Tag: infertility

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…)

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!

Soooo sleepy but still managed to dodge a few balls

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Today I started the letrozole. 2 teeny 2.5mg tablets a day for five days. This small prescription should result in ‘super ovulation’; hopefully this should stimulate development of multiple follicles and eggs being released, therefore increasing the chances of pregnancy. The nurse provided me with an info sheet and described some of the side effects. The only strange feeling I had today was sudden extreme tiredness, when I was driving!! That was very bizarre, so much so I almost skipped dodgeball this evening. I checked the pharmacists long list of side effects, tiredness was on there. But so was almost every other side effect known to man! Has anyone had this with letrozole too?

Although I was glad I got out the house, I wish I had skipped dodgeball. whilst playing I pulled a tendon in my thigh. It kills! Being on letrozole means that I can only really take Tylenol as a pain killer (which I have none of in the house! Doh!). So it’s going to be an uncomfortable nights sleep. Why can’t I be sleepy now???!!!

I wasn’t sure how much my prescription was going to cost, but the nurse showed me a good website www.goodrx.com that gives you coupons for prescriptions. She told me I should pay no more than $10 for the letrozole. So I printed the coupon and discovered my insurance covers it, and I payed just 0.26c for it. I’m so happy!!!

These ten pills can cost over $150 :-s but if you find a coupon they can be about $15

These ten pills can cost over $150 :-s but if you find a coupon they can be about $15

Mild Insurance Panic!

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This evening I was helping Chris with filing his taxes and was searching through our medical paperwork.  I pulled out our insurance policy booklet and flicked through it to read about infertility treatment coverage.  I already knew we were 100% covered, but what I caught sight of was that we needed prior approval for certain procedures – such as IUI! Whoops…!!

We are learning a lot about medical insurance, policies, bills, coverage, approval, pharmacies – the lot!  But there is so much to keep tabs of that I am not used to.  This was one of them.

After mildly panicking that I had screwed up, I called up my insurance company, and phew, I discovered that I did not need prior approval for this.  Panic over.  These insurance booklets can be very confusing.  Especially when our insurance is worldwide cover, so depending on which country you are in, depends on the process. Grrrrrrr.  However, I am entirely grateful that I do have amazing insurance.

I appreciate the NHS – I really do, particularly when it comes to the complicated billing system we have here.  However, if we were in the UK right now things would be different.  NHS guidelines used to be that IUI treatment was offered on the NHS if:

However, new guidelines released in 2013 state that IUI is no longer offered in these circumstances. Instead, we would probably have been advised to keep trying to conceive through regular unprotected sexual intercourse for a total of two years. Only after this time we may be offered in vitro fertilisation (IVF).  So if we were in the UK right now we would be 10 months and counting, then going straight to IVF.  That would be pretty scary.  I’m kind of glad we are where we are right now in the US!!

It can all get a little confusing sometimes

It can all get a little confusing sometimes

IUI beginnings & Chocolate Pudding

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Last night my period started, a day earlier than expected.  I cried with Chris.  He is so good at helping me see the brighter side of life.  But this only really meant one thing for us – we are going to start IUI.  Everything I have read about is now becoming real.  I had already picked up the Letrozole last week.  It didn’t seem real then because there was still a chance I wouldn’t need to take it. Now it is real.  I start the Letrozole on Thursday for five days.  I have scheduled in my first ultrasound for Friday 13th.  Talk about an ominous date.   I guess the rest will happen as it happens…

In the mean time, I’m going to chill out here with my chocolate pudding and try to forget about all of this.  Well until Thursday at least.

Sporting activities during the two week wait – stupid to do it or stupid to not do it?

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Day 12 of the two week wait – and on day 11 I did something which might be stupid.

Chris and I are both keep active and we like to try new sports.  Here is a list of sports we have done over the last few years or so…

  • Rock climbing
  • Hiking
  • Skiing & Snowboarding
  • Yoga
  • Insanity exercise programme
  • P90X3 exercise programme
  • Dodgeball
  • Volleyball
  • Softball

SAM_0997Our favourite sport is anything which involves being outdoors – particularly if it is quiet and remote (much to my mother’s horror!).  We have had discussions about whether or not putting myself at risk from a big fall on a climb was worth it, and we decided to give climbing a break and spend more of our free time travelling to cities and taking the opportunity to do some siteseeing around Virginia.

We have missed climbing a lot over the last year.  We also skipped a couple of ski trips last year too, similarly, not wanting to put myself into a risky situation with a big fall.  But after the last year we looked back and realised that you can’t put your life on hold just because you are trying to conceive.  Although I didn’t wrap myself in cotton wool during the two week wait, I was very conscious about doing something silly in case I was pregnant.

So this weekend we headed west on a ski trip with a few friends.  I decided to ski the easier runs and not put myself in potential danger on the black runs this time round.  This was so much fun, I was in my element, enjoying being outside on the mountain.  The second day, Chris and I decided we would keep going with our lessons to learn each other’s sport.  I took a snow board lesson (my third one) and Chris took a ski lesson.

As I am a beginner on a board I knew I would be sticking to the bunny slopes – little chance of big falls here!  Perhaps a few bruises and bit of hurt pride, but other than that – safe as houses.  This was all until the very last run of the day.  I had two lessons that day, and suddenly snow boarding began to click (hooray! at last!!!!).  Well…..so I thought!  I felt comfortable picking up some speed (but not quite as fast as I ski, so I know what stupidly fast is), and as I came into the flat, I caught an edge and landed heavily on my backside – I was winded.  When Chris hurried over to me, I could barely breathe.  I cried.  I cried because it was such a stupid thing for me to do.  Also, my stomach and back was writhing with pain.  I can deal with bruises – but my abdomen just throbbed like hell, as if I had been punched in the stomach.

I know it is highly unlikely that this fall could cause a failed pregnancy this time – but why would I risk it for my selfish desire to do these dangerous sports??!!  When you try to look at other people’s experiences with these sports, I have not found consistent guidance on whether they should be avoided completely.  The only common guidance I found was to seek advice from your doctor, I suppose because each individual is different.  And this is exactly what I shall do next time I see her.  But I have read that after IUI, strenuous exercise should be avoided, so this could be a mute point if this month is a failure and we proceed with IUI next month.

When I am pregnant then I want to keep doing as much as is thought to be reasonable.  But what is reasonable?  I like this lady’s story about rock climbing when she was pregnant: Anonymous mom – I was a pregnant rock climber (www.mommyish.com) She talks about how she felt during her pregnancy and how people made hurtful comments (unintentionally sometimes).  You have to be a strong person to do this.  I’m not sure I can.

I found two books which I have seen a good few reviews about, these are going on my to read list:

Exercising Through Pregnancy by Dr James Clapp

Fit & Healthy Pregnancy: How to stay strong and in shape for you and your baby by Kristina Pinto