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.
Friday, October 16, 2009
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!).
Monday, September 21, 2009
A quiet week in Lake Wobegon...
I haven’t posted in a while. Not much happening on the ttc front. I had a long business trip to Europe this month which, while a bit of a drag, did help to take my mind off of babies.
Last week I had my pre-op appointment with my RE. She spent at least 80 minutes with me – I was quite impressed. She described her plans for the surgery, answered all of my questions, and did an internal u/s to check on things. (Yep – cyst and blocked left tube – present!) The good news is that the right side is still looking normal, so there is a chance that after all is said and done we will still have the option of trying naturally. My mom will visit the day of surgery, and probably come back a few days later when J leaves on a trip to Yosemite. J had a 3rd SA done earlier this month, but has still not picked up the results.
I have been on the bump boards less and less lately. I think I needed a mental break, and I find myself popping in more on nest boards that aren’t baby related. It’s refreshing to not feel obsessed for a change!
Last week I had my pre-op appointment with my RE. She spent at least 80 minutes with me – I was quite impressed. She described her plans for the surgery, answered all of my questions, and did an internal u/s to check on things. (Yep – cyst and blocked left tube – present!) The good news is that the right side is still looking normal, so there is a chance that after all is said and done we will still have the option of trying naturally. My mom will visit the day of surgery, and probably come back a few days later when J leaves on a trip to Yosemite. J had a 3rd SA done earlier this month, but has still not picked up the results.
I have been on the bump boards less and less lately. I think I needed a mental break, and I find myself popping in more on nest boards that aren’t baby related. It’s refreshing to not feel obsessed for a change!
Tuesday, August 25, 2009
Pins and needles
J and I went to see Julie, my acupuncturist, on Sunday. While I don't love the process (the needles don't bother me so much as feeling like I can't move), I'm a fan of Julie and the results she has achieved for other clients.
Since we are pushing up the timeline of pursuing treatment, I am going to start seeing Julie again on a weekly basis. I convinced J to come along as well to see if she could help with his morphology numbers.
Julie's take on J's results was that he should have a 3rd SA done to confirm them. She found the good count and high motility a strange contrast with the zero morphology. And while she didn't say she couldn't help the morph at all, she thinks it would take a very long time (longer than the time between now and whatever treatment we pursue this fall). She has had good results with improving count and motility over a few months, but not so much with morphology.
So, it's up to J to schedule yet another SA. Meanwhile I started my treatments in an attempt to achieve "balance" in my body. Back on the table, needles in every limb and on my belly and head, I actually did start to relax for a change.
Wednesday, August 19, 2009
Good fortune
We are in a holding pattern until my surgery in late September. At first I was excited to have a TTC break. I was getting so stressed out by everything and it was nice to not feel the pressure of trying to make everything work. But now, just a few weeks later, I’m feeling impatient and wanting things to move more quickly.
So, I’m trying to take a step back, take a deep breath, and enjoy the moment. Just because I don’t have a baby in my life yet doesn’t mean I can’t enjoy what I do have to the fullest. And so, here is my short list of things I am thankful for:
1) My general health. Aside from my reproductive issues, I am very healthy.
2) My SO. I am so very lucky to have him as a partner.
3) My dog. She makes me smile every day.
4) My family and friends.
5) My job. It may not be perfect, but I am employed and it’s a pretty good gig.
6) Where I live. Northern California is one of the best places on earth.
7) Good food.
8) Yoga and dance.
9) My house and yard.
10) Good literature and movies.
I am very, very fortunate, indeed. If we are lucky, J and I will add a child to our family sometime in the next few years. And we will have been lucky to have this time together, just us and the dog. Once we have a child, life will never be the same. And life, as it is now, is excellent. So instead of focusing so much on what I want, I am going to do my best to cherish this time and appreciate all that I do have.
So, I’m trying to take a step back, take a deep breath, and enjoy the moment. Just because I don’t have a baby in my life yet doesn’t mean I can’t enjoy what I do have to the fullest. And so, here is my short list of things I am thankful for:
1) My general health. Aside from my reproductive issues, I am very healthy.
2) My SO. I am so very lucky to have him as a partner.
3) My dog. She makes me smile every day.
4) My family and friends.
5) My job. It may not be perfect, but I am employed and it’s a pretty good gig.
6) Where I live. Northern California is one of the best places on earth.
7) Good food.
8) Yoga and dance.
9) My house and yard.
10) Good literature and movies.
I am very, very fortunate, indeed. If we are lucky, J and I will add a child to our family sometime in the next few years. And we will have been lucky to have this time together, just us and the dog. Once we have a child, life will never be the same. And life, as it is now, is excellent. So instead of focusing so much on what I want, I am going to do my best to cherish this time and appreciate all that I do have.
Monday, August 10, 2009
No fancy title
After playing phone tag with the RE for a bit over a week, I finally got to speak with her by phone.
We talked about our options with the repeat SA results and now that J has added me to his insurance plan that will cover IUI/IVF (up to a limit). Basically, I have two choices.
1) Go back off the pill and try IUI
2) Have a laparoscopy to assess/treat my left tube, remove as much endo as possible, and determine best course of action. Follow with IUI or IVF.
J and I agree that going through more periods without any additional treatment is not an option for me. It's just too painful. So now I wait for the scheduler to call - the RE said I will need one week off work and can't travel for two weeks, which may be tricky with my work travel this fall. And I hate to give up five more days of my time off for surgery (as opposed to real vacation), but truly, for the chance to have a baby, it is more than worth it.
We talked about our options with the repeat SA results and now that J has added me to his insurance plan that will cover IUI/IVF (up to a limit). Basically, I have two choices.
1) Go back off the pill and try IUI
2) Have a laparoscopy to assess/treat my left tube, remove as much endo as possible, and determine best course of action. Follow with IUI or IVF.
J and I agree that going through more periods without any additional treatment is not an option for me. It's just too painful. So now I wait for the scheduler to call - the RE said I will need one week off work and can't travel for two weeks, which may be tricky with my work travel this fall. And I hate to give up five more days of my time off for surgery (as opposed to real vacation), but truly, for the chance to have a baby, it is more than worth it.
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