P.S.

The only "glitch" in speeding things up was that they usually do a day 3 FSH blood test 18 days before starting the Lupron. Well first of all today is day 7 and secondly I am on the pill so they can't do the FSH test while I'm on the pill. Even if we had waited until July to start, I would still have wanted to stay on the pill because otherwise it would be very hard to predict when I would be 7 days past ovulation. The success rates are much better when the FSH is less than 10 on day 3. If the FSH is higher then it usually means you are harder to stimulate (won't have many follicles). If it's between 10-20 they still will consider IVF as long as you know your chances are much less for pregnancy particularly as you get closer to 20. They never do IVF if your FSH is greater than 20 unless it's with donated eggs. So she tried to see if I had my FSH tested before. I knew I had, but she couldn't find any record of it. The other clinic used to test FSH on day 3 at the start of every inj cycle so I (falsely) assumed this clinic did as well. Turns out they were only tracking my E2 at that point. Well she consented to starting the IVF without knowing what my FSH level is, especially when Dr. Awad was so confident that understimulation is not a concern in my case. I just dug through my medical records and found three FSH results - 5.4 in May 2003 (not sure what day of the cycle that was), 4.4 on March 2, 2004 (day 3), and 6.63 on July 12, 2004 (day 3). So although my FSH has likely increased some in the last 3 years (it goes up as you get older), I feel confident it's still less than 10 since it was between 4 and 7 in 2003-2004. I will show her these records on July 5.

IVF update

Well our appointments only last 4 hours and 15 minutes rather than the full 5 hours projected. One other couple was there with us for our initial training with the nurse at 9am, and they still had appointments left to complete after we left so it definitely does take 5 hours for some couples. I didn't really learn much during the "class" we took with the other couple; the only things I learned were as follows:

• They usually won't do an ER if you have less than 4 follicles (I have no worries about that as I have always stimulated very easily) and the most they will allow is 30.
• If you have more than 30 then they will still retrieve the eggs, but they will not do a fresh transfer (just a frozen transfer later) due to the risk of OHSS.
• The ideal number they are aiming for is 12 follicles. I feel I could easily have 12 follicles, and I am glad to know that is what they are aiming for (rather than say 30).
• As for the 3 day vs. 5 day transfer, if you have more than 10 embryos (and they said typically 75% of eggs are fertilized the traditional way when they put 500,000 sperm in the petri dish with each egg, and about 50% of the eggs are fertilized when they inject one sperm into an egg which is called ICSI and costs more $$) then they will do a 5 day transfer (at the blastocyst stage).
• If you have nine or fewer embryos then they do a 3 day transfer and any embryos that are still alive at day 5 are frozen at the blastocyst stage (as the thaw rate for embryos frozen at the 3 day stage is only about 50% compared to about 100% at the 5 day stage).
• They strongly discourage only transferring one embryo. They recommend two, but will allow a couple to transfer three at the most. If we have three embryos I want to transfer three. I know there's a 14% chance for triplets and 28% chance for twins, but I also know the chance of getting pregnant at all is higher and I'm okay with twins or triplets.

The mock transfer and hysterosonogram were VERY painful in my opinion. As in tears rolling down my face painful while I squeezed the living daylight out of Paul's hand. They said it would hurt a little (as the uterus doesn't like having objects thrusted into it), but I would not define this as a "little." The doctor said #1 my cervix is tighter than "normal" (I was told that with my first IUI in 2004) and #2 my uterus is titled a little to the left so he said having to put the catheter at a sharp angle made it more painful. Well it's over. I will be under sedation with the retrieval and the transfer won't be as painful as this was. So he said the worst is over in terms of most painful procedure. I had taken Advil prior to the HSG in 2003 as the doctor in Allentown recommended (dye through the fallopian tubes test); I wish they had suggested I do that prior to this test as I think it might have helped decrease the pain and cramping.

Well the doctor was surprsied I was on the pill (not a good thing to do if you're trying to get pregnant, lol), but I told him I only started it a few days ago just in preparation for IVF as sometimes my cycles are very long (although not lately but still I never know for sure what might happen). So anyhow he said that in light of that I didn't need to wait until August to get started. He said to ask the nurse if I could start the Lupron in July. So she checked her calendar and said if we started the "usual" day (21) it would be too late as then my ER would be falling during their first "down" week in August, but she said when you're on the pill you don't have to wait until day 21 (since I won't be ovulating); she said you can start on day 14. So over the last week I went from #1 being told the ER must be schedule 3 months in advance (ie. late Sept at the earliest) to #2 on Monday being told oh yes I could have it the last week of August (2 months in advance) to today being told I can have it the last week of July (5 weeks in advance). Yikes!!! But this is good news. It means that everything will be done LONG before school starts in the fall. Presuming we aren't on strike (I hope not but will find out in the next 3 days) I will be teaching Mon/Wed pm from July 9- Aug 15. So those teaching times do not interfere At All with doctor appointments. The only possible glitch is VBS which I teach in the mornings the week of July 16 but that shouldn't pose a problem as I'll just need one appt that week (July 19) and I can schedule it for like 8:00am long before VBS starts that morning.

So here's what the timeline is looking like:

1. July 5 Paul and I go back to meet with the doctor to sign consent forms and to be trained on all the shots I will be taking (which won't be hard as we've already done two of the kinds already)
2. July 6 I will start the Lupron shots (daily) which will sort of make my body think it's in menopause (in other words I might have hot flashes and such)
3. July 19(or so) I will come in for an ultrasound and labwork and soon after that will start two more types of injections (one in the morning and one in the evening) in addition to the Lupron
4. August 2(or so) I will have the egg retrieval

So I ask for prayer:

1. For me emotionally throughout this whole rollercoaster ride experience especially as my body is being pumped with high doses of hormones.
2. For me physically (such as that I not get OHSS or an ectopic pregnancy).
3. If it's the Lord's will, that I would give birth to a baby (or babies!) in April 2008.
4. That just the right amount of embryos would be created (not that we will destroy any "extras," we would give them up for adoption if we felt we already had as many kids as we could "handle," but I'd rather not be in that situation).

Nurse called back

Well Alice Ann called me back this morning, and she said that if my next cycle begins around July 17 then yes I could have a late August egg retrieval. My calculations were correct. You do not have to schedule it 3 months in advance. Now this wouldn't have been possible if I hadn't started the pill on Saturday, although my body has been fairly cooperative lately on its own (32-33 days). So we will keep our 5 hour appt for Thursday. There is still time to change my mind if for example our dossier is submitted in Ukraine today or next Monday. The insurance will pay for these tests so although we'll be paying $8,200 up front on Thursday, really if I change my mind we'll get all our money back. Actually the shots probably won't start until early August so in reality I have another month to make SURE I want to do this. But I want to keep this appointment for Thursday to keep that option open. If I was ever going to do IVF, now would be the time (meaning in the summer rather than during the fall or spring semester when I teach three mornings a week).

Another website

The last few years I've always used the CDC website to look up the stats on different clinics that do IVF. Well I found another one today - http://www.sart.org/find_frm.html. And this one is now reporting data from 2005. It makes sense they can't report 2006 yet as someone could have gotten pg from IVF near the end of 2006, and you wouldn't know yet if it qualified as a "live birth." Anyhow the clinic I am planning to use definitely had better numbers in 2005 than 2004 - https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=2158. For those under the age of 35, almost half (47.6%) of those who made it to retrieval (25% of the cycles were cancelled) resulted in live birth. So although the % of attempts to live birth was 35.7 for under 35 it's nice to know that those who made it to retrieval had a decent chance of making it to live birth. They also had better succes with those ages 38-42 that year (4 out of 14). I know if we keep the appt on Thursday they will give us the data for 2006 as well as 2007 so far. Well hopefully Alice Ann's answer to my the question I left on her voicemail today will help us figure out what to do. Part of me says okay...I'll do it...it's worth the try.... and part of me says "no, I just can't bring myself to go through with it." So please pray for wisdom!!!

Having second thoughts

Well all the reasons I have for the past 4 years been unwilling to do ivf have again been running through my mind the past couple of days; we started our first fertility treatments 4 years ago and that was the first time we discussed what we were and were not willing to do. And ivf was in the summer of 2003 on our "no" list. Just a few weeks ago I was wanting a break, and I guess emotionally that's still where I am. Although the thought of being pg thrills me to pieces, the thought of going through all those shots and procedures is totally overwhelming. I haven't done ivf before, but having done inj 7 times (with 5 iui's), I have a pretty good idea of what this will entail physically and emotionally (and financially one try will cost 3 times more than all 7 inj tries put together cost).

The CDC reports the IVF success rates for every clinic in the US. Unfortunately the info is always delayed so the most current stats they have are for 2004. The clinic we were planning to use that year did 37 cycles with women under 35 of which 11 resulted in a live birth, 10 between 35-37 (that's me!) of which 3 resulted in a live birth, and 9 for women 38-42 (no pregnancies). So if we only count those women up to age 37, they had about a 30% success rate. I know God is in control, and He could allow me to be in that 30%, but I also believe if He wanted me to get pg He could do so without IVF even though it hasn't happened in the last 5 years.

Well at the very least I decided to find out if there is ANY chance of having the ER the end of August. I left a message with the nurse, and I hope she calls me back tomorrow. I believe my next cycle would start around July 17 or 18 so I asked her if I started the protocol then (first birth control pills and then add in Lupron shots) would the timing be right for a late August ER? It seems to be adding up just right for me, by my calcuations if I started July 17 that would be about August 28 for ER which is good timing as they don't start the next cycle of ER until August 27, and that's also the first week of school for me so I'd have most of it done before school started. If she says that's not possible, then I think I just want to wait. I really can't see doing IVF while teaching MWF mornings from 8-11 as that's when most of the appts are and it would be nigh impossible to schedule all my appts for T/Th/Sat.

If she says it WOULD be possible, then I think I'll keep our appts for Thursday, but I'd still like more time to think about it. I think it would be a little easier to make this decision if we knew for sure that Lifetime and Ukraine are closed doors. Who knows when Lifetime will make their decision, but in terms of Ukraine we'll know by July 2 which isn't far away at all. Plus I am concerned about the potential strike at work and how that might effect us financially (in terms of whether we can afford IVF), and we'll know whether there will be a strike or not by July 1. So even if we follow through with our appts on Thursday (which is dependent on what the nurse tells me), I might still decide to say "time out" and not do ivf this summer. It's a tough decision to make. I'd put my body through just about anything if I knew the result would be giving birth to a baby, but it's hard to psych myself to go through it knowing the more likely scenario (70%) is that won't happen.

Status report

Well Cathy (of AC) emailed Friday to say she got our contract. I already knew that as of Wednesday as I had paid for delivery confirmation so from the tracking number I knew she got it on Wed. I am anxious to hear what her feedback will be regarding the profile we've used for Lifetime - what changes she might suggest, etc. She said she will be emailing us more forms to fill out and return to her.

Still no word from Lifetime; we've waited 18 days so far, and we've been w/o a contract for 16 days. I have no clue how all this extra time is helping them make their decision. It's such an easy one in my book. #1Did the Kennedy's do everything we have asked them to do? (yes! - I have emails from them as recently as April 5, 2008 which confirm that). #2 Have we matched them with a birthmother yet (no! they've never had even one possible match). Then we should keep trying to find them a match! See it's that easy, lol!!! Honestly though even if they were to give us an extension at this point I don't feel I can trust their word any more so I don't know if that piece of paper will mean anything to me. But I am still curious how long it will take for a final decision to be made and what that decision will be.

As for ivf, I have to admit I am having a case of second doubts today. Just thinking about all the shots and bloodwork and ultrasounds and procedures has me wanting to run in the other direction at the moment. Today is "day one" which is usually an emotional day for me so maybe I should chalk it up to that and assume I'll be ready to start the tests on Thursday morning - not that I am really excited at the prospect of having saline injected into my uterus and such. I guess I feel like I've already put my body through so much when it comes to all this stuff....

As for Ukraine, if our dossier doesn't get in on Monday (25th) then we're down to just one more chance (July 2). I am not expecting it to be submitted either day, but there is obviously SOME chance of it happening. So I am glad that at least one aspect of the suspense will be over in about 9 days. Although I do feel it's best to pursue two things at once, I don't think it's best to be pursuing four things at once - not financially wise and not emotionally manageable!

Also, the anniversary of the date of my one and only miscarriage is coming upon us shortly - July 5. So that too has me a bit more emotional than usual I think...

$8,200 up front

Well I talked to the financial lady at the RE today, and she said for IVF you have to prepay $8,200 prior to your first appointment (which for us is June 28). They are charging $1,200 for all the tests we are having done that day, $1,000 for the bloodwork/ultrasounds, and $6,000 for the egg retrieval and transfer (and embryology in between). ICSI and other "optional" procedures are additional costs. I figured we'd pay the $1,200 now and the other costs closer to the egg retrieval, but she said no. If we do a second ivf later on (I hope not; I'd love the first try to be successful!), we wouldn't have the testing so we'd pay $7,000 up front that time. She said my insurance will pay for the testing and bloodwork and ultrasounds so we'll get most of that money back (less our $10 copays) so likely we'll get about $2,100 back. I think our total cost (if we don't need ICSI or assisted hatching or anything like that) will be about $6,200 including the cost of meds (which are thousands and thankfully mostly are covered by our insurance). We have a choice of insurance at the university where I teach, and I purposefully picked the HMO instead of Blue Shield which most people select because this HMO does pay for some fertility stuff whereas BS does not. One reassuring thing is Denise said usually you are paying this bill two months before the egg retieval. Whew...that was just what I was hoping (for a late August retrieval date). Alice Ann's "3 month" estimate yesterday was not what I wanted to hear, so hearing this today confirms that there is a chance I could start the Lupron early August and have most of the stimming done before school starts on August 27. We'll find out for sure on June 28, but that's what I am going to ask for.

Made the first appointment

Well our contract, profile, and $4,900 check are now en route to California. I will be curious to hear what Cathy will say about our profile once she gets it (how she suggests that we modify it before we made 30 more to send to her for her to use).

I also talked with the RE nurse, and we now have an appointment for June 28. They only do these first ivf appts on Thursdays and they take five HOURS. Yikes! Well she said any where from 3.5 to 5 hours. If it were to take 3.5 hours I would be able to JUST make it to BU in time for my 1:30 class, so to be safe I asked a colleague if he will cover my class that day (he used to teach the course), and he agreed to do so. We will have bloodwork (some of what we did for adoption in January will be used for this but we didn't have hepatitis and such done in January so we still need some additional bloodwork as required by law before ivf) and other tests and start the discussion on how many embryos to transfer back, etc.

They just started doing egg retrievals (ER) on June 11. They do them for a period of 8 weeks and then they take a 3 week break. So the next time they would start doing them would be August 27. I am really hoping we can schedule ours for that week although I think they are going to think that's too soon as they like to schedule them 3 months in advance. I'd rather do as much as possible (such as the Lupron shots and then the stimming) prior to school starting (August 27) as from July 9 - August 15 I am only teaching two nights a week so I am free as many mornings as necessary for bloodwork and ultrasounds, but we might have made this decision too late for that to be possible. I guess we'll find out on June 28 as that's the date we'll pick a tentative ER date (although things don't always go exactly as scheduled and the actual date might be a little sooner or a little later).

Father's Day

Well Father's Day is not nearly as hard for me as Mother's Day, but there is still a "sting" to it. I think mainly because of Father's Day 2005. I found out I was pregnant on June 15, 2005, and I used a Father's Day card as my way of telling Paul I was pregnant (handed it to him at work in the middle of the day along with one of his favorite candy bars). Also, I remember tears of joy streaming down my face a few days later on Father's Day at church as I sat in the choir loft and looked out at Paul and realized he was finally going to be a father. It's hard to believe 2 years have passed. In some ways it feels like it was just yesterday. I know not to assure myself that he will be a father by Father's Day next year, but it's certainly something I hope and pray will be true.

Exploring options

Well I emailed Cathy at http://www.adoptionconsultantsinc.com/. In 2004 we had it narrowed down to two options and this was the other one besides Lifetime. The other ladies who picked Adoption Consultants all got matched very quickly whereas Kelli and I (who both picked Lifetime) are still waiting for a match (Kelli is on her first contract extension). Cathy has a program where you pay $300 for the year to be shown when the birthmother doesn't pick any of her contracted families (she contracts with a maximum of 25 families at any given time and of course not every family will be a possible match with every birthmother based on what the family is wanting and also what the birthmother is wanting). We paid Mark Miller $200 to be shown twice so it doesn't seem crazy to spend $300 to be shown as many times as that situation might arise in a year. OR we could paid $4,900 for a 2.5 year contract and if matched then we pay the other $4,900 (same fee of $9,800 we paid Lifetime in Dec 2004). So I emailed her and asked her some questions.

Also, I emailed two ladies at church whose husbands are doctors to see if they have any suggestions of who might be able to help us with our medical forms (prior to October!) for Ukraine. A huge percentage of the people at my church are doctors or nurses etc as the biggest employer by FAR in that town is a large hospital.

And I am thinking of calling the RE's office to get the nitty gritty on the ivf option. I had said in March that if something didn't happen with Ukraine or Lifetime by early July that we would reconsider IVF, so that's what we're doing. Again. Paul has always been strongly in favor of it. I am earning more money this summer and fall than expected so maybe these extra funds could be spent on ivf and if it didn't work it wouldn't be dipping into our adoption fund. That had been my fear in the past that we'd spend thousands on ivf and if it didn't work we couldn't afford to adopt, but given this extra income I think we could afford both.

So anyhow please pray for us to have wisdom what to do. We are still waiting to hear back from Lifetime of course and that will influence our decisions. I think the one lesson I have learned is to pursue TWO things at once. That is the mistake we made with Lifetime. We put all our eggs in that basket until Nov 2006 when we started working with another adoption lawyer (in FL) and also with Ukraine in Dec 2006. Well I take that back, we did four more rounds of inj/iui while contracted with Lifetime so I guess we were still pursuing more than one thing at least some of the time (last fertility cycle was July 2006). Anyhow we are trying to decide which TWO options to pursue right now of the following three: domestic adoption (Lifetime or maybe switch to Adoption Consultants?), IVF, and Ukraine dossier #2.