IVF #3 has begun. I didn’t quite know how to feel about it. Many people have asked about my feelings. I was feeling ambivalent for a while. You know, the constant struggle between trusting that it will happen to us and doubting that it’d ever work. After last week’s BFN, I got all 40 vials of Menopur just like the first protocol that Dr. E and I had talked about using for this cycle. I had a luteal phase of 15 days. I often think that a luteal phase of 15 days is such a tease. There is a glimmer of hope that we might just be one of the lucky ones that beat the odds and got pregnant in between IVF cycles. Especially when the basal body temperature was well above the coverline. On Satuday, the temperature dropped and that little sliver of hope disappeared. I knew that I wasn’t pregnant even before the drop of the temperature but that was still a little disappointing.
When AF came at full flow, I notified Dr. E via email. I assumed that we would start four vials of Menopur on CD2, just like the first cycle. She responded with a whole new protocol. I was to get my bloodwork done on CD2 and start taking three pills of Femara on CD3. Huh? I was confused. The schedule said to take 3 Femara from CD3 to CD8, and to start two vials of Menopur on CD6. Dr. E will see me on Saturday for the first monitoring ultrasound. Okay. I just got 40 vials of Menopur but good thing I got them through a friend at a discounted rate. But still. And I was again confused. Last cycle, I was put on 2 Femara at first and then four vials of Menopur. There were no embryos left to be transferred. I am a little weary about being on Femara again. But, since I decided to go with this RE, I have to trust that she knows what she is doing. My FSH turned out to be 19. This is the highest I have ever gotten but it’s not too far off from my previous highest, which was 18.7. I asked Dr. E why the change of protocol. She responded with this:
“When women have less than 5 follicles they respond better sometimes to starting the Femara first. When I saw your ovaries on ultrasound I saw very few follicles. Given the FSH of 19 and the few follicles, the ovaries want me to whisper to them.”
Remember I never asked her the number of antral follicles? I guess I really only had a few on the scan. Dr. E has officially become the “Ovary Whisperer”. I hope that she is not talking so softly that the ovaries are put to sleep instead.
This cycle is not without its minor dramas. My RE’s medical assistant called in the script of Femara for me. I called the pharmacy down the street from work at 4pm on Monday to make sure that they had my prescription ready. The lady reassured me that they were working on it and it should be ready by 5pm. At 5:30pm when I arrived at the pharmacy, I was told that it wasn’t processed because my insurance only approved for one pill per day and denied three pills per day. The pharmacist tried to override it online but was rejected. He said he’d call my insurance and see if he could get it overridden. I had to be at my Bible Study at 6:35 or so and it was 45 minutes away with traffic. I needed the meds that night. Needless to say, I was antsy and stressed out. But then, I quickly reminded myself that this was something out of my control and there was no use to be stressed. I prayed and calmed down. Once I was done praying, the pharmacist called my name and said that as long as I and my doctor knew the risk of taking a high dose, the insurance was okay with paying. Yes, we are aware of that. So I got my pills for that night. The pharmacist rocked. And guess what? There was no traffic so I got to Bible study on time.
A bigger drama was due to my husband’s work. We have been on COBRA from his old job so we still have our fertility coverage. His current company agreed to giving us a monthly stipend to cover for the cost of COBRA. So I have not been in a rush to finish up any treatment or medical appointments because I thought that we would keep the same insurance. Last week, his current job rolled out their healthcare coverage. It’s not a Cadillac plan like the one that we have now but it’s okay. It’s more like an Accord or Camry. I am okay with switching over in January as long as I can finish my fertility coverage for this cycle. However, I didn’t realize that his current company is going to start the new coverage on December 1st instead of in January 2014. In order to use up our fertility coverage, we have to finish a portion of the cycle by November 30th. We have about $2900 left. Unfortunately, because the amount is not enough to cover for the whole cycle even with the insurance contractual rate, we are now officially “cash-paying” client. As a cash-paying client, we hand over a $12,400 check at our first ultrasound visit, which is this coming Saturday. My RE’s clinic is going to hand me a superbill for the claims so we could be reimbursed with the remainder of $2900 from the insurance company. I know that $2900 is not much in comparison to $12,400 that we have to pay. But every single bit of money helps. Dr. E’s finance person reassured me that as long as we do our retrieval by 11/30, the cost of the cycle up to the retrieval should be enough for us to claim the $2900 back. I think we’re cutting it very close this time. It looks like the retrieval will most likely be Friday 11/29.
“If there is going to be a retrieval.” I keep hearing that sentence in my head. That’s the part of me that does not trust and does not believe. That’s my biggest fear, that we wouldn’t even get to retrieval.
Anyhow, because of this, Bob has been feeling a little guilty about switching jobs and giving us this drama with healthcare coverage. He is also feeling the stress of IVF as well as the same ambivalence that I have been feeling. Needless to say, all of these stresses make us prone to fighting. A discussion of the insurance coverage late a night after a long day of work turned into another fight. We’re fine though. We usually talk things out then and there. But I could totally feel the nervous energy yesterday throughout the day.
I also think Femara is giving me a headache everyday.
On the plus side, I gathered enough courage and told my mom about our history of IVF #1 and 2 and that we were about to start #3. My mom is a very sweet and supportive person. I never doubted that I would get tremendous support from her. However, I was afraid of her not being able to keep a secret given her history of sharing everything with her sisters. I hadn’t told her anything because she was traveling in Asia during our first two cycles. I considered not telling her and hiding all the medications. Bob and I discussed about it and felt that we should come clean so we don’t have to tell any white lies. We wanted to be open about what goes on in our household. And open we are. The talk with my mom went very well. She had read up on the process before and had some basic understanding of it. She promised me that she wouldn’t tell my aunts. She was probably a little mad that I had shared with my dad but not with her. She can’t blame me for doing that. My dad is the best secret keeper in the world.
My mom has been cute ever since then. On Monday she checked on my husband several times in the evening whether or not I got home already because I had to do my injections. (We were doing 25 unit of Omnitrope.) She asked me many thoughtful questions and was concerned that the process was painful. I hope that she does keep her promise of keeping things to herself. We shall see about that.
I chatted with God for a long time this morning. I prayed to Him and talked about all my fears and my ambivalence. I talked about our desires to be parents but at His timing. I prayed for my total trust and submission to His authority and to be joyful and hopeful regardless of the outcome of this cycle. I prayed for protection over our marriage so that we are for each other rather than against each other. Unlike the nervous energy that I felt all day yesterday, I have been feeling tremendous peace throughout the day today. I hope that this peace will remain with me the remainder of this cycle.
And I hope that we see a few follicles growing on Saturday.