Friday, August 31, 2007
FET schedule
Well the head nurse called me back a few minutes ago, and she said if we lengthen this cycle I can have the FET on November 1 or 2 (which day just depends on the Doctor's schedules not me - there is a new RE joining Dr. Awad in September and she doesn't know if they will do FET on Fridays or not; this last year Dr. A has done all FET on Thursdays but previously when there were two RE's they did them on Fridays). I am to start the bcp tomorrow and stay on the active pills (I will need more than one pack) until early October (probably about October 4). So this cycle will be about 50 days long, but that's fine by me. I will then start the Lupron up again on October 1 and have my baseline b/w and u/s on October 15 and start the estradiol valerate injections that day as well (I've never had that one before and it's an intramuscular inj). Then on October 29 I'll have another u/s to make sure my lining is thick enough, and then the transfer will be on either Nov 1 or 2. We'll know about a week later if I am pg or not. I have done the calculations, and if this FET doesn't work (I pray it does!!!), I should still be able to do another ER in early January in Chicago. Of course I hope and pray that's not necessary. I am not going to ask again if this clinic will let us do the b/w and u/s locally if we do ivf #2 in Chicago until we find out if this FET worked or not. I could easily start second guessing myself as to whether this is the right decision or not, but I think I just need to set all that debate aside and just go with this. If it works, this is the least draining physically, financially, and emotionally. So there will be about exactly 3 months in between the first and second ET.
Thursday, August 30, 2007
I wish...
that my RE used a simpler FET protocol. I just read another woman who is also having a FET of just one frozen blast (left over from a successful IVF transfer a few years ago). She has to be on estrogen patches starting on cd1 and then starts the PIO shots 2 days before transfer. Sigh...that would be so much nicer. Only about 10 days of shots if BFN instead of more than 6 weeks of daily injections which is what I am looking at. She made one good point also about whether to do the FET first or not - the storage fees. This is true. We are paying $29 a month to store our one embryo starting this month so that's another reason to pay the $1,600 and do the FET sooner rather than later.
Talked to Paul
Paul agreed that in light of the better than average thaw rate and the cost being a little lower than we thought, we should do the FET first - IF we can do it in October (so that we could do the 2nd ivf in Dec/Jan if this FET doesn't work). She never called back; so I left a message this evening after talking with Paul. I told her we did want to do the FET but that we want to do it in October. I told her I am traveling in November which is true. I am going to Chicago in early November for a conference and then traveling to Maryland around Thanksgiving as my sister and her family who live in Turkey and I haven't seen since May 2006 will be in MD. The other reason (which I didn't state) was that we want to make sure it will still be possible to do fresh #2 when we can get the tax deduction for it. Paul also said that if FET doesn't work we should really try to get them to allow us to do the b/w and u/s there. He said we should talk to the RE ourselves (as he seems far more flexible than the head nurse), and if he says "no" we should talk to our insurance. They do pay for the b/w and u/s and it's really going to start to make the process unaffordable for us if we have to pay an additional $1,400 for those services that normally we pay about $50 for especially if we have also just paid for this FET. So hopefully she will call me back tomorrow and will have figured out a way we can have a transfer in October (I told her I was willing to go on the bcp or whatever it would take to slow things down or speed them up - whatever they need so I can have a transfer sometime in October). So hopefully she will come up with a way for that to work. I asked her to call me on my cell phone either before 8am or after 11am (since I teach in between 8-11). So that's the plan for now. If she won't agree to that then we'll probably do the fresh cycle before the FET.
Tough decision
I am going to give a warning that likely this will be a long post!!!
Well we met with the RE this morning. Paul suggested we go out to breakfast prior to our appointment. We both enjoy a hot breakfast and very rarely have one. So we went to Cracker Barrel before our appointment, and I said to Paul let's make sure we have our questions ready that we want to ask the RE. Well as we started to talk about it I almost starting crying, and so I asked that we change the topic so I wouldn't be crying in public. Then we went to the RE and after sitting in the waiting room they had us sit in an exam room while we were waiting for the RE to call us back to his office. It was really hard for me to sit there. I did cry a little and felt like bawling my eyes out. I sat staring at that ultrasound screen and thought how I have had more than 50 ultrasounds in this very room and none of them were the happy kind where we saw a gestational sac or a heartbeat or anything on the screen. I even had several ultrasounds in that room during my brief pregnancy in 2005, but the only thing they could see in the uterus was the corpus luteum. Anyhow it was tough.
Then we went back to talk to the doctor. He said I stimulated very well (26 eggs) and to have 18 mature eggs was excellent. He said the quality of our embyros was outstanding. I said that most clinics seem to use an A, B, C type rating scale and how would ours be rated. He said they use a scale of 1-4 (four being the best) and he said 3 of our embryos were "fours." I was surprised. I expected him to say they were "threes." He said the other 4 embryos were a mix of "twos" and "threes." He said the worst part of our cycle was that we had such a low fertilization rate. He said it might be a problem of egg quality. I guess my age is already a factor. He said if I hadn't stimulated so well and produced so many eggs he would not advise us to ever do another fresh ivf cycle but would advise using donor eggs. He said he frequently advises couples to use donor eggs but was not recommending that for us since #1 I produced so many eggs that even with a low fertilization rate we still had 7 embyros and he said many couples don't have 7 embryos that make it to the 3rd day and since #2 we had such high quality embryos. He said many couples our age have only very poor embyros (all ones and twos). So he wouldn't recommend donor eggs for us.
Personally, I still feel like they must not do a great job at picking the best sperm for ICSI. For example the clinic in IL advertises an 85% fertilization rate with ICSI. This clinic told us their average with ICSI is 50% and in our case it was 39%. The fact that this clinic's average fert rate is much lower makes me think that likely if we did ivf/icsi elsewhere that our fert rate would be higher than 39%. He said it could have been a fluke and if we did ivf again at their clinic it might be higher than 39% the next time.
Paul asked him about assisted hatching. It's funny because 2 weeks ago that was high on my list to talk with the RE about but I totally forgot about it this morning so I am glad Paul remembered. We were VERY strongly leaning toward wanting AH done on our one embryo if we did a FET. Well he was VERY opposed to the idea - thought there was a greater risk of damaging it. Well that again to me shows the quality of this clinic as most clinics seem to do AH on everyone and I am sure they wouldn't do it if they thought there was a high risk it might damage the embryo. He said if we did another fresh transfer at 3 days he would recommend doing AH, but he was not recommending doing AH on a 6 day blast.
I asked him what their thaw rate was. He said it was higher than 90% for blasts. I said but the national average is 50%? He said that some freeze the embyros at day 3. He said if we had frozen the other 4 embryos at day 3 then yes likely 50% or less would have survived the thaw, but since we only froze a 6 day blast he said it was very close to 100% chance that it would survive the thaw and be able to be transferred.
I asked him what happened to the other 3 that weren't frozen. I admit I was nervous that maybe they had still been alive but not made it to blast and been destroyed. I really, really, really didn't want any of our embyros destroyed. I was very, very, very relieved when he told me they had already stopped growing on their own. He said none of those 3 even made it to the morula stage (which they are supposed to get to on day 4) let alone the blastocyst stage. So I am very glad to hear that their deaths were of natural causes so to speak.
Then we talked to one of the nurses. She explained their FET protocol. Ugh. It involves more shots than most FET protocols do. I come in on day 21. If my progesterone is at least 3 then I start the Lupron shots and continue on those for 10-14 days. If my progesterone is less than 3 (which it would be if I hadn't ovulated yet) then I take Provera for several days and then start the Lupron shots. Then I have my baseline u/s and b/w. Then I am on Lupron for an additional two weeks during which time I also will have two estrogen shots a week (intramuscular). Then I will have another u/s to make sure my lining is thick enough. If it is then I stop the Lupron and start the PIO injections 5 days before the transfer. So it's going to be about the same amount of shots as last time although there aren't any FSH shots (and I had 21 of those last time). We asked her if we could do the u/s and b/w here if we did an IVF cycle in another state. She said she wasn't sure, and we'd have to check with the head nurse.
As we walked out we talked about it and although we both went into the appointment thinking we were strongly leaning toward doing a fresh cycle first, we both left a little more undecided. The RE was very hopeful that this FET might result in a pregnancy. The fact that they have a 90%+ thaw rate definitely swayed our thinking some. I said to him but isn't the FET success rate much lower than the fresh one? He said that in his mind 3 embyros transferred at 3 days had as much chance of success as 1 high quality blast transferred at 6 days. He feels our chance at pgcy is equal although of course the chance for multiples is now extremely low (only an identical twin is possible which is rare when AH isn't used). He viewed that as a "plus" although I don't necessarily feel that way. He said the most blasts he allows to be transferred in a woman under the age of 40 is two so we are talking about transferring one instead of two rather than one instead of three. He did a pretty good job at making us feel like there was a reasonable chance of success with this one frozen embryo.
Once I realized that u/s and b/w were part of the process, I figured that likely our total cost would drop. So I called the financial lady this afternoon and she said yes the breakdown is $750 for monitoring and $1,500 for the transfer. So we would get reimbursed about $700 from our insurance so likely we are talking about (including meds) $1,600 total cost instead of $2,300. Paul doesn't know that yet. Finding that out definitely was swaying my opinion even farther toward doing the FET first. If this FET would work it would be much cheaper than doing a fresh cycle + a FET. Of course if it doesn't work doing another fresh plus 2 FETs is more expensive - but this clinic charges $1,500 whereas Chicago charges $2,900 plus we'd have to pay to have our one frozen embie shipped which would cost at least $200. So it's not really like we'd pay for two FETs at the Chicago price but rather sort of 1 1/2. So at that point I was leaning toward saying YES to doing the FET.
So then I called the head nurse to make sure our dates were falling in their "up" time for doing transfers (they have what they call up and down weeks as far as when they are and aren't doing ER and ET). The nurse we spoke to at the office made it sound like it was rarely a problem - only if Dr. Shabanowitz (who is in charge of the lab and not our RE) was going to be away at a conference or something. Well that didn't prove to be true. The head nurse said it wouldn't work to start the Lupron in 10 days or so because whether I need Provera or not - either way my date of transfer would fall in a down week. I was sooo deflated by that news. I don't know why but when I heard that I almost broke into tears. You might think I cry all the time, but trust me - in a typical year I probably cry about once about something unrelated to adoption/ttc. I am not one who often cries much. And frankly I haven't cried much about ttc the last couple of years. I used to cry EVERY time I realized I wasn't pg. Anyhow it was frustrating to realize we can't do the FET in October. I know some women who have done a FET within 3 weeks of finding out the fresh IVF didn't work. This clinic has you wait at least 8 weeks and now it's looking like it will be at least 13-14 weeks.
Then I asked her if we could do the u/s and b/w there but have the results faxed to a clinic in another state and that office would call me with the med instructions and we'd fly out there for the ER and ET. She said typically they do not allow this, but she could ask the RE if he'd give us special permission to have the u/s and b/w done there. They still will get paid over $1,000 for those services. Why would they say no??? I guess they don't want to make it easier for you to take your business elsewhere. Well I have been going to this clinic for over 3 years and still not pg. Of course I haven't gone there every month, but I have done 6 inj cycles with them and now also 1 ivf. If they say "no" then this increases the cost of doing IVF in Chicago by $1,400 plus means I need to stay out there an additional 10 days or so.
So I guess in light of the better than average thaw rate PLUS the fact that the cost of the FET just dropped $700 (we'd have to pay $2,250 up front but eventually we'd get $700 back just like we paid $8,200 for the IVF and I'm expecting to get about $1,000 back eventually) I am now leaning toward doing the FET first. The curve ball in all of this is that in light of not being able to do an October FET, I don't think a fresh ivf in Dec/Jan will be possible if we aren't doing the FET until November. If we had done the FET in October and it didn't work, we still could have done a fresh IVF in Dec/Jan. I am not sure if it's possible now. I guess first I need to find out when is the soonest I could do a FET if we did that first. It really is a big advantage to pay for the fresh ivf in 2007 if we're ever going to do another fresh ivf. It saves us about $2,000. Of course we would get the tax savings from the FET so actually that would drop the cost another about $400 so maybe true out of pocket expense for the FET after subtracting what we'd save in a tax deduction would be about $1,200.
So bottom line is that *at the moment* I am leaning toward doing the FET first even though we only have one blast. If we had two, I would not have even given it a moment's thought. I would have been 100% sure I wanted to do the FET first. But I know one little girl who was a student in the school where I was principal who was the result of IVF. Her mom did a fresh cycle and transferred three embryos back and lost all three. They only had one frozen embyro and transferred that one back and it resulted in a healthy pgcy. So maybe we will have a similar result? Who knows. I know the odds are not in our favor. I know that although he tried to make it sound really hopeful, I know the odds are probably at best 30% that it will work. That's this clinic's success rate for fresh cycles for my age so it's certainly not higher than that.
I just went online and looked up the stats for the clinic. I included the thawed (non-donor) transfers for women under age 35 PLUS those age 35-37. For those two age brackets from 2003-2005 they had a 25% pgcy rate per transfer with an average # of embryos transferred rate between 2-3 (which contradicts what he told me today that they only transfer 2 blasts at a time). But I guess I'm willing to pay $1,200 for a 25% chance that this embyro will finally lead to me seeing a heartbeat on an ultrasound screen.
The nurse hasn't called me back yet as far as when we could do the FET since we can't do it in October, and of course I need to talk with Paul. But my feeling at the moment is that probably we'll do the FET. The one big downside to doing this first, is that I have a gut feeling that I might never do another fresh cycle if we do this FET now in part because of the fact it's going to cost about $2K more to do it in another tax year and in part because I am not hopeful that they will allow us to do the u/s and b/w here which adds $1,400 to the cost of another fresh cycle. So I really hope and pray this little blast STICKS!!! Sorry I was so verbose...
Well we met with the RE this morning. Paul suggested we go out to breakfast prior to our appointment. We both enjoy a hot breakfast and very rarely have one. So we went to Cracker Barrel before our appointment, and I said to Paul let's make sure we have our questions ready that we want to ask the RE. Well as we started to talk about it I almost starting crying, and so I asked that we change the topic so I wouldn't be crying in public. Then we went to the RE and after sitting in the waiting room they had us sit in an exam room while we were waiting for the RE to call us back to his office. It was really hard for me to sit there. I did cry a little and felt like bawling my eyes out. I sat staring at that ultrasound screen and thought how I have had more than 50 ultrasounds in this very room and none of them were the happy kind where we saw a gestational sac or a heartbeat or anything on the screen. I even had several ultrasounds in that room during my brief pregnancy in 2005, but the only thing they could see in the uterus was the corpus luteum. Anyhow it was tough.
Then we went back to talk to the doctor. He said I stimulated very well (26 eggs) and to have 18 mature eggs was excellent. He said the quality of our embyros was outstanding. I said that most clinics seem to use an A, B, C type rating scale and how would ours be rated. He said they use a scale of 1-4 (four being the best) and he said 3 of our embryos were "fours." I was surprised. I expected him to say they were "threes." He said the other 4 embryos were a mix of "twos" and "threes." He said the worst part of our cycle was that we had such a low fertilization rate. He said it might be a problem of egg quality. I guess my age is already a factor. He said if I hadn't stimulated so well and produced so many eggs he would not advise us to ever do another fresh ivf cycle but would advise using donor eggs. He said he frequently advises couples to use donor eggs but was not recommending that for us since #1 I produced so many eggs that even with a low fertilization rate we still had 7 embyros and he said many couples don't have 7 embryos that make it to the 3rd day and since #2 we had such high quality embryos. He said many couples our age have only very poor embyros (all ones and twos). So he wouldn't recommend donor eggs for us.
Personally, I still feel like they must not do a great job at picking the best sperm for ICSI. For example the clinic in IL advertises an 85% fertilization rate with ICSI. This clinic told us their average with ICSI is 50% and in our case it was 39%. The fact that this clinic's average fert rate is much lower makes me think that likely if we did ivf/icsi elsewhere that our fert rate would be higher than 39%. He said it could have been a fluke and if we did ivf again at their clinic it might be higher than 39% the next time.
Paul asked him about assisted hatching. It's funny because 2 weeks ago that was high on my list to talk with the RE about but I totally forgot about it this morning so I am glad Paul remembered. We were VERY strongly leaning toward wanting AH done on our one embryo if we did a FET. Well he was VERY opposed to the idea - thought there was a greater risk of damaging it. Well that again to me shows the quality of this clinic as most clinics seem to do AH on everyone and I am sure they wouldn't do it if they thought there was a high risk it might damage the embryo. He said if we did another fresh transfer at 3 days he would recommend doing AH, but he was not recommending doing AH on a 6 day blast.
I asked him what their thaw rate was. He said it was higher than 90% for blasts. I said but the national average is 50%? He said that some freeze the embyros at day 3. He said if we had frozen the other 4 embryos at day 3 then yes likely 50% or less would have survived the thaw, but since we only froze a 6 day blast he said it was very close to 100% chance that it would survive the thaw and be able to be transferred.
I asked him what happened to the other 3 that weren't frozen. I admit I was nervous that maybe they had still been alive but not made it to blast and been destroyed. I really, really, really didn't want any of our embyros destroyed. I was very, very, very relieved when he told me they had already stopped growing on their own. He said none of those 3 even made it to the morula stage (which they are supposed to get to on day 4) let alone the blastocyst stage. So I am very glad to hear that their deaths were of natural causes so to speak.
Then we talked to one of the nurses. She explained their FET protocol. Ugh. It involves more shots than most FET protocols do. I come in on day 21. If my progesterone is at least 3 then I start the Lupron shots and continue on those for 10-14 days. If my progesterone is less than 3 (which it would be if I hadn't ovulated yet) then I take Provera for several days and then start the Lupron shots. Then I have my baseline u/s and b/w. Then I am on Lupron for an additional two weeks during which time I also will have two estrogen shots a week (intramuscular). Then I will have another u/s to make sure my lining is thick enough. If it is then I stop the Lupron and start the PIO injections 5 days before the transfer. So it's going to be about the same amount of shots as last time although there aren't any FSH shots (and I had 21 of those last time). We asked her if we could do the u/s and b/w here if we did an IVF cycle in another state. She said she wasn't sure, and we'd have to check with the head nurse.
As we walked out we talked about it and although we both went into the appointment thinking we were strongly leaning toward doing a fresh cycle first, we both left a little more undecided. The RE was very hopeful that this FET might result in a pregnancy. The fact that they have a 90%+ thaw rate definitely swayed our thinking some. I said to him but isn't the FET success rate much lower than the fresh one? He said that in his mind 3 embyros transferred at 3 days had as much chance of success as 1 high quality blast transferred at 6 days. He feels our chance at pgcy is equal although of course the chance for multiples is now extremely low (only an identical twin is possible which is rare when AH isn't used). He viewed that as a "plus" although I don't necessarily feel that way. He said the most blasts he allows to be transferred in a woman under the age of 40 is two so we are talking about transferring one instead of two rather than one instead of three. He did a pretty good job at making us feel like there was a reasonable chance of success with this one frozen embryo.
Once I realized that u/s and b/w were part of the process, I figured that likely our total cost would drop. So I called the financial lady this afternoon and she said yes the breakdown is $750 for monitoring and $1,500 for the transfer. So we would get reimbursed about $700 from our insurance so likely we are talking about (including meds) $1,600 total cost instead of $2,300. Paul doesn't know that yet. Finding that out definitely was swaying my opinion even farther toward doing the FET first. If this FET would work it would be much cheaper than doing a fresh cycle + a FET. Of course if it doesn't work doing another fresh plus 2 FETs is more expensive - but this clinic charges $1,500 whereas Chicago charges $2,900 plus we'd have to pay to have our one frozen embie shipped which would cost at least $200. So it's not really like we'd pay for two FETs at the Chicago price but rather sort of 1 1/2. So at that point I was leaning toward saying YES to doing the FET.
So then I called the head nurse to make sure our dates were falling in their "up" time for doing transfers (they have what they call up and down weeks as far as when they are and aren't doing ER and ET). The nurse we spoke to at the office made it sound like it was rarely a problem - only if Dr. Shabanowitz (who is in charge of the lab and not our RE) was going to be away at a conference or something. Well that didn't prove to be true. The head nurse said it wouldn't work to start the Lupron in 10 days or so because whether I need Provera or not - either way my date of transfer would fall in a down week. I was sooo deflated by that news. I don't know why but when I heard that I almost broke into tears. You might think I cry all the time, but trust me - in a typical year I probably cry about once about something unrelated to adoption/ttc. I am not one who often cries much. And frankly I haven't cried much about ttc the last couple of years. I used to cry EVERY time I realized I wasn't pg. Anyhow it was frustrating to realize we can't do the FET in October. I know some women who have done a FET within 3 weeks of finding out the fresh IVF didn't work. This clinic has you wait at least 8 weeks and now it's looking like it will be at least 13-14 weeks.
Then I asked her if we could do the u/s and b/w there but have the results faxed to a clinic in another state and that office would call me with the med instructions and we'd fly out there for the ER and ET. She said typically they do not allow this, but she could ask the RE if he'd give us special permission to have the u/s and b/w done there. They still will get paid over $1,000 for those services. Why would they say no??? I guess they don't want to make it easier for you to take your business elsewhere. Well I have been going to this clinic for over 3 years and still not pg. Of course I haven't gone there every month, but I have done 6 inj cycles with them and now also 1 ivf. If they say "no" then this increases the cost of doing IVF in Chicago by $1,400 plus means I need to stay out there an additional 10 days or so.
So I guess in light of the better than average thaw rate PLUS the fact that the cost of the FET just dropped $700 (we'd have to pay $2,250 up front but eventually we'd get $700 back just like we paid $8,200 for the IVF and I'm expecting to get about $1,000 back eventually) I am now leaning toward doing the FET first. The curve ball in all of this is that in light of not being able to do an October FET, I don't think a fresh ivf in Dec/Jan will be possible if we aren't doing the FET until November. If we had done the FET in October and it didn't work, we still could have done a fresh IVF in Dec/Jan. I am not sure if it's possible now. I guess first I need to find out when is the soonest I could do a FET if we did that first. It really is a big advantage to pay for the fresh ivf in 2007 if we're ever going to do another fresh ivf. It saves us about $2,000. Of course we would get the tax savings from the FET so actually that would drop the cost another about $400 so maybe true out of pocket expense for the FET after subtracting what we'd save in a tax deduction would be about $1,200.
So bottom line is that *at the moment* I am leaning toward doing the FET first even though we only have one blast. If we had two, I would not have even given it a moment's thought. I would have been 100% sure I wanted to do the FET first. But I know one little girl who was a student in the school where I was principal who was the result of IVF. Her mom did a fresh cycle and transferred three embryos back and lost all three. They only had one frozen embyro and transferred that one back and it resulted in a healthy pgcy. So maybe we will have a similar result? Who knows. I know the odds are not in our favor. I know that although he tried to make it sound really hopeful, I know the odds are probably at best 30% that it will work. That's this clinic's success rate for fresh cycles for my age so it's certainly not higher than that.
I just went online and looked up the stats for the clinic. I included the thawed (non-donor) transfers for women under age 35 PLUS those age 35-37. For those two age brackets from 2003-2005 they had a 25% pgcy rate per transfer with an average # of embryos transferred rate between 2-3 (which contradicts what he told me today that they only transfer 2 blasts at a time). But I guess I'm willing to pay $1,200 for a 25% chance that this embyro will finally lead to me seeing a heartbeat on an ultrasound screen.
The nurse hasn't called me back yet as far as when we could do the FET since we can't do it in October, and of course I need to talk with Paul. But my feeling at the moment is that probably we'll do the FET. The one big downside to doing this first, is that I have a gut feeling that I might never do another fresh cycle if we do this FET now in part because of the fact it's going to cost about $2K more to do it in another tax year and in part because I am not hopeful that they will allow us to do the u/s and b/w here which adds $1,400 to the cost of another fresh cycle. So I really hope and pray this little blast STICKS!!! Sorry I was so verbose...
Wednesday, August 29, 2007
Touching card
Today in the mail I got a card that all the members of the handbell choir signed on Monday night. It was extremely touching. They aren't readers of my blog so it's not like they read my previous post, but it almost seemed like they had. There were no "annoying" comments. Several of them referred to it as our loss. That meant the world to me to have that acknowledged that way. For example, one wrote, "Please know I am praying for you a for the Lord to comfort you as only He can. My heart aches for you. These words seem so shallow, but please know I cry." Those words are NOT shallow. The compassion expressed in those words was very, very touching. This card I will definitely save. I have already read the individual comments each member wrote several times. I had saved a couple of sympathy cards I got in 2005, and the only card I got this time was the one that had an "annoying" comment so I didn't really want to save it. I don't have hpts to save this time, but I will save 6 roses, this card, and my one u/s photo that was taken during the embryo transfer when we saw the 3 little dots moving within me. The photo is of the gorgeous roses I received yesterday from one of my fellow bell ringers.Tomorrow is our appointment with the RE. I would appreciate your prayers for our wisdom in knowing what to ask, etc. I am a little nervous whether they will agree that I can do the u/s and b/w there if we do the 2nd and last fresh cycle in IL. I mean they will be paid by my insurance so I can't see why they wouldn't want our business, but I admit I've been nervous about that the last 2 weeks.
Tuesday, August 28, 2007
How sweet
A florist just delivered an arrangement of a dozen roses (white, pink, and yellow) in a vase. I wasn't sure who they were from, but it turns out they were from a couple from church. Peter plays in the handbell choir. He wasn't there last Monday (I had a little meltdown last Monday so everyone knew I was struggling emotionally), but someone must have told him of our recent loss. I think I am going to save these roses (dry them later). It's a tangible reminder of the 6 little babies we lost. I am truly overwhelmed by the thoughtfullness and kindness of a fellow bell ringer. I am really, really touched. It was totally unexpected.
Hard to understand
The day after my Beta, I got an email from a colleague at work announcing she is pg. Of course the timing was a little hard, but actually I can honestly say I was happy for her. She is a few years older than me and also has been ttc a couple of years longer than we have. I immediately sent her a big congratulations email, and it wasn't hard to do so. I knew last summer they had pursued adoption a little, and during the last school year she had switched to a different doctor (she used to go to the same RE I have gone to the last 3 years). She had done Letrozole a few times in the spring (I think the last try was in May). They had unexplained infertilty, and she had never been pg (she told me in 2005 when I had the ectopic that she would prefer to have a m/c as at least then she'd "know she could get pg"). She never did inj; she only did Clomid and Let. She said she didn't think she could give herself injections in the stomach so she wasn't open to inj/iui or ivf. She never even had an iui. And she was a nurse practitioner (and now is a nursing professor). I would think it would be easy for a nurse to give herself shots.
Okay so this is the hard part. Her office is a couple doors down from mine. Every time she told someone yesterday that she was pregnant, she did NOT sound happy about it. She kept telling people how she and her husband had decided they wanted a childfree life and how this meant they would have retired earlier, bought a condo, etc. She was medically ttc about 3 months ago. I just can't understand how THAT quickly she could get to the point where she sounded disappointed that she is pregnant. I talked to her as well and she was saying the same stuff to me. She was also talking about how awful she felt (morning sickness) and said how can I feel joyful when I feel nauseous? She said to me "I am sure once the baby is born I'll feel joyful." I didn't know what to say. I'd gladly throw up every day for 9 months if it meant I could give birth to a baby.
I guess I just don't understand how someone who ttc for more than 7 years wouldn't be thrilled to find out she's finally pg. And of course it's really hard to hear someone sounding disappointed that they are pg when I gave myself 59 shots and we spent $7,500 recently trying to get pg. And of course that's not to mention the ER process etc. It's one thing to find out someone is pg and they are excited. But it's really hard to listen to someone practically complain that they are pg. What's sort of ironic is that in 2005 there was a colleague who got pg about the same time I did. And ever since her daughter was born in Feb 2006 I've been shown lots of photos which are hard as I know that's how old our child would have been had he or she lived. Since then, I haven't had any pg colleagues at work - of course there have been staff and faculty pg since then, I just mean no one I regularly have contact with has been pg since then. Her due date is also in April as mine would have been if any of the embryos had lived. So every day I go to work I am going to be seeing a pg women who is at the stage I "would have been." It's just beyond ironic to me that just like in 2005 there is going to be a constant reminder at work. This is actually going to be harder than in 2005 as I will see this colleague far more than I see the other one. Well maybe she'll at least start being happy/ grateful that she's pg. That would help me a lot.
One other P.S. to this little story would be that when she told me she was pg she told me that it finally happened when they "gave up" and that she got pg while they were on vacation. Great. Just reinforced two pieces of advice people love to give. Well Paul and I have gone on LOTS of vacations over the past 6 years, and we had truly given up with ttc awhile ago. We have zero hope that we will ever get pg aside from IVF or FET. So giving up and going on vacation hasn't helped us. Of course they had NO male or female problems ever diagnosed by a doctor which is not our case either.
Okay so this is the hard part. Her office is a couple doors down from mine. Every time she told someone yesterday that she was pregnant, she did NOT sound happy about it. She kept telling people how she and her husband had decided they wanted a childfree life and how this meant they would have retired earlier, bought a condo, etc. She was medically ttc about 3 months ago. I just can't understand how THAT quickly she could get to the point where she sounded disappointed that she is pregnant. I talked to her as well and she was saying the same stuff to me. She was also talking about how awful she felt (morning sickness) and said how can I feel joyful when I feel nauseous? She said to me "I am sure once the baby is born I'll feel joyful." I didn't know what to say. I'd gladly throw up every day for 9 months if it meant I could give birth to a baby.
I guess I just don't understand how someone who ttc for more than 7 years wouldn't be thrilled to find out she's finally pg. And of course it's really hard to hear someone sounding disappointed that they are pg when I gave myself 59 shots and we spent $7,500 recently trying to get pg. And of course that's not to mention the ER process etc. It's one thing to find out someone is pg and they are excited. But it's really hard to listen to someone practically complain that they are pg. What's sort of ironic is that in 2005 there was a colleague who got pg about the same time I did. And ever since her daughter was born in Feb 2006 I've been shown lots of photos which are hard as I know that's how old our child would have been had he or she lived. Since then, I haven't had any pg colleagues at work - of course there have been staff and faculty pg since then, I just mean no one I regularly have contact with has been pg since then. Her due date is also in April as mine would have been if any of the embryos had lived. So every day I go to work I am going to be seeing a pg women who is at the stage I "would have been." It's just beyond ironic to me that just like in 2005 there is going to be a constant reminder at work. This is actually going to be harder than in 2005 as I will see this colleague far more than I see the other one. Well maybe she'll at least start being happy/ grateful that she's pg. That would help me a lot.
One other P.S. to this little story would be that when she told me she was pg she told me that it finally happened when they "gave up" and that she got pg while they were on vacation. Great. Just reinforced two pieces of advice people love to give. Well Paul and I have gone on LOTS of vacations over the past 6 years, and we had truly given up with ttc awhile ago. We have zero hope that we will ever get pg aside from IVF or FET. So giving up and going on vacation hasn't helped us. Of course they had NO male or female problems ever diagnosed by a doctor which is not our case either.
Saturday, August 25, 2007
Choice of words
Okay I admit I was really nervous about what comments people might make to me after they found out I am not pregnant. Mostly however I have to say people actually said the "right" things and in many cases that was admitting they didn't know what to say. Only two people really said something that hurt. I know they meant well. I realy do know that. In both cases they had taken the time to send me a card - one e-card and one through the mail. That was SUCH a kind, thoughtful gesture which I truly do appreciate. So I am not trying in any way to pick on these people. And they are not readers of my blog so I am not worried about hurting their feelings through this post. So why write this post? Well just in case any of my readers have a friend or family member who does IVF in the future I just wanted to throw this out there as what NOT to say to someone who has had a failed IVF.
The first comment was in an e-card I got on the 17th. The line that really hurt said something like "remember we don't get everything we want in life." Of course that statement is true, but I think it's TOTALLY in appropriate to say when someone is grieving a loss. No one would think of making such a comment to someone who just had a relative or friend pass away. This wasn't a case of hoping conception would occur and it didn't. This was a case of losing triplets that were alive within me at one point.
I think the bottom line is that I wanted people to acknowledge that three babies died inside me. I know it was really early, and I am sure had I seen three heartbeats on an ultrasound and then lost the babies after that it would have been worse. But that doesn't mean I didn't lose three little babies. From the moment I knew we had seven embryos I felt like a Mom to each of them, and I was praying countless times a day for all seven babies. Of course I prayed even more intensely for the three dots that I saw on the ultrasound as they traveled to my uterus. I have a picture of that moment thanks to a kind doctor. Yes, I know they were microscopic and I wasn't seeing them in particular but rather the fluid they were traveling in but truly we all watched three little dots move across the screen. Anyhow to me this was an early miscarriage. I realize that many couples probably have lost babies this way and they have no idea conception had occured because the baby was lost prior to implantation or shortly after that so they never knew about the life or lives that were within them. But I knew! I wanted all three babies to live. I believe even if I had gotten pregnant, as ELATED as I would have been, if I had found out I was only carrying one or two babies, I still would have had a little grieving to go through for the one or two that we lost. I even felt that way on August 7 when I found out only one of the four embryos was frozen. Yes, I was happy one had continued to grow, but I was sad for the three we had already lost. That I think is a really hard part about IVF. You know how many tiny embryos you have at one point and it's highly unlikely that many (or even possibly any) will make it. When it happens when a couple is trying on their own, they don't know it happened so there is not as much grief involved although of course failing to get pregnant can involve a grieving process as well. There is a difference though between grieving the loss of something you hoped would happen and didn't versus grieving the loss of little babies who were alive and are no longer. I really think a failed IVF is emotionally almost identical to a miscarriage.
The second annoying comment came in the mail today. "We were saddened to learn of your recent disappointment." Ditto on what I said above. I wish it said "of your recent loss." Disappointment implies to me something didn't happen that you wanted to happen. It happened. God allowed 7 little babies to come into existence, but for whatever reason it wasn't His will for 6 of the 7 to still be alive at this point. We don't know yet what the outcome will be for our 7th baby. I know I am not alone in feeling this way as a woman on an IVF discussion board this week who found out she was not pregnant wrote a similar post. Someone also used the disappointed word with her and she said "devastated" would be far more appropriate than disappointed. I don't think anyone would use the word "disappointment" if a couple lost a baby later in a pregnancy.
Okay I'll get off my soap box. Again I truly do understand that these people meant well, and I am not holding it against them in any way. I am only saying something just in case my sharing my thoughts/feelings could help someone else down the road with what they do/don't say to someone who has experienced a similar loss.
The first comment was in an e-card I got on the 17th. The line that really hurt said something like "remember we don't get everything we want in life." Of course that statement is true, but I think it's TOTALLY in appropriate to say when someone is grieving a loss. No one would think of making such a comment to someone who just had a relative or friend pass away. This wasn't a case of hoping conception would occur and it didn't. This was a case of losing triplets that were alive within me at one point.
I think the bottom line is that I wanted people to acknowledge that three babies died inside me. I know it was really early, and I am sure had I seen three heartbeats on an ultrasound and then lost the babies after that it would have been worse. But that doesn't mean I didn't lose three little babies. From the moment I knew we had seven embryos I felt like a Mom to each of them, and I was praying countless times a day for all seven babies. Of course I prayed even more intensely for the three dots that I saw on the ultrasound as they traveled to my uterus. I have a picture of that moment thanks to a kind doctor. Yes, I know they were microscopic and I wasn't seeing them in particular but rather the fluid they were traveling in but truly we all watched three little dots move across the screen. Anyhow to me this was an early miscarriage. I realize that many couples probably have lost babies this way and they have no idea conception had occured because the baby was lost prior to implantation or shortly after that so they never knew about the life or lives that were within them. But I knew! I wanted all three babies to live. I believe even if I had gotten pregnant, as ELATED as I would have been, if I had found out I was only carrying one or two babies, I still would have had a little grieving to go through for the one or two that we lost. I even felt that way on August 7 when I found out only one of the four embryos was frozen. Yes, I was happy one had continued to grow, but I was sad for the three we had already lost. That I think is a really hard part about IVF. You know how many tiny embryos you have at one point and it's highly unlikely that many (or even possibly any) will make it. When it happens when a couple is trying on their own, they don't know it happened so there is not as much grief involved although of course failing to get pregnant can involve a grieving process as well. There is a difference though between grieving the loss of something you hoped would happen and didn't versus grieving the loss of little babies who were alive and are no longer. I really think a failed IVF is emotionally almost identical to a miscarriage.
The second annoying comment came in the mail today. "We were saddened to learn of your recent disappointment." Ditto on what I said above. I wish it said "of your recent loss." Disappointment implies to me something didn't happen that you wanted to happen. It happened. God allowed 7 little babies to come into existence, but for whatever reason it wasn't His will for 6 of the 7 to still be alive at this point. We don't know yet what the outcome will be for our 7th baby. I know I am not alone in feeling this way as a woman on an IVF discussion board this week who found out she was not pregnant wrote a similar post. Someone also used the disappointed word with her and she said "devastated" would be far more appropriate than disappointed. I don't think anyone would use the word "disappointment" if a couple lost a baby later in a pregnancy.
Okay I'll get off my soap box. Again I truly do understand that these people meant well, and I am not holding it against them in any way. I am only saying something just in case my sharing my thoughts/feelings could help someone else down the road with what they do/don't say to someone who has experienced a similar loss.
Friday, August 24, 2007
Not much new
I am happy to say that physically I have felt back to normal since Tuesday which has been a great relief, and it has helped me emotionally also. Emotionally I would say most of the time I feel like I've "bounced back," but there are moments when I still feel really sad and cry over the loss of our 6 tiny little babies. Unfortunately these moments seem to hit me more when I am some place other than home. It happened today at work while I was in my office. I don't even know what triggered it today, but I felt like just bursting into tears. Thankfully this time I was able to hold it together.
We haven't made any decisions; I haven't even called the clinic in IL yet. First we need to get more info and input from Dr. Awad (next Thursday morning). I did bounce of Paul the idea of a shared risk plan. We had contemplated doing a plan like that in PA, but you have to be under 35 to be eligible for that one so that's no longer a possibility. However the one in Chicago does extend it for older women but the price is higher. There's a little jump up for 35 & 36 year olds and a bigger jump up for 37 & 38 year olds (nothing for those 39 or older unless they use donor eggs). They have a variety of plans - those that include 3 fresh cycles, 4 fresh cycles, with and without medication costs, with and without ultrasound monitoring, and also 80% refund or 100% refund. The only one I would possibly consider is the 3 cycle without medication, without ultrasound monitoring, and with an 80% refund. The others are just too expensive. That one for my age is $18,000. If we do one fresh plus one FET in Chicago what we pay them that would be $11,700. And the other reason I am considering this is you do not have to do all 3 cycles. You can terminate the program at any time as long as you have used all frozen embyros and still get your 80% refund unless of course you are pregnant.
So if we paid the $18,000 and got pg the first time then we OVERpaid by $9,200 and will still need to pay $2,900 later for the FET which would mean we probably wouldn't do an adoption through Cathy (because of the $$) but just adopt through the foster care system if we didn't end up with at least two children through IVF. If we paid the $18,000 and didn't get pg on the fresh cycle but did get pg on the FET, then we will have OVERpaid by $6,300. However if we paid the $18,000 and didn't get pg, no matter when we stopped (even if we stopped after one fresh plus one FET), we will have spent $8,100 LESS than if we just paid for one fresh and one FET ourselves ($3,600 vs. $11,700). So that will be a tough call. If the IVF works the first time or with the FET we will have been better off just paying for it the regular way, but if it doesn't work, we'll be better off financially with the shared risk plan. And my "odds" at this clinic are a smidge less than 50% for a fresh transfer.
Well as I said, no decisions will be made until after we talk to the RE. I am going to ask him about the possibility of donor embryos that day. So far everything I have found on the internet the cheapest way with adoption/donated embryos would be to have our one frozen embryo shipped to TN and have a transfer there with our one embryo plus donated frozen ones. That would cost about $5,000 compared to $2,250 if we just transferred our one locally. So that's not very appealing. So probably the only way we'll consider donated or adopted embryos is if we can do it for no (or very little) extra $$ at our local clinic.
We haven't made any decisions; I haven't even called the clinic in IL yet. First we need to get more info and input from Dr. Awad (next Thursday morning). I did bounce of Paul the idea of a shared risk plan. We had contemplated doing a plan like that in PA, but you have to be under 35 to be eligible for that one so that's no longer a possibility. However the one in Chicago does extend it for older women but the price is higher. There's a little jump up for 35 & 36 year olds and a bigger jump up for 37 & 38 year olds (nothing for those 39 or older unless they use donor eggs). They have a variety of plans - those that include 3 fresh cycles, 4 fresh cycles, with and without medication costs, with and without ultrasound monitoring, and also 80% refund or 100% refund. The only one I would possibly consider is the 3 cycle without medication, without ultrasound monitoring, and with an 80% refund. The others are just too expensive. That one for my age is $18,000. If we do one fresh plus one FET in Chicago what we pay them that would be $11,700. And the other reason I am considering this is you do not have to do all 3 cycles. You can terminate the program at any time as long as you have used all frozen embyros and still get your 80% refund unless of course you are pregnant.
So if we paid the $18,000 and got pg the first time then we OVERpaid by $9,200 and will still need to pay $2,900 later for the FET which would mean we probably wouldn't do an adoption through Cathy (because of the $$) but just adopt through the foster care system if we didn't end up with at least two children through IVF. If we paid the $18,000 and didn't get pg on the fresh cycle but did get pg on the FET, then we will have OVERpaid by $6,300. However if we paid the $18,000 and didn't get pg, no matter when we stopped (even if we stopped after one fresh plus one FET), we will have spent $8,100 LESS than if we just paid for one fresh and one FET ourselves ($3,600 vs. $11,700). So that will be a tough call. If the IVF works the first time or with the FET we will have been better off just paying for it the regular way, but if it doesn't work, we'll be better off financially with the shared risk plan. And my "odds" at this clinic are a smidge less than 50% for a fresh transfer.
Well as I said, no decisions will be made until after we talk to the RE. I am going to ask him about the possibility of donor embryos that day. So far everything I have found on the internet the cheapest way with adoption/donated embryos would be to have our one frozen embryo shipped to TN and have a transfer there with our one embryo plus donated frozen ones. That would cost about $5,000 compared to $2,250 if we just transferred our one locally. So that's not very appealing. So probably the only way we'll consider donated or adopted embryos is if we can do it for no (or very little) extra $$ at our local clinic.
Monday, August 20, 2007
Feeling better
Well I think (and hope!) the worst is over. The intense pain has finally gone away. It lasted about 24 hours. A friend called this morning and I had to hang up abruptly as I was in so much pain I couldn't even talk on the phone. She called back later to make sure I was okay. Not that I feel ready to go walk 3 miles like I did on Friday and Saturday, but at least I am not contemplating whether I need to be seen by the RE tomorrow. I am planning on trying to go to handbells tonight. I figure I can always leave early if it proves to be too much for me.
I will say though I really miss my hubby! I have been spoiled to have him around the past 6 days. He went back to school today. His classes start on Wednesday. A couple of years ago my niece Jenna used to sing "I need a hug, hug, I need a hug, hug" to the tune of "You are my sunshine." Well that's what I feel like singing today. I am in hug withdrawal, LOL!
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