They are out to haunt me

I have not been feeling particularly nice these past few days.  It’s weird because my period has already passed so I can’t blame it on PMS.  I did see many pregnant ladies on Sunday though.  There were many different sizes of bellies.  Every corner I turned there was a big bump.  My husband said that these ladies were all out there to haunt me.  It could well be true.  At church I turned around and saw this lady that got pregnant the month after she was married.  She got married nine whole months ago.  She is about to be due.  Talk about crazily fertile people.  It doesn’t help that her bump is extra huge because she is so petite.  And then I turned to the other side and noticed that a lady who already has the cutest two-year-old boy all of sudden had grown a belly.  I must not have paid much attention to her in the last couple of weeks.  I swear that I just saw her not too long ago and her belly was flat.  When did that happen?  Fertile people have a way to sneak up on you without you even knowing.  I thought I would be safe in the early elementary Sunday school class that I teach.  Ugh.  Wishful thinking.  A six-year-old announced to me that there was a baby in his mom’s tummy.  Thank you very much, kid.  I did see his mommy in the parking lot from afar.. Hmm.. Her belly was flat.  But kids don’t lie.  She could be just 12 weeks along.  Did I mention that Sunday school kid already has a younger sister?  I guess this is what happens when you can so perfectly space your children apart.  She could well have experienced some sort of infertility or losses.  But I was feeling particular judgmental on that day.  Anyhow.  The Sunday bumps must have started me off on the wrong foot this week.  My Dear Colleague shared with me that she thought that she was accidentally pregnant with number three.  Fortunately (?) it was a false alarm confirmed by a negative pregnancy test.  She does NOT want a number three.  I looked her straight in her eyes and said, “If that happened, that would be the end of our friendship.”  It sounded like a joke but I was actually dead serious.  Yup.  I don’t think I can handle Dear Colleague’s baby number three in 2 1/2 years.  Hey Dear Colleague, I know you read this.  I still love you but if number three truly happens, I will step away from your life for a little (or long) while.  Anyhow, yup.  I am feeling particularly bitchy.  Thank goodness the universe is allowing this friendship to continue on and blossom.  I need her support.  Anyhow, hopefully after this week I will be back to be the nice person that I usually am, provided that I am not again bombarded with big baby bumps everywhere I turn.    

What IS the next step?

Looks like this is the trend that I don’t have much time to blog until the weekend.  How’s everyone doing?  Hi to those who are here for ICLW!  This is where I am at in my TTC journey.  My husband and I have been TTC for 21 months.  That does not quite equate to 21 cycles because of my short cycles due to diminished ovarian reserve.  At one point my cycles were 23 to 24 days depending on when I ovulated.  Sometimes ovulation could be as early as CD9.  Acupuncture has helped me push back ovulation to day 12 and even 13, which makes my cycle a little longer.  Anyhow, Bob and I have done two egg retrievals.  The first one resulted in a day 6 blastocyst that was graded 2BB.  We had it frozen and was waiting for it to be transfer back at our second retrieval.  The second retrieval in September resulted in zero embryos to be transfer.  We also couldn’t transfer back our one frozen embryo because of a fibroid that looked like it was in the uterine cavity.   We have yet to do a transfer.

I am relieved to report that my visit to the RE last Thursday was great.  The fibroids are NOT in the uterine cavity!  So we’re all cleared to move onto the next step.  Now here is the fuzzy part.  What IS the next step?  Well, it all depends on what we choose to do.  

A few possible scenarios:

1) Do a fresh cycle with Dr. E and thaw Clay (our little frozen embaby) no matter what so we have something to transfer

2) Do a frozen embryo transfer only and thaw Clay

3) Begin to go down to Southern California and start trying to bank embryos at L.ife IVF hoping that we will be able to bank at least four to five blastocysts before we start doing frozen embryo transfers

Why so many choices? Well, they all have to do with money.  My husband’s employer currently offers $10,000 lifetime maximum of fertility insurance that surprisingly goes a long way when it comes to cycling with a doctor who is in network.  Compared to the $12,400 price tag as a cash-paying patient, a doctor agrees to be paid at a discounted, contractual rate by the insurance company.  Since we have not done a full cycle and just the two retrievals, we should have at least a couple of thousand dollars left.  Now here comes the problem.  Since we only have a couple of thousands left, the doctor’s office is not going to take the risk of billing the insurance company first.  Since the remaining amount is not enough to do a fresh cycle, we will become cash-paying patients if we want to do a fresh cycle that includes a retrieval and a transfer.  I have been emailing Dr. E’s financial person back and forth.  Now I understand that we will pay the whole $12400 package price up front, in full, at our first monitoring ultrasound.  We will get a super bill from Dr. E’s office with the full amount that we paid and ask the insurance company for a reimbursement of a portion of the cost.  So we will no longer have the fortunate privilege of paying a $35 copayment at every visit.  We will pay 350 times of that.  On top of that, Dr. E recommends going back to the first protocol which was 4 vials of Menopur and Omnitrope.  The reason?  I responded well to it and we have one blastocyst.  The second protocol was a lot cheaper (Femara was covered by insurance) but nothing resulted from it.  Did it really have to do with the protocol?  Or just the egg quality for that particular cycle?  Really, nobody knows.  But we would want to be safe and do the one protocol that seemed to work.  The downside is that it will cost about $5000 in medication.  Are you doing the math for me in your head?  Don’t you think that this is A. LOT. OF. MONEY for ONE CYCLE?

If I had all the money in the world, I would do a fresh cycle with Dr. E because she knows my body.  With DOR, you just need to try your luck every single cycle hoping that you will encounter that one good normal egg.  But, I don’t have all the money in the world.  So what do we do?

We could potentially just do a transfer and see if Clay would stick.  That way, insurance should cover for the whole FET and we don’t have to worry about meds and other things.  If it works, then it’d be great!  But we do want to have two children.  If we could do a fresh cycle now and gamble to get more eggs/embryos, we may have something to freeze with younger eggs/embryos so that we can help Clay get a sibling in the future.  Younger embryos are theoretically better than older embryos.  

Another question is whether or not we could switch from Insurance Company A to Insurance Company B and still get a new batch of $10,000 lifetime maximum.  If so, then we could start our new insurance in January.  If not, then we have to seriously think about how to spend our savings on subsequent IVF cycles.  

Our last resort is to travel 500 miles to L.ife IVF and try doing natural IVF or mini-IVF.  The pros are that it’s a lot cheaper ($9900 for three cycles) and the cost of medication is also a lot cheaper (Dr. Y there is known for using Clomid).  The cons are that we will have to travel there monthly to do egg retrievals and I’ll have to take a few days off each month to do that.  I was thinking that this would be the way to go since I only get one embryo or no embryo each IVF cycle so far.  The cheaper option will mean a higher chance at pregnancy but also a lot more taxing on my persistence and patience in this process.  The lab at L.ife is known to be good at culturing blastocysts.  However, recently I have read that the policy for out of town patients has changed for the worse, i.e. OOT patients do not get their instructions until noon time the next day AFTER a blood draw or a monitoring ultrasound.  L.ife is simply getting too big and a little more chaotic.  It makes me nervous to know that it will be stressful and hectic to get information and to ask questions.  

Bob and I have a lot to pray about.  If we go with Dr. E for more cycles, our IVF fund will be depleted quite quickly.  If we go with Dr. Y at L.ife, we will have more chances at a lower cost without compromising the quality of the embryos/blastocysts.  L.ife is a lot farther away and requires out of town monitoring and traveling.  I love Dr. E and love the care and attention that I get.  It’s such a tough decision.  

My thought so far: We’ll do a fresh cycle with Dr. E in November and thaw Clay no matter what.  We’ll have to pay out of pocket for this visit.  Why November?  Because Dr. E will be gone for four days in October (for Disneyland with her kids, how cute is that?) which will coincide with my egg retrieval.  I am paying HER money for the cycle so I don’t want other people to be doing my egg retrieval.  If we do a cycle in November, I’ll be guaranteed to have Dr. E doing all the procedures and also have the time to figure out the insurance money part.  If we don’t get pregnant after that, then we will most likely sign up for L.ife IVF in January as it is more wallet friendly and makes the most sense.  I will hate to part with Dr. E but financial reality will force us to do so.  

Life is so complicated when money is a requirement to do the simplest thing such as making a baby.  I know I have thought about this a lot and really want to have some control over it.  But really, who is in control?  We have to go back to God and ask God for wisdom, strength, and His timing.  Not an easy task, but I am trying to depend on Him.  And I am grateful that we have a chance and the means to try.  

I have my moments

Nobody got on my nerves.  Nobody said anything insensitive or mean to me today.  I was just going about my own business and wrapping up things at work.  I read a blog post and my emotions just hit me like a ton of bricks.  A fellow blogger is 12 weeks pregnant today.  Her egg retrieval was on the same day as my first egg retrieval.  She got a positive beta with a much deserved pregnancy.  My cycle didn’t go the way I wanted.  I have been following her and cheering for her, sometimes silently and sometimes with comments.  Today… after reading her post, it just dawned on me that it could have been me.  I could have been the one writing a post about being 12 weeks pregnant if that truly was how it turned out.  But it is not me.  The could haves and what ifs were just too much for me to bear in that one moment.  Emotions are such a complicated thing.  I was happy for her, a bit jealous of her, feeling sorry for myself, and then feeling guilty for feeling sorry for myself and jealous of her.  It was so tough.  I was having a moment and starting tearing up about the lost opportunity, the unknown future of my frozen embryo, a reminder that twelve whole weeks have passed, the brutal reality of a second retrieval that resulted in nothing, and the road ahead that is so hard to predict.  My dear officemate said to me, “I am surprised you don’t have more of these moments.”  Well, I don’t have many of these.  But today I do.  And I am confronting my feelings instead of hiding from them.  And what else can you do other than forging forward with what is left in us hoping and praying that the outcome will be what we have always wished for?  I wiped my tears and moved on.  Sometimes it is good to cry.

Take three

It proves to be a lot harder to blog when the summer is over and the fall schedule is in full swing.  I started two blog posts that never got to the finish line.  Hopefully this one will be the winner!  A lot has happened since we learned about the fate of Daisy more than a week ago.  

After a lot of thoughts and discussions, Bob and I have made the decision to accept the job offer at Tiny Startup Company!  It is such a big leap of faith to switch from Big Corporation to a tiny little company that has not even hired any employees.  I’m proud to say that Bob and I are on the same page and we came to the decision together without any fights or arguments.  At first the one thing that made me the most fearful was the insurance coverage.  Since it is such a new company, the founders cannot even start to buy health insurance for their employees until the employee count reaches two.  So there is no way to find out what the insurance coverage will be.  After a lot prayers and thoughts, we came up with the plan to negotiate with the new company to pay for our COBRA coverage.  In the US, COBRA allows a former employee of a corporation to continue the same level of insurance coverage by paying the full premium (rather than a discounted premium as the corporation subsidizes the rest of the premium for its employees).  The full premium for our current insurance has a whopping $1500 price tag.  If Bob’s new job pays for this COBRA coverage, then we can stick with our current levels of coverage.  We are currently insured with Insurance Company A and have $10,000 lifetime maximum fertility coverage.  We recently discovered that under Bob’s current job, we may be eligible to get another $10,000 lifetime maximum fertility coverage if we switch over to Insurance Company B next January.  If that’s the case, once our fertility coverage runs out by the end of this year with Insurance Company A, we could get new batch of fertility coverage  with Insurance Company B beginning in January.  Bob did a great job negotiating with Tiny Startup Company and got them to agree to pay for most of our COBRA for the next 18 months!  I don’t have to worry about our insurance coverage for the next 1.5 years.  That is truly a big blessing.  

We both know that this new job has its risks. It’s such a new company that it could fold at any time.  The payoff could be huge though.  Bob will get to do what he likes to do and use his talent.  His commute is shorter.  He gets to trade off Big Corporation politics with Tiny Startup politics.  If the company strikes gold and gets acquired by some huge huge corporation, he may even make good money with his shares of stock.  The downside is job instability and a slight pay cut.  He has been doing a very good job at his current position but the office politics is getting to him.  Plus the work he is doing right now is not interesting or challenging enough.  I firmly believe that this is the right decision.  We both have tremendous peace about it.  And if this job doesn’t work out in the future, I have no doubt that he will find another job soon.  We have discussed this with many friends and with our families.  The consensus is that this is a great time to try a startup company since Bob is still young and we don’t have kids yet.  The last point stings a little…. as if not having children is a blessing in this case.  But even if we had a little child right now, we could still afford to have Bob switch jobs.  I am excited for him!  How many people get the opportunity to be employee number one at a company and help build the product of a company from scratch?  I am proud of him.  He will officially accept the job offer on Monday.

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Last Sunday, I finally received a text from Kate,  one of my bridesmaids, asking if we would want to have dinner with her and her family after they finished their family photo session in the city.  I wrote about Kate about a month ago about how disappointed I had been with her for not checking in with me after my first IVF.  I was very tempted to say Yes to her dinner proposal but we had already prepared for dinner.  Through texts, we made plans to see each other in three weeks.  After thinking a lot about it, I decided that I couldn’t just see her without first letting her know about my feelings in the last two months.  I made a decision to write her a detailed email about it.  And I did it on Wednesday!  I just felt that it was the right time.  I let her know that I wasn’t mad at her but I was sad and disappointed that I hadn’t heard from her.  I hit Send and left it at that.  Again, I had tremendous peace about it as I knew that it was the right thing to do.  Kate wrote me back immediately, thanking me for letting her know, and saying that she was very sorry about it.  Apparently I wasn’t the first person who had said the same thing about her so she realized that she has to do better with her friends.  She said that I am very important to her, there is no excuse for her not to check in with me, and she wants to make things right.  I am very glad that we had a chance to clear the air.  I am very relieved.

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Life has been very busy.  I am a group leader of a discussion group for an international bible study organization.  There is daily homework, in-depth summary of the bible passage of the week, and weekly contact with the 15 or so ladies in my group.  I attend a two-hour training bright and early on Saturday mornings at 7am and facilitate my group discussion on Monday nights.  There was a nice long break during the summer since last year’s session ended in May.  I guess that was when I felt like I had time to write my own blog in June.  I already feel a bit overwhelmed with the amount of work that I have now.  And I am also thinking ahead.  What if we decide to head down to Southern California to cycle with L.ife?  How do I handle the unpredictable schedule?  I am someone who would really want to stick with the commitment that I have made.  I really don’t want to skip serving every Saturday and Monday if it’s not necessary.  I don’t want to burden other group leaders repeatedly to cover for me while I am gone.  So my prayer this year is that God will clear my schedule so that I can participate in the weekly training and weekly discussion group as much as possible.  I know that He has called me to this role and He will help clear my schedule for me.  

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A good friend of mine asked me if I felt depressed about my fertility most of the time.  I thought long and hard about it.  Nope.  I don’t.  I am in general a happy person.  I do have moments when I am sad and I need to cry it all out to release my emotions.  But God has protected my emotions.  I am still living life the way I want to.  I am still enjoying life with Bob.  I am still doing my job the way I would like.  I do not feel depressed.  I actually felt more depressed about a year ago when we were so unsure about the next step for us.  I wasn’t ready to let go of being able to get pregnant naturally and “declare defeat” and “succumb” to IVF.  Now my thought has changed.  I have decided that IVF is the way that will most likely result in our desired take home baby.  It is hardly a defeat.  It takes courage on our part to go this route.  So thankfully, I am not depressed.  

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Who has gained weight from IVF?  My favorite jeans aren’t comfortable anymore.  I detest this side effect of IVF.  

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I have been taking a nice break from taking my basal body temperature.  A week ago the back of my hands and my forearms were filled with tiny bumps and rashes that would flare up and itch when it was hot outside.  Dr. E said that it could be contact dermatitis or a sudden allergic reaction to the supplements.  She suggested that I stop taking the supplements for now.  Once the bumps subside and the itch stops, reintroduce them slowly to see it they were the cause of such a skin rash.  It is a weird sudden break from TTC: no temping and no supplements.  AF should arrive on Monday.  I will most likely go at the end of the week to get a saline sonogram.  

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Wow this is long.  But I did finish!  Thanks for sticking around until the end.  You get an award for being persistent and patient!

No more Daisy

In the last two days, I have already prepared myself for bad news.  I really didn’t think that a grade three three-cell embryo would turn into a blastocyst.  Of course I still hoped for the best.  Miracles do happen.  Just didn’t happen to me this time.  I start to think that maybe we got very lucky the last cycle.  I wonder if this is going to be the norm for future cycles.  Maybe the name Daisy is too weak.  Clay didn’t get its name for nothing.  Bob joked that maybe Daisy should have been Delilah.  I seriously laughed very hard at that joke.  Maybe this is still early.  Maybe I have already cried like crazy on Wednesday.  I didn’t feel a thing in my heart when I saw Dr. E’s email.  I find my mind moving towards the next step.  Do we do one more cycle with Dr. E after this so that we can transfer Clay?  Do we keep Clay frozen and start banking embryos down at L.ife IVF in Irvine?  Do we take care of the fibroids first before even talking about banking embryos again?  Unfortunately, having the diagnosis of DOR means that we are in it for the long haul before we can have our take home baby.  That is, if we use our own eggs.  Things may move faster if we go the donor egg route.  I don’t think I am ready to give up on my own eggs yet.  On top of fertility matters, Bob received a job offer at the startup company I mentioned about before.  I am very proud of him!  At the same time, we have to seriously evaluate the offer and see what kind of health insurance we’ll get.  I am okay with a plan that offers a high deductible.  I just need to know what we’re dealing with.  So there you go friends.  The end of our IVF #2.  We have to sit down and talk about what IVF #3 may look like.  We may not go with Dr. E anymore.  As much as I love her, once insurance money is finished, she’s almost three times as pricey as going to L.ife IVF.  We haven’t decided yet.  I think I will need another thinking break from IVF.  Thanks for all the support you have all given me.  It makes this journey more tolerable.

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Edited to Add:

Ugh.  It doesn’t help that one of my friends shared her pregnancy news with me today.  Well, she didn’t exactly share.  She had been quite cryptic about why she had been taking time off and resting at home for the last week or so.  Since I have been on vacation, she knew that I was available online and kept on sending me messages.  So finally I asked what was wrong with her body.  She told me to call her.  Big mistake on my part, especially today.  Once I called, she began to complain about all day sickness and nausea and what not.  I asked again what was wrong with her body.  She then proceeded to ask me to guess why she had been home.  All I asked was, “How far along are you?”  I didn’t say congratulations.  I wasn’t being a good friend.  But hey, I think I could do that today.  I felt no joy for her.  And I was super annoyed to hear her go on and on about the IV drip, the all day nausea, and not having a chance to go on a babymoon because she’s been so sick.  I mean… she has been trying for a baby for a long time (at least 3.5 to 4 years) so I should be very happy for her that she finally got pregnant on her own.  But… I just feel no joy for her today.  She asked how we were doing.  I said… not good, but I didn’t want to go into it.  And then this comes out of her mouth:

“Just let nature take its course.  It’ll happen when you least expect it.”

Yeah.  Maybe true for you.  I said, “With my diagnosis, I highly doubt it that it’ll happen to us naturally without any medical intervention. We’ve done two IVFs and have gotten some bad news.”

I really didn’t want to hear her whine.  So I found an excuse and hung up.  Sorry.  I am not a good friend today.  But I need to self-preserve.

Grade three, three-cell, on day three

Okay.  I got my ugly cry out of the system already.  I am doing okay.  

First of all, thanks for all the support from the last post.  I really appreciate all the virtual hugs.

Today is day three after retrieval.  I was quite nervous this morning.  You know that mental state?  It doesn’t matter what you tell yourself, you’re still nervous.  Dr. E usually updates us early in the morning.  We waited and waited, refreshed my email account on my phone many times, and stared at the computer screen while I was at it.  No email.  I think the not-knowing kills me more than the bad news.  This morning I had to take Bob to his immigration appointment in downtown at 11am.  Still no news when I was waiting in the car for him.  I was hoping that Dr. E wouldn’t call me on the phone.  I somehow equate bad news with phone calls.  I was thinking, “Please please no phone calls”.  When Bob got back to the car, he asked, “Any news?”  I said “No” while refreshing my phone screen.  And there it was.  One new email.  My heart was pounding and my hand was shaking a little.  I was hoping for at least similar progress as last time: grade one four-cell embryo on day three.  Unfortunately, the news wasn’t what we wanted.  This is Dr. E’s email:

“This morning’s report is not as encouraging

but there is always still a chance as you know from experience

our day 3 embryos is a 3 cell grade 3. The likelihood that it’s genetically normal is low but not zero.

the second embryo isn’t dividing.

I will update you on Friday

I’m sorry this cycle isn’t going better

but there’s still a chance we have a blastocyst

I will let you know on Friday”

 

Cue ugly cry.  Well, it took me maybe two minutes before I felt it in my heart.  The oh-so-familiar feeling from last cycle, although this time the feeling was worse.  I don’t know what grade three three-cell translates to when it comes to making a blastocyst.  I don’t want to consult with Dr. Google or ask a friend.  I just know in my heart that this could be a bust.  All the stimulations, monitoring appointments, waiting, driving.  It comes to this low point of ONE embryo not dividing the way we want it to.  All the hopes and dreams riding on this one embryo, again.  Daisy doesn’t seem to have the kind of persistence that Clay did.  I really want Daisy to prove me wrong here.  

I AM grateful for Clay that is still frozen in time, waiting to come home.  And I am ultra-grateful for 1) getting this news when I am on vacation and not at work and 2) Bob being around and hanging out with me all day while I recuperated.  We have given names to embryos up to the letter i.  I hope that we really don’t have to use up all the names before we get our take home baby.  

We don’t know the outcome of this cycle.  I may be pleasantly surprised again.  I may not be.  But I do know that every time with embryos that don’t grow, my heart dies a little.  

I know the Lord will help me get through it though.  I know it.  

Deja Vu

This sounds so familiar.  One embryo is a grade one two-cell.  Just like the last time at this point.  The other one has stopped dividing as of now.  But Dr. E said that we’ll continue to keep an eye on it.  My fear is that this grade one two-cell embryo may decide not to divide and grow.  We really want to make a Daisy this time to join Clay.  Why is this so hard?  I am going to be off for the rest of the week so I have a lot of time to ruminate on the embryos.  Ugh.

I am praying for God to take care of my emotions so that I can keep calm and keep faith and trust in Him that He already has a plan for us.