Thursday, March 7, 2013

Long time, No chat!

I’ve been quiet. Again. I’m sorry you guys. Here’s an update:

So, I attended a consult with Dr. P on Monday. The previous two nights, I had stress dreams about the appointment. In my dreams, the consult was a round-table discussion but I wasn’t allowed to provide any input about my cycles, desires, or treatment. I felt helpless and foolish. It was not a good dream. It wasn't until I was heading to the appointment that I figured it out: I was scared of giving up control over our TTC plans. By getting Dr. P involved, I was letting someone else make the decisions. I don't do well with that...

I’m glad to say that the consult went well. I was able to provide input and really felt like Dr. P was listening to me. But it still went completely differently than I imagined.

Prior to the appointment, I had a plan: Natural cycle with ultrasounds, trigger shot, two rounds of home insemination with acupuncture after. Easy, simple, straightforward right?

Apparently not.

First, although Dr. P wouldn’t force us to do anything we weren’t comfortable with, he thinks that home insemination is a waste of time and money. Fair enough. I know what a longshot it is.

Second, if we were to go low-tech, he recommends a single-insemination IUI. Long story short, we would still do a natural cycle with ultrasounds, trigger shot, then single insemination IUI at 36 hours. I would probably still do acupuncture after. The cost of the IUI is balanced by only having to purchase a single vial of sperm. The increase expenses come from the ultrasounds ($250/ea) and the recommended HSG ($575, ouch).

The third option, which Dr. P is most excited about, is a shared IVF cycle. The short version is that we do IVF and say we retrieve 25 eggs. We get to keep eggs 1-6 and 21-25. Eggs 7-20 go to the frozen egg bank that our center is developing. With our coverage, the procedure would be $6000 including meds, but Dr. P is so passionate about building up this new egg bank that he worked some magic and got it down to $3000 including meds (plus $1000 for the sperm we need). Which is BANANAS. He is being SO generous, SO kind, SO personal in his treatment plan…

And we can’t do it.

Even at the incredible discounts and free services he is offering, we just don’t have it. I was very clear with Dr. P that we only have $1400 and MIGHT be able to stretch to $2000, but that was it. And I was very clear that, even before he tried to get the price down, it looked like IUI was going to be the most realistic option for us with our budget. It was after I told him our budget that he got to work with trying to make IVF as affordable as possible and had the finance office call us on Tuesday with the totals.

Realizing that IVF was still out of reach was incredibly disappointing. I was in a funk all Tuesday afternoon. I was upset that we were offered IVF as an option only to be told, again, that it wasn’t possible for us.

It wasn’t until I put Little K to bed and curled up in front of the fire with R that I started to sort it all out.

We have been saying all along that our family building is in God’s hands. We have seen Him work in amazing ways: three years to get here, R agreeing to a cycle, providing me with a work from home job… These things have clearly been the Lord’s work. We went into the consult with a plan we were comfortable with – home insemination – and came out with a possible treatment plan that was really stretching the boundaries of R’s comfort on the whole subject (75% chance of success).

But, in that meeting, another treatment plan was offered that: 1) we could afford, 2) was similar to what we envisioned, 3) that R was comfortable with, and 4) that offered a slight increase in odds (going from 15% to 20%).

Once I realized that, I began to feel better. God has been at work in our TTC plans and that includes providing us with a very specific budget. So, since we’re leaving the outcome in His hands, why does it matter that we’re not doing IVF? We are still cycling and, if our family is supposed to be expanded, then He can do that with or without IVF.

And, if not, then we’re going to be okay.

So, that’s it then. We will be doing an IUI in April.

I’m glad to have a plan. It’s been a crazy few days but it really does feel good to have those hard conversations and decisions behind us.

Next steps: I’m supposed to call on CD1 to schedule my HSG. Any advice on handling the procedure?


  1. Good luck with your IUI! It sounds like you've thought about it and are making the best decision for yourself!

    As for the HSG, see if they can code the order for it with something ANYTHING other than infertility and it will be covered. I just had mine covered 100% by having the nurse code the order with diagnosis 620.9 "Unspecified noninflammatory disorder of ovary, fallopian tube, and broad ligament"

    Technically you are concerned there may be something abnormal in there, which is why you're having the test right? So, you can always say something to your dr. like this... "We would really like to have the HSG done, but will only be able to do it if it's covered by insurance. If there a way we can make sure to code the order with a code that is of diagnostic nature rather than a fertility related nature, it would be extremely helpful. I feel like it's needed to get a better picture of what is going on from a gynecological standpoint, whether we were undergoing fertility treatments or not."

    When you get the HSG, I would take 3 ibuprofen beforehand (or a Vicodin) beforehand. You can also request that a 5 French catheter be used, as this is the smallest catheter available for that procedure as far as I know. My tech told me that's the one she uses and to always request it. I have had 2 HSG's and both were easy breezy. Hope you're able to get it with no problems and it gives you some answers!

  2. I'm glad you were able to stay focused on the positive. I am looking forward to continuing following your journey and I am sending you lots of good vibes :)

  3. Hope your HSG goes well, I've never done one, but I'm sure you will be just fine!

  4. I am glad that in the end you were able to see the positive side. You might not have gotten to do IVF, but you did pick up an extra 5% chance than what you came in with. I had my HSG done while I was under general anesthesia for my lap so I don't have any advice for you there.

  5. Sorry I'm so late to comment here, but I am so glad that you have a Plan. I hope it will give you a sense of hope and control in some way.

    In terms of the HSG, I don't have experience with this, but after comparing my experience with contrast dye injected prior to my appendectomy with my friend's experience of her HSG, it sounds pretty similar, if not less painful than what I had to go through (the dye gets injected into your rectum. Yep. Really). I just hope it's quick and my advice is breathe....breathe through it.