Acupuncture? Counseling?

J and I have yet to decide when we want to begin IVF and which "package" we plan to go with. Maybe July? We will have to sit down and have a major discussion soon (likely with a bottle of wine nearby).

In the meantime, we've been discussing options like fertility counseling and acupuncture, both of which are offered at the same office as our new RE. Have any of you had any experience with either? Would you recommend them? We know our insurance would cover a portion of the counseling and are looking into acupuncture.

Counseling: J and I both feel like this might be a good idea at this point. We've been TTC for years and are about to embark on the mother of all fertility treatments. Some extra emotional support may be helpful, right?

Acupuncture: I've heard mixed reviews. Some believe it merely helps to relax women during a stressful TTC cycle, while some truly believe it can improve your chances of success. Thoughts? At what point during a TTC (specifically, IVF) cycle is acupuncture recommended?

IVF Cost Breakdown -- WHAT to do?!

Again, not sure I'm ready to delve into the emotions/stress J and I are feeling about our (tentative) upcoming IVF cycle, particularly the financial aspect of it, but maybe soon. Not because the whole of the internet is dying to hear me spill my guts, but because the gut spilling usually seems to be a cleansing, useful thing for me. Another day, though.

For now, questions. ICLW is this week and I'm hoping to get some advice from those of you who have been through this! We basically have three options:

A. Pay as we go. An IVF cycle costs around $14,516 including all out-of-pockets. If we have success on the first try, terrific. If we don't, we start from scratch.

B. Through the Attain program, the "Multi-Cycle" option. Pay more money up front, but less per cycle if we end up using up to 2 fresh and/or 2 frozen cycles. The breakdown ends up being around $22,516 for one fresh, $26,532 for two fresh, and tack one $1,000 for each frozen cycle (up to two) we use, assuming we will have viable eggs/embryos to freeze.

C. Through the Attain program, the "Refund" option. Again, pay more money up front, less per cycle if we use them, AND a 70% refund (not including out-of-pockets or meds) if we don't go home with a baby. $27,666 for one fresh, $31,682 for two fresh, $35,698 for three fresh, and tack on around $1,000 for each frozen cycle we use. If we don't go home with a baby after all of that (and LORD help us if we don't...), we would get around $16,555 back in the form of a refund.

What on earth should we do?! Obviously option "C" is the smartest, I suppose. However, do we really have that much money? Well, of course not, we certainly don't. We have a portion of that money. I suppose the question in, do we really feel comfortable spending/saving/borrowing that much money? I really, really, really, really hate this gamble, either way you slice it. Each option is a risk. Each option scares the daylights out of us. I think we are going to take a little bit of time to think about it before we make a decision, but realistically, we would like to get started with IVF this summer (July?) when we both have less going on and can focus all of our efforts and energies on it. Until then, if someone could please remove the watermelon-sized knot in my stomach, it would be much appreciated.

IVF: As it turns out, expensive.

More on this in a bit when I've calmed down. For the time being, I'll say this: If I see one more picture on Facebook of someone's pregnant belly that they obtained free of charge, I might run through the house screaming.

Vacation Responder

Contrary to evidence that might suggest otherwise, I have not fallen off the face of the earth. J and I have been taking a much needed vacation from TTC. Initially, our intention was to merely put a temporary stop to fertility treatments, shots, ultrasounds, etc. You know, the invasive stuff. To put all of that on hold until we were ready to revisit that world.

Somewhat organically, our little TTC vacation has turned out to also be a vacation from even talking about TTC. We never discussed this as being an intentional part of taking a break, but as it turns out, neither of us were eager to discuss all of that crapola while supposedly taking a break from it. And you know what? It feels fantastic. We needed a mental break as much as we needed a physical break. Perhaps people have some sort of sixth sense about these things, because our family and friends have been really good about not bringing it up in conversation. This is not to say that I don't welcome the occasional question, update request, or supportive email. I appreciate nothing more than the interest and support of our loved ones. But for the most part, we've taken a complete hiatus from discussion. Which, in turn, has included blogging.

Where are we now? Not sure. We had a little chat a few days ago and agreed that neither of us are eager to dive back in just yet. We are really trying to listen to our hearts and wait until we feel really ready before starting the process again. We are fairly certain that IVF will be our next step and feel that it would be wise to wait until we feel rested and strong enough (mentally and physically) to go in swinging.

It's tough. Babies all around. Adorable, chubby, laughing, happy babies and their happy parents. Putting aside the normal fears about becoming parents, J and I feel more ready than ever to be parents. That being said, though, we think that waiting for the "right time" for IVF is important and will probably be beneficial to our success.

So, we're still here! Feel free to check in once in a while. This is the healthiest I've felt in months. I definitely needed a break. Time to breathe, clear my head, and think about other facets of my life that don't include injections, 7am ultrasounds, and planning my life around cycle math. I would estimate that sometime in early 2011 we will make the decision to go in for a second opinion and, if recommended, go ahead with IVF. How very exciting/terrifying/surreal.

Taking a vacation from my problems!

J and I are on a wonderful vacation. Perhaps a lovely Mexican resort, you ask? Nope. Just a vacation from TTC. A much needed vacation, as it turns out.

As I mentioned in a recent post, I haven't been this relaxed in quite some time. I'm remembering what it feels like to be normal again. My only fear? It feels really great. I'm not anxious to board that train again anytime soon.

When J and I first started trying to conceive back in 2008, I couldn't fathom taking a break. Why would you take a break? Why not keep charging ahead? Time's a' wastin'! Shows what I knew. J and I really hit a breaking point last month and we both realized that a break was absolutely necessary for our sanity.

But what if I want to stay in Oz forever?

I shared my fears with a friend recently. Two friends, actually. They went through all of the TTC/IF crap that we've gone through and more. After one IVF cycle, they finally became pregnant and are expecting in a couple of weeks! I'm beyond thrilled for them. Anyway, they had Follistim left over and donated it to our cause, saving us a LOT of money. So, to thank them, we took them to a tasty local restaurant last week. On the way there, I spilled my guts. Confessed my feelings of current ambivalence to trying again. My friend calmed my fears, for the most part. He said that they reached a similar point and actually cancelled a previous IVF cycle due to a minor meltdown over those very feelings. (Thank GOD! I'm not crazy or alone!) They ended up taking a few months off, gained some perspective and clarity, and eventually tried again (and succeeded). He advised that we do the same -- follow our hearts, listen to our feelings, don't jump into anything before we feel absolutely ready. I really look up to these friends -- they are older, wiser, and have been through the IF wringer. So, coming from them, this advice meant a lot.

It's odd, though. This has been such an intense focal point in my life for the past handful of years and taking a vacation from it altogether makes me feel like a part of myself is missing. It's somewhat unsettling. Leave it to me to spend a mental vacation worrying about the vacation itself.

Let's focus on some fun times.

I'm taking a bit of a much needed mental break from thinking/talking about TTC. Honestly, it feels fantastic. I don't feel like a dark cloud is following me around for the first time in years. I don't feel sad all the time. I'm not constantly consumed with follicle size or injections. Eventually I will have to face the music, but for now, I choose the ignorance-is-bliss route.

So, instead, I'll blog about something fun! A few months ago, my brother married the love of his life. I absolutely adore both of my brothers -- the three of us are really close, which is something that I am incredibly grateful for. The wedding was a b-l-a-s-t. Due to the aforementioned closeness, I cried through the entire ceremony.

A few of my closest friends came along, which made the whole weekend even more wicked awesome. My sister-in-law has absolutely beautiful taste and the wedding and reception were impeccably planned down to every last detail. Care to take a peek? Here is a trailer for their wedding video, which will come out later this year:

Flavia & Elliott - Cinematic Movie Trailer from Simply Cinematic on Vimeo.

Pretty fantastic, huh? I tear up every time I hear my brother's Best Man toast AND when I see J tying my brother's tie. What can I say...I'm a bit of a softy. Speaking of my three favorite boys, here is one of my favorite pictures from the wedding:



Freakin' adorable.

Now I just need to find another opportunity to wear long, blonde hair extensions (my hair is only about shoulder length), because that was lots of fun. The rest of the bridesmaids? Well, their hair is actually that long. Me? Jealous. I've also been heavily debating chopping my bridesmaid dress off to make it knee length. I LOVE the dress and can hardly stand to consider parting with it in its current form, but honestly, when will I be able to wear a floor length dress again? If it were short, I could wear it much more easily and it would still be cute, right? Oh, but the thought of butchering it makes me sad. Then again, the thought of wearing it again is tempting...

IVF (Terrified)

I've been avoiding writing this post. I've been avoiding even thinking about our TTC future because it scares the daylights out of me.

Last week after we had to cancel our IUI cycle, I called the nurses and asked them to be very frank with me. They've known J and I for a few years now and I wanted their honest opinion. I asked them, "If it were you, what would you do, knowing what you know?" They uttered those three letters that I've been dreading: IVF. It's not that IUI can't work for us, but it's a gamble. If we try a few more IUI cycles and don't have any success, we may as well have paid for IVF. I've been told that because I have PCOS, I'm tricky, and my RE can better control my body and our outcome with IVF than with a straight injectible cycle.

I was hoping that we would never get to this point, though. It terrifies me. It's a crap ton of money and will take a real toll on my body. Four or five different kinds of injections, four or five different kinds of pills. Ultrasounds. Bloodwork. Retrieval. Transfer. Emotional rollercoaster. What if it doesn't work.

I'm not quite ready to deal with this. I think IVF will probably be the direction we go in next, but not yet. Neither of us are ready. We are out of strength. Out of morale. Out of fight. We need some time. We want some time. Time to be ourselves, time to enjoy our lives, time to be normal. When we're ready, we'll move forward. Thankfully, we're both very united on this issue.

In the meantime, we may also go somewhere else for a second opinion. Does anyone have a fantastic RE in Ind.ian.apol.is that they would recommend?

Need You

J came home last night having listened to a story on NPR about some dude who apparently has the 3rd most performed song in the last 50 years, according to Terry Gross (my favorite public radio interviewer!). Neither of us have heard of this person or his (country?) song, but J heard this lyric:

"I need you more than want you and I want you for all time."

...and said it reminded him of me. I am one lucky girl. But I already knew that :)

In other news, Moulin Rouge is on TV. J and I are both asking ourselves, if you were 10 minutes from death, wouldn't you realize it? Especially, as J put it, while putting on a "rompin' stompin' Bohemian-style musical?" I love this movie, but really, Satine. How does she manage to get through said musical and then die almost immediately after it ends? Just sayin'.

Kicked right in the ovaries.

Not sure where to start. I suppose I'll just dive right in. We went in for our ultrasound this morning and got some insane results. I suppose I should have seen it coming, based on Wednesday's results, but I was trying to remain positive and hope for the best.

The moment I saw the ultrasound screen, I knew. HUGE circles all over the screen. As it turns out, I have fourteen (fourteen!) follicles that were 16mm or greater. We've always hoped for lots of mature follies, but by "lots" we meant four or five. My estrogen is at 2,823 pg/ml. Needless to say, Dr. G is cancelling our IUI cycle. Not only that, but we are to avoid intercourse until after my next period to make sure I don't get pregnant. There is just too high a risk of multiples. And while J and I are game for the risk of two or three, fourteen is dangerous.

It's the ultimate irony, isn't it? If we were to go forward with our IUI, or even have intercourse without the help of the trigger shot, we would have a very high chance of getting pregnant. What we've been dreaming of for years! But instead, we are forced to abstain from any activity that could possibly result in a pregnancy. What a kick in the teeth. Not to mention flushing thousands of dollars down the drain.

J and I hugged and cried in the parking lot. Maybe the third or fourth time I've ever seen J cry and it absolutely broke my heart. We're just so tired. Frustrated. Sad. Angry. People get pregnant all the time! Why is it so hard for us?! What have we possibly done to deserve this? Will we ever get pregnant? We're so tired of these questions. So tired of this being our lives. But, as I've said before, the only thing worse than what we're doing right now would be to give up and never have children.

To add insult to injury, the bill for my Laparoscopy arrived in the mail this week. A whopping $1,600. Our savings is now gone. Zero dollars. We used to have money in savings! We worked our asses off to pay down our credit card debt and are finally free of it. We don't buy anything. We don't take expensive vacations (even though we could definitely use one now and again). We sock away money whenever we can. We are so damn responsible with our money. But still, savings, drained. We've used every last penny on TTC and related hospital bills.

We haven't yet sat down with Dr. G to discuss the next plan of action, but both nurses we spoke with today brought up IVF. Apparently today's results would have been perfect for IVF because they are able to control the number of fertilized eggs. J and I are beginning to strongly consider it. The Follistim/IUI cycles we've been doing are now setting us back about $3,000 a pop and IVF costs between $10,000-$15,000. That's A LOT. But what if we keep doing what we're doing and keep getting the same results? Should we just bite the bullet and move on to IVF? Clearly we'd have to save our money and never eat again. Would it work? What are our chances? How would we possibly handle it if it didn't work? If it doesn't work the first time, is it usually possible to freeze leftover eggs for future IVF cycles, making future cycles more affordable?

We're just full of questions. I suppose it's time to schedule another consultation with Dr. G.

--------

Update: Just received an additional bill for the Laparoscopy, bringing the total up to $1,800. Vomit.

Do we have room in our home for an entire soccer team?

We made it to this morning's ultrasound! I'm still not feeling fantastic, but I'm no longer knocking on death's door. Also, lost a normal amount of hair this morning in the shower. THANK GOD. I was completely freaked out yesterday. Hopefully it was just a fluke.

Results (CD9): My Estradiol is up to 1,123 pg/ml. Whoa there! And my follicles: 16, 15, 14, 13.5, 13, 13, 13, 12.5, 12.5, 12, 12, 9.

And that's my LEFT OVARY.

Right ovary: 15.5, 15, 15, 14, 13.5, 12.5, 11, 11.

Holy cow. I've never (never!) had results like this. I've always have plenty of follicles, it's just a matter of getting them to grow and mature. So, perhaps because they are all around the same size, we're just going to have more that grow to maturity this time, which we're not used to. I'm thrilled with these results! My only slight fear is that too many of them will mature and Dr. G will cancel this cycle. After all, J and I want one baby (or two, maybe three), not a litter. Fingers crossed that things will work out!

Dr. G instructed us to lower my Follistim dosage to 75 this evening and to go medicine-free tomorrow night. Ultrasound Friday at 7am and if all looks good, insemination on Monday! I'm excited about how well this cycle is going. This could be our month!

Cyrus the Virus

Anyone else a fan of "Con Air?" No, just me? Okay, we can move on, then.

I went to my primary care physician today and she ruled out strep. So, unfortunately (?), I just have a wicked virus and will have to simply wait it out with the help of Tylenol and Advil. I felt so sick when I was at her office. I don't think I've ever felt that bad in public before. The worst part was feeling sick to my stomach and running back and forth to the bathroom just in case I had to vomit. I haven't, yet. Fingers crossed.

In addition to my general symptoms, I also told my doctor about something that completely freaked me out this morning. In the shower, I was pulling out handfuls of hair. Every time I wash my hair I seem to lost 5-15 hairs. No big deal. Today? I kept pulling hair out. I lost enough to make a decent sized lock of hair. One of the scariest symptoms of PCOS is male pattern baldness, so I was terrified.

My doctor seems to think that it is nothing to worry about -- perhaps a combination of stress and hormonal changes due to all of the drugs I've been on in the past year or two. I'm still kind of shaken up, though. Has anyone else had this experience? In the past year, I've lost about 15 pounds, have begun to eat a little better, and have lowered my fasting blood sugar level over 10 points, so I would be surprised if my PCOS symptoms would be getting worse. Hopefully she's right and it's just stress and/or a side effect of the Follistim!

I called my RE's office three times today. Shameful. I kept coming up with questions, though. Basically, if I'm not feeling well enough to go in for my scheduled ultrasound tomorrow morning, we'll have to cancel this cycle. The nurse said that if I'm that sick, it's likely that my eggs won't cooperate anyway. Hopefully, for multiple reasons, I'll be feeling much better tomorrow.

Chugging along!

J and I had our first mid-cycle scan yesterday (CD7). I had nine or ten follicles worth measuring: 14mm, 13mm, and handful between 9mm and 11mm. My Estradiol (E2) was 476 pg/ml, which is the highest it's ever been after four days of Follistim. I'm guessing it's high because I have so many mid-sized, growing follicles. Dr. G decided to take my Follistim dose of 175 down to 125 to avoid overstimming. Hopefully we will have three or four mature follicles at tomorrow's scan! J and I were both pleased that all of my follicles were around the same size. Usually, I will have one that is much larger than the others ("going rogue," as our nurse dubbed it). Because Dr. G doesn't want my follicles to become too large, he tends to have us trigger when the largest follicle is in the high teens or low twenties. If that follicle is quite a bit larger than the others, the others often don't have enough time to grow to maturity, leaving us with only one mature follicle. I would prefer to have several chances, even given the risk of multiples.

In other news, I wasn't feeling well yesterday afternoon, which quickly developed into feeling absolutely miserable by last night. It could be just a cold, but I'm going to the doctor this afternoon to make sure it isn't strep. I'm hoping that my being sick won't affect our IUI cycle. And if it turns out to be strep, am I all clear to get a penicillin shot while putting all kinds of other hormones and madness into my body? I guess I'll find out this afternoon.

Is this some kind of sick joke?

WHAT the hell. For the past year or so, I have mysteriously been receiving Parenting Magazine. Every month, there it is in my mailbox. I mean, what gives? Clearly, I am not a parent. Clearly, I did not order this magazine. Clearly, neither J nor I appreciate receiving this backhanded reminder of our lack of offspring.

My guess? The good people at Parenting somehow got their hands on our bank statements. Therein, they discovered the large sums of money that have been pouring out of our account and into the hands of fertility drug companies for the past handful of years. After a while, they figured, "Hey! These people have been doing these fertility drugs for quite some time. Surely they have a child by now. Probably two! Let's go ahead and send them our magazine for free. They'll be so excited."

Sorry, guys. No children yet. For the time being, do me a solid and stop sending us your crapola. You're barking up the wrong tree.

This isn't my first rodeo, cowboy.

Here we go again! Back on the proverbial horse! Bright and early this morning, J and I went in for our CD 2 baseline ultrasound. Today is J's birthday -- good omen, yes? Everything checked out, so we are on our way to our first (and hopefully last?) IUI cycle! Tomorrow night, I will start giving myself daily Follistim injections. I must say, at the risk of sounding a bit cocky, that I have become a pro at giving myself injections. I still remember our first injectible cycle. My brother, C, was in town. I carefully put together my injection pen and told him that J and I would be disappearing into the other room for a few minutes to brave our first injection. It took me a good ten minutes and several tears before I worked up the courage to stab myself in the abdomen. The first time was less than graceful and by the end of the week, I had a lovely smiley-face-shaped line of little purple bruises drawn across my stomach.

But now? I hardly ever end up with so much as a mark! If abdominal injections became a sanctioned Olympic sport, I would qualify and excel, perhaps even medal. What still makes me nervous? The trigger shot. Even though J is an excellent nurse and has gotten fairly good at administering the shot quickly, it's still not my favorite part of the cycle. After all, who enjoys a long needle being injected into their rear end? Even if it is a 25 gauge? I suck it up, though. Honestly, I think it's worse for J. I'm not sure I could ever muster up the courage to give someone else an injection.

So, injections on Thursday, Friday, Saturday, Sunday, and then a 7am ultrasound/blood draw on Monday to check on my growing follies. Wish us luck!

Silent Sorority, Part 2

Remember a few days ago when I blogged about wanting "Silent Sorority?" Well, shortly after that, it arrived in the mail! My fabulous friend, C (the one getting married -- see bridesmaid dresses below), saw my post and bought it for me! She has been incredibly supportive ever since I told her about J and my struggle with infertility. Even though she lives far, far away (me: Ind.iana, C: Tex.as), she has been a constant source of strength, support, and kindness. C, I love love love you!

During some free time this afternoon, I couldn't help but dive right in. I found myself constantly nodding along and making quiet murmurs of agreement with the author. This is the first book I've read that deals with IF/TTC and I'm so glad to have found it! In the first chapter, the author (a fellow infertile) shares a memory of running to the bathroom to hide while her peers discuss mommyhood, minivans, and bedtimes. I think we've all been there! Whether it be a discussion centered around children or the occasional, "So, when are YOU going to have a baby?!" question, I've done my fair share of bathroom-ducking.

Looking forward to reading on! Will report back!

Silent Sorority

I want this.

Bridesmaid Dress -- A, B, or C?

My awesome friend, C, is getting married in October and is allowing her bridesmaids to choose any short dress from David's Bridal that comes in "tangerine." J and I went this evening to try and make a decision, but I walked away with three favorites. Which shall it be? Opinions needed!

Remember, the dress will be tangerine, so don't let the colors be a part of your decision. Also, only the dark purple one is in my size -- the other two are one size too big, so they would fit better once I got them in a size smaller.

Post-Op

Today was my post-op appointment with Dr. G. J and I were shocked and amazed when he came in at 11:35 for our 11:30 appointment. Dr. G isn't exactly know for his punctuality, so it was nice to get in and out of there in a timely manner today.

As I expected, he said my incisions looked great. I'm feeling virtually back to normal. He showed us before-and-after pictures of all of my insides, which was kind of awesome. How often do you get to look at pictures of your uterus, ovaries, kidneys, and fallopian tubes? We also saw pictures of my (fairly mild) endometriosis before it was removed.

Then, onto the next plan. Dr. G asked us if we wanted to take 3 to 4 months and just "see what happens." Uh, NO! Absolutely not! We are 2 1/2 years in and have had to take breaks this year for the HSG and Lap -- we're tired of breaks. We're ready to get back on the horse! So, we decided to move on with IUI. Until now, we've always done timed intercourse (which is just as exciting and spontaneous as it sounds), so we are hoping that IUI will increase our chances a bit. That plus the Lap and freshly flushed tubes = our best chance yet, right?

A note on timed intercourse. We are both beyond okay with moving on from that. J and I used to be dead set on trying to get pregnant just like "normal" people. We wanted to feel like we did things as naturally as possible and get pregnant the "normal" way -- by having sex! Plus the help of drugs and many ultrasounds, sure, but at the end of the day, sperm meets egg. You know what? We're over that. It was a lovely dream, but at this point, bring on the more advanced tactics. To tell you the truth, we're tired of sex being a means to an end. When it's "timed intercourse," it's not fun. It's not sexy. It's not exciting. It's a job, plain and simple. Plus, IUI takes the guess work out of the process and puts it into the hands of professionals.

So, once my next period starts, full speed ahead with IUI! Someone correct me if I'm wrong, but I believe it's the same spiel as before -- Follistim 175mg, frequent ultrasounds, trigger shot, and then into the office for the procedure.

This all sounds great, right? Right. So why did I cry all the way home from our appointment? Why do I feel stressed, overwhelmed, pessimistic, and sad? I suppose after 2 1/2 years and seven failed medicated cycles, it's hard to keep believing that we'll ever get there. But as J keeps telling me, this should be our best chance yet. Our last cycle looked great on paper, and our chances should only improve. I need to take a deep breath and relax. Maybe this could be our time! Dr. G joked with us on the way out that hopefully we won't get "more than two" out of the deal. J's response to that is always, "Two beats zero!" He's right. The thought of multiples is a bit frightening, but it always beats zero! We just want a baby. Or babies. We're ready.

Fun with Wordles!

Make your own Wordle! Now if I could only figure out how to make mine show up larger...

The Happiest Place on Earth

Well, Stirrup Queens has done it again. Her most recent post about her trip to Disney World brought me to tears. I read through it, nodding along, thinking that I will feel exactly the same way when J and I can fulfill our dream of finally bringing our future, hypothetical children to Disney World.

Disney World is like a second home to me. I've been nearly every year (some years more than once!) since I was a little girl. J and I know it backwards and forwards and yet never get tired of going. In recent years, trips to Disney have been bittersweet. On one hand, we joke that we are stroller free and can, therefore, navigate our way through crowds and lines like ninjas. We can ride the adult rides until we're blue in the face and don't have to worry about bed times, being slowed down by toddlers, screaming children, or paying for extra tickets. Then again, we want nothing more than to deal with all of the above. I can't imagine how special it will be to share Disney World with children of our very own.

Until then, we will enjoy our ability to run through Disney World like pros without being slowed down. But deep down, we'll be wishing and hoping for the day when we can leisurely push a stroller around EPCOT and watch our little boy or girl experience the magical world of Disney for the very first time.

P.S. The little guy in my picture is Pierre, our gnome. We bought him in 2007 to take with us to Europe for picture-taking-fun, and he's traveled with us ever since!