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Archive for the ‘IVF#1’ Category

Lupron!

Posted in BCP, IVF#1, Lupron, medication side effects on January 14, 2009| Leave a Comment »

Turns out, my nurse had emailed me a protocol and Lupron start date… oh… Friday and Saturday. And she’d updated it on Monday. Turns out, I was supposed to have started the Lupron on Monday. Whoops.

See, and I hadn’t wanted to be a big pest about it, even though on Friday she had said she was going to definitely work on the protocol and email it to me and sure had make it sound like she was going to have it that day. I just figured that she was getting push back from the doctor or the clinic calendar or something. And I feel like I pester her enough, so I hadn’t wanted to keep bugging her.

Well, it turned out she’d been spelling my email address wrong, but it hadn’t been bouncing back to her, so some other perky chick is getting emails about IVF protocols from some random nurse at Ye Olde Fertility Clinic wondering what the *bleeping bleep* this is all about!

Meanwhile, back at the ranch, I was supposed to have started Lupron on Monday. Um, whoops? That’s okay, there was no frickin’ way I could have picked up my drugs on Monday anyway. Monday was a cluster-*bleep* of a day, the worst possible of Mondays, and I was a total, blubbering mess, incapable of coping with life. (Hey! It turns out, that’s thanks to the estrogen in the pill… isn’t it going to be fun when I start taking estrace at egg retrieval time?? Whee!)

So I’m going to take the Lupron as soon as I get home (was supposed to be this morning). Then I’ll take it around noon tomorrow. And Friday I’ll take it in the AM on schedule. This will get me back on schedule. And Friday will be the last day I have to take this God-forsaken BCP. The thing I’m REALLY bitter about is that if I’d known I was to start Lupron on Monday, TONIGHT would be my last BCP!! Gah.

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Dear John

Posted in IVF#1, The Waiting Game, Ye Olde Fertility Clinic on January 14, 2009| 1 Comment »

It’s not you, it’s me.

Heh. Actually, the break up with The Hatchery went better than I thought. The nurse happened to call me to see if I was still planning to start my IVF cycle in a week and a half. I didn’t say, “Well, yes, but not with you!” I instead fudged the truth slightly and said that just that week my insurance had taken an odd little twisty turn and now I was on a plan that didn’t cover them, and if I went to them it would be out of network, etc. etc.

She was super nice about it and said that it made a LOT more sense for me to go back to Ye Olde Fertility Clinic and told me to get my records (small as they are) sent back over to them and to let her know how things turned out, etc.

Such a lot of stress for nothing.

Meanwhile, BCPs are making me a blubbering mess, AND I’m all crampy and icky and having spotting/breakthrough bleeding, so I’m not even having the benefit of no period! Hello? The whole POINT of back to back pill packs is to avoid all of the PMSy period stuff! Gah. This is completely unfair.

But … things are moving along. I got all my drugs for the IVF cycle yesterday. My copay for everything was $125. Not too shabby. And I’ve got refills on everything, which rocks. I still don’t know when I’m supposed to start the Lupron. Waiting for that day is agonizing. Hello? When is that going to happen? SIGH.

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Not much of an Update

Posted in IVF#1, The Waiting Game on January 11, 2009| 3 Comments »

I talked to my nurse on Friday because there’s been a bit of confusion about whether I should roll into a new BCP pack after my last active pill (yesterday) or take a five day break and start a new BCP pack, which would delay things by three weeks. Sigh. Rolling into a new pack would mean that I could get the ball rolling on Lupron as soon as all the ducks are in a row. Any day now, in other words.

It seems SuperDoc is driving my nurse crazy these days, leaving cryptic messages in her email for her, telling her I can start Lupron now, forgetting that she needs to have certain things in place first, etc. She has to have the go ahead on the schedule for a date that I’m allowed to start stims, because if they end up not having room on their schedule for retrieval… well, we’re screwed, right? So just starting Lupron at will is not so easy. It’s not as simple as him saying, “Yeah, go ahead and start.” There’s a lot of work on her part in the background.

So anyway, finally she concluded that I should just roll into another BCP pack until we could sort all this out. As soon as she can get me a stim start date, she’ll get me a Lupron start date, and she’ll call in my drugs to the pharmacy. Since my copay is based on the prescription, not on each vial, she’ll make sure she calls in enough for the entire cycle, so that I won’t need refills, etc.

Therefore, probably sometime next week you can expect me to start bitching about headaches, hot flashes, fluid retention, and general pissiness. Good luck with that. If I were a good person, I wouldn’t bitch about any of that, I would simply be grateful for this opportunity to have another attempt at getting pregnant and bringing a life into this world. But I’m not a good person. I’ll probably do plenty of bitching.

Meanwhile, my consents have been notarized. Seth’s ID bloodwork has been done. Mine hasn’t, but I’ll hopefully take care of that on Monday. I haven’t gotten my HSG results faxed over to Ye Olde Fertility Clinic from The Hatchery yet, but I’ll get that done. I’m not sure exactly why I’m dragging my feet on that. There’s no logical explanation for it, other than I’m really swamped in the rest of my life and I haven’t gotten to it yet. Seriously, if you had ANY idea what else is going on in my life? You’d know there simply isn’t time to breathe, let alone deal with making just one more phone call.

Oh, um, as part of getting my HSG results faxed over from The Hatchery, that would involve letting The Hatchery know that I’m leaving them. My Dear John letter, so to speak. I’m not good at that sort of thing, even though this is ostensibly an insurance decision (except that I technically have BOTH insurances right now, so I could go either place). I feel awkward about the whole deal, because I do like The Hatchery, but something feels right about going back to YOFC (several of you even noted that I sounded content, even giddy, after seeing SuperDoc, and you know? I was!)… so it’s the right switch for me. And yet? Making that phone call? I haven’t been able to bring myself to do it. (Remember that it’s a very small office – one doctor, one nurse coordinator, one secretary… it’s not like I can just call and talk to a random admistrative assistant who I won’t know me from anyone)

Anywhozit, I know that’s not much of an update. After all, I even entitled this post, “Not Much of an Update”… but that’s what I’ve got.

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Mock Turtle Soup

Posted in IVF#1, mock embryo transfer, Ye Olde Fertility Clinic on January 6, 2009| 9 Comments »

I had my mock embryo transfer. I now have a mock embryo on board. I will love him, and hug him, and call him George. I hope he will grow into a perfect little mock fetbryo some day.

But seriously, folks. It turns out, I still have a uterus. Go figure. And ovaries. And hey! My ovaries? They’re stiiiiiiill perky! Who knew? And I once again got called meshuga by SuperDoc. He told the nurse who was there that I wanted to put back 5 embryos, but he talked me down to 4. Yeah. Something like that.

Anyway, if I can get my test results transfered over to Ye Olde Fertility Clinic from The Hatchery right quick, I should be able to get this show on the road really quickly. It’s incredible how quickly YOFC moves.

I didn’t ask SuperDoc about not doing the Lupron protocol – Dr. McB at The Hatchery was planning on using an antagonist protocol instead of a Lupron protocol to avoid OHSS. Dr. McB’s belief is that Lupron is partly responsible for OHSS issues in patients with my profile. I thought about mentioning this theory to SuperDoc, but he is confident that he can keep my risk under control, and I am confident in his experience, and I don’t feel like playing back-seat-doctor in his office right now. I am all set to start Lupron as soon as the doc gives the go ahead, which will be as soon as I have my pap smear, ID blood work, and HSG report all sent over from The Hatchery. Whoo Hoo.

Oh, and I confirmed financials with the insurance company last night. No preauthorization required. SuperDoc is an authorized in-network doctor, so I can just go ahead and do whatever I want. Copay is ridiculous – $40 per visit, $1500 coinsurance for the IVF, etc. But it could be much, much, much worse. I could have no coverage at all. Drug coverage is $50 per prescription, so my nurse is going to call in a LOT of medication, rather than making me get refills as I go along. I love her. 🙂

That is all. Love to all, from the perky one.

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I had my consult…

Posted in IVF#1, Ye Olde Fertility Clinic on January 6, 2009| 5 Comments »

…and all I have to show for it is a picture of a plastic uterus:

Okay, so I have a little more to show for it than THAT.

I met with Ye Olde Fertility Clinic this afternoon. SuperDoc called me back with a bit of a smirk on his face. He looked… bemused. I said, “I’ll bet you never expected to see me again!” “No, no I most certainly did not!” I told him that if he could see the gorgeous smiles on my babies’ faces every morning, he would know why I have to make more babies.

“Well,” he said, “I’ll tell you for sure, if you’re serious, all I have to say is IVF with SINGLE embryo transfers; no discussion.”

“You think??” I retorted. “Hello? I begged for IVF the last time around. I swore to you I’d end up with HOMs if I did IUI and from the looks of my ultrasound report from that day, I’m lucky I didn’t end up with three or four more!”

He pulled up my charts on the screen and said that it was really out of the realm of possibility – my estrogen level was very low, so low, in fact, that the possibility of HOMs hadn’t even been on the radar. This was also why they weren’t concerned about me hyperstimming when I triggered – with estrogen that low, it wasn’t a factor. This made me feel significantly better about what I’d found in the report, at least with regards to the risk of hyperstimming. I still maintain that if I’d ended up with HOMs, given the follicles that I had, low estrogen or not, I’m lucky I didn’t end up with a few more.

Anyway, I told him I’d met with The Hatchery and that they’ve never done elective single embryo transfers – I’m petrified of that. Ye Olde Fertility Clinic does ~15% SETs in their cycles (and has a 67% pregnancy rate in those elective SETs – but that’s because with elective SETs, generally you’re dealing with a population of women who have lots of very high quality embryos to choose from. He predicts that my chances of pregnancy in an elective SET cycle are closer to 40%). I do have a 2% chance of having monozygotic twins in an SET. It does happen. But then we’d just know G-d has a sick and twisted sense of humor and that would be the end of that.

I’m doing my mock embryo transfer/sonohystogram tomorrow at 7:45am. I’ll be starting on Lupron injections either this week or in a couple weeks, depending on what my nurse tells me in the next couple days. Then 125IUs of Follistim injections and 37.5 of Luveris (I have no experience with Luveris whatsoever – do any of you?). We’ll likely be aiming for a 5 day transfer since with SETs they try to go to blast.

I have to send my HSG results from The Hatchery and my ID bloodwork from The Hatchery. My nurse is calling in my drugs to the pharmacy downstairs from their offices ASAP. We’ll get everything rolling as soon as we can. My husband and I have a notary public coming over this week to get our consent forms signed (if they’re not signed in the office, they have to be notarized. Since my husband and I are never in the office at the same time to sign the consents – a notary it is. Sigh. Big pain in the tushie.

And that’s all the interesting news there is. Now I need to go to bed.

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Seriously?

Posted in IVF#1 on December 21, 2008| 6 Comments »

A friend of mine delivered her babies yesterday – a set of healthy perfect HOMs. I called my friend, M, to tell her the news. M and I haven’t known each other for all that long, though we emailed a bit after my babies were first born, but recently we’ve become very close. M also has HOMs and did the whole infertility thing, so she gets me. (Though she didn’t do the extensive fertility journey that we did – one IUI and *boom* a set of HOMs!) Anyway, I called her to tell her the news, and I had this funny conversation:

Me: I have exciting news!!!
Her: You’re pregnant!!
Me: Um, no. Not that exciting.
Her: Oh. Really?
Me: Yeah. That would be ironic, actually. I just started birth control pills for an IVF cycle, so wouldn’t THAT be funny? So anyway, no way I’m pregnant.
Her: Birth control pills for an IVF cycle?
Me: Yeah, it’s standard protocol for IVF – it’s part of the suppression cycle in an IVF protocol. I forgot you never did IVF.
Her: So, really? You’re seriously doing this? You really meant it? You’re really having another one?
Me: Yeah!
Her: You know it could be two. Or three. Or… Right?
Me: Oh no. Dr. P. told me I’m not allowed to have two. Or three. Or four. Or…
Her: Yeah, we see how well that worked for you last time. Really? You’re actually starting an IVF cycle?

Sometimes I forget that people don’t realize I’m serious. (not that there are many people in real life that have any clue that we’re doing this…)

So just for the record – We are doing this. For real. I’m not kidding. Though my mental stability has been called into question, so there is that little teeney stumbling block. But aside from that…

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CD3

Posted in BCP, IVF#1 on December 19, 2008| 2 Comments »

Oh, did I forget to mention CD1? I’ve been a little busy. Wednesday around 4:30pm I discovered that, right on schedule, my period had arrived. Now, I know that I’m still waffling between The Hatchery and the old clinic that has yet to receive a pseudonym (suggestions welcome), but just in case, I’m still proceeding as if The Hatchery is where I’m going until I have my consult with the old clinic.

So, since I’m ever-so-good at following directions (shut UP!), I called the nurse at The Hatchery to let her know it was CD1. Great, she said. They would be having two IVF cycles in January: one starting 1/10 and one starting 1/24, which was I thinking would be better for me. I started to panic about the 1/10 cycle. I’m worried about working out the insurance details by then, and what if I get confusing answers from the old clinic on 1/5 and want to reevaluate? So I told her my schedule was going to be too wacky on 1/10, so let’s go for the 1/24 schedule.

She wasn’t sure the doctor would want to start me on BCPs this early then, because that would mean me being on BCPs for nearly 5 weeks and that could mean me being an under-responder for the cycle. But, she said, aren’t I normally a bit of an over-responder? “I have HOM’s,” I said. Yeah… probably not an issue. She would talk to the doctor and get back to me on Thursday with the plan. The only concern with me just waiting until Jan to get a period on my own is… well, sometimes I just don’t get a period on my own, and that could mean a flurry of bloodwork, provera, hoping the provera works, and probably ending up with a February cycle instead. Not that Feb. vs. Jan. is really the end of the world, but you know how it is. One delay leads to the next delay leads to the next one… Next thing you know, five years, 12 medicated cycles go by and you have a set of HOMs… oh wait, that was last time.

Thursday she got back to me just as I was about to walk into a shiva visit, so I was a bit flustered, but the plan is I’ll start BCPs tonight and take 2 packs (no placebos) until the 23rd when I’ll go in for a baseline ultrasound and start injections on the 24th. Won’t this be fun? We’ll obviously talk plenty between now and then.

So. Um.

Whee?

My perinatologist had asked me when I saw him on Monday if I thought there might be any possibility that I might have a spontaneous pregnancy to avoid the whole twin possibility – I laughed and said in six years it had never happened (plus, really, with this many kids? who has time for any romancin’ ? JUST KIDDING!). Now I guess our chances of having a spontaneous pregnancy are completely gone, starting tonight.

I know every woman starting an IVF cycle talks about the irony of taking birth control pills in order to get pregnant. I don’t think for me that I find it ironic. I’m struck with a profound sense of – change. This feels like a big step toward my new goal. Toward my new hopes of family building.

I fear that the fall from hope will be devastating.

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