FET #1: 1+1=4

FET1_gestational_sacs

Two gestational sacs measuring at 5wk3days and 5wk4days which is right on track. Baby A has a yolk sac but they said that it’s early so it’s fine if we don’t see a yolk sac for Baby B.

And.. everything else looks good! 1 more ultrasound next week and then we might actually graduate! Due date’s technically in early August but that’s not really happening with twins so sometime in July? Right before my FMLA kicks in.

We’re cleared for everything else – exercise, sex, even running (except for things like hockey). Doctor had a lot of dire warnings about the high-risk-ness of a twin pregnancy. “I wasn’t aiming for two”. Sigh. But then why did you use 2?? I’m happy. Slightly terrified but happy.

This is all such a relief – the last several days I’ve been so incredibly stressed about this (and the PIO drama didn’t help). After the ultrasound, I ended up sobbing because I kept expecting something to go wrong and I was so so relieved that everything was ok.

And now the uber planner in me working overtime ‘what have we gotten ourselves into? How can we afford daycare for two? How do we work out logistics?’ But Hubby as always is my voice of calm and we have nine (well, 8?) months to get there.

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PIO update

  • I managed to find a single vial in some random Walgreens so that’ll take me through another ten days
  • For the remainder, I figured out a combination of someone local who has some leftovers and a random AZ pharmacy that has the ethyl oleate formulation.

Thank you so so much to everyone who offered!

Also, for an FYI for others, the pharmacy that had the ethyl oleate version is: Integrity Rx in Scottsdale AZ.

So I learnt some of the backstory from my doctor — there’s been a national shortage for a while. It’s manufactured in Puerto Rico so… *click* it makes sense now. Various pharmacies are trying to make it de novo but it’s not quite worked so far.

One of the pharmacists recommended my checking out a clinic meant for LGBT to see if they have supplies. She was a bit cagey about it until I directly asked – “is it used for transitioning?” Turns out it is. Apparently she was trying to be careful about it. But turns out, I peripherally work with that clinic. And anyways, so much of my current work is with that community that I’m hardly going to be shocked at hearing the word ‘transgender’. Man, I feel so bad for anyone mid-transition who’s now dealing with medication supply issues. What a crazy world.

PIO anyone?

fuckfuckfuckfuck

My progesterone runs out in a few days. So I call my pharmacy for refills as usual. It’s backordered. TILL NEXT YEAR. EVERYWHERE IN THE COUNTRY! AHHHH!!!!

So now I’m panicking and calling every pharmacy in the US I can think of.

http://abc7ny.com/health/patients-scrambling-to-find-critical-fertility-medication-amidst-nationwide-shortage/2737048/

Update: After calling a gazillion pharmacies we found 1 which has a single vial. So hopefully we can get that. And hopefully my clinic has more in stock.

Should Insurance cover IF?

I should start by saying that we’re very very lucky. We live in one of the (good) infertility mandate states. I made sure before we moved here that there was a mandate in place but I didn’t realize until much later just how much the mandates vary.

I have strong opinions about how I think insurance companies should treat infertility : it’s a medical issue. Therefore it should be covered like any other medical issue. And IMO, it’s as simple as that.

But I am very curious what the blogosphere at large thinks about this? Pre-IF would you have wanted insurances to cover IF? Post-IF? Do you think there should be limits? Means-testing?

Costs so far…

I had some time today so I downloaded all my claims info and tabulated it (actually I didn’t have time but a friend asked and it was on my to-do list so I did it anyways).

Slide1

So… IVF is expensive.

Couple of caveats about this:

  • This is over the course of 2.5 years. And the first year’s insurance plan was kinda shitty so we paid way more out of pocket than we should have.
  • I can’t find information about the adjustments for any of the medications. It’s possible these numbers reflect the actual costs but also possible that I’m not capturing them.
  • Part of the reason my out of pocket costs are so high for IVF is that sperm freezing ($500) and embryo freezing ($1200) aren’t covered by insurance. Ok, I kinda get why sperm freezing is a non-essential but why wouldn’t you consider embryo freezing as essential. (a) I’ve read enough to see that there can be a difference in success rates between fresh vs frozen for white vs non-white. (b) So you’d just advocate throwing the remaining embryos. And spending thousands more to retrieve a new batch?
  • Most of the IVF money is meds ($7k). $3k for all the monitoring blood tests and ultrasounds. $1k for the retrieval. $4.5k for the transfer (my guess is this includes the ICSI and Assisted Hatching costs). And a few hundred for various consults.
  • PGS isn’t covered by my insurance (I think that’s probably true across the state) so I have no idea how much that would add to costs.
  • Also this isn’t entirely accurate because it still needs to include several more rounds of progesterone/estrogen/ultrasounds (assuming that this pregnancy continues) for FET 1.

FET #1: Beta #3

HCG: 1490

Slightly more than a 48 hr doubling time so I’m a bit concerned. The clinic seemed perfectly happy with it though so.. I’ll take their opinion.

That’s the last one before an OB ultrasound. This all feels very unreal.  I’m still waiting for the sword to drop and something to go wrong.

As for symptoms, as far as I can tell it’s been rather textbook. Breast tenderness – check (so much so that my first pregnancy related purchase is going to be a maternity sleep bra). Tiredness – check (though that could be from the pregnancy hormones, the FET lining support hormones, getting up at 5 every other day for an early morning blood test, waking up promptly at 3am every night from or just the sheer amount of work on my plate). Nausea – check (tough this could also be from the aforementioned lack of sleep).

I got the go-ahead to do some mild yoga so that’ll be nice to stretch out a bit. And other than that I’m just trying to get through all the work I have – I have a couple of talks in the next couple of weeks and a grant deadline in early Jan and several paper deadlines in Feb. Onwards!

FET #1: Beta 2

HCG: 770

Thank God. For some reason I was really really stressed out about today’s. On Friday, I kinda knew what to expect based on physical symptoms. But I can’t really tell the difference between some HCG in my body and more. And random symptoms went up and down (breast tenderness started reducing; cramping and twinges started increasing). All of which is consistent with HCG moving either way.

Anyways, so far so good.

FET 1: Beta 1

HCG: 207; Progesterone: 17. Go embryo(s)!

We’re still on the waiting train for now – they’ll measure HCG every couple of days to check doubling. But so far this is a good sign.

Funnily enough, I wasn’t surprised. It’s felt more like “of course.” Now I’m not at all confident about next week’s results or the ultrasound but I was fairly sure that today’s test would be positive. At this point, I’m so aware of so things going on in my body, especially reproductive related. And there were a lot of signs: the breast tenderness (they’re so sore by the end of the day they feel like they’re going to fall off. I predict I’ll need a sleep bra by the end of next week); the insomnia (hello 3am again!); the intermittent cramping; the continued feeling of heaviness (I can tell these days when my lining is building and not). Honestly even if it were negative, I would have assumed a chemical because my body is definitely reacting like it did back in March with the ectopic.

I’m also playing a guessing game with myself – how well do I really know my body? I think the embryo(s) implanted on the left side of my uterus — there’s been a fair bit of cramping there. I also have a small suspicion that it’s twins. Mostly because I’m superstitious and I went into the FET expecting one of two outcomes – no pregnancy or twins. Somehow it seems less likely to me that the ‘average’ thing would happen – this whole journey has been a mess of less than average things happening. Anyways, all these are faint suspicions that I’m telling Hubby just so if anything is true, I can say “HA!” to him 🙂

Mostly I’m feeling a sense of peace. For now, things are good. I don’t want to celebrate but I can pause just a bit and concentrate on the moment.

 

Friendships

I’ve been thinking about this a lot lately. For the last year or so, I’ve become increasingly protective of myself and ruthless about cutting away relationships that don’t make me feel better after spending time/talking to the other person. But sometimes I wonder if that’s the right strategy in the long term..

To give some context, Hubby was talking to a close friend of his. This friend and his wife were really close friends of ours. There were several years when we’d see each other at least once a week, often more. We’ve celebrated birthdays and holidays together. Then they moved our of the city (and so did we). We would still chat and even took a vacay together. But then they got pregnant. Three months after starting to try. (I know this because when we visited them and she was complaining about how stressful it was to get a period every month and know a failure and a couple of months later, they announced their pregnancy).

I actually can’t fault her/their behavior all that much. We were the first people (outside family) that they told. They told us right after their first confirmation ultrasound. They’ve never said anything like “so any news?”. They didn’t send overly cutesy pregnancy pictures. I didn’t even realize till last week but they’ve barely sent any baby pics. When Hubby was talking to them, he asked them to send some and then they did. But… somehow I can’t bring myself to have a genuine conversation with them. I don’t want to know about the baby or see pictures. I don’t want to hear complaints about how hard it is to manage a baby. I would give anything to have those complaints! Whenever they ask me how I’m doing, I go into raptures about my job (because damnit at least something in my life is going well).

But when Hubby mentioned that he had asked for pictures… well, I realized that I haven’t exactly been a good friend to them either. From their perspective, this was a life changing event for them and I couldn’t even muster up fake interest. I don’t respond to baby posts on common chat groups. I barely respond to anything on those and instead let Hubby be the social one. I don’t reciprocate the “How are you?”‘s because I don’t want to hear baby stuff. Of course I could explain and get into all this IF stuff. But that takes energy too. And I don’t trust them not to say something like “Have you tried ayurveda?” or “Don’t worry, it’ll happy”, neither of which are remotely comforting.

One realization I had – the only people I’m capable of maintaining a friendship with these days are those who listen to me. Those who might not have gone through these problems but know that it’s hell and are sympathetic. And don’t flinch at complaints about sore butts (ugh PIO shots) or hormone crazies (thank you Lupron) or sore vaginas (here’s looking at you ultrasound wands and speculums). They understand that a few months of disappointment is a different order of magnitude than years of it. And they have problems too which I happily listen to them unburden. It’s not quite a quid pro quo but.. right now, if I’m not able to talk about IF which is this big huge overwhelming thing in my life right now, I really don’t have the mental bandwidth to spend with you.

As for these friends.. well, the relationship won’t ever fully die for various reasons. I don’t know what they think of me. And I’m not in a mental place to let them in. So… I’ll continue staying low for now. As my mom said, its not really breaking off a friendship as much as putting it on pause. And hopefully we can unpause in the future with relative ease.

FET #1: Waiting…

So far, I’ve kept my promise to self not to google symptoms. But after TTC for so long, my brain is my own little symptom lookup.

So at 7dp5dt, here’s where I am:

The good – I haven’t taken a pregnancy test. I haven’t googled symptoms. I haven’t emailed my nurses obsessively. But….

The bad – I’m so so aware of every little twinge in my body. My sore butt (that’s definitely from the PIO shots and its all so sore now that I don’t even feel the needles anymore). Really sore breasts (the last time it was like that was …. when I was pregnant with the ectopic). Intermittent cramping, especially on the left side (personally I think if I am pregnant, the embryo implanted on that side).

So I’m trying not to over-obsess. But the sore breasts to me is a strong positive sign (it doesn’t happen much with periods for me). And I remember how sore they got by just 6 weeks with an HCG of ~700. But I also don’t want to set myself up for disappointment. So I’m trying to ignore all my body’s signs and just be a good little patient taking her meds.