Let The Shots Begin!

I started my Lu.pron (Leuprolide acetate) shots this morning.

For purposes of IVF, Lu.pron is used to suppress the ovaries prior to stimulation to prevent untimely ovulation.  This is important so the the eggs can be retrieved before ovulation occurs.  I will be taking 20 units of Lu.pron in the morning, for at least 10 days, then the dosage will be reduced later.

For a while there, I was confused if I should be taking this once or twice a day.  I received a kit in the mail that included a 14-day supply vial of Lupron, 14 disposable syringes with needles, and 28 alcohol swabs.  In addition, I also got an a bag of disposable insulin syringes that is to be used with Lu.pron.  It made me question if I should be taking this once or twice a day, though I know the nurse that did the consult with me said mornings only.  So I am assuming these are spare syringes, just in case I need it.

Luckily, I double checked the handout I received during our shots class, and it did say only mornings for regular Lu.pron.  Now if I were on the micro-dose Lu.pron, then I would need to take it both in the mornings and evenings.   Another confusing thing is regular Lu.pron does not need to be refrigerated, but the micro-dose ones do need to be refrigerated.  All these discrepancies got me a little nervous last night and it took me a while to fall asleep.

Though I have never been on Lu.pron before this, the shots are very similar to the Supre.fact injections I had from my last IVF cycle a year ago.  Small doses using a small insulin syringe.

The injection went well this morning, I did it right before we left for church.  I gave myself the shot in my tummy like I did in the past.  It helps that I have a nice roll of fat that is perfect for stabbing a needle into!  DH was there to watch and support me, though I think it was more out of curiosity.  He offered to give me the shot, but I said no.  It's easier and less painful if I do it myself.  He is so looking forward to stabbing me with a needle in my a$$ for the HCG shot (he won't admit it, but I can just see it in his eyes!).  It stung a little, I think because I hesitated a bit when sticking the needle.  But the medication did not sting when I pushed the plunger, though a tiny drop of blood popped up after I removed the needle.

According to Dr. Goo.gle, Lu.pron's side effects include constipation, dizziness, general body pain (what the heck does that mean?), headache, hot flashes, loss of appetite, nausea or vomiting, stuffy nose, trouble sleeping and weakness.  Oh what fun......

I'm not one to experience much side effects when on medication, so we'll have to see what, if any side effects I experience.  Then again, it could also mean that I am just clueless and don't pay enough attention to even know that I am experiencing any.

What side effects have you experienced on Lu.pron?  I'll make sure to blog about it if/when I notice them.

A Good Couple of Days

Sunday was Valentine's Day and also Chinese New Year.  For my Babe and I, it was a fairly quiet day.  Though we don't really celebrate the much hyped Valentine's Day, we did have a small Chinese New Year (CNY) Celebration.  I am ethnically Chinese, so I was missing the CNY festivities at home.  After church, we met up with two other couples and their kids for lunch at a Chinese restaurant.  Being that it was CNY, we ordered a set dinner which included pork with watercress soup, Peking roast duck, pork chops in Peking sauce, steamed whole walleye with ginger and scallions, stir fried crabs with ginger and scallions, salt and pepper squid, chinese broccoli and dessert.  It's not often we get to eat like this!  Then my Babe and I came home and took a nap.  It was a nice way to just relax and eat.   Eating is a HUGE part of Chinese New Year.

Yesterday I got a call from Nurse Mary that did my annual exam.  The lab had found that some traces of blood and protein in my urine during my appointment last Thursday.  She asked me if I had experienced any increase in frequency in peeing, or any burning sensation, etc, symptoms of of UTI (urinary tract infection).  I said no, in fact I don't even remember if I've ever had UTI.  So she sent those my urine out to the lab to be cultured anyway, just in case.  So yesterday (Monday) I got a call from Mary, they found that I had a mild grade UTI or bladder infection.  She called in my prescription and I picked those up last night.  Talk about great timing, because by the time I picked up my drugs, I was starting to feel discomfort in pelvic area, nothing serious but just kind of an icky feeling.  I have been told that I am lucky that they found my UTI early and and did not have to suffer severe symptoms.  I am on antibiotics for 5 days.  I'm glad it was found now before I start my IVF.  What great timing!

Today, I had 2 appointments at the Dr. Hopeful's clinic,  a shots class and a nurse's consult.  There were just 2 couples, we first watched a video on how to do the shots for Follis.tim, Lupr.on, Men.opur and HCG.  Then the nurse went over our syringes and pens to show us how to do the shots hands on.  We didn't actually inject anything, but it was nice to be able to touch and feel the actual "hardware" before we got them from the pharmacy.  The nurse also showed us where to inject intramuscular (IM) shots so our hubbies don't stick us in the wrong spots!  The other gal that was there found out I am not doing progesterone in oil (PIO) shots, and using Endome.trin suppositories instead.  She was not happy, and wanted to switch!  I felt bad for her and I am so glad I am not doing the PIOs!  I guess she is planning to talk to Dr. Hopeful to see if she can switch too!  I have to say I think my Babe is kind of looking forward to the opportunity to stick a big-a$$ needle in my butt!  I am doing the rest of the shots myself!  We left the shots training with a Follis.tim pen kit.

After the shots class, we met up with Nurse Stacey who did our consult.  My Ovarian Assesment Report (OAR) results came back.  

• I had an Egg Retrieval score, or "chance of successful retrieval" of 9, which was "fair" .  This score indicates that there is a fair chance of obtaining 5 eggs or more through ovarian stimulation.
• Compared to other women 36 to 40 years old, my egg retrieval score is average.

I'm not really sure what this really means.  All the nurse would say is that they would not be changing my protocol.  So I'm hoping that this does not mean bad news.  Ughh.... I don't really like the sound of "fair" and "average".  Why can't it be "good" or "excellent"?

We then went over all our meds, dates of shots, ultrasound and blood work appointments.   I start Lup.ron on 2/21, Meno.pur and Follis.tim on 3/5.  Depending on how my stims go, I could have my egg retrieval on the week of 3/15.  We'll see how it goes.  We also went over instructions for HCG where timing is crucial.  And of course my Babe will make his "butt sticking" debut.  I am expected to do a Day-5 blast transfer and I am hoping that we will have some embryos to freeze for future use.

Before we were done, Nurse Stacey also gave me my "goodies" bag, a bag with 4 boxes of FREE 300 IU Follis.tim AQ samples!  Woo hoo!  Free meds!  That's about $1,000 worth of free meds!  I was so excited!

In a packet that was sent to me earlier, it was indicated on the drug list that it was possible to get Vi.velle and Endome.trin samples too.  Stacey said she would check into it as they don't always get those samples to give out.  I asked if I should wait to order those, to see if they get any in later since I wouldn't need those till later in my cycle.  She said she would check another spot to see if they had any.  She later came back with 3 boxes (6) of Vi.velle patches and 2 boxes (12) Endo.metrin samples for me.  Score!!  More free drugs!  My Babe was quite impressed with the way I was able to "finagle" more free meds.  See, I told him, ask and you shall receive!  And I did ask nicely =)

After the consult with Nurse Stacey, we met up with Melissa, our financial coordinator.  We put down our prepayment of around $7K.  We had decided we were not doing the shared risk program and would be paying by the cycle.  We thought we would be paying for everything out of pocket.  But there was a surprise waiting for us!  

We were told we had a lifetime maximum coverage for infertility treatment of $5K!  We will have out-of-network coverage of 60/40 for the actual IVF procedure (egg retrieval and embryo transfer), but the follicle monitoring (ultrasounds and blood work) will be covered by in-network 80/20 coverage.   Plus we also had a $5K lifetime coverage for infertility drugs!  Oh, such awesome news!!  Even though it is not a huge dollar amount, it makes such a huge difference.

We didn't realize that when I left my job last year, and switched our insurance to my husband's company, the benefits started all over.  We had maxed out our infertility coverage at my old company, but now we start afresh!  If I had not left my old job, we would be paying out of pocket for everything!

I am having a pretty good couple of days.  Early detection of infection, unexpected insurance coverage and free meds!   I am praying that this is a sign of more good things to come!

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?