Over the holiday my nurse emailed me to let me know she's moving positions and that I'll have to get assigned a new nurse. It took a few days of back and forth but then I involved my doctor and was finally assigned a new nurse. We set a baseline date around my work schedule and I'm working on getting a quote for medication from several different pharmacies.
In the meantime I also started getting information from our new financial counselor. I got us a refund for a portion of the last cycle because we overpaid for something that should have been submitted to insurance. It's crazy how on top of things I have to be - isn't that literally their job? They just don't care how they get paid. If payment comes from insurance great, if it happens to come from our pocket also great. It's a challenge to constantly be on the ball and know that if I miss something then we lose out.
I'm trying to not overthink this cycle. Whatever will be will be. IVF 6 kicked me in the nuts with recovery and results. I'm hoping that an upcoming Jan trip will be enough motivation to keep me happy and energized. Bottom line is that it's a hellish 3 weeks and regardless of results it too shall pass.
So how did we get to this decision? As I was thinking about what we want to do next, I tried figuring out how to do another cycle and another transfer before January. I don't know why that was a deadline in my mind. It's possible because the clinic OR shuts down the last week of December for their yearly scrubbing and they don't start any new cycles leading up to that week. No matter how I sliced it, I couldn't get the calendar to fit both an IVF and a transfer which meant we had to choose one. In the back of my mind I was also thinking that it would be nice to do a trip and take a real break.
My husband's work schedule dictates our vacation schedule and we calculated that it may be possible to take a trip in 2018. The more we talked about it the more we realized how much we both want to go. We decided to try to book a trip for earliest possible time in 2018. With that decision made everything else seemed to fall in place. We knew we didn't want to try to do a transfer before the trip which made it easy to choose the time in Nov/Dec for another retrieval. At this point the bar is set so low that the very least will be that we tried something and didn't waste the time, regardless of the results of the cycle. My office is closed for winter break at the end of December so I'll have a solid week for recovery.
Even though it's only mid-October I asked my new nurse to see if she can schedule the retrieval for early December. It gives me time to get back to some routine first and get my head in the game. It also allows me to take care of several work events between now and then without the stress of the cycle and meds. It also gives me the chance to enjoy the Thanskgiving break. It just makes sense overall. There's not much that we can control when it comes to treatment, but for the things that we can it makes a difference.
Wednesday, October 25, 2017
Tuesday, October 24, 2017
Boston
We did a quickie getaway to Boston for a few days. We used points for hotel and flights, so only ended up paying for transportation (Uber and taxis), activities, and food.
The itinerary included a whale watching cruise, guided Freedom Trail tour, self-guided fenway park stroll, and walking around Harvard and along the Charles River. We lucked out with beautiful weather. It was an awesome chance to get a change of scenery without using too many vacation days. We had a great time.
The itinerary included a whale watching cruise, guided Freedom Trail tour, self-guided fenway park stroll, and walking around Harvard and along the Charles River. We lucked out with beautiful weather. It was an awesome chance to get a change of scenery without using too many vacation days. We had a great time.
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| View from the boat, on way to Whale Watching |
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| One way to see things |
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| Street art in the park |
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| Fall foliage |
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| Cafe Eilat |
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| Fluffy clouds |
Thursday, October 19, 2017
Feeling good
I talked a lot about redoing our bedroom and it finally happened. I bought the furniture we liked at a Labor Day sale knowing it would take a while to ship and it finally arrived. It's spectacular! The room is still a work in progress but I'm happy to report progress. Next up is lighting, decor, and accessories.
After seeing what the architect came up with, I've decided against renovating the house to add a master bathroom within the current perimeter. Either we'll finish off the basement or we'll do an addition upstairs (or maybe both eventually down the line). I don't want to have tiny rooms and teeny bathrooms and pay out the nose for it. So that's on hold for now.
I've been talking with my new nurse about our next cycle. I'm trying to schedule retrieval around my work schedule. Things are going to get hectic in the next several weeks so I want to see if we can work backwards from mid-December. That gives me enough time to get mentally prepared and enjoy a few more weeks of normalcy. It will also give me a chance to drop the extra holiday pounds.
I've been enjoying our non-treatment break so, so much. It feels amazing to just be regular without discomfort or pain or fluctuating hormones making me crazy. It's incredible to be able to hold my emotions, something really difficult while on medication. It's so nice to be able to plan a few days in advance because I don't have to assume I likely won't feel well.
On one hand I hate having to gear up to get into this again for IVF 7, knowing the hell coming up. I also hate the idea of all the shots coming up for whatever transfers we end up doing, along with all the side effects that come with it. On the other hand, feeling like this makes me happy to know that whatever treatment hell has in store, it's temporary. It will be over eventually. It's not forever. There's a light at the end of the tunnel. I can and will feel normal again, it's just a matter of time and a difficult chapter to get through. The mere idea of all this being "in the past" and having gotten to the other side is exciting.
Over the past few weeks there was a significant change in my attitude: I've been happy and hopeful. I have energy and a spring in my step. I'm not sure what specifically to attribute it to. The break and lack of meds is probably a big factor. I know that the holiday season was incredibly difficult where we were reminded of our childlessness non-stop. At shul, at family gatherings, at holiday celebrations - triggers were everywhere. Before Kol Hanearim this year at Simchat Torah our rabbi read this prayer specifically geared toward couples dealing with infertility. It was special and gut-wrenching at the same time.
So maybe we hit a new low regarding feeling sad that there was only one way to go, which is up. Regardless of the cause, I'm glad to be feeling good and more like myself, making decisions and taking chances on things I may not have otherwise. For the first time in a while I'm looking forward to what's ahead even thought it's still scary and out of my control.
After seeing what the architect came up with, I've decided against renovating the house to add a master bathroom within the current perimeter. Either we'll finish off the basement or we'll do an addition upstairs (or maybe both eventually down the line). I don't want to have tiny rooms and teeny bathrooms and pay out the nose for it. So that's on hold for now.
I've been talking with my new nurse about our next cycle. I'm trying to schedule retrieval around my work schedule. Things are going to get hectic in the next several weeks so I want to see if we can work backwards from mid-December. That gives me enough time to get mentally prepared and enjoy a few more weeks of normalcy. It will also give me a chance to drop the extra holiday pounds.
I've been enjoying our non-treatment break so, so much. It feels amazing to just be regular without discomfort or pain or fluctuating hormones making me crazy. It's incredible to be able to hold my emotions, something really difficult while on medication. It's so nice to be able to plan a few days in advance because I don't have to assume I likely won't feel well.
On one hand I hate having to gear up to get into this again for IVF 7, knowing the hell coming up. I also hate the idea of all the shots coming up for whatever transfers we end up doing, along with all the side effects that come with it. On the other hand, feeling like this makes me happy to know that whatever treatment hell has in store, it's temporary. It will be over eventually. It's not forever. There's a light at the end of the tunnel. I can and will feel normal again, it's just a matter of time and a difficult chapter to get through. The mere idea of all this being "in the past" and having gotten to the other side is exciting.
Over the past few weeks there was a significant change in my attitude: I've been happy and hopeful. I have energy and a spring in my step. I'm not sure what specifically to attribute it to. The break and lack of meds is probably a big factor. I know that the holiday season was incredibly difficult where we were reminded of our childlessness non-stop. At shul, at family gatherings, at holiday celebrations - triggers were everywhere. Before Kol Hanearim this year at Simchat Torah our rabbi read this prayer specifically geared toward couples dealing with infertility. It was special and gut-wrenching at the same time.
So maybe we hit a new low regarding feeling sad that there was only one way to go, which is up. Regardless of the cause, I'm glad to be feeling good and more like myself, making decisions and taking chances on things I may not have otherwise. For the first time in a while I'm looking forward to what's ahead even thought it's still scary and out of my control.
Monday, October 16, 2017
Next
The last days of the holiday were nice. We were home for all the meals and socialized with friends and neighbors in the afternoons. We chilled, relaxed, overate. It was good.
The working plan now is a retrieval cycle in Nov/Dec, trip in January, transfer in February. Details to follow.
Monday, October 9, 2017
Sukkot
The first days of Sukkot were tough. Our sleepover guests were exhausting and demanded all of our time and energy. I wrote up a whole post of what was difficult about their stay, but even in an anonymous post on an a supposedly nameless blog, it's still the internet where everything is public and permanent. Suffice it to say it was a lot of work and most of it felt unappreciated.
I used shul as an escape, which kind of backfired because that's where all the ladies with pregnancy bellies hang out (apparently) with their beautiful cute little families. There were triggers everywhere.
Over the holiday I received an email from my nurse that she's moving to a new position. This was our third nurse. Even our nurses get to move on from this hellish journey. I'll be assigned to a new nurse once we let them know we're off our break and decide what we want to do next.
We still don't know what we want to do. We've been enjoying just being a normal married couple, talking about other things. There are a few days we took off at the end of October to take a quick getaway but we're still undecided about where to go. Florida is our first choice but it's still unclear if they're completely zika-free. We also got the Israel-trip-bug again and we want to see if we can try to make a trip work for 2018. On one hand we want to give treatment the best chance possible and really believe it's priority. On the other hand it's an expensive trip and we're sick of the merry-go-round. I don't want to postpone any treatments because I feel my age ticking but I also don't want to feel like I let life slip by while waiting for results.
I know I'm not the best version of myself these days. I feel drained and exhausted. I feel like I'm surviving, not thriving. Just taking it one day at a time, one hour at a time. I want to make changes to help make things better. Maybe it is worth spending the money on an expensive trip to get change of scenery and a fresh outlook on life.
I used shul as an escape, which kind of backfired because that's where all the ladies with pregnancy bellies hang out (apparently) with their beautiful cute little families. There were triggers everywhere.
Over the holiday I received an email from my nurse that she's moving to a new position. This was our third nurse. Even our nurses get to move on from this hellish journey. I'll be assigned to a new nurse once we let them know we're off our break and decide what we want to do next.
We still don't know what we want to do. We've been enjoying just being a normal married couple, talking about other things. There are a few days we took off at the end of October to take a quick getaway but we're still undecided about where to go. Florida is our first choice but it's still unclear if they're completely zika-free. We also got the Israel-trip-bug again and we want to see if we can try to make a trip work for 2018. On one hand we want to give treatment the best chance possible and really believe it's priority. On the other hand it's an expensive trip and we're sick of the merry-go-round. I don't want to postpone any treatments because I feel my age ticking but I also don't want to feel like I let life slip by while waiting for results.
I know I'm not the best version of myself these days. I feel drained and exhausted. I feel like I'm surviving, not thriving. Just taking it one day at a time, one hour at a time. I want to make changes to help make things better. Maybe it is worth spending the money on an expensive trip to get change of scenery and a fresh outlook on life.
Thursday, September 28, 2017
Choices
The financial counselor that has screwed me over in the past is no longer there, thankfully. I took my questions directly to a supervisor to make sure I understood my options.
As we debate next steps whether to do IVF 7 or FET 6, I want to know exact numbers. What are the costs? What programs are available? Are we getting the biggest bang for our buck?
As I mentioned before, my clinic has several "Shared Risk" programs. One such program has the option of doing up to 6 fresh IVF and unlimited transfers from embryos from those cycles. They make you transfer every viable embryo from one IVF before doing a new cycle, up to six times. After six IVF cycles and all the transfers from those cycles have been transferred, if you don't have a take-home baby they refund 100% of the money (not meds, of course). Any embryos I have in the freezer right now wouldn't count toward the program. So while I can't count them in the "unlimited" transfers, they also won't hold us back from doing fresh IVFs. That's fine with me. Even though it includes everything except meds, it's a lot of money up front. There's also an additional fee if we want to do back-to-back cycles without transfers in between. Once you get a take-home baby the contract is complete, regardless of how many cycles you've done. Let's put a pin in that for a minute.
My insurance won't cover a fresh IVF as long as we have embryos in the freezer. Since we are interested in "preserving fertility," as they like to call it, we've opted to do fresh cycles even when there were transferable embryos in the freezer. At this point we have two embryos we can transfer (IVF 4, 4/16; IVF 6, 9/17).
I believe we overpaid for a combo IVF/FET which includes one transfer for every IVF in the global fee. I don't want to pay for the FET out of pocket; I want them to go get authorization for it from my insurance. Why should I pay for it if I still have benefit dollars I can use up? Insurance only denies coverage for IVF while there are still embryos in the freezer, but I still have coverage and the clinic should get authorization and use it! For this last cycle I paid for a combo IVF/FET per the advice of the now-fired financial counselor. When I spoke to the manager I asked for a credit for the FET portion of the fee I paid. If we decide on a fresh IVF cycle, the credit will go toward a new cycle and I will only be charged for the IVF part of the global fee. If we decide to do a transfer, they will submit to insurance for authorization which they said they will as soon as they have a start date. How's that for fun?? I saved nearly $4,000 just for spending 15 minutes asking questions. Take that Geico.
While I feel like getting more embryos is the way to go, I'm not sure I feel that way for the right reasons. As long as they're in the freezer, they're safe and there's hope. In the past five transfers we've ended up with only disappointment and heartache so I hesitate to pick a transfer. I don't want to "waste" embryos. It's obviously flawed logic because if we don't transfer we have no chance at a pregnancy and baby which is the ultimate goal here. Embryos on their own are not babies. When we only had one in the freezer, the choice was easy: don't be left with nothing, keep retrieving. But now that there's more than one, does it make sense to keep doing IVF? I don't know anymore. The right path isn't clear when there's no guarantee one way or another.
In April 2016 when we got 3 healthy embryos to transfer from IVF 4, I thought it would be the last time we'd ever have to do a retrieval. Then this time in IVF 6 when we had 14 embryos on Day 5 I again thought we'd never have to do another retrieval but then only two made it to biopsy. Maybe I have to stop thinking that we're never going to need to do more retrievals. Then there's my age to consider and while I'm not old yet, at 33 the "advanced maternal age" of 35 is just around the corner. There's no way to know how my body will react to a pregnancy, if I ever get that lucky, and no way to know how many transfers it will take to get pregnant with number 2.
I've tried to focus on working on getting one baby at a time, but it's impossible not to think about the future. I know there are no guarantees, but with embryos in the freezer I would be a lot calmer to enjoy baby #1 before needing to rush back in and get started again to try for a sibling. I never thought there would be a specific number I have in mind of how many I need in the freezer before I feel comfortable transferring. I thought I'd be ok with having one. But now that there are two, I want to keep two. Knowing what I know now, I don't know if I'll ever feel content with anything regarding fertility treatment. There are just too many unknowns and things beyond our control.
We got results earlier than we anticipated, which meant that we could still decide to not skip a month. I wasn't so happy with taking a break. If we decide we want to do IVF I want to get it over with. But I recognize that we still need to live our lives. It's been non-stop for over two years. We just need a break to be normal for a few weeks. Not be depressed, not be niddah, not feel nauseous, not be in pain or uncomfortable. We're aiming to do a small vacation end of October and that would've needed to get rescheduled if we restarted treatment earlier. In addition, my coworker who is now on maternity leave will not be back before December and I know there will be a lot of slack to pick up while she's out.
Back to the Shared Risk program, I don't think I'm going to want to do more than two back-to-back IVF cycles in a row. Maybe after the break we can do one more (at a reduced fee based on my conversation with the manager and the newfound credit on our account) and then start transferring. A transfer would be easier and if it fails we can always do the fresh IVF after.
If this journey has taught me anything it's that there are no guarantees and there are no wrong choices. If we do a transfer and it works then we have a baby and we've won. If we do a retrieval and get more embryos to transfer then we've won. We already know either one of those can fail, or worse start out hopeful and then crush our hearts. We've been there done that: high embryo counts that never develop into blasts; pregnancy that took but ended as a blighted ovum. So I don't know what the right path is; I can only hope that the one we choose leads us to our ultimate goal of having a family.
Just thinking. I don't have the answers, but these are the choices.
G'mar chatima tova.
As we debate next steps whether to do IVF 7 or FET 6, I want to know exact numbers. What are the costs? What programs are available? Are we getting the biggest bang for our buck?
As I mentioned before, my clinic has several "Shared Risk" programs. One such program has the option of doing up to 6 fresh IVF and unlimited transfers from embryos from those cycles. They make you transfer every viable embryo from one IVF before doing a new cycle, up to six times. After six IVF cycles and all the transfers from those cycles have been transferred, if you don't have a take-home baby they refund 100% of the money (not meds, of course). Any embryos I have in the freezer right now wouldn't count toward the program. So while I can't count them in the "unlimited" transfers, they also won't hold us back from doing fresh IVFs. That's fine with me. Even though it includes everything except meds, it's a lot of money up front. There's also an additional fee if we want to do back-to-back cycles without transfers in between. Once you get a take-home baby the contract is complete, regardless of how many cycles you've done. Let's put a pin in that for a minute.
My insurance won't cover a fresh IVF as long as we have embryos in the freezer. Since we are interested in "preserving fertility," as they like to call it, we've opted to do fresh cycles even when there were transferable embryos in the freezer. At this point we have two embryos we can transfer (IVF 4, 4/16; IVF 6, 9/17).
I believe we overpaid for a combo IVF/FET which includes one transfer for every IVF in the global fee. I don't want to pay for the FET out of pocket; I want them to go get authorization for it from my insurance. Why should I pay for it if I still have benefit dollars I can use up? Insurance only denies coverage for IVF while there are still embryos in the freezer, but I still have coverage and the clinic should get authorization and use it! For this last cycle I paid for a combo IVF/FET per the advice of the now-fired financial counselor. When I spoke to the manager I asked for a credit for the FET portion of the fee I paid. If we decide on a fresh IVF cycle, the credit will go toward a new cycle and I will only be charged for the IVF part of the global fee. If we decide to do a transfer, they will submit to insurance for authorization which they said they will as soon as they have a start date. How's that for fun?? I saved nearly $4,000 just for spending 15 minutes asking questions. Take that Geico.
While I feel like getting more embryos is the way to go, I'm not sure I feel that way for the right reasons. As long as they're in the freezer, they're safe and there's hope. In the past five transfers we've ended up with only disappointment and heartache so I hesitate to pick a transfer. I don't want to "waste" embryos. It's obviously flawed logic because if we don't transfer we have no chance at a pregnancy and baby which is the ultimate goal here. Embryos on their own are not babies. When we only had one in the freezer, the choice was easy: don't be left with nothing, keep retrieving. But now that there's more than one, does it make sense to keep doing IVF? I don't know anymore. The right path isn't clear when there's no guarantee one way or another.
In April 2016 when we got 3 healthy embryos to transfer from IVF 4, I thought it would be the last time we'd ever have to do a retrieval. Then this time in IVF 6 when we had 14 embryos on Day 5 I again thought we'd never have to do another retrieval but then only two made it to biopsy. Maybe I have to stop thinking that we're never going to need to do more retrievals. Then there's my age to consider and while I'm not old yet, at 33 the "advanced maternal age" of 35 is just around the corner. There's no way to know how my body will react to a pregnancy, if I ever get that lucky, and no way to know how many transfers it will take to get pregnant with number 2.
I've tried to focus on working on getting one baby at a time, but it's impossible not to think about the future. I know there are no guarantees, but with embryos in the freezer I would be a lot calmer to enjoy baby #1 before needing to rush back in and get started again to try for a sibling. I never thought there would be a specific number I have in mind of how many I need in the freezer before I feel comfortable transferring. I thought I'd be ok with having one. But now that there are two, I want to keep two. Knowing what I know now, I don't know if I'll ever feel content with anything regarding fertility treatment. There are just too many unknowns and things beyond our control.
We got results earlier than we anticipated, which meant that we could still decide to not skip a month. I wasn't so happy with taking a break. If we decide we want to do IVF I want to get it over with. But I recognize that we still need to live our lives. It's been non-stop for over two years. We just need a break to be normal for a few weeks. Not be depressed, not be niddah, not feel nauseous, not be in pain or uncomfortable. We're aiming to do a small vacation end of October and that would've needed to get rescheduled if we restarted treatment earlier. In addition, my coworker who is now on maternity leave will not be back before December and I know there will be a lot of slack to pick up while she's out.
Back to the Shared Risk program, I don't think I'm going to want to do more than two back-to-back IVF cycles in a row. Maybe after the break we can do one more (at a reduced fee based on my conversation with the manager and the newfound credit on our account) and then start transferring. A transfer would be easier and if it fails we can always do the fresh IVF after.
If this journey has taught me anything it's that there are no guarantees and there are no wrong choices. If we do a transfer and it works then we have a baby and we've won. If we do a retrieval and get more embryos to transfer then we've won. We already know either one of those can fail, or worse start out hopeful and then crush our hearts. We've been there done that: high embryo counts that never develop into blasts; pregnancy that took but ended as a blighted ovum. So I don't know what the right path is; I can only hope that the one we choose leads us to our ultimate goal of having a family.
Just thinking. I don't have the answers, but these are the choices.
G'mar chatima tova.
Wednesday, September 27, 2017
One
It only takes one!
We got PGD results back and of the two embryos we sent out, one came back healthy. Amazing!!! We had very low hope that anything would come back from this cycle and we're surprised and incredibly grateful that it wasn't a complete bust as we feared.
We're still debating between a fresh ivf and a transfer, but this gives us options. I have more to say about cost but another time. For now, it's a small sigh of relief: a high on this journey's roller coaster.
We got PGD results back and of the two embryos we sent out, one came back healthy. Amazing!!! We had very low hope that anything would come back from this cycle and we're surprised and incredibly grateful that it wasn't a complete bust as we feared.
We're still debating between a fresh ivf and a transfer, but this gives us options. I have more to say about cost but another time. For now, it's a small sigh of relief: a high on this journey's roller coaster.
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