My first ‘self’ injection and my true valentine hero

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I wish wish wish I had video recorded my experience with my first ‘self’ injection with Ovidrel.  It would have been pure comedy and had you all rolling around in stitches.  But I didn’t video it because I had no space left on my iPhone and at 1130pm I was too tired to be bothered with all that.

I worked my self up into a bit of a nervous panic knowing I had to do this self injection.  Fortunately, the evening was spent mostly distracted with a romantic dinner at a lovely local restaurant.  There were 6 courses and I was stuffed silly by the end.  The last thing I felt like doing after all that food was grab the fat of my tummy and stick a needle in it.

I watched several you tube videos with other people doing the injection.  The instructions given to me were pretty clear to follow, but I wanted to see other people’s experience with it.

Here is one adorable couple trying the injection for the first time: http://youtu.be/Yv_KvnNfCOg

And another lovely couple: http://youtu.be/Gm7AkZgVHkA

I wanted to be able to do the injection myself, and I tried, I really did.  But every time I came to put the needle on my skin I freaked and stopped myself.  So I asked Chris to do it.  But then he was nervous and didn’t look comfortable doing it.  So that made me more freaked out more.  So I closed the bathroom door and tried to do it again on my own.  But I just could not bring myself to do it.  So I called Chris back in.  We agreed I would hold my tummy skin, and I would look away.  He was just as nervous as me, and is not particularly good with seeing needles either.  So he counted.  On two he stabbed me gently, then counted to three til it was all the way in, then counted one – two whilst he injected the drugs in and was out on three.  So six seconds in total and it was all over with.

It didn’t hurt, but I felt really queasy afterwards, it’s just the thought of the needle that always gets me.  We had a good giggle about it afterwards.  Afterwards I felt overwhelming love for my husband; he overcame his own fear because I was too chicken to do it myself.  This was his greatest valentines gift to me ever.

Big Fat Freddie Fail F for Freedom Fertility Pharmacy

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The savings I made with Freedom Fertility Pharmacy were not worth the hassle I have experienced!

Yesterday the Pharmacy promised to deliver my medications today via FedEx.  I checked the tracking order number this morning and the package had made it to Virginia Beach early this morning.  Hooray! We headed out late morning for some shopping, and as we were out I had a feeling I should check the delivery status with fedEX one more time.  It said ‘Delivery Failed.  Delivery rescheduled for Monday 16th’.  I freaked!  Chris, my lovely husband, calmly took my phone away from me (to save me from throwing it somewhere I guess) and called FedEx for me.  He asked if we could pick it up from their delivery centre.  Not a problem, they said, pick it up after 2.30pm from the main office.  So at 2.45pm we arrived at the delivery centre –  and it was shut!!! It had closed at 1pm.

Why oh why did they tell us to pick it up after 2.30pm if it was going to be shut??!!!  So Chris knocked on the side door and made a bit of a racket.  I had almost given up hope when a man opened the door.  Chris explained that the FedEx centre had told us to come after 2.30pm to pick our refrigerated medicine……please please please can we get it!!  So the man kindly went to look for our parcel, and I signed for it.  Thank goodness! A huge sigh of relief.

All became clear what had happened.  FedEx never made it to our house because the address was incorrectly spelt!  I don’t know how many times I confirmed my address with Freedom Fertility.  So it wasn’t FedEx’s fault at all, just the Pharmacy.

I will get my prescription from Walgreens next time, I don’t care how much I won’t save.  A big fat Freddie Fail F for Freedom Fertility. Never again Freedom Fertility.

On a more positive note, I have my meds now, just in time to inject myself in 10 minutes time (1130pm to be precise).

Finally my ovidrel injection and progesterone suppositories arrived in the post!

Finally my ovidrel injection and progesterone suppositories arrived in the post!

Another post on that tomorrow.  Wish me luck, because I am nervous as hell about this pesky injection.

My what big follicles you have – all the better for inseminating with!

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Today is Cycle Day 11 and I attended the first ultrasound for my first ever Intrauterine Insemination (IUI).  The clinic were very efficient today, I was in and out within 15 minutes.  I sat waiting in the examination room for the doctor to arrive, and there on the wall was a poster explaining the differences between fraternal twins and identical twins – A handy guide or perhaps more of a handy reminder of the increased risk for multiples with IUI.  Today, the doctor had a student shadowing her, I had no problem with this, but I think he looked a bit awkward throughout – bless his cotton socks.

The doctor showed the student my good uterine lining – apparently three lines is good.  This is all new to me, so I appreciated her explaining everything.  I had two follicles in the right ovary (as I had predicted) one 20mm and the other 28mm.  I also had a teeny tiny one in the left ovary, only 6mm, but she said it might be nothing.  So I am ready to go.  They don’t open on a Sunday, so my appointment is on Monday 16th Feb.  As a romantic Valentines day gift, I get an injection of Ovidrel at 1130pm.  Not looking forward to this given my phobia of needles.  I am undecided yet whether I will do it myself or get Chris to poke me in the abdomen.

This is all assuming my medication arrives tomorrow as freedom fertility pharmacy have promised me.  Today I called them to check the status of my order with regard to my insurance approval.  They had the approval for the Ovidrel, but not yet negotiated the progesterone.  I don’t understand how this system works in the background, but from what I understand, it is crazy.  So I said I would go ahead and pay full price for them rather than wait for the insurance company to do its thing.  If it is covered, then I can just try to claim it back later….but I needed my meds ASAP!

The progesterone was $49 and the Ovidrel was $123 full price, with the insurance agreeing to pay up, my 10% copay made it only $12.30.  Not too bad.

Cost of this IUI cycle, full price:

  • Meds inc. letrozole, ovidrel & progesterone: $311
  • Ultrasound: $225
  • Sperm Wash:$140
  • Insemination:$225

Total: $901

Expensive stuff!! Chances of success? Our doctor told us our chances were about 20%.  Advanced Fertility.com breaks down the success rates even further depending on age, sperm mobility and treatment options. Apparently there is a 7.6% chance of success with one follicle, and an increase chance to 26% with two follicles. Wooohooo!  But those numbers are still pretty small. there is almost a 4 in 5 chance that we won’t conceive.  Putting it like brings you back down to earth.

Fingers crossed for a Valentines baby (Just like Chris is!).  Happy Valentine’s day everyone!

Freedom Fertility Pharmacy Fail

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My nurse recommended freedom fertility pharmacy rather than my usual pharmacist, Walgreens, because the ovidrel trigger shots and progesterone suppositories are much cheaper if my insurance does not cover it.  Sounds great, I said, let’s do it!

So once my prescription was ready freedom fertility pharmacy dutifully called me via a robot, who then proceeded to tell me there were no free reps available at that time, please call back later.  Unfortunately, every time I tried to call them back their lines were busy and I was put on hold for aaaaaages.  Usually I don’t mind waiting if I can leave my phone on speaker and wait for a representative to pick up.  Unfortunately freedom fertility put in ads and notices over the music.  Something I don’t really want my colleagues around me listening to.  So I gave up.  Then there was the snow storm and they were closed.  Eventually when I did get through to them several days after they called me, I arranged delivery of my meds for 11th Feb (Cycle Day 9).

Later that day I had a missed call from freedom fertility.  I thought it was probably the robot that kept calling me to say I had to call them, so I ignored this.  If it wasn’t the robot I’d get another call.  And I did not get another call, so I wrongly assumed all was well.  This was until yesterday when I came home expecting my meds to have been delivered.  Nothing, nudda had been delivered.  I had no missed calls asking me where my house was (a frequent occurrence from delivery people) and no email saying delivery had failed.  So first thing this morning I called them up.

‘Oh’, the representative said, ‘your order was cancelled because your insurance card expired.’

My insurance card doesn’t expire! And no one bothered to check with me????!??!?!?!?!?! BAHHHHHHHH!!!!!!

So I re-confirmed the insurance details, which went through correctly this time (why couldn’t the other lady have done that when I was on the phone last time??).  I said I needed the delivery ASAP because I will probably need to do the trigger shot this weekend.  ‘No problem’, the lady said ‘we will get it to you tomorrow, stay with your phone today in case we need anything else from you’.

As I am driving home this evening I had another missed call from freedom fertility.  So I call them back as soon as I could….

‘we are sorry, we are currently experiencing a high caller volume, please hold’ DOUBLE BAHHHHHHHHHHHH!!! Luckily for them someone answered within three rings.

The representative said ‘we have to have authorisation first’….Okaaaaaay….I said ‘sure you have my authorisation!’ I thought this was for payment as I had previously set a limit on my card.  Then there was this awkward silence.

‘So we can put the meds on hold then?’ the lady on the phone said.  ‘Ummmmmm, wait, what? No?  I don’t understand, we may have our wires crossed’ I asked thoroughly confused.

The lady realised she was talking to a bit of an insurance process idiot and explained that the Ovidrel shot required prior authorisation from my insurance company first.  I thought to myself, isn’t that what I checked with my insurance company the other day?  No – apparently the insurance company have to check with the doctors about something, they will do that within 24 hours. So you are telling me that even though a doctor has prescribed me some medication, they still have to check with them?  I am sooooo confused.

So let’s hope that my follicles aren’t quite big enough at tomorrow’s ultrasound and I can wait another day.  I am sure the clinic will help me figure it out tomorrow if I do need the shot sooner.

Eeeeeeeeeeek!  Why is it all so confusing???!?!

Research shows that age is not correlated with fertility…um OK

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I’m back on my data hunt for my course project to develop a web app…and I came across a research paper that explored factors associated with fertility in a small district in India*.  The abstract of the paper begins with:

“This paper focuses on the cause and effect relations on human fertility. Here fertility is used as the number of children ever born for a woman….”

Alarm bells rang as soon as I see ’cause and effect….’.  But I was intrigued, so I read on.  The factors that this study looked at were ‘natural factors’ (including age of woman, age of woman at marriage, religion and type of family) ‘economic factors’ (including employment of woman and spouse, income of woman and spouse) and ‘knowledge factors’ (including education of woman and spouse).  I should now mention that this is clearly NOT a piece of medical research, rather came from a journal of anthropology.  Studies that look at non-medical factors can be revealing never-the-less, so here we go…
I loved the result that the more educated a woman and her spouse were the fertility rate lowered.  Basically you can possibly turn this around and say that the less educated you were the more likely you were to have children.  I think we can guess why.  But it is the way that the report concludes which makes it sound rather amusing…
“Conclusion: Higher employment, higher income of both husband and wife and nuclear family system could bring the reduction in the fertility level of the women in Kanyakumari district”

CORRELATION DOES NOT EQUAL CAUSATION – BAHHHHHH

I know that this research paper was probably trying to assess what causes the high birth rate in this particular district, but I think the translation and the way the conclusions have been made make this a paper a funny read if you are into that kind of geekery.  So Ladies – lose the jobs, dumb up your brain cells and knock a few out of your husband too, and don’t worry, age is not correlated with fertility, that is if we want to learn some lessons from Kanyakumari district!

Oh yes and here is another one of my favourite xkcds.

Cancer Causes Cell Phones – Duh!

* K. Senthamarai Kannan* and V. Nagarajan, “Factor and Multiple Regression Analysis for Human Fertility in Kanyakumari District“. Available at: http://www.krepublishers.com/02-Journals/T-Anth/Anth-10-0-000-08-Web/Anth-10-3-000-08-Abst-PDF/Anth-10-3-211-08-416-Kannan-K-S/Anth-10-3-211-08-416-Kannan-K-S-Tt.pdf

Wonky Boobs – a side effect?

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If I could post a picture of my wonky boob I would, but I don’t think the internet needs anymore pictures of wonky boobs, I’m guessing it’s a pretty saturated market out there.

Yesterday I woke up and looked in the mirror to discover my right boob had grown overnight, it also felt overly soft compared to normal.  Chris thought I was exaggerating.  So I didn’t think much else of it.  But this morning it was still like that, so rather than poo pooing my crazy claim, Chris examined it a bit closer.  Upon closer inspection, he concurred that my right boob had indeed grown in size, whilst also laughing in amazement when he came to this conclusion.  Luckily I shared his humour on this one.  I am guessing this is a side effect of the Letrozole (well I can’t think of any other explanation for it!).  I am due to ovulate from the right side, so is it coincidence that it was my right boob that grew?

Will my boob return to normal size and match the other one??? I hope so!  Or perhaps next cycle the other one will catch up – may be I won’t need a boob job after all!  (Just kidding, I don’t really want a boob job, and never have, luckily I like my boobs as they are).dani

Who’d have thought that writing about pudding would be so hard….?

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This is hard. Perhaps hard is not the right word to use, uncomfortable is more appropriate….

We are a lucky couple, we have no secrets (or is that incredibly naive…?) and talking about fertility is not a problem for us. Quite the opposite in fact, we have even found ourselves making inappropriate sperm and egg jokes whilst out at the supermarket. It is wonderful that we can talk so openly about things. We share how we feel, what worries us, what scares us and just as importantly we share our hopes, and the things that make us look forward to this adventure.

Writing appears to be a release for Dani. Looking back at her previous posts I am amazed at the detail she is able to find on the processes and procedures related to fertility treatment. I’m also amazed how openly she can write about these experiences and how they make her feel. It is a good way to help make sense of the things that are confusing, whilst hopefully helping others who are going through the same, or similar experiences. I am pleased she has found a way to express herself, a way to share thoughts and feelings throughout this adventure, although I must confess to some surprise at the details given in her writing, sharing things that I didn’t think she would want to broadcast to the world, things we have talked about but are quite personal.

Then Dani asked me to write a blog post for her site, a post about how I feel…

… I can’t, after an hour the blank page stared back at me. Why was this so hard? I have written a book and am working on another, I have multiple websites and must write at least 200 emails every day, so why can’t I write 500 words about fertility?

The issue isn’t in the topic, it is in the medium. I can talk to the checkout lady at the work food hall about giving sperm samples in a plastic cup (more on that in another post….maybe!) yet I cannot find a way to comfortably write about how I feel. This isn’t some macho ‘guys don’t have feelings’ thing, it is down to the different ways people communicate. I like to talk (as those who know me can confirm), and I have no problem talking to people about fertility and how it makes me feel. Writing is different. Writing is permanent. Writing can be seen by everyone. Writing about my feelings makes me feel vulnerable in a way that I have no control over.

So what? What is the point I am making here? Well I guess it is that everyone has different ways of communicating how we feel, and that people find comfort, or discomfort in the different ways of sharing. Couples starting out with fertility treatment should find ways to communicate that suit them both as a couple, and as individuals. It doesn’t matter what method is used, find what work for you whilst also being sensitive to your partner who may find other channels more comfortable.

Dani might have wanted me to write about how I feel and it turns out that I just can’t do that. Yet in a way this blog is about feelings, feelings of discomfort based on talking about feelings. There is more than a little irony in that.

The best part of writing this post (apart from finishing it) is that I know that she will understand. I don’t hide my feelings and often allow myself to be vulnerable with her, but those feeling are not for all the world to read, they are between me and Dani (and the lady in the office food court…)

Letrozole all gone – waiting for the Ultrasound CD11

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I took my last two Letrozole tablets today.  I haven’t had tiredness today like I had last week, but I do have some abdominal pains so I am sat here with a hot water bottle.  Maybe its a psychological thing, but I think the hot water bottle helps.  I don’t really know if it is my Irritable Bowel Syndrome or a side effect of the Letrozole that is causing it.  Either way, it sucks and wish it would go away.

The abdominal pains started today after lunch, just as I was about to lead a workshop for the afternoon.  I thought about all the possible excuses I could come up with as people arrived.  I looked around the room filled with men all over the age of forty five I decided that I would only end up embarrassing one of them with the truth.  So I stuck it out.  But as soon as I got into the workshop I forgot about the pain.  It was only when I stopped thinking and took a breather for a minute that I realised the pain was still there.

I’ll start my ovulation predictor tests tomorrow, a couple of days sooner than when the nurse suggested.  But I have paranoia that I will have a short cycle this month and miss out on IUI!  I’m not sure the nurse was aware that I sometimes have short cycles of 22 days.  It was only after I got home and read the information pack I thought perhaps I should start the tests a bit sooner.  Yey! Holding my pee in the mornings to pee in a cup time.  Trying to do it in the dark can be fun when I don’t want to wake Chris up too early.

Chris took this photo yesterday - It says so much more about him than a blog post possibly could

Chris took this photo yesterday – It says so much more about him than a blog post possibly could

I asked Chris to guest blog for me this week.  He wants to, he is just not sure what to write.  He is a good writer.  He has a published book already and has been writing a novel in his spare time over the last few years, so he knows how to write well.  Unlike me!  He has some ideas what to write about, but is nervous sharing his thoughts.  I said he should read some of the blogs from other men, perhaps it will help him see from a different perspective how blogging can be a bit of therapy for the mind.  I hope he does write something, but I am not going to pressure him or make him feel bad.  Blogging is not everyone’s cup of tea and I am certainly still learning – so far it tastes pretty good and I can see it fitting into my daily routine.  Let’s see how addictive it can get 🙂

Statistics statistics – infertility and treatment – who to believe?

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Did you know?? Over 1% of all infants born in the US are conceived using Assisted Reproductive Technology*.

Luckily I am an analyst by trade, so I am quite aware of the lies, damn lies and statistics.  I am quite skeptical when it comes to stats that don’t explain the data source.  A lot of websites quote stats and don’t tell you either where the data originated, how it was collected or how it was analysed.  So which stats can you believe?

I am undertaking a small project for an online course in data science – part of my project is to develop an online app.  The app can be anything I like, but it has to be an interactive tool using data.  Seeing as I have been looking at lots of statistics online about fertility treatments, I thought, why not design my own web app that allows a user to interact with all that data out there?  Hmmmm perhaps I am being ambitious.  But I have a couple of weeks to complete it – so lets see!  In the mean time, I have been doing some research on potential data sources…

The most up to date fertility treatment data I have found so far is from the Centers for Disease Control and Prevention (CDC).  (Ha! I didn’t expect to find the data here!!)  Apparently there is an Act that mandates all clinics performing Assisted Reproductive Technology to provide annual data to the CDC.  I think this data is THE most comprehensive (or certainly largest) source of data to understand the factors that contribute to a successful birth when using Assisted Reproductive Technology*.  The CDC has been collecting data since 1995.  All their data is freely available to download along with reports and interactive tables.  The most recent data released is from 2012, collected from 256 clinics with in the US.

When I was reading the CDC 2012 report that was published in 2014 I found an interesting stat that surprised me – In 2010 about 7.4 million women aged 15-44 received infertility services at some time in their lives.  That makes it about one in ten women of that age group.   If I look at all my friends and family on my facebook in that age group, that could be 12 of my friends affected somehow.  Woah.

Anyway, the data provided by the CDC gives stats on almost 98% of clinics in the US.  The link below (provided by the CDC website) takes you to an interactive tool that allows you to see the data for your fertility clinic – they probably report it on their website.  But you have to be careful when you look at the numbers and what they all mean.  I’d highly recommend reading the whole report to help understand it all.  I did not see this data before we decided which clinic to use.  To be honest the number of choices for us weren’t particularly big, but we did have a choice.

The data looks good for my project, I just need some ideas on how to make a useful app out of it.  If anyone has any suggestions on what they think would be a useful way to see the data I’d be interested to hear from you.  I’ll keep you updated on my stats research as I come across it…

Ps. Hope this post wasn’t too geeky!! I can be quite geeky sometimes.

View the latest U.S. Fertility Clinic Data

*Note. The CDC define Artificial Reproductive technology as a procedure that involves surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning then to the woman’s body or donating them to another woman.  They do NOT include treatments in which only sperm are handled (ie. IUI) or procedures in which woman takes drugs only to stimulate egg production without the intention of having eggs surgically retrieved.

When to tell work that you are having fertility treatment?

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Should I tell work about our troubles with fertility?  I had so many questions about this, playing out many scenarios.  Who should I tell?  When is an appropriate time to talk about?  How do you get onto the subject?  What my colleagues would think?  Would they treat me differently? Would they see me differently?  Would they even care?

We had our big team meeting to discuss our annual programme of work two weeks ago, just after our doctor diagnosed ‘unexplained infertility’.  At the time, my head was spinning with all these big questions.  Knowing that we were going to be talking about the coming year and which project each person would be assigned to, I thought perhaps my team should be aware that I had a good reason for why I was less keen to travel for work.  But I chickened out of telling anyone.  It was too difficult to bring up the subject and I had no idea how to raise it.  So I left it at that, I said nothing  We planned our programme of work, and agreed when I would travel.

This year, so far, I have work travel plans to go to Paris, Washington DC, Toronto and Bavaria.  I’m not going to be racking up the air miles gold status like I did in 2014, but it’s enough to be starting with.  It’s enough to probably mess up a few chances to conceive – or if I were to fall pregnant, then I would need to be cautious about how much I fly.  Last year we were very lucky.  Despite my many trips to other side of the pond, there was only really one time where my work travel reduced our chances of success.  It really was quite amazing!

Back to the question of when to tell work?  Well, a good opportunity came along when I had a one to one with my line manager to discuss annual personal objectives.  I struggled to get the words out, but eventually managed to explain that Chris and I were going through fertility treatment.  My boss is very nice and has always joked with me ‘wait ’til you have little Chris and Dani’s running around!!’. So as you can imagine, he provided some comforting words – mostly focusing about what would happen when I do get pregnant, how much support I would get and not to worry about anything.  I felt very comforted, but I could not really talk about what my biggest concern was – taking time off work for appointments and treatment.  I have plenty of leave I can take, but a lot of my work requires advance planning, so with treatments based around my irregular cycles, this may have an impact.

Once I get a bit more comfortable talking about it, I know I will be able to easily talk to him about it.  I am very lucky.  It’s actually myself who is the biggest hurdle in all this.  I have great colleagues who I know will definitely be very supportive and understanding, but it’s knowing how to initiate that discussion I can’t quite get over.  Maybe next week, if I’m feeling brave!