The consultation and the aftermath

So last Tuesday we got up bright and early to head down to Iowa for our consultation with the new clinic.  We were really early, so we had some lunch and then went to the mall for a bit before heading over to the clinic.  We registered with the receptionist and were taken back within a few minutes.  The nurse that took us back took my weight and blood pressure and then we met with Dr. C.  As usual, he started with the whole medical history bit, and went through my records and entered all of my test results into his system.  After that, he went through all of the basic causes of infertility and crossed them off one by one and ultimately came up with the conclusion that we have unexplained infertility (duh).  The only possible explanation that he gave us for our difficulties in conceiving was that that it is possible that Mark may have developed antisperm antibodies as a result of a hernia repair surgery that he had last year.  If that were the case, it would lead to fertilization problems, which could explain why we’re not pregnant yet. 

 

Once he officially gave us his diagnosis, he said that he guessed that we were ready to move on to IVF since most people wouldn’t travel 4+ hours for clomid and IUI’s.  BINGO!  At his clinic, they do ICSI for 90% to 95% of their IVF cycles, and he would recommend that for us too because of the possibility of antisperm antibodies and ICSI would bypass the entire fertilization issue.

 

Dr. C seems to think that IVF will do the trick for us, and of course we are hoping that he’s right.  He said that I have responded well to the oral meds in the past and that bodes well for how I will respond to the injectables.  He also thought that we should be able to participate in the shared risk program which will allow us to do three fresh IVF cycles along with any associated frozen cycles for one fixed cost.  The nice part about this particular program is that meds are included in the package price which is a HUGE cost savings.  Comparing my previous clinic’s shared risk program to this new one, we will save somewhere between $6,500 and $17,500 depending on how many tries it takes us to get pregnant. 

 

So before we can move on, Dr. C said that I would l need to have another sonohysterogram/mock transfer.  This will be done so that he can determine the curvature of my cervix so that inserting the catheter for the embryo transfer is as easy as possible, and also to determine the shape of my uterus so that he can put the embryos in the “sweet spot” where they will have the best chance to implant.  Mark and I also both had to have blood tests for HIV, Hepatitis, etc, which we did on Thursday. 

 

All that’s left now is to have a phone meeting with the financial advisor Monica and then take the IVF patient education class.  And unfortunately, that seems to be where we’ve hit some stumbling blocks.  Dr. C said that he would have Monica (who also seems to be the person who determines if we can participate in the shared risk program) call us last Wednesday to go over everything.  Well, today is Monday, and we still have not heard from her.  I left her a voicemail and also sent her an e-mail, and still no response.  My mock transfer is scheduled for Thursday and I need to know if we are accepted into the shared risk program before then.  If for some reason we cannot be a part of the shared risk program, then we will likely not go forward with this particular clinic due to the distance.  There is no sense in heading down there for a mock transfer if we won’t be pursuing treatment with them.  So at this point I am beyond frustrated with the lack of communication.

 

Additionally, we need to attend a patient education class before we can start IVF.  It just so happened that they were doing one of these classes on the very same day that we were there for our consult.  We actually asked if we could stay and do it then since it would save us a trip, but the receptionist insisted that we must have all of our pre-testing and financial appointment completed before we can take the class.  We had asked Dr. C if there was any way that we could do both the SHG/mock transfer and the class on the same day, and he said that it would probably be doable.  Well when I called to make my SHG appointment, the receptionist told me that the next class wasn’t until late, late August.  What?!?  Do they only do these classes once a month?  If we had to wait until late August before we could take the class, we would miss a whole other cycle, which is certainly not what we want at this point.

 

So I called on Friday afternoon to see if there was any way that we could pay extra to have a special class just for us.  If not, could we start the birth control pills BEFORE we took the class since you don’t really need a whole lot of education to pop a BCP.  Either of those two options would work out just fine for us (of course we’re hoping that somehow we can arrange a special class just for us on Thursday, which would save us another trip down there), but we still have not heard anything back yet.

 

I’m frustrated because when I initially contacted this clinic, I had asked about doing treatment from out of state.  Monica had responded that they just had a client from Wisconsin get pregnant from treatment there the previous week, which made it seem like they were experienced in dealing with patients from out of state and that perhaps they were accommodating to their needs.  So far I have not noticed that to be true, and my frustration with their lack of response is certainly growing with each passing hour with no return phone call.

 

In my heart, I feel like this is the clinic that we need to be at and we will get pregnant from this.  But at this moment, I am so upset and frustrated, I just don’t even know what to do with myself.  I know that frustration is the last thing that I need when we’re going to be starting IVF, so I really hope that the communication improves from here on out.  I have no idea what we will do if it doesn’t.

 

In more positive news, a woman in my real life support group who has been undergoing IUI’s for over a year (her husband is sterile due to cancer treatments) finally got her BFP.  It was so thrilling to hear that it finally worked for her.  I cannot imagine taking 12.5 mg of Femara and doing two IUI’s every month for 15 months.  The stress and emotion of 5 IUI’s was nearly too much for me. 

 

Additionally, two women from my online buddy group are also pregnant, one of which was just about to start IVF for severe male factor infertility.  She thought that the only way they could get pregnant was IVF with ICSI and somehow they got a miracle BFP.  It is exciting to know that it is happening for other women.  On one hand it makes me think that if it can happen for them, then it can happen for me.  On the other hand, of course, it makes me wonder how come they can get pregnant with presumably such major issue, but we can’t with presumably minor or non-existent issues.  It’s a frustrating mixed bag of emotions.  But I am very truly happy for all of them.  I’m just wishing that our time comes soon too.

Off the Wagon

Well, after nearly three months of a concerted effort to not consume any sugar, sugar substitutes, caffeine or alcohol, I’m off the wagon. Mark and I went to a wedding for a former co-worker yesterday and I determined that I was going to allow myself to fully enjoy the day eat and drink whatever I wanted. Since I made the decision early in the morning, I also picked up some peanut butter M&M’s and some Nestle Tollhouse cookies when we were at Target getting the card for the wedding. The M&M’s and cookies didn’t really taste as good as I thought that they should have, so I was wondering if the absence of sugar in my diet had altered my tastes, but the cupcakes that they had at the wedding were FABULOUS, so I guess my theory probably wasn’t correct. Sugar, check. Caffeine, check. Might as well throw some alcohol in there for good measure, so two glasses of white wine were consumed at the wedding as well. It was a great time and totally worth it.

And today I don’t feel the least bit guilty about it, but I am left wondering what to do about things now. I know that eliminating alcohol is something that I will continue to do because I wasn’t a big drinker in the first place so it’s not a huge sacrifice to make. And honestly, cutting the sugar out of my diet was a lot easier than I thought it would be, and even if it doesn’t even directly help me to conceive, it’s still just a healthy thing to do and helped me to lose 6 pounds without any other diet modifications. But dealing with infertility is a stressful thing and there are times that I think that sometimes a little sugar for comfort is nice. So for this moment, I’m planning on getting back on the wagon tomorrow and I guess we’ll just see where things go from there. One thing I’m sure of is that I’m not capable to having a just a little bit of sugar. I’m definitely a binger…once I get that taste in my mouth, there’s no stopping me. As a testament of that, two thirds of the bag of M&M’s is already gone. It’s shameful, I know.

In completely unrelated news, I went to Wal-Mart today to pick up my prescription for Femara. When I picked it up, I was notified that they were only able to partially fill the prescription and that the rest would be in tomorrow. So I only have enough pills to get me through tonight, and then I need to go back tomorrow to get the rest. Sigh. Why is nothing at Wal-Mart easy? Of course the easy solution would be to transfer the prescription to a different pharmacy, but the cost savings at Wal-Mart is pretty significant, and I’m a cheapo.

And as you’ve probably already figured out from the previous paragraph, we are indeed pursuing one more round of IUI with Femara. When we started seeing Dr. P and Dr O, we agreed that we would give them at least three shots at IUI before moving on, so this is it. I’m hoping that the third try is a charm, of course, but if not, then we are ready to move forward with IVF. In fact, we’re so ready to move on to IVF, than I’m pretty much writing this entire cycle off and already thinking ahead and trying to plan our IVF path.

After discussing some options with Mark, he’s ready and willing to throw $30,000 towards one of those “you’ll get a baby within three fresh cycles of IVF or you get 80% of your money back” kind of deals. Of course since I’m stingy (and also partially because I think that we would have a really good shot with IVF and might get lucky on the first try), I’m not as ready as he is to sign up for such a huge financial commitment. If we were lucky enough to succeed at our first try at IVF, then I’d forever be kicking myself for “wasting” that money. Without a doubt, it’d be so worth it to spend the money and get a baby out of it, but I’d rather just give one cycle a shot and see what happens.

Of course the caveat to the whole thing is my FSH. I’m not sure that we would even qualify for any of those “money back” programs with an FSH of 12.9. And what if we did sign up for one of those programs and then find out at the first IVF that my eggs are no good? Can we get a refund for part of that fee and opt out of the rest of the cycles? Domestic donor egg cycles are way too expensive for us, so converting the rest of the package to a DE cycle would be out of the question.

And then there’s the option of doing an IVF vacation, which I’m TOTALLY on board with. This would definitely be my first choice as to treatment options if we need to do IVF. I am most interested in the Czech Republic right now as their costs are very low and they have great success rates. Not to mention that the Czech Republic is a beautiful country to boot! I spent a few days in Prague on vacation when I was studying in France and it was gorgeous and I would absolutely love to go back. The biggest issue with doing IVF abroad would be the time commitment. If we were to do a cycle with my own eggs, we would need to take at least two weeks off of work. Donor egg is a much shorter time commitment since I wouldn’t need to be around for monitoring; we would just need to be there for egg retrieval and again for transfer, probably a week or less, but we aren’t ready to pursue egg donor yet.

Anyway, there are a lot of options out there, so there is much research left to be done. Regardless of what path we choose, I am feeling very hopeful that a baby will be a part of our near future.