Little did I know when I last posted that fate was not on our side. After all of the drama I went through to get the meds for the IUI this upcoming month, we had a change in insurance and as of Jan. 1 will no longer have fertility coverage. For us, that means we simply cannot afford to proceed with the IUI.
To say that I was crushed when I learned about this is an understatement. I felt like my dream was placed in my hands and then snatched away from me cruelly. To be soooo close to something you want sooo badly and then to have it taken away is horribly heart-wrenching. It's been at least a couple of weeks since we found out about the changes, and it's taken me until now to be even slightly ok with it. Initially I thought that maybe we could proceed without insurance coverage - than the fertility clinic told me it would be roughly $3000 for one IUI cycle, and we just don't have that kind of money right now (or will we ever??). Yeah, that was not good news. But, we do have a plan...
Most of you are aware of my current job situation - it's temporary, and most likely I will no longer be employed as of the end of January, maybe February at the latest. The timeframe isn't certain, but interviews have already been conducted for the position that will replace mine, and I can only assume that those making the hiring decisions are simply waiting until the holidays are over with before an announcement is made. I'm guessing they will give me 2 weeks notice, but I'm not even certain of that.
Anyways, I've been searching for a job for well over a month now, and we are hoping that wherever I end up employed will have good insurance coverage - coverage for infertility treatments. Until then, my fertility meds sit in the fridge, waiting to be used, and we're trying naturally in hopes that we may get incredibly lucky and get pregnant on our own (yeah, not getting my hopes up for that one!).
I'm keeping my chin up, grateful that we at least had coverage for all of the fertility testing we went through and I at least have some answers as to why I'm not getting pregnant. And I still have hope that one way or another, 2012 will be the year we finally become parents.
Wednesday, December 28, 2011
Tuesday, December 13, 2011
Life is good :)
Yes, life is good. Really, really good :). Maybe it is part of Heavenly Father's plan to have all this IUI stuff work out for us, because sure enough, the injectable meds I need to take for the best success possible were pretty much covered under our insurance. We still had to fork out roughly $280, but that was for 3 different meds - all of which arrived at our house today! I won't need them for about another 2-3 weeks at the earliest (I think, lol), but I like to be prepared, and having the meds already on hand helps me stress less.
Yes, I'm stressed. But I'll get to that in a minute ;). First, let me update you on the whole insurance/meds issue. Can I just say that it drives me crazy when people - especially within the same company - are NOT on the same page. First Caremark (our prescription pharmacy) tells me Gonal-F is gonna be at least $1000 for a small dosage (and I was gonna need A LOT), and that I need pre-authorization for it. Then I'm told it will be at least $1500 for that small dosage. Then I discover I'm being prescribed Follistim instead of the Gonal-F, and when I call to talk to Caremark about it, I find out I don't need a pre-authorization for it afterall (that's only needed for the HCG trigger shot), and I'm told it's $87.50 per 900 units (I need 1200 total). Um ok, HUGE DIFFERENCE PEOPLE! I understand that the cheaper price is for a different drug, but they do the same thing and Follistim is actually stronger than Gonal-F, so I think it's pretty safe to assume that the price differences should be small (plus my fertility clinic told me that too). Anyhow, when the woman I spoke to at Caremark told me that all the drugs I would need would be under $200 total, I had to force myself to not cry on the phone. Yeah, totally serious about that. I told her she had completely made my day, and can I just add that she was soooo sweet about everything too, even wishing me good luck with my baby in the future. Yes, there really are good hearted people out there still :). (Besides all of you of course!)
Anyways, so after confirming some things with the fertility clinic, I got a call from Caremark to schedule the delivery of my medications! These type of medications have to come from a speciality pharmacy, so they get shipped to me, overnight. Although the Caremark representative was able to tell me that I would have a copay that would need to be paid before the meds shipped, she unfortunately could not tell me what the copay would be. Ugh - yet again there I was waiting...yeah, it had been a week by this time - that's too long to wait to know something so important!! Thankfully I didn't have to wait more than a few hours, and found out I owed just a little over $280. Yet again, that was not the under $200 total I was told I would have before, but whatever - it was good enough! The meds were ordered, I paid, and they were on their way. Jeremy had the day off today, and when I got home from work he had already unpacked everything for me and put the Follistim in the fridge (it has to be kept cool) and everything else in it's proper place. Yeah!!
Ok, back to me being stressed. Nervous is actually a better way to sum up how I'm feeling right now. So as if just not being able to get pregnant in the first place isn't nerve-wracking enough, let's add on the insurance complications! I'm glad it's pretty much figured out now, but geesh, what a way to work up a girl's emotions!! Because I thought I was waiting for a pre-authorization from my insurance company, I was trying to be patient and wait until I heard back from the fertility clinic as to whether or not I had been approved and we could go ahead and get the order started so I could find out the price. Yeah, trying is the key word there, lol. Friday I called the clinic and there hadn't been any word yet. So I was forced to wait until Monday, when I swear I called the fertility clinic about 4 times asking about the pre-authorization and other things I was trying to figure out. I'm at the point now where all I have to do is say my name and they know who I am....lol...Anyways, then of course today I have to call them again because the pharmacy forgot to give me the "pen" I need to actual inject the meds (the clinic has extras so they will give me one when I go up for my next appointment). They must love hearing from me, lol...if my calls start going unanswered I'll know it's because they've learned my phone number and don't want to answer any more of my questions, lol. Nah, they're actually always sooo nice and understanding, thank goodness!
So the insurance/meds mess was my big stressor for awhile, but now that that's taken care of, reality is starting to sink in a little more, and my nerves are starting to get on edge a bit about this whole process. For one thing, I hate needles, and injecting myself every day (especially now that I have the meds and can see what the needles look like) makes me feel slightly nauseated. Thankfully Jeremy has lots of experience sticking people with needles, so that's his job in this process (other than the obvious of course, lol).
Most of my anxiety about all of this though comes from the potential results. Of course if we're successful my elation will be too immense for words....but if we're not, well, that's it for fertility treatments (other than maybe just some cycles of pills which I don't really have any faith in). I'm determined to be a mother, one way or another, but I desperately want my own biological child. If we have to adopt I will love that child more than life itself, but if we aren't forced to go that route, I don't want to. And that's what I'm worried about - I don't want to have to go that route. I want a child that's me and Jeremy. I wanna go through morning sickness (yeah, call me crazy, lol), have cravings, gain weight for a logical, accepted reason, and experience childbirth. I want to watch our child grow into an adult from infancy. When it comes down to it, I'll take whatever I can get, biological or adopted child, but this whole fertility testing process has really reinforced my desire for a biological child. The two weeks I have to wait after the insemination to find out if I'm pregnant will probably be the longest two weeks of my life. And then of course if we are lucky and get pregnant, I'll be a worry-wart through the entire first trimester, thanks to my previous miscarriage.
Hopefully I won't have to wait too much longer though...if all goes as planned, we should know if we're pregnant no later than February 18 or 19, which means my first trimester would be over no later than April/May...here's to hoping February hurries up and gets here!!
Yes, I'm stressed. But I'll get to that in a minute ;). First, let me update you on the whole insurance/meds issue. Can I just say that it drives me crazy when people - especially within the same company - are NOT on the same page. First Caremark (our prescription pharmacy) tells me Gonal-F is gonna be at least $1000 for a small dosage (and I was gonna need A LOT), and that I need pre-authorization for it. Then I'm told it will be at least $1500 for that small dosage. Then I discover I'm being prescribed Follistim instead of the Gonal-F, and when I call to talk to Caremark about it, I find out I don't need a pre-authorization for it afterall (that's only needed for the HCG trigger shot), and I'm told it's $87.50 per 900 units (I need 1200 total). Um ok, HUGE DIFFERENCE PEOPLE! I understand that the cheaper price is for a different drug, but they do the same thing and Follistim is actually stronger than Gonal-F, so I think it's pretty safe to assume that the price differences should be small (plus my fertility clinic told me that too). Anyhow, when the woman I spoke to at Caremark told me that all the drugs I would need would be under $200 total, I had to force myself to not cry on the phone. Yeah, totally serious about that. I told her she had completely made my day, and can I just add that she was soooo sweet about everything too, even wishing me good luck with my baby in the future. Yes, there really are good hearted people out there still :). (Besides all of you of course!)
Anyways, so after confirming some things with the fertility clinic, I got a call from Caremark to schedule the delivery of my medications! These type of medications have to come from a speciality pharmacy, so they get shipped to me, overnight. Although the Caremark representative was able to tell me that I would have a copay that would need to be paid before the meds shipped, she unfortunately could not tell me what the copay would be. Ugh - yet again there I was waiting...yeah, it had been a week by this time - that's too long to wait to know something so important!! Thankfully I didn't have to wait more than a few hours, and found out I owed just a little over $280. Yet again, that was not the under $200 total I was told I would have before, but whatever - it was good enough! The meds were ordered, I paid, and they were on their way. Jeremy had the day off today, and when I got home from work he had already unpacked everything for me and put the Follistim in the fridge (it has to be kept cool) and everything else in it's proper place. Yeah!!
Ok, back to me being stressed. Nervous is actually a better way to sum up how I'm feeling right now. So as if just not being able to get pregnant in the first place isn't nerve-wracking enough, let's add on the insurance complications! I'm glad it's pretty much figured out now, but geesh, what a way to work up a girl's emotions!! Because I thought I was waiting for a pre-authorization from my insurance company, I was trying to be patient and wait until I heard back from the fertility clinic as to whether or not I had been approved and we could go ahead and get the order started so I could find out the price. Yeah, trying is the key word there, lol. Friday I called the clinic and there hadn't been any word yet. So I was forced to wait until Monday, when I swear I called the fertility clinic about 4 times asking about the pre-authorization and other things I was trying to figure out. I'm at the point now where all I have to do is say my name and they know who I am....lol...Anyways, then of course today I have to call them again because the pharmacy forgot to give me the "pen" I need to actual inject the meds (the clinic has extras so they will give me one when I go up for my next appointment). They must love hearing from me, lol...if my calls start going unanswered I'll know it's because they've learned my phone number and don't want to answer any more of my questions, lol. Nah, they're actually always sooo nice and understanding, thank goodness!
So the insurance/meds mess was my big stressor for awhile, but now that that's taken care of, reality is starting to sink in a little more, and my nerves are starting to get on edge a bit about this whole process. For one thing, I hate needles, and injecting myself every day (especially now that I have the meds and can see what the needles look like) makes me feel slightly nauseated. Thankfully Jeremy has lots of experience sticking people with needles, so that's his job in this process (other than the obvious of course, lol).
Most of my anxiety about all of this though comes from the potential results. Of course if we're successful my elation will be too immense for words....but if we're not, well, that's it for fertility treatments (other than maybe just some cycles of pills which I don't really have any faith in). I'm determined to be a mother, one way or another, but I desperately want my own biological child. If we have to adopt I will love that child more than life itself, but if we aren't forced to go that route, I don't want to. And that's what I'm worried about - I don't want to have to go that route. I want a child that's me and Jeremy. I wanna go through morning sickness (yeah, call me crazy, lol), have cravings, gain weight for a logical, accepted reason, and experience childbirth. I want to watch our child grow into an adult from infancy. When it comes down to it, I'll take whatever I can get, biological or adopted child, but this whole fertility testing process has really reinforced my desire for a biological child. The two weeks I have to wait after the insemination to find out if I'm pregnant will probably be the longest two weeks of my life. And then of course if we are lucky and get pregnant, I'll be a worry-wart through the entire first trimester, thanks to my previous miscarriage.
Hopefully I won't have to wait too much longer though...if all goes as planned, we should know if we're pregnant no later than February 18 or 19, which means my first trimester would be over no later than April/May...here's to hoping February hurries up and gets here!!
Tuesday, December 6, 2011
Fertility Future, Part 2
Did you get enough of a breather, lol?? Ok, here we go...Part 2!
So my insurance has no coverage limits for infertility diagnosis. It does, however, put a $1500 lifetime maximum on infertility treatments. That include medications. We have what is known as a Health Reimbursement Account, which means that our insurance gives us an allocated amount to use for "free" before we start paying anything (including copays!). We are given $650. Ironic, aye? (remember, the IUI procedure and the things included with it should come out to be about $650.) That DOES count toward the $1500 max though, so that means that if the IUI cost $650, we only have another $850 that the insurance will cover to any degree. That remaining $850 will only require us to make our copays, but once we've reached that limit, we're completely on our own.
Here's the problem...the FSH injections (Follistim) are not cheap. My doctor originally told me that I would be taking an injectable called Gonal-F (instead of Follistim). After speaking to my insurance this morning, I was told that I could expect 900 units of the Gonal-F to cost about $1500. Well, my doc told me that I would need to take roughly 260 units A DAY for 12 DAYS, which means I would need over 3000 units...which means it would cost more than $5000 JUST FOR THE MEDS! Um yeah, sooo not gonna happen.
After talking to a lot of you last night on Facebook, I decided this morning that I needed to call my fertility clinic and ask them about the meds. What I found out was fantastic! After I left my appointment last night, my doctor apparently reviewed my case and decided that she wanted me to take Follistim instead of the Gonal-F, and since it's stronger than the Gonal-F, I will only need 100 units of it a day. According to the nurse I spoke with at the clinic, usually the Follistim costs about $100 per 100 units. Which means that over the course of the 12 days I need to take it, it should be roughly $1200. Yeah, that's a HUGE difference!! Anyways, my insurance requires prior authorization before I can take/it will cover any injectable medication, so today the nurse I spoke with was going to get the process started so that I can stop worrying. Seriously, there are such incredible people working there!! She's ordering the Follistim through the specialty pharmacy (normal pharmacies don't generally carry FSH injectables), they will send her an authorization form for the insurance approval, she will submit that to my insurance, they will approve or deny it, and then she will call me to let me know what the EXACT cost will be. From what I am told the authorization usually only takes a couple of days, so I am hoping that I hear sooner rather than later. Approval from the insurance companies depends on whether or not they feel that the medicine is medically necessary for what I am doing...if they deny it, I'll be shocked. I really can't forsee that happening, especially since it says in my coverage (and I verified it more than once with insurance in the past 12 hours, lol) that medications for the treatment of infertility are covered to a certain amount.
Sooooo, now it's a waiting game. I swear Heavenly Father has a sense of humor...He knows I'm not a patient person, and let me tell you, this ENTIRE infertility issue has been the biggest test in patience for me EVER, lol! If it all works out like I'm hoping it will, we will end up paying, out of pocket, about $450 for EVERYTHING. Now that's affordable!! What sucks is that if this IUI cycle doesn't work, we won't be able to afford to do it again, since we will have maxed out our lifetime benefits...unless...I get a new job, with health insurance that has fertility benefits. Then we will switch to that insurance and maybe we will try again!
Anyways, I think I about covered everything...except I wanted to say to all of you, THANK YOU!!! Never before have I felt so much support and love from people all over the globe for what we are going through. I cannot even begin to express to you all how much it means to me to know that you are praying for us, thinking of us, giving us your advice, helping us in any way you can. It has been your support that has seriously gotten me through all of this, and I cannot thank you all enough!! I love you all!
So my insurance has no coverage limits for infertility diagnosis. It does, however, put a $1500 lifetime maximum on infertility treatments. That include medications. We have what is known as a Health Reimbursement Account, which means that our insurance gives us an allocated amount to use for "free" before we start paying anything (including copays!). We are given $650. Ironic, aye? (remember, the IUI procedure and the things included with it should come out to be about $650.) That DOES count toward the $1500 max though, so that means that if the IUI cost $650, we only have another $850 that the insurance will cover to any degree. That remaining $850 will only require us to make our copays, but once we've reached that limit, we're completely on our own.
Here's the problem...the FSH injections (Follistim) are not cheap. My doctor originally told me that I would be taking an injectable called Gonal-F (instead of Follistim). After speaking to my insurance this morning, I was told that I could expect 900 units of the Gonal-F to cost about $1500. Well, my doc told me that I would need to take roughly 260 units A DAY for 12 DAYS, which means I would need over 3000 units...which means it would cost more than $5000 JUST FOR THE MEDS! Um yeah, sooo not gonna happen.
After talking to a lot of you last night on Facebook, I decided this morning that I needed to call my fertility clinic and ask them about the meds. What I found out was fantastic! After I left my appointment last night, my doctor apparently reviewed my case and decided that she wanted me to take Follistim instead of the Gonal-F, and since it's stronger than the Gonal-F, I will only need 100 units of it a day. According to the nurse I spoke with at the clinic, usually the Follistim costs about $100 per 100 units. Which means that over the course of the 12 days I need to take it, it should be roughly $1200. Yeah, that's a HUGE difference!! Anyways, my insurance requires prior authorization before I can take/it will cover any injectable medication, so today the nurse I spoke with was going to get the process started so that I can stop worrying. Seriously, there are such incredible people working there!! She's ordering the Follistim through the specialty pharmacy (normal pharmacies don't generally carry FSH injectables), they will send her an authorization form for the insurance approval, she will submit that to my insurance, they will approve or deny it, and then she will call me to let me know what the EXACT cost will be. From what I am told the authorization usually only takes a couple of days, so I am hoping that I hear sooner rather than later. Approval from the insurance companies depends on whether or not they feel that the medicine is medically necessary for what I am doing...if they deny it, I'll be shocked. I really can't forsee that happening, especially since it says in my coverage (and I verified it more than once with insurance in the past 12 hours, lol) that medications for the treatment of infertility are covered to a certain amount.
Sooooo, now it's a waiting game. I swear Heavenly Father has a sense of humor...He knows I'm not a patient person, and let me tell you, this ENTIRE infertility issue has been the biggest test in patience for me EVER, lol! If it all works out like I'm hoping it will, we will end up paying, out of pocket, about $450 for EVERYTHING. Now that's affordable!! What sucks is that if this IUI cycle doesn't work, we won't be able to afford to do it again, since we will have maxed out our lifetime benefits...unless...I get a new job, with health insurance that has fertility benefits. Then we will switch to that insurance and maybe we will try again!
Anyways, I think I about covered everything...except I wanted to say to all of you, THANK YOU!!! Never before have I felt so much support and love from people all over the globe for what we are going through. I cannot even begin to express to you all how much it means to me to know that you are praying for us, thinking of us, giving us your advice, helping us in any way you can. It has been your support that has seriously gotten me through all of this, and I cannot thank you all enough!! I love you all!
Fertility Future, Part 1
*Warning: This is a long post, with more information than you may care to know, lol...*
What an emotional rollercoaster the past 24+ hours have been. I was incredibly nervous going into my appointment, elated when I was told we were good candidates for IUI, and then the worry about the medication costs set in on my drive home. And then, I called the insurance company and was told that the least I could expect to pay for only a third of the medication I would need was probably $1000. Yeah, soooo not in the budget. Then today, I'm told that's wrong...needless to say, I'm emotionally exhausted, and it isn't over yet. Before I get more into all of that though, let me talk more about what I found out at my follow-up consultation yesterday.
First off, let me just say for the billionth time that I absolutely LOVE this fertility clinic. They are all sooo nice, so caring, and so sensitive. I'm so grateful for that! So my doctor reviewed all the results of both Jeremy's tests and my tests, and here's what I learned:
The Good
1. There is absolutely NOTHING wrong with Jeremy. His tests all came back well above where they need to be, so we know he is not contributing at all to me not getting pregnant. Good news!
2. My good and bad cholesterol levels are all normal and in a healthy range, and both Jeremy and I tested negative for the slew of things they tested us for.
3. My hysteroscopy back in November showed that I had some tissue that my body didn't get rid of when I had my miscarriage back in 2009. Thankfully the hysteroscopy removed it, and it shouldn't be a problem in the future. (It being there could lead to future miscarriages, so I'm glad it's gone!)
4. My fallopian tubes are completely open.
The Not So Good
1. My PCOS is producing a crazy amount of eggs. This wasn't too surprising to hear since my doc had show at least 20 of them to me when I had an ultrasound done back in October.
2. Because I produce so many eggs, some of them are bound to be made up of some abnormal chromosomes...this is most likely what caused my miscarriage in 2009 (although there's no way to be 100% sure, it's a pretty good guess).
3. My body has a hard time metabolizing folic acid correctly - which is sooo important during pregnancy! Because of that, I have to take medicine to correct that, from now until the time my first trimester ends, whenever that happens!
4. Somehow they have tests that measure how close you are to starting menopause ( I can't remember exactly what it is that they measure). A menopausal woman measures at a 10 - at age 28 I'm measuring at 7.5...I should be between a 4-6. Basically, it just means I have less time than someone else my age to get pregnant (like I really needed something else working against me!).
Overall I am pleased with the results of all the testing. One thing is for sure - I now definitely believe in seeing a fertility specialist and going through the tests for anyone who has unsuccessfully been trying to get pregnant for awhile. We were going to do IUI in Fairbanks but decided against it because the timing wasn't right for us financially - I can't help but think how that may have been a blessing in disguise...had we had a successful IUI cycle without me knowing about my folic acid deficiency or the excess tissue from my previous miscarriage, we could have lost the baby or had a child born with serious health problems.
Anyways, here's the overall conclusion: The only thing standing in our way of getting pregnant is my PCOS. I can't even begin to explain to you how relieved I am to have heard my doctor say that. I went into the appointment prepared to be told that I would never be able to get pregnant. Instead, I'm told that pregnancy is totally possible. Saying that I was relieved would be the understatement of the century!
My doctor recommended IUI, done with injectable FSH (follicle stimulating hormone). So here's the plan:
1. Wait until my cycle starts again, and call the clinic the first day. If I don't start on my own by New Years then I will once again take Provera for 10 days to jumpstart my cycle (the last time I took it I started the day after I stopped taking it).
2. On day 3 of my cycle I will go to the clinic for an ultrasound and bloodwork. That's also when I will start injecting myselg with a drug called Follistem (the FSH medicine).
3. For the next 12 days approximately (give or take a day or two) I will inject myself daily - really I should say that Jeremy will be injecting me, since I have a fear of needles and there is no way in heck that I could poke myself daily with a needle in my abdomen or thigh!!
4. During the 12 days I am injecting the FSH I will go to the clinic every 4 days for an ultrasound and bloodwork, where they will measure the follicles I have growing inside.
5. When I have some (or maybe just 1? but I'm guessing at least 2) good sized follicles, they will give me what is known as an HCG trigger shot, which will induce ovulation.
6. 36 hours after the trigger shot Jeremy and I will be back in the clinic. Jeremy will give his sample, they "wash" it (basically they seperate the sperm from the seminal fluid, and the not so good sperm are left behind), and they will then place it directly inside of my uterus using a special catheter and syringe. The idea is that the sperm will be right there waiting for the egg. Usually sperm have to travel through a pretty hostile environment to get to the uterus, so IUI removes those obstacles:).
7. After the procedure I will go back to the clinic a few more times to do bloodwork to measure my progesterone and other things that are needed to sustain a healthy pregnancy.
8. Two weeks after the procedure, I go in and they tell me if I'm pregnant!
9. If I am, I will see my fertility doctor up until I am 10 weeks, and then start going strictly to my OB/GYN in Lake Havasu, and the rest is history!
Phew...are you tired of reading yet? Yeah, there's more...sorry, lol! So the IUI - which includes my ultrasound on day 3, the collection and wash of Jeremy's sperm, my bloodwork, the ultrasounds throughout the whole process, and the actual insemination - should be roughly $650. But then there's the cost of the medications...that's the game changer...
Ok, take a breather...that's the end of Part 1, lol!
What an emotional rollercoaster the past 24+ hours have been. I was incredibly nervous going into my appointment, elated when I was told we were good candidates for IUI, and then the worry about the medication costs set in on my drive home. And then, I called the insurance company and was told that the least I could expect to pay for only a third of the medication I would need was probably $1000. Yeah, soooo not in the budget. Then today, I'm told that's wrong...needless to say, I'm emotionally exhausted, and it isn't over yet. Before I get more into all of that though, let me talk more about what I found out at my follow-up consultation yesterday.
First off, let me just say for the billionth time that I absolutely LOVE this fertility clinic. They are all sooo nice, so caring, and so sensitive. I'm so grateful for that! So my doctor reviewed all the results of both Jeremy's tests and my tests, and here's what I learned:
The Good
1. There is absolutely NOTHING wrong with Jeremy. His tests all came back well above where they need to be, so we know he is not contributing at all to me not getting pregnant. Good news!
2. My good and bad cholesterol levels are all normal and in a healthy range, and both Jeremy and I tested negative for the slew of things they tested us for.
3. My hysteroscopy back in November showed that I had some tissue that my body didn't get rid of when I had my miscarriage back in 2009. Thankfully the hysteroscopy removed it, and it shouldn't be a problem in the future. (It being there could lead to future miscarriages, so I'm glad it's gone!)
4. My fallopian tubes are completely open.
The Not So Good
1. My PCOS is producing a crazy amount of eggs. This wasn't too surprising to hear since my doc had show at least 20 of them to me when I had an ultrasound done back in October.
2. Because I produce so many eggs, some of them are bound to be made up of some abnormal chromosomes...this is most likely what caused my miscarriage in 2009 (although there's no way to be 100% sure, it's a pretty good guess).
3. My body has a hard time metabolizing folic acid correctly - which is sooo important during pregnancy! Because of that, I have to take medicine to correct that, from now until the time my first trimester ends, whenever that happens!
4. Somehow they have tests that measure how close you are to starting menopause ( I can't remember exactly what it is that they measure). A menopausal woman measures at a 10 - at age 28 I'm measuring at 7.5...I should be between a 4-6. Basically, it just means I have less time than someone else my age to get pregnant (like I really needed something else working against me!).
Overall I am pleased with the results of all the testing. One thing is for sure - I now definitely believe in seeing a fertility specialist and going through the tests for anyone who has unsuccessfully been trying to get pregnant for awhile. We were going to do IUI in Fairbanks but decided against it because the timing wasn't right for us financially - I can't help but think how that may have been a blessing in disguise...had we had a successful IUI cycle without me knowing about my folic acid deficiency or the excess tissue from my previous miscarriage, we could have lost the baby or had a child born with serious health problems.
Anyways, here's the overall conclusion: The only thing standing in our way of getting pregnant is my PCOS. I can't even begin to explain to you how relieved I am to have heard my doctor say that. I went into the appointment prepared to be told that I would never be able to get pregnant. Instead, I'm told that pregnancy is totally possible. Saying that I was relieved would be the understatement of the century!
My doctor recommended IUI, done with injectable FSH (follicle stimulating hormone). So here's the plan:
1. Wait until my cycle starts again, and call the clinic the first day. If I don't start on my own by New Years then I will once again take Provera for 10 days to jumpstart my cycle (the last time I took it I started the day after I stopped taking it).
2. On day 3 of my cycle I will go to the clinic for an ultrasound and bloodwork. That's also when I will start injecting myselg with a drug called Follistem (the FSH medicine).
3. For the next 12 days approximately (give or take a day or two) I will inject myself daily - really I should say that Jeremy will be injecting me, since I have a fear of needles and there is no way in heck that I could poke myself daily with a needle in my abdomen or thigh!!
4. During the 12 days I am injecting the FSH I will go to the clinic every 4 days for an ultrasound and bloodwork, where they will measure the follicles I have growing inside.
5. When I have some (or maybe just 1? but I'm guessing at least 2) good sized follicles, they will give me what is known as an HCG trigger shot, which will induce ovulation.
6. 36 hours after the trigger shot Jeremy and I will be back in the clinic. Jeremy will give his sample, they "wash" it (basically they seperate the sperm from the seminal fluid, and the not so good sperm are left behind), and they will then place it directly inside of my uterus using a special catheter and syringe. The idea is that the sperm will be right there waiting for the egg. Usually sperm have to travel through a pretty hostile environment to get to the uterus, so IUI removes those obstacles:).
7. After the procedure I will go back to the clinic a few more times to do bloodwork to measure my progesterone and other things that are needed to sustain a healthy pregnancy.
8. Two weeks after the procedure, I go in and they tell me if I'm pregnant!
9. If I am, I will see my fertility doctor up until I am 10 weeks, and then start going strictly to my OB/GYN in Lake Havasu, and the rest is history!
Phew...are you tired of reading yet? Yeah, there's more...sorry, lol! So the IUI - which includes my ultrasound on day 3, the collection and wash of Jeremy's sperm, my bloodwork, the ultrasounds throughout the whole process, and the actual insemination - should be roughly $650. But then there's the cost of the medications...that's the game changer...
Ok, take a breather...that's the end of Part 1, lol!
Sunday, December 4, 2011
Tomorrow, tomorrow...
Not much has been going on fertility-wise this past month, but per a friend's request, I'm updating my blog today nonetheless - you know who you are ;).
It's been more than a month now since my last entry, and since all my tests were completed. When I scheduled my follow-up consultation with the fertility clinic, I was NOT happy that I was going to have to wait an entire month before seeing my doctor again. Did they not have anything sooner? Apparently not. So, the date was set for Dec. 5, and what'ya know, that's TOMORROW! I totally thought the month of November was going to creep by, but it actually passed pretty quickly - thank goodness :). We all know I'm not patient, so a slowly passing month would've driven me crazy!
Anyways, so tomorrow is the day when I find out the results of all of my tests and the tests Jeremy had done. I already know some of the results - my fallopian tubes are open, I had 3 polyps on my uterus, I definitely have PCOS. But tomorrow I will get to sit down with my doctor, review ALL of the results, and hear her tell me if IUI is an option for us. It's a day I've waited for for a LONG time, and I'm glad it's finally here. But, to be perfectly honest, I'm nervous and scared.
You see, throughout this whole process I've tried not to get my hopes up, keeping in mind that we can't afford IVF, and that if IUI or other methods don't look promising for us, we will begin the adoption process once again. But I failed - my hopes for having our own biological child are totally up...that's why I'm nervous and scared about tomorrow's appointment. If my doctor gives me bad news, I'll be completely crushed :(. If it's good news, I'll hardly be able to contain my excitement! I know Heavenly Father has a plan for our family, but that's not always the easiest thing to accept, especially when it seems like everyone around me is pregnant or already has children. But, I trust in God's plan for us, and if I don't get the news I want to hear tomorrow, I'll know that my plan and Heavenly Father's are not the same - it wouldn't be the first time that's happened, especially in this arena, lol.
So tomorrow is the day. The day our future will start to change forever, one way or the other. Here's to hoping it goes well!
It's been more than a month now since my last entry, and since all my tests were completed. When I scheduled my follow-up consultation with the fertility clinic, I was NOT happy that I was going to have to wait an entire month before seeing my doctor again. Did they not have anything sooner? Apparently not. So, the date was set for Dec. 5, and what'ya know, that's TOMORROW! I totally thought the month of November was going to creep by, but it actually passed pretty quickly - thank goodness :). We all know I'm not patient, so a slowly passing month would've driven me crazy!
Anyways, so tomorrow is the day when I find out the results of all of my tests and the tests Jeremy had done. I already know some of the results - my fallopian tubes are open, I had 3 polyps on my uterus, I definitely have PCOS. But tomorrow I will get to sit down with my doctor, review ALL of the results, and hear her tell me if IUI is an option for us. It's a day I've waited for for a LONG time, and I'm glad it's finally here. But, to be perfectly honest, I'm nervous and scared.
You see, throughout this whole process I've tried not to get my hopes up, keeping in mind that we can't afford IVF, and that if IUI or other methods don't look promising for us, we will begin the adoption process once again. But I failed - my hopes for having our own biological child are totally up...that's why I'm nervous and scared about tomorrow's appointment. If my doctor gives me bad news, I'll be completely crushed :(. If it's good news, I'll hardly be able to contain my excitement! I know Heavenly Father has a plan for our family, but that's not always the easiest thing to accept, especially when it seems like everyone around me is pregnant or already has children. But, I trust in God's plan for us, and if I don't get the news I want to hear tomorrow, I'll know that my plan and Heavenly Father's are not the same - it wouldn't be the first time that's happened, especially in this arena, lol.
So tomorrow is the day. The day our future will start to change forever, one way or the other. Here's to hoping it goes well!
Monday, November 7, 2011
Understanding PCOS
Since my first consultation with my fertility specialist, I have wanted to blog in order to better explain Polycystic Ovarian Syndrome. I was diagnosed with the disorder roughly 2 years ago, but the way it was recently explained to me completely opened my eyes to just why PCOS has made pregnancy such a hard thing for me.
Notice that the PCOS ovary has MANY more follicles present than the normal ovary.
Again, notice that there is a dominant egg in the normal ovary, whereas the PCOS ovary has no dominant egg about to breakthrough.
Many of you know about PCOS (and indeed some of you have it yourselves), but I encourage all of you to read this in hopes that it may be just as enlightening to you as it was to me. And, PCOS is the leading cause of infertility in women - you never know who it may affect - so you may be doing yourself, your daughter, your friend - a huge favor to know what it is and what the symptoms are.
First of all, I'm going to explain what PCOS is and why it makes pregnancy difficult. Then I'll explain the signs/symptoms of PCOS. I made some drawings to try to better illustrate my points. I'm by no means an artist, but I think they get the point across :).
To be vague, PCOS is a hormonal disorder involving a woman's reproductive hormones. For a woman NOT experiencing PCOS, at the start of each menstrual cycle, a woman's estrogen levels are low, and that is when the brain sends a signal to the reproductive organs to begin sending out FSH (follicle-stimulating hormone). FSH causes a woman's follicles to develop into a mature egg that can eventually be fertilized. Although several follicles generally begin to develop, one is usually dominant - receiving more of the FSH - and is the egg that eventually is released from the ovary - it is, per say, the strongest of the bunch - while the remaining follicles disintegrate.
To be vague, PCOS is a hormonal disorder involving a woman's reproductive hormones. For a woman NOT experiencing PCOS, at the start of each menstrual cycle, a woman's estrogen levels are low, and that is when the brain sends a signal to the reproductive organs to begin sending out FSH (follicle-stimulating hormone). FSH causes a woman's follicles to develop into a mature egg that can eventually be fertilized. Although several follicles generally begin to develop, one is usually dominant - receiving more of the FSH - and is the egg that eventually is released from the ovary - it is, per say, the strongest of the bunch - while the remaining follicles disintegrate.
When a woman has PCOS, her cycle begins the same way. When FSH begins to be sent out, in essence, a competition begins for the many follicles to become the "most mature." However, no dominant follicle presents itself, and in general, no one egg becomes the most mature. An egg may not be released at all, or if it is, it generally is not a very good quality egg and thus if it is by chance fertilized, can result in miscarriage, birth defects, etc. In the meantime, the other follicles that were trying to mature do NOT disintegrate as they should, and thus cause what look like cysts on the ovaries (my doctor pointed out that they are actually NOT cysts as the name of the disorder implies, but are, essentially, eggs).
Here's a diagram of what the ovaries look like at the beginning of a woman's cycle:
Notice that the PCOS ovary has MANY more follicles present than the normal ovary.Now here is what the ovaries look like right before the egg is released:
Again, notice that there is a dominant egg in the normal ovary, whereas the PCOS ovary has no dominant egg about to breakthrough.Do those diagrams help PCOS make more sense to you? Maybe it doesn't clarify it for you like it did for me, but honestly, this was a major breakthrough in understanding for me. No one had ever explained PCOS to me like this before, and once I understood it I really began to understand why PCOS patients have a horribly hard time getting pregnant and keeping their babies if they do conceive.
Ok, so here's what you really need to know about PCOS. I know that some of these things can be embarrassing for people to admit, but know that you (or your daughter, friend, etc.) are NOT alone. I'll admit that I suffer from almost every single one of these symptoms.
Symptoms (in no particular order or importance or dominance):
1. Irregular/abnormally long periods - a normal cycle is generally no more than 35 days long. This one symptom by itself should be enough to prompt a visit to your doctor.
2. Hair growth on the face, back, chest, toes, stomach, thumbs - PCOS patients have excess testosterone in their system, the cause for this embarrassing "manly" attribute.
3. Difficulty losing weight/gaining weight - a majority of women with PCOS have a hard time losing weight and keeping it off.
4. Difficulty getting pregnant - there are a lot of things that can contribute to an inability to conceive, but it's worth asking about PCOS if you've been trying unsuccessfully for more than a year (I wouldn't even wait that long).
5. Blood sugar issues - women with PCOS can have problems with insulin resistance, and are at risk for developing diabetes
6. Skin problems like acne, dandruff, oily skin and skin discolorations
Keep in mind that not every one of these symptoms have to be present in order to have a PCOS diagnosis. Likewise, my doctor also emphasized that PCOS is a very loosely used diagnosis and may very well be given to women who do not have the disease. The only way to know for sure is to talk to your doctor about your symptoms and have the necessary tests done that can determine if PCOS is the cause.
I realize I've given a lot of information in this post, and for anyone wondering if they or someone they know has PCOS, I would be happy to answer any questions you have. Feel free to ask me in the comments here, on Facebook, or you can send me a private message on FB if you feel more comfortable. PCOS has forever changed my life, and I'm here to help. I'm also here to be a support to others suffering from this. Please feel free to share this post with anyone you feel may benefit from it.
Thursday, November 3, 2011
I survived
At first I was afraid, I was petrified...ok, I wasn't really petrified, but by the crocodile tears running down my face as I sat in the fertility clinic business office this morning, you would have thought I was scared for my life. Don't worry - everything's great, I just got a little shaken up. I'll tell you why in just a second :).
First, let me recap what happened on Monday. After working 3.5 hours, I made the now-tedious drive to Vegas for my early cycle blood work and ultrasound. Seriously, the appointment made me a little angry, but I got over it quickly. I mean really, did I seriously have to drive all the way to Vegas for an appointment that took no more than 15 minutes? It's at times like those that I have to remind myself what the purpose of all of this is. Anyways, Monday's appointment was easy - 1 tube of blood and an ultrasound that showed all of my maturing eggs this cycle. Yeah - there is no doubt I have PCOS after that ultrasound. One day I'm going to draw some diagrams, take pictures of them and post them on my blog to explain PCOS better (because it's seriously so much easier to understand with pictures!) but for now you'll just have to try to understand my written explanations. Basically, a healthy woman without PCOS should have about 6-10 eggs each cycle. I had MORE THAN 20. Just how many more than 20 I'm not exactly sure (it wasn't too many more than 20), but still....that's nuts!! Anyways, it was oddly reassuring to see that my body was screwed up - it helps me know that we are doing the right thing by seeking help from fertility specialists. Anyways, the drive home Monday was horrible - thank you mom for keeping me awake by talking to me on the phone! Yeah, I was so tired I'm surprised I could drive at all. Yet another good reason why I stayed in Vegas tonight instead of driving home.
Ok, so on to today and my crocodile tears. First of all let me say that in the past couple of days I really started to get nervous about this HSG procedure today (it's supposed to be pretty painful). I shed a few tears at home wishing I didn't have to go alone and wishing I could know how painful it would be for me, but Jeremy's work schedule just wouldn't allow for him to come with me, and really, the only way I am going to know how painful it is is to have it done. Anyways, I got up bright and early today and was on the road to Vegas at 6:30 a.m. I needed to be at the clinic to do all my necessary paperwork by 9:30. I arrived with time to spare, and impatiently waited for my turn. I was finally called back, and that's when the drama began.
When I first had my consultation, I was told that I would have 3 diagnostic tests done in the surgery center affiliated with the clinic. One of those tests (a hysteroscopy) would require me to be put under anesthesia. Jeremy and I decided that we would forego that test (it didn't seem completely necessary to me at the time anyway) since having him there to take care of me after I was put under anesthesia would be difficult to manage. Well, today when I was filling out paperwork in the business office, I'm given a consent form to sign for anesthesia! Um, no, I'm not having that procedure done...I'm not going under...Almost immediately I started tearing up while telling the office manager (not sure if that's really her title, but that's what I'm gonna call her) I was not having a procedure requiring anesthesia. She then asked the xray tech who was there if I needed anesthesia for the HSG procedure (the one I was planning on having done that wasn't supposed to require anesthesia), and he said yes! Well, I pretty much lost it. I felt like such a big baby. I'm sitting in the office manager's office crying my eyes out thinking that I drove 3 hours on an almost empty stomach, took time off of work, got a non-refundable hotel reservation and stressed myself out about this, and now you're pretty much telling me I can't have the procedure done?! And on top of that I'm not allowed to pee because I have to have a full bladder (and trust me, I had to go!). Yeah, not a good way to start the day.
Anyways, to make a long story short, the doctor stepped in and told me that I indeed did NOT need anesthesia for the HSG, and that if I chose to have the hysteroscopy done today as well then she could just give me localized anesthesia, which would allow me to drive myself to the hotel. She also informed me that if the test I was supposed to have tomorrow showed anything in my uterus, I would have to come back the next week to have the hysteroscopy done anyway. If I had the hysteroscopy today, there would be no need for the test tomorrow. After an internal dilemma of what I wanted to do, trying to figure out things with my insurance, and calming myself down so I could make a rational decision, I went ahead with the HSG AND the hysteroscopy, both under local anesthesia.
So, without boring you with anymore of the details, let me first say that the HSG (which injects dye into my fallopian tubes to see if there are any blockages) showed the my tubes are OPEN! Yeah!! Secondly, during the hysteroscopy the doctor found 3 polyps that she removed from my uterus - polyps can implant on the uterus and take up space in areas where embryos try to implant. So it was definitely a wise choice for me to have the hysteroscopy done today. My follow-up consultation is Dec. 5, and that's when we will see where we go from here (sooo wish I didn't have to wait so long!).
Now, on to the pain part. In the past I have had to have numerous procedures done on my feminine parts. Generally I'm told by the doctor that I will feel some degree of pain or pressure, and generally, the procedure is pretty much done before I even realize she's started. Yes, I'm that lucky. Today I didn't get off so easy, but the cramping I felt with the HSG was no worse than my normal period cramps. Actually, my normal cramps last MUCH longer. One person I know of said that the cramping they felt was worse than labor pains...I don't know what labor pains feel like, but I consider myself lucky. I have a feeling the anesthesia helped :). I cramped a little bit off and on for the next couple of hours once the procedure was over, but that's been about it!
Anyways, let me end this since this is a super long post. I don't have to go in tomorrow since I opted to do the 2 tests today, but because I was tired and under the direction of my doctor I decided to stay the day/night in Vegas and drive back to Lake Havasu in the morning. It's been a pretty good day ( I got some shopping in and ate some good food :) ) but I am bummed that I didn't make it to the temple...I knew there was no way I could go feeling as tired as I do, so I will have to save that for another time. I was pretty tired shortly after the procedure, but I discovered long ago that if I nap during the day I have trouble sleeping at night, so I forced myself to stay awake all day. Add on getting lost driving around Vegas (I desperately need to update my GPS maps) and I'm exhausted. I think it's time for me to go enjoy the gorgeous view of the strip I have from my hotel room :).
First, let me recap what happened on Monday. After working 3.5 hours, I made the now-tedious drive to Vegas for my early cycle blood work and ultrasound. Seriously, the appointment made me a little angry, but I got over it quickly. I mean really, did I seriously have to drive all the way to Vegas for an appointment that took no more than 15 minutes? It's at times like those that I have to remind myself what the purpose of all of this is. Anyways, Monday's appointment was easy - 1 tube of blood and an ultrasound that showed all of my maturing eggs this cycle. Yeah - there is no doubt I have PCOS after that ultrasound. One day I'm going to draw some diagrams, take pictures of them and post them on my blog to explain PCOS better (because it's seriously so much easier to understand with pictures!) but for now you'll just have to try to understand my written explanations. Basically, a healthy woman without PCOS should have about 6-10 eggs each cycle. I had MORE THAN 20. Just how many more than 20 I'm not exactly sure (it wasn't too many more than 20), but still....that's nuts!! Anyways, it was oddly reassuring to see that my body was screwed up - it helps me know that we are doing the right thing by seeking help from fertility specialists. Anyways, the drive home Monday was horrible - thank you mom for keeping me awake by talking to me on the phone! Yeah, I was so tired I'm surprised I could drive at all. Yet another good reason why I stayed in Vegas tonight instead of driving home.
Ok, so on to today and my crocodile tears. First of all let me say that in the past couple of days I really started to get nervous about this HSG procedure today (it's supposed to be pretty painful). I shed a few tears at home wishing I didn't have to go alone and wishing I could know how painful it would be for me, but Jeremy's work schedule just wouldn't allow for him to come with me, and really, the only way I am going to know how painful it is is to have it done. Anyways, I got up bright and early today and was on the road to Vegas at 6:30 a.m. I needed to be at the clinic to do all my necessary paperwork by 9:30. I arrived with time to spare, and impatiently waited for my turn. I was finally called back, and that's when the drama began.
When I first had my consultation, I was told that I would have 3 diagnostic tests done in the surgery center affiliated with the clinic. One of those tests (a hysteroscopy) would require me to be put under anesthesia. Jeremy and I decided that we would forego that test (it didn't seem completely necessary to me at the time anyway) since having him there to take care of me after I was put under anesthesia would be difficult to manage. Well, today when I was filling out paperwork in the business office, I'm given a consent form to sign for anesthesia! Um, no, I'm not having that procedure done...I'm not going under...Almost immediately I started tearing up while telling the office manager (not sure if that's really her title, but that's what I'm gonna call her) I was not having a procedure requiring anesthesia. She then asked the xray tech who was there if I needed anesthesia for the HSG procedure (the one I was planning on having done that wasn't supposed to require anesthesia), and he said yes! Well, I pretty much lost it. I felt like such a big baby. I'm sitting in the office manager's office crying my eyes out thinking that I drove 3 hours on an almost empty stomach, took time off of work, got a non-refundable hotel reservation and stressed myself out about this, and now you're pretty much telling me I can't have the procedure done?! And on top of that I'm not allowed to pee because I have to have a full bladder (and trust me, I had to go!). Yeah, not a good way to start the day.
Anyways, to make a long story short, the doctor stepped in and told me that I indeed did NOT need anesthesia for the HSG, and that if I chose to have the hysteroscopy done today as well then she could just give me localized anesthesia, which would allow me to drive myself to the hotel. She also informed me that if the test I was supposed to have tomorrow showed anything in my uterus, I would have to come back the next week to have the hysteroscopy done anyway. If I had the hysteroscopy today, there would be no need for the test tomorrow. After an internal dilemma of what I wanted to do, trying to figure out things with my insurance, and calming myself down so I could make a rational decision, I went ahead with the HSG AND the hysteroscopy, both under local anesthesia.
So, without boring you with anymore of the details, let me first say that the HSG (which injects dye into my fallopian tubes to see if there are any blockages) showed the my tubes are OPEN! Yeah!! Secondly, during the hysteroscopy the doctor found 3 polyps that she removed from my uterus - polyps can implant on the uterus and take up space in areas where embryos try to implant. So it was definitely a wise choice for me to have the hysteroscopy done today. My follow-up consultation is Dec. 5, and that's when we will see where we go from here (sooo wish I didn't have to wait so long!).
Now, on to the pain part. In the past I have had to have numerous procedures done on my feminine parts. Generally I'm told by the doctor that I will feel some degree of pain or pressure, and generally, the procedure is pretty much done before I even realize she's started. Yes, I'm that lucky. Today I didn't get off so easy, but the cramping I felt with the HSG was no worse than my normal period cramps. Actually, my normal cramps last MUCH longer. One person I know of said that the cramping they felt was worse than labor pains...I don't know what labor pains feel like, but I consider myself lucky. I have a feeling the anesthesia helped :). I cramped a little bit off and on for the next couple of hours once the procedure was over, but that's been about it!
Anyways, let me end this since this is a super long post. I don't have to go in tomorrow since I opted to do the 2 tests today, but because I was tired and under the direction of my doctor I decided to stay the day/night in Vegas and drive back to Lake Havasu in the morning. It's been a pretty good day ( I got some shopping in and ate some good food :) ) but I am bummed that I didn't make it to the temple...I knew there was no way I could go feeling as tired as I do, so I will have to save that for another time. I was pretty tired shortly after the procedure, but I discovered long ago that if I nap during the day I have trouble sleeping at night, so I forced myself to stay awake all day. Add on getting lost driving around Vegas (I desperately need to update my GPS maps) and I'm exhausted. I think it's time for me to go enjoy the gorgeous view of the strip I have from my hotel room :).
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