Vacation from Procreation

Guess who just picked up a pack of birth control pills?? Don’t worry, I didn’t throw in the towel just yet. The pill is the first of many medications I will soon be ingesting.

After our consultation this past Thursday, Kaptain and I have made the decision to move forward with at least one round of IVF. It feels good to have a plan of action even if it is a nerve wracking one. We are done with timed intercourse and IUIs for now. I’m done peeing on OPKs to try to determine the most advantageous time to procreate. We have a plan.

On the first day of my next cycle, I will call my RE’s office. At that time, they will set me up for a CD3 blood work up. I also have a sonohysterogram and an endometrial biopsy scheduled for the 1st of March. Woohoo- sounds like tons of fun. Whoever would’ve guessed I’d look forward to the days when they just take my blood. An endometrial biopsy is just what it sounds like. A speculum is inserted then a metal tubular device goes through the cervix and is used to take a small piece of the uterine lining/endometrium. The SHG/sonohysterogram is when a saline solution fills the uterus via a catheter through the cervix then an ultrasound is taken to determine whether there are irregularities with the shape of the uterine cavity or if there may be blood clots, polyps, etc preventing pregnancy. Both will be the same day.

Assuming all of that shows a safe and healthy environment for conception, I will start taking birth control the month we determine we will be moving forward with our IVF retrieval cycle. Based on my work schedule, we are estimating April/May. My doctor’s protocol kicks an IVF round off with BCP moving into stimming, (those are the pricey drugs that develop lots of eggs at once), then triggering with HCG, retrieval of the eggs under anesthesia after which my eggs will be manually injected with Kap’s best sperm by an embryologist. I’ll then take progesterone and another drug to lower my immunity, then transfer 2 embryos back into my uterus at day 5 assuming we have any.

Yes, a lot of people go through all this and no embryos make it to day 5. Unfortunately, IVF is a process of diminishing return. For example, on the day of retrieval there may be 20 eggs removed. 15 may be mature and have sperm directly inserted into them. Of those 15, 10 may fertilize. Over the next 4 days, more and more of them will cease developing. By day 5, there will likely only be a couple embryos left. At that point, my doctor will transfer 2 fresh embryos into my uterus and freeze any remaining embryos. The slang for the diminishing return is the Hunger Games. Much like the books/movies, every day there are fewer tributes.

Because of my advanced maternal age, (I’m 37), I am likely to have far fewer genetically normal embryos. That means that if we do have any embryos to transfer, while we will transfer 2, only one will likely implant if that. Even if it does implant, there is a 1/3 chance of miscarriage. Most miscarriages come from genetically/chromosomally abnormal embryos. We could do PGS testing on the embryos before transferring them into my uterus but with a $5,000 price tag that is not covered by insurance and less than 100% accuracy, it’s hard for me to get behind. Instead what will happen is likely a few other scenarios for genetically abnormal embryos. The embryos won’t survive to Day 5 to be transferred. They won’t implant if they are transferred. I’ll miscarry due to their abnormalities. On my 10-week blood test, I’ll discover the pregnancy isn’t viable and will have to abort. While all those options sound pretty terrible, it’s important for me to know the best case and worst case possibilities.

So those were worst case. I’m starting to actually daydream about best case and that’s such a slippery slope into my hopes being entirely too high. Best case would be 10 healthy embryos make it to day 5. We transfer 2 back in and 1 implants. 9 months later, we have a healthy happy child. 18 months after that we get 2 more embryos transferred and 1 implants again. Another happy healthy child. We are able to donate the 6 remaining embryos to someone who hasn’t been able to conceive using their own sperm and eggs. Such a good fantasy. You’ll notice my fantasy didn’t include twins. While I would be happy for 1 pregnancy and done, twins carry additional health risks for both the mother and children. Since it’s a daydream, I’m going with a non-high risk pregnancy fantasy.

Emotionally I’m torn between excitement for the potential of having a plan with the highest likelihood of a take home baby and feeling sad and resentful that we are having to go through so much and spend so much time and money when it seems like everyone else is able to conceive at the drop of a hat. Seriously, it’s frustrating. I know life isn’t fair and this is one of those situations that really drives it home. For now I’m just trying to stay calm and think about logistics. If I can work that out, I can deal with the emotions later. The biggest logistics piece is planning how to pay for everything without racking up massive amounts of credit card debt. Luckily, my insurance will cover about 80% of the IVF retrieval and transfer total cost leaving us responsible for about $4,000 towards that and then the cost of the meds for about $3,500. So much friggin’ money.

Time for me to get on my soapbox. Most people don’t have fertility coverage so we’re talking $20,000+ for 1 round. Some of the infertile people without fertility coverage attempt crowd sourcing through go fund me or something similar and it never fails that some jackass will say, “If you can’t afford to create a baby maybe you don’t need one.” Argh!!! Can you imagine every person who ever made the decision to try to have a child having to pay AT LEAST $7,500 up front?? The human race would be on the endangered species list. And we’ve got it good because of my insurance so we ONLY have to pay around $7,500 up front. And mind you, that’s just for an attempt. No guarantee we’ll actually have a child. We’re paying thousands just for a 34% chance. I really don’t want everyone’s opinions anymore than we already get them so at this point, no crowd funding for us. It looks like we will be heavily cutting extraneous expenses and doing a low interest loan. Once again, we are fortunate it’s even an option.

And stepping back off my soapbox… for now. That’s where we’re at presently. Until my appointments there isn’t really much to do. Here’s hoping things will be okay in the preliminary testing and we can get this show on the road. C’mon, uterus, do your thing and be awesome.

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