IVF Baby Clothes

In my Google-travels, researching IVF, I came across a Cafepress store of designs for IVF babies and their parents.

My favorite:
My parents did IVF and now all they can afford is this lousy t-shirt.

Coming Soon to a Uterus Near You!

No surprises on my beta today. Big ol' negative.

But, I did talk to several different people at the RE clinic and got a lot more information about what comes next.

First, I will continue to take Prometrium through the weekend, to delay my period for a few days and buy us some time until we've got all our ducks in a row to begin my mock cycle.

There's a really good explanation of a typical mock cycle, and a typical donor IVF cycle at ParenthoodOptions.com.

First thing Monday morning, I'll call the RE's office to set up a time for us to go in and do an injection class.

The shots I'll be taking (more on that in a moment) will be intramuscular (in the butt) so we need all new training, since we've only been doing subcutaneous in the belly, so far.

Or, possibly, they might just let us get Shrike's mom to show her how to give them to me, since she's an RN and knows such things.

And, yes, Shrike will be doing them. So far, I've been doing the majority of the injections myself, but Nurse D (who is kind of taking over for Nurse E, now that we're moving to the donor egg program) said that it's really much easier for someone else to administer IM shots since, well, it's easier for her to reach my butt than for me to!

Once I start my period, we'll jump right in, beginning the injections on Day 2. I'll take estrogen injections every 3 days (Days 2, 5, 8, 11).

Then on Day 12, I'll have an ultrasound and bloodwork, to check my uterine lining and hormone levels.

I'll continue the estrogen (days 14, 17, 20, 23) and add daily injections of progesterone.

I hear that the progesterone in oil shot is a tough one; because it's so thick, it really hurts going in. I guess I'll be finding out for myself soon enough.

That continues through Day 23, when I'll have an endometrial biopsy. That involves going in through my cervix (that, I'm used to) and grabbing a tiny bit of endometrium (not so used to that!).

At that point, I think I stop the shots and start my period a few days later.

When my biopsy results come back, that will tell us whether my endometrium responded as we want, in which case we'll use the same protocol for the real cycle. If not, it might be tweaked a bit.

Meantime, Shrike and I will both be doing some other testing things. A prescreener is suppose to contact me next week to give me a checklist about that.

Once my mock cycle is done, we will both start birth control pills (isn't it ironic) to get our cycles sort of synchronized.

They don't need to be exactly synchronized, in fact I'll be about five days ahead of her. According to ParenthoodOptions.com, once my lining is good to go, I can be in a "holding pattern" for several days waiting for her eggs to mature.

I believe we'll both be taking Lupron at that time, too, if not sooner. That will suppress our bodies' natural hormone production, so that we're only doing what the doctor wants us to do, not trying to control our own bodies internally. (Again, see ParenthoodOptions.com for a better explanation.)

We'll schedule the pills for me to have a period about a week before Shrike's, if I'm understanding correctly.

At that point, I'll start the meds, as above (with possible tweaks, depending on the biopsy results) and about 5 days later, Shrike will start FSH injections, for 10 - 13 days, to stimulate lots and lots of follicles to develop.

I'm assuming she'll have a Day 3 ultrasound first, to see how many antral follicles we've got to work with. (36, again?!?)

Then she'll also have monitoring ultrasounds, much like I've been doing, to check on follicle development. Then she'll get an HCG trigger shot (it actually triggers the final development of the eggs, not the release) and the next day, they'll do the egg retrieval.

The eggs will be inseminated and cultured for a few days, and 3 - 5 days later, we'll transfer a couple of the best-looking ones (of course, being Shrike's, they'll all be pretty cute!) to me, I'll be on bedrest for 24 hours, and then we wait. Again.

On the financial end of things, it looks like Shrike's insurance will not cover her meds, which could be around $3000/cycle, so I'm thinking that we'll most likely go with the "all inclusive" shared risk plan, which is several thousand dollars more, but would cover the meds, so that money would still be guaranteed.

If we're successful quickly, we lose money by going with that option, rather than paying for the meds out of pocket, but we have a baby, so it's worth it.

On the other hand, if we do six cycles and aren't successful, it's the difference between getting back almost all of our money (my meds and, of course, sperm are still not covered) or having no baby and several thousand dollars of of debt.

We're also investigating the possibility of doing preimplantation genetic diagnosis (PGD), which would involve taking one cell from each embryo at around day 2 or 3 and checking to make sure that it's chromosomally normal (exactly the right number of each) and, I think, also checking for some specific genetic diseases (none of which Shrike has any risk factors for or family history of).

Our primary reason for wanting to do that is the higher risk of chromosomal abnormalities because of Shrike's age. If we can be sure that we're only transferring chromosomally normal embryos, then our odds of success should be higher and our odds of discovering some sort of a problem later on should be much lower.

We will have to consider the cost, though, as that will be $3500 / cycle, and is not covered under the shared risk program.

That's $1500 to our RE's office for removing the one cell per embryo, and $2000 to the PGD lab for actually doing the testing. The price is the same no matter how many embryos we test.

So, to summarize, we are, of course, bummed about the negative beta, but we were totally expecting it, and had already moved on, emotionally.

I'm anxious to get started with this mock cycle, because the sooner that's done, the sooner we'll get to the real one.

The mock cycle will take about four weeks, then about four more on the pill, getting synced, then we start the actual IVF cycle.

It should be about three more weeks, I guess, til we're ready to do the retrieval / transfer, which puts the earliest possible conception date around late February or early March.

So, maybe a newborn for next Christmas?

A Quick Update

I need to get out the door to work soon, but just wanted to post real quickly that I just heard from Nurse E that we "got a big, fat no" for using my eggs for IVF.

So, I will leave another message with the donor IVF coordinator and let her know that we want to start my mock cycle with my next period (which will probably start on Monday or Tuesday) and Nurse E said they will order my meds for it as soon as they get my beta on Friday.

Assuming, of course, that it's negative. Which is what I'm assuming, because I've seen no indications otherwise on the pee sticks.

Thursday Thirteen #40

Thirteen Baby Names That We Have Considered / Are Considering
In no particular order. Some are first, some are middle names. Some are still in the running, others have already been rejected.

1. Matthew
2. Elizabeth (Ellie)
3. Samuel (Sammy)
4. Genevieve
5. Lynne
6. Theodore (Teddy)
7. Samantha (Sammy)
8. Emily
9. Emma
10. Grace
11. Lucas (Luke)
12. James
13. Joseph (Joe)

Get the Thursday Thirteen code here!
The purpose of the meme is to get to know everyone who participates a little bit better every Thursday. Visiting fellow Thirteeners is encouraged! If you participate, leave the link to your Thirteen in others comments. It’s easy, and fun! Be sure to update your Thirteen with links that are left for you, as well! I will link to everyone who participates and leaves a link to their 13 things. Trackbacks, pings, comment links accepted!

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Wordless Wednesday #37: Snow Day

Well, it's not really a snow day, because we still have to go to work, but it is snowing - and the puppers seem to be enjoying it.

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The Next Step

After talking with a financial person at our RE's clinic, I realized that the whole insurance appeal is to get coverage for the IUIs that we've already done, based on the fact that they never told us there was a limit of three.

We might get them to pay for that, but there's no way they'll cover any future IUIs.

Based on that, we've decided that if we don't get some good news from my beta on Friday, we will be moving on to IVF.

"But, wait" you say. "I thought IVF was going to be prohibitively expensive?"

Well, yeah, it was going to be, but my parents have offered to cover a significant portion of the costs, leaving us with a quite doable amount to pay ourselves.

They'd said, a couple of times over the past few weeks, that they would help "big time" if we had to go to IVF, but I had no idea until last night just how much they had in mind.

With that part worked out, I made some calls today, to the donor IVF nurse and financial coordinator, trying to sort out the rest of the details. I got a bit more information, but I think I may have come away with more questions than answers. They are both working on getting us more information.

I've also asked Nurse E to check with Dr E on whether there is a possibility of getting approved for shared risk using my eggs, because that would be about half the cost.

I don't have a lot of hope for that, though, so we're expecting to go forward with using Shrike's eggs.

I'm trying to get things lined up to go right into the mock cycle if things don't turn out as we hope this cycle, but I don't know if I'll be able to.

Right now, we're trying to find out what kind of insurance coverage Shrike has that might help with her meds and / or testing. If it's good coverage, we might go with the shared risk option that does not include those, and pay them separately.

On the other hand, that money would then not be guaranteed. We'd be out it either way.

But, if even a few cycles would cost significantly less with insurance than the difference in the full versus partial plans, it might be better to go that way.

I'll have to discuss it with my parents, of course, since it will be mostly their money at risk.

There are still a ton of details to work out, and also a ton of things to process personally, including coming more fully to terms with giving up on my own eggs and a genetic connection to our child, but with my parents' offer, it's like a huge weight has been lifted, and suddenly IVF looks possible, rather than some crazy fantasy.

I am still just blown away by their support and their generousity. I have, of course, thanked them, but there is no way that words can ever be sufficient for a gift like this.

We are very, very lucky, indeed.

Ten on Tuesday #12

10 Favorite Things to Complain About

1. Not being pregnant yet (that we know of)
   
2. The amount of money involved in getting pregnant
   
3. The amount of money involved in everything
   
4. Our work schedules


5. Our dogs


6. Our cats
   
7. Republicans


8. My insurance company


9. Stupid people


10. Shrike leaving her mug of tea in the microwave all day (she actually reminded me about that one)

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Manic Monday #17

1. What's the longest you've ever waited in line?
   That would probably be when I was in college and got in line in the wee hours of the morning (but not the night before) to wait for Bruce Springsteen tickets.


2. It's been said that, "The best things in life are free." Do you think this is true? Why or why not?
   Hmm, well, a year or so ago I might have said yes, but looking at what it's costing us - and how much more it could cost - to try to get pregnant, I might have to revise my answer.
   
3. If you could go back in time and re-live one day in your life, which day would you choose and why?
   Oo, that's a tough one. I don't really think I can pick one specific day. And I'm not sure if I'd want to pick a really great day, to enjoy it again, or a day that wasn't great, so I could maybe change the outcome, a la Quantum Leap. Is that allowed?

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Frustrated

I don't know why I bothered to pee test yesterday and today, knowing damn well that it was most likely too early to get a positive result, even if things are going well. Tomorrow might be far enough along to see something, but even that is a bit of a stretch.

All I accomplished by starting it yesterday instead of waiting until tomorrow was wasting the $2 for the tests and discouraging myself. Ugh.

I know I've got five more days to see something on a pee test, and five more days til my beta, so there's still plenty of time to get good news, but at this point, it kind of feels impossible, like we're just doing all this stuff and going through these motions - and spending all this money - for something that's just some crazy fantasy.

Like if we were spending all our money on lottery tickets or something.

And, now, I'm totally freaked out about this whole insurance thing, and what to do if they're not going to pay for any more IUIs. Do we pay for three more out of pocket, at about $3000 a pop? Or do we go right to IUI - and borrow like $40,000?

What the hell am I saying? We can't borrow $40,000.

Well, we could borrow it, but we couldn't pay it off.

Sidebar:
Shrike is reading over my shoulder and just said:
"What are they going to do, repossess our baby?"

"No, honey, they're going to repossess our house."

(No response.)

So, that's where we stand. I've emailed Nurse E to ask who to talk to about the status of the insurance appeal, and how long it should take.

We have a week before we'll know anything, but if my beta is negative, at that point, we'll need to decide pretty quickly what comes next, because I'll need to start meds on day 3, which could be as early as next Wednesday.

Ugh.

Photo Hunter #37: Red

Our Little Red Dyke Truck (and my Little Red Dyke Wife), dropping off leaves at the composting center. That's not a hill in the background, it's a huge pile of leaves!

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