Fertilization Report

I'm impressed. The clinic emailed my fertilization report before I even finished flying home today. 3/4 eggs were mature and fertilized! The fourth one was immature. The embryologist will culture him for another day. If he matures by tomorrow she'll ICSI him, too. Next report is on Monday.

I didn't cry this time when I left for the airport this morning. Last time the tears were streaming down my face as I got in the car to leave. I felt so guilty for leaving our 'babies' in California all alone. You invest so much of yourself in this process. And I have always allowed myself to get attached. My reasoning is if that's all I ever get to experience being a mom, I'm going to make the most of it. When I arrived on Tuesday one of the first things I did was drive by the clinic and say, Hi babies, Mommy's back! It felt good to be in the same zip code with them again. I'm sure the embryologist laughs at me. Last retrieval when I got the final blast report I jokingly asked her if she would read them a bedtime story and give them a blanket for the freezer. Yea, totally attached. I can only imagine what I'll be like if I'm ever so lucky as to have my own baby in my arms.

Why I LOVE Mini-IVF

Retrieval was this morning. Four eggs were retrieved. It still completely blows my mind how much easier it is to do mini-IVF versus conventional. My one high stim IVF that led to a transfer I only got 3 eggs and one embryo. I stimmed for two weeks, shoving up to three needles a day into my body. Then came retrieval and I got to stick estrace and crinone up my vag. I thought I also remembered an oral med or two in there as well. This cycle I took clomid for 8 days, did ONE shot to trigger and we got FOUR eggs. Hmmm....pretty sure it's not even a contest on which IVF I'd do. I only wish I had found my clinic sooner. And have we discussed cost?!  For what some women spend just for meds on a conventional cycle, I can do two full rounds of mini IVF - including retrievals, transfers, meds, and embryo cryo preservation and storage for a year. Seems like a no brainer to me. Talking with Dr. Y today after retrieval even he shakes his head at why more places aren't doing this. Don't get me wrong, a lot still goes into this type of practice. A huge part of it is having a well qualified doctor and a top notch lab. But still. Even flying halfway across the country is worth it to do the mini-IVF.

I think Dr. Y may have finally convinced me to try a natural IVF round next cycle. I have been hesitant because it is still so hard to trust the process. Depending on what these eggs decide to do, we will either do another mini or try natural with a transfer next cycle. A natural cycle would be even easier. Baseline appt on day 2. Second monitoring on day 10. Trigger. Retrieval. Transfer. Wait for beta. The only drugs would be the trigger shot of Lupron (sub q, no IM needed) and I would need progesterone support due to a luteal phase issue. I think some people don't even need progesterone. How fantastic does that sound?! Cycling here has given me hope that I may actually get pregnant. And I whole heartedly now embrace the less is more philosophy.

Hoping tomorrow brings a good fertilization report. Dr. Y predicts 2 quality blasts. We shall see. I'm still amazed he got four eggs out of me. My follicles on trigger day were 18, 16, 13, and several smaller. He aspirated every follicle he could find. I went in hoping for two and was blessed with double. I still think it's incredible to watch the retrieval and actually see the follicles aspirated and see my little eggs lined up. It's worth the pain of no anesthesia or pain control.

Triggered Last Night

Last night I did my trigger shot. I've been taking ibuprofen every 6 hours (helps prevent ovulation) and I'm currently on my way to California. Medication-wise this cycle was even easier than my last. I took half a tablet of clomid for 8 days and the only shot was my Lupron trigger. Easy. Only this cycle it is looking like only 2-3 follicles will be retrieved. I know this is still considered good for mini-ivf but it is hard to see that when we got so many eggs last time. As Dr. Y keeps telling me, quality over quantity. We shall see. Retrieval is scheduled tomorrow morning.  Fly home Thursday. Quick trip. Originally we had booked my trip until Sunday, but with triggering earlier this cycle, I decided to just  go home after retrieval. I love the beach, but it gets lonely all by myself. Hoping for some good eggs tomorrow.

IVF #4 Update

Life has been crazy around here since this cycle started. The day before CD 1, I had to attend to a family emergency on my husband’s side of the family. Let’s just say I spent several hours frantically helping pack up a household with my one year old nephew strapped to my chest. Not a good situation, but things are moving in the right direction. Then my husband insisted on driving to see his family for a couple of days after the family emergency. We left to visit after my CD 2 monitoring appointment. Then we got back the day before all of my family descended on our home. I spent the week entertaining and trying to keep our home clean. Hopped up hormones and the need to keep my home a clean oasis clashed this week. I’m proud to say I only cried into my pillow twice. Thankfully everyone left this morning. I don’t know if I could have handled much more family time.

Today I had my second monitoring appointment. CD 9 today. On CD 2 I had 17 antral follicles, but four of them were larger than 8mm. Dr. Y changed my protocol a bit this time. I am on half the dose of clomid – 25mg and so far I have not been instructed to do any booster shots. Today’s ultrasound was hard to tell for sure, but I think I have at least 2-3 large follicles with another 2-3 not far behind and then some smaller ones. I don’t think the tech I had today was very good. I’ve had enough ultrasounds done and it didn’t seem like she was measuring very accurately. We shall see. I’ll get the final report from the clinic later today. Last cycle I had more follicles growing at this point. I don’t think we will retrieve as many eggs, but it’s all about quality. I would think the retrieval will be Friday, but with the size of the larger follicles, I almost wonder if I won’t trigger tonight. I am scheduled to fly out to California tomorrow.

It’s looking like we may not end up using our insurance much. I feel that typically I am reasonable and level headed, but I lost it when talking to the insurance company today. I absolutely hate losing my cool like that. I need them to approve IVF before I have the retrieval this week. They received the request from the clinic over a week ago. The end of last week they sent out a notice by SNAIL MAIL stating the clinic needed to submit more documentation. Yea. My clinic hasn’t even received the letter yet. Specifically they need 2 years of clinical documentation to support IVF. Well, to provide that much, we have to go back to my previous clinics. I’ve been making phone calls and scrambling to get this all to go through in time. I no longer have any faith insurance is going to get their act together. And it is near impossible to get a straight answer from them. Basically every conversation is me asking them questions, them putting me on hold for 10 minutes while they ‘go ask someone else’, then getting back to me without answering my questions in the first place. I’ve had it. We’re just going to finish paying for the package pricing for the three cycles and just submit monitoring and pharmacy fees to insurance. It’s not worth delaying IVF to jump through all of their ridiculous hoops.

I’ve done all I can at this point. It’s time for me to sit back and relax and just let all the frustration go. We never thought we would have insurance coverage so even though it will be frustrating to not be able to use it, it will be ok. I have to get my suitcase packed. Sunshine and beaches, here I come!

CD 1...Let IVF # 4 Begin!

Finally, my uterus cooperated for once. I was worried about whether or not this cycle would work for us since we have family coming this week. If my cycle had been its usual length (25 days) we would not be doing this cycle. But my body decided to have a NORMAL (I rarely get to use that word…) 28 day cycle, so we will be proceeding. Yay! Let’s get this done and over with.

I spoke with my clinic yesterday. I have my baseline appointment on Monday, should start meds on Tuesday. I am doing another mini-IVF banking cycle. I would anticipate the same protocol – clomid plus a few booster shots. I’ll be in California the following week. We’re still debating what days to book my flights. My second monitoring appointment should be cycle day 9, so I think I will do it locally as well and fly out the next day. Five days of lounging by the pool and on the beach are in my very near future. Maybe I’ll regain some of the color I lost after my last trip out there.

We’re still working on insurance. The business lady at the clinic pushed through the prior authorization so hopefully we will hear on that early this week. I hope to hear before I fly out. Either way, we’ll be proceeding. If insurance doesn’t work out, then we’ll just go ahead with paying for the rest of the three cycle package. We don’t want to put things off. I want to get all of my banking cycles done before I turn 33 in four months. Dr. Y thinks it’s fine to do back to back cycles, but I really feel it’s important to give my body a break. I did have an increase in endo pain for the cycle after my last banking cycle, so for me, I think it makes sense to take a little break. And we have a wedding to attend during my next cycle anyways.

I have some anxiety, but it’s not nearly as bad as last cycle. I think it helps knowing what to expect this time. I know I can fly out there by myself. I know I can navigate the area and not get lost (thank you gps!) I know that time will fly quickly. I know my body is still capable of producing eggs. I know I can get through retrieval without anesthesia by myself. I can do this.

It's a Love/Hate Thing

The saga of my insurance coverage continues.

And we only have about 2-4 days left to figure it out or I won’t be doing this cycle.

Dun. Dun. Dun.

There are so many hoops to jump through even the business lady at my clinic is starting to get exasperated. And this is someone whose job it is to deal with insurance companies every day. The referral is in place and now we’re trying to get the prior approval submitted. And I verified my clinic is indeed a participating BCBS provider. It they weren’t, anything the clinic charged above what my insurance company pays for services, the remainder would come back to me.

I’ve done the math. And depending on what my clinic submits to insurance for two banking cycles and two transfers, we may just end up keeping the three cycle package we signed up for. The package is just under $10,000 and includes 3 cycles and 3 transfers. We have already used one cycle. If we switched to insurance we would have to convert the first cycle to an individual cycle/transfer which is $5950. We paid for half the package and would need to still pay the $950 to make up the cost for the individual cycle.  Without knowing how much is going to be billed to insurance at this point and assuming it stays within our limit, it would be about $2500 more to keep the package. But this is only if we do not exceed our lifetime infertility cap. If we do, then using insurance could end up costing more. Ironic, isn’t it?!

The other kicker is that this year if we paid for the 3 cycle package we would have spent enough out of pocket to claim some on our taxes. But with insurance spreading our cost over this year and next and being hopefully less, then we won’t get the tax break this year.  Yep. I’m at the point of just shaking my head and laughing because in the end there is nothing more I can do.

Some days I think I should have been an accountant to figure this all out.

Can an IVF Cycle Ever go Smoothly?!

Banking cycle number 2 is coming up quickly. Maybe. I had planned on cycling with the start of my next cycle. But of course, the timing may not work out very well. I have family visiting from out of state that I see once a year. They are only here for a week and plan on staying with us. Depending on my current cycle, I could end up needing to leave in the middle of their visit. If I put off cycling until the next cycle, then I would end up missing the wedding of very dear friends of ours. We had hoped to finish up with our three banking cycles before the holidays. I had hoped to start transferring in January.

Insurance may also impact my next cycle. I know how blessed we are to have some coverage, but getting the coverage in place is turning into a rather big hassle. My in-network hospital in town does not provide IVF and the insurance will pay at the in-network level for out of network IVF, but you need a physician referral. I have the referral already from when I met with a local doctor for monitoring. But when the local office tried to submit the referral it wouldn’t go through because my insurance company was showing I still had a policy in effect from another company (a policy that ended two years ago!!). I have just had a lot of back and forth phone calls and explaining things to many different people. Stuff like this just really annoys me for some reason. I know in the grand scheme of things when insurance does pay out, every second of frustration will be worth it. Anyway, the referral still needs to go through and the insurance company needs to approve it before I can start on my next cycle.

I’m just keeping my fingers and legs crossed that my current cycle goes longer than the more recent 25 days. A 28 day cycle would be awesome this month. Adding to the pressure is my deal seeking husband that can currently find cheap airfare from here for the approximate timeframe we are looking at. The problem with booking now is I do a natural start and my cycles have ranged from 23 days to 29 days in the last year. Last cycle we booked the flight on CD 3 and I left on CD 8. This time I hope to do more local monitoring and would spend less time out in California, perhaps leaving CD 10.

I know everything will work out in the end. It is much less scary this time around since I’ve done this all before. And now that I know how much easier mini-IVF is on my body, I’m not as anxious to cycle. I really just want to get the banking cycles done with so we can start transferring.

I have also been meaning to mention for anyone curious about mini-IVF. One of the sources where I learned more about it and also found the clinic I use was a forum for infertiles with high FSH.  http://www.network54.com/Forum/53068/ 

The forum says high FSH over 40, but there are plenty of younger women posting on there. I myself am an information junkie and did tons of searching before we considered trying IVF again. I really feel that you need to be your own advocate and not just always believe the first doctor you speak with. I also feel that because our emotions are all over the place I think it’s easier to sometimes just go with a doctor because you like them, instead of being able to step back and look at the clinic success rates as a whole. Each person needs to figure out what will work best for them and the only way is by doing lots and lots of research. I post on the above mentioned forum under the name Amanda. I have probably discussed more details there about my mini-ivf experience than I’ve put on my blog so far. I miss more regular blogging. Hopefully I will get myself back into it.