Well I had another doctor appointment this morning and we are moving closer to the retrieval.
This whole cycle has been different for us - we have had to change our mindset to the approach. The last 2 cycles it was about getting as many eggs as possible to give us the best chances of having them fertilize as well as hoping for some to freeze. Well, that hasn't worked out well, we haven't had any to freeze from either one. So this time, we are trying to switch mentalities to think about getting the best 3 embryos we can for the transfer and letting the others just be there. They won't survive anyway but it increases our odds.
That has made it difficult though because it is a switch in thinking. We had been so concerned at the ultrasounds about having as many as possible. This time has been a slower growing cycle overall and I am struggling to not jump to the bad thoughts about it all. The doctor is happy with our progress though and is happy with everything.
We should be looking at doing the big trigger shot tomorrow or Thursday and having the transfer Monday or Tuesday.
We are getting there - slowly.
So ready to be off this part of the emotional roller coaster please.
Tuesday, July 31, 2012
Well I had another doctor appointment this morning and we are moving closer to the retrieval.
Thursday, July 26, 2012
I am not a violent person, but yesterday hopped up on hormones, I surely felt as though I could get physically violent with someone if I continued to get the run around.
I was trying to get my medicine ordered for this cycle of IVF. We had some left over from the last cycle and thank god we did. My insurance covers the meds (I am not complaining about the fact they cover it, I am grateful) however, their procedures to get it approved and shipped leaves something to be desired.
When I went to the RE's office to get the baseline blood work and ultrasound showing things were a go, they sent the information to my insurance to get their approval for the cycle. Okay, kind of annoying, but not a huge deal. However, they have to approve it and then send it to the specialty pharmacy for them to get it in the system to then set up a delivery of the medications. This shipping is done overnight due to one of the meds having to be refrigerated. BUT - the issue comes that the day you go in for the blood work and ultrasound, you need to start the shots THAT night and the earliest you can get your meds if the system is working at its finest is the day after the RE visit. Why doesn't this system coordinate with the cycle set ups????? This is the million dollar question.
So, yesterday being 2 days after my appt with the RE, I still had not heard from the pharmacy about setting up delivery and was getting awfully close with one of the medicines to running out. So I called them to get a status update. They say that RE's office needed to send them a particular form that was not included with all the other papers before they could set up shipment. Called the RE's office and they sent it right away. 2 hours later, I call back to the pharmacy and am told the same thing, still waiting for the form in order to get through the approval process. I started to freak out because I cannot start and stop this medication on a whim. We tried to see if we could get it locally, as long as insurance would approval an override since they were not going to be able to ship it for me to have it before the medication would run out. The specialty pharmacy finally had all the approval, but it was past the time for me to get shipment the next day and there wasn't anything they could do about it. I was really ready to lose my mind and was struggling to make sentences because my hormone-filled self was seeing bright red. I was having to work very hard to maintain my composure and I was just completely defeated with the whole process. Really, I just wanted to cry.
Needless to say it took 6 more phone calls after that to the insurance and RE's office before they magically resolved the problem. Even though I was told I was being "rude" to their customer service person who was just following their procedures and that their hands were tied due to those procedures. Well a total of 8 phone calls to the insurance pharmacy and 5 calls to the RE's office would cause anyone to be frustrated with the situation. Let's add several days of hard-core hormones to the situation and then you may be close to where I was at that moment.
Oh, and while all of this is going on - our dishwasher decides that time is the perfect time to not drain and back up.
When it rains, it pours.
While our area which is currently in a severe drought needs rain, this is not what I would have wanted it to be in terms of a downpour.
The meds were here this morning and we are set for the rest of this cycle and man do I hope it works so I do not have to go through all this again with this stupid pharmacy. They are too much hassle! This process is very complicated as it, why add insult to injury and make something more difficult than it needs to be???
I have another appointment on Saturday morning to do an update to the follicles and I really hope they are growing large and in charge so we can get through the retrieval as soon as possible.
Some people make me angry with all of this. Ignorance is not an excuse to be hurtful.
I received this as a response to a post I had on Facebook about the medication costs before insurance:
Have you thought about going to a new specialist. No offense, but if they haven't helped you, do you think the more expensive drug will benefit you, simply because it cost more? I am sorry If this is crass, but I feel for you and worry about the effects of said drug. I hope something will give for you two. Mother nature works itself out. My thoughts are with you!
My angry response:
My meds are only $75 a piece with insurance. There are not many drugs that do what they need to do and some of them are actually more expensive than those. I am friends with people around the country and they are paying more than those costs for the same medications and are having to do it without insurance helping them out. The meds are doing exactly what they are supposed to do in the protocol for IVF - there is not a magic cure to make the embryos implant and there is not a medicine to take to make that happen. These meds are carefully monitored to see how they are affecting the growth of the eggs to make them grow without growing too quickly which can cause permanent damage. My specialist and the other 5 in her practice are amazing, I wouldn't trade them for anything in the world. We are fortunate that my health insurance covers over 90% of the procedures and that I am only paying $75 of a $1900 medication. Some women I know have paid over $20,000 for the procedures themselves and nearly $4,000 for the medications.
As for mother nature working itself out, that's not going to happen. I have undergone more testing than I care to think about over the course of the last 6 years and on our own, we have less than a 1% chance of conceiving on our own. And the 1% is a high estimate to the situation. We cannot just wait for mother nature to take over and handle this because it is not probable to happen that way. These doctor's have given up a 56% chance of conceiving which is nationally the best average for someone in my situation - 1% to 56%, I will take those odds.
Make sure you have the facts people, please before saying something. If you don't know - ask. Don't assume you know anything unless you have asked or experienced it yourself.
Now, I really want to scream...
Monday, July 23, 2012
The ultrasound tech said the ovaries looked really good and that they were down to the size we were looking for them to be. The nurse called and said that the estrogen levels were great too.
So, what does that mean??
Shots, shots, shots.
We start the 2 shots a day again tonight. I have my next blood draw and ultrasound on Saturday morning. Ugh, but a necessary evil.
The RE is recommending us to do a technique called "assisted hatching" this time. This is when they take the outer shell of the embryos and busting through it before they are transferred back into me.
My eggs are great quality, Aaron's sperm count is high and strong (much to his ego happiness), so that's not the issue. We have done 2 different medical protocols and neither have taken, but we have had great numbers of embryos retrieved and many of them fertilized - there has to be something else going on that is keeping those little guys from taking hold in me. I have had my uterus checked out and the lining is good, no polyps or cysts - everything is good everywhere else.
Man, it's frustrating as hell. Everything is lining up great, but those embryos have not taken hold.
They also want us to consider transferring 3 embryos instead of 2.
What the frustrating part is that they do not usually do assisted hatching and this many embryos in someone my age (31 - 32 in November) because women my age often do not need to have their outer layer broken. It happens as we get older and by the time they are doing IVF on women in their late 30s, it's common practice.
How does this make me feel??
Pseudo-broken that I am on the younger side of the IVF protocols and have to do the techniques for more challenging IVF cases.
Frustrated that this is where we are now.
Hopeful that these changes will make all the difference.
Annoyed at the stimulating shots taking over my life again.
Scared for the pain of the retrieval.
Nervous for the 2ww.
Broke because it's 2 cycles in as many months.
Excited that we will get it in before the new school year starts (I could have my Beta test on my first day of school with students full time depending on when the retrieval will be set.)
Relieve that we seemed to have determined exactly what the issue is with the failures.
Semi-worried that if we do all 3 in the transfer and what happens if they all take???? (Talk about getting more than your dream!!)
Yes, that's quite a bit of emotions running the whole spectrum of emotions. Unfortunately, it's all at the same time and comes to me in different waves. Sometimes, the waves are tidal waves, other times they are just little ripples in the water.
Well, I have to run and start doing shots again - this is my life from now until who knows when? I hate this part, thank goodness it's only a few minutes a day.
Sunday, July 22, 2012
I will go in to the doctor in the morning to have an ultrasound and a blood test to see if my body is ready for it. If yes, I will start med tomorrow. If not, then we have to wait at least one cycle before we can start.
We are hoping that we can start right away so we can try to get it all in before the new school year starts. At least with the rough aspects, so I am not trying to go through all of that while the beginning of the school year is going on. That is enough in and of itself.
Aaron and I have talked about it and we are going to be very closed with this cycle. Not because we are trying to close people out. Not because we don't appreciate the support. Not because we are trying to hurt anyone. We just need to for our own reasons that are really not going to make sense to anyone else.
Friday, July 20, 2012
We had the blood test yesterday and it was not good news. The embryos did not take.
We had such high hopes after all the positive improvement to the whole protocol from the previous attempt. Things seemed to be looking up and moving in the right direction. We had more eggs retrieved and the embryos they transferred were of so much better quality and growth than our try last year.
We have nothing to show for it except incredible heartache, bills to be paid, and much self-doubt.
We are no further along than we were when we started all this journey years ago and it's so tough to not get so discouraged and feel like a failure.
Now, all the questions of the future are flooding my brain and I am just overwhelmed.
The amount of support and love that we have received helps, although I could never put into words how much that support means because there are not words of gratitude that exist to fully explain it to them. It's like trying to describe an intangible feeling to someone without experience with emotions. We are so grateful.
I cannot talk about it out loud right now - every time I have tried, I start sobbing uncontrollably.
The only thing I can say is that this hurts so much more than everything we went through last year. Why do I feel that way? I am not sure.
Again my specialist is going to meet with the others in her practice to review it all to make their recommendations for the future as they did last time. Our fear is that they are going to say we just had the bad luck of being in the 44% that do not work for absolutely no reason at all AGAIN. That was what the result of the first one was.
Aaron and I have talked about it and we want to go ahead if it's recommended right away. We are hoping that we can get through the back and forth to the doctor's office as well as the retrieval before my school year starts to help with me not having to take days off work, if possible.
Ugh - to do it all again is so frustrating.
We are good people, we have a good marriage, and such a desire to be a family. Why is this not happening for us?????? I know, I know, I could drive myself insane with this wondering but it is so hard to not think about.
Today, I am doing a sad day.
I am going to be sad for all the process we have been through so far in our journey. I am going to be sad for the pain of the procedures. I am going to be sad for the terrible luck we seem to have with it all. I am going to be sad for all the emotions we are going through, both individually and as a couple.
It's like the grieving process. Something I am all too familiar with right now with my mother's recent passing.
I am scared to death for a million reasons - scared this will never work, scared of the pain again just to start with.
Now, onto my sad day to try to deal with this all.
Thursday, July 12, 2012
I don't really feel much more than some random cramping and the side effects that are associated with the progesterone shots I have to have everyday.
By the way, I hate this shot so much even though I know it is helping with the situation. It is a painful shot and for those few minutes everyday when Aaron is giving me the shot, I really don't like him because he is the one who is administering it to me. :-( He doesn't like that it hurts and that he is the one who has to do it.
We still have a week to go - our blood Beta test is next Thursday. It would be Wednesday to be exactly weeks from the transfer but I will be out of town until Wednesday afternoon so I will not be around to get the test.
We are anxious and nervous.
I am working really hard at not letting these get to me, but sometimes for a few minutes everyday - I just can't help it. :-(
1. This won't work at all for no medical reason like what happened to us last year.
2. We would have to do it all again - taking on the financial, emotional, and time commitments all over again.
3. This won't work for a specific medical reason that we are not aware of before now - as in some medical condition that no one saw coming.
4. Can I go through it all a 3rd time??????
5. What happens if we do it a 3rd time and it still doesn't work? My fertility coverage only covers 4 lifetime successful tries. They determine "successful" as having an egg retrieval with eggs that fertilized. We would be cutting it so close to our limit.
My husband is amazing through this, he stays as positive as he can (even sometimes to the point, I get annoyed with his optimism). He makes sure I am drinking all the fluids I am supposed to and he makes sure that I take all my meds on time. He checks in on me throughout the day just to see how I am doing and he tries to talk me down when the fears/anxieties kick in. I don't know what I would do without him.
One week to go - seems like a lifetime.
Wednesday, July 4, 2012
We had 2 strong 8-cell embryos that were put inside me - that is better than we had last year, I think the best we had was a 6-cell embryo.
The doctor is very optimistic about it all this time.
Now I am on bed rest to let those little guys implant inside me and grow, grow, grow!!
My blood test will be on July 19 - would be the 18th but I am gone to a workshop with the Illinois State Board of Education until the afternoon of the 18th, so can't get to St. Louis for the blood test.
Monday, July 2, 2012
Of the 18 eggs they retrieved - 14 of them fertilized!!!!!
We did not do the injection of sperm into the eggs (known as ICSI for intra-cytoplasmic sperm injection) this time as we did last time. Most people think this is standard IVF procedure to inject the sperm directly into the eggs, but that is an entirely separate procedure altogether. Standard IVF procedure is to pour the sperm directly onto the egg in the petri dish and allow the two to naturally connect.
We had better success with the standard IVF last year, more of those eggs made it so we opted to do only do that this time. Apparently, this has been quite successful for us this time as well.
Now we just wait to see if we are going to do the transfer back into me on either Wednesday or Friday depending on how they are growing. Since medical science cannot replicate the human body, the sooner we can get the eggs back into the body the better the chances. We are hoping that the two best ones are the only ones we will need and that the others can make it to the freezing point so that we have options down the road.
This is all so complicated and I am trying to explain it to people as best as possible because there is quite a bit of confusion with it all. Some thought as soon as we started shots that we were on our way, some thought with the retrieval, but really we are not done until the transfer is complete. Then it's 2 straight days of bed rest or more if possible to hopefully allow the eggs implant in my uterus and taking the strain off my body to let it rest after this whole process.
Our appointment was at 8:30 am and it was very quiet at the doctor's office given that it was a Sunday.
The procedure itself didn't hurt nearly as badly as it did last year but they did not have an issue getting to my ovaries as they did last year. I am not going to say that it was pain free, but it was not nearly as painful this time. I was in huge pain last year, but this year it wasn't much more uncomfortable than I was with the swollen ovaries from the stimulation.
They collected 18 follicles which is awesome. The doctor's office will call me today to let us know how many of the eggs were not only mature but fertilized.
We are hopeful that many of them will have fertilized so we have many options.
It will be Wednesday at the earliest before we could have the transfer, Friday at the latest.
They will only transfer 2 of the eggs back into me according to the regulations they recommend for someone who is my age. They will not put more than that back into me to help reduce the risk of having a multiple pregnancy. According to the doctor, they are not looking for me to have more than 1 successful pregnancy. However, I am in the category of a higher risk for twins due to many different factors.
So more of the waiting game to find out how many eggs fertilized, then more waiting to see if it is going to be Wednesday or Friday for the transfer, then 2 weeks of waiting to see if it worked or not. It's all a hurry up then wait game.