We’ve decided on IVF.
It really wasn’t a hard decision. J’s 4th SA results came back with no new issues preventing us from doing IUI (good count & motility, morph at 8.5 but at a less strict lab, good survival and motility after 24 hr incubation). But after considering all the factors, IVF felt like the right choice.
It’s been a bit of a whirlwind ever since I told the nurse our decision. I went in today for more blood work and a mock transfer, which really wasn’t bad at all. I have a tentative schedule for the beginning of the cycle:
Nov. 4 – Class for J and me – drug injections, etc, more b/w for J
Nov. 8 – last BCP
Nov. 12 – baseline u/s
Nov. 13 – Start FSH
From what I can tell we’re doing an antagonist protocol. I am set up with the pharmacy – they called and read off the list of medications. Wow. Just wow. I knew it would be a lot but I really didn’t expect such a long list. As soon as we are ready to start meds I will call and they will ship them overnight. I should be getting a more formal calendar from the nurse later this week. And kicking it all off is our trip to CT & NYC – J is already in CT, and I fly out on a red-eye on Wednesday night. Yippee!
Monday, October 26, 2009
Friday, October 16, 2009
The New RE
The appointment got switched from Tuesday to Wednesday, and J was able to come after all (yay!). We spent about an hour talking with Dr. S. These are the stats he gave us:
Approximate chances of conceiving in a given cycle:
Normal healthy couple - 20%
Clomid/IUI – 10%
Injectables/IUI – 15%
IVF (2 embryos transferred) – 40-50%
IVF (1 embryo transferred) - 35%
FET – 40%
Us, naturally – 2-5%
It’s not hard to see why one would choose IVF, all else being equal. But, you have to consider the cost and the medications and invasiveness of that procedure as well. We are extremely lucky in having significant insurance coverage for infertility. Which means it’s a lot easier to think about going straight to IVF.
It might seem like I’ve jumped from considering trying naturally to IUI to IVF very quickly. But I’ve known that IVF might be in my future since my first laparoscopy in 2007. And since there is a medical motivation to get pregnant as quickly as possible (to minimize the recurrence of my endometriosis), IVF is becoming more and more appealing.
We haven’t made a final decision. J is having one more SA done, this time with testing of motility and survival after 24hr incubation. Dr. S says this will tell us if IUI is even worth considering. In the meantime, I’m staying on BCP. He also gave us some literature about the risks of multiples. I was happy about that, because I haven’t been able to convince J on my own that twins really aren’t the goal. Given my age (relatively young, for IVF), we may decide to transfer just 1 instead of 2 embryos. But we’ll cross that bridge when we come to it.
The second part of the appointment was an internal ultrasound. Dr. S said things looked pretty quiet around my ovaries, which is good, and not unexpected because of the BCP.
So now, I go on my work trip, and a few days after that I fly to the east coast and meet up with J. We’ll visit his family and then spend a few days of R&R in NYC.
Approximate chances of conceiving in a given cycle:
Normal healthy couple - 20%
Clomid/IUI – 10%
Injectables/IUI – 15%
IVF (2 embryos transferred) – 40-50%
IVF (1 embryo transferred) - 35%
FET – 40%
Us, naturally – 2-5%
It’s not hard to see why one would choose IVF, all else being equal. But, you have to consider the cost and the medications and invasiveness of that procedure as well. We are extremely lucky in having significant insurance coverage for infertility. Which means it’s a lot easier to think about going straight to IVF.
It might seem like I’ve jumped from considering trying naturally to IUI to IVF very quickly. But I’ve known that IVF might be in my future since my first laparoscopy in 2007. And since there is a medical motivation to get pregnant as quickly as possible (to minimize the recurrence of my endometriosis), IVF is becoming more and more appealing.
We haven’t made a final decision. J is having one more SA done, this time with testing of motility and survival after 24hr incubation. Dr. S says this will tell us if IUI is even worth considering. In the meantime, I’m staying on BCP. He also gave us some literature about the risks of multiples. I was happy about that, because I haven’t been able to convince J on my own that twins really aren’t the goal. Given my age (relatively young, for IVF), we may decide to transfer just 1 instead of 2 embryos. But we’ll cross that bridge when we come to it.
The second part of the appointment was an internal ultrasound. Dr. S said things looked pretty quiet around my ovaries, which is good, and not unexpected because of the BCP.
So now, I go on my work trip, and a few days after that I fly to the east coast and meet up with J. We’ll visit his family and then spend a few days of R&R in NYC.
Thursday, October 8, 2009
No easy road
IUI.
That's what my RE is recommending. We could try naturally, but she feels IUI offers better odds. IVF is an option but is much more expensive and invasive. Given that I have *maybe* a 6 month window before the endometriosis is back at unpleasant and unhelpful levels, it makes sense for us to up our chances, even though it means giving up the dream of conceiving naturally.
Don't get me wrong, I am not opposed to IUI or IVF. I will do what I have to in order to have a child. But both J and I would love to get pregnant without additional intervention. We like the idea of not having to schedule more appointments, take medications, undergo procedures. We like the "easy" road. Who wouldn't?
But of course, life can't always be easy. So, I've scheduled a consultation at another clinic with another RE. Since J's insurance covers at a higher level if we go to clinics designated as "Centers of Excellence," and since my current RE happens to not be at one of these locations, I'm doing my due dilgence and exploring our options. I love my RE, but if we go through several IUI or IVF rounds, every penny will count, since the insurance coverage does have a limit.
So, more paperwork, more phone calls, more time missed from work. I couldn't convince J to go to this appointment with me (well, really, I scheduled it before checking with him and it was incompatible with his schedule. But I offered to reschedule and he woudn't hear of it). He trusts me completely and doesn't feel the need to be there. Truth be told, I wish he wanted to come. But I know he wants a baby and I know he loves me, so really, why push it?
That's what my RE is recommending. We could try naturally, but she feels IUI offers better odds. IVF is an option but is much more expensive and invasive. Given that I have *maybe* a 6 month window before the endometriosis is back at unpleasant and unhelpful levels, it makes sense for us to up our chances, even though it means giving up the dream of conceiving naturally.
Don't get me wrong, I am not opposed to IUI or IVF. I will do what I have to in order to have a child. But both J and I would love to get pregnant without additional intervention. We like the idea of not having to schedule more appointments, take medications, undergo procedures. We like the "easy" road. Who wouldn't?
But of course, life can't always be easy. So, I've scheduled a consultation at another clinic with another RE. Since J's insurance covers at a higher level if we go to clinics designated as "Centers of Excellence," and since my current RE happens to not be at one of these locations, I'm doing my due dilgence and exploring our options. I love my RE, but if we go through several IUI or IVF rounds, every penny will count, since the insurance coverage does have a limit.
So, more paperwork, more phone calls, more time missed from work. I couldn't convince J to go to this appointment with me (well, really, I scheduled it before checking with him and it was incompatible with his schedule. But I offered to reschedule and he woudn't hear of it). He trusts me completely and doesn't feel the need to be there. Truth be told, I wish he wanted to come. But I know he wants a baby and I know he loves me, so really, why push it?
Thursday, October 1, 2009
Post-surgery recap
It was a very long week. It started on Weds, Sep. 23 with bowel prep. I’ll leave out the gory details, but the short story is that I had to drink a gallon (literally!) of Go-lytely solution, and it is quite possibly one of the nastiest things I’ve ever had to consume. I followed the instructions of the pharmacist (8 oz every 10 min.) and finished in about 3 hours or so. Not fun, not fun at all. But as it turns out, it was good that I was able to do it.
For the rest of the day I was on a liquid diet, and of course, no food or water after midnight. I was very jealous of J’s yummy-looking dinner. I had my last glass of sports drink around 10 pm.
My mom arrived around 9:30 on Thursday, and we visited for a bit before leaving for the surgecenter. All the prep went smoothly – I answered the same questions over and over about the surgery and my history to the very nice male nurse, my RE, and the anesthesiologist. I think they wheeled me in around 1 pm. I was already hooked up to the IV, and within minutes they had me on the table, arms out, stockings on my legs. I was feeling lightheaded right away, and the anesthesiologist told me he’d started my meds. My RE was with me, I told her my mouth felt tingly and she confirmed with the anesthesiologist that it was a normal effect from the drugs. That’s really the last thing I remember before waking up in recovery. I woke up feeling nauseated, in pain, and very cold. The nurses gave me something to help with the nausea and pain, and plenty of warm blankets.
My RE spoke with J and my mom about the surgery. It apparently went well, as these things go. They removed what endo they could, drained the ovarian cyst, and resected the left tube. I *think* they may have drained the tube, but I don’t remember for sure. They did a D & C – I’m not sure if there was a problem with the uterine lining to cause this. Part of my bowel is adhered to the back of my uterus. My mom thinks this was observed during the first lap, and she may be right, but I didn’t remember it. The key point there was that it shouldn’t have any negative effect on pregnancy. But my bowel was also apparently up around my left ovary and tube, and neither my RE nor her assistant surgeon (another RE from the same practice) felt comfortable messing with it. Fortunately there was a general surgeon who happened to be available and was able to step in and work on it. To be honest, I’m not sure exactly what he did. I suppose I’ll get the details at the post-op appointment.
The best news is that the right tube and ovary all looked normal. We may actually have a shot at trying naturally for a few cycles if we decide to.
Recovery was a bit rough. I had a lot of pain, both cramping and gas pains, the first 2-3 days. I also had taken my last birth control pill the day before surgery, so I had a period but was still on the vicodin, so the cramps were mostly bearable. I started the BCP again on Monday. By then I felt better but was still very tired and napping a lot. I was off work for a week, and needed every day of it. This is my first day back and I’m glad I have no meetings, so I can sit at my desk all day.
My post-op appointment is next Tuesday, so I should be able to clarify some of the details (and hopefully be cleared for sex!).
For the rest of the day I was on a liquid diet, and of course, no food or water after midnight. I was very jealous of J’s yummy-looking dinner. I had my last glass of sports drink around 10 pm.
My mom arrived around 9:30 on Thursday, and we visited for a bit before leaving for the surgecenter. All the prep went smoothly – I answered the same questions over and over about the surgery and my history to the very nice male nurse, my RE, and the anesthesiologist. I think they wheeled me in around 1 pm. I was already hooked up to the IV, and within minutes they had me on the table, arms out, stockings on my legs. I was feeling lightheaded right away, and the anesthesiologist told me he’d started my meds. My RE was with me, I told her my mouth felt tingly and she confirmed with the anesthesiologist that it was a normal effect from the drugs. That’s really the last thing I remember before waking up in recovery. I woke up feeling nauseated, in pain, and very cold. The nurses gave me something to help with the nausea and pain, and plenty of warm blankets.
My RE spoke with J and my mom about the surgery. It apparently went well, as these things go. They removed what endo they could, drained the ovarian cyst, and resected the left tube. I *think* they may have drained the tube, but I don’t remember for sure. They did a D & C – I’m not sure if there was a problem with the uterine lining to cause this. Part of my bowel is adhered to the back of my uterus. My mom thinks this was observed during the first lap, and she may be right, but I didn’t remember it. The key point there was that it shouldn’t have any negative effect on pregnancy. But my bowel was also apparently up around my left ovary and tube, and neither my RE nor her assistant surgeon (another RE from the same practice) felt comfortable messing with it. Fortunately there was a general surgeon who happened to be available and was able to step in and work on it. To be honest, I’m not sure exactly what he did. I suppose I’ll get the details at the post-op appointment.
The best news is that the right tube and ovary all looked normal. We may actually have a shot at trying naturally for a few cycles if we decide to.
Recovery was a bit rough. I had a lot of pain, both cramping and gas pains, the first 2-3 days. I also had taken my last birth control pill the day before surgery, so I had a period but was still on the vicodin, so the cramps were mostly bearable. I started the BCP again on Monday. By then I felt better but was still very tired and napping a lot. I was off work for a week, and needed every day of it. This is my first day back and I’m glad I have no meetings, so I can sit at my desk all day.
My post-op appointment is next Tuesday, so I should be able to clarify some of the details (and hopefully be cleared for sex!).
Subscribe to:
Posts (Atom)