IVF Consult

I did a little searching on TB for questions to ask at an IVF consult and found this list, which I've been tweaking a little here and there, but it sure looks like a good jumping off point!  If you, my dedicated and awesome stalkers, have any suggestions of things to ask, please feel free to comment and let me know what I'm missing!  Also, my RE talked about doing an endometrial scraping - any advice??

IVF Cycle Questions
1.    How soon can we start our IVF cycle?
2.    Will you be doing the egg retrieval/embryo transfer yourself, or will it be another doctor?
3.    What protocol do you suggest for us, and why? What meds will I be on, and at what dosages?
4.    How many follicles are you hoping for in a cycle? At what point would you cancel or convert to IUI?            What abut concern for OHSS?
5.    How many embryos would you transfer in our situation?  Do we get final say?
6.    Are embryos that aren't selected for transfer frozen?
7.    What day would you normally transfer on, or does this depend on embryo quality?  When will we                  know?
8.    What are your success rates for our age group? Per embryo transferred? For our type of infertility?              What do you anticipate our success rate being? What is your live birth rate?
9.    How many cycles would we need, realistically?
10.  How much information do you give as we go through our cycle? (ie: follicle size, count, E2, P4 etc…            while stimming. What about fertilization and embryo reports?)
11.  How will I be sedated for egg retrieval?  Can you walk me through the procedure?
12.  Do you perform “natural IVF”?  (this was on the list I mostly C&P'd, I want to Google this, and              Mini IVF and any of the other IVF options!)
13.  Do you recommend bed rest after embryo transfer? For how long?
14.  What are the pros and cons of ICSI?
15.  What's the difference, and are both offered, between ICSI and assisted hatching?
16.  If the first round fails, what's the process for doing a FET if there were frosties?  How soon?

Medication/Supplements Questions
1.    When should I be stopping supplements, and is there anything in particular that you would suggest, or            that we should stay away from? (ie: Melatonin, DHEA, Tribulus Forte, CoQ10…)
2.    Do you use PIO, Crinone, or suppositories?
3.    Can we purchase our meds at an independent pharmacy?
4.    What do you think about acupuncture?
5.    What medications will we be on, and at what dosages?

Testing Questions
1.    Does any testing needs to be repeated?
2.    Any new tests?

Lifestyle Questions
1.      What lifestyle changes do I need to make prior to cycling?
2.      What will my physical limitations be while cycling?

Monitoring Questions
1.      How available is a nurse/doctor while cycling? (via phone or email)
2.      How often do you do monitoring?

Financial Questions
1.      How much will this cost?
2.      Do you have a price list? Detailed cost list?
3.      What are some “extra” costs that might pop up during a cycle?
4.      Do you have a shared risk or multiple cycle program?
5.      What about other types of discounts?
6.      How much will a FET cycle cost?
7.      What is the cost of freezing embryos?  Storage fees?
8.      Where will they be stored and for how long?

*this is a work in progress, I may alter this list as I go!

And benched...

I was a little nervous heading in for monitoring this morning, H & I had agreed on a plan and felt ok with it, but I have had a few instances of intense pain and cramping in the last couple of weeks, so I was a little apprehensive about things.  And apparently, with good reason.  There are a number of "left over follicles" from last cycle, which I think are cysts but they seemed hesitant to use that word.  They weren't too bad/severe but the RE (the one with the foot in mouth syndrome) did not want me to stim again this cycle, especially with how well I respond to injects, she thought a break would be a good idea.  She did mention the idea of Femara but I don't see a point, it didn't do much for me before and if the point is to give my ovaries a break, let's give them a break.  So a natural cycle it is.

She also looked over all my medicated cycles and we discussed my IUI cycles in more depth, apparently many people respond fairly consistently but not me, I'm a special snowflake, "and enigma" she said.  We seem to keep getting more and more follies, which as she pointed out, will be ideal for IVF.  She strongly encouraged us not to waste time or money on another IUI, she really thought it was time for us to move on to IVF.  On the positive side, my response has been great to injects, I have lots of follies, she is hopeful we'd have some to freeze also, but I know that's part of the gamble.  I can do it anytime I like, there's no schedule or anything like that.  She said if we were ready for IVF in May, toward the last half of this cycle we could do our consult and I could have an endo scraping, which they do before an IVF.  I've heard both the REs mention good stats and promising results on "touching" or "disturbing" the lining before a transfer, and I've heard it a few places also - it's on my list of things to research.  But essentially, we can get going anytime we're ready.

So now I have a project while I warm the bench - reading up on IVF, finding out about different clinics in the area, price comparing, etc.  At least I have something to do, I guess?

Twenty-two

Cycle twenty-two, that is, started yesterday - Happy Easter to me.  After our shittastic beta on Thursday, H and I were grateful for the holiday Friday so we could just be together and wallow in our sadness, curse IF, get angry and then start to figure out how to move forward.  This cycle hit H really hard.  I think he really never thought we'd need to seriously discuss IVF.  I think he really believed that one of these cycles would work for us.  But after 3 failed Femara cycles and 4 failed IUIs, we're both thinking it's time to try something new.  Every cycle has been the same or better than the last.  Every one of them has looked perfect on paper.  And every one has ended the same way.  I think this weekend was a real turning point for H, and I think it's been hard for him to wrap his head around taking the next step - moving to IVF.  Neither of us honestly believed we'd get here.  I am terrified of taking this step.

I'm terrified that this is the end of the road, there are no further medical advances, IVF is it.  I know there are different protocols and such, but for every step we've taken, there was an incrementally small-ish step to take next.  Natural to Femara.  Femara to injects + IUI.  But IVF just seems so final and scary.  I know it's expensive for everyone, but that scares me too. This is a huge gamble - $12k and no guarantees.  And it terrifies me to see how often IVF isn't successful.  I used to always imagine that was the guaranteed way to get pregnant if you're struggling and nothing else works, but now, my eyes are open, and I know it's not nearly as sure a bet as I used to think it was.  And as happy as I am that Ontario is moving toward funding one IVF cycle, that's not expected until next year sometime, and who knows if it will go through as quickly as expected.  So much about taking this next step scares me.

So the plan moving forward then is to go ahead with IUI#5.  I think by the time we do this last one, we will both feel like we've really exhausted this option, making it easier for us to move on to IVF.  In the mean time, we will make an IVF consult appt (for $400...seriously??) with our current clinic, I'm interested to see the protocol and overall schedule they would suggest for us.  In addition, I did some googling to see if there are any other clinics near by that we couple compare.  I am grateful on a regular basis that my clinic is a 15min drive.  Inject cycles require you to be there so very often (some weeks, with IUIs, I've been in 4-5 days in a row) so location is important to consider.  In my googling, I found another clinic/website that seems to be in the same building I'm in now but on another floor.  It's not obvious to me if it's a full on clinic or if they are more labs/facilities, since a lot of their webpage talks about sperm bank,egg and embyo donation I'm a little unclear about what exactly they offer, but I think I'll give them a call and find out.  So there it is, cycle 22 will be our fifth and final IUI while we research and budget for IVF.

Fuck This, Fuck That

This pretty much sums up how I feel about today.  I POAS this morning and there it was, the stick with one, single, solitary line staring back at me, mocking me.  I told H I think those tests don't really turn positive, he concurred they must be defective.  The sad part is I know they're not, but it sure does make me feel defective.  Why won't my body cooperate?  Why won't this work?  We have awesome cycles on paper - lots of follies, tons of sperm, everything goes just perfect - except the end.  And I hate not knowing what exactly isn't working.  Is it the creating of an embryo we struggle with?  Can we get an embryo but it can't seem to implant?  I hate not knowing what is going on, but more than that I hate feeling like my body is betraying me, failing me.  This is what it is designed to do!  This is one of nature's miracles.  This is something I have dreamed about and wanted my entire life - to be pregnant and to then to meet our baby.  That dream feels so far away right now.  I can't help but think of Einstein's quote, "Insanity: doing the same thing over and over again and expecting different results."  That's often how this feels.

When I was a kid (and still to this day), I had really terrible motion sickness.  When we'd go to an amusement park, my mom and brother would go on all the big rides and roller coasters.  I didn't particularly like those rides, especially roller coasters.  One of my biggest fears was being on one and half way through feeling sick and not being able to get off the ride - it's the not being able to stop it part that created a lot of anxiety for me.  Right now, I feel like I'm trapped on this IF roller coaster from hell and all I want to do is get off, get my feet planted firmly back on solid ground, and feel like everything is ok again.  But getting off the IF ride right now would mean no baby, and that's not an option, so now I must prepare myself to go round and round again, for the 22nd time.

Today means that we officially will not get our Christmas miracle.  It means we will not be holding our baby in our arms in 2014.  It means that the earliest we could meet our baby is 2015, which right now, feels like a lifetime away, especially when I think that we started trying in 2012.  Why is this so easy for some people, and so unbelievably difficult for others?  Why does this have to be so hard?

Heartbroken

This world can be so cruel and unfair.  I am just devastated for my good friend, Becky and her family right now.  I can't stop thinking about her, sending all my love and prayers.  It's so hard when you know there's nothing else you can do for someone you love.  There are no words that can take away her pain, there is no way to "fix" this for her.  All I can do is tell her how much I love her, that she is not alone, we are here for her.  This is what I keep telling myself.  Then, driving home from b/w this morning, I was listening to some Mumford and the perfect song (Timshel) came on at the perfect time, and the refrain is just so fitting:

But you are not alone in this

And you are not alone in this

As brothers sisters we will stand

And we'll hold your hand

Hold your hand

Becky, if you read this, please know that you are not alone, we are all here for you, and we love you, your husband, and your sweet baby girl, more than words can express.  I love you.  <3

Stressed the fuck out

Mom and Dad, I'm talking to you!

Holy fuckballs, what a very shitty week this has been.  I am emotionally exhausted, thank goodness it's Friday at least.

I feel like the weight of the world is on my shoulders and let me tell you, it is mighty heavy.  This shit with my parents is weighing hugely on me, but I'm trying desperately to stay out of it as best I can.  However, it has directly led to another very serious issue, and that is my mom and how she's handling all of this.  I won't downplay it, she's going through a lot right now, but the way she's choosing to deal with it, and not deal with things, is really not ok.  Even though this is my personal blog and no one IRL knows about it, I'm still hesitant to put it all out there, plus I honestly don't have the energy.  At any rate, I took a very difficult first step and have reached out to a couple of my uncles/aunt and my mom's friends (who I have very good relationships with also) to help.  My brother and I are simply not equipped to help her through this, she needs more than we can give her and pretending like this isn't happening is not helping her, it's only potentially causing more harm.  So I'm hopeful that together we can come up with some ideas on how to help her and selfishly, I'm really glad to be starting to feel like this isn't all on me.  I simply cannot handle anymore, so I asked for help.  It was hard and exhausting asking for it, but as I've told my mom, I think this will all get worse before it gets better, but we need to start making some progress at least.  Ok, that's all I can manage for today.

I think I've posted this before, but I need to remind myself of it right now.

I took another big step this week that was also hard for me.  A couple weeks ago I called our insurance to ask about coverage with a psychologist and did some googling and found someone who's not too far from here.  That email draft has been sitting in my "Drafts" folder since then.  Yesterday I finally hit send.  In my email I asked about her experience or knowledge about IF because if I'm going to talk to someone, I would really prefer if they had some background so I don't spend a bunch of time explaining tests, treatments, etc to them.  I haven't heard back yet, and I may need to look for someone else depending on their response to me, but I am proud of myself for hitting the "Send" button at least.

Quick cycle update: I'm 7dpiui, pt2.  With all the drama of this week I've barely been paying attention, which is not good because of the reason, but silver lining is I'm half way through the 2ww I guess?

And if I didn't already think the universe was cruel, a good friend had to go to the hospital yesterday because of some serious complications with her pregnancy.  I am sending all of my love, strength, prayers and well wishes that things turn out well for her and baby.  B, if you're reading this - I love you and Thumper and I am sending so much love your way <3

Round and round we go...

I've touched a little bit on here about my parental drama and I hate to say, it is still ongoing with no end in sight.  I really don't feel comfortable airing all the family dirty laundry, but this is my place to vent and that's just what I need to do right now, but more so in the way this is effecting me because I think that's my right.

I am so angry that this is all going on.  And selfishly, I'm really angry that this is going on WHILE I'm dealing with all this IF shit.  IF is a huge, life changing, mind fucking obstacle that life has thrown at me.  There is no book on how to deal with this, how it will end, when it will end, how I will feel along the way - I am doing the best I can every day.  It it largely thanks to the amazingly supportive friends I have made online that help me get through.  They are there to encourage me and root for me, help pick me up when IF is beating me down, help me find a silver lining where I may not see one, they let me vent and explore my feelings without ever making me feel bad about them, without ever judging me for those feelings.  I would be a mess, and totally lost, without them.  Am I crazy for wanting a little bit of that from my family?  Don't get me wrong, my mom is very supportive of us, she's always praying for us, wishing me well, asking but not prying - she's wonderful.  BUT there is this huge added stress in my life because of their marital problems.  I'm 30 years old, I never in a million years thought I would want my parents to separate or not be together.  But I look at them and do not know how they could possibly rebuild what's been destroyed.

I'm angry that my family is falling apart, and I HATE that this is happening when I am desperately trying to start a family.  The juxtaposition of that is so confusing and overwhelming in my head.  I'm mad that my dad is ruining our family, slowly and painfully, nonetheless.  No one has called it quits, they are sort of working on things, but who knows what that means.  I feel like we've been on a loop for months, one minute they're trying and seem to be doing ok, and then the next there's more shit to deal with and it's really bad again.  It's exhausting and stressful and just so hard for me to deal with.  Normally I love how close I am to my parents, now it's almost a curse.  My mom can't say "Hi" without me knowing if she's ok or if she's upset and probably just stopped crying - I know her too well, and then I don't know how to talk and pretend like I can't tell she's upset.  But I don't want to ask because I don't want to know.  I can't know anymore details about their marriage or their issues.  I can't.  Especially not if I ever hope to have a relationship with my father again.

I feel stuck.  It's not my marriage, I don't get to make any decisions, it's up to them.  But no one is deciding anything and I feel like this back and forth is much harder than dealing with parents who choose not to be together anymore.  I know they need to get there in their own time, but I really hope that's soon, because this has been bad for months and it's just too much.  I don't know how to be here for my mom but not, because I can't be too involved.  I don't know how to fix my relationship with my dad, and frankly, I don't want to just yet.  I may in time, hopefully I will, I can't imagine not having him in my life anymore, but I have no idea how to put the pieces back together after he broke everything.  I just need something to give.

Another one in the books!

The day started out rough, I got out of bed and was immediately folded over with some rather bad cramps and bloat and just feeling really uncomfortable.  H & I headed to the clinic, we drive separately so he can go straight to work after (clinic is half way there) and I cringed most of the 12 mins drive because holy pot holes!  Every bump and jerk of the car was felt in my ovaries and ute.  I popped a couple Tylenol and hoped for some relief.  So groundhog spermination day, except that today the office was packed!  I have never seen so many people in there.  It extra irked me that Dr. R seems to be off these last couple of days - there are only 2 doctors, you know how many patients you have, perhaps he could spend a little more time in the office??  Anyways, H did his thing, I had an uncomfortable u/s and then off to Timmies, our usual breakfast/waiting spot.  It's roll up the rim time and this year they've even added another chance to win on every cup.  And finally, this morning, I won a coffee!!  I realize the value of said prize is $1.65 but fuck that, I won something!  Hooray!

Back to the busy waiting room we went, the nurse asked if I had b/w but I hadn't before since it was so busy.  I was secretly hoping to get away without it, 5 days in a row is tough to find a non-bruised spot on my arm.  Then back to the old exam room to wait.  RE came in and said H aced his SA yet again - >100 mil, >90% motility.  Then the stupid RE makes yet another quip about H being a sperm donor, with his impressive samples.  This is not the first time she's made this joke, but guess what?  I didn't find it funny the first time, and I did not find it funny today.  We have been TTC for almost 22 months, with them about 8 months, we were supposed to be "an easy case" and yet here I am, lying half naked and exposed on the table desperate that this will be the cycle that works, and you think now is a good time to suggest we use H's sperm to impregnate some other women??  I have NOTHING against sperm donation, I think it is an amazing thing, I just think it's really insensitive to say that to me particularly at that moment.

So besides winning a coffee, my other highlight today is that I get a much needed break from the clinic, from the needles and vag cams!  I will start progesterone tonight and will add the baby aspirin starting tomorrow.  I go in Apr 8 for progesterone draw, Apr 14 for my baseline (they measure hcs to compare your beta against) and then Beta day will be Apr 18, two weeks today.  So on to the wishing and hoping and praying portion of the cycle.

And sperminated!

First I just wanted to say that last few days were a bit rough and I couldn't be more grateful for my fellow Dreamers.  It is so hard to have negative feelings, and even worse to feel bad about feeling bad!  It really meant a lot to be able to talk to other people who really understand, people who let me feel what I'm feeling without judgment or criticism - I felt much less alone feeling the love and support from all of them, so for those Dreamers who read this, a very heartfelt thank you <3

In Ute News, we had IUI part 1 this morning.  My 5 follies we had been watching ended up at 21 & 4x 20s.  So targets?  Check.  H and I did our usual routine - early morning, over to the clinic, he did his thing while I was poked and prodded for the 4th consecutive day this week, then off to Timmie's!  IUI went pretty smoothly.  I did feel it going in today - it's just a strange sensation, feeling like your insides are filling up with liquid!  It doesn't hurt, it's just very odd and a little uncomfortable at moments.  H's post wash numbers were amazing - >150 mil, >90% motility.  Swimmers?  Check.  He got praise, yet again, from the RE; I think he was feeling pretty good about himself ;)  Because we're looking at the same number of follies as last cycle, and after the trigger yesterday I've been feeling a lot more bloated and activity in the ovary region, and since we know insurance actually pays for it (yay!) she gave me a script for Dostinex again.  Hopefully starting it now will help prevent me from getting too uncomfortable, nip it in the bud, as they say!  Then after tomorrow's IUI I will start on progesterone and baby aspirin.  And I will finally get a break from the clinic, woo hoo!  At least for a few days, tomorrow will make 5 days in a row there, that's more than enough for me, and my bruised arms - 5 days in a row of b/w is not fun!  Come on, lucky #4!!!!!!

So.Many.Feelings.

I have so many mixed emotions this morning.  As of yesterday evening, I now have another nephew.  I am beyond happy for my BIL&SIL, I love them so much and I'm so happy for them.  I'm also happy to have another nephew!  I love being an aunt, I love my nephews so much, I cannot wait to meet the latest addition to the roster!  I just wish I could stop there, I wish that was all of my feelings about this, but fuck you IF, it's not.  I can't help but feel this overwhelming sadness for us.  I am angry at IF and how unfair it all is.  I'm pissed that it is tainting what should be a happy and joyous occasion with feelings of jealousy and bitterness and sadness. I feel terrible that I was over the moon excited when my first two nephews were born (seriously, I was probably the most excited aunt you'd ever find!) and I want to feel like that now, I want to solely be happy and excited, but I can't.  I feel so guilty for feeling this way.  I'm jealous of my SIL who got KU with #2 on their first try, after we'd been at this for a year.  I felt like I was being lapped then, but we were just starting out at the RE and I thought I at least had a good shot of getting pregnant while she was pregnant, it's a whole nine months, right?  Yet here we are, nine months later and she's at home holding her beautiful new baby in her arms and I feel empty inside.  I'm jealous of how easy it was for them (not that I'd ever wish for anyone to struggle), I'm jealous that they got to have sex and make a baby while I'm at the clinic way too often, being poked and prodded, vag cam'd and needle jabbed, all in a desperate hope that one day (soon!) it will be our turn.  When will it be our turn?  Will it ever be our turn??  Why is this so hard???

And a quick update on me.  At monitoring this morning, follie check showed 20, 3 x 19s, 18.  I was really hoping for only 3-4 but the RE assured me she was confident moving forward with this.  I did ask her straight up if she was concerned with that many and she said she was confident to move forward.  She then told me (again) that not all follies will contain eggs, not all will be mature, even less are likely to fertilize and even less to implant.  It makes sense when she says it, it's just a little different than some of the things I hear/read online from other ladies.  I'm all triggered up and done with injects this cycle, woo hoo - mini victory!  We will do IUIs tomorrow and Friday, and then I'll start the baby aspirin and then back to waiting.  And praying, lots of praying.