IVF Wait List?

Source

I've mentioned in the past about how I'm on a waiting list to do IVF.  If you don't know why then read some of my posts from the past.  But the short answer is because it's cheap.

In May at my first appointment at the RE I asked to be put on the IVF wait list even before I did the IUI's.  I knew the wait list was a year long.  If an IUI worked then I'd take myself off the list and give someone else my spot.  If it didn't work then I wouldn't be waiting so long for IVF.  I was given April as my tentative date and was told I'd be added to the list.

Another time in June I was asking about my spot on the list.  They couldn't locate me because the nurse said there was no "find" option in the program.  Which I'm sure wasn't true.  But she swore I was on there and if she couldn't find me she'd add be right away and mark it that I wanted to move up if I spot become available.  Not everyone is interested in moving up.

I called a month ago and asked if April was still my date, no one ever returned my call.

So I've still been assuming April is my IVF date.  I'm going to be pretty pissed if March comes around and I find out I'm not even on the list.  

I'm part of a forum online for this doctor's office.  One women mentioned tonight that she got moved from June to March, skipping two month in-between.  That's weird because shouldn't someone with an IVF date of April or May move up to March, not someone in June?  They never called me about the opportunity.

I asked her what month she was added to the list, thinking maybe it was before me.  October, as in a month ago!  Not May like me.

Someone who was added less than a month ago gets March, but I was added six months before I have April.  

I have nothing against this person.  But Madigan RE does have some explaining to do.  They ether never put me on the list, or they are taking people out of order.  Both seem unfair to me.  Waiting an extra month isn't that bad.  But if I'm re-added to the list now my IVF date will be fall or winter of 2013.  That just doesn't seem fair.  I will voice my concerns at my appointment next week.  If it doesn't get figured out then I'll spend the extra money and switch to another RE for IVF.  I can't take much more of Madigan's bullshit and misinformation.  

-Selbe

What About Me?

As I was standing in the check out line at the grocery store the other night the cashier noticed the couple in front of me with the newborn baby.  Of course the cashier began adoring the baby.  My mind was filled with all the bitter things that one infertile could think of.  Along with the "I fucking hate babies" thought.  But the second though that came into my head: "what about me?"  

You can't really tell how long a couple has been TTC by just looking at them.  They could have been TTC for a whole two months, or did IVF after five years.  I admit I automatically go with the first of those two options.  Odds are they couldn't tell you much about most fertility treatments.  The "what about me" question pops into my head when, even though I have no proof, I believe I have been waiting longer for my baby while someone else is getting attention for their newborn.  I think of not just the months we have been TTC for, but years.  I have "done my time" with fertility treatment and think of my past loss.  To be absolutely honest I'm envious.  I wish some cashier (or anyone) was looking at my baby and tell me how beautiful s/he was.  But they are not.  I fall off the radar.  I am non-existent because I'm not a mommy.

I deserve some good attention.  Not some depressing crap when people ask how my fertility treatment is going.  It's going just as crappy as the last time they asked.  But I'd love for someone to look at my big belly, or my newborn or child, and compliment it.  

One of the things that upsets me the most and I was never given a chance at being a mother.  We can think for great mothers out there.  But we can also all think of horrible ones ether from the news or those we actually know.  The women that doesn't deserve to be mothers, or can't take care of the children she already has.  I'm not saying I'm going to be the absolute best mum on the face of the planet, no one it that.  But I have to be better than some of those other examples.  Why is it when the stork comes around to give their baby handouts for the month I am always passed up?  And every other infertile women.  Honestly, we can't be that bad of a future mother.  We are never even given a chance at parenthood.  Not even one tiny bit of chance.  Or worst yet, we are given a chance the baby is taken away from us.  

We have a great home here.  The baby will have his or her own room with painted walls to match the gender.  There will be a new crib and everything else will be brand new.  The best products for 2012, and everything checked for safety.  The SUV we bought last year is awesome.  The yard is a decent size and fenced in.  The baby will have a college fund before even being born.  We are financially stable enough that I can stay home and take care of the child for the first five years of their life.  Fuck I think I almost described a yuppie.  But whatever, none of that seems to be good enough.

The feelings that go with infertility is so complex.  I honestly don't believe one could even understand the emotions unless they have been in the shoes.  There is no "fairness" or waiting your turn.  Sometimes it so hard to justify what is happening.  The only thing we can hold onto is the quote: "everything happens for a reason".  But after a couple years honestly, what is the fucking reason?

The Future

Many days I just want give up on fertility treatment.  Even if money was unlimited, I don't want to do another IUI, I don't want to do IVF, I don't ever want to see Clomid or any of it's fucking friends again, and I hate OPKs.  No more!  I just want to be left alone.  I don't want a newborn, I don't want a child, I like my sleep and freedom.  I want to spend all my money on myself, I want to take off without needing a babysitter.  I want to keep my current body with my non-sagging breasts, and kinda flat stomach.  

And there is my husband with his one fucking million sperm he left me.  I am still angry at that.  It seems like his count keeps getting lower and lower over time.  I asked him to take the CountBoost or FertilAid but he told me those had the some vitamins and such as his regular multivitamin that he already takes.  I never looked into whether that was true or not, nor do I know if he even takes those multivitamins on a daily basis like he should.  What about the occasional alcoholic drink he has?  Or his stressful job?  The last two IUIs were great on my end, one and two eggs.  My cervix isn't a problem since they bypass it with the IUI.  My right fallopian tube isn't a problem since I know at least one egg went down my left tube.  I am left feeling like I should be pointing fingers and you can take a good guess who at.  

Some days I say it's OK I don't have children, or at least anytime soon.  I told Bean years ago if we never have kids I'm getting my boobs picked back up once they begin to sag.  I think the surgery cost less than IVF.  I might even be able to get it done for free if I can convince my health insurance my real boobs cause me emotional pain.  Because it's not like infertility cause anyone emotional issues, ever.  No one gives a fuck about that.  But new plastic boobs, well can't have me crying and being self-conscious about the pair I have now, can we?

I fucking hate life.  

Source

And I don't think there is a God anymore, not that I was 100% sure to begin with.  There I said it, and offended a few people.  I didn't grow up with too much religion in my life.  But somewhere I got in my mind that if I pray enough everything things would be alright and whatever I needed would be given to me.  I did pray, many times.  I'm also done blowing out birthday candles, wishing on stars and throwing pennies into a fountain for the same wish.  I'm sick of answering the same thing each year when Bean asks me what I want as a gifts for holidays.  It's been years since I've asked for a gift other than "baby".  And yes, I equated blowing out candles to prayer.  If there is a God I'm pretty sure he despise me or something, and my feelings seems to be heading that way too.  It's going on three years, God hasn't answered my prayers yet.  Unless you want to count the time I did get PG and it was taken away soon after.  I'd honestly rather of never been pregnant to begin with than be pregnant for a month and lose the baby.  I loved my baby boy but there is pain even today.  I still don't make it a whole week without crying about it.  For Christmas this year I want a really expensive piece of electronics, not even sure what.  And for the birthday, just let me eat the cake.  Fuck you candles.  If I'm stuck on this miserable earth I might as well have fun.  God, we are done.  

Next up on the list of spontaneous and random ideas I have:  skydiving.

Sometimes I look at the last ultrasound photo I have of my baby and think of how beautiful he was.  You can't see his face, or arms or much of anything.  But for some strange reason I find that blob to be beautiful.  

-Selbe

On a Break

And then there was the end...

That pretty much sums up IUI #2.

It Only Takes One

Fertile and infertile women say this to me all the time, especially after my last IUI.  I know they are trying to be optimistic for me but I really find it annoying.  Honestly being in my shoes look at it this way:

	IUI #1	IUI #2	IUI	IUI
Motility	83%	45%	-	100%
Rapid & Linear	58%	5%	-	100%
Total Sperm	12.5 mil	1.3 mil	1	100 mil
Total Eggs	1	2	4	3
Outcome	-	- ?	LOL	+ ?

Logically if 12.5 million swimming to 1 egg = negative, then 1.3 million non-swimming to 2 eggs = most likely negative.  So just one sperm, swimming or not, to 17 fucking eggs is also going to equal negative.

I'd much rather be honest and realistic, and I know that doesn't work for some people.  But that is what works for me.  Once I get the hope in my mind, all the other happy thoughts and dreams come with it.  When I find out it didn't work I end up crying my eyes out for hours.  It's better off to be realistic, expect the worst and be emotional prepared for it.

Don't tell me "well it only takes one".  Just fucking say you're sorry and move on.

Maybe I've just had a crappy life and I'm used to horrible luck.

Chemical

My cramps have mine really bad this cycle.  I've been drugged up on Midol every few hours.  TMI  Tons of clots and my spotting was almost purple.  That combined with the test from the other day, maybe I'm having a chemical pregnancy/early miscarriage?  I'd never know since I didn't get blood work and I'm not going to wander over to the ER now to have it done.  Not like they could do anything  for me anyways.  Labeling myself as having a chemical pregnancy isn't exactly on honor.  

Future Plans with IVF

My plans before with using Bean's cryopreservation was to complete about 8-ish IUIs before I got to the top of the IVF list.  So far we've done two, August and then September 2012.  October is canceled.  November might be canceled depending on some other scheduling.  December is still on.  After that my schedule gets sketchy.  It looks like December will be my third IUI and that's it.  I wouldn't mind going to IVF and not completing a third IUI.  Bean's numbers are not that great, so I'm not even sure it's worth it.  Only reason I even do the IUIs to begin with is there's a tiny bit of hope and they are only $200.  

I'm looking forward to this break for a cycle or two.  I'll still be on Met everyday.  I'd hate to stop and have to spend another three weeks of my body getting used to it again later on.  It's just easier to stick with it.  Met usually takes about three month in your body before it starts to work so I'm interested in seeing it it kicks in.

I hate the number 13.  The ultrasound was on a Friday the 13th.  Ever since I'm superstitious of it.  I don't like odd numbers, and 3's.  I don't really a baby born in 2013.  That might sound weird, but I really hoped to make the 2012 cut off.  Now 2014, that's a safe number.  At least I've checked off over half of 2013 now.

I'm going to call Madigan tomorrow and double check with them when my approximate IVF date is.  I can't always trust the things they tell me because they tend to leave out details and are unorganized.  I think the price increased from $6000 to $8000 a couple months ago too.  I'd like to have around $12-14k saved up for IVF and possibly a FET or two.

An IVF cycle ($8-13k) consists of injectable drugs, blood work, ultrasounds, going in to retrieve the eggs when mature, having the eggs combined with sperm in the lab to create embryos, and then a few days later putting 1 or 2 embryos in the uterus.  The extra embryos, can be none, can be 20, are frozen. If the IVF cycle does not work (or you want your baby to have siblings years down the road) then the next cycle the frozen embryos are used.  This cycle is called a FET (Frozen Embryo Transfer) and costs about $4k on top of what you already paid for the IVF.  Every time you go to do FET with the remaining embryos and you have pay again.

I'm a much better candidate for IVF than IUI due to my age and that fact I have tons of eggs for the average 27 year old.  Plus if I have ten eggs, well theoretically Bean only needs 10 sperm, not 10 million.  And they don't even need to be swimming or have tails.

Since I'm not TTC I'm not sure how much I'll be blogging for the next month or so.  Forgive me if I'm missing for bits of time.

PS I got a new basal thermometer today!  My old one needed a new battery, and it was cheaper to buy a new thermometer than one of those tiny watch batteries.  I'll keep my current one as backup.

-Selbe

A Move Closer to IVF

Today's IUI was done with 1.3 million sperm, not good.  "Vial 1" from May had 10 million post freeze, and most of those didn't survive the thaw.  I asked about "Vial 2" from June that was still frozen and they said it would produce about 2 million, 3 at the most.  A little bit better.  But the RE would like 10 million and above.  Plus motility and R&L went down.

	IUI #1 - BFN	IUI #2
Volume	0.5 ml	0.5 ml
Concentration	30 millon	5.6 millon
Motility	83%	45%
Rapid & Linear	58%	5%
Total	12.5 millon	1.3 million

They gave me the option of canceling the cycle and just walking away.  But I already did the Femara, trigger shot, had two great eggs and got lost in Seattle trying to get to the RE.  I already drank four cups of water to have a full bladder and I was half naked on their table.  The chances of getting PG with those numbers are next to nothing, even with two good quality eggs.  But I paid the $225 for the IUI and went through with it.  The fact that I actually had eggs to ovulate was rare and I just can't go home to have timed intercourse as a backup.  I had to do something.  

This is my first and last cycle doing IUI from a non fresh sample.  "Vial 2" will be labeled for IVF only, or discarded in the future.  

I will wait for AF and then next cycle I will have no meds except Metformin.  The October IUI will be canceled obviously.  My PCOS will probably just make my ovaries go into sleep mode again.  Right before my husband comes home from deployment I will take Provera to start my cycle again.  

I'm going to call the RE on Monday and double check where my spot is on the IVF wait list.  Then possibly having a WTF appointment and talk about having my ovaries drilled out while I wait in October.

-Selbe

Game Over

IUI #1.5... failed.

After five days of spotting and calling up the RE with the WTF question it finally came.  I would count Friday as CD1 but my flow didn't pick up 'til really late at night, so today it is.  I can't start my new cycle of meds 'til Monday anyways.  

My husband got deployed last week.  In the last couple months he had frozen sperm incase IUI #1 #1.5 didn't work.  Which is great now because I can use it and be the talk of every bored military wife if it does work.  The bad thing is that frozen sperm doesn't always hold up as well as the fresh stuff.  Many die in the freeze and thaw.  We also have low count to begin with.  Plus we can't get extra sexy time in before and following the IUI like last time.  The odds are not in our favor.

My Choices:

1. Pay $10k at least and have IVF done at a doctor outside of the military, going ahead of the military wait list.
2. Do IUI #2 with frozen sperm.
3. Do nothing.

I'm going with the second one.  We have two vials in storage, enough for two IUIs well he's gone.  Tentatively mid-September for #2 and mid-October for #3.  I'll put TTC on hold after October.  If the thaw for IUI #2 is really bad then I'll just stop there.  

For IUI #2 I'll start Femara Monday, U/S around the 7th and IUI around the 11th.

I did cry when I knew this didn't work (which has been several days now).  It was more of a combined cry with my upcoming due date (another post).  Which is now CD1!  It's hard for me to understand 1 egg to 13 million sperm in such a small place.  Where does it go wrong?  Not one of those fucking 13 million could find the egg?  

IUI Success Rate - Source

I'm getting rid of baby aspirin also.  Not sure if it helped my follicle grow or if it was all Femara.  I had 10mm follicle with 6mm lining on Clomid.  Compared to 17.5mm follicle with 8 mm lining on Femara.  But if I do crappy on my next follicle scan they'll just move me to injectables like I've been asking for anyways.  All I will waste is time.  That is fine because my race to get pregnant by the end of 2011   have an apocalypse baby   to give birth in 2012    to get pregnant before my due date to beat the deployment is over. 

Normally an RE will tell you your best chance of success from IUI will be in the first three cycles.  Not saying it won't happen, just less likely.  Depending on why you think the IUI failed, how hopeful you are and the price difference between IUI vs IVF, this can move up or delay IVF.  Or in my case a really long wait list, cheap IUI and nothing but time to kill.  I will probably make it to 5 or 6 IUI (if unsuccessful) before IVF.

Deployment

As for my husband's business trip I don't know where he went or when he'll be back.  We have very limited contact.  No Skype, Facetime, Internet, phone call, text messages, snail mail or emails.  I can send him 10 messages the whole deployment and each has to be under 50 words.  Good ol' family grams.  Each one is read by someone before it is sent off, and then read aloud in front of a bunch of people before it is given to him.  Not much privacy there.  I can't say anything too depressing or it won't get sent, or too much "code" text.  And he won't respond to any of them, ever.  There is nothing I can do to get him to come home early, except for maybe dying.  I'm on my own.  I also have a lot of free time.

Etsy

I re-listed a bunch of my old stuff I made on Etsy.  Only thing that really sell is my small animal bedding sets, which goes for about $30 a set.  I'm paid by PayPal for everything, which I then use to buy other things online.  I feel like I get things for free that way.  Problem is I don't put much effort into it.  If I made new bedding all the time and advertised I'm make a lot more.  Right now I get about five orders a week.  

-Selbe

Fertility Treatment is Elective

Edward wants some new
tits too!

I am so fucking sick of women that have the same insurance company as myself asking if they cover cosmetic, plastic surgery, boob jobs or whatever the fuck else.  There is a rumor that they will cover one cosmetic surgery per life.  An exception I can think of is if you are in a car accident in need facial reconstruction.  Or you have large breast that cause back pain and other health problems.  

If you have A or B boobs and want them bigger, pay for them yourself.  Or lipo or a butt lift or whatever else you may hate about yourself.

And don't even use the "I feel negatively about myself and I'm depressed" excuse.  I have fat thighs, stretch marks, acne scars and my right boob is smaller than my left.  I'm not depressed and crying over those things.  Maybe I just have more depressing things to actually waste my time blowing snot about.

If my insurance company pays for someone to have D cups so they can feel better about themselves, well then they also need to pay for my whole IUI/IVF cycle.  Just saying.  

I'm so sick of fertility treatment getting put in the same group as plastic surgery, elective.  I didn't choose this, I didn't want to be infertile.  

-Selbe

Prescription Mess

I went to pick up my Clomid today.  It became more of a mess than I ever thought picking up a prescription could be.  It seems like everything here turns the simplest things into a clusterfuck. 

I went to the pharmacy earlier in the afternoon because later on the wait is insanely long.  If I get in and out before 2PM then I'm good.  I figured it would take 30-45 minutes, I'd be home in about an hour to take the dog to the dog park on this nice day.  I showed up at 1PM, grabbed a number and waited for it to get called.  They were on 404, I was 412.  It took about 25 minutes to get to my number and I went up to the counter.

There are two pharmacies here.  This one mentioned above, Bremerton.  And the one my RE is at, Madigan.  Bremerton is a lot closer, only 15 minutes away verse the hour drive to Madigan.  Obviously I want to drive to the closer one.  The RE will send my prescriptions (like Provera last week) to Bremerton so I don't have to drive.

At the counter the lady told me my prescription was already filled at Madigan, so they can't refill my prescription here.  The RE did send it to Bremerton, but for some reason Madigan grabbed it off the system instead, poured the pills in the bottle, stuck my name of it and put it on the shelf for me to pick up.  I don't understand why they would do this.  The auto-fill option (which I didn't even know they could do) is great... if I was going to Madigan.  My only option is to drive the hour to the other pharmacy.

I tried to get a hold of the RE but no luck.  About 95% of the time they never answer the phone and it goes to voicemail.  Bean started calling too.  I got the the gas station about a mile down the road to get gas since I wasn't going to make it to Madigan anyways.  I also grabbed a soda & snack because I didn't realized this was going to be an all day thing.  The apple and water I brought was not going to last.  Bean got a hold of them and told me they would have it back at Bremerton at 2PM.  It was 1:55 so I went back to Bremerton.

I met the lady in the elevator that helped me before.  She told me not to grab a number but at 2:05 and 2:10 it went from "filled" to missing all together.  I grabbed a number just in case.  I was 460, they were on 439.  I waited a half hour, they only made it to 444.  I cut in line at a window and asked if they had my prescription in the system yet.  Still missing.  I turned around and walked out so I could just drive to Madigan.  

In the car I went to open my soda.  It exploded everywhere.  There I was in my wet pants and sticky steering wheel, even more pissed off than before.  I drove home to change my clothes.

This time Bean came with me.  I got there went right to the desk.  It was 3:15PM, I was sick of waiting.  The first person I just asked if the prescription was in, I wasn't going to grab a number to fill it if it wasn't even there.  This asshole tells me to "pick a number" and won't even help me.  I grab a number, 511, they are currently on 490.  OK, this is bull shit.  This was my third number and I've been waiting over two hours.  

I went to another window.  This lady at least looked it up.  They found it!  She told me to pick a number to have it filled.  OK, but I still don't want to have to wait.  I went over to the window of the lady I had before, the elevator lady.  (This has to be the best person I dealt with all day!)  She remembered me and put it in to get filled immediately.  About 15 minutes later my name was called and everything was set.  It was 3:45, I had waited just under 3 hours!  BTW number 511 hadn't been called by the time we left.  

Bean filled a complaint before we left because he was so upset at this.  Along with last weeks problem, when they lost my referral in early May, and Dr. Idiot refusing to do pretty many anything for me.  The IUI ($200) and IVF ($6,000) are really cheap here, that's why I stay on Tricare Prime insurance.  I can switch to Tricare Standard and get away from these people, but the cost of the IUI ($3,000) and IVF ($13,000) increase when I go out in town.

I waited three hours for them to fix someones mistake.  Least I think that's what happened.  Not sure if I just don't understand how this health care system works out here and I'm slow.  Or they are really bad at explaining it to me.  I seem to always running into trouble.  

-Selbe

Much Better Day

Special Puppy

After many phone calls and rushing my old records (which were supposed to be transferred over a month ago) we finally got what we wanted.

Provera & Pregnancy Tests

They gave me Provera.  Same 10mg but seven days this time.  I'm on day two of seven and I usually get AF 14 days after the last pill.  So CD1 in about three weeks.

Before the Provera they made me get a pregnancy test.  A urine PG test.  What is that?  I thought I would explain the two types of PG tests.

• Qualitatively - Meaning you get a "yes" or "no" if hCG is found.  Never a maybe.  This is with all urine tests (lab or at home) & some blood tests. 
• Quantitatively - You get a number of how much hCG is found.  Results are based on the number, so < 5 is not PG, 5 to 25 maybe, and > 25 is pregnant.  This is always blood and used by all REs.  I've never heard of an RE using a urine test.  This is also good because after multiple blood tests they can look at the trends in number to see if there is a problem with the pregnancy.  In the infertile world this is simply know as "beta".  

After being infertile this long I feel like a urine test is too much work for me.  Blood tests I just hop up on the chair, they stick me with a needle and then 30 second later I'm patched up and out of there.  It's more "painful" for me sitting in the overly crowded waiting room than the actual needle.  The urine test they gave me a bag with a cup, wipes and stickers and told me where the bathroom was.  Next I'm standing the the bathroom looking at the 12 steps on the wall of instruction on how to give a urine sample.   Then wondering to myself if this is enough pee to fulfill their 30ml requirement.  This is too much work, just stick me with a needle next time.  Anyways, it was negative.

Clomid Increased 

They decided to give me the Clomid this cycle, as long as I go to the high risk appointment on the 26th.  This also means I am doing Ovidrel with IUI.  Yay!

Last week they wanted Clomid 50mg for me.  After reviewing my records today they decided to increase my dose to 100mg.  Though I still hate Clomid I have more hope in 100 over 50.  

Frozen Sperm

We went into Seattle to freeze Bean's sperm yesterday.  It went well.  I don't have a count or any other numbers.  But he did produce one vial worth for freezing.  It's sperm in the freezer so I should be happy.  And we do plan on doing it a couple more times in the next few weeks.  But does one vial per ejaculation sound normal?  I'm trying to Google and it seems like only one is used per IUI.  Sustained all of Saturday, Sunday and Monday.  

I'm so grateful that Bean goes along with these ideas.  I know it's not easy to jerk off in a strange room with people walking around outside. 

Blood Work

Last Friday I has another series of blood work, seven vials this time.  I looked at my hand after he got done and it turned purple with white spots.  It was pretty amusing to me.  Today I picked up the results.

	Selbe's	Normal Range
Estradiol	134	27 - 433 pg/mL*
DHEA	205	18 - 391 ug/dL
LH	14.31	1.2 - 103.03 mIU/mL**
FSH	6.28	1.79 - 22.51 mIU/mL ***
Prolactin	10.53	3.34 - 26.72 ng/mL
Insulin	8.86	1.9 - 23 uIU/mL
Creatinine	0.8	0.6 - 1 mg/dL
ALT	32	30 - 65 U/L
Fasting Glucose	92	70 - 110 mg/dL
TSH	1.38	0.34 - 4.82 uIU/mL
Testosterone	68	2 - 45 mg/dL
HgbA1C	5.1	4.3 - 6.1 %
17-OHP	79	< 285 ng/dL ****

* Estradiol - Mid-follicular phase: 27-122;  Periovulatory: 95-433;  Mid-luteal phase: 49-291

** LH - Follicular phase: 2.12-10.89;  Mid-cycle: 19.18-103.03;  Luteal: 1.2-12.86

*** FSH - Follicular phase: 3.85-8.78;  Mid-cycle: 4.54-22.51;  Luteal: 1.79-5.12; Postmenopausal: 16.74-113.59

**** 17-OHP - Follicular phase: <185; Luteal phase: <285

A few of those with the *'s depend on where I am in my cycle.  Since I'm CD60 I'm guessing I'm in the luteal phase?  I'm sure that isn't right because I never ovulated.  The only number that is high is my testosterone and that is common for a women with PCOS.

IVF

I was told yesterday the IVF wait list is at about 9 months right now.  But it could become shorter if other people drop out of the program.

-Selbe

RE Appointment 5/24

My appointment went good today.  We did get lost when we first arrived.  I asked the little Korean lady at the information desk where to go but she didn't know where the "fertility clinic" or "Reproductive Endocrinologist" was.  She gave me two options.  First being the OBGYN on the third floor, for pregnancy tests, pregnancy and giving birth.  No, that's not me.  Plus when I made my appointment I was told me ground floor or lower level.  The second option was the OBGYN on the ground floor.   Hmm, I don't think that is me, but it could be?  I walk down to the OBGYN clinic and as soon as I walked in the door I notice the waiting room full and there are tons of newborns and babies everywhere.  Fuck!  I really hope this isn't the place.  Sure enough he sends me a door down to the actual fertility clinic.  This waiting room just had a couple waiting alone and a few women.  Much more my taste.

Basic Appointment Testing

Source

• Medical History - They didn't seem to care about the records that have yet to arrive.  Just asked me questions.
• Ultrasound
• Uterine Lining - Measured 15mm, too thick.  Obviously it's been some time since AF.
• Ovaries - I've never had cysts before, at least they haven't been found.  She showed me the left ovary, covered in small cysts.  Then scanned to the right ovary, also covered in cysts.  It's nickname is Ring of Pearls.  Yup, the classic PCOS cysts.
• Blood Work - I go for that tomorrow morning.  I'm having glucose done along with a few other thing, mostly stuff I've had done in the past.
• Semen Analysis - She's a little worried about Bean's low results in the past.  I'm not too concerned, they could be worse & I seen PG with less.  They are not bad enough to send us to an Urologist.

Dr. C told me there is overweight PCOS and skinny PCOS.  I have skinny PCOS.  Even with my anovulation and cysts I still don't look PCOS.  Which is probably why I've made it so long without a diagnosis.  I'm not overweight enough and I don't have thinning hair, hair in strange places or darkening of the skin.  She also said no amount of weight loss will make my PCOS better.  Though I don't like to make excuses nor am I lazy, this is something I have thought about from time to time due to the fact that my problems began when I was 16 and underweight at the time.  I actually wasn't allowed to donate blood in high school because I didn't weigh enough.  If I see the same problems at a BMI of 18 and a BMI of 29, weight probably it's related to it.  

Cervix

The description of the my cervix from the RE looks bad.  I guess most of it is gone and it's very short.  I am at a great risk for cervical incompetence and a cervical cerclage is most likely going to be needed.  This also comes with bed rest.  This scares me because I am a military wife without family in the area and very few friends.  I will have to figure out a plan once I get pregnant.  This also isn't new news to me so no surprise about the cerclage.  

She is having me met with the high risk OBGYN even before pregnancy is achieved so I know what to expect.

Overall

Even with my failing cervix, my polycystic ovaries and Bean's 23 million sperm count we are ready to move forward with IUI.

Move to IUI

I began spotting this morning, randomly without any cramping.  Not sure if this is AF, but if it is then tomorrow or the following day should be CD1.

I need to have a beta PG test done to make sure I'm not PG.  This part really doesn't seem necessary.

On CD3 I'll start Clomid 50mg for five days.  I'm not a fan of Clomid, I didn't ovulate at 150mg, let along 50mg.  My five rounds of Clomid before were unmonitored they don't know how I responded to it, other than not releasing eggs.  This time I will have ultrasounds to show the number of eggs and their sizes, along with the trigger shot to manually release them when they are ready (vs waiting for if/when my body to do it).  So I guess it's better, but I still don't like Clomid.  I've just already been down the road before and see no hope there.  

Around CD12 I'll have my first ultrasound to check the size of my follicles.  Possibly a few ultrasounds after that until my follicles are large enough.

I'll be given the Ovidrel trigger shot.

Following that will be my IUI with Bean's fresh or frozen sperm, depending on if he is home or not.  If it is fresh sperm and Monday-Friday then I'll go to Tacoma, if it's frozen or fresh on Saturday or Sunday then I'll go to Seattle.  

Next Tuesday we drive to Seattle to "drop off" some sperm to be frozen. 

Cost 

Clomid & Ovidrel are covered by my insurance, along with any blood work or ultrasounds.

The IUI is $200 for the sperm washing and inseminating me.

Freezing sperm and keeping it frozen is $250 for the first three months, then $125 every three months after that.  

This is a pretty good deal.  There is about a 20-25% chance of it working each cycle.

I'm also on the list for IVF.  It's about a year wait and costs $6000.

-Selbe

Health Insurance & WIC

My Current Cycle

Each day goes by with no AF and all BFN.  I'm beginning to think I never ovulated.  Fuck.  Since my D&C my ovaries have begun shutting down again.  I wont get AF until they give me Provera again.  Maybe I'll start taking my Vitex again (I stopped after what I thought was O).  I'm going to be happy to start fertility drugs again and be monitored.    

My Insurance & Military Treatment Facilities

There are two main MTF (military treatment facility, military hospitals) in the area.  MTF Bremerton (US Navy) is 20 minutes away and the primary one I go to.  MTF Madigan (US Army) an hour away.  MTF Bremerton does basic OBGYN, low-risk pregnancy and low end fertility treatment (Clomid only, no trigger, injectables, IUI or IVF).  Since I have already done my five rounds of Clomid with no luck I am ready to move on.  In order for me to go to MTF Madigan I need a referral from my PCM (primary doctor) at MTF Bremerton, I just can't make an appointment there on my own.  

There are only a handful of MTF on the country that do more advanced fertility treatments.  Our last base was MTF Portsmouth, they didn't do much of anything there.  The closest to Portsmouth was 500 miles away in Washington DC (I believe).  So I was sent out into the civilian world.  Hence how I ended up at FCNE with Dr. H.

This is for Tricare Prime.  The only way I can get out of this referral system is downgrading to Tricare Standard.  I can see whatever doctor I pick in the civilian world (as long as they take Tricare) but have to pay copays.  Depending on your situation one can be better than the other.  But fertility treatment at a MTF tends to be cheaper than at a civilian doctor.

I'm hoping that my one natural pregnancy, although failed and ended with a miscarriage, means I'll have good odds with more advanced fertility treatments.  Though I've ovulated about five times in two years, I do have a good chance of getting PG when I ovulate.  IF I ovulate.

Referral Runaround

MTF Bremerton pissed me off yesterday.  At my appointment on Monday they told me my referral to MTF Madigan would be put in and in two days I could call up to make my next appointment.  

I called up yesterday (two days) to schedule my appointment.  The appointment line could not find my referral so they could not give me an appointment.

I called the referrals office.  They also couldn't find my referral, ether processed or waiting to be processed.

I then called my PCM that gave me the referral to begin with.  They couldn't find the doctor, or the referral and had no idea when they would.  Zero help.

Which left me only one option, call the appointment line and make another appointment with my PCM for another referral.

The appointment line only had two appointment available: A. in nine minutes; B. in two weeks.  Nine minutes just wouldn't work, and two weeks seems like a long wait for someone else's fuck up.  

So I drove there and talked to a couple people in person.  The PCM forgot to put the referral in.  I was informed a new one would be put in today and in two days (hopefully) I could make an appointment.  Which I'm sure in itself won't be for a month or so from now.  

WIC

I grew up in a family where getting food stamps, WIC or any other types of government programs was avoided as much as possible unless really needed.  It was an embarrassment.  My father says that times are changing and it's become less of an humiliation and more of people abusing the system.  I do believe there are many people out there abusing it, for as long as possible.  I also believe there are those that really do need it.  Our system just sucks at weeding out those that are abusing it and giving it to those that need it.  

I have been on government programs twice in my life.  I didn't have health insurance in my teens and early 20's, no job that offered it, no money to pay for private health care, and still in college.  I had government health insurance to remove cervical dysplasia, since that becomes worse if not taken care of.  Then another time to remove my tonsils since I was in a lot of pain and could not pay for the surgery out-of-pocket.  During this time I ate the same cheap food everyday and would donate blood to get free cookies and juice.  Though I was eligible, never during this time did I sign up for food stamps.   

I've also worked retail at several places that accepted food stamps (now EBT, no wait SNAP) and WIC. Again there are people out there that really do need food stamps.  Food stamps covers most food items. Every once and awhile I'd have a customer want to buy a "food item" and the card wouldn't accept it.  One example was years ago I had customer want to buy one of those tins filled with popcorn that stores sell around Christmas time.  The tins with not the greatest in the world but tolerable popcorn, and once you got done eating it (or throwing the stall shit out) a plastic bag was stuck in it and use around the house as a trash can, until it begins to rust.  She flipped out on me.  I've watched customers buy lobster, potato chips, soda pop, gum, and candy with food stamps.  Never fruits, vegetables or Ramen noodles.  I'm sorry, but if someone is broke and starving they have learned that if you eat certain foods they fill you up better than others, regardless of the calories.  And they know just how much sometimes cost.  I was limited growing up by my father on what I could buy at the grocery store to about $10/week.  One time I even got yelled at for wanting bread and milk in the same week.  Yes it was probably wrong on his part, and not something I'd do to my own child, but fuck I figured it out.  And now taxes are pulled from my crappy minimum wage job to pay for such programs. I don't really give a fuck that your Easter candy and not covered and how you "need" it.  Bitch to me and I'll tell you the real difference between a NEED and a WANT.  

Now moving on to WIC.  I like WIC better than food stamps because it does limit what you can purchase with it, such as only approved cereal, cheese, produce, formula, etc.  However WIC is a bitch for cashiers to ring out.  The WIC program requires cashier to go as far as writing their numbers perfectly (yes, they provide you a sheet on how to write a "7" correct).  Along with making sure the products are the correct type stated on the check and approved by WIC.  When a customer goes to use all her newly expiring WIC checks all at once it takes a great deal of time. 

I bring up this topic because Bean and I went to Wal-Mart late at night a few days ago.  When we got in line at 11:50PM there was only one person in front of us.  A lady, several years younger than myself, not married and with her daughter (about 1 year old) in the cart.  First off, it's almost midnight.  That child should be in bed asleep.  I don't understand why people don't have a sit bedtime and bring their kids out shopping late at night.  (Fuck, my six month old puppy even has a bedtime and falls asleep at 10PM, midnight the latest, each night!)  And then I looked at the belt and saw it.  Her separated stacks of groceries (baby food & formula) and the stack of EIGHT WIC checks right besides it.  

My infertile self got pissed.  She's broke, unmarried, has a child and for the next fifteen minutes I'm forced to stare at her in front of me.  Bean and I have been married for three years, have money (enough), a house, a dog, two cars and zero babies.  All I have to show for it is this shit and a dead baby.  Spectacular!  I looked at Bean and then her and mentioned something along the lines of "that is what you get when you don't use birth control".  Some days I admit, I'm just not a good person.

Not My Kind

Sometimes I wonder when I do get pregnant again how I'd react to other pregnant women around me that haven't had the same trials.  What if they got PG with little trying or on accident, instead of with fertility drugs, procedures and surgery?  Will I feel like they are not my kind?  Will I feel like I am above them? Especially if my pregnancy COST more (fertility treatment) than theirs?

Other Links

My old RE is offering a contest for a free IVF cycle.  This is only for those living in ME, NH, VT, MA, CT and RI.  You can enter to win by filling out the entry form here.  

An ultrasound device has been invented to work on smart phones.  I'd buy it if it wasn't $8k.  

-Selbe

BFN, TWW and Move to IUI

My OPKs got confusing this cycle so I don't know when I ovulated.  I got a dark positive CD12, then another a little lighter positive CD13.  There was also a lot of soreness on both the right and left sides from CD12-CD15.  And clear fluid CD12 and CD13.  Lets just guess and say CD14 was when I ovulated.  I'd be 13dpo today.

Not Pregnant

I never got any more pregnancy tests with a line as dark as the other day.  So NOT PREGNANT.  Maybe it was an evaporated line or something? 

There is still time, I didn't get my last BFP 'til 15dpo.  But I don't feel pregnant.  I also don't feel like I'm going to get my period tomorrow or Sunday.  I've gotten menstrual cramps all week, however, they only last a few hours at the most and then disappear again.  I don't know what to think.

I'll try another pregnancy test in the morning.

New Doctors and New Procedures Coming Soon

I went to get registered on base for my insurance today.  My old base I got sent out into the civilian world for my ENT, OBGYN and RE, just because they didn't have doctors there to care for me.  This base is much larger and has many of those things.  My first thought, "they can't possibly have the correct services to care for my screwed up self, I want a REAL doctor."  And then, 

"look at those girls in the OBGYN clinic, they're all pregnant and so young. I hope they don't expect me to sit in there with them."  I was pissed about the latest BFN.  Last thing I want to do is get stuck in a waiting room with a bunch of pregnant women who don't have the slightest idea what infertility is about.

I'm not sure how long it is going to take to get an appointment with my primary doctor, then OBGYN, then finally send me to a fertility specialist.  My husband's job sends him away from long periods of time with no real schedule.  This starts in a couple weeks.  This current cycle was our last TTC naturally (as in penis in vagina).  Maybe a couple times a year we'll get a chance but they'll be no schedule ahead of time or planning.  And with myself being annovulatory a lot of time, well I'm even more useless.

IUI - Source

I'm moving forward with IUI.  It was a decision made last year once my husband started going out to sea again, though I hoped I'd get pregnant and stay pregnant so it wouldn't come down to this.  It will be with my husband's frozen sperm so I'm not waiting on his schedule.  And I'll probably be using all injectables, unless they decide to give Clomid another try with monitoring this time.  I'm hoping to get all these appointments done, whatever testing they want, and the sperm in the freezer by August so I can start the IUI then.  Not sure if that is a realistic date with military doctors.  The waiting list is a year or two out for IVF so that's not doing to happen anytime soon.  My husband's schedule is going to be like for for the next three years.  I see the women in their 30's and 40's at the RE office, I know my insides are failing already.  I need to get this done and not wait three years.

No BFP and AF this weekend, then IUI is my next step.

On the positive I always did want twins, and IUI will bring me closer to that.

My two week wait symptoms:

Abdomen

Bloating - 0dpo-now off & on - Could be anything.  I feel fat sometimes.
Ovary Pain - 0dpo-2dpo - Ovulation?
Sharp/Stabbing Pains/Pulling/Twinges - 0dpo-2dpo - Ovulation.
Cramps - 4dpo-6dpo light, 10dpo strong, 11dpo-now middle - Could be AF coming.
Sore Muscles - 3dpo-now off & on - Lots of moving around.

Back & Legs

Backache - 8dpo-12dpo - Pain in the middle, usually I have upper or lower.

Chest

Heartburn - 6dpo - Burning throat, not sure what heartburn feels like.
Sore Breast - 2dpo-9dpo sore, 10dpo-12dpo really sore, 13dpo really really sore - Could be high estrogen or progesterone.

Emotional

Irritability - 11dpo-now - Could be PMS.
Happy - 0dpo-now - Ether really happy or PMS.
Anxious - 10dpo-now - I want this TWW to be over.

Head

Bleeding Nose - 12dpo - Dry nose?
Headache - 0dpo-now - Normal.
Stuff Nose - 4dpo-now - Allergies?
Dizziness/Light Headed - 9dpo-10dpo

Overall

BBT Luteal Phase Dip - 7dpo - Gave up on BBT though.
Vivid Dreams - 11dpo-now

Skin

Acne Breakout - 0dpo-now

Pelvis

Diarrhea - 7dpo-now off & on - With a lot of dairy.
Increased Cervical Fluid - 11dpo-now
Increased Appetite - 2dpo-now - Sometimes I've just starving, other times I'm fine.
Nausea - 5dpo-now - Morning and nights before I go to bed.  Sometimes it's so bad I almost dry heave.  This happens frequently when I don't eat much.
Food Aversion - 11dpo-now - Chicken.  Keep it away from me.

-Selbe

Post-Op Appointment 3/29

You know a doctor's office is expensive
when you see these in the waiting room.

Today was my last appointment with my RE since I'm moving. We went over the surgery from last week.

Uterus looks normal.  Nothing wrong with it and it has been cleared for a "healthy pregnancy".  The abrasions they found during surgery in October are gone.  And the D&C in January left no scar tissue or damage.

Estrogen blood work from a couple weeks ago was high.  But RE isn't concerned.

One of my ultrasounds (ether in January or September) shows I have lots of follicles (eggs) in my ovaries.  They look good for 27 years old.

Biopsy of my uterine lining shows I'll get my period soon.  It has high levels of something I forgot the name of.  First he said that was because I ovulated.  I asked when he thought that was, because I don't.  Then said it might be due to the Provera I was taking being absorbed.  That's a better explanation since I was on it for the whole week before.  I should get my period in the next few days, or a week max.

Pregnancy Checklist for Fertiles & Infertiles

On another blog recently I saw a checklist for an infertile who recently got pregnant after a miscarriage in the past.  It was pretty much her detailed list of things that needed to be accomplished before that baby could arrive. 

Before I become infertile if I had to make a list it would include things list "buy baby stuff" or "paint baby room."  I looked at this women's list and saw "maintain cardiac activity" written several times.  It didn't matter about what shade of pink the walls were, she just wanted a healthy baby.  I think sometimes we take that for granted.  

So I have a checklist for fertiles AND infertiles.  Keep in mind this is VERY bias towards infertility (hence the blog).  So don't take it to heart.  But in my eyes this is how I see the world right now.

	Infertile	Fertile
Week 1	Maybe this is my turn after waiting several years.  Maybe some more fertility drugs.  Google, buy, & try new set of products that someone told you would work to get you pregnant.	Maybe this is my turn after waiting a cycle or two.
Week 2	Lots of OPKs, more drugs, maybe IUI/IVF.	Vagina + Penis Time.
Week 3	Google every early pregnancy symptom you can think of.  Take a few HPT just in case you get an early +.	La la la...
Week 4	+HPT, have blood pregnancy test beta #1 taken, worry about miscarriage, worry about beta #2 not going up quickly enough, worry about ectopic pregnancy.  Keep taking HPTs to make sure line is getting darker.	Hmm, late period.
Week 5	First ultrasound, look for multiple babies, hope to see SOMETHING, worry about baby growing, worry about no heartbeat found, worry about miscarriage, worry beta #3 doesn't go up enough.	+HPT, announce to EVERYONE you know, including Facebook
Week 6	Second ultrasound, look for heartbeat, again worry about growing, heart, miscarriage, and find some other things to worry about.	Again make sure everyone knows. Call OBGYN, they won't see you 'til 8 or 12 weeks. :(
Week 7	Repeat week 6 for third ultrasound.  Make sure heart is still beating.  Take trip to ER because you think your spotting equals miscarriage.	Start baby shopping.
Week 8	Forth ultrasound.  Baby still alive?  Write birth plan.	La, la, la?
Week 9	You are so grateful for morning sickness.  This means my baby is healthy.	Complain to everyone how horrible you feel with morning sickness.
Week 10	Baby still alive?  Graduate to OBGYN.  This is bittersweet.  Tell OB you ovulated January 13th at 11:30AM.  Get a very confused look.	First OBGYN appointment.  Complain about something.  Maybe having to get a pap smear. Tell OB you can't remember what your LMP was.  What's LMP?
Week 11	Worry about miscarriage.  Another trip to ER.	Start thinking about baby shower.
Week 12	Baby still alive?  I love throwing up.	First ultrasound, cell phone picture of ultrasound on Facebook before I even get home.  I hate throwing up.
Week 13	Out of first trimester.  Odds of miscarriage decrease.	Happy to be throwing up less.
Week 14	Worry about cervical incompetence.	Worry who to invite to baby shower.
Week 15	Baby still alive?	Shopping?
Week 16	Yes I need maternity clothes!  Look at that bump!	Worry about getting fat & needing maternity clothes.
Week 17	Re-read baby & pregnancy book for third time.	Buy pregnancy book.
Week 18	Worry about something.	La, la, la?
Week 19	Gender ultrasound.  Is my baby OK?  Does it have all limbs and organs?	Gender ultrasound.  I really want a ____.
Week 22	Worry baby isn't moving enough.	Buy stuff.
Week 24	Chances of baby surviving out of womb are higher now, if I went into labour early.	La, la, la?
Week 25	More tests?  Yes!  Is my baby healthy?	I hate the ____ test!
Week 26	Pay off expensive fertility treatment loan.	Buy expensive baby stuff.
Week 27	I wish I could have a free baby like fertiles.	All this baby stuff is really expensive.
Week 28	I love feeling the baby kick so I know it's OK.	This baby kicking is painful.  Soccer player on the way?
Week 29	Bedrest?  Sure, as long as my baby is healthy.	Yell at the 16 year old cashier at Babies"R"Us for something stupid & you'll regret later.  Dam hormones.
Week 30	Finally take baby bin out of basement that you've been saving for the last few years.	Set up baby's room.
Week 35	Hard time sleeping, but at least my baby is healthy.	So uncomfortable.  I want this baby out of me soon.
Week 36	Maybe I should of had a baby shower.  But I always hated those things.  Nevermind, something threw me a surprise shower anyways. :/	Use few giftcards I got for baby items.
Week 37	Worry about baby being stillborn, or something wrong with it.	Worry about baby being stillborn, or something wrong with it.
Week 38	I can't wait to met my baby.	I want this baby out of me NOW.
Week 39	La, la, la.	Employ the help of your whole Facebook friends list on how to induce labor.
Week 40	La, la, la.	After a few false alarms, finally in labor & delivery.
Baby Week 1	My baby is amazing.	My baby is amazing.

-Selbe

Post-Op & Planning Appointment 11/3

The Surgery:

It went well.  I recovered quickly and he didn't even look at my stomach at the appointment.  I guess the stitches (?) is suposed to fall off or go away on it own.  I've never actually had stitches before.

RE talked about the same things from the pictures before.  

Right Fallopian Tube:  Eh but he's not too concerned the risk of an ectopic pregnancy.

Uterus:  I have an hyperplastic endometrium.  Not too much of a concern though.  The biopsy of it came back normal.

"a condition of excessive proliferation (cell growth) of the cells of the endometrium (inner lining of the uterus.)...

...result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones which ordinarily counteract estrogen's proliferative effects on this tissue. This may occur in a number of settings, including obesity, polycystic ovary syndrome, estrogen producing tumours and certain formulations of estrogen replacement therapy." - Wikipedia

Cervix:  I also have cervical stenosis as "very little normal cervix was remaining" and it was a bitch to dilate.  This was already assumed for awhile.  My cervix is scarring over and the opening is very narrow.  This is why cramps are so painful to me and my HSG was a trip from hell.  It's complements of my LEEP in 2005 and 2009, but mainly the second one.  It's a rare risk of having a LEEP done but of course my body loves to be "rare".  I forgot to ask Dr. H about the possibility of having an cervical cerclage put in if I do get PG.  The actual thought of having my cervix stitched closed terrifies me so we will put that thought off for awhile.  FYI a cervical cerclage is used in women that have a incompetence.  The cervix begin to dilate way before it should, maybe times due to the weight of the growing baby.  It results in miscarriage or early labor.  The cervix is stitched closed around 14 weeks and the stitches are removed around 37 weeks.

Ovaries, left fallopian tube and vagina are all good.  Fuck something semi works.  

What's Next?:

I have CD21 Progesterone BW next Monday.  I need to have at least a 3.3 to have ovulated, even if it's a crappy ovulation.  No 1.7!  A 10 is ideal for a non-medicated cycle.  (It was 15 when I was Clomid or if I'm on any other drugs.)

And then I need to decide, ovulation or not.  No ovulation then Provera will be my buddy again.  

Source

Dr. H began talking about doing an IUI (intrauterine insemination).  It's a couple types of shots and then Bean's sperm is poured into my uterus once I've ovulated.  My cervix hates me and I fear having another tube stuck up it, even though the RE assures me it is much smaller than the one for the HSG.  The cost is between $2000-2500 which will not include my meds, an additional $500.  But spending $3000 does not 100% get me a baby, only about a 17% of one.  So odds are I'll need multiple which is $3000 each cycle/month.  

And then there is IVF.  We are not even going to get into that because each cycle costs $12,000.  Again no 100% guarantee.  But if I buy two (results in BFN) then the third if free.  How nice of them!  If I spend $24k I'd better get a lot for free, along with a free crib, stroller and all the other stuff.  We can just pretend like this doesn't exist for now, like the cerclage I'll probably need.

My insurance will NOT cover any of my meds used for an IUI or IVF.  In fact they will even refuse to pay for basic U/S and BW.  They want no part of it.  (Then again my infertile ass is expensive, I don't want to pay for me ether.)  But they will cover my meds for timed intercourse (TI).

So for TI it is the same meds and monitoring as an IUI.  Except when I ovulate I have sex like a normal person, you know penis in the vagina, no tube of sperm in the uterus.  I'd like it to be as normal as possible.  This has a lower success rate but then again it's a lot cheaper.  

The meds I'd use for the TI (or IUI) are:

Gonal-f RFF Pen 450 IU @ 75iu/day - Daily injection used for ovulation induction (OI) with FSH hormone from CD4 for a week or two.  This makes my ovaries produce lot 'o eggs.  This is much like Clomid but for those who don't do so well on it.  I can't wait to stab myself in my stomach!

Ovidrel - Once injection of HCG hormone for my ovaries to drop all the eggs.  I'll be monitored with several U/S to see when my eggs have fully matured with Gonal, then this shot is used.  

I might be on Progesterone also to reduce the risk of MC since my body doesn't produce enough of it on its own.

The injectables come with a higher risk of multiples.  I'm pretty sure it made Bean worry a bit when the nurse said that.  But it's a 10% chance of twin, and much lower for triples and so on.  She let him know there wouldn't be six which I'm sure he was picturing in his head.  To be honest we are both pretty excited for twinkies!

Decision:

I'm going to see what the Progesterone comes back as.  If it's good then I'll hang out on Vitex and hope to be normal for awhile longer.  Or I'll move to TI with the injectables.  If it's too low then I'll definitely be moving to TI.

I'm not ready for IUI.  We have the money but I feel I haven't had enough time having natural sex to have given it a good shot.  I've been having unprotected sex for over a year but very rarely have my ovaries actually released eggs.  And a couple my age only has 20% change each time with perfect timing.  

I'm also waiting to move since our new home (hopefully) has an Army base that does IVF at a discounted rate and includes the drugs.  

Bean is most likely going to be sent back out to sea in the spring.  I can do IUI and IVF while he is gone with his frozen sperm.  I'm going to use the "fresh" stuff now.

If TI works:

I'll have BW for check my betas (PG test) 14dpo after each TI cycle.

I will stay at my RE until 8-14 weeks before being sent to an OBGYN.  My first fetal U/S will be at 6 weeks, then one or two more at a later date before going to the OBGYN.

-Selbe 

CD19, 4dpo