Saturday, December 20, 2014

Day 30 - The end (for now).

I have a confession to make.  My blog posts were not in real time; they were actually delayed by four days so when Tower and I found out, we would have time to digest the results before sharing them.  We now know, that this cycle was unsuccessful.  This is why I've skipped posting the past couple days.  I had more I wanted to say - more material to cover - but it all seems pointless now.

To say the least I am to say the least, I am devastated.  Mainly, it's hard to comprehend with no glaring fertility issues why two perfect embryos didn't make it.  I want answers, but I know I won't get them.  When the nurse called with the results, she told me to immediately stop taking the progesterone and that I should get my period.  I am also to call and schedule an appointment for another nurse's talk, where we will discuss the game plan going forward.  We briefly discussed over the phone that I will skip this cycle, and next cycle we will try to do a frozen embryo transfer with our two embryos on ice.  I am happy that we have two to work with, but also nervous because these two were not "Cadillac" embryos like two implanted this time.  And they also have to survive the thaw process.

The one thing that this news has reminded me is that  I married a good man.  And for that I am already blessed leaps and bounds.  Tower immediately left work after learning the news.  I was unaware he was headed home  and was completely embarrassed when he found me fat girl consoling myself with Chinese takeout.  He just held me and we talked about it - he told me he was sad too.  We only had a couple hours to compose ourselves because we then had my work Christmas party to get fucking jolly for.  Life goes on.

So that's it - for now anyways.  There will be more to this journey.  But for now, I just need a couple days to cry this one out.  Then maybe I'll get to the topics I wanted to discuss and the lead up to next cycle.  Then again, to be honest, I don't know if I will keep up with this blog or not.

I do look forward to getting my body back to it's normal operating level.  The second thing I did after telling Tower was schedule a boot camp class.  I need to shake off these six pounds I've gained through the process (the hormones really contribute to weight gain, never mind the holidays). 

I've been absolutely touched by the support many of you have extended.  Thank you from the bottom of our hearts.

-nineteen eighty & tower

Tuesday, December 16, 2014

Day 23 - Pineapple pussy.

Six days post transfer: Implantation continues.

I still feel like I have period cramps.

Tooooooooot Tooooooooooot!  If you are trying to get knocked-up hop on board the Pineapple Express!  When you are going through this process it is amazing what you will find via google and try.  For example, did you know pineapple allegedly is an aid to embryo implantation?  I just happen to  love pineapple so sure as shit on the day of my embryo transfer I cut myself a fresh one and have been gnawing on it every day since.

Apparently, I am not alone.  Blog commenter Jeanine left me a comment on transfer day suggesting the same and yesterday I got a text from Curly-Q regarding the fruit.

Curly-Q:  I feel crazy admitting to this, but I've been eating a chunk of pineapple core every night.  Have you heard anything about that?  It's supposed to help with implantation.

Me:  It's not crazy!  I did the same thing!!  I bought a fresh pineapple the day of transfer.

Curly-Q: Did you?!  I have my last core chunk tonight!

Me:  I sure did!  Sometimes I put chocolate syrup (and whipped cream and maraschino cherries)  on it to make it like a desert.  I am also keeping my feet warm with cabin socks.  Warm feet equal warm uterus.

This is what crazy ladies trying to make babies talk about.  If I was not trying to procreate and was reading this I would probably vomit in my mouth in annoyance while gurgling, I swear to God, I will never be like them.

If by chance you are still reading but not trying to make a baby - well, I have good news.  Pineapple still might be the fruit for you.  Especially, for those single gals, I still love to live vicariously through.  Rumor has it that pineapple can make your lady lips smell like a fruit bowl.  No shit!  In fact, there was a whole Kardashian episode dedicated to pineapple pussy.  Don't believe me, google that fun fact for yourself.

Now you know.

 - nineteen eighty

Monday, December 15, 2014

Day(s) 20, 21, 22 - Struggling.

Three days post transfer:  the blastocyst begins to hatch out of its cell

Four days post transfer:  the blastocyst continues to hatch out of its shell and begins to attach itself to the uterus

Five days post transfer:  the blastocyst attaches deeper into the uterine lining, beginning implantation

I still feel like I am having period cramps. 

Despite having a really nice weekend, I am struggling mentally.  With the cost of all this, the last thing I should be doing is spending money.  But my sister and I went for a spa day on Saturday and that night we did a casino night for Tower's birthday.  A group of us headed out to the casino buffet and then ended the night at the roulette table.  It felt so good to get dressed up and head out for a night on the town. 

If you unfortunately ever have a friend that is going through something like this, the best thing you can offer them is to spend time with them.  Distracting them with non-kid/baby activities.  Saturday night was the best thing for me.

Sunday was a whole different story.  I had nothing to do and my mind started to wander and I turned to the interwebs.  I ended up having a breakdown and crying into Tower's chest.  Gals, I don't really know how to explain it, but I just don't feel like I am going to have a positive outcome.  Tower listens of course, and is supportive, but he is so annoyingly relaxed about the whole thing.

Me: If this doesn't work, it's going to be my fault because the embryos were perfect going in.
Tower:  It is no bodies fault, if it doesn't happen, it doesn't happen.  We try again.

Me: This is so much pressure; having spent so much money.
Tower:  At least we can afford to do it.
Me:  True, but we can't afford to do it forever.

Me:  I don't know if I can go through all those injections and appointments again.
Tower: We will get through it.
Me:  We.  Phish, you fucking cried bloody murder when I showed you a needle.  Plus, you have no idea what it's like to surrender your body to all those foreign hormones.  It's horrible.  And I've gained 6 pounds!!

Me:  Plus!  My top three stress-freeing vices aren't available to me.  No coffee, vodka, or exercise.  I have no outlets.  I have nothing!  We haven't even had sex!
Tower:  Do you want me to give up Starbucks?
Me:  No - because you will hate your 1hour and 20 minute commute even more.

At least for Tower, everything seems so simple.  In my mind it is not.  It is constant.  I am so thankful for my fertility discussing texting buddies Clare St. Clair and Curly-Q (both of which I've connected with through social media) who give me that extra sympathy I don't get from Tower.  Honestly, lesbians are on to something.  I am well aware that my statements to Tower were not all that rational - but, hell, that's just one other thing women understand.  There are just certain times, such as anything dealing with the reproductive system, when we are granted, "get out of being rational free" cards.  

Am I right?

Never underestimate the power of a good girlfriend.  After all, I truly believe - it takes a village.

-nineteen eighty

Friday, December 12, 2014

Day 19 - Morons.

Two days post transfer: The cells of the morula (Mulberry) continue to divide, developing into a blastocyst.
Another pitfall of this process is dealing with the morons that be billers and insurance companies.  I have BCBS and Tower has Cigna.  Mine offers absolutely no fertility treatment assistance but Tower's offers some; albeit not substantial.  So I have been very clear that my primary insurance should not be billed and instead go straight to my secondary, Tower's (yes, we are paying out the wazoo and carry two family insurance plans).  I told this to both the financial counselor we met with and the lady who takes my billing paper work after each appointment.  And guess what, they still fucked it up.  I received a bill today for "non-covered services" because they only ran my claim through BCBS.  It's so fucking irritating.  I can't tell you how many phone calls I've made dealing with the insurance companies to even understand our coverage, get pre-approved, and I've even had to track down two-instances of getting charged inaccurately because things were coded wrong. 

The bill was for $842 and was for my first ultrasound and blood work monitoring during stimulation.  $842!  I went back and counted I had a total of four ultrasound/blood work combos and two additional just blood work appointments ($342 each) while prepping for the egg retrieval.  Shit!  You can really see how this adds up fast!  I still don't know what our portion will be because as evidenced by the bill I received today, they haven't run anything through our Cigna benefits yet. For more information on potential total cost click here.

I was able to remedy today's issue with a quick call but I would almost bet my life that I am going to have to make that same call for every billing instance.  It's sucks to have no faith in a system, especially, when it's such a stressful and important thing.

-nineteen eighty

Thursday, December 11, 2014

Day 18 - TWW.

And so the dreaded two week wait (commonly referred to as TWW) to determine if this cycle worked begins.  Many in the community consider this part the worst part of the process.  The waiting, wondering, hyper-analyzing and over-googling.  I am at the beginning of my wait and I've already done some version of all four. 

I still have period cramps, they are pretty constant which I find annoying because A) I want to go back to feeling normal and B) I want to "listen" to my body for any indicators.  From what I've read, I found that I might-as-well throw any analyzing out the window.  I am still recovering form the egg retrieval and taking progesterone supplements both of which can both mimic and mask any pregnancy symptoms.

I did find a timeline of what my embryo(s) are up to if they have in fact decided to go forth and prosper.  This timeline would also apply to a three day embryo achieved through a natural pregnancy.

One day post transfer:  The embryo continues to grow and develop, turning from a 6 - 8 cell embryo into a morula. 

I searched "morula" on the interwebs and I didn't understand an ounce of what I was reading other than morula was Latin for mulberry because that's what it resembles.  So I guess for now I'll just have to visualize a little mulberry getting cozy in my belly. 

-nineteen eighty

Wednesday, December 10, 2014

Day 17 - Hey, hey, it's transfer day!

Guys!  Guys!  Guys!

I am so happy to report that things went as well as they possibly could go today.  Mentally, I feel the best I have in a while.  What's done is done and it's out of my hands

Tower and I went into the Fertility Clinic this morning.  My only direct order was that I arrive with a bladder full of 30 to 40 ounces of water.  I grabbed two 20 oz bottles on my way out the door and aggressively drank them on our commute down.  Upon arrival, we were taken back to the recovery area and I was instructed to change into a gown, booties, and don a hair bonnet.  Your partner has the option to join you during the transfer.  Tower was very uncomfortable with this as he hates anything to do with hospitals, but I insisted.  He's going to have to man up sooner or later!

Next the embryologist and doctor and explained the status of our four embryos.  All four were still alive and had been graded.
  • 8A
  • 8A
  • 8B
  • 5A
The number indicates the number of cells the embryo is now comprised of.   Ideally, the embryos reach 8 cells by day three.  That's not to say, that my 5A is a lost cause.  It may be a little bit behind but it's still growing and has a good grade.

The letter grade refers to how the cells in the embryos look. A grade A embryo, for example, is one in which all of the cells are the same size and there is no fragmentation in the embryo.   This is ideal. A grade B embryo may have minor fragmentation.  The lower the grade, the more fragmentation.

Embryos are not like diamonds - as in there is not a universal or standard grading system.  This is just the way my Fertility Center grades.

My doctor and embryologist proceed to tell me that the first 8A is actually getting ready to divide again - which is wonderful.  And that they consider both of my 8As Cadillac embryos.  By this time I am grinning ear to ear.  It's all I could hope for.

They then ask us if we want to transfer one or two.  I quickly respond, "TWO".  I had mentioned to Tower that we would get to chose, but we never really talked about it.  I kind of made up our mind for the both of us.  Hey - I am the one who would have to carry them.  I want the best chance.  Plus, I actually would really like twins.  Tower and I initialed a sheet a paper confirming we want the two and then both walk into the same operating room where they did the egg retrieval. 

I laid down on the table and Tower sat at my head.  The doctor, embryologist, nurse, and ultrasound tech were all in the room.   The ultrasound lady guided the doctor while he inserted a catheter into my uterus.  The reason they want you to have a full bladder is because it straightens the uterus and makes it easier to access.  When the doctor was in the embryologist loaded both embryos (which are invisible to the naked eye) into a transfer catheter.  The embryos were then pushed through the transfer catheter with a small puff of air.  The doctor pulled out he catheters, speculum and literally 5 minutes later he was eating a Greek salad (I will take it as a compliment that I didn't ruin his appetite) at the nurses desk and I was walking to the car.  Unbelievably easy.  The egg retrieval was much more of a production. 

Despite having two transferred our chances of this working are still only 45%.  Our other two embryos will be frozen for round two.

I did not sleep well last night so I came home and napped.  I am not restricted to bed rest and tomorrow I can pretty much resume normal activity - sans high intensity workouts.  I physically feel fine besides the bloating and cramps I mentioned yesterday.

Now we wait two weeks to find out.  I am scheduled for a beta blood test the week of Christmas.  I will be sharing the results here but at this time am not going to disclose the actual date of the test.  I want time for just Tower and I to digest the results before divulging them to the masses.  With all this free time, I do plan to keep the blog up until the results.  So if you have a question - please leave it in a comment or if you know me in real life, text me. 

Speaking of comments, I appreciated the ones on yesterday's post and laughed big at the "drink until pink" line.  Today I received texts messages of encouragement and beautiful roses with a note, "four for four!".  Sincerely thank you to each of you.    I know some people may balk at that the idea of sharing something so personal.  It's weird, but for me over sharing comes naturally.  I am also a very curious person.  Together its the perfect storm and I've chosen to advocate for fertility; albeit a small audience.   

....cue, NBC's the more you know campaign.

Thank you so much for allowing me to share this journey with you. 

-nineteen eighty


Tuesday, December 9, 2014

Day 16 - Prune juice, yo!

I was on pins and needles today wondering if my four embryos made it through the night.  The Fertility Center doesn't advise you to call and check on them.  They say long as you don't receive a call canceling the transfer, you have at least one viable embryo to work with. 

I'm a rule breaker.

I texted my friend, Clare St. Clair, to see if maybe I should just try the egg line.  After all, the phone number was just burning a hole in my recent calls list.  Clare St. Clair quickly pointed out that I am paying them enough; I should be able to call them whenever I wanna.  Enough said, Clare St. Clair.

The egg keeper was not friendly at all.   

Did you have your retrieval yesterday? 

No.  The day before yesterday.

Well, the embryologist does not like to pull the embryos out of the incubator, but I'll double check.  Please hold.

You are in luck, she pulled them out earlier today and they look good.  You now have two - 4 cell embryos and two - 2 cell embryos.  They should continue dividing and we will be looking for 8 cell embryos at transfer.  

Yes!  My little tetrad of embryos are alive and well!  Of course I confirmed with Dr. Google that they are right on target with their division.   My research also shows that rarely do 100% of fertilized eggs make it to transfer day.  So fingers crossed, mine continue to be the exception.  Can I get a four for four!

So that's the good news.....

......the bad news.....

Someone please pass the prune juice, yo!  I'll try not to over due it with the details, but I could use a roto rooter over here.  From my research it's very common to be plugged up, bloated, and crampy from all the meds and trauma from the egg retrieval.  I am some wicked form of all three.  At one point today,  my vision closed in on me and I thought I was going to pass out.  It's not good people, not good at all.  I really wish I was going into tomorrow feeling better physically.

So what do I do when I am not feeling great.......

Happy hour with Tower, of course!  You know, because that makes complete sense.  A few Buffalo wings and a cosmo(s) to calm the nerves.  No need to judge, there aren't any rules against it.

Cheers to tomorrow!

Monday, December 8, 2014

Day 15 - Tetrad.

hello.  egg hotline.  I am calling to see the status of my dozen eggs.

you had four mature eggs.

escusez-moi.  but-buttttttt twelve eggs were retrieved yesterday.

yes, but unfortunately, you had a lot of eggs which weren't mature enough to be fertilized.  there is good news though.  all four did fertilize.

is that normal?

well, it's hard to say what normal is, but you did have a lot of immature eggs.

ok, thanks, bye.

......and that's how the conversation with the egg keeper went.  dang!

I must say, I am disappointed that my dozen yesterday has dwindled down to four.  At the same time, it is great news that all four fertilized (go, Tower!).  As I sit here and type this, I can't tell you what exact number I was aiming for because I don't know.  With IVF you want to strike a delicate balance of just enough.  If you create too many embryos, you'll be left with extras, and for me it would cause a moral dilemma of what to do with them.  Do you want to destroy them, donate them to science, or put them up for adoption?  And truthfully, I don't like the sound of any of those options. 

If you create too few, you don't have extras to freeze, and you would go through the whole egg retrieval process again if another IVF cycle is required.  For me, I would like a few spares because, if I am going to need another IVF cycle, and chances are I will, I'd rather preserve my 34 year old eggs.

The other thing is that all fertilized eggs do not make it to day three - aka transfer day (day 17 for me).  Many arrest, or in other words, stop dividing and are no longer viable.  

It's such a delicate balance.  One that you have absolutely no control over. 

For now I suppose I need to focus on the success of the four that I do have.  Go team!  I mean four is a good number.  four leafed clover.  four seasons. the beatles.  My doctor and my goal for this cycle was to transfer two embryos on transfer day.  That gives Tower and I our best chance.  And at this moment, there is no reason to believe that isn't still possible for us.   

It's time to let go, and let God. 

-nineteen eighty


Sunday, December 7, 2014

Day 14 - A full carton.


How cool is that?  I ended up with exactly a carton of eggs.  I am one proud mama.

The actual egg retrieval went well.  This morning, exactly 36 hours after taking the trigger shot, I found myself laid out on an operating table with my legs hoisted up in stir-ups.  The anesthesiologist, who was in her 57th year of practicing medicine (how is that even possible, by my calculations she has got to be close to 80) was telling me about her cat Chanel, when she administered the sweet nectar and knocked my ass out.  The next thing I remember was being in the recovery room. 

My fertility doctor stopped by real quick and let me know that things went well and they were able to get twelve eggs.  He explained that was a pretty good number, as 10 eggs were average.

Really, that was about it.  There was no lengthy conversation with the doctor.  It was in and out.  They are clearly running a business.  Of course, I'd appreciate it if the process was more personable but I feel like my hands are tied.  It's not like I have an abundance of options, even in a decent sized city.  And from everyone I talk to - sterile - is par for the course.   

Prior to me going under, Tower had to do the walk of shame to the sexy time booth.  I told him to snapchat me the details - but all I got was one lousy picture of the December (Christmas themed) Playboy cover.  At least they are current.  At some point today, my eggs were exposed to Tower's sperm in hopes of them being fertilized.  Tomorrow morning I'll be able to call in and get the results.

The discharge process was easy and I've just been lounging around today.  Tomorrow I can resume life as usual - sans high intensity activity. 

They prescribed me with a steroid and antibiotic to keep me strong and infection free.  I am also supposed to take a baby aspirin each day to prevent clotting during implantation.  Last but not least, I'm to start the progesterone suppositories.  Awesome. 

Besides cramping, I physically feel fine.  SO looking forward to calling the egg hotline in the AM.  Embryo transfer is tentatively scheduled for day 17.  This is really happening! 

-nineteen eighty

Saturday, December 6, 2014

Day 13 - I am a pussy.

Be cool, girl, be cool.  repeat.  When did I become such a pussy?

I've done some major things in my life.  I moved to Pittsburgh without even scoping the city out.  I literally drove up on a Sunday, got myself a hotel room, and started a new job on Monday.  I spent six months in Iraq.  Dare I toot my own horn and say I could go on?  Because I could.

But never have I ever experienced anxiety like I am now.  Never ever.  Chest pains, hives, and a crippling knot in my back. 

Up until this point I've been bound and determine to keep my cool with all this baby making stuff.  I've said it a million times before, Tower and I will be happy either way.  In fact, I wish I was younger so we could enjoy this newlywed thing a little longer.  I want to go on an African Safari and get an Volvo C70 convertible.  I wouldn't mind a Burberry scarf either.

On the other hand, I realize how lucky we are to be able to pursue the IVF route.  We are also blessed in the sense that we have no glaring issues between us so we have no reason to doubt that we will eventually become parents.

So I don't know what it is - but egg retrieval day has me in a mother fucking tizzy!

Suddenly, besides being a materialistic brat, I realize I really want this.  Desire mixed with a dash of faux hormones and unanswerable questions is gut wrenching.  I am barely functional.  Paralyzed. 

A big fear is how in the world does this dang trigger shot work.  You inject it and magically, 36 hours later you are at the brink of ovulation and ready for retrieval.  What if I arrive tomorrow and it's too late; I've already ovulated.  It's just so much faith and trust in something I can't even comprehend the science behind.  I am powerless, out of control and scared.  Not to mention there is a hell of a lot of money riding on my ovaries.

I am digging deep and the show must go on.  Maybe not everyone can see it but there is something beautiful about being a pussy.  Isn't it amazing that my future holy terrors are already loved and wanted this BIG?   I can't even imagine what it is like to see them for the first time.  I proudly look forward to the day that I will be able to tell them, mommy loved you so much, she was willing to be a pussy for you.

- nineteen eighty

Friday, December 5, 2014

Day 12 - Pull the Trigger.

My estradiol reached 2,700 today and I received the go ahead to take the trigger shot tonight at 10pm.  After that, I am all done with injections this round!  I report to the Fertility Center the morning after next for egg retrieval!

-nineteen eighty

Thursday, December 4, 2014

Day 11 - Friends in Strange Places.

Whelp, my streak of not crying ended today!   But for a really touching reason.  I received a card today from someone whom I only know from social media........

I feel like writing a note is more personal than leaving a comment or typing up an email.  I just wanted to let you know I'm thinking about you and Tower and your future babies!  I was so naive when I got pregnant for the first time.  I was 19 and scared.  And I cried.  So unaware of how many women were crying - because they got a negative on their stick.

I bought you a little present.  It's coming from an etsy shop in PA so I'm just having it sent straight to you.  It's a fertility bracelet - but even if you don't "believe" in the power of stones - just know that you are adored and loved,  friend.  And it's a physical reminder.  

I hope this whole process goes as smoothly as it can and you to celebrate a baby next Christmas!  Good luck to you and Tower.  You are loved.

My gosh, how beautiful and thoughtful.  It literally brought tears to my eyes and I immediately had Tower read it.  It amazes me how someone whom I've never met is cheering me on and finds my story relevant.

Relevancy is such a funny thing when going through something like this.  I find that real life friends are only moderately interested.  I've told some of them about this blog and many haven't even taken a glance.  That's ok, they have their own reasons and I get that.  We are all so busy.  Plus, sometimes we don't need or want all the dreaded details.  We just want to know the end result for heaven's sake.  At the same time, I've also come to the conclusion that if there is a true and deep friendship between people- whatever one is going through should be relevant to the other - whether the topic interests you or not.  That's what real friends are for.  From here on out, I hope this revelation makes me a better person. 

This is just why I am so touched by receiving this card.  And surprisingly it doesn't stop there.  Through this blog I've connected with another lady who is also stranded out on infertility island.  We've exchanged numbers and now text on the daily.  It is so nice to have someone who understands this roller coaster.  Let me tell you, the ups and downs are huge.  And it is such a relief to have people to navigate through it with.

With all that said.....drum roll please......

Today's blood work and ultrasound revealed that I have lots of follicles and my estradiol is above 1700.  That's great!  I was instructed to take reduced doses of Menopur tonight and Follistim tomorrow morning.  I also return tomorrow for another round of blood work and hopefully will get to use the trigger shot tomorrow night.

To celebrate, a friend of mine, who just so happens to also be going to the same fertility doctor as Tower and I (she's also been a great sanity check), went out for margaritas.  And she offered to drive!  Bottoms up!  My fingers are optimistically crossed that my drinking days are numbered.

-nineteen eighty

Wednesday, December 3, 2014

Day 10 - TMI.

No blood work or ultra sound today since yesterday's results showed that my estradiol has just a wee more to go to get over the 1,000 mark.  I am to continue with my three injections and return to the Fertility Center tomorrow to for another look under the hood.  We also got orders to "be intimate" so that Tower could be fresh, yet, not too depleted for fertilization.  They say he needs to pop three to four days before egg retrieval.  Finally, a protocol I can get into!  That's what he said.  And this means we are getting closer!

My hormone levels still seem to be even and my moodiness continues to be manageable.  At this point, I've done multiple injections in the car, so I am pretty much an expert.  The track marks or bruises aren't terrible either.  My biggest complaint is the ever growing gut.  I've been told that the ovaries grow from the size of a walnut to an orange during this process.  Well no wonder! 

So happy to be another day closer.

- nineteen eighty

Tuesday, December 2, 2014

Day 9 - Looking up.

I went in this morning for blood work and another ultra sound.  I received my results this afternoon and I've progressed.  My estradiol level was up to 959 and I have 9 follicles considered mature (measuring 10mm or more).  To recap, an estradiol level of greater than a 1,000 and at least 5 mature follicles are required to do the egg retrieval.  Almost there!

I am still sticking with my three-a-day injections and I report back for another round of blood work and ultrasound on day 11.

I am also proud to report that I haven't cried in at least three days and no major moodiness.  My body must be getting acclimated to these foreign hormones. if I could just do something about this expanding gut of mine.  Have mercy!

-nineteen eighty

Monday, December 1, 2014

Day 8 - IVF. The new $tatus $ymbol.

I just had my injection protocol to follow today since I didn't have to go in for any testing so I thought I'd use my extra free time talking about the unGodly costs associated with IVF.

Before my first visit to the Fertility Center, I had heard that the average IVF cycle cost approximately $10,000.  This is fairly accurate, but what I did not know was the cost of the medications is additional.  Eye-ye-ye!

When it started to look like we were going to pursue the IVF route, we were provided with a list of procedures, approximate costs, and fees.  We also met with a financial counselor which is a requirement to proceed.  The estimated cost we were provided for a fresh cycle without insurance assist was $9,637.  This includes the cost of blood work and ultrasound monitoring leading up to egg retrieval, the egg retrieval, embryo transfer, and cyropreservation of embryos (if we have extra).  The cost is sliding because the longer the stimulation process takes, the more costs you will incur because of more blood work and ultra sounds.  Conversely, if your follicles are rock stars, you may be ready for retrieval sooner and therefore incur less costs. 

It is my understanding that most people do not have any sort of fertility treatment coverage.  Until recently, Tower and I included.  However, in a round about way, we lucked out.  Earlier this year, Tower lost his job and was unemployed for several months.  In September, just as we were making up our mind as to whether or not we wanted to try IVF, he was offered and accepted a new job.  To our surprise, his new company offered health insurance with fertility treatment assistance.  Score!  Our fertility benefit is $10,000 in assistance per lifetime.  His unemployment was very difficult to get through, especially during our first year of marriage, but in retrospect it has been a blessing in more ways than one.

When we met with the financial counselor, we learned that since our health insurance company does so much business with our Fertility Center, we get special negotiated rates.  What a rip-off and double whammy for people who don't have coverage!  The cost should be the cost!

The financial counselor verified our coverage and stated that cost of the IVF cycle would be significantly lower; perhaps even half of what it would cost if we did not have insurance.  I have not seen an explanation of benefits or bill yet so I am not sure yet what our running tally is and how good of a discount we are receiving.  For those who do not have any insurance, payment is due in full before the cycle begins.  Same goes for the medication, which is outsourced to a pharmacy.  You can read more about the medication costs here

In summary, if we did not have any health insurance benefits towards fertility we would be looking at approximately $9,637 for the IVF cycle and another $6,000+ for the fertility medication.  God, that ain't nothing to balk at!  Over $15,000 for a 45.6% (our Fertility Center's success rate for someone like me) chance at having a baby.  I feel so blessed that we have assistance - which is one of the reasons I was aggressive in pursuing treatment at this time.  You never know when your life can be turned up-side-down and certain resources and options no longer going to be available. 
.......but remember when they do, there's always a new better door waiting to be opened.

-nineteen eighty

Sunday, November 30, 2014

Day 7 - On the Low Side.

I went in again this morning for more blood work.

There are two main things I need to accomplish to graduate from the stimulation phase to egg retrieval.  I need an estradiol level greater than 1,000 and at least 5 mature follicles (10mm or greater).

The results of this morning's blood work showed that my estradiol level was 427 and the nurse explained that this was on the low side.  Since the nurse spoke so rapidly yesterday, I asked her to recap my follicle results.  She reported that I had three that matured to at least 10mm and were big enough for retrieval.  My ovaries sill have some work to do and I am to continue on my three-a-day protocol.

Since my numbers were low, I get to skip a day of monitoring and am due to report back the day after next for blood work and another ultrasound.  On the bright side, today marks only 6 days of the stimulation drugs and on average, it takes about 10 days to reach the pinnacle. 

Despite knowing I was only half way though the average number of stimulation days, hearing "on the low size", caused me to panic.  Of course my fingers ran off to Dr. Google.  My research put me at a slight ease as I learned many women are slow developers and that numbers could double overnight.  But then I also read that some women have to cancel their cycle because they never reach optimum ripeness.  So once again, anything goes.  I have no choice but to do my best to remain optimistic.  I figure I might-as-well until someone gives me further reason not to.

Grow, girls, grow! 

-nineteen eighty

Saturday, November 29, 2014

Day 6 - Three-a-days.

After you've been on the stimulating injections for five days they have you come in and do a round of blood work and an ultrasound to see how your follicles are doing.  I did as such and received a call back from the nurse this afternoon.  She reported that my follicles were looking good and growing.  My blood work, which also tests estradiol, progesterone and lutenizing hormone levels, also looked good.  She gave me some of the numbers associated with the results but rattled them off so quickly they didn't register.  Whenever they call they seem like they are in such a hurry.  I hate that.  I am sure a list of other broads to call, but this process is anything but routine for me.

Since things looked good she told me to add the Ganirelix injection to my daily routine, bringing me up to three injections a day.  The purpose of Ganirelix is to prevent me from ovulating prematurely.

Lastly, I was directed to return tomorrow morning for blood work.  I will have to continue to report daily for the next five days or so until everything looks nice and ripe.  Reporting daily is going to be a royal pain.  It takes about 40 minutes to get to the Fertility Center from home.  It's in downtown Pittsburgh so if I don't get street parking I have to park in the garage and pay.  This is why I can't stress enough to consider convenience when selecting a Fertility Center.

Despite my gripes about being on this roller coaster, I can already tell you it's worth it.  I know Tower and I will have a good life whether we have a family or not.  But I believe in no regrets so you got to try your darndest - which is what has brought me to here. 

-nineteen eighty

Friday, November 28, 2014

Day 5 - Just be Normal.

Surprise, surprise I was a bitchy Betty again today.  I think I've cried the past three days in a row.  Awesome.

Tower had to go down to the Fertility Center to do his Cystic Fibrosis test.  We will get the results in about 10 days.  By the time we get the results it will be too late to change the way we are doing this cycle.  If he tests positive for the Cystic Fibrosis gene and we need to do a second cycle, we will have the option to do genetic testing of the embryos before implantation.

It is becoming kind of a pain of the ass to get my shots in at a specific time.  Tonight I had to pre-mix my Menopur before leaving the house and inject myself in the car on the drive to meet friends for dinner.  On the bright side, I am definitely getting more comfortable with the process.  I am taking great care to follow my protocol to a T while maintaining as normal of a life as possible.

I have not cut out caffeine or vodka yet (nor have they told me to).  I am not an over indulger in either, but a little nip of both on the semi-regular probably keeps me more even-keel than without it.  I have been making play dates with girlfriends to engage in the occasional vent session and just as important - to hear what's going on in their lives - the drama and dates.  I am also proud to report that I am keeping up the workout regime I had in place before beginning this process.  For me sweating is so key in maintaining my mood.  It also helps me feel better about injection filled gut.

........keep on, keeping on.

- nineteen eighty

Thursday, November 27, 2014

Day 4 - Ima Bitch.

I can be a bitch on my best day.  But - damn, these hormone injections have taken my bitchiness to a whole new level.  Today, I was just evil to Tower.  God Bless him.  This is not an easy process for either partner.  The money, time, and needles that goes into this is enough to send anyone into a tizzy.  Add the injections and you don't even recognize yourself anymore. 

Speaking of needles, Tower and I got into today because he says I "chased" him with a needle.  Hardly, you wuss!  You see, he hates needles.  In my effort to keep him engaged in the process I simply held the poke up for him to see and said in a calm playful voice, look at this, do you think you could do this.  Admittedly, sometimes I play up the suffering so he sees what an amazing and determined women I am for enduring this for the sake of our future family.  See, I told you I was a bitch - a greedy one at that.  : )  But truth be told, I am glad we both are having irrational moments through this process so that we counter balance each other.  With that said, if we were keeping score on the irrational moments I'd totally be winning.

The stomach continues to feel tight and bloated.  Not fun.  It's darn right hanging over my pants.

-nineteen eighty

Wednesday, November 26, 2014

Day 3 - Two-a-days.

Today I started my protocol of twice daily injections of the Follistim and the Menopur.  I had to watch another video this morning to learn what to do with the Follistim.  Unlike Menopur, which you have to reconstitute and draw into a syringe, Follistim uses a nifty pre-mixed injectable pen.  Both get injected in my stomach below the belly button and I alternate between my right and left sides.  The injections need to be about 12 hours apart and so I've decided on 7:00a/p.  I am scared I am going to forget about this new daily ritual, so I've set an alarm on my phone.

It's hard to explain but I can definitely tell that something is up with my belly.  It feels bloated and tight and honestly my jeans were snugger today.  Also, I don't know if it's possible for the hormones to have already taken over, but I got irritated this morning at something that I normally wouldn't even have registered with me.  I could feel myself getting upset and the tears started so I decided I better go workout to try to release some of the tension.  I ugly girl cried hard the entire 15 minute ride to the gym but was fine for the rest of the day.


-nineteen eighty

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, 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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