Monday, December 14, 2009

Countdown to RE Appointment

It is almost exactly one month to our next appointment with the RE on January 13th.  The last time we were at the clinic was February 2008.  We were supposed to have a conference with our RE in April 2008, but we cancelled our appointment.  We knew that the next step would be to pursue IVF and at that point, DH was not ready for that.  So we decided to take some time off from fertility treatments.  Well it will be almost 2 years by the time we go back in January.  How time flies!

I have not had much to update about our TTC efforts since I started the blog last month, but infertililty has always been on my mind.  For now, I am trying to prep myself both mentally and emotionally for the first appointment.  A few big things:
  1. Biggest concern:  Cost of IVF!
  2. Biggest question: Should we do the Shared Risk program if we qualify?  Will we qualify?  For those not familiar with the Shared Risk program, it is like an "insurance".  For our clinic, you pay a set price of about $24K for up to 3 fresh cycles of IVF, and 3 frozen embryo transfers.  If you don't bring home a baby after that, you can get refunded up to 70% of the cost back.  However this does  not include the cost of fertility meds that can cost $3K - $5K per cycle.  But if you get pregnant, and bring home a baby on the first try, you pay the full amount (I'll probably blog about this more in a different post).
  3. Biggest fear:  Intramuscular shots!  I have no issues doing sub-Q shots, but I am terrified of having to do IM shots.  Not sure if I can do it myself, or if I will need DH to do those!
  4. Biggest to do list: Get a list of questions to ask the RE at the appointment.
So if you have gone through IVF, what are your opinions on the above?


  1. Having JUST gone through my first IVF, I am certainly no expert! But I can identify on many levels -- we, too, had several failed IUI's and needed time "off" before making the big jump to IVF. Since you asked, (and since I"m currently on bedrest post-transfer and have nothing better to do -- haha!) here are my two cents on the questions you posed:

    1. Cost of IVF -- horrendous, particularly without insurance. Hubby and I got "lucky" and were left an inheritance when his father passed 18 months ago. It is the ONLY way we could even consider it right now. Definitely a major hurdle -- but one that can be overcome. Does your RE offer payment plans? Some even do an in-house credit card that can be paid off over time. Some (younger) women may be offered to do a donor egg cycle (you keep half, give half to someone else) for a reduced price. We considered it, but ultimately were excluded due to health reasons.

    Biggest question: Should we do the Shared Risk program if we qualify? -- Depends. My clinic's "unofficial" position is to go with your gut. If you think you'll need more than one shot at IVF, then you're probably right. However, most typical cycles are successful within two tries. If you can pay for two out-of-pocket cycles, our embryologist said, do so. It will come out cheaper.

    However, qualifying is another question. Usually they are looking for healthy women, without previous IVF failures, of a certain age group.

    I personally wanted to go Shared Risk, as I liked the "money back" idea after so many negative betas. Mo, my hubby, though, is confident it will work and couldn't stomach such a high price if it worked on the first try. So, we paid the traditional one-time fee. The jury is still out on whether or not that was a good decision! :-D

    Biggest fear: Intramuscular shots! Good news: the only IM shot is the POI (progesterone in oil) that you will take during the 2WW. IF your protocol calls for it. Our clinic has found that there is not a difference between progesterone that is delivered vaginally (i.e. Endometrium) or intramuscularly (POI). So, I avoided all IM shots this time! Yay! (Not that the suppositories are fun, but they ARE less painful!)

    Biggest to do list: Get a list of questions to ask the RE at the appointment. -- This is essential. Write them down, because you will forget. Insist on taking as much time as you need to understand everything you need to. Ask about success rates in cases that are similar to yours. What protocol will they use? Why are they using that particular one? Will it be a 3day or 5 day transfer -- and why? What additional costs (such as assisted hatching, ICSI, or freezing of leftover embryos) might be incurred? How will your meds be delivered? How often is communication made during monitoring? Are doctors/nurses available via phone or email if you have questions?

    As you can see, I ran a bit long with this post. But I wish you the very best of luck at you appointment and will be rooting you along on this journey!


  2. Jo, Thanks for your comments! Very helpful indeed. Good luck with your IVF cycle. I will be following your blog!

  3. It is a tough decision, and one I hope I never have to make. (But I fear if this, my third IUI, fails I'll be asking myself the same questions. best of luck.

  4. i know it was really helpful to me to read questions that others asked when meeting with their REs about IVF, so i wanted to share my list of questions:

    good luck!

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