My Own Worst Enemy: Me

The timing felt right for a fertility update, particularly since the last few days have been a bit of a roller coaster.

*Disclaimer* Obviously some medical information is contained in this post.

Following my hysterosalpingogram last month, Husband, my doctor, and I decided that it seemed logical to take the next step to IVF. We'd attempted IUI three times without any success. Though the hysterosalpingogram showed no medical reason for the failed IUIs, it just seemed silly to continue that option, especially when another option, with much higher rates of success was available to us.

Husband and I are super lucky in that his insurance provides amazing coverage in this regard. There have been so many times I've seen other couples handing over hundreds of dollars as a co-pay, or in some instances just paying out of pocket 100%. Our co-pay is only $35 and our insurance pays for four egg retrievals in my life time. This really impressed our insurance liaison since most companies pay for a certain number of "cycles", but by classifying as "retrievals", we have the option for more if we opt to freeze embryos. It's nice to know that Husband's long hours at work are good for something!

But anyway, we met with our insurance liaison and she explained the process of beginning IVF. First, we had to attend an information seminar with about 40 other couples. We did that two weeks ago.

I got to the seminar early and snagged an aisle seat by the door. Husband arrived a little late and joined me. A few minutes after Husband arrived, the husband of the woman sitting next to us showed up: a guy we attended law school with and whose father Husband currently works for. Needless to say Husband spent most of the seminar making sure this other guy didn't recognize him. Whereas I spent the seminar wondering what the law school put in our water since this makes the eighth person we know who had to participate in some sort of fertility treatment.

Don't get me wrong, I did pay attention to most of the presentation and let me just say this: there should be a test before people are allowed to procreate, particularly in a controlled setting like a fertility clinic.



Let's play Guess That Embryo!
Who does this embryo look like?

 At the end of the session, the presenter (who happened to be our doctor) asked if anyone had any questions. There was a moment of silence and our doctor was ready to wrap up, but then a gentleman towards the front of the room put his hand up.

Random Dumb Dude: "How do you make sure you don't mix up the specimens?"

Doctor: "What"

Random Dumb Dude: (And I swear he actually said this) Well, all babies look kind of alike so I assume that all embryos look kind of alike. How do you make sure that you transfer the embryos into the right uterus?
Doctor: "We label everything. Several times and in several different ways."

Duh.

What I wish my doctor had said was, "You, sir, are too stupid to have children. Please leave now."

So basically this guy is under the impression that the embryos are running around looking anything like their eventual parents and that's how the lab technicians figure out which embryos belong to which couple. I told Husband that I'm going to make it my mission in life to accidentally have Random Dumb Dude's baby.

Husband agreed that would be awesome because (1) it would be freakin' hysterical and (2) he would be able to stay home and watch baseball rather than going back down to our clinic to make a "deposit" of his own.

Thankfully that was the only truly stupid question of the night and the seminar ended without further incident.

Onto step two of the IVF process: an individual meeting with our doctor.

We did this on Wednesday afternoon. I like my doctor a lot and he let us call the shots on a few issues that I thought he might push back on (i.e. the number of embryos to transfer). My suspicion is that Husband wooed him a bit with his questions about success statistics. The doctor was basically chasing us down the hall to give Husband the most up-to-date though not-yet-published statistics from the clinic. I told Husband that he was probably so excited to be asked intelligent questions as opposed to "Where do babies come from?" (Random Dumb Dude, I'm looking at you) that he wanted to extend the conversation as long as possible!

This embryo appears to be in disguise.
Can you figure out who it belongs to
or are you stumped like Random Dumb Dude?

The final step was a teaching session with a nurse. Since IVF requires more injectable medications than IUI (and many people doing IVF didn't do IUI), the nurses walk couples through the process of preparing and injecting the medications. As we left the office on Wednesday, my doctor said we'd schedule that session in the next week or so and asked when I expected my period.

My diagnosis is Polycystic Ovarian Syndrome which basically means that I don't always ovulate. When you don't ovulate, there's no trigger to start your cycle so I tend to go anywhere from 35 to 65 days between periods.  I reminded my doctor of this and he agreed to write me a prescription for Provera to trigger my period. He then ordered some blood work to determine if I had ovulated this month.

About an hour later, the nurse called me at home: I had ovulated.

Of course I had! The girl with the condition that means she doesn't ovulate always ovulates the month when she needs an extra week before she gets her period. It's like the plot of a bad made for TV movie.

I spent about an hour on Thursday on the telephone with three different people from the clinic: the insurance liaison, Nurse A, my doctor's lead nurse, and Nurse B from the IVF team. They all agreed that Husband and I could take the training online and made a note for the training nurse (Nurse C) to call me on Saturday.

Just when I had that all resolved, I got a phone call about one of my cases. It was one of those situations that I had known for months was hanging by a thread. There were two possibilities: we'd get the case dismissed before the sh*t hit the fan or we wouldn't. Late on Thursday afternoon, I had confirmation that we wouldn't and on Friday, we had to go to court.

After numerous conferences with attorneys, appearances in front of the judge, and conversations with my client, I came to the realization that my client wasn't going to be leaving the courthouse with her 8 month old child. As we walked out of the courtroom, I explained this to her and predictably, she burst into tears. She started crying, the father started yelling, and the baby, in her mom's arms, stared at me wide-eyed obviously not knowing what was happening.

And I lost it.

I could tell for about twenty seconds before I started crying, that I was going to start crying. I tried the relaxation technique that my therapist had recommended (breathe in through the nose "Time" and out through the mouth "Out"), but it was too late.

Because the father was yelling, several security officers came running to where we were standing. I can only imagine when they saw him yelling and me crying, that they thought he had attacked me because they all rushed to me first. I shook my head to let them know that I was fine. Then I realized that if I wanted tissues, I had to go back into the courtroom, thus exposing myself to even more people who would have no idea why I was seemingly taking this so hard.

It was awful. Of course, it was awful for my client, but (and I know this sounds a little cold) I've been through this exact situation before and I was fine. On Friday, it was something about everything that we've been going through that just hit me...hard.

After I calmed down, and calmed my client down, I went back to my office, where I promptly started crying again. Then when Husband got home that evening, I had my third cry of the day. I swear there's no way I have any tears left!

On Saturday morning, I woke up feeling crampy. Of course I was!

Luckily we had an appointment to go meet with Nurse C. We needed to sign some releases and she had to go over the instructional packet with us. While we were there I mentioned that I expected to get my period later in the day. The one pharmacy that our insurance allows us to use is closed on weekends...and in Florida so best case scenario we'd have the meds by Tuesday, two days after we needed them. Husband said that he'd be willing to pay for the meds out of pocket and fight insurance ourselves for a reimbursement, but thankfully Nurse C had some sample medication in the lab that she reserved for us. The sample meds will get us through Tuesday when the pharmacy finally decides to ship everything to us.

So we officially start the medications on Sunday. My dose of gonadotropin is 200 iu, up from 75 iu on the last IUI attempt so I'm expecting some more serious side effects. I got off easy with the lower doses, really only feeling slightly elevated moods and more tired than usual.

And lest anyone think that the medical professionals have managed to outsmart my body's attempts to sabotage this entire process, consider this: our projected timeline based on a start date of Sunday February 13 means a transfer on February 25, a day that I had intended to travel two hours to visit a friend and her new baby and that Husband had scheduled a deposition...in Florida.

Oh Kathleen, you stinker!

Happy Sunday!