This morning I woke up with one of my horrible stomachaches. So no temping today. At first I thought it was my ovaries, which didn’t make sense since it was so painful… then I thought it was just a full bladder – a very uncomfortable one – but when I got up to pee and that didn’t help… sigh. I couldn’t lay there in bed anymore afterwards, just got worse.

I realized while laying there – if my horrible stomachaches are caused by gas, which they seem to be, is this is what it’s going to feel like post-lap? They pump gas into your abdominal cavity for a better view, and I’ve read several places that talked about horrible pain afterwards as the gas is absorbed slowly. Oh I do not look forward to that.

For now I drink hot chocolate and try to burp a lot. :/ Yarg.

Well. At least the doctor answered my questions and is basically up to whatever I want to do as far as the lap and IVF go.

I didn’t get called in to see the doctor until 12:05. My appointment was for 11:30. I don’t know if you remember, but that happened for our very first appointment as well… apparently it wasn’t a rare occurrence like I had hoped. So that was a little irritating, sitting there waiting for over half an hour.

I wrote down a ton of notes. I’ll get to those in a minute.

After we left her office I stood at the desk with her and a couple of nurses as they flipped through my chart to double-check a few things and gave me my information pamphlet on my injects cycle. Then they made a few discoveries in my chart. First of which being that it’s written down that I have a $1500 lifetime max on meds. I have 3 IUIs and 2 IVFs covered, but as written that means the procedures themselves, the meds fall under the $1500 rule. As anyone who has gone through ART knows, that might be enough to cover one cycle of IVF. An injects cycle she said could be around $1000. So basically if we go ahead with our injects cycle we could be screwing ourselves out of an IVF cycle. So I’m going to double check with our insurance to make sure we’re interpreting that rule correctly. If we are, Den wants us to go ahead with IVF right away. I understand we’re lucky to have any coverage at all, much less as much as we do, but it’s still frustrating. I had fully intended to do an injects cycle before an IVF, but if we do that how are we going to find another $500-$1000 to pay for IVF ourselves? And god forbid the first IVF doesn’t work.

The other minor problem they found was that I hadn’t had all my bloodwork done. WTF? I told them I’d had my CD3 bloods done through them, and my 7dpo progesterone, and my OBGYN had done my screening for HIV/Rubella/Hep and Thyroid. But apparently they also want my blood typed (since I don’t know it), and testing for my prolactin level and RPR. So soon as I left the RE’s office I went downstairs to the lab, expecting to just go quick get my blood drawn like every other time. I swear I sat there another 20-30 minutes. I don’t know what the hell was going on behind that desk, but I blame it on the old people in front of me who didn’t have their insurance card/blood script. Ugh. But I finally got called in and got that taken care of. It hurt though – more than the other times.

All in all, for an 11:30 appointment I didn’t leave until around 1:30.

Okay so my questions/answers and notes from the actual appointment:

* She said there is no real research indicating why injects has a higher success rate than clomid, but that it does so it’s worth a try for us.

* But with a higher success rate it also comes with a higher rate of multiples. 20% chance of twins, with a 5% chance of triplets or higher. So she said, especially with my age and how my body responded to clomid, that we should be prepared to deal with that possibility. She asked me again about our decision regarding selective reduction (she said if a couple is against SR it means there is a lower threshold for cancellation – they’ll cancel a cycle much sooner to avoid the risk.)

* She said if overstimulation does occur – and she said 4 follicles would make her nervous – there are three options. Cancel the cycle (she doesn’t know how our insurance would handle that scenario… she said some insurance counts that as a cycle, others will do another one); continue with the IUI knowing the risks and prepare for SR; or, if there are 5 or more follicles, convert to IVF. I asked if there is a good success rate for doing that, and she said yes.

* Whether or not we could do injects and then start IVF the very next cycle depends on my follicles. If there are cysts left over then I’d have to wait a cycle.

* I will be using a Follistim pen for the injects cycle, and for IVF it would be birth control, lupron, follistim.

* We have our injects class scheduled for next thursday. If we do decide to go with IVF in the near future then we need to take an IVF class, they give them twice a month, the next one is on Feb 14.

* I stated ahead of time that it was probably a silly question, but I asked if my heavy lifting at work could be preventing implantation. She says there’s no reason to think that it would. As for when to stop the heavy lifting, she basically said two things: that it’s not really good on your body to be doing heavy lifting at any point, pregnant or not, and that I should take care to do it properly and avoid it if possible; and that there’s no real date you need to stop when you get pregnant, she said mainly it’s in the third trimester that it becomes a problem (causing injury to you, not the baby).

* As for the lap…. she said endo might not even affect IVF unless it’s really bad – removing a small amount of endo may not give any benefit. The lupron in an IVF cycle could possibly reduce endo if it exists, anyways. Plus having a lap may mean the IVF cycle is postponed for a cycle. But regardless of all that, she said she’s happy to do it if I want to. I didn’t make a decision there, I thought I’d gather some opinions and think on it a little more, but she did say that booking is 6 weeks in advance so I’d probably need to book it soon.

SO, that’s the report. Sorry for all the detail, I’m just trying to keep track of it all. So now we have to decide if we want to jump straight into IVF or not. The ball’s already rolling on the injects cycle, though, so I need to make that decision very quickly. I should probably call the insurance people right now. Sigh. I hate phones.

Gut feeling was right – I just confirmed with an insurance agent that all medications for any cycle fall under the $1500 limit. I’ve called and asked the nurses to give me a ballpark figure for what we’re looking at for an injects cycle, and what we’re looking at for an IVF cycle. Then we’ll sit down and decide if we’re going straight to IVF or not.

Based on the costs that the RE suggested it looks like we’ll be doing IVF sooner rather than later. Fuckity fuck.

I’m so upset with our insurance right now.

Excuse me for a tiny moment while I vent some frustration. A nurse just called me back. I HATE dealing with these damn nurses on the phone.

Basically, she said so-and-so has talked to your insurance multiple times… blah blah blah…. and repeated everything I already fricking know about my coverage. I SAID THAT in my voicemail. I ALSO SAID that I JUST TALKED TO the insurance people who confirmed the $1500 limit. Which apparently falls on deaf ears. Because the nurse basically said to talk to so-and-so. Great. Fabulous. Do you listen to my messages at all?? Or do you just call me back?? Seriously??

She did say however that injectible cycles can cost “between two and four thousand dollars.” Obviously she didn’t take the time to look up the protocol that I was given. They even phoned it in to the pharmacy. I guess I’ll have to call the pharmacy to find out how much it will come to.

However it’s looking more and more like I’m going to have to cancel the injectables cycle to save that money for IVF.

Fabulous. I hate how “helpful” the damn nurses are. ARGGGHHH.

Sorry for all the posts today. It’s how I am – nothing for a while, then all at once. ;)

I realized that since we’re not going to be doing an injects/IUI cycle that means we still have one IUI cycle left – we could do a clomid/IUI cycle. The IUI itself is covered seperately from and wouldn’t affect our IVF coverage. And the clomid itself is so cheap we can afford that ourselves. 4 cycles of clomid – yeah, okay, that’s probably pushing it. But then I’d be taking two cycles off before starting IVF. I mean insurance is jerking us around with these limitations – I at least want to use everything I’m given. Just in case the third IUI is the charm. I think it would give me some finality before moving on.

And yes, I said two months off after the next one. Looking at my upcoming cycles chart I’m eyeing my May cycle for starting IVF. Baby conceived in May would be due in February, and I like that. January is still so close to Christmas. February is a good month. Waiting until May seems like a long time, but it will give us time to do the lap, take the classes, save some cash, and mentally prepare.

So yeah. I’m feeling much better about everything this evening. I guess I just needed to wallow for a few hours. Typical me. :) I just hate changes to my schedule – especially when it’s not my idea. (It’s part of my obsessive-compulsive – I used to totally freak out at Den when we first started dating because he liked “surprizing” me with things. I’ve gotten a hell of a lot better, but when it comes to major decisions I still hate surprizes.)

PS – The binder the RE gave me about IVF is huge. Full of info. I love it. :D

I made a bunch of phone calls today. The first one was to the pharmacy that the injects meds was going to go through, in order for me to find out the cost of them all: $621. That’s pretty low for an injects cycle, from what I’ve heard. (Of course there’s the possibility that I wouldn’t respond well and need more. But the RE seemed to think that my body would respond pretty well.) I also told the guy at the pharmacy that it might get cancelled and I’d call back in a day or two after talking to my doctor. (The pharmacy wasn’t going to get anything started until they got my insurance info anyways. I still feel bad about making changes like this. Gah.)

Then I left a message for the nurses to give me a call back so we could talk about what DH and I have decided to do. Someone called back a little later.

She was extremely helpful. :) She wrote down in my chart our changes, that we’re not doing injectibles in order to save that money for IVF, and we cancelled that class we were going to have to take next week on injects. I asked her about possibly doing a clomid/IUI cycle again, she said she thinks that would be fine but she’s going to double-check with the RE. :) I’m not too concerned, since I’m only, what 2dpo today. I have two weeks to figure it out. ;)

Then a couple hours later I got a call from someone on the IVF side. I guess someone must have passed on my info. She said if I know which protocol I’m going to be doing for IVF, if the RE told me, then she can give me a better idea about prices. She said in general she quotes people $5000. For the meds. O.O Den nearly choked when I told him that later. I really really hope my protocol will be lower than that! The RE did say lupron/follistim for my IVF, but I don’t think I know enough yet (like how much of each) in order to get a price for my own situation. But if it’s seriously going to be $5000 then we may have to wait a lot longer to do it, as most of that will be out of pocket. Yikes. Where the heck are we going to come up with that kind of money? (Which of course is the reason I’m trying to find out a ballpark now – so we know what we’re going to have to come up with.)

She said before doing IVF there’s a few steps that need to be done, first of which is going to an IVF Overview class. I need to call the IVF “people” (I guess it’s a seperate set of nurses and coordinators) to set that up. I’m unsure if I should schedule that for Feb or just wait until later.

I totally forgot to ask about scheduling a lap. I think I’m probably going to go ahead with it. Scared about it, though… which makes it easier to say, “Well, the RE didn’t think it was necessary…” but with insurance covering diagnostics it does make sense to go ahead just in case.

So everything seems to be settling back down again and heading in the right direction. I’m still worried about the physical stuff I will have to be going through with the lap and the IVF, and now we’re worried too about the financial aspect. :( IF is hard enough without worrying about paying for it – I don’t know how people do it when they have to pay for ALL of it themselves. Yikes.

The blog My Dear Watson needs a mention. Hilarious. Definitely a good read when you’re feeling crappy. I especially love the line, “I started thinking about how I am sort of riding the Infertility Short Bus wearing the head gear and everything.” Infertility Short Bus. OMG. That is too fricking good.

Yeah… that sounds like a good idea right about now. lol

I realized something yesterday that could take a little bit of the pressure off me: frozen embryos. I mean I knew about it, knew people did frozen egg transfers, but it never really clicked in what that really means for me. And that is: much less meds. You still need estrogen and progesterone, but no lupron, no stims. That should cut down on the cost considerably.

Obviously this doesn’t affect our first IVF cycle. And there are no guarantees in this world – I could end up stimming horribly and not have any to freeze. But if we do that could mean that a second IVF cycle could be doable for us! (Because insurance pays for two IVF cycles, just not the meds – and I’m guessing not the cryopreservation either.)

It’s funny how none of it may come into play at all – but, again, it’s another safety net. That IVF#1 won’t be our last play… that even if that fails, we still have another try at it before really being SOL.

I mentioned in a previous post that the nurse I talked to said she generally quotes people $5000 per IVF cycle for the meds. At one point this weekend after I relayed that information to Den he told me that if that’s the case for us he doesn’t want to do it for another year. And I know he’s thinking solely from a financial standpoint, and I know he’s probably being completely logical about it, but the idea of waiting another year just really freaked me out. Another year? What? How in hell am I going to survive that, month after month of just enough hope to knock me down again? So I’m just really believing – believing – that our meds will be much less than that price. Yes they will. Think positive here. (I’m new at it.)

A friend of mine in some forums, she got pregnant with her second child… pregnant again after a miscarriage. It was a good thing. :) She is/was 7 weeks and started bleeding. A lot. She said she passed a huge clot or two. Everyone was so upset for her… it’s just not fair for one person to have to go through that much pain, you know? So yesterday she had her blood drawn to confirm her hcg levels were dropping appropriately.

They had doubled.

She scheduled an U/S and went to check… and they saw a very live baby measuring right on track, heart beating away.

Let it be known… miracles DO exist.

(She thinks she was pregnant with twins and lost one of them… but the doctor’s can’t confirm that one way or the other.)

Update: I am very sorry to have to edit this to say that at the next ultrasound it was discovered that the baby’s heart had stopped beating.

I’ve been so wracked with anxiety lately. I mean I understand and accept that the new information from the last RE appointment had me in bit of a spin, but it hasn’t really gone away. Improved? Yes, absolutely. But I still feel general anxiety… and it’s not about IF. It’s just general anxiety about everything. This is not normal – unless I forget to take my meds, but I’ve been taking them faithfully (because of the anxiety!). Today I still feel jittery. Nervous, but about what? Also feeling very insecure, and I really don’t like that feeling.

I’ve been having twinges/minor main in my left ovary for a few days now. I’m really hoping that does NOT indicat a cyst. If it continues I’ll have to call the nurses and ask them about it. (Otherwise they won’t give me an U/S before starting my next cycle of clomid, and I know how bad that can be.)