Meds, Acupunture & Photos!

Wow, this week started off busy!

This morning I put in my order for my meds.  Lu.pron, Es.trace, Progesterone in oil, and Va.lium.  A total of about $355.

Found out Lu.pron is not covered by my insurance, so I am paying $129 for it.  Es.trace, even with insurance comes up to $195 for 60 pills.  Kinda crazy!  That's more than $3 per pill.  Without insurance it would have come up to $243.  Unlike my previous IVF cycles, we have crappy insurance this time.  Still, I am grateful I do not need stimulation drugs like Follis.tim or Meno.pur which would cost thousands.  I should get my meds on Wednesday.  Won't get my FET protocol until 8/15.

I went for my acupuncture session today.  It was kind of weird going back after so long, but also nice.  The last time I was there was for my last IVF cycle almost exactly 3 years ago.  Back then she was pregnant with her second child.  Now, he is almost 3 years old.  Also, she bought out her partner, so she is running the business all by herself which is great because she really didn't need her partner.  She specializes in infertility and has had many success stories.  After my session, I asked her for some recommendations.  She said:

1. Avoid dairy as it can cause congestion in the body.  Especially if you drink coffee (which I currently still do), avoid using creamer (which I also love!), as it is especially bad.  Ok, ok, time to give them all up totally.
2. Eat more raspberries as they are great for building up the endometrial lining.
3. Use a warm/hot pad on the lower abdomen/pelvic area 2 - 3 times a week to stimulate blood flow to the uterus.

Fortunately, I do no need to take any Chinese herbs this time.  I did it for my last IVF cycle to help increase the quality of my eggs but since we are doing a FET (frozen embryo transfer) this time, no need for that.

When I got home, I received an email from Debbie, our fertility counselor for NEDC.  I had a discussion with her earlier today because we are considering switching around our order of donors.  Because the second donor family had be so upfront about sharing information and photos about their family, we felt we had more information about them than the first family.  After discussing this with Debbie, she suggested seeing if the first donor family would be willing to share some family photos.  The email from Debbie included 3 photos of our first donor family.  Oh my, they are a gorgeous family.  And the twin boys are so stinking cute.

Now that I have seen pictures from both donor families, I feel pretty good about both of them.  I feel like I am already in love with both families.  I still have not decided if we will switch the order or keep it the same, but for now, I love being able to put faces to names.  We have up to 2 weeks before our transfer to decide.

Finally, if you have not heard, I am having a giveaway in honor of my 40th birthday on Thursday!  Go leave me a comment here for a chance to win one of two $20 Amazon gift cards.

Stim Day 11 Update

Today is day 11 of stims.   I added Ganire.lix to my morning shots this morning.  This will ensure that my body does not ovulate before my retrieval.  So 2 shots in the morning now - Ganire.lix and Meno.pur.

I had may appointment with AcuGirl today.  I had to move up my appointment this week as I have my job interview on Wednesday.  I told her I was a little concerned that the follicles are growing slow, but she assured me that may not necessarily be a bad thing.  We want quality, not quantity.  She used the heating lamp in my pelvic area again, and it felt good after.  I have been feeling "full" in my ovaries all day.  Tomorrow morning I go back for another ultrasound to see how my follies are growing.

I'm still keeping my fingers crossed that this won't interfere with my job interview on Wednesday.  Or maybe I sayg that the job interview won't interfere with this IVF cycle?  Where are my priorities??

AcuGirl and I had a discussion about how this cycle is going.  I have to say, I'm not sure if it's the acupuncture, the TCM herbs, not being on loopy Lu.pron, or just being distracted with the whole job thing this cycle, but I have not been feeling much side effects or stress.  At all.

No headaches, no hot flashes, no stress.  I'm feeling pretty good!  AcuGirl believes the TCM herbs really help with side effects.  I'm not sure what it is, but I am not complaining.  It feels like this cycle has flown by.  I can't believe I am almost at my retrieval already.

I have to prep for my job interview, but I am so not motivated......

Nurse's Consult and Acupuncture Session

Babe and I had our nurse's consult this morning.  It was pretty brief and simple, since this will be our 2nd IVF with this clinic.  We went through our IVF schedule and the list of the meds that I will be on.  We are on a different protocol this time around, using the antagonist protocol.  Last time I was on the long Lu.pron protocol.  This time no "loopy Lu.pron"(yay!), so the cycle will be much shorter.  I will be starting my stims (Meno.pur and Follis.tim) on July 2nd.  Ganire.lix (antagonist) shots will start when the follicles are 14 mm or larger.  If all goes well, egg retrieval will be on the week of July 11th.

I only have one week left of BCPs.  Yay!  For some reason, I have a hard time remembering to take my BCPs.  I find myself running out of bed at night to take my them, remembering only right before I fall asleep!  It's so annoying.  I'm glad I'm almost done with them.  I was able to get a bunch of free samples of meds last time - Follis.tim, Endome.trin, etc.  I asked about them again, but I wasn't so lucky this time.  We got nothing.  I guess they were out of everything.  This time though, I asked to make sure we get enough meds on the prescription sheet the first time around.  There is a copay for each drug on we get from the pharmacy.  The last time, I needed additional Follis.tim and Menopur because I needed to stim a couple days longer.  So we had to pay copay again for the refills.  Hopefully, this time we will have enough without having to do a copay again.  We also made our payment for this cycle.... ouch!  It's a huge investment.  Let's hope this investment pays us back greatly!

I also had my appointment with AcuGirl this morning.  I am enjoying my acupuncture sessions and look forward to it every week.  Every week, AcuGirl asks how I'm feeling, what my stress level is, how I am feeling emotionally, etc.  She always checks my pulse - today my pulse was fine - fine as in thin, not fine as in OK.  Not really sure what that means.  Also my tongue looks good today.  I had been told to avoid dairy as it can cause "congestion" in the body.  Last week she could tell that I had been been a bad patient and have been having dairy by looking at my tongue.  Today, she was quite happy with the way my tongue looks.  She also advised me to eat a handful of goji berries everyday.  I like AcuGirl.  She and I get along well and chit chat quite a bit.  We always talk about food and discuss new places to eat.  We even talked about how Babe and I are starting to have less in common with our friends because everyone has kids but us, and she's having the similar but opposite experience.  All her friends have decided to not have kids, so now her and her husband (they have a young son) have less in common with their friends.

***While I was writing this post, the pharmacy called to verify my prescription order (the nurse faxed it in this morning) and to tell me that I had almost reached the $5,000 max of my coverage for infertility drugs.  After my last IVF cycle, I now only have less than $1,500 left.  I would have to pay the rest in cash.  That means I have to pay around another $4K in cash!!  This sucks!  I knew IVF meds are expensive, but I guess I didn't really know how expensive they are!  I told the pharmacy to hold off on filling out my script until I've had a chance to talk to (warn) Babe tonight.  Plus I am really going to have to bug the heck out of the clinic for some samples!

Still Alive

I'm alive!!  Yes, I'm still alive and kicking!  Sorry, I have been MIA, and for such a long time too!  I can't believe my last post was 2 weeks ago!  Apologies are due to my readers!

I have had a busy last couple of weeks.  I had the sincerest intentions of posting about them in detail, but looking back now, I think I will just do a overview of the last couple of weeks.  The more I waited to post, the harder it was to sit down and write.

So here's what you missed in the last couple of weeks.

• I started acupuncture.  It took a lot of thought, reading, research, counsel and prayer before I decided to actually do it.  I knew what to expect, but yet didn't quite know what to expect.  Does that make sense?  I thought maybe it would be a more dramatic experience, but it was quick, simple and relaxing.  My practitioner, we'll call her AcuGirl, put needles in on the top of my head, between my eyebrows, on my hands between my thumb and index fingers, my lower abdomen (ovaries and uterus), my lower legs and near my big toes.  After the first session (I've had 3 so far), she also used a heating lamp on my lower abdomen area.  I found that to be very relaxing, and could feel a change in my blood flow in my pelvic area.  I could even feel the difference later in the day after my appointment.  I plan on seeing AcuGirl once a week, unless my cycle changes once I start stims.  I also started taking Chinese herbs as well.  I'm hoping this will help with the quality of my eggs.
• Four of us gals from the Patiently Waiting infertility support group got together for lunch.  It was a fun girls lunch out, and of course we chatted about the frustrations of TTC.  
• A high school friend from my home country was in town over a weekend.  He was traveling for work and happened to be in town visiting some of his clients.  Babe and I played host over the weekend.  We enjoyed some very delicious (and expensive) French food.  It was so worth it though.  Even Babe, who does not care too much for "fancy" food was super impressed.  I was so happy he enjoyed it.  We also had some delicious Japanese food - sushi, sashimi and other seafood.  I guess you could say that "luckily" I am not pregnant, so I can actually enjoy these food!
• Remember my last post where I talked about working on my resume and prescreen questions?  Well, I did it.  I applied for not one, but 2 positions at the same company.  After submitting my resume, I got a request for a phone interview.  Of course, since I had not been using my noggin' (brain) in such a long time, I decided to have the phone interview the next week.  I spent all week stressing out and prepping myself for a phone interview.  Well, the interview was a high level prescreen call.  And I mean a very high level call.  I was expecting the recruiter to ask me some classic interview questions, maybe even some behavioral questions.  Nope, nada, zip.  Not one.  He just asked the basic salary, why I left, why I want to work there, etc.  I think I had more questions for him and he did for me.  In the end, I think the call went fairly well.  I should find out at the end of today or early next week if they want me to come in for an in-person interview.  Keeping my fingers crossed.  And just in case, I got my suit dry cleaned.
• Every year, Babe's family has a family reunion at one of his aunt's house by the lake.  This year was no different.  There were 8 kid running and chasing around their Uncle Babe.  They all ADORE Babe.  It's so funny because all his nieces and nephews wanted to sit next to him at lunch.  He's so great with kids, and like the last few years, it still hurts somewhat to see him playing other's people's kids but not our own.  I can't wait till he can focus all his attention on HIS kids.
• We were supposed to have a nurse's consult on Tuesday for our next round of IVF.  I cancelled it because I wanted to talk to Dr. Hopeful about trying to access the eggs from my right ovary.  I will post about this later.

It's amazing how a little distraction away from IF related stuff can cause me not to post for 2 weeks!  Also, I'm 2 weeks behind in reading my everyone else's posts.  I hope I am not missing out on too much.  It will take me a while to get back in the swing of things.

Confession and RE Update

Confession
First of all I have a HUGE confession to make.  For those of you that have been following or reading my blog I hope you understand why this is something I did not make known previously in my blog.  I will explain later.  So here goes.


This will not be my first IVF.  A year ago, we through one round of IVF overseas.  Unfortunately it was not successful.


I grew up in Asia and was home visiting family for a couple of months and decided while we were there, we'd try a round of IVF.  It was a lot cheaper to do it there compared to the US.  Only my family and a few of my close friends know we did this.  It's not something we like to share because some people frown on the idea of going overseas for treatment.  Plus we weren't sure if it was something we would share with our RE and if it would disqualify us from the IVF shared risk program.  Last night, DH and I discussed whether we should tell our RE about this.  Giving her this additional information may come in handy in her decisions on our protocol and procedures.   We decided it would be the best to be honest, even if it meant jeopardizing our chance at the shared risk program.


Overall we had a good experience doing IVF in this Asian country (due to the anonymous nature of this blog, I will not be disclosing the country).  I will write about it in more detail in a later post.


Now that you know the truth about our IVF experience, I will be updating my TTC history in this blog.


RE Update
Now, on to the part that you have been waiting for, the update on our appointment with the RE.

Last night, I again had a hard time falling asleep.  I think I got 4 hours of sleep, max.  I was tired, but felt pretty good at the appointment.  Since our last visit, the RE clinic had moved to a newly built and much nicer building.  There must be a huge market for the fertility business because the clinic was much bigger, fancier, and covered 2 floors.  The waiting room was twice the size of the old one and it was pretty busy, even in this sucky economy.  We found out later from our RE that the new facility included a new world-class IVF suite, with its own procedure rooms, andrology lab, embryo lab, incubators, recovery room, etc.  "The best that we could find", as she put it.

Our meeting with the RE, whom we shall call Dr. Hopeful, went really well.  She noticed it's been 2 years since our last visit so she asked us what we've been up to.  Right away, we were upfront about our previous IVF overseas.  I was worried about how she would react to it, but she seemed OK with it.  She was quite pleased with how I responded during that cycle, other than the fact it didn't work.  Our meeting lasted almost an hour and she gave me lots of information.   I was given the following handouts.

• IVF handbook
• Estimate of charges broken down into details by monitoring, IVF procedures, medication and additional charges.
• Statistics of IVF results for the clinic
• List of acupuncturists in our area.  Dr. Hopeful could not recommend acupunture medically (inconclusive research), but her thought is if it makes you feel good and help you relax, then do it.
• Comparison sheet for the cost of IVF by fee for service (pay by cycle) vs. share risk program.
• Classes for Mind/Body program, which she highly recommended.

In addition I found out the following:

1. Dr. Hopeful does not think a previous failed IVF necessarily means we don't qualify for the shared risk program, and recommends applying for it.  More details about the cost and payment of IVF will be discussed with Melissa, the financial coordinator.  In the mean time, we still have not decided if we will do the shared risk program.
2. Only 2 embryos will be transfered
3. Based on our fertilization success during our last IVF, we will not need to do ICSI.
4. There is an 18% change of miscarriage with IVF.  
5. I will be on Lupron, Menopur and Follistim.  I have had experience with Follistim, but will need to pay attention to researching side effects of Lupron and Menopur.
6. I will NOT need to do PIO (progesterone in oil) shots!!  The is the BEST news yet!!  I guess I will be on a suppository called End.ometrin.  I am so happy about this!
7. We will probably go in for a shots class so DH can figure out how to stick a very long needle in my butt.
8. I will need to do one IM (intramuscular) shot for the HCG trigger shot, most probably be done by DH.  I can handle doing one IM, but so relieved I don't have to do daily IM PIO shots.
9. The doctors at the RE office rotate through the procedures weekly.  This means Dr. Hopeful or one of the other doctors may actually perform the procedures.
10. We will need to do the following tests: 

• Ovarian Assessment Report -  to test the quality of my remaining eggs
• SIS (Saline Infused Sonogram) - check the uterus
• Trial transfer - measure the uterus prior to embryo transfer
• STD screening

It sounds like after my next AF arrives, I will start BCP on day 2 or 3 for 21 days, then start stims.  Today I am on CD11.  If AF is on schedule (which she probably won't be), I should start BCP on Feb 1st, and then we go from there.

In the mean time, I am waiting for a nurse to call to schedule a consultation and also for Melissa the financial coordinator to call to discuss costs and payments.  Actually someone from the clinic called this afternoon to discuss starting my IVF cycle but I was napping, thanks to only 4 hours of sleep the night before.  Tomorrow I will call the clinic and find out our next steps.

I'm getting excited about finally starting this, but at the same time I'm torn about the huge amount of money we are about to spend of IVF.