The Plan

Fun Fact:
This blog is now the number one Google result for the search term "obsessed with peeing on sticks."

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We had our initial consultation with Dr. E, the Reproductive Endocrinologist, yesterday and it went very well. We really liked her, and she spent a lot of time telling us everything that we'll need to do, as well as answering all our questions.

She does not see a need to start with Clomid or anything similar at this point. She reminded us that although, on paper, I am an infertility patient, we've not even tried yet, and we could get pregnant the first time. She said that she's had very good luck with other lesbians who don't have any actual issues of their own, just a lack of sperm.

It will, however, be a much more intense process than what we were looking at with Dr. B, and she gave us quite a list of things-to-do in the next three weeks before the first insemination.

• Prenatal Vitamins
  She gave me all the chewable samples that she had, plus a prescription for more, and said to go ahead and start on them.
• Get a permission slip from my nephrologist
  This is a "CYA" thing - she just wants it on paper that he doesn't have a problem with me getting pregnant, in terms of the affects on my kidneys.
• Talk with a social worker
  This is required for anyone using donor gametes (eggs or sperm). Generally the discussion is about whether, when and how to tell the kid how they were made. That's kind of a no-brainer for us, but we still have to do it. She kind of apologized about it. We're already scheduled to see Dr. T next week, so were going to see if she can just write us a note, instead of having to schedule a special appointment with this stranger.
• Antibiotics
  I have to do 7 days of doxycycline before we "start sticking things where they don't belong" (the IUI insemination). They've got me totally freaked out about that - take with food, don't take with milk, don't take with vitamins or calcium, stay out of the sun, remain upright for 15 minutes after taking, may cause nausea. Jeez-us
• Get the sperm back from the bank
  It was returned to the cryobank on Monday and should have arrived yesterday. They will call us shortly to find out what to do with it. Instead of paying for storage there, we'll just have them send it to the RE's office, where they have storage facilities.
  
  (This kid is going to be quite well travelled. The sperm will have been to three states, before it's even conceived!)
  
  In addition to the vial that we own, there are only 4 more vials of BowTie left, and he's no longer with the program, so there won't be any more coming (so to speak).
  
  We debated whether to buy it all up, but that would be about $2000, which would be wasted it we don't need that many attempts.
  
  If it doesn't leave the bank, they'll buy it back at 50%, but then we'd be paying $150/month to ship to the RE.
  
  On the other hand, if we shipped it all now and stored at the RE, we'd be stuck with the total cost.
  
  Popeye, our second choice, has more than 50 units in stock, though, so we've decided to try with this one that we've got and if it doesn't work the first cycle, we'll stick with BowTie (purchasing it as we go) as long as he holds out.
  
  If we run out (or someone buys it up) we'll switch to Popeye. We've got no problem with him and there's the advantage of having the adult photos.
  
  When we thought about it in terms of, "If someone said 'BowTie costs $1000 more than Popeye,' would we pay it?" that kind of put it in perspective.
  
  We'll get the baby we're supposed to have, with the donor we're supposed to have. If BowTie sells out, he wasn't our donor.
• Testing
  On Day 3 of my next cycle, I'll have blood drawn to test a bunch of hormone levels, as well as a few other disease-type things that we didn't cover before. I'll also have an ultrasound that day to look at, well, I'm not exactly sure what. Ovaries? Uterus?
  
  Funny thing is that Shrike also has to be testing for STDs and the such, since even though she's not physically making the baby, she would be exposing me to any cooties that she has. (As though I wouldn't already have been thoroughly exposed over the past nine years!) Dr. E apologized for that one, too.
• Monitoring
  Starting around Day 10 (or when we get home from Texas, which ever comes last) I'll pop by the RE's office on my way to work for daily ultrasounds of my ovaries to monitor the development of the follicle(s). I may or may not also have bloodwork done at that point.
• Triggering Shot of HCG
  When the follicle(s) reach the right size, I'll get a shot of HCG to make me ovulate roughly 24 hours later. They might do this in the office when I'm there for monitoring, or we could do it at home.
  
  They discussed having us take a class on how to give injections, but since it's just the one shot, since Shrike has some experience (giving daily insulin to a diabetic dog, as a teenager) and since her mom is an RN who could help us (instruct Shrike or do the shot for us) they said we don't have to do that
• IUI Insemination
  Within 24 hours of the triggering shot, we'll do the insemination. Dr. E likes to inseminate just before ovulation, so the sperm are ready and waiting when the egg is released. She sometimes does 2 inseminations per cycle, but since that would not double our chances, it's not cost-effective for us, so we'll just do one.
• Take progesterone
  This helps to make an nice comfy uterine lining, and to maintain an early pregnancy until the placenta takes over a few weeks in
• Pregnancy Test at 15 days post-insemination
  This will be a quantitative HCG, to give my exact HCG levels, not just a "yes" or "no."
• If Negative
  Repeat for about 3 cycles before considering Clomid
• If Positive
  
  • Recheck HCG levels every couple of days for a while to make sure they go up like they're suppposed to
  • Continue to take progesterone for a few weeks
  • Dr. E will monitor me through week 8, then release me to Dr. B

Well, that sounds easy enough!