Friday, May 31, 2013

Day 4

Today I got a call from my nurse saying she as able to get me one sample box of Menopur, which is one of the injectable meds I am using. My insurance only approved coverage for 10 vials (which should be 10 days worth) even though my last cycle proved I am a slow responder. My insurance is a huge pain to work with. So much so that my nurse would rather call their drug rep and ask for samples than call my insurance and try to get more meds covered. The drug rep initially said she didn't have any samples to give until July, but somewhere was able to get my nurse one box, which is 3 doses. This will give me up to 3 more days of meds for a total of 13 days. This may not sound like that big of a deal, but it could make all the difference in the cycle. If my insurance won't approve any additional doses, then I would have to pay out of pocket and that would be around $110 per dose. Even with my insurance, the co-pay is $250. Anyway, my nurse is amazing and she has made this whole process a little easier.

Also, I wanted to share a poem that an online friend shared in one of the support groups I frequent. She wrote it to share on FB during National Infertility Awareness Week. Shortly after she shared this post with us, she found out that her treatments were successful and she is now about 8 weeks pregnant. I thought it was a good analogy and I can relate to the way she was feeling.

"I am running a race. A race I didn't sign up for. A race I didn't train for. A race I know nothing about. But deep down in my heart I know I'll find that rainbow at the end.
I hire coaches, paying them a lot of money to help me through it. But not even the most knowledgeable coach in the world can promise me that I'll ever make it to the finish line. They can't even tell me what mile I am currently on. I am struggling between giving it my best and giving up, between running as fast as I can and taking a break to save my energy. An exercise so natural to most is turning into a traumatic experience for me. 
Sometimes I feel I can see the finish line in the distance and get hopeful only to get crushed again and again and ending in hopelessness. And then I get back up and start all over. Struggling at every turn, wondering if I am going the right way this time. All of a sudden this race is turning into a full time job and an emotional rollercoaster that is out of my control. If I only tried a little harder, then maybe I'll get a little closer. And then again, maybe I'll never make it.
It's a lonely race most of the time - few people are running, mostly undercover. Sometimes there are family and friends standing on the sidelines trying to support, but they don't understand what all this running is about. And sometimes I feel like I am just running myself into the ground." -kati&jerry

Thursday, May 30, 2013

Day 3

Today I had my first blood work monitoring. My last treatment cycle, my estradiol (E2) level did not rise like it was supposed to. The rise in E2 shows that the eggs/follicles are growing and that the uterine lining is thickening, so at this point in the cycle, the number should be going up and should double about every 48 hours. Last cycle, mine dropped before it started to rise and was barely doubling in 48 hours, so I was very discouraged. I was on a very conservative dose of medication though and the goal with IUI is 1-3 mature eggs, where as the goal with IVF is as many mature eggs as you can get basically (without compromising quality, it's a delicate balance).

Anyway, my E2 more than doubled so I will do the same dose (150IU Bravelle and 75IU Menopur) of meds tonight and tomorrow and then go back for my next monitoring appointment on Saturday morning. I will also have my first ultrasound of the cycle, so I am hopeful that I will have a lot of follicles growing. Some women get a lot of eggs during IVF, upwards of 20-30+. Because I have diminished ovarian reserve (DOR) I will be happy if we get between 5-10 mature eggs. My doctor said she would be pleased with 5-8. So as I write about the numbers, don't be discouraged for me if the numbers sound low. This is to be expected and we are focusing on quality vs. quantity for my cycle.

This is the part of IVF that is supposed to be "exciting." It is supposed to move fast. It's where all the action happens. ha ha I don't mind the injections, but I do mind the drive to the appointments. Our clinic is in Quincy and we live in Middleboro. In no traffic, it is about a 30-35 minute drive. Quincy is about 10-15 minutes south of Boston, so there is no such thing as no traffic on a weekday morning. So I take the earliest monitoring appointment I can get (usually between 6:45-7:00, the latest they do them is 8:30) so I can leave my house around 6:00 and get there on time. Today traffic was pretty bad, so I was late. I left my house at 6:15 for my 6:55 appointment but didn't get there until about 7:10. For those that have ever driven with me, you know I do not tolerate stupid drivers very well. It is a challenge for me, but I have just had to let go of all of that because I want to keep my stress level low. So I always go prepared with water and a snack and listen to music and try to enjoy the drive. And then I take a nap when I get home. :-)

Overall, I am feeling pretty good for now. It is still early in the cycle and I will know a lot more this weekend when I have the ultrasound. Physically, I feel fine. I don't have much of an appetite, but that is how I felt last time I did injections. I read about some women who can't stop eating while doing injections, so I'm glad that hasn't happened to me. I have a little nausea and some occasional cramping, but nothing too crazy. And so far, no bruises on my belly from the injections. John does good work. :-)

This was traffic on my way back, at about 7:30am. I was at a complete stop, waiting for my turn to merge (people in MA are very bad at merging). Good times.

Tuesday, May 28, 2013

Day 1

Night one has been a success. This early in the process, it's not that exciting. But here are some pics of what goes on every night. My meds come in powder form and have to be reconstituted with saline solution for injection. So I draw 1ml of saline into the syringe and then squirt it into the first powder vial. Then I do the same for 2 more vials, then put the needle on and we're ready for the injection. Mixing to two meds together is great because then I only have to do one injection each night instead of two. The meds I am on are Bravelle (FSH) and Menopur (FSH+LH).

All my supplies ready for mixing

John takes this very seriously :-)

Ready to inject! The needle is only 1/2 inch, so it's not so bad, but John has to do it for me because I can't bring myself to stab myself.


I've gone back and forth on whether or not I wanted to blog about this whole process and my/our experience. I obviously decided to write about it. This whole process is very stressful and sometimes overwhelming, so it is helpful to me to have a place to document everything and share my feelings. I have come across a lot of IVF blogs since I first started researching IVF and I have learned so much from other women, complete strangers. So maybe no one but me will read this, and that's okay too, but hopefully someone will get something out of it. I will try not to be too graphic, but I plan to document the process as best as I can.

So first, a little background. John and I first started to try to conceive (TTC) in March 2011. We were living in MA and decided to move back to UT later that year so that we would be around family again when we had our baby. We first started testing at the 9 month mark, just to check all my hormones and make sure we were good to go and John also did some basic testing. At the one year mark I had a procedure called a hysterosalpingogram to make sure my tubes were open, and they were. From there we started treatment with Clomid. I did 3 months of that with no success so then we moved on to Clomid plus FSH (follicle stimulating hormone) injections and IUI (intra-uterine insemination) and we did 2 cycle of that last fall, again with no success. At that time I had some blood work repeated and they re-tested my AMH (anti mullerian hormone), which basically measures the hormone produced by your resting follicles (immature eggs) and can give you an idea of the quantity of eggs you have left. Mine came back low for my age (.70) so my doctor in UT recommended we move on to IVF and gave me the "time isn't really on your side" talk.

John and I had already decided that if we moved forward with IVF that we would move back to MA. While we were living there, we found out we had really great infertility insurance coverage. What we didn't realize, is that we only had that coverage because we lived in MA and not just because we had awesome insurance. So we lost that great coverage when we moved back to UT so we paid for all our treatment in UT out-of-pocket. IVF is significantly more expensive, so in our opinion, worth the move back to MA so we could have the coverage.

We are so lucky to have such supportive and helpful family. My sister and her husband our living in our house while we are gone and taking care of our cats. And it's not really our house, it is John's parent's house. We are renting it from them and helping them do some improvements while they are traveling and enjoying their retirement so the house will be ready to sell once they are done traveling. So everyone has come together to help us put some things on hold while we pursue our dream of starting a family.

We moved to MA at the new year and started over with a new doctor. We had to do repeat blood work and testing. My new doctor is more thorough than my old doctor and she was able to catch that my glucose levels were a little off and I started treatment for pre-diabetes. Everything is good now, but I had to meet with a high-risk doctor and an endocrinologist to talk about potential risks during pregnancy.  We had further delays when we found our insurance required 3 failed IUI cycles before approving IVF, so we had to do one more cycle of injections and IUI. Since that still didn't work, they finally put in the order for IVF and the cycle got approved.

We are very lucky to have the coverage we do, but it is not free and is still costing us a lot of money just to be living here. We are grateful for the opportunity to be able to try IVF and we are excited to finally get started. I posted a couple of links with info about infertility and ways to be supportive (and things that are not helpful) as well as a link to our clinic's website if anyone is interested in learning more about IVF or infertility in general. I am obviously very open about all of this and will answer any questions.

All my meds ready to go!