Tuesday, November 25, 2014

Day 2 - First Injection.

I went for my baseline blood work and ultrasound and immediately afterward I headed into work.  Anytime I go in for blood work or an ultrasound the nurse will call with the results between 1:00 - 3:00p.  On schedule, the nurse called and let me know that everything looks good and there were 8 to 9 follicles visible on each ovary - which is very good.  In fact, it's even slightly better than my first ovarian reserve count. Small victory!

The nurse also gave me the go ahead to do my first evening injection tonight and begin my twice daily injection protocol in the morning.  I prepared the syringe along with the web video and without too much hesitation, let it rip.  The poke is actually very smooth and painless and the medicine did not irritate or burn.  All good and I am so glad to have the first needle behind me.

Now off to celebrate over a Margarita with Tower.......might as well.  I'm going to be cut off in a couple weeks.

-nineteen eighty

Monday, November 24, 2014

Day 1 - Janky Genes.

I started my period this morning so it is time to finally get this show on the road!  I called the nurse line and left them a message - yo!  Aunt Flow is in town.  They returned my call fairly quickly and scheduled me for my baseline bloodwork and ultrasound for tomorrow (day two).  The baseline testing needs to be done on day two, three, or four of your cycle.  I was feeling nervous, yet excited that this journey is about to begin.

Then.....about an hour later I received another call from the nurse.  She said, I don't know how we missed this but your Cystic Fibrosis genetic test came back and you carry the gene.  Fuck, really- you are just telling me this now.  She proceeds to ask me if my husband was tested....no, he wasn't....well, then we would really recommend that you wait to proceed.  Fuck!  I had just wrapped my head around the fact that this process was starting.  Not to mention, I just spent $5,000 on medications.  She goes on to say, that it is our choice but they need to their due diligence and explain the risks.  She also recommended that Tower be tested for the gene and we schedule a genetic counseling session.  

As it turns out, a Caucasian person has a 1 in 29 chance of carrying the gene.  If both Tower and I carry the gene, then our child would have a 25% chance of having Cystic Fibrous.  On top of that, we have a 45.6% chance of this IVF cycle working out.  It's just like playing roulette in Vegas - do you want to place your chips on red or black, baby?!?  I hate that.

Tower and I decided that we would proceed with this cycle.  If things would have worked out naturally for us, we wouldn't have this tidbit of information.  And as it is, I am uneasy with the amount of science that goes into this.  Raised Catholic, I'm uncomfortable with playing God.  In the meantime, Tower will get tested and if this cycle doesn't work out we will know more going forward.

- nineteen eighty

Saturday, November 22, 2014

Box o'IVF meds.

Tower picked up a huge box, containing my medication today.

The box.

Stimulation Medication - these medications work to directly stimulate the ovaries to produce follicles.  I was prescribed both Follistim and Menopur.  For approximately 10 days, I will inject the Follistim in the morning and Menopur in the evenings into my belly.

Holding Drug - this will prevent ovulation while continuing to stimulate my ovaries with the stimulation medication.  I was prescribed Ganirelex, another injectable, and this will start around day 5 of my cycle.

HCG - this medication is known as the "trigger shot", meaning it induces ovulation within 35 hours.  It was was prescribed Ovidrel and you guessed it - it's another injectable.

Progesterone - this medication is used with a treatment cycle to support the endometrial lining.  There are actually several different types but for the sake of no more needles I selected Endometrin which is a vaginal suppository.  This is used after the embryo transfer.  If the transfer is successful, use will continue until week 12 of the pregnancy. 

Our out-of-pocket grand total for this was $5,183!  It's shockingly expensive and you better believe they make sure it's paid in full before they give you the goods.  This is after assistance from our insurance company, which after a $3,000 deductible pitches in and cover a percentage of the cost.   Fuck, that's a lot of money.  When I whined to the pharmacist she reminded me of how lucky we are because people that pay completely out-of-pocket are slapped with a bill in the range of $6,000 to $7,000.  And let me remind you this, is just for the cost of the medication.  The IVF procedure is whole other bill.

We were also lucky enough to have $450 to apply towards the $5,183 in meds from a health savings account, Tower's company provides.  If you are looking into fertility treatments do your due diligence and look into starting a health savings account or a flexible spending account beforehand.

The hugely frustrating thing about the meds is that the Fertility Center gave me a list of medication options under each one of those categories.  It was incumbent upon me to do the research on each of them and chose which ones I wanted to use.  Additionally, I was provided with a list of specialty pharmacy to call and price out the said drugs.  Unfortunately, you can't just go to the Walgreens down the street.  This is so dumb - the process is so confusing and stressful as it is.  I would be so much more comfortable if they selected the medications.  Especially if the recommendations were based on success rates.

I took the easy way out and called just one pharmacy on the list, I selected them because they were local and we could pick up the medications.  Believe or not, said pharmacy has a dedicated line to a fertility department and those people know their stuff.  They were able to quote me the prices off the top of their head and because they were local were familiar with what most people who go to my doctor select.  They also were able to explain which ones were easiest to administer.

The other thing that I am shocked about is that the Fertility Center does not give you any instruction as to how to administer the drugs.  Instead they directed me to this website to watch freaking videos.  Dumb.  And I am scared.

- nineteen eighty

Friday, November 21, 2014

IVF & Me.

It has taken me exactly one year to get this point.  Tower and I just celebrated our one year anniversary, which means we've officially been trying to start a family for 12 months.  I'm 34 and he's 37 so given our age we decided to hit the ground running. 

The first couple of months of trying consisted of monitoring my cycle with the p tracker and clue iphone apps.  After that didn't work, I graduated to the ovulation predictor kits (OPKs).  According to the smiling pee sticks, I was ovulating and my cycle was on point.  Yet, still no success.  A few months later, I met with my gynecologist and she ordered the typical protocol for someone who is trying to conceive.  This included blood work to test my follicle stimulating hormone and progesterone level,  and a hysterolsalpingogram (a test to determine if both Fallopian tubes are wide open for business).  Tower was also summoned to get his swimmers tested.  Everything for both of us was normal.  I was then referred to a Fertility Center in Pittsburgh.  More testing ensued; more normal results.  The only exception was that from my hysterosalpingogram, my doctor could not say with 100% certainty that both of my tubes were open.  I found this super annoying because the doctor who conducted the test, said they both looked good.  GAH!!!!!!  

Another one of the factors my doctor looked at was my ovarian reserve which measures your antral follicle count.  My understanding of this is that it's a measure of the quantity and quality eggs you have left.  My count was 12 and they really want you to have at least 9.  I passed and am in a normal range for my age, but did not achieve rock star status. 

So based on a possible clogged tube and not achieving rock star status my doctor recommended IVF.   I'd rather be able to do this naturally but on the other hand I feel blessed that it's an option for us.  It is SO expensive but with the resources and insurance available to us, we are going to be able to finagle it.  I could wait and continue to try naturally, but I ain't getting any younger and I also have Ulcerative Colitis, an auto-immune disease.  While the auto-immune disease shouldn't impact my fertility - you just never know.  

I wish I would have started documenting this process earlier because there has been a lot of other steps to get us to this point.  But in summary, by now I should basically have a reserved parking spot at the hospital.  I highly recommend when selecting a fertility center you really consider the convenience of their location.  You will be there ALOT!  Especially, when you really get into a treatment cycle. 

I will try to go back in fill in some of the pre-treatment cycle blanks as I continue down this path.  I wanted to share this story because we are part of a generation in which women are waiting to start families and I want to share the possible side effects of postponing motherhood.   It is nothing to be ashamed of as so many amazing people of all ages struggle with infertility.  Additionally, when I looked for blogs on the subject - I didn't find any that were frank nor candid about the cost or injection process.  All of which has stunned me. 

At this point, we just wait for my cycle to begin so we can start.

- nineteen eighty

I've decided to use nineteen eighty, my birth year, as my pen name because during this whole process I have recited my birth date countless times.  Anytime I call anyone about anything related to this, I must state my first and last name and birth date before they will give me any information.

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