medicine called Lupron to prevent ovarian cysts from occurring, and to block spontaneous ovulation during the stimulation cycle. Basically, during this phase they want to shut down your reproductive system so that they can have full control of it.

So next up on the schedule is 2 1/2 weeks of birth control pills and a baby aspirin every morning...let the meds begin and let the control end.



Total cycle pill count: 2

Day 1: Financing & Paperwork

YAY! We’re officially at the starting line. Day 1. For the next 8-10 weeks we’ll be living our lives on truly a day-by-day basis. Every day for the next 60+ days has a task for us to complete (appointments, shots, tests, etc). There is no doubt, this treatment plan will be intesnse, but as a list person, this to-do list regimen is right up my alley.

Today our biggest decision was regarding financing and payment. We met with a financial counseler a few weeks ago at the clinic. She gave us an treatment estimate for 1 IVF cycle with a total of $13,070 + medication which is estimated to add an additional $3,000 - $4,000. So all up, one cycle through the clinic is about $16,000 - $17,000. Unfortunately, for us zero, nada, zilch of these costs are covered by our insurance so all $16-17k will be out of pocket.

Since she knew we were paying out of pocket, the financial counselor also mentioned to us a partnership they have with a company called ARC. The way I understand it ARC has partnerships with clinics nationwide and they offer ‘package’ deals and refund guarantee programs. The good news is that it has been a while since the clinic has renegociated their fee rates so the ARC contracts in place are based on the old, less expensive fees. So I called ARC and found out that we could get what is called a “One Cycle Plus Plan” for a total of $9,437 at a base cost. The plan give us a ‘bundle’ deal of 1 fresh cycle and 1 frozen cycle for a cost lower than the 1 cycle directly through the clinic. Duh, that’s a no brainer. Sign us up! Now there are a slew of costs this bundle deal doesn’t cover (meds, baseline ultrasound, trial transfer, anesthesia, etc.), so I estimate that the total cost is really like $15,000 for one cycle, but we’re still saving about $1-2k and we are still getting the 1 frozen cycle basically ‘free’ with this plan. I also think it was very was nice for the counselor to suggest it since it sounds like less money for the clinic at the end of the day.

So then the tough decision for us was considering what they call a “Refund Guarantee Program.” Basically this is an add on insurance policy. You pay an incremental amount more, but if not successful at the end of the 2 cycles, you’ll get a portion of your money back. We filled out an application and it came back with an add on cost for us of $7,000. So if we added on the refund guarantee we pay $16,400 instead of the $9,400, but if not successful at the end of the 2 cycles, we’d get $11,000 back.

I was a bit discouraged by this figure as a result of my application. Basically this tells me that they think there is a pretty good chance I may fail, and therefore a pretty good chance they’ll need to pay out the refund. Therefore they want to charge us a crapload upfront to help mitigate the risk. The analogy to this would be the auto premium that is charged to an 18 year old male driver of a red sports car. Seriously, am I that much of a risk?!

Anyway, we talked about it and feel like this is NOT A GOOD DEAL. We’d rather keep our $7,000 in the bank. Hope, pray, beg, and think positive thoughts that this will work for us and if for some reason it doesn’t, we’ll decide where to go from there.

So we signed the 7-page contract for the One Cycle Plus Plan and sent in the credit card #. It is a bit painful for me mentally to let go of the money aspect all of this. It is one of the many unnatural parts of this IVF process and in some ways we feel like we are buying our baby. As a bargain shopper (I LOVE a good deal) I can’t help but feel like we’re getting screwed. Why do we have to pay $15,000 of our hard earned savings to get something that 95% of the population gets for ‘free? In fact some people get it for free and don’t even want it.

But, I just need to remember a lesson my parents ingrained in me at a very young age —Life isn’t fair. Unfair is right.

Big day tomorrow with an 8 am appt with the Dr. I’ll send out an update tomorrow night with the details!

Let the TMI begin...

As I finished up that first post, I ironically started my period. Let the official IVF process begin. I'll put a call in to the official "Day 1" voicemail line tomorrow at the doctors.

After sitting on the sidelines for the past 3 months I am ready to go. I am $20,000 and 8-10 weeks away from a potential pregnancy. That gets me excited!

Another blog...

I've thought long and hard about documenting our struggles with infertility on our public family blog. It is suppose to be ALL about our lives and in a lot of ways I feel like a fake painting a picture that our life is always rosy and fun filled with romantic dates, exciting trips and fun with friends, when behind closed doors that isn't always the case. Yelling, screaming, tears, heartbreak, jealously, anger...Behind closed doors our lives have been anything but rosy and fun over the past 2 years as we have desperately struggled to have a baby.

In some ways I want share all of the details with our friends and family since I tend to be a pretty open person, especially with those close to me (and, oddly sometimes with strangers -- e.g. the yoga teacher I told today about our IVF!). In other ways I've lost a lot of myself during this 2 year struggle and in many ways and on many days I am a screaming, crying, mess of a person. This messy, vulnerable person isn't someone I want to share with our larger social group.

So why start another blog? Well, for a few reasons:

- I think it will help me to open up about this process. I often go to bed at night with a lot of it bottled up in my head and heavy on my heart. The Husband can only handle so much and in some ways it is a whole lot easier to talk to a keyboard and computer screen than a real person. For one, they don't judge and two, never say the wrong thing.

- There are hundreds of blogs out there about IVF and infertility and it has been so helpful to read about the experiences of others. Plus, just about every blog I find about IVF eventually makes the "I'M PREGNANT" post so perhaps there is a part of me that thinks there may be some good karma which comes from sharing your story and helping other desperate and confused infertile women. And if good karma is being passed around, I want to be sure I'm in line to receive a generous helping of it.

- And finally, the blog will be a great distraction for me. The waiting game that is involved in this process is more painful for me than any of the shots I've received or the procedures I've undergone. I want the next few months to fly by and blogging is a good time suck activity.

There is a very good chance that no one will ever read this blog besides the small handful of friends I will share this URL with...and I am okay with that. But I also welcome others who may find me via search and find comfort in the fact that they are not alone on this long, windy, scary road of infertility.