Preparing to jump... revisitied

A few weeks ago I wrote a post about the possibility of going off birth control in an effort to put in our 'one year of trying' so we'd line up with when we'd like to do an FET likely in early 2015.

There is big news on that front- our insurance requires no referral, or registering for infertility services. Our previous insurance required both a referral to an RE and we had to register as infertile with a specific branch of the company. At which time they asked and recorded all that we'd tried and we were cleared to see an RE. This is not the case with our new insurance. So, I am able to stay on birth control right up until we are ready to jump back in.

I am so glad it is working our this way for us. I was really worried about what my body would do without birth control. I'm not convinced met.formin would make me cycle regularly and I cannot imagine taking progesterone every couple of months with two one year olds at home- that stuff makes me SO TIRED!

So, now we don't really have to plan ahead. When we're ready, we make the appointment, and its GO TIME! If we keep with our current plan, that will be in about a year- crazy- and really exciting!

Preparing to jump.... again

As I said in my last post, thoughts of another baby are beginning to surface. Its funny, these thoughts of a second pregnancy are a little surprising to me. When I think about another pregnancy, it is in thinking about 'planning' it. So much about infertility (part one) was being a slave to not building expectations, learning to live without a plan at times and learning to live my life by a calendar someone else handed me at others. And now, now we have more pieces in our puzzle. We have seen success, and we know what (at least last time) works for us. We have three frozen embryos which are similar in quality to those we transferred during our two fresh cycles. Both of those cycles I did become pregnant, at least briefly, and because of that, I am hopeful one of those three embryos will become baby number three.

In a perfect world we would begin the FET process in January of 2015. So, why am I already thinking so much about all of this? We have fertility insurance. And while I am very thankful that we have it, it does add more hoops to be jumped. Like the fairly common '1 year of timed intercourse' before benefits can be utilized. Though I'm not sure that applies to someone who already has an infertility diagnosis, it is still very much dominating thoughts of growing our family. What this all means, is I'll need to go off birth control sometime around Christmas this year.

Its crazy. 'Trying' for a baby just a couple of months from now feels a little nuts, but we are being realistic in knowing an FET is very much a part of our plan. This may come as a surprise to some, but I don't have any desire to become pregnant naturally- nor do I think it will happen. I have three perfect embryos that I would like to give a chance to, and I'd rather not push that out longer and longer.

The three embryos we have are something I think about daily, and something that makes my husband feel somewhat uncomfortable. We aren't big fans of those babies just sitting and waiting for us for years to come. And if we're being completely honest, we aren't sure how this story is going to play out. Will we try with all three (not at once), will one or more of them not survive the thawing process, will we become pregnant with our first FET attempt or will it take multiple tries, will any of those three embryos become our third child? I'm fairly confident in the process and I trust my doctor entirely, so I do believe the boys' sibling is waiting for us. But, the unknowns are somewhat daunting.

I'm somewhat worried about going off birth control. I'm worried I wont have regular cycles due to my PCOS and I'll have to resort to the very much unenjoyable progesterone to stimulate cycles. I'm looking forward to the possibility of another baby and our little family growing, but it feels somewhat surreal to be thinking/preparing to jump back into all of this no matter how far off it is.

I don't often hear/see people speaking about their frozen embryos. I think I've read just one blog post about a family donating after their twin pregnancy/birth and I know of one blogger who fully intended to try with every embryo she had, but as it turned out it wasn't something she needed to worry about.

I'd love to hear your take on this, or what your plans are, my fellow IVFers. Either leave me a comment, or post your thoughts on your blog and leave me a link in the comments.

$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.

Updates!

It has been so long since I've written much other than a monthly update for the boys. So here are a few bullet point to get things caught up!

• Insurance is still lame. I was denied by another company for a private policy, so we've decided for the moment to have Hubs continue working where he is. On the plus side, the infertility coverage remains, and depending on how long he stays at this job we may be able to use the remainder of our IVF benefits.
• Depending on the above, baby number three may be thought about sooner than originally planned. Likely closer to a year from now instead of two this is both exciting and terrifying at the moment!
• We went on a family vacation a couple of weeks ago. Nothing too grand, we just rented a great big house and hung out for five days! Relaxing and fun!
• I am still taking met.formin... on the days I actually remember. I was SO good about it when I was on it and trying to get pregnant. Now? Not as much. I'm hoping to get better about it, because I know it will help.
• My lack of summer clothing is somewhat comical. I was hugely pregnant last summer and the summer before I didn't buy many new things because I was doing IVF and hopeful I'd be pregnant and expanding soon. So, that leaves me with things that are a few years old, a little dated and worn out! Its time to go shopping I guess!
• Over the weekend hubs and I removed some furniture from our living room and rearranged it so we could add a large-ish gated area for the boys. They are both crawling and climbing now and we had to do something before I went INSANE!
• 9 month sleep regression... not my favorite. 9 month sleep regression coupled with two babies with a cold... a little slice of hell. 
• The boys HATE finger food. H will try a few things, A turns his head and clinches his lips. Any tips tricks, food ideas?!?
• We're in the market for convertible car seats and a side by side smallish (reclining) double stroller.... any recommendations?
• I'm so excited for summer! Farmer's markets, festivals and fun outing with my little family on the weekends- pure joy!
• We finally put both cribs back in the nursery- I love the way it looks!
• I currently have one child napping in the swing that I need to return to a friend- They haven't been in it in months because I was trying to wean them from it. Buuuut, mama would do anything for a little nap time with two cranky stuffy babies
• It seems insane that we are already starting to semi-plan the boys' birthday party! We are really excited and want it to be plenty special for our little guys-- I have approximately one million craft project to complete in the next three months.
• My husband asked me the other day what I wanted to be when I grew up. I responded first with 'am I not grown up?' and second with 'I'm doing exactly what I've always dreamed about. Being a mom and taking care of my family.' It is not always (or ever really!) a glamorous job, but it is pretty close to perfection in my book!

Insurance

Ugh.

This morning has been upsetting... I'm not sure that word even encompasses all I've felt.

In the past several months Hubs has been considering a new job. It was never his long term plan to be there forever, but it was easy to stay- the money is good, the insurance is great and he really likes the people. This past week he received a job offer. While the position is a fantastic fit, their health insurance options are not the best. Being a small company (compared to the very large one he currently works for) the premiums are HIGH... like nearly 3x what we are currently paying for amazing (infertility included) coverage. We were willing to walk away from our IVF coverage to the possibilities that were in front of us, and even take a slight pay cut all with a plan for the boys and I to get a private health insurance policy for a significantly reduced rate. Sure it wouldn't be perfect, but it would be doable. Until I was denied. I have to be honest, I was surprised. I knew infertility could be a problem, but I guess I just assumed (obviously incorrectly) that since it  is not covered under this policy that it would be a non-issue. Wrong.

It is upsetting because while I do still very much identify with the infertility community, I feel like it is behind me to some extent. We have three more embryos we intend to try with, but I feel pretty resolved at this point- if they don't produce a pregnancy, I'm finished with treatments. I get that I may change my mind, but I have been in such a great place since becoming pregnant with our boys. Today, well today reminded me of the hurt I felt before. That failure feeling- because now this possibly great fit job for my husband may have to be declined because we need to stay with our group health plan- because once again my reproductive system is getting in the way of the plans we have for our family.

Thankfully my husband does not blame me in any way for this. Infertility has always been something that was an 'us' thing, not a 'me' problem. I am so very thankful for this fact, and for the fact that he sees how this all hurts me and generally knows just what to say. He has been nothing but gracious this morning, saying if it doesn't work, it doesn't work. He is ok with having to continue on at his current employer if it is what it takes. He really is an amazing provider for our family.

I just wish infertility didn't have to steal our joy once more.

Scattered...

I don't have anything cohesive to say today so, as usual, its a list kind of day...

• I went to the gym twice yesterday- 7 miles and over a thousand calories. Who am I?
• ONE.MORE.BCP
• Christmas gift wrapping starts this weekend- I can't wait!
• Doxy.cycline makes me sick every freaking day. Next Wednesday can not come quick enough.
• I finally did some sewing today that had been in my to-do pile for weeks. 
• I just had the most pleasant call with my insurance company EVER. The rep not only spoke English, he also knew how to use his computer and I'm fairly certain had been educated past the 8th grade... AND he told me exactly what I wanted to hear which always helps :) Thanks, TJ!
• The injection tally is up to 3 at this point- only one bruise and two tiny red dots on my belly. 
• I wish the laundry fairy would come to my house. We used to be able to go weeks between laundry days if we wanted because I had a ridiculous amount of clothing. Now that I've packed up 4 huge tubs of clothes that no longer fit, laundry is more of a pressing issue- lame. 

Well, that was more boring that I anticipated. You can count on a celebratory post tomorrow after I swallow that last BCP!!

Can't win 'em all...

Turns out blogging about your missing period is all it takes- she was ready and waiting when I woke up this morning. I've called my clinic and we are all set to start our cycle! I'll start birth control on Wednesday and be on it for a whopping 24 days, about a week before that is over I'll start lupron and I'll have my suppression check (AKA, the handing over of my bank account!) the day before Thanksgiving. I can't believe it is already almost November!

The title of this post is in reference to the rest of my morning. Insurance. I have a love hate relationship with it. I actually HATE talking about it on here because I know many of you would love to have my problems if only you'd get a little coverage, but I have to get it off my chest. I've called about the same claim probably 15 or 20 times now, and only today did they tell me how to fix the problem. I'm not exactly happy with the fix, but I'm so over fighting about it that I'll just eat the $163 and be done with it. It is all because of my trial transfer back in May. According to their infertility department it isn't a covered claim- it is to be 'inclusive' with the ER/ET. If I keep the claim and have it paid by the insurance it takes away one of my lifetime ART courses of treatment (because it is billed under the same coding as ET). If I have it removed, I'll have to pay for it out of pocket. It makes me a little angry, but at this point it is the difference of $163 or about $10k.... I think I'll just count my blessings and pay the dang $163. Insurance wins this one.

However, I while I was on the phone with the infertility department (who is IMPOSSIBLE to get through to) I asked a few questions that I'd been wondering about, and low and behold I was very pleased with the answer. Up until this point I'd been under the impression that if we ever had three or more embryos frozen that were of similar stage (in our case, day 6 blasts) then we would have to choose a frozen transfer over a third fresh cycle. This had been worrying me, because I know that we want more than one child and the scenarios were running through my head about what we would do at the end of this cycle depending on the number of embryos that were available to freeze and their grades. It turns out with our plan, it is a choice that will be made by our doctor and us, not the insurance company. I am hoping and praying with all I have that I never have to face another fresh cycle, but if I do, I know now that it is a choice we will be able to make.
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We have a fish tank in our guestbedroom/office that is making a horrid sound and I can't possibly sit in here and type out the insensitive-sister-in-law story, so you'll have to wait for another day!

MIA...

I'm back! The hubs and I took a little trip, and now that we've returned I'll be returning to this little blog and my corner of the Internet. 

There isn't much to report, because we spent the majority of our time relaxing.... and it was glorious! 

In other news, I took my final BCP for our 'rest' cycle on Wednesday, and I'll start BCPs for our IVF cycle likely on Tuesday-ish. My pharmacist called this week to go over my drug order with me, all I'm going to say about that is I'm pretty sure angels were singing when I got off the phone with him. God bless insurance... about 50% of the time. 

The pumpkin carving party was a success- I didn't take any pictures. I'm lame. Maybe I'll take a picture of my pumpkin before her face caves in- its hilarious. 

Congratulations if you're actually reading this babbling- I promise to be back with something more interesting soon! 

5 more weeks...

I'm running out of things to say... Life is marginally boring when you're trying to get pregnant, but swallowing a birth control pill every morning! No wonder 'outsiders' don't understand this process... It's nuts!! I'm enjoying every boring minute right now :)

The hubs and I are hosting a pumpkin carving party this weekend, so preparing food and our home for that event is keeping me plenty busy. We keep meaning to really enjoy this time in our life despite the hard things- this little get together should fill that void!

We're also hitting the road early next week for a little getaway. We've been meaning to do it, and finally made it happen. I'm looking forward to not doing much of anything other than relaxing!

Five more weeks of birth control! It seems like kind of a long time, but I'm sure it will go quickly. I'm excited for our second ivf cycle, but very calm at the same time. I don't love all of the appointments, but I find the process super fascinating and always love seeing inside of my body.

The sock collection is growing... Now if we could just get to the point of wearing them!!!!

IVF #2 with ICSI has been approved by our insurance and has a start date of November 18th. I love it when everything begins to fall into place and there are fewer things to worry about!

Ps, in case you were wondering, the insurance issue from MAY has still not been corrected!

Ugh...

So, you might remember over a year ago I went to see my primary care doctor to get a referral to my current RE. Well, that referral is only good for a year, and unfortunately I didn't remember that it would expire. Seriously, I never imagined we would still be trying to get pregnant an entire year later. Long story short, my referral expired in August. I've since had a couple of ultrasounds and some blood work run at my RE's office- this could have all been covered if I would have remembered that I needed to get a new referral- unfortunately now it is most likely going to be paid out of pocket.

I am so stinking mad at myself. When I called my PCP's office to get another referral I spoke with my favorite nurse who also happens to be dealing with infertility and asked her if it was possible to back date the new referral. She is going to attempt it, but we aren't sure if it will work. I'm not so angry that we have to pay for it, because in the scheme of things we really are getting off pretty inexpensively for infertility patients. It is just the fact that it could have all been covered that is killing me. Thank goodness for FSA's I guess.

This news came shortly after I opened an email with our deposit information... gasp. I nearly lost my lunch until I realized our insurance pre-auth hadn't come through yet.

Why does infertility have to be so expensive.... and exhausting?!?!?

Let this be a lesson to all of you.... KNOW WHEN YOUR REFERRAL EXPIRES!!!!!!