Egg Free is the Way to Be

I had my egg retrieval on December 13. I know, you're so excited that I'm yet again blogging about IVF. :)

For those who aren't sick of hearing about my reproductive woes, here goes.

I got the call from my doctor Tuesday afternoon that we were a go for Thursday egg retrieval. That meant that I would take my normal shots at 8PM as well as an additional two shots at 11PM. People--I'm old. I wake up at 5:30AM for work, so I am definitely asleep by 11. I had to set a dang alarm for this shot. I was so paranoid that I had Brad set one, too.

That was an excellent move on my part because guess who shut off the alarm as a minor nuisance in her sleep? This lady.

Anyway, took my shots like a champ and went back to bed.

Brad went to work as normal the next morning and I waited for my dad to arrive to drive me to the hospital. Luckily, Brad works at the hospital where my doctor and all procedures are, so it works out nicely.

You know what else works out nicely? Valium. I got to take a valium upon arrival at the hospital along with the smallest sip of water. Then, I was taken to my "room" to put on the gown and wait. Dad waited with me and kept me calm. The valium probably helped with that, too.

When the doctor's were ready, I was taken to the procedure room. When they called to schedule this, they encouraged me to bring some music to listen to. I made a lovely mix CD of songs that reminded me of Brad and why we were doing this and it began to play when I was brought to the procedure room. The hooked up the pain meds to my IV to help keep me sedated and pain-free. A man named Steve opened a trap door from next door (the lab) and had me verify my name and birth date. Steve's job was to take the eggs, fertilize them, and grow them in my petri dish.

The retrieval itself is a bit fuzzy, as it should be, but recovery was a little rough. While I was still at the hospital, I managed to almost pass out and I did get sick. Dad stuck with me and Brad came to visit for awhile, so I felt well-cared for. Just rough. After they released me, I laid on the couch at home with Dad nearby. He wanted to stay with me until Brad got home from work. I was OK once I was released and I slept for a bit.

I had made it through that part and I had the knowledge that our children were conceived while Brad was at work and I was hanging out with my dad. How many people can say that?

Ovaries Like Footballs

I know I've been a total slacker about writing and I apologize. I've been a little busy, though, giving myself shots every night and winning battles with the insurance company.

Last you heard, the insurance company had informed us that we had zero coverage for IVF and they sincerely apologized for two months worth of telling us that we did. Well, that was ridiculous to me and we continued to fight. I asked for a document to review with my lawyer (not an empty threat) and they came back with a settlement offer. A very nice offer. We reviewed that with the lawyer and Brad and I agreed to sign it. They gave us the maximum infertility benefit as a lump sum in exchange for dropping the fight and agreeing to not submit claims. We're still waiting on the check (last I heard, it was mailed on Friday) and I'm so excited. The settlement is enough to pay for two tries and the new dining room chairs we ordered. Priorities, people.

My Follistim kit. Pretty user-friendly.

 

While we were in the midst of fighting with insurance, Brad's parents loaned us the money we needed to start the process. I was on birth control pills for three weeks in order to regulate my cycle and then I began nightly injections on November 30. For one week, I had nightly injections of Follistim. I began at 150 units, but had to double the dose in order to see results. Beginning on December 3, I've had every other day ultrasounds and bloodwork to check progress. I added another shot--Ganirelix-- on December 7. I've done really well with giving myself shots, which is a huge deal. My poor stomach has little bruises and I'm bloated, but I'm surviving and thriving.

Follistim pen in use. Well, not actually.

This picture was a bit staged as I need both hands

for my shots--one to operate the pen and the other to a bit of stomach chub.

 

At this point, I have around 16-20 follicles of varying sizes happening. Most are mature, which means they're huge. It hurts to sit sometimes and I'm wearing dresses the rest of the week for comfort purposes. Hence the title of the post. I know they're not really the size of footballs, but they feel big.  I've also had to increase my fluid intake to keep headaches at bay. And I cry. A lot. Pretty much, I'm a mess. I'm so optimistic about this, though, that it makes up for it. I'm going to add my trigger shot tonight or tomorrow and they'll harvest and fertilize my eggs on Thursday or Friday. That means that implantation could occur as early as Sunday or Monday. Guys, it's happening. We're moving forward.



I will keep you updated as we learn new things, but expect maybe some silence or fluff posts around January until we're OK sharing the news (either way it goes). Oh, and because they're gorgeous, here's our new chairs that United Healthcare paid for. Brad's dad is building us a dining room table for Christmas and I'm beyond excited for that, too. More frequent dinner parties are for sure in my future.

These beauties are from Industry West.

We have six of the tall ones and two of the short ones.

Sperm in a Coffee Mug

So, much like the title implies, we extracted Brad's sperm yesterday. Because he was born without a vas deferens (exit ramp, if you will), the doctors had to go in and manually extract from the source. Brad got to marinate in some local anesthesia (he also had a shot and some pills) and then they stuck a huge needle in there to gather his reproductive material. I, then, was handed a to-go mug with the vials tucked inside so I could drive it to the lab. People, this was real-life. I was driving around in the wind, rain, and sleet that was Cincinnati's Hurricane Sandy with a to-go mug of my husband's sperm.

We gathered five vials to freeze. They like to shoot for three vials, so Brad did wonderfully. Both the urologist and the lab immediately found the presence of sperm. Brad slept most of yesterday away and hasn't had to take any pain medication. He is a trooper! I know he's just thrilled that it went well and his part is completed.

My part is next. I'll start on the medication protocol in the next week or so and we'll go from there. Brad's parents are loaning us the $8250 we need for the IVF and I'm still fighting with United Health Care in order to recoup most of that money. Brad's procedure yesterday was $1200 and we plan on fighting with United Health Care for that and also relying on our flex spending account. Once we pay the doctor the $8250, they'll go ahead and prescribe my medications. Normally, they would run around $4,000. However, I was asked yesterday to be part of a research study looking at success rates for control women, obese women with PCOS, and lean women with PCOS. Apparently, it's hard to find women for the lean PCOS group, so they really need me. It doesn't mess with my success rates and pays for $2800 of my medications. There's an extra blood draw and a procedure to measure the size of my uterus (which I've been warned can be similar in discomfort level to the HSG x-ray). I'm in, I think.

I'm sorry for the sporadic updates. I'm still trying to figure out a balance in my life right now between work, Brad, IVF, and adoption training. Stay with me, please. I think it'll be worth it.

Currently...

So, I haven't really written here in a while and a lot has happened.

On September 16th, Brad and I celebrated our first wedding anniversary. We ate cake, bought me some flowers, ran out of gas on the highway, and had an amazing dinner overlooking Cincinnati and Northern Kentucky. We didn't let the baby stuff get in our way and I'm so glad for that. I love that man so much. He is my favorite.

Fancy dinner time!

 

 

Since then, we have made a pact to not buy anything for birthdays or Christmas this year. Growing our family is our priority.

 

We had talked about adopting well before we even tried having a baby, so it wasn't any surprise to us that we went ahead with investigating that as an option. We've been attending our training class for three weeks now and look to be approved by February or March. The program we're going through will lead us through a straight adoption or a foster-to-adopt situation. The state of Kentucky pays for all costs associated with adoption, so that is saving us $20,000-$30,000. We like knowing that our approval will be in place so that we can adopt when we're ready.

 

We've also been chugging along with infertility treatments. I've been doing my homework with our insurance carrier to ensure coverage and even had appointments lined up. My insurance company set up a telephone conference with me for this past Monday just so we could clarify coverage. Overall, IVF was covered, but I was getting some inconsistencies as to the nuts and bolts of covered procedures.  Well, on Monday they called to clarify that IVF IS NOT A COVERED PROCEDURE.

 

I was pissed. I had two months of countless telephone calls (kept in a notebook with representative's name and reference number of call) that had confirmed coverage. Now, they were taking it all away and offering me a simple, "Sorry." I'm still so, so angry. The lady that I spoke with encouraged me to appeal and cited all of the documentation that I had.

 

Long story short, Brad and I are making a go of this this winter. We're scheduling the appointment to extract his sperm and I will start the first round of self-injectables in about seven weeks. By the time we do our first injectables, I need to pay the office $9,000. That doesn't count the $1800 for Brad's procedure ($1200 if he just does this with a local anesthesia) or the drugs I'll need (around $4,000). The cost is huge. One of my drugs is $3,000 alone. The office can obtain samples of that, but they're not sure they'll have them in time for me.

 

I'm a wreck at work. I don't feel like I'm doing my job to the best of my ability. Most people around me know what is going on and, in a women-majority workforce, they understand and help me out. It still doesn't mean that I feel good about it. I am trying to relax at this point. I'm going to start crafting the appeal letter now so that I have the letter and accompanying documentation ready to be mailed when we finish procedures in late December/early January.

 

The part that still creeps to the front of my mind when I'm trying to work and live my life is that there is no guarantee. Brad wants this to be a one-shot deal and I support him in that. He is supporting me through trying it once. Not only is the financial cost huge (and I hope to recoup $9000 of that back from the appeal), but the emotional cost is greater. We're going to ask for two embryos to be implanted, but there is no guarantee that we'll get good embryos to implant or that either one of them will stick. I am gearing myself up for that because I will still need to go through the appeal process. It will nearly break me, I'm sure, to appeal and fight for a failed IVF attempt. The emotional scars will be great.

 

I guess I'm asking for support right now. I need prayers. I need snark about insurance companies. I need letters of support and hugs. I need money. If you can help with any of the above, I'll be happy to give you my address. There is nothing better than getting a card in the mail and knowing that someone cares. I have two of those cards and they live in my files and doctor notes as a reminder that Brad and I are strong enough to get through this. That we're not the only ones going through it.

 

Thank you for reading this. I know a lot of people are curious as to how everything is going. I'm going crazy over here and trying to be strong. It's hard to write about everything, but I'm trying to keep you all updated. I still feel like we are supposed to share our story and I'm still working out how to best do that.

 

Melanie

melaniemcb at gmail dot com

My Blog, Elsewhere

Guys, I am going to be blogging for The Bump a few times a week, so please check out that site for updates on the infertility journey.

You can check out my first post here.

Fantastic News

My niece after eating an ice cream cone.

She perfectly represents how happy I am today.

 

 

You guys, I got the BEST news today. United Health Care has added infertility benefits (finally!) and they cover IVF!!!!!!!!!!!!!!!

I called them to verify what I saw in print online and I have the printed copy and the reference number for my call and they'll cover it. They'll even cover to store (freeze) reproductive materials, such as sperm and embryos. 

I'm so happy I just want to shout it from the rooftops and cry all at the same time. This is such a blessing and a relief.

Thank you for any good thoughts and prayers. We still need them and appreciate all of the support. 

:)

Fertility Update

I'm sorry, guys. I feel like I've abandoned you, but I needed the break. I have lots that I want to share with you, such as how the rest of summer was, first day of school (students started back today!) and updates from some other things. However, I wanted to let you know how things are going on the baby front. I feel like I dumped a bomb on you and then never came back to help clean up the pieces.  My bad.

Also, please note that this will not turn into a fertility blog. I just write about everything and anything going on in my life and this is a pretty big part right now. I also still feel like Brad and I are very much supposed to share our story.

OK, so when we left off, we had just heard initial notes from the doctors. We have come so far since then.

August 7, 2012: Brad saw a urologist who officially diagnosed CBAVD (Congenital Bilateral Absence of the Vas Deferens) (laymens' terms--he has no tube to carry sperm out of the body). Brad may be a carrier of the cystic fibrosis gene or he may only have one kidney--both are linked to CBAVD. We are waiting on the Dr. to put in the order for an ultrasound for Brad. Brad's hormone levels are also a little low, so the urologist prescribed Clomid. The plan for Brad is to take the Clomid for three months in preparation for sperm extraction. The doctor's refer to this as "testicular aspiration" and I think that sounds ridiculous. They're going to knock him out and take sperm. Call it like it is, people.

August 15, 2012: We consulted with a fertility doctor who specializes in artificial insemination (also called IUI). He ordered a lot of blood work and procedures for me to finish out the diagnosis for my side of things. So far, I know that my estradiol and FSH are good. I also know that I am heterozygous for the MTHFR gene, which is involved with blood clots. That gene puts me at a higher risk for developing blood clots, but it turns out that another of my factors is wonky (will update when I know the name Update: It is the anticardiolipin antibody IGM that is elevated.) is a more significant risk. I also had an x-ray today (8/22) called an HSG. They injected contrast dye into my business and x-rayed to make sure that all my tubes and uterus are open and inviting.  Good news--they are. We are still waiting on some of the blood work to come back (including my CF gene testing). Current medications: Prenatal with DHA, Vitamin D, Calcium, MTHFR capsule. Also, he explained why we would need to investigate IVF (which he doesn't do)--sperm goes through its final maturation period in the vas deferens. When it is extracted before going through that, it's like pulling out tadpoles when you need frogs. The sperm aren't great swimmers and won't be able to make it to an egg. That rules out not only IUI, but regular IVF. We would need IVF with ICSI. In everyday words, IVF puts eggs and sperm in a petri dish and plays the love-making music. With ICSI, scientists will literally place a sperm in an egg and make the magic happen.

August 22, 2012: In addition to the HSG x-ray this morning, I consulted with an IVF doctor this afternoon. He went over a lot of the history (which I'm getting a little sick of sharing) and then did an ultrasound (my second this week). He said everything looked great and even did a mock implantation to see if my systems are open to IVF. They are. The Dr. explained that for the first go, they would implant one embryo. I have over a 50% chance of that resulting in a "take-home baby" (their words). If subsequent rounds of IVF are needed, they will start with any frozen embryos we have and implant up to two. My chance of "take-home baby" are around 38%.  I met with the financial adviser, too, to see exactly what we were looking at.

The group offers a money-back guarantee IVF, but we aren't eligible for that since we have to surgically extract the sperm. So, the first round of IVF will cost us $9200 (plus the cost of drugs, which can reach $2,000-$3,000). My plan is to call insurance tomorrow to see exactly which pieces they will and will not cover. Then, I want to start baking for a Bake Sale for Babies. Ha. The financial piece is big. I'm trying not to focus on it, but Brad and I certainly don't have $9200 for IVF, plus whatever other pieces we'll need, such as sperm banking and embryo freezing. I'm not sure how we'll come up with the money, but I know that neither of us want money to stand in the way of having a baby.

*Sigh* There's all the official things we've done since finding out the initial news. We've also talked with friends who we have found out are facing the same issues and coworkers who have gone through similar struggles and emerged with children. So far, we have yet to talk to anyone who has gone through IVF. I'm also struggling with anger and frustration. I'm getting really upset while reading facebook and twitter if one of my friends is complaining about morning sickness or pregnancy discomforts. I am doing a pretty good job of biting my tongue because I am so happy for them and I love them. I know they aren't trying to hurt me. I also know that I'm frustrated and angry with what Brad and I have to go through--I'm not mad that they're pregnant, but I'm hurt that I'm not.

Again, I feel like I'm not explaining all my feelings very well. I'm sorry. I'll try to work on that, but it is not easy to explain the myriad of emotions I feel (sometimes in five minutes' time). Please feel free to ask questions.

Melanie

Trying

Brad and I have been trying to get pregnant since the beginning of the year. Instead of this being a post about how happy we are about an upcoming arrival, I am writing to let you know that we are feeling anything but happy right now. However, I feel like we are supposed to share this journey, so please bear with me.

 After six months of unsuccessfully trying to get pregnant, my doctor asked us to go through some routine testing. I simply had to have my blood drawn on day 21 of my (irregular) cycle while Brad had to undergo a semen analysis. My results came back first and my doctor informed me that my progesterone levels were so low that he didn't believe that I was ovulating. He recommended Clomid, but wanted to have Brad's results before we moved forward. We were disheartened by this, but not too badly. My sister had been through the same sort of thing and now has two beautiful girls. I half expected that I might need a little extra help. Brad's results came around a week later. I was putting away dishes when he came to me and said that the doctor called. The sadness filling his eyes told me a lot, but I needed to know what the doctor said. We were both crying as he told me that there were no sperm in his sample. The doctor also noted that he couldn't feel the tubes designed to carry sperm. He recommended that Brad make an appointment with a specialist.

 Brad and I have a lot of questions about what will happen. We are sad, distraught, angry, and hopeful. As we cried over the news, we both talked about the unfairness of the situation and how much we wanted to be parents. I cried over the possibility of never being pregnant. Brad cried over feelings of blame. We've been a wreck all week, really. We talked about adopting, which is something we've talked about before. We never thought adoption might be our only option, though, and that is a hard pill to swallow. We started talking about options we know are out there (sperm bank, in vitro fertilization, etc.) and what lines we might not want to cross. We talked to our parents and siblings. We talked and prayed with our pastors. Limbo is the worst spot to be in. Brad and I are trying really hard to hold off on discussing options until we know what the options really are.

 I want to type more about how this feels, but I don't know how. Also, it just hurts. It hurts when people have been telling us for six months to do it on such-and-such days or assume that they got pregnant first try and we would, too. It hurts when we're asked when we'll be having kids. It hurts to see friends and family share their pregnant news or photos of their babies. It doesn't mean that we're angry with those who ask about expanding our little family. We know they mean well. It also doesn't mean that we're not happy for those expecting babies or cuddling their new babies. We love babies and are so happy for the joy they bring. We are just in a state of questioning. I no longer assume I'll be pregnant, but I do believe that Brad and I will have kids one day. If you have a story of your own to share, please do. Brad and I figure that we're not alone in this, but we've never heard of a story quite like ours. Please feel free to comment or to email me at melaniemcb at gmail dot com.

 P.S. If you are family/close friend and are learning about this through the blog, please understand that it is very hard to rehash again and again. We love you and wanted you to know what we're going through, but it is so hard to talk about over and over. Thank you for understanding.