Starting Suppression Meds

At 8:00 tonight I start taking my birth control meds and my z-pak pills. This is the first step of the IVF – suppression – and it comes before the stimulation. Basically they want to start at zero so that they can tell the body what they want it to do instead of just letting it takes its normal course.

Normally, I may release one egg per cycle. With IVF, they want me to release as many eggs as possible. In our education packet, they said that is anywhere between 8 and 20.

Since these meds stop everything, the doctor has more control which also helps to prevent the dreaded Ovarian Hyperstimulation Syndrome or OHSS*.

Learning about the possibilities of what could go wrong was probably the hardest part of our education packet. I definitely want to know what issues this can cause, but when this is basically our best chance, it felt more like these were the thing that we were willing to risk. OHSS is when fluid begins to collect in the abdomen. Mild forms are uncomfortable, cause you to gain a little weight in your abdomen, and usually goes away in less than a week without meds. This happens in less than 10% of patients.

Severe OHSS is massive amounts of fluid that collect in the abdomen and usually needs medical help to get it to go down. You can gain up to 30lbs on this one, and it is quite painful.

Neither one sound awesome so I am all about anything that will help prevent that from happening.

One thing that I keep reading is how important it is to up my water intake during this process. While it seems like it should be easy, the general consensus is starting to make this a habit now is important so that when I am on the stimulation drugs, it is ingrained in my head. When I am uncomfortable and needing to pee every minute anyway, the last thing I’m going to want is to think about drinking more water.

They’ve ordered my prescriptions from Caremark Specialty so I am waiting to her what my bill from them is going to look like. I’m not sure how long I’m supposed to wait before following up about the prescriptions, but curiosity is beginning to set in. I really want to know how much this is going to cost. They are starting me on the Ganirelix protocol instead of the Lupron protocol, so I know that much at least. The good thing about Ganirelix is that it comes in pre filled syringes so yay?

I feel like I know so much more about IVF than I have right now, but without having gone through this before, I feel like I know nothing. It’s new and scary and there are so many unknowns.

 

*I am not a doctor and this information is not meant to give medical advice. This is information that was provided to us. If you have a health issue or think you are dealing with OHSS, please contact your doctor immediately!

 

The Process of Starting IVF

 

We found out last week that we won’t know how much is going to come out of our pockets until we start toward an IVF cycle. After talking about it over the weekend, we decided that we could try for May. We aren’t planning on traveling. It is before the summer and super hot summer weather. It just seemed to work, and this way we will know how much it is going to cost. We can always postpone it a coupe of months if we need to once we get those numbers, but if they are what we are guessing, May should work with our budget.

So Tuesday (March 28th) I emailed the fertility center saying let’s go for May and by the way my March period started that day as well, just because they have been keeping track.

I get an email back that afternoon from their IVF coordinator saying that they are setting me up in the system, and that she is ordering my birth control meds THAT DAY.

I think I stared at the email for a solid five minutes letting the idea that starting in May means that we actually start now. For some reason this hadn’t registered to me, but it was super exciting at the same time. Plus they are going to get all of our insurance sorted before our contract appointment on April 19th. FINALLY.

As soon as you say we are ready to start, it’s like it puts a fire under everyone. Suddenly instead of you trying to sort things out, you are given check lists, and emails, and information packets, and deadlines.

Most of the checklist we have already had done since it was part of the process to sort out what was wrong with us in the first place. Primarily now it is contracts and education about IVF and the medications we are going to be administering (David is more nervous about the needles than I am, even though they are going in me).

Before, it felt like this might happen someday. Now, it finally feels like this may be happening. I’m trying to not get too excited because a lot of the information we are having to read says a lot about how there is a large possibility that this will not work. We are praying that it does, though.

I informed my boss yesterday, and she was very helpful and willing to work with my schedule (especially on short notice). David’s boss is on vacation this week, but there are really only two days that are required for him to be present and accounted for (according to the schedule they gave me). I’d like him to be at every appointment with me, but it sounds like there are going to be a lot of them so I’m pretty sure I can manage the easy ones by myself.

We also scheduled my Saline Infused Sonogram and Trial Transfer (SIS/TT) for next week. Basically it is the HSG (NOOOOOOO) again except this is at the fertility center (YAY), and they are using saline instead of dye. The process helps them to map where they are going to be transferring the embryo at the end of the IVF process (YAYAY!). I think knowing what this is for is going to make this one a lot easier.

Everything is moving quickly, and I am not upset about that. Knowing that this IVF cycle will be completely finished by June 2nd is actually a relief. I’m not excited about the medications I’m going to be on. I’m not excited about the retrieval, but I am so glad that we are starting this process now instead of waiting a few more months.

Waiting on Insurance

We are playing the waiting game (again) waiting to hear back from our insurance.

The first step to even consider IVF at our facility is going through a financial consultation. Until they hear back from our insurance about our coverage, they won’t do the consultation. Hearing back from the insurance can take up to ten days… so we are stuck not even knowing if it is possible to start this right now.

As much as we would love to, paying the entire $10,700 for the IVF plus another $4,500 for prescriptions out of pocket is not currently possible for us.

So we wait. We pray. We hold on to hope while processing our grief.

I started looking at adoption and holy cow, batman. That is so expensive if you do infant adoption. We had considered fostering to adopt before which is how we are leaning now.

I’m not giving up on my kids. Now, though, I have no idea where they are going to come from. Adoption will take a little longer as well because we want to have a couple of more rooms in our house before we bring kidos in. We were already looking at moving, but it is now necessary for that option.

Processing everything during this time is hard. There are so many emotions that just keep popping up and suddenly I’m crying during dinner. It’s so strange because I’m still hopeful even though this disappointment is overwhelming. I still feel hopeful. Maybe because there is not a 100% no. Something is going to work. I’m not sure whether to talk myself down or keep my hopes high though.

As I keep my phone close by, I keep wondering I keep praying and I keep waiting. It’s not what I planned, but I am learning (very slowly) that I usually do the most growing when my plans don’t work out like I expected.

 

Update/Venting: I am so grateful that our insurance is going to be paying anything toward infertility, but trying to get numbers from them is like pulling teeth. I’ve called numerous times. Our fertility center has called numerous times, and neither of us can get a straight answer as to how much they cover. Super super frustrating.

We have United Health Care which has a special place we have to call and register before we can get any coverage for fertility.

The Reproductive Resource Center puts you in contact with a nurse (which is very helpful if you have any questions).

Thing is, if you live close to one of their “centers of excellence” you go there and get all of the benefits. If you don’t go to a center of excellence, you get less than a third of the benefits. If there is not a center within 60 miles of where you life you qualify for a gap exception so that you get the full benefit even though you aren’t going to one of their centers. Confused yet? Well, we don’t live close to their centers, so we should get the gap exception. We are talking about the difference in $30,000 in coverage vs $10,000 in coverage in our lifetime for IVF and $10,000 in coverage for prescriptions vs nothing for prescriptions.

Granted we still have our copays, but this is huge. This is massively important.

After all of this calling and all of this waiting to see what goes through, though, we get a phone call from the fertility center that finally says that they won’t give us our coverage until we have chosen a start date and decided what cycle we are going through the IVF on.

It wasn’t the answer we were wanting, but at least it was an answer!

So now we decide what to do WITHOUT know how much it is going to cost us….

Follow Up with the RE

We had our follow up apt yesterday. I was going to try to write this last night but couldn’t. We didn’t call family. We didn’t have a party. David got me a milkshake from Chick-Fil-A, and we went home.

I think I made it through the appointment without breaking down, but that’s as far as I made it.

The idea of potentially not being conceive had never even occurred to me. Now, it is a reality that I am having to wrap my head around.

The cocktail that is my husband and I have less than 5% chance of ever getting pregnant naturally.

We add IUI, it goes up to 10% to 15%.

We go IVF, we are looking at 45% to 50%.

So you can guess which one was recommended. The idea that there is still less than 50% chance of pregnancy with IVF makes that an extremely difficult option because of its expense.

So now decisions that we didn’t think we would have to make are now ones we have to work through.

Do we want to try on our own or look at adoption solely?

We had always planned to adopt as well as conceiving so it’s not the adoption that is the sticky point. It is are we ready to go that direction entirely and if the 5% chance happens, awesome. If not, we are no less a family but I will never have carried a child.

I know it may sound lame, but pregnancy is an experience that I looked forward to. I know it doesn’t make me any more of a mom, but thinking about not having that just once is difficult.

So, hi ho hi ho it’s off to counseling I go. Fighting off depression that is calling me to sit in a dark room and not leave my bed.

My perfect plan of my perfect life is now wrapped in a blanket of student loans and infertility. My plans have literally unraveled. In literally three weeks we did all of our tests and had our results, they were just not the results I was hoping for.

As I look for things to be thankful in this time, I am brought back to the peace in my heart. Yes, there is an ache there as well, but I know that my purpose is not over because of this news. It means that I simply cannot look for my purpose in this area.

I have been so consumed in the idea of getting pregnant, anything less felt like failure. Is it failure? No. It is my AMH being extremely low and my husband’s morphology. There is literally nothing we could have done to prevent either of those things.

As we pray and seek wisdom about if we go for IVF or adoption right now, I cannot hate me. As upset as I am, the sun is still shining. I have a wonderful and supportive husband, and this is just a chapter in our story. While we cannot change what happened, we can chose to move forward instead of remaining here and focusing on our statistics.
As a side note, I may be signing off social media while we are deciding this. Seeing all of my friends pregnancy announcements, updates, and baby pictures is not helping me make solid decisions right now. Besides, I cannot compare my life to theirs. My life is mine. I want to be happy for them. There is no point in me creating a toxic environment for myself.