$42,620

I know I've spoken pretty freely about the infertility insurance we were blessed with through my husbands employer. Were. Past tense, he ended his position with them last Friday and began a new position with a new company today. One of the biggest worries I had with him changing jobs was how that would impact our family building plans. With our previous policy we were VERY blessed to have 'full' coverage for 6 iui's and 3 ART courses of treatment (3 fresh or frozen IVF cycles). We live in a state that does not have mandatory coverage laws when it comes to infertility, so it was a huge blessing that Hub's company was based in a state (IL) that did have such mandates. It was a pretty big surprise to find out that our new policy would also have a bit of coverage. Though it isn't as impressive as the last package, it is something-- and money that we will not have to come up with when we are ready for an FET. Thank goodness!

In an effort to keep some info from our infertility treatment days without searching through EOBs, I took a little time today on our old insurance company's website to make a list of what we've spent on infertility and also a list of what was billed- since our new policy is a dollar amount instead of a # of cycles.

I kind of wanted to throw up when I saw that number. I talked to my mom last week and kind of off the cuff said without our coverage we probably would have spent about $40k on treatments so far. When I said that it seemed like a big number that was probably inaccurate. Guess who was painfully close to correct?

$42,620 for consults, testing, six IUIs and two fresh IVF cycles.

Oh my gosh. What would we have done if we didn't have that coverage? Found a way I suppose, but I am even more thankful now than I was then. To paint the whole picture, we only paid about 12.5% of that out of pocket-- most of which was co-payments.

Insane. It is heartbreaking to me that there are so many couples who are unable to do all that we've done because they don't have the insurance coverage we had and the money just isn't there to afford trying for the baby/babies they long for.

Thirty

Today, I leave my twenties... forever. It isn't a sad day, I can assure you, if I were still in the throws of infertility it would be an incredibly rough day. But, here I am, waking up to two perfect boys- happily skipping my way out of my twenties. Those years held some of the best of times, but also many of the worst.....

20: I was in college. I was living with my best friend from high school- she turned out to be not exactly what I was looking for in a roommate. I continued to date my high school sweetheart and our relationship grew and grew.

21: My parents threw me a 21st birthday BBQ. Still in college- new roommate. We had an insane amount of fun together. Hubs and I spent spring break visiting his sister out of state.

22: Became engaged, planned a wedding and graduated from college! One of the best years EVER!

23: Got married and honeymooned in Mexico. Upon our return we move away from our hometown. We ended up in a more metro area than where we grew up and we enjoyed being newlyweds with very few responsibilities.

24: Hubs worked hard and I worked as a sub here and there until I got a long term position at the world's worst private school. Looking back it was probably a good experience, but those were some rough months.

25: Started trying to get pregnant. It was fun right up until every female of childbearing age in my family got pregnant. Then it just got difficult. I was beginning to realize something might be wrong just in time to celebrate all of the baby showers. Cue a round of clomid to finish out 25. On a happy note, my first nephew was born just 4 days before my birthday.

26: It started with a hopeful heart- surely I'd be pregnant with clomid before the rest of babies were born... wrong! We did 5 more rounds of clomid and then decided it was time for a break. It was a dark and depressing year.

27: I finally decided one month exactly after my birthday (on our anniversary) that it was time to bring out the big guns and see a fertility specialist. That year we found out I have a thyroid problem and PCOS. In addition we did six unsuccessful IUIs, took a very short break and then geared up for IVF#1. This year was filled with hope, disappointment and longing.

28: We did our first round of IVF shortly after my birthday. I took my very first positive pregnancy test and was able to tell my husband for the first time that he was going to be a daddy. Unfortunately, just a couple of weeks later we also had another first- a chemical pregnancy/miscarriage. This broke me- but built me up all at the same time. I was SO ready to try again. And try again we did- just a few months later. With a second fresh IVF cycle I became pregnant with my boys. I spent 6 months of this year pregnant with twins and loved every last second of it!

29: I spent the first six weeks of the year largely pregnant with twins putting the finishing touches on their nursery and preparing for our life to significantly change. Then, on August 15th, the best thing to come out of my twenties happened- we became a family of four. I spent the remainder of the year raising my boys and with struggle and sleepless night came coos, crawlers and kisses so sweet they take away much of the pain and despair it took to get here.

So while it wasn't the easiest decade of my life, it was probably the sweetest. We grew and we fell more in love with each other in the hard times, but also in the good. We watched as we became mama and dada- my life changed in my twenties and that I will always remember- maybe someday the other memories will fade, but I hope I always remember how sweet 28 1/2 - 30 were!

I take it back...

Uhhh, guess who spoke too soon? My nurse called this afternoon I'm starting stims on Friday instead of Saturday. Which in the long run could be great news (I'll explain when I'm not typing on my phone) but for now, it really eff's with my black Friday mojo.

I'm sure I'll figure something out. How exactly do I explain needing to see my husband privately for 10 minutes at 6:30am when no one knows we're doing IVF? I'll let you know what I come up with!

In a year...

About once a month I randomly think to check out my blog archives and see what I was doing the previous year on that date.

One year ago today we found out that our first IUI cycle didn't work. I kinda of remember being sad that day, but mostly I remember turning the other cheek, and getting ready to do it all over again. I was determined.

In the last year, we've faced a few more failures and a short lived success. Since that day, we've done five more IUI cycles, two natural cycles, and and a round of IVF/ICSI. I've received five more phone calls relaying the news that I wasn't pregnant, one telling me I was pregnant, one telling me I might still be pregnant, one with the news that it didn't look good, one saying the pregnancy wasn't viable and to stop taking my meds, one relaying the news that my beta was under ten, and one that it had finally reached zero.

What a difference a year makes.

Even though we are in the same spot... not pregnant, we've learned a great deal about our bodies, and we've faced challenges that seemed unthinkable. We are stronger for it.

On Wednesday I'll take my last birth control pill for our 'rest cycle' and we'll officially our second IVF cycle just a few days later. I'm excited, but it doesn't take away the bit of anxiety that is in the back of my mind thinking- what if it happens again? But, I keep reminding myself I have two choices:

1. Quit because I'm scared
2. Face my fears

If I learned anything from the trials last summer brought, it was that I'm plenty capable of facing my fears, and if it all happens again- I'm also plenty capable of pulling myself back up.

Whoa!

Oh.my.gosh.

So the other day my husband and I were talking about all of the medications I have taken in the effort to get pregnant. He said he wished I would have written it all down- I looked at him like he was crazy and said 'I have!' So he asked me to put it all in one place so we could keep track, just for kicks. Um, its NUTS!

I of course have a list of ALL the meds I've taken, but for this I just focused on stimulation drugs and hormone supplements.

Without further ado, after 6 unmonitored clomid cycles, 6 IUI cycles and 1 IVF cycle...

Progesterone (pro.metrium, caps, endo.metrin) -- 18,600mg

Clo.mid -- 5,000mg

Fo.llistim -- 2,850iu

Men.opur -- 825iu

Lu.pron -- 175iu

Es.trace -- 70mg

Hcg (Ovi.drel, Nov.arel) -- 11,500iu

Just just so you know... that breaks down like this-
159 pills swallowed
78 injections- thankfully only 12 of those were in my rear!
111 suppositories inserted

... and that doesn't count 3 years worth of pre-natal vitamins, one year of met.formin 3x per day, antibiotics or steroids- that would add over 2,300 pills swallowed. This from the girl who took baby Tylenol through college because I could not swallow a pill. Oh, the lessons we learn!

Wowsers... that is A LOT! Lets hope there is only ONE more cycle to add to this list!

A few things...

I don't have much to say, so I thought I would just give a bullet point update from CD11 of a natural cycle....

• The hubs is going to be out of town for what will possibly be peak ovulation time... if I ovulate on my own this cycle. Oh-well.


• I managed to make it through the baby shower over the weekend. The guest of honor was kind of on my sh*% list before the shower, but that is a another post for another day.


• We sent a second email to our parents. It had been about a month since the first, and we felt like we should update them on the final failed IUI and that we are moving on to IVF soon.


• Two weeks until our IVF consult. This will also be my first appointment with my RE when she is NOT pregnant!


• I found out my sister-in-law is having a shower for baby #2. Although I really am happy for her and my brother, I am NOT really happy to be attending another baby shower which will be out of state AND on Mother's Day weekend. Lord help me.


• My best friend ended up ditching her duties helping get ready for the baby shower on Saturday, and instead she joined me for a wonderful pedicure and a nice long talk over lunch. I REALLY needed that.


• I've been very surprised that my in-law's response to all things IF, and have felt more supported by them than my own parents. I was super worried about it, and it has proven to be great.


• Every time I get in the car a super inspiring song comes on the radio. I am loving it!


• Not taking fertility drugs is amazing :)


• I love being able to go to the gym and do whatever I want without worrying about my growing ovaries!


• I am meeting a fellow IF blogger at the end of the week!


• My insurance company makes me CRAZY!

Skipping The Weekend...

I know it is an odd request, but I'm wondering if we could just skip the upcoming weekend and move right through to the following week? Whats that, you'd like to keep your weekend? Well, I guess if your going to be picky, maybe we could just skip Saturday.

If you hadn't already guessed, I have a baby shower to attend on Saturday afternoon. While I am extremely happy for the mama-to-be, I can't help but despise the idea of going and sitting in a room FULL of pregnant women ogling over tiny baby clothes. Unfortunately the shower had to fall 2 weeks after our final failed iui cycle. It would have been worlds easier to attend if I were still feeling hopeful in the 2ww, but why would things start going my way now?!?!

I think the part I hate the most is that I was asked to co-host this shower shortly after the pregnancy was announced early last fall. I confided in one of the other hosts that it would just be too difficult if I still wasn't pregnant and facing fertility treatments to make cute decorations and come up with fun party games. I had it all counted out and I knew when our last IUI would be approximately. I knew if those didn't work, that around this time we'd be moving on to IVF. Deep down I think I knew then that this is where we'd be. Maybe I jinxed myself!

Perhaps I deserve a pedicure on Saturday morning. You know, to relax a bit before heading into the lion's den. Too bad the majority of my friends are co-hosting the shower and will be together preparing for the big event. For some reason pedi's are always better when shared with a friend.

Ok, enough is enough. This pity party is O-V-E-R! I have 4.5 days to suck it up. I can do this. I can do this. I can do this!

Twisted...

Is it sick at twisted that while I'm not even pregnant with our first baby I am already kind of freaking out about getting pregnant with the next one? My husband and I have agreed that if we get pregnant with twins when we do IVF, we will probably not ever seek fertility treatments again. The probability of us having twins is pretty stinking high, but part of me gets sick to my stomach thinking about the possibility of doing this all over again. On the upside, at least I'd know what to expect.. you know, like 6 failed iuis. Is this normal? Those of you who would like for this elusive pregnancy not to be the ONE and ONLY, are you already worrying about subsequent possible pregnancies?!?

Stronger...

On Monday while I was driving to the clinic for my beta I was doing my best to prepare myself for a result that I was already pretty sure of. I'd been praying for peace and beginning to wrap my head around the idea of IVF in the next couple of months when this song came on the radio.....

The Results Are In....

... and they are again the same as they always are. It looks like IVF is officially on the horizon. We have the option of one more IUI cycle with injectables, but to be honest, I just don't have it in me. My doctor made it very clear before she went on maternity leave (fitting) that we could move on to IVF whenever we were ready... we are ready-ish. Our doctor wont be back until mid April, so that means we will have a natural cycle and a much needed break from any fertility medication. Once she returns, we will get set up to begin the IVF protocol with the following cycle. All of this is terrifying and but kind of exciting all at the same time. A 70% chance over a 25% chance is pretty appealing at this point!!!

Trumped...

I'm afraid the "signs" from earlier in the week were trumped this morning at 5am when I sleepily put my thermometer in my mouth. My temperature has been higher than it has ever been for that last week or so, and I was beginning to let hope (to be honest, a lot of hope) creep in. Today however, it dropped. My beta is tomorrow morning, so I'll drive 40 minutes each way to confirm what I am already pretty sure of... I'm not pregnant. I guess it is time to drag out the old white folder and give it a more serious look.

SIGNS...

... literally.

Tonight while I was on my way to meet a friend for dinner I saw two signs that nearly made me pull my car to the side of the road just so I could get a picture to post... it was raining, so you'll just have to take my word for it.

The first was an adopt a road sign. The road was adopted by BFPS. Which was comical because those letters stand for an elementary school that I interviewed with a couple of years ago... I can't imagine if I worked there now and had to constantly look at things labeled BFP!

I had barely recovered from the BFPS sign when I looked up just in time to see another sign, I'm not sure what it was for, but it clearly read PUPO.

I am not typically a 'signs' kind of person, but I am 9dpiui.....

The Aftermath...

I've had a lot of people ask how things went with our parents after we shared our infertility story with them. The short answer is.... great!

For so long, we (mostly me) were worried that there would be endless questions, awkward moments and enough pity for all of the infertiles of the world. We thought there would be opinions flying and judgements made. And to be honest, maybe there have been. Thankfully though, we haven't had to hear any of it.

We didn't go into extreme detail in our email, but we made it very clear it has been a very long, hard road with many treatments, fertility drugs, and dejected spirits. We were also abundantly clear that we hoped this wouldn't become a topic of conversation, and much to our surprise it hasn't. We asked that if they had questions they email them to us and allow us to decide together what we were willing to share. So far, not a single question. We received an initial email back from both sets of parents that was short, sweet and supportive of our choices for our family.

We saw both sets of parents last weekend for the first time since the email and although we did receive a slightly tighter hug upon arrival, a few thoughtful glances when families or babies were being talked about, in general it was business as usual.

For the moment, I am happy with our decision. We have their support if we need/want it, and more importantly we don't have to tip toe around anymore making excuses for not being able to make it to an event.

Honesty really is the best policy.

Blessed...

Some days are hard. Some days I feel like it may never happen. Some days I just need to take a step back and realized just how blessed I am.

So, today in an effort to count my blessings I decided to tally up all of our infertility costs from September through the first week of March.... oh.my.gosh. Wondering why this painful number ($11,628) makes me feel blessed? Well, I've mentioned it before... we have incredible insurance. Of that large price tag, we've only paid a fraction (about 1/8). If that isn't reason enough to feel blessed, I'm not sure what is.

I was recently talking with someone about the SART website, so today I was intrigued to see if there were new stats for my clinic since the last time I looked back when we were choosing a clinic. After looking at the 2009 success rates, I was curious about other places across the nation. I was very surprised at the vast difference in success rates at various clinics. I am counting myself blessed that my clinic has some of the highest success rates that I found for my age group. It makes the possibility of an IVF cycle a little easier to stomach.

So even though I am currently finding myself 6.5 months into treatment still not pregnant, I am still counting myself blessed. The situation could ALWAYS be worse. Sometimes that is hard to remember on the hard days, so I just have to go out of my way to remind myself :)

Picture This...

...my husband, a RE, a nurse and myself all in a TINY exam/ultrasound room. I am not exaggerating on the size. Within the room there was the exam table, a small stool for the doctor, a counter with sink and cabinets, an ultrasound machine, one chair, a large garbage can, a magazine rack and one of those bendy spotlight things. Keep in mind that this room, containing all of the previously mentioned items and people, is only about 6'x10'.

Moving on.

Upon arrival to the room, the nurse gave the usual instructions about undressing from the waist down and then we were left to wait for the doctor. Once the doctor arrived he gave us all of the information about my husband's sample (which was the best one yet!!) and then briefly explained what was about to happen. All the while I am thinking to myself, "really, you are going to explain an IUI to me right now? Check out my chart, this is NUMBER SIX! I am pretty sure if you gave me a mirror and a third arm I could do this myself!"

Once we were educated on what was about to happen, he grabbed the end of the bendy lamp out from the side of the exam table that was right up against the wall and asked me to put my feet in the stirrups, lay back and scoot to the edge of the table. As the doctor begins "preparing the cervix" the bendy spotlight flickers and then goes out. Perfect.

It is important to note at this point, that said spotlight was plugged in behind the exam table that was pushed up against the wall of the tiny exam room. Let me also point out the the outlet it was plugged into was about half up up the exam table, about mid torso while I was laying down.

So, once the doctor realized that it may be an issue of not being firmly plugged into the outlet he stands up and proceeds to examine the issue from right between my legs... which of course are still in the stirrups. He is reaching for the plug to make sure it is fully engaged in the outlet and all I can think about is what if he loses his balance as he reaches? He is going to end up in a VERY awkward position!

This of course all took place moments after the "scoot to the edge of the table" comment that nearly always makes me giggling after another blogger (who shall remain nameless... HI!!) told me about her not so graceful, unintentional dismount from the exam table at her IUI recently. Let's just say I scoot with a little more care now!

Needless to say, number six was memorable!

I am feeling really hopeful about number six. I had two follies, a nice lush lining, we had a great sample and the doctor said that the insemination went perfectly and he was able to get right up to the top of my uterus. I REALLY hope this is it!

Six.

Tomorrow is the big day.... our sixth and final IUI. Six.

I managed to find a little hope for this cycle after Friday's ultrasound appointment. As of Friday, I had two follies that looked like they would be plenty mature, and my lining was thicker than it has been in the past with a triple stripe pattern. I am trying to believe that this might be it, but with our track record it is SO hard!

White

Yesterday I brought something home from my baseline appointment that I had been hoping and praying for the last six months would not EVER enter our home. I think deep down, I knew it would, but it doesn't make it any easier to have a shiny white folder on my coffee table.

Let me explain. This is not the first folder to make a one way trip from the clinic to my coffee table. First it was shiny blue. Blue= IUI/oral fertility drugs. It was scary because it was the first, but now looking back, that reading material was like a children's book... maybe even a fairy tale. Then came red. Red was full of information about IUI with gonadatropins. Red was more like a choose your own adventure book. Although exciting with possibilities, it was also terrifying all at the same time. The side effects sheet alone had me shaking in my boots. Then yesterday. Yesterday I brought home yet another folder. The final folder. The dreaded shiny white folder.

The white folder is all about IVF. I don't even know what kind of book to liken this folder to. Instead I will just list its chapters for you...

IVF Registration
Financial Agreement
Cost Breakdown
Pre-Treatment checklist
Psychological Services
In Vitro Fertilization (IVF) Explained
Sonohyserogram
Acupuncture and IVF
Participation in IVF Procedures
IVF Medications
Side Effects: Gonadotropins
Facts about OHSS
Complications of Multiple Gestation
Egg Retrieval and Embryo Transfer
Comprehensive Chromosome Screening
Do's and Don'ts for a Treatment Cycle
ART Glossary
Fertility Pharmacies
Anesthesia

Yesterday I hardly got past the first few "chapters" before I started to get a little nervous. Then I stopped to remember a bible verse that I'd read just a few days ago... Psalms 46:10.

"Be still and know that I am God."

Be still.

6th and FINAL IUI cycle...

Baseline: No cysts- several resting follies on both sides.

E2: 36

Tonight: First follistim injection of the cycle.

Tomorrow's post: The dreaded white folder...

Waiting...

Just waiting for cycle day one for the twenty-second time.

We've been trying for over two and a half years and have had twenty-two failed cycles.

Ten failed Clomid cycles.

1 failed injectable cycle.

5 failed IUI cycles.


We are going to do one last injectable IUI cyle. If that isn't successfull... well, you know what comes next. Right now, I am trying not to think about it!

If you were wondering....

... five was no luckier than one, two, three or four. Not pregnant. Still.

I think I have one more try left in me... then... well, lets not talk about it yet.