IVF 2.9 - Scared

I knew this post was eventually coming, I just didn't think I would be writing it so soon.  I am scared to death right now about this IVF.  As an act of self preservation I have tried really hard not be super emotional about this cycle.  But now that it is essentially over and things are in God's hands now, I am truly afraid.  So let me share my two biggest fears:

• I am afraid that this will not work, that I will test next week and it will be negative.  I want this pregnancy so badly. I am not sure if we can go through all of this again.
• I am afraid this is going to work.  Which then creates for me 2 additional fears:
• If this works, will we miscarry again like last time? when will I feel comfortable that this pregnancy is actually going to happen?
• If this works - OMG .. what the heck am I going to do with a baby? or two if both of our embryos stick? what have I gotten myself into?

All in all, I have realized that fear is normal and that no matter what I will make it through this. More than anything I want to be a mom. I keep that in my head everytime I start to get worked up. I feel like I've been through the war, but it's not quite over yet.  Just a few more weeks (months, years - maybe) and things will be ok.

IVF 2.8 - Embryo Transfer

This morning we did a 3 day transfer of two 8 cell embryos.  We still had all four embryos going strong this morning.  They were as follows: 8 cell graded at A-, 6 cell graded at B+, 8 cell graded at B, and 8 cell graded at B.  The last 8B embryo was only a 2 cell yesterday, so it's development caught up to the rest of the embryos.  We transferred the A- and one of the B's back today.

And the doctor was very hopeful. She seemed to think things look great and that we have a really good chance of this working for us.  She is also hopeful that the other two embryos will make it to freezing, but time will tell with them.  Hopefully things work out and she said that she feels better having the embryos back inside me now than waiting and letting them be in the lab any longer than necessary. 

We are hopeful, but even if it works and we get pregnant, I don't think I will be comfortable until we get to the first ultrasound.  Then I might actually believe it might work out. For now I am just trying to stay positive and have belief that this will work.

IVF 2.7 - Fertilization Report

Today I was on pins and needles all morning.  I was anxious to hear the results on how our eggs fertilized.  Finally a little after noon the nurse called.  Of the 10 eggs that were retrieved they were able to do the ICSI on 9 of them.  Of those 9 ICSI'd eggs, 4 of them fertilized.  So currently we have four embryos chillin in the lab.

I am a little disappointed about this number.  Last time we had seven embryos starting out and by the time we got to day 5 we only had 1 really great embryo and 2 lesser quality that never made it to freezing on day 6.  I am worried that these 4 embryos are not going to make it. And I don't know what we will do if that happens.  I am also starting to realize that the problem must be me and my body.  I am starting to fear I just don't make very good eggs.

Tomorrow we should hear from the nurse again to find out when our embryo transfer will be.  The nurse said today that it will either be Sunday (a 3 day transfer) or Tuesday (a 5 day transfer). At this point I am thinking that we might be doing a 3 day transfer because it might be better for the embryos to be inside me than taking the risk of going to a 5 day transfer. Guess time will tell.

Right now I am just trying to stay positive.  I realize that 4 embryos are better than none and I keep telling myself that the goal this time is quality, not quantity and with any luck these four embryos are going to be the best quality possible.  I just hope it's true.

IVF 2.6 - Egg Retrieval

Egg retrieval was this morning at 8 am.  I wasn't nearly as nervous this time as I had been the last time.  I think it's because I was able to anticipate what was going to happen.  I was still nervous, but mostly just because I am a worrier by nature and I can't help but worry about all of the "what ifs".  Plus I worry about silly things like, will I talk when under anesthesia and what will I say, will I snore, or will my body do something embarrassing? And as many times as I try to tell myself that they have probably seen it all, I still can't help but worry.

Steve and I were up early to shower and get ready and drove the hour to the clinic. Once there Steve went to the lab to produce his specimen and I went to the waiting room.  Eventually the nurse came to get me and took me back to the procedure area. She hooked me up to an IV, took my blood pressure and started getting me ready to go.  The doctor came to see me and said she anticipated at least 10 eggs and possibly a few more if they had grown since Tuesday morning. The procedure went really well.  The doctor was able to retrieve 10 eggs and she said everything looks great.

I am feeling pretty good after everything. I came straight home and went to sleep for about 3 hours. I have just a little bit of cramping but nothing overwhelming. I am anxious to hear the fertilization report tomorrow.  Then I will find out on Saturday if we are doing a 3 day or 5 day transfer. We are also hoping to transfer 2 embryos back.

IVF 2.5 - Follie Check 4 & 5

Monday was our fourth follie check.  Everything looked good and in the words of the nurse we were "so close".  So they scheduled another follow up for this morning and had me double my repronex last night and keep my normal dose of bravelle this morning. 

Follie check number 5 today went pretty well. According to the nurse my estrogen level is at 2559 and my lining is 11. On the right ovary I have 2 measuring at 21, 2 measuring at 18, 1 at 17, 1 at 16, and a bunch of 14 and 13's.  On the left ovary I have 1 measuring at 16, 3 measuring at 15, and 1 at 13.  She said it looks like I will have 7 eggs at retrieval, maybe 10 if a few of the smaller ones grow over the next few days, but they don't want to keep me going for another day or two because they don't want to lose the larger follicles. The nurse told me that anything 16 and over is considered mature. She said we could end up with less eggs if any of my follicles don't have an egg, but at my age she said it isn't very likely to have happen. Basically - I am a late bloomer and we are in great shape.  I feel so much better than I did this weekend and now I'm really excited.

This also means that Egg Retrieval is scheduled for Thursday morning at 8 am! Transfer will be either Sunday (3 day transfer) or Tuesday (5 day transfer). For trying so hard not to get too attached or too involved in this cycle, I am really excited to be doing the retrieval. I hope that this works for us, that we are able to transfer back two really great quality embryos, and possibly have a few embryos left over to freeze. 

Wish us luck!!!

IVF 2.4 - Follie Check #2 and 3

It is very late and I cannot sleep because of a late nap I took on the living room couch this evening. I figured that this is the perfect time to update on the progress of IVF #2. 

Last Thursday, the 19th, I had my second bloodwork and ultrasound check.  The nurse called that afternoon and left a message letting me know that things looked "good", but didn't give specifics about the number of follicles. She did say that the doctor wanted me to take a second shot of Bravelle for that day along with my normal lupron and repronex doses in the evening.  She also wanted me to increase my Bravelle in the morning from 150 units to 225 and come back on Saturday for repeat bloodwork and ultrasound.

This morning (Saturday the 21st) I had my third bloodwork and ultrasound appointment.  This time the nurse, who is not my normal nurse, gave me all kinds of information when she called.  She let me know that again things looked "good".  My estrogen was 937 and my lining was 10.  Follies are as follows, on the right: 2 at 15, 1 at 13, 1 at 12, and 3 at 11, on the left: 1 at 12. She said to continue my current doses of medication and to return on Monday morning for another bloodwork and ultrasound check.

Needless to say, I am a little disappointed.  With the follistim last cycle I was doing the egg retrieval on Tuesday.  At this point the earliest the retrieval will be is Wednesday.  And I am concerned about the sizes of the follicles.  None of them are particularly big and only 2 are at 15.  I can't remember what they want them to be, but I don't think any of them are anywhere near where they should be.  I know that the reason we are doing different meds this time is to try to get better quality eggs, but it seems I am not responding as well to these new meds.  And maybe that's the point.  More quality and less quantity.

I also didn't realize how emotionally invested in this cycle I am.  I have been trying to keep my distance from it all so that I don't stress myself out or become super attached to anything.  I have to do this for my own sanity. Otherwise I would be so scared and a total basket case.  But somehow, without realizing it, I have become invested.  And who was I kidding? How could I be anything but invested in this? It's my body and you can't inject yourself full of hormones and go through all of this without being invested.  I think it's one of the biggest investments you can make.

So .. for now it's a wait and see.  In general I am not feeling super optimistic, but I also know that it's not over till it's over.  All we need is one or two really great embryos ...

IVF 2.3 - Follie Check

Today was my first follicle check since I started the stim meds last Friday.  Currently I am taking 150 units of Bravelle in the morning, 5 units of lupron in the evening, and 75 units of Repronex in the evening.  Three shots a day are starting to take a toll on my poor belly.  I feel like I am starting to resemble a well used pin cushion.  I think I am having a reaction to the Repronex because the area around the injection site is red and hurts to touch, but goes away after a few days. 

So, back to the follie check.  Things are looking good so far.  The ultrasound tech told me that I have 2 on my right ovary measuring about an 11 and several on my left ovary that are just under 11.  The IVF nurse told me that my estrogen level is good, the lining looks great, and follicles are growing.  I am to continue my same dosage of meds and go back in on Thursday morning for repeat bloodwork and ultrasound.

I am a little excited now that things are started and coming along.  However, I think I am also trying not to get too emotionally involved in all of this because I know what can happen when things go wrong.  A part of me wants this so bad, but another part is afraid that it will work. I suppose that's how everyone feels. I just keep praying that things work out for us this time around.

IVF 2.2 - I hate insurance companies!!!

Like the title says .. I Hate Insurance Companies!!! Why you might ask? Well let me tell you. Steve and I payed full out of pocket costs for our IVF cycle in July.  We didn't have insurance coverage so that was that.  If we had done the IVF in November as planned we would also have payed cash for that cycle too.

Then in November we had open enrollment for our insurance and in the "changes for 2012" page of the booklet I noticed that it said the more expensive PPO would now be covering infertility treatments at 50% and included GIFT/ZIFT/IVF.  So I elected the more expensive plan and figured we were good. 

That was until I got a call from the IVF clinic the week between Christmas and New Years and was told that it doesn't appear I had coverage for IVF in 2012.  Although the information about the deductible and copays was also incorrect.  The billing lady figured that the insurance company hadn't updated its information yet because it was not the beginning of the year.  So she told me she would call again after the first and verify the benefits.  But it really made me nervous!

So being the obsessive compulsive and gotta have everything together person that I am, I of course called the insurance company first thing January 3rd (because of course they were closed on the 2nd in observance of the holiday). And lo and behold, I do not actually have coverage for IVF. What??!! So I fire off an email to the Admin person on campus and asked them why I was being told I had no coverage when I had 2 documents showing I did.  I of course scanned those documents in the email and hoped for the best.

The next day I get an email back from our corporate office telling me that the insurance company would call me directly to discuss the coverage.  I check my voicemail and there is a voicemail from someone at the insurance company, her name was Jacinda.  I call them first thing and Jacinda was not available so the lady on the line said she could help me.  Long story short, we spent about 2 hours on the phone over multiple phone calls trying to figure out what IVR was because this was covered while IVF was excluded. This went on until about noon when the lady, Donna, told me she would have to talk to her supervisor and call me back once she got everything straightened out.

At 12:51 pm I got a call from the insurance company.  It was the girl I talked to the day before, the first time I called the insurance company. She told me that she had made a mistake the day before and that the IVF was in fact covered.  Apparently there was a second page to the benefits and she hadn't realized it. WTH?? I walk away from my cubicle to talk to a coworker for a moment, walk back and see that I have a voicemail. It's the IVF clinic, they wanted to let me know they had also called the insurance company and was told that there was no coverage.

I call the IVF clinic back and tell her everything that has transpired over the past few days and she tells me that unfortunately she needs to hear from the insurance company that we have coverage and not from me.  So back on the phone I go with the insurance company to find out what the heck is going on.  This time I ask for Jacinda and luckily she was available.  She verified the benefits again explaining that the system needed an update that would show the coverage. I asked her to call the clinic and let them know, so she put me on hold, called the clinic.  Then while I am still on hold I get a call from the clinic letting me know everything is fine. So yay!! Hang up with the clinic and wait for the insurance company to come back on the line.  She comes back and then gives me all the information I need so that if anything gets denied I can get it taken care of.  Huge sigh of relief, everything is going to be OK!!

Or so I thought ... because an hour later I get a phone call from the clinic again.  Apparently she called the insurance company again to find out if the embryo cryopreservation would be covered and talked to Donna.  Apparently Donna was still attempted to find out what IVR meant and what was covered under that. So the clinic didn't want to accept the 50% coverage quote they received until they heard it from another person at the insurance company.  Once again I called the insurance company to find out what the heck was going on.  I talked to Jacinda again and she was really upset that Donna had talked to the clinic again. She tells me that she will have her supervisor call the clinic the next day (because they were already gone for the day by this time) and let them know that everything is fine.  I voiced my concern that if we were having such a difficult time obtaining verbal confirmation of benefits, what was going to happen when the clinic began submitting bills for the cycle.  Jacinda told me she had the same concern so her boss was going to put a flag on the account letting the billing people know they needed to read the notes and would see that the services would be covered.  But of course things could slip through the cracks and if there were any problems I should call them immediately and they would get it taken care of.

So It's official, we have 50% coverage for our IVF cycle.  YAY!!!

On a side note - have been on the lupron for 5 days now and things are going well.  Stopped my birth control pills last night so I am expecting my period in the next few days. Thursday is my baseline ultrasound and bloodwork and Friday I start the stim medications.  It's hard to believe that in 3 weeks we will hopefully be transfering our babies back into my uterus!!  It's so exciting!!!!