Rebekah #FlipsTheScript

Rebekah is fearless. I know this, not just from the fact that she fights a mean game of dodgeball, but also because she is an infertility warrior. 

Rebekah is here to #FlipTheScript for national infertility awareness week, here’s her story...

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First of all, tell us a little bit about you and your partner….how did you meet?!!

Hi! I’m Rebekah, 32, an Aussie living in the USA!! My Hubby is Will, we seriously have the most unconventional love story…it started as a nightmare. Christmas Eve 2014, I thought I would treat myself to a bathroom remodel. A few weeks later when the construction workers didn’t turn up to start their demolition work I called Will, the project manager from Home Depot overseeing my remodel. I was furious! Not one of my greatest moments, but let’s just say my vocab was very colorful. Six weeks later, two burst bathroom pipes, a leaky shower pan, new downstairs carpet, new ceiling drywall and paint, Will would manage to calm me down from this bathroom disaster every day. He became my new best friend.

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When did you realize that you were facing a diagnosis of infertility, how did you find out and what were the issues that you faced?  

In 2004 I went for my annual OBGYN checkup, I specifically remember the doc saying “oh, wow are you pregnant? Your uterus is quite large!!” Not something a single, 18 year old really expects to hear! I went for an ultrasound, and it seemed like the longest ultrasound of my life – I knew something was wrong.  I was in there for two hours waiting for an explanation.  It wasn’t until my follow up appointment that I found out that I had a 10cm x 8cm x 9cm mass on my left ovary.

I needed surgery. The first question I asked when I woke up from the procedure was “Is my ovary ok?”  They told me they had to remove it. I was left in tears wondering what this meant for my future as a mother.

As well as losing my left ovary, I was diagnosed with Poly-Cystic Ovarian Syndrome (PCOS).  I didn’t truly understand what PCOS meant until several years later when I was 22.  I married young, and began my journey to have a baby. I was on Clomid and stimulants for almost a year, but the pressure of it all contributed to our break up. The stress of timed sex, and not knowing if I would get pregnant caused so much strain on our new marriage that it ended just 8 months after our wedding. For me, it was actually a blessing in disguise.

I suffered from endometriosis and over the years had several more surgeries to remove as much of it as possible, and then another two more surgeries on my right ovary for large cysts. Luckily, my one remaining ovary remained “safe.”

When I was 28 I started to panic, I lost 80lbs in order to try to preserve my eggies and one ovary from any more cysts.  That was when I ventured to the fertility clinic specialist to get a baseline of where I was down below.  I wanted to know what the future held and how I could become a mother.

Although I was single at the time, I realize now that I put too much pressure on myself .  I wanted to be a mother so badly. The yearly surgeries took a toll on my body, and emotionally, I was a wreck.  I thought that freezing my eggs would at least take some pressure off the fact that Mr. Right hadn’t come along yet, and give me the chance to be a mother.

My Reproductive Endocrinologist doctor was amazing; I didn’t get the news I wanted, but she reassured me about it all,: I had low AMH, low progesterone and estrogen, and with just one ovary, I was facing a lot of challenges.  To add to it all, a Hysterosalpingogram (HSG) revealed a mass in my uterus and meant more surgery to remove.

By this point, Will and I had only been dating a month!! It felt weird to involve him so early, but I wanted to be transparent with him since not having children could be a deal breaker for some. Three months after my surgery to remove the uterine mass I went for a checkup…

…and there it was…the big 55mm cyst engulfing my ovary, my nightmares come true. The whole reason I was at this clinic was to be proactive in saving my ovary and getting eggs, and now it might not even happen – I was devastated.

I started hormonal treatment, but when I went in for a checkup we found it wasn’t working and the only choices was MORE surgery.  But as I was prepped for surgery I finally got the good news I had been waiting for, the cyst had finally started to shrink!  So the doc cancelled the surgery and when I went back for a follow up appointment, not only had the cyst continued to shrink, but I was about to ovulate! WHAT! I couldn’t even believe it!! And this was my opportunity!

I was faced with the ‘now-or-never question’…do I get a sperm donor? Do I see if my new-ish boyfriend of a few months is willing to do the deed??!

I took all the information I needed discussed it with Will, and well, he was 100% on board.  I got pregnant that cycle with my now 2-year old son, Wyatt!

Where are you on your infertility journey now?

After I gave birth to Wyatt, I knew I wanted more children. I had a complicated pregnancy and birth, but we returned to the fertility clinic at 6 months post-partum to discuss number trying for number 2. But as I stopped breastfeeding I got pregnant, without intervention. Unfortunately that pregnancy ended in an interstitial pregnancy (this is a uterine, but ectopic pregnancy: the pregnancy is located outside the uterine cavity in that part of the fallopian tube that penetrates the muscular layer of the uterus.) I didn’t even know what an interstitial pregnancy was.  I went for a D&C (Dilation & Curettage, a surgical procedure to remove the fetus) and also opted to take Methotrexate.  This is a drug usually given to cancer patients, but as the pregnancy was in a challenging location the drug ensured that no more cells from the pregnancy would remain.

Two weeks after the treatment I began to experience severe pain on my left side (keep in mind I didn’t have a tube or ovary on the left).  I discovered that my hCG beta levels were still rising, and not declining like the should have been; this meant that I was pregnant but they didn’t know where. I presented to the Emergency department with severe pain and they admitted me for pain management. Being that I work in healthcare I knew this was a “BS” diagnosis, they didn’t believe I was in pain and in their eyes had done everything- Ultrasound showed no internal bleeding, D&C and Methotrexate- what else could be done?

The doc told me “well I can take you to surgery but I’m going to pull your right ovary if we do.” My heart sank, I was in pain, but I did not want him to just pull my ovary because that would put me in to auto-menopause and shut down my baby factory.  I went to bed to try and sleep off the pain. At 2 am I woke- I thought I was dying. I have never experienced pain like it in my life. I rang the buzzer and the nurse came. She was cold and heartless, standing at the door she told me “your Dilauded isn’t due for another hour.” I knew I didn’t need more pain meds, I needed a doctor, RIGHT NOW! The pain was like no other. 45 minutes of excruciating pain, I finally I found someone to help me as they walked past my room, they called rapid response, and within 10 minutes I was being prepped for the OR. My uterus had ruptured and I was bleeding internally.  With my 6 month old baby and husband at home, I didn’t even know if I was going to see them when I woke up – not to mention having more children. I was terrified.  Thankfully I am still here to tell my story. With another surgery under my belt, my journey just got even more complicated.

Four months post op I returned to the clinic to talk about trying to conceive #2… again!! I was scheduled for another HSG to check the integrity of my uterus after the surgery, but amazingly against all odds, I was actually pregnant with my now 7 month old daughter, Miss Emma.

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Has infertility changed your relationship with your partner? 

Will has been super supportive. But given he had “no issues” I always felt guilty for having all the doctors’ appointments, the bills and meds. I don’t think it really changed our relationship, but at times I did feel like I was a bit of a burden.

How has infertility impacted you financially? Did your healthcare insurance provide coverage for infertility treatment?

It makes me nervous to even think about how much we have spent between surgeries and medications! When I was on progesterone to support my three pregnancies, each time it was about $800/month.   My insurance didn’t cover anything; and to date we have spent about $40k.

How have you taken care of yourself physically and emotionally during your struggles?

After my first miscarriage I ate my way through every emotion. At the time, it seemed like a great idea until I found myself weighing in at about 240lbs. I knew I would never get pregnant weighing that much with PCOS, so I lost 80lbs, it was life changing. Emotionally, I felt so much better, and physically I knew I was helping my body.

How have your friends and family supported you through your journey?  Have you had any experience of lack of support or misunderstandings?  

Looking back, I wish I had seen a counselor or therapist to help deal with my losses, but sadly I didn’t have much support from friends and family, I was left to cope on my own. The whole miscarriage topic is so taboo, I was scared to even bring it up, and felt like I just had to sweep it under the rug and move on.

Telling someone who just lost their baby or is trying to get pregnant that “it was meant to be”, “God has other plans” or “everything happens for a reason” did not help.

I had this longing for a baby and I couldn’t understand why this would happen, it was horrible. I wouldn’t wish any of this on anyone.

What has been the hardest point of your journey and how did you deal with it?  

I think knowing that some things are just out of our control (as hard of a pill that is to swallow sometimes) taking things one day at a time, and just trusting the process helped me keep faith. Not giving up on my hopes of being a mother was my inspiration.

If you could go back in time, what advice would you give yourself?

I wish I had been gentler with my emotional health, and been more public about my journey. I am amazed at how many people have been through the same thing, and instead of hiding it and pretending like it isn’t an issue we should support each other.

As it’s national infertility awareness week, what message do you want to share about infertility to the general public? 

The most difficult part about my journey was when people told me “don’t worry it will happen.” Thankfully my story did happen, but I have friends that haven’t had their sticky bean yet.

Is there anything else you would like to share that I haven’t asked you about?

While I was going through my journey I loved reading your blog, it gave me so much inspiration and peace knowing there are others out there that are also in a similar situation ❤

Rebekah, I think you have made me cry twenty times already.  Through all your battles you have come out of the other side every time a true fighter.  It might not have felt like it at the time, but I can see it from how you never really gave up.

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Please leave a comment or message of support below for Rebekah and Will 🙂

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Period after HSG and miscarriage

If you are not into reading about periods and period blood you should stop reading this now and come back tomorrow when I will be talking about less gross things in life 🙂

This is my first period since my recent Hysterosalpingogram – HSG – test.  This is also (probably) my second period since my miscarriage.  And it’s a weird one!!  It is on schedule – for which I am truly grateful for (isn’t it funny how we celebrate the little wins on this journey!!).  But this period is weird so far.  The pains are different, I cannot explain what is different about them, they don’t hurt so much, but the pain ‘rumbles’ inside me rather than the typical’radiating’ and ‘sharp’ pains I get from my normal period.  The blood is a heavy watery-pinky-mucusy mix.  Normally I get dark brown or red, thick and clotty blood.

So I got onto my friend google (like you do in a situation when weird stuff happens to your body).  I extensively searched for possible causes and whether this is normal or something I should call the nurse about.  My biggest concern is that my uterus lining won’t be up to scratch in preparation for our next round of IVF.

The best and corroborated explanation for this unexpected weirdness is that it may be an indicator of anemia or low iron stores and/or unbalanced diet/suffer from poor digestion.  Both of these things are plausible in my case, but can be easily resolved with some supplements.

I was worried it could be associated with the HSG procedure or the miscarriage, but it seems to not be the case.  So nothing to  worry about or to call the nurse about specifically, but I will mention it when I speak to her next.

Crisis averted, thank you google!  Now….pass me the liver and spinach 🙂

Random happenings on our first night out in a while

I am trying hard to keep my eyes open, but I don’t want to miss out of NaBloPoMo15. I have a bit of jet leg confusion going on with my body right now….it has no clue what time zone it is in.  All I know is that I am currently in Germany and am due to start working in approximately 8 hours :-s

Speaking of confusion, we went out with friends to have a couple of drinks on Friday evening, at our new local brewery.  It opened up at the end of our road which is perfect because we can both drink and not drive!  During the evening, I went to the toilet only to discover blood in my knickers.  Not much, but enough to make me wonder what the hell was going on. I was on cycle day 11. That’s not supposed to happen! I had a pad with me so it wasn’t a big deal.

—–Note——Last night I fell asleep at this point whilst writing this post!  I woke up at midnight with my laptop still on my lap and I had slept sitting up in bed for an hour!! There were random sentences and words typed after this point.  Who knows what crazy things I was thinking semi-asleep! So I never made it to posting this on Sunday. Whoops- there goes my blogging every day in November promise to myself!  Oh well good intentions and all that…anyway…back to the story!!!——

After freaking out a little bit, realising that there is nothing I could do, and I wasn’t in any pain, I returned back to my friends.  They were talking about going to a strip club.  I’ve never been to this kind of club before, everyone else had.  I panicked  – I didn’t want to go far from home just in case I started bleeding heavily.  So I made up an excuse that I couldn’t possibly go to a strip club with my husband because it would be weird! As you can probably imagine, this excuse wasn’t a sufficient enough reason to void the trip to the club. (although it is true that it would be a little bit weird to go to a strip club with my hubby!)  Eventually, I explained why I really didn’t want to go.  And it was kind of weird because I couldn’t explain it well.

My friends are lovely and understood, but really I couldn’t understand it myself.  It was the first time Chris and I had been out for a couple of drinks together in quite some time.  Why did my body have to go and ruin it?!

The bleeding stopped the next morning.  Who knows what it was and why it happened.  Perhaps it was a delayed response to the HSG test.  One thing I do know is that I am getting used to the unexplained!!!

I survived!

Of course I survived…no one dies from an HSG right?!?!

As I sat on my own in the procedure room waiting for the doctor I noticed just how dated everything in this room looked.  I also noticed two capsules stuck with cellotape onto the wall behind the head of the bed and the other on the needle disposal box.  I was intrigued because they said ‘amonia’ on them.  I wondered why these capsules were stuck there.  As more time passed I finally figured out what it was for – smelling salts for passed out patients! There was a piece of paper stuck on the wall that gave steps of what to do in an emergency – the kind of emergency when  patient passes out and you have no clue what is wrong with them.  The first step said: Keep calm! I found this quite amusing that a doctor/nurse needed to be reminded to keep calm first of all.  One of the other steps described how to use the ammonia capsule to see if the patient ids responsive. There was another sheet of paper stuck on the wall next to these emergency instructions, giving instructions for what to do if a patient was having an allergic reaction.  I suppose some poor people in the past have found out that they truly are allergic to shell fish or iodine as a result of this HSG procedure! So I guess you can die from an HSG afterall.

After waiting for 20 minutes ready to go, the doctor came in and introduced herself – as if I had never met her before.  She didn’t recognise me at all.  Even with my British accent she didn’t recognise me and proceeded to ask me questions as if I was a new patient.  Considering the number of times she has seen my vagina and cervix (I can count 8 monitoring appointments and 2 inseminations) I was a bit upset by this fact.

So we got down to the business….and the procedure hurt so much that I had tears in my eyes.  It was all over after only 5 minutes, but they were a painful 5 minutes.  I peeked at the video of the x-ray as she was cleaning me up.  I could see my upside down uterus and the dye free flowing through my tubes.  And then something weird happened – my uterus flipped upright at the end of the procedure!  I felt her do something weird, did she manipulate my uterus? Or was it just the xray moving to a different position?  Logically the latter doesn’t make much sense…but then again neither does the manipulation! I’ll know exactly what happened when I go for my baseline ultrasound in the new year.

Good news is that I passed the test!! IVF round 2 is on in the new year!!

After the procedure I went back to the waiting room to pick up Chris because he wasn’t allowed in with me.  And there sitting in the waiting room was someone I knew.  It was funny because Chris was sat with his back to them and he didn’t realise he knew them.  It was a bit of a bizarre moment because I guess we didn’t really know what to say to each other.  I don’t know why they were there specifically, but I feel a little sad that infertility affects so many of us around us we just don’t know about. Today was just another reminder of that fact.  Infertility – you truly are a sneaky bag of crap.

The dreaded HSG

I am not going to pretend to be brave here.  I am actually a little bit nervous about tomorrow’s HSG procedure.

The Hysterosalpingogram – AKA the HSG – is an x-ray procedure to check whether the fallopian tubes are open or blocked, and if the uterus is normal.  Iodine dye is inserted into the uterus to allow a contrast to be seen on the x-ray.  It allows the doctor to see on the free flow of the fallopian tubes and any abnormal lining of the uterus.  The procedure is relatively quick -about 5 minutes.  But for me it really was painful.  I took 800mg of Ibuprofen an hour before the procedure as instructed – it still hurt.

For my first test I was naive and had no clue it might be painful, so I wasn’t nervous.  But now, knowing what I know now!  I AM anxious!  The crappy thing is that Chris isn’t allowed in with me, there is nothing more I would like than for him to hold my hand whilst the dye is injected and I feel that burning cramping sensation run through my body.

When I called the clinic to make my appointment the receptionist who now recognises my voice (OK so I bet they don’t have that many Brits as patients) asked me why I hadn’t had an HSG already.  I pointed out I had one in January but I had to have another one after the possible ectopic pregnancy thing and how much I was dreading it.  She was very sweet and apologised, her tone also changed to be more somber for the rest of the call.  Bless, it was nice that she sounded to care. It must be a hard job working in a fertility clinic – it must be a bit bi-polar with so many highs and lows everyday.

Perhaps I will do some meditation to help me relax a little before hand :-s

On the positive side about this – once we have the results of this test we can go ahead and hopefully firm up plans for IVF round 2.

My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

IVF round 2 – December/January 2016

We met for our follow-up appointment with our doctor yesterday.  There were no surprises.  Which is a good thing!  So the plan of attack is a fresh round of IVF…get a couple more embryos frozen:

  1. Schedule a Hysterosalpingogram (HSG – if you would like a refresher what this procedure entails, check out my post from last time here) – I will do this as soon as I start my period (who knows when that will be!!!).  It is very unlikely that my fallopian tubes will be blocked, but she wants to be sure.  Fair enough.  However, I am NOT looking forward to this test.  Last time I was completely naive to the potential pain ahead for this particular procedure, now that I know exactly how much it can hurt I’m a wee bit nervous!
  2. Plan to start Birth Control Pills to regulate my cycle in December with an egg retrieval date for early January 16.  There is a period of 3 weeks that the embryology lab is closed over the Christmas period.  Seriously – how unlucky am I?? Last time my cycle was delayed because the embryology lab was being refurbished.  Oh well – I guess everyone needs a holiday.

There is a potential chance we could start Birth Control Pills in November, and do a retrieval before Christmas, but I think it will be close to my 3 month period of ‘no baby making’ because of the methotrexate shot I had affecting fetus development.  I have been researching this, and I would be willing to go ahead a week or two earlier because doctors are overly cautious with this 3 month time stamp.  As long as I keep taking my folic acid I should have no problems.  However, this is something to be discussed once we have a better idea of a) when my period is likely to be and b) assuming my HSG test is all clear!!!

There will be no change to my protocol, perhaps a slight increase in some of the medication dosages to mature more of my eggs.  As a reminder from our first round we had 9 eggs retrieved, 6 of these eggs were mature, 4 of these eggs were successfully fertilised by ICSI, 2 good 8 cell embryos were transferred on day 3, and 1 of the 2 embryos made it to Day 5 blastocyst and was frozen.  Our doctor mentioned that she would consider waiting to Day 5 for the transfer this time around, especially as our frozen one is Day 5 – she wants them to be the same.  We like this plan!

This gives me some time to concentrate on work for a little while, get my body healthy and start growing some strong eggs!  What is amazing is what the horrrorscopes says for me next week…

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I was already planning on going back on my sugar free, healthy diet next week! Freaky! Sooooo….which old friend should I Skype on Sunday next week and wants to reveal a long-held secret to me??!!!?!

You might be upside down, but you’re gorgeous to me dear Uterus

I have been told by several doctors that I have a beautiful cervix, and today I discovered that my uterus is just as “gorgeous”.  Well these were the exact words of my Reproductive Endocrinologist (RE)!!!

Today was my hydrosonogram (also known as a Saline Infusion Sonogram).  This procedure was the final test I required prior to our IVF treatment.  The hydrosonogram is a procedure where the doctor inserts a catheter into the uterus and injects saline into the uterine cavity whilst performing a transvaginal ultrasound.  The water shows up as dark black on the ultrasound against the white endometrial lining.  This allows the doctor to look for smooth edges of the uterine cavity.  If the ultrasound shows an edge that is not smooth then these rough and lumpy edges maybe polyps, fibroids or scar tissue which could be a possible problem for embryo implantation.

The procedure in itself was an interesting experience.  Greedily, I had three doctors in the room as well as the nurse! The three doctors were: my RE, the doctor whose name I can’t pronounce and performed two of my IUIs, and one of the male student doctors Chris conversed with at our last IUI.  I wasn’t quite sure if my RE was overseeing the procedure, or she had called in the other doctor because she was more familiar with my cervix and therefore inserting the catheter.  Either way, there were a lot of people clambering around my vagina in this one tiny examination room.  It was rather amusing.

First the doctor with the unpronounceable name inserted the speculum, and then peered up from between my legs and showed me the ‘flexible’ catheter and said, “remember this?  Was it this one we used before?”. Ummmm….. “I think so??!!!” I replied.  How am I supposed to know these things???! When she inserted the catheter I could hardly feel it at all.  The speculum was removed with the catheter still in, and then she inserted the vaginal ultrasound ‘wand’.  We could see the catheter on the screen, there was a lot of excitement amongst the doctors.  The nurse was tying to hold something in whilst the two female doctors discussed tactics of why it wasn’t distending with the saline, perhaps the catheter was up against something, my uterus wall…or perhaps it was bent somehow.  Either way, when they removed the magic wand, the catheter came out.  They apologised and said they would try again.  So back in the speculum went (this was only the painful part, no different to a pap smear), the catheter went back in, speculum was removed, magic wand went back in.  And there was a gaggle of excitement as this time it had clearly succeeded; the saline filled the uterine cavity and I could quickly see there was a nice oval shape, with no rough edges on the screen.  My RE told me my uterus was “gorgeous!”.  She took a few shots on the screen, and showed me in 3D my uterus.  With this image it actually looked more like a normal shaped uterus that you see in biology books rather than what I saw on the screen during my HSG x-ray.  You can see from the image from my HSG below that it was upside down.  Today’s ultrasound, it was the right way round and looked almost perfect.  Text book.

My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

I don’t have a copy of images from my ultrasound from today, but I have found a link that shows the difference between a normal and abnormal result from a hydrosonogram.

After all the excitement and the nurse had cleared everything up, suddenly my RE exclaimed! “Wait!  I need to see her ovaries so I can calculate her dosages!” So back in the stirrups I went and the nurse re-prepared everything for another peek inside using the magic wand.  We had a very quick look at my ovaries to count the number of follicles.  As today is Cycle Day 7 I had about 5 or 6 follicles in the right ovary and then a dominant one in my left.  She seemed pleased with this. I mentioned that I knew it was going to ovulate from the left his month because I could feel it.  I can always feel pain in my ovary on the left side when I’m ovulating from this side.  I’m not sure why.  The doctor who’s name I cannot pronounce seemed very interested in this fact. I left wondering why.

All in all, I left with a sense of relief.  But my feelings were mixed.  I was relieved that we can still proceed with IVF and there was nothing seriously wrong that would require surgery, but I had the feeling of frustration. In the back of my mind, we still don’t have an explanation for why we have not been successful in conceiving so far.  Unexplained infertility can really niggle away at your mind.

On a side note, today I have experienced two more pregnancy ‘announcements’.  One whilst I was at the fertility clinic, a lady found out she was being released from the fertility clinic to her OB/GYN.  She kept asking the nurse if she was sure, then she cried a lot (tears of happiness of course) which made pretty much everyone else around cry too.  Including myself.  And secondly another of my colleagues who recently married is pregnant.  Soooo all I’m thinking is – who is the third?  They usually come in threes, right??!

The $$$ lowdown

I have created a new page on my site that sums up all the costs of our infertility journey so far.  I will keep this up to date as much as possible…I have copied the text from it and pasted it below (or here is the link to the page)

We are very lucky that our medical insurance includes coverage for the treatment of infertility, including IUI and IVF.

We are being open and honest about these costs because it is important for people to understand the difference having insurance coverage can make.  Only 15 states in the US make it mandatory for insurance providers to cover infertility treatment, and even some of those are extremely limited.  There is much debate on whether infertility should be covered as an essential health benefit.  There are many campaigns ongoing to change state law in this regard (www.resolve.org)

There is definitely a lot to be said about the psychology and stress to infertile couples over spending this vast amount of money if they do not have insurance coverage for infertility.  Chris and I find this process stressful enough as it is without the added burden of the actual cost.  I cannot even begin to imagine what it would be like without coverage.  At each stage of our journey we have had to get approval from our insurance company and with having an ‘unexplained’ diagnosis we have always been nervous that they will not cover us.  However, we have been fortunate so far. Fingers crossed they will cover our IVF too.

Item Full cost Insurance covered? Final cost to us
Ovulation Kit (pack of 20) x3 $70.00 No $70.00
Pregnancy Tests (various types) x4 $85.00 No $85.00
Basal Thermometer x1 $13.00 No $13.00
Pre-seed Lubricant x1 $24.00 No $24.00
Chris blood tests $572.00 Yes $10.25
Dani blood tests $560.00 Yes $14.43
Reproductive Endocrinologist Consulting Fees (Doctor visits) x3 $340.00 Yes $5.85
Ultrasounds x4 $900.00 Yes $71.72
Anti-biotics for HSG $15.97 Yes $1.60
Sperm Analysis $110.00 Yes $1.53
HSG $835.00 Yes $29.18
Letrozole x3 $8.53 Yes $0.86
Ovidrel x3 $371.16 Yes $37.11
IUI x3 $765.00 Yes $36.81
Sperm Wash x3 $320.00 Yes $16.80
Progesterone suppositories x3 $147.00 No $147.00
Running Total* $5,136.66   $565.14

A note about our healthcare insurance.  We pay a 10% co-pay for each bill of the ‘in-network’ cost, not necessarily 10% of the whole cost.  Our current infertility clinic (or ‘provider’ as it is also called) is ‘in-network’ so we get extremely preferable rates; for example our new doctor visit it was $190.00, our insurance paid $0, so we paid $0.  This is because our insurance company has negotiated these types of ‘bulk’ discounts in advance with our provider.

Choosing an ‘out of network’ provider can increase overall costs.  There is one other fertility clinic in our area we could have chosen, but is out of network.  It was something we considered, but we went on recommendation and did not think too much about this at the beginning.

Currently my insurance premium is ~$500 a month, plus my employer contributes ~$1100 a month, this covers both Chris and I for all medical expenses including dental and optical.

*As of 10th May 2015

Surprise surprise!!!! IVF!

Well my blog post title has given the game away, so in summary…our next step will be In-Vitro Fertilisation!

This morning we met with our RE who reviewed our progress so far, or lack there of.  Our tests were all normal, the three IUIs all went according to plan (except of course for the pregnancy part), I responded well to the letrozole with 2-3 follicles, Chris had awesome sperm.  We remain unexplained, but she does still suspect endometriosis.  If my period pains were so bad that they affected my life and I wanted that to change then she would recommend a laparoscopy.  This surgical procedure comes with risk, side effects and can take several months to return to normal, so if my periods were so bad this would be the way forward, however, in my case the benefits are unlikely to outweigh the downsides.  So she recommends we move straight to IVF.  She explained the overall process:

Week 1 to 2 – after menstruation I start birth control pills for about 14 days, these help to control my hormones

Week 3 – start injectable medications to control ovulation and stimulate follicles to grow – many many more than the 2-3 that were stimulated with letrozole in order to get the best chance of retrieving some ‘good eggs’.

Week 4 – continue injectable medications…have ultrasounds every other day to monitor follicle growth, along with blood work to monitor hormone levels.  When the follicles are ready, we will inject the hCG Ovidrel trigger and 36 hours later I go for egg retrieval surgery.  Under sedation my eggs are extracted from my ovaries.  Chris provides his sperm and my eggs are fertilised in-vitro.  After the eggs have been fertilised, the embryos grow for a few days under close watch.  Then if they survive, one or two embryos are transferred directly into my uterus.

Week 5-6 – start injectable progesterone until the big pregnancy test either says – “woohoo you are preggers”! then I stay on progesterone, or…”booooo it’s a BFN my friend”, then we will…..well, let’s not go there right now.

This is everything I expected her to say, except for two things slightly different.

  1. First, I need to go for a hydrosonogram.  This procedure will produce a 3D ultrasound of my uterus.  I will have this last test because I have a severely retroverted uterus they could not see it very well on the HSG X-ray, they want to double check that there is nothing preventing the implantation stage.
    My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

    My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

    I have been promised this does not hurt quite as bad as the HSG.  THANKFULLY!!!!

  2. Secondly, she thinks it would be a good idea to do Intra-Cytoplasmic Sperm Injection (ICSI) because we are ‘unexplained’.  ART_logoThis is a procedure where a single sperm is selected and injected directly into the egg rather than normal IVF where the sperm is placed near the egg.  This procedure is an extra $2,420 so we need to check whether our insurance would cover this or not.

Talking of costs….it is going to cost $9,075 for the IVF which includes office visits, endocrine monitoring, ultrasounds, retrieval, transfer and first pregnancy test.  Plus, it is an additional $400 for the anaesthesia. Medication will be approximately $4,000 to $6,000.  Then the ICSI procedure is $2,420.  Cryopreservation is $1000 then $60 a month for any embryos frozen.  Yikes!!!!  But we roughly knew this anyway, it’s just a bit scary seeing it listed out like this.

So for now, we start the negotiating with our insurance and the diary planning. It’s looking like a late June start.

Ultimately, today I walked away with this one key figure she gave: for us – a 50% chance of success.  In my mind that is pretty amazing.  I’ll take that.  I’ve always been a glass half full kind of girl, lately it’s been half empty, today I think I’ve been topped back up 🙂

Thank you for all your support and kind thoughts so far, I’m feeling pretty encouraged this will work!

Infertility Tests – wands, needles & fishy dye

I scheduled my initial round of infertility tests as soon as I could, but due to work commitments and travel back to the UK for Christmas the tests ran over two more cycles.  Over December 14 and January 15 I had a vaginal ultrasound, cycle day 3 blood work and HSG.  Chris booked his sperm analysis in January.

Vaginal Ultrasound. An ultrasound wand was placed in my vagina to check if I had follicles in my ovaries.  And I had many!  The ultrasound also showed that I was just about to ovulate from my left ovary (which is the ovulation pain I had been feeling earlier that day – it’s nice to know that I can tell which ovary I am ovulating from!!).  The doctor confirmed everything looked healthy and normal. Woohoooo!

Cycle Day 3 blood work.  I was horrified at the amount of boxes that had been ticked on the blood paper work….I calculated at least 4 vials of blood.  I am not good with needles.  I cannot bear to look at them without feeling faint.  Just before I deployed to Iraq I had to ensure all my vaccinations were up to date (all four million of them).  The army nurse asked me how I wasDani thought with needles.  I replied ‘not particularly good’.  He said ‘well now is the time to overcome your fear, I’ll tell you when you can look away’, and then immediately proceeded to jab me four times, after he just laughed, ‘see?  I told you would overcome your fear!’.  I walked away dizzy and attempted to find the toilet to be sick.  I also have donated blood once, and passed out after giving 1/2 a pint.  Apparently even when I voluntarily want to give my blood away my body won’t let me!  This time, for these particular blood tests, the nurse was lovely (despite him coming to the conclusion that I ultimately kill people for a living), he put me at ease straight away.

A big difference between the UK and the US, is that here in the US it is possible to get your blood test results online before your doctor sees them and discusses what they actually mean.  I am not a doctor and I can barely pronounce the name of the tests, so using the internet to help me decipher the results was a TERRIBLE idea!  In the UK you call up your doctor and then a receptionist will tell you if the results were normal or you need to book an appointment.  I am not sure which way round I prefer!!  Anyway, my results were normal.

Hysterosalpingogram also known as a HSG.  I’m not sure any human being would want to have this test performed out of choice. This procedure is where dye is injected through the vagina into the uterus and by using x-rays to see if the fallopian tubes are blocked. I was given an information sheet about the procedure, I felt prepared, and took the 800mg of Ibuprofen as prescribed an hour before.  My friend accompanied me as it recommended that you have someone drive you home afterwards. I am very pleased she was there with me, I couldn’t have gone it alone.

I was a bit nervous, naturally, but it wasn’t until the nurse asked me ‘Are you familiar with the procedure?’, I said, ‘yes, I read up’.  The nurse looked a little worried ‘uhoh you haven’t been reading the internet have you?’.  Now that part made me nervous!  I had not thought to look up the procedure online because the info sheet given to me was sufficiently detailed.

The procedure was very uncomfortable, and painful at parts, it felt like my insides were on fire and I had immediate cramping.  I could just about see the screen with the x-rays on it and could make out that my tubes were flowing freely.  Great news!!!! But the doctor asked me ‘did you know you have a retroverted uterus‘? Nope, no I did not know that.  Well everyday is a school day after all.   The only question I had on my mind at that point, was  what does all of these results really mean?  What will Chris’s results be?  I felt sad and guilty that Chris would be feeling more pressure about his sperm analysis.

Google – Jekyll & Hyde?  After my final test, I went home intrigued, and googled “HSG”.  I am so glad I did not read any forums before going for this procedure, there are some sad and terrifying stories out there.  The nurse was right to look so worried.  A lesson was certainly learned here – I’m going to  keep trusting in the people I am paying lots of money for to look after me.  Maybe I’m being naive, but google isn’t always your friend.