Tag: Infertility treatment

Our options widen…but not on the kids’ parties front

1 Comment

I had a great email today from our legal department.  They told us that the US government forsees no legal impediment based on our visa status for adopting in the US, either domestically or internationally. They are also aware of two other families from my organisation who have previously adopted successfully, however one family had a few complications over the legal issues.  However, it sounds like if you have money to burn, the legal issues will disappear.  I don’t mean in a corrupt way, but rather the more you pay the more you get in terms of service.

We asked our legal team to help us look into our visa status so we would know if it was actually possible for us as ‘legal aliens’ to adopt if we decide to stay in the US.  It took about three weeks for everything to be double checked, but it was worth the wait and now we know….we can adopt!

I also had a phone call from our IVF nurse co-ordinator today.  We have an appointment next week with her to go through the whole process in more depth than the doctor did – apparently it will take about 1.5hrs!!  She sounded very friendly and helpful (I guess you have to be do that job!)  She also informed me something the doctor forgot to tell us last week.

The Embryology lab is going through a refurbishment in late June/early July!

Fortunately it sounds like it won’t affect us as we would expect an egg retrieval in mid July.  I hope they don’t over run their re-furb or delay it because that would suck going through all that just to have our cycle cancelled because of some lazy painters!!! But I’m sure they wouldn’t let something like that happen.

I’m currently on Cycle Day 19 and I’m feeling great.  I have had the odd pain, but nothing like the sharp pains from the last two IUI cycles.  Fingers crossed they don’t come back that it was just a side effect of the progesterone and nothing else nasty causing them.  Our break from trying to conceive has been quite fun; next weekend we are planning a trip to our local beer festival and Bush Gardens to try out their new roller coaster ‘Tempesto’!

Physically the break is doing me good.  Mentally, I’ve still had a few odd moments.  This last weekend we didn’t go to our friend’s daughter’s 3rd birthday party at the petting zoo.  Now, I love animals. Love love love them, and who doesn’t love to pet animals!  But I freaked out at the last minute about going someplace where everyone else will have a kid with them and we would be the odd ones out.  I mean, why would anyone go to a petting zoo without a kid in tow?  If it had been a party at their house or somewhere more neutral in that sense I wouldn’t have had a problem. It was just the idea of feeling like we didn’t belong, with the potential for random strangers asking ‘oh which one is your kid’? Or, like the time a random granny noticed us at a Christmas tree lighting ceremony, told us ‘It’s OK that you don’t have a kid’. Yeah, I’ve been there before….and right now it is not for me.  I felt bad that I couldn’t pull myself together to go, I hope they can understand.  I’m sure they do.  I just wish I didn’t feel like this.

So to end this post on a positive note…here is a picture of a cheeky goat that we know.

Who wouldn't want to pet this cheeky goat? Oh that would be me, big chicken pants.

Who wouldn’t want to pet this cheeky goat? Oh that would be me, the big chicken pants.

The $$$ lowdown

2 Comments

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!

12 Comments

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!

The great dismal swamp – not quite so dismal

4 Comments

For the last nine days I’ve had a break from blogging and we are on a break from trying to conceive.  I needed both a bit of mental break and a physical break, trying to catch a breather in preparation for our ‘Next Steps’ appointment with our RE tomorrow.  But taking a break hasn’t been plain sailing.  I have had a couple of ‘break downs’ in the last few days, mostly ending with me snapping at Chris and/or crying as a a snivelling mess.  Why? Because I hate this limbo ‘not knowing’ business.

Unexplained infertility is a sucky non explanation for why we haven’t been able to conceive so far, even with a little help.  There are so many questions I have that may never be answered…and it is difficult to get out of this hole of asking “why?” and “what if?”.  Chris has been amazing, he is strong and can handle my random outbursts of crying, reminding me not to bottle all up.  But I can see it in him too, he has the same questions as me.  I know at tomorrow’s appointment we will not have many of these questions answered immediately, but it will help make the path a little clearer in the next steps.  It’s the baby steps I need to help keep me sane, a break has so far been physically good for my body but mentally it has been hard.

So where better to get one’s self out of a dark hole?  The great dismal swamp…this place can take your breath away, and can be anything but dismal.  The swamp is huge, over 112 000 acres and in the heart of this wildlife refuge is an amazing lake, lake Drummond, that is an impressive 3000 acres.  Apparently it is one of two only natural lakes in Virginia.

Lake Drummond at the great dismal swamp

Lake Drummond at the great dismal swamp

The swamp also has a lot of history steeped in it, particularly as this is where many fugitive slaves lived, under the cover the swamp land.  I’ll tell you something, the mosquitoes are horrific in the summer.  This wildlife refuge is always so quiet, and it is easy to quickly feel like you are in complete wilderness, it is anything but dismal.

This time of year is renowned for rare warbler birds and many stunning butterflies.  So today we took our bikes and got on the trails.  In addition to the many sightings of deer we were pleasantly surprised to see thousands of hairy caterpillars, munching so loudly it sounded like it was raining in the swamp.

Hundreds of hairy caterpillars and wishes too!

Hundreds of hairy caterpillars and wishes too!

I feel refreshed this evening after our mini trip to the swamp.  No more tears, I’ve promised Chris this, for at least a few more days anyway 😉 I cannot tell you how much I am looking forward to our appointment tomorrow…..

The wish

Chris got some cracking photos today: The wish

Understanding: #YouAreNotAlone, #NIAW, #WeAreNotAlone

8 Comments

NIAW-CMYK

The baby shower

I sit in the corner, quietly observing the group, hoping no one talks to me and asks me how I am.  I’ve been dreading this day for weeks.  I am not really sure what the etiquette of baby showers is.  I’ve learned about wedding, birthday parties, funerals and baptism etiquettes, but as a Brit living in the US, baby showers are new to me.  One thing I do know for sure is that sobbing away in the corner, trying to make sure no one sees is not part of the celebrations.  Why all the tears?  Because this should be my time for my baby shower.  I don’t mean to sound self-centred, but you see we have been trying to conceive for 17 months now.

Like the singleton table set aside at weddings, baby showers should come with a table reserved for infertiles.  After all, 1 in 8 couples of reproductive age could have a seat at this table.

My tears are short lived, of course, as the excitement of adorable ‘mini-me’ baby gifts and funny games take the course of the day.  Our friend who has that beautiful pregnancy glow to her skin, was happy.  So happy.  For me this was all I needed to prevent me from drowning in my own misery and enjoy the party.

Unfortunately, it seemed that not all of us could cope this well.  One of the guests left within 10 minutes of arriving.  She had driven hundreds of miles for the baby shower.  Why would you drive all that way just to stay for 10 minutes?  And so the speculation and rumours started.  My husband interjected with a suggestion “Perhaps she is trying for a baby and found it all too much?”.  We both looked at each other with that ‘knowing’ look.  Sadly, no one in the room bought this excuse, dismissed it and the speculation continued. The departing lady, who I did not know personally, may have been infertile, or perhaps she had some other good reason for leaving the baby shower as quickly as she had arrived.  Statistically, the chances were high that at least two of us at the shower were suffering from infertility. With both my husband and I in the room, it was easy to wonder who else is silently suffering?  If it was this lady, I wish I could have told her:

“You are not alone”

I would have held her hand, hugged her and told her it’s OK, I understand, we can face this disease together.

wish2

But for some people experiencing infertility, a hug from a stranger will never make the pain and hurt go away.  I know this.  I feel more comfortable on my infertility journey than I ever have been because I discovered a place where hugging strangers is quite a common place. The blogging world.  I have been surprised to discover comfort and understanding from the ‘virtual’ hugs, support, discussion and love from the biggest group of ‘strangers’ I know.  It’s not just strangers that have joined us on our journey, but a small group of family and friends too.  The ability to communicate, open my heart and share my feelings has been a therapy for me.  But not everyone we care about knows of our struggles because it is not easy to talk about.

Please help us on our journey.

As it is infertility awareness week, we are taking a big leap and inviting you to join us on our journey – or more aptly put – the hunt for the great pudding club.  You have been invited because we trust and love you.  We want you to know that this week we will be starting a new chapter in our journey.  Ironically it is National Infertility Awareness Week.

We have been diagnosed with unexplained infertility, it is a surprisingly common diagnosis for about 25% of those with infertility.  To date we have tried three rounds of artificial insemination, known as IUI (Intra Uterine Insemination).  This week has been particularly difficult for us as our final prescribed round of treatment failed.  With each round of treatment the sad news of our failure does not get any easier to digest, rather, the sadness stacks up and our hearts grow heavier.

The IUI procedure summed up

The IUI procedure nicely summed up

We are now at the cross roads stage where we do not know exactly which route we will take: IVF, gestational carrier, adoption or even child-free.  Whichever route we do decide to take, we want you to be there with us.

How you can help us

Opening our hearts about our infertility journey leaves us with open wounds, and the occasional feeling of self-inflicted nausea (wishing it was nausea from pregnancy, of course!).  If you would like to come with us we have some ideas on how to help us through our journey…

  1. Ask us how we are doing, and if we do not to tell you every intricate detail of our treatment, please don’t be offended. Sometimes we just don’t want to talk about it because we have been thinking about it all morning and just stopped thinking about it.
  2. We love hearing stories about how your little one was conceived, especially the funny stories. But please do not tell us that we should try this position, or that method.  After all, I am pretty sure we have tried everything we could possibly google.  Legs up, from behind, on top, downward dog, on holiday, when drunk, herbal tea, with a full moon etc… The chances are slim that we will be able to conceive naturally.
  3. Although telling us about your friend that conceived after X time, with X procedure might seem affirming, everyone with infertility is different and so your story probably won’t apply to our situation. The obstacles each one of us faces will be different and the path we take will be unique.
  4. Please don’t ask us 14 days after our fertility treatment procedure if it worked. If it worked, we will tell you in our own time if we find out I am pregnant (it won’t be long after we find out, I am sure the excitement will be too much!); if it didn’t work, we need some time for ourselves to contemplate our next steps and to just have a big old cry.
  5. We like emails, phone calls, skypes and messages that remind us that there are other things going on in the world. We don’t want to think about infertility and babies all the time.  It can be emotionally exhausting at times.  Send us photos, tell us funny stories or pass on a couple of memes.  Please don’t feel like you are treading on egg shells around us or worry that we are too busy to speak to you.
  6. We also want to hear about your little ones too and would love to be invited to events and parties too, after all we are going to be parents sometime soon too 🙂
  7. Finally, please don’t suggest ‘You can just adopt’ to us. If you look into adoption you will quickly learn that this process is not easy, cheap or free from emotional baggage.  There are no guarantees. The casual statement of ‘you can just adopt’ makes it seem like not being able to conceive isn’t that big of a deal and ironically is often said by people who already have their own children. Such a casual, throw away statement makes the whole process seem like we can simply go to the store and pick the type of baby we want from the range on the shelves.

The list above is specific to us, not everyone who suffers infertility will feel comfortable with what we are suggesting, each couple will deal with it in a different way, so if you know someone else who is going through this you should ask them how you can help.

Regardless of the individual items on people’s lists, one thing we can all do is be cautious, being a little more sensitive and take a little time to think before asking anyone about having children. If you know a couple that has recently married it is easy to ask ‘so when will we hear the pitter patter of tiny feet, eh?’ but what if the couple is struggling to conceive? Such an innocent question and yet it could be devastating. We’re not saying don’t ask questions, just don’t make assumptions. Until we had gone through this experience I would often be the one asking such questions, I only realise now how hurtful those questions could have been.

What else can I do?

Come join us, support National Infertility Awareness Week by adding a twibbon to your facebook profile.  You can follow my blog or facebook page, read the links below to help understand more about infertility.  Share your awareness so that others who quietly suffer do not feel like they are alone.

Thank you for understanding as we go through some challenging decisions and supporting us, giving us hope like you have already, we feel very much loved in the knowledge that we are not alone on our journey.

Dani & Chris X

#WeAre1in8 #YouAreNotAlone #WeAreNotAlone

Beer, Beer and more Beer!! Wait – should you really be drinking beer?

11 Comments

Beer – the cool, refreshing, golden nectar.  My first beer was admittedly at a young age of 13.  I hated it, but that’s what everyone else was drinking, so beer it was.  As my palette has grown accustomed to the varieties and tastes I have become a distant admirer of certain beers.  Particularly German Hefeweizen beers.  So during my 2WW it was difficult to come all the way to Germany and avoid the stuff…..so……here I am – two beers in hand!!!

Hofbrauhaus in Munich. Mmmm Beer!

Hofbrauhaus in Munich. Mmmm Beer!

Officially, Chris and I both gave up alcohol almost 17 months ago.  I say ‘officially’ because we have both had alcohol in these months as we have caved on occasion.  However, we have significantly reduced our intake of alcohol to maybe one or two beers/glasses of wine a month, if at all.  The reason?  Because ‘they’ tell us alcohol affects both fertility and the development of the foetus in the early stages.

It is logical, after all, if alcohol is capable of making you do silly things with your mind, then surely it can affect other things too.  I have no qualms in giving up alcohol, plus it saves on the purse, and reduces the calorie intake (never hurts).  There are many conflicting views about the impact of alcohol on fertility.

The UK Government suggests a pregnant woman, or a woman who is trying to conceive should drink no more than 1-2 units once or twice a week (ie one small glass of wine).  Their drink aware campaign (www.drinkaware.co.uk) website is quite informative about alcohol and fertility for both men and women.

One interesting bit of research I read about from Harvard University found that couples undergoing IVF found that women who drank more than six units per week were 18% less likely to conceive, while men were 14% less likely*.  Although this statistic sounds quite high you will only need to drink 3 times a week or more, that is quite a lot.  LAst time I drank that much was at University!!  Generally, I go with the school of thought that one small drink every once in while is unlikely to have any significant impact.  But as the stakes grow higher and more money is invested in our treatment, the more cautious I am about alcohol intake.

So what about that picture above with me holding two beers from Friday night?  Well they actually are not mine, they are the beers of my new colleagues.  BUT! I did enjoy three non-alcoholic Weizen beers!  Obviously the fact that I had three meant I must have enjoyed them.  It was only after one of my German students told me that he was taking a case of the non-alcoholic stuff back to Rome with him that I thought I should give it a go.  Usually, non-alcoholic beers remind me of the bitter taste of Beck’s non-alcoholic that was served when I was on my tours of duty in Afghanistan.  Beggars can’t be choosers, but that stuff put me off it all for several years.  Well at least until now that is.

The non-alcoholic beer definitely doesn’t give you that light headed happiness feeling you would ordinarily experience with the alcoholic version.  But throughout the night I realized that I felt comfortable drinking with my new friends without the pressure of feeling like I had to drink.  In fact near the end of the evening, one of my friends pointed to my glass and said to the waiter “I’ll have what she’s having”, I quickly pointed out it was non-alcoholic.  Obviously he immediately changed his mind, and looked disappointed at me.  He was disappointed because all along he thought I was keeping up with the lads without getting pissed and I was drinking them under the table!  But it was quickly laughed off and nothing more was said.

I think I will try these non-alcoholic options more.  In fact, a fellow blogger (the longest journey) came up with a cracking idea….to put some juice/fizz in a wine glass to give the impression of drinking wine.  Psychologically, that surely has to have the same effect as a non-alcoholic beer.  Well I’m going to try it and let you know 😉

At the top of Kofel in Oberammergau.

Bye Bye Bavaria!  Thank you for the beer discovery!

*Harvard University Website. Alcohol hinders having a baby through IVF, couples warned.

Accessed from: http://news.harvard.edu/gazette/story/2009/10/alcohol-hinders-having-a-baby-through-ivf-couples-warned/

Irritable Bowel Syndrome and Trying to Conceive

6 Comments

I have Irritable Bowel Syndrome (IBS).  It is a relatively common disorder of the gut.  The weird thing about IBS is that no one really quite knows what causes it exactly.  Symptoms are variable depending on the nature of the IBS.  For me, I suffer from abdominal pain and diarrheoa.  I’ve had it since I was a late teen.  But I don’t really remember when it truly started, but it got worse at university.  There is no cure for IBS, only treatment of the symptoms.  Approximately 1 in 5 people will suffer from IBS in their lives, some may never realise they have it.  Symptoms vary on scale and nature and is slightly more common in women than men.

I am writing about IBS because last night as I boarded the plane for my transatlantic flight and experienced an awkward situation.  As I sat down the family next to me asked if I could switch seats with their son (about 13yrs old) so they could all sit next to each other.  Sure I said, no problem, I don’t mind moving a row back!  But then they pointed to the dreaded in centre seat.  I had specifically booked an aisle seat because I go to the toilet a lot.  And as this was a red eye flight I would not do well sitting here, I would have asked the person next to me to move at least 10 times so I could go to the toilet.  I looked at the boy, realised he was 13 and thought he would be perfectly fine there, plus one of his parents could always sit on their own if they were worried about him.  So I politely declined to switch seats and told them of my predicament to be near the toilet.  But then the mother told me she couldn’t swap because she had a fear of flying.  Yes I felt guilty, but I was very willing to swap with anyone in an aisle seat.  Eventually a nice lady the other side of the plane volunteered to sit in the boys seat so I could sit in her aisle seat.  But it just reminded me of the hidden side of IBS, even though I told the family my reasoning, they seemed pretty pissed at me.  They didn’t understand.  I know of people with IBS who have disabled toilet keys because when it is bad, it is very bad!!  I don’t have this extreme requirement, but IBS is a hidden disability.

I self manage my symptoms.  I know that stress makes it worse, and eating certain foods such as potatoes and pineapple can give me killer cramps and half a night on the toilet.  I have simply learned to avoid certain foods or when I have a craving, give in and just expect it and manage it when it happens,  I prefer it that way rather than take drugs.  I tried a lot of things at university to relieve the symptoms, but ultimately cutting out the stress seemed to work the best.

In order to diagnose IBS the doctor will put you through a series of tests to rule out something more serious, like Chron’s disease, cancer of the ovaries or coeliac disease.  These are tested usually with blood and stool tests.  For me, the doctor said that there was a possibility of having endometriosis, which can only be detected through a laporoscopy.  But before doing this invasive procedure she wanted me to try an exclusion diet to see if there were certain foods that increased the symptoms.  After several weeks of hunger, cravings and a very large shopping bill, we figured that IBS was likely.  So I never had a laporoscopy to rule out endometriosis.  My current Reproductive Endocrinologist has suggested there is a chance I do have endo, but a laporoscopy can do more harm than good to my fertility if it is just a little bit of endo.  I find it strange that I have no definite diagnosis whether I have one, the other or both conditions.

As I get further into my two week wait and I get pains even a couple of days after IUI, I wonder are they IBS pains?  Or are they related to the IUI and the progesterone? What has IBS got to do with infertility?  Well I didn’t think there was much of a linkage, but as always google shows you something interesting.  There were two interesting conclusions that came out of my, albeit brief, search, in general the research is pretty thin on the ground.

There is no evidence to suggest IBS causes infertility.  A couple of sites discuss this and conclude that there is no evidence of a linkage.

IBS increases risk of miscarriage and ectopic pregnancy.  A research study* looked at 100 000 women who became pregnant during the period 1990 to 2008.  Of these 100 000 women 6% suffered a miscarriage, which is considered to be the ‘normal’ statistic.  Of these 100 000 women, 26 000 women were diagnosed with IBS.  Of these women diagnosed with IBS, 7.5% lost their babies.  That is a significant difference, increasing the risk of miscarriage for women with IBS by 30%.  It should be noted that IBS is linked with other disorders which are also potentially linked to miscarriage, for example chronic fatigue syndrome and fibromyalgia, therefore it is not wholly conclusive evidence.  The authors wanted to stress that the chance of miscarriage was still small, and that they wanted to highlight the need for more research into IBS and fertility.  I have not been able to find anything more up to date than this report from 2012.  Maybe they are still researching it…maybe no one carried it forward. But I think it definitely deserves some more attention.

*Increased Risk of Miscarriage and Ectopic Pregnancy Among Women With Irritable Bowel Syndrome, Khashan, Ali S. et al. Clinical Gastroenterology and Hepatology , Volume 10 , Issue 8 , 902 – 909

Injecting in the car park…not your average day!

12 Comments

I never finished my story of ‘Don’t panic Mr Mainwaring‘.  Not long after I wrote my blog post, Chris called me back. He could not make it home to give me my injection because he had a meeting in less than an hour.  Rather begrudgingly I agreed to meet him at his work for him to administer the Ovidrel I needed.   Just as I was leaving,Chris called me again.  He had read my blog post and felt guilty, so was going to come home.  But I missed his call as I got in the car, so at his work it was to be!  Unfortunately, his work place does not have any ‘private’ meeting rooms we could use, they are all glass walled, so we decided to just do it in the car park (AKA parking lot for my American friends).

Yup, this is where it was going to go down!  I got out of the car and handed him the equipment.  He could tell I was in a grump; I said I didn’t want to talk about it, rather to just get it over and done with.  I held up my shirt so he could wipe my belly down with an antiseptic wipe, he got the air bubbles out of the pre-filled needle, took the cap off, and whilst I squeezed my belly, he injected the needle into me subcutaneously.  He didn’t even count this time, I just held my breathe, closed my eyes and didn’t move until he told me it was over.  He threw away the needle in the mini bio-hazard bin that the pharmacy had provided me with.  And that was it….within seconds I felt dizzy, as usual.  I sat back down in my car, I didn’t think driving to work would be a good idea for a little while.  Chris went back to work, and so I sat there in my car eating the sour jelly beans I had brought along as a treat to myself.  These were the only things holding back the tears.  I think it is actually impossible to cry whilst stuffing your face with jelly beans.

I was upset at myself for being so pathetic!  Why couldn’t I have just done the injection myself?  I was psychologically torturing myself. I hope that is the last time I ever have to do it, otherwise next time I am going to have to get the nurse to coach me through it.  All you ladies that have managed to inject yourself – kudos to you. Kudos.

Don’t panic Mr Mainwaring!

1 Comment

You know how I said third time round means I must be expert on IUI and I felt at ease with this round of treatment?  Well today is Cycle Day 11, everything had been going to plan so far…..But this morning I had my CD11 Ultrasound to check how my follicles are doing.  (By the way, you know you are in serious business when they send my actual doctor to do the ultrasound – they were obviously sending in the big guns for round 3!  It was good to see her.)  Back to my follicles, they are looking good.  I have two maturing, one in the left ovary and other in the right.  Both are 22mm – perfectly sized!  My doctor commented on how good my uterine lining was – 7mm.  She pondered on why the eggs hadn’t wanted to make a home in this nice uterus already!  She knows all the right things to say 🙂 I told her that I thought I was about to ovulate in the next 24hrs because this morning I had a 0.53 degree drop in my body basal temperature and my Ovulation Predictor Kit came up with an almost positive line.  She thinks I will probably surge on my own, but I should take the Ovidrel shot, just in case.  But this would mean I would have to take the shot now for an IUI procedure tomorrow pm (Weds).  OK….sounded good! Just one problem – I’ve got to go home, get the shot out of the fridge to bring back to room temperature – and I’m going to have to do this thing alone! Oh and I’m supposed to be back at work too. Cue panic attack.

I furiously attempt to call Chris to see if he can come home to give the shot, because I really don’t want to have to give myself a shot for the first time under pressure.  Chris must be busy. So here I am, sat here with my Ovidrel shot warming up next to me, whilst I wait for Chris to call me back. I’m freaking now because it’s either do it myself or nothing. And nothing is not a valid option.  You’d have thought stabbing myself with a needle is a very small price to pay to have this chance of having a baby and my logic would take over my fear.  But no logic does not dictate in this case.  Come on Chris!  Call me back!!!!!

For those of you who have not heard of the ‘saying/quote’ “Don’t Panic Mr Mainwaring”, here is a little video excerpt….

Third time’s a……

1 Comment

Three Times a Charm

I think I am getting the hang of this IUI thing now.  I understand exactly what is going to happen each day, what drugs to take, what side effect will happen and when, who to speak to on the phone, who NOT to speak to on phone, how to ask for what I want, how to make myself understood, how to refill my various prescriptions, what bills to expect, even what emotions I am probably going to feel on this roller coaster of a cycle.  For example, I am on Cycle Day 4, and having taken two 2.5mg of Letrozole last night at 7pm, I knew at approximately 4pm Today I was going to be mega sleepy.  And I was! Where I work, if you have done something more than twice you are considered an expert, so I’m going to declare myself “IUI Subject Matter Expert” on my “CV of life”.  I’m feeling quite chilled out about it all, that is except for one, teeny, tiny, annoying thing.

INSURANCE.

The thorn in my side right now.  Needles have nothing compared to this pain in the….

You may recall before we started IUI that my insurance company wrongly stated that I did not need pre-approval for IUI treatment.  It was only after I started my first cycle all became apparent that we needed pre-approval before any fertility treatment.  Since then, we have been trying to get things straight with our insurance company.  I am not entirely blaming the insurance company here.  I am blaming ‘the system’.

It seemed so simple, our insurance company required copies of our medical records to determine pre-approval for our IUI treatment.  Well that’s easy! No? Fertility clinic – please provide our insurance company with our medical records.  “No problem, we will get the nurse right on that” they said.  Well each week we chased them, they claimed no knowledge of this request, but wait, what is this? …oh there is a note in our records to do this.  Hmmmmmm.  At our last appointment 2.5 weeks ago, the nurse promised us the request to send the medical files was with their business team and they were going to action it that day.  Well it turned out that was all bull.  No medical records were ever sent because we had to fill out a release ‘form’.  And after the number of people we spoke to try to make this happen, not one person mentioned a form.  Things also got complicated when the fertility clinic realised that our insurance’s medical office is located in Belgium.  This would be impossible! Sending medical records abroad – there are different laws for this. They were not quite sure how they are going to do it,  come on, surely there is a form for that too!  How about I google it, I bet google knows the answer.

So after we hit this road block, Chris tried a different approach.  He has given the half completed ‘pre-approval’ forms to our insurance company to chase up with our fertility clinic.  When my insurance company emailed me this morning to say could I please provide them with a contact number for my doctor, oh, by the way we would need approval for each round of IVF….I flipped!  As you can imagine we had dutifully and carefully provided a contact number and address, but most importantly, it clearly stated on the form the treatment was IUI.  I even provided them with a breakdown of all the costs for each procedure and medication.  Aghhhhhhhhh!

I have no idea what is going on right now, but it is all now in the hands of the insurance company and our fertility clinic to figure our laws, methods of handling medical records, procedures, money and what not.  Why couldn’t we have got to this stage two months ago?  At this rate we will probably get our “pre-approval” for IUI after we have finished all three rounds of IUI!

Without pre-approval we have paid for our first round of IUI out of our pockets and hoping we will be able to claim some money back.  Soon the bills will be coming in for the second round of treatment.  It would be nice if they figured it out before then.  My worst nightmare is that they deny the claim because there was a small test we had to do or form we had to complete before we started with the IUI.  There is little advice the insurance company can provide us on whether we are covered or not until they have our medical records.  Similarly, they can’t answer if we are covered for IVF until they see our medical records.  This makes financial planning for the future a little challenging.  But we are planning for the worst, just to be safe.

I should point out that we do have a rather strange insurance arrangement – because my organisation is international, Allianz, our insurance company, provides coverage for all staff across the various countries.  Allianz uses United Healthcare as their service provider in the US to purely deal with admin for claims made in the USA and negotiate in network deals with providers.  This makes things complicated for medical providers here in the US when we try to explain that they have to provide medical records to Allianz, not United Healthcare.  I hope I didn’t lose you there!

Third time...

Third time…

So to sum up today’s post – Insurance sucks and starting IUI cycle 3 is going to be a breeze.  As the saying goes….third time lucky!  Or….third time a charm!  Let’s hope it’s not like the other google search term on the list above – third time out :-s