Entering the world of Assisted Conception...like it or not...

[Neener]

Hi Ladies -
Would it be ok for me to join?
I've gone back and read the whole thread. You ladies have been through so much. Congrats to those of you that got your bpfs.

Hiker - I've been following your journey and am rooting for your eggie. Hoping this is all you need.

Bronte - sorry to hear about your last cycle and I hope the next one is more fruitful. At least you know what to expect now.

Lemon - glad your surgery went well. Wishing you a speedy recovery so you can move forward.

AFM - DH and I were married in Nov. 2014 but didn't start TTCing until Feb 2015. In June 2015 my periods started becoming irregular and I was spotting and bleeding all the time. Went to OBGYN who told me my cycles probably got out of sync due to stress or random unknown reason. By January 2016 I decided enough was enough and scheduled appointment with RE, but unfortunately there was a 3 month wait for new patients. In March found out I had low AMH but everything else was ok - I have some PCOS symptoms, but not enough for a diagnosis. Dr. decided to do hysteroscopy to find out about irregular periods. That was done in June and in July had IUI round #1 with BFN.

We just got a new insurance policy with my husband's new job so I went to my Dr.'s office to officially give blood for the beta for failed IUI. While I'm there I give them insurance information and ask them to verify IVF benefits. Good news is the policy does indeed cover some infertility - $18,000 medical and $12,000 drugs. Bad news is that although my Dr. is in network for nonfertility services, the clinic isn't considered one of the plan's Center of Excellence so they won't cover ANY infertility treatments. I really like my Dr. and the facility even though it's a 45 minute drive from my house and I was feeling like we were finally moving forward with a plan. There's a Center of Excellence two minutes from my work that I can go to (in fact, I almost went with them initially, but found out they had a 3 month wait for new patients). So I've called and left them a message to see if I can get an appointment and have my medical records transferred over. However, I'm just nervous that 1) I'll have a long wait to be seen 2) I won't like the Drs. as much 3) the Drs wont be as willing to treat me as I'm overweight and have low AMH numbers. These are all "what if" situations that may not even be realistic, but it's all I can think about right now. I knew we were going to wait out this cycle due to the insurance situation and that was already making me anxious but the thought of sitting out 2-3 more cycles to be seen by a new practice has me feeling a little defeated. What would you ladies do in this situation - should I try a couple more IUIs with my current Dr. and pay out of pocket or even an expensive self-pay round of IVF and hope the drugs are still covered so I can keep the ball rolling? Or just be patient to see when the new clinic can schedule me in? (Pretty sure that's the route that DH wants to go but he's not as panicked about my AMH numbers as I am). I don't have the luxury to not do anything bc my hormones are out of balance and I don't O on my own, so us trying naturally is futile and if I don't O there's a good chance I could start having irregular periods and thickened lining again and i don't want to go through hysteroscopy again. So if I take a couple cycles off I'll need to at least be on BCP so my hormones don't go wonky.

Thanks in advance! I really appreciate the support these forums provide!

 

[lemon_tree]

Hi, Neener! Nice to meet you.

I've got low AMH, too (endo on my ovaries), so I understand that fear. What is your AMH #?

That's a tough decision. My insurance requires that I go through a COE, too. If I were you, I'd probably have another IUI or two at your current facility to avoid losing too much time, and save the $18k benefits to put towards going straight into an IVF cycle at the new place when you get seen. You may end up loving the doctors there, you never know!

Wishing you lots of luck and

Let us know what you decide. I'm curious about what the other women here may recommend, too.

 

[star_e]

Hi neneer!

I do not O on my own either and totally understand how frustrating it can be. I agree with lemon. If it were me I'd do an iui while waiting to be seen by the other clinic just in case. It could work. Let us know what you decide. Good luck!

 

[BronteForever]

Neener - welcome to the group. I think Lemon's suggestion sounds perfect. You don't lose much time and you might not have to use your med benefits for IVF then if the IUI works. I can imagine it would be hard to switch clinics since you have a good rapport with them and they seem to be doing a great job for you. But it's awful hard to turn down benefits like that. Even if you weren't successful for the IVFs, at least you wouldn't be out nearly as much money and could invest that into other options.

Though I just got told my BMI was the likely culprit of my failed IVF cycle. I don't disagree to some extent. So I actually don't think it would be bad to just wait the three months and focus solely on losing weight and improving egg quality. My eggs were horrible. I focused heavily on what I ate and really tried to make it an IVF friendly diet of higher protein, low carbs, and hardly no sugars. None of that helped, but I did lose weight, which was beneficial in general. And if you want to add in supplements like Ubiquinol (CoQ10, which I was an idiot for not at least adding it in during my 3 months wait for treatment), then those take 90 days to take effect since that's how long it generally takes for an egg to grow.

Whatever you decide to do, it sounds like you have options. So I really hope you have success.

 

[Hiker1]

Bronte,
Thank you for that link. I've gotten lots of other helpful information from that site before - they are great! It really helped me to understand the egg quality thing - that it's just like rolling the dice. Although if I were the one in charge of how women's bodies work, I would say logically that the "good" eggs would be released first and then in order from best to worst. But I guess this explains how my friend, who gave birth yesterday at 42 to a healthy baby boy, had 3 miscarriages when she was 39. I'm hoping my one is a "green dot" too! I'm holding my breath until tomorrow and hope the little one is still going when they check it tomorrow on day 3.

Nurse yesterday said the docs would like to push for a day 5 fresh transfer and to not freeze because it's just the one. They said there is no better success rates with day 3, and if they make it to day 5 and are looking good, then the odds are much more in our favor. If they arrest after day 3, they would have likely done so in the body too (she said). So just trying to stay optimistic for our one that we have and go from there!

Also, some good news today - my husband and I got genetic bloodwork results in, as we were tested for 281 different diseases. While we are both carriers for various things, there were none that we were both carriers for, which essentially makes the likelihood that any child of ours would have any genetic conditions very, very unlikely. A big relief!

Star e, I stimmed for 10days. Last protocol I believe it was 12 days. This time my follicles developed faster and my E2 went way higher, but in the end, for both retrievals on the 2 protocols, they got 4 eggs. Last retrieval (on antagonist protocol, natural start) 2 fertilized, and then this one (microdose lupron, BCP's), 1 fertilized. So based on that I guess we have learned that there isn't one protocol that has proved to be drastically better than the other for us. I'm looking online and found another protocol, Estrogen Primed Antagonist, that looks promising. If this round doesn't work, I want to ask about that. Like you have both said, unfortunately due to the high cost, it's not like we have the luxury of trying all these different things and tweaking things month after month to see how changing one thing or another might affect results. Some folks only get one or 2 tries with IVF and then that's it. It's so frustrating to be hindered by finances when trying to make a baby....how's your stimming going? sounds like you are a special case with having to go on for an extended number of days. Hope you are feeling a little more comfortable with what's going on with this process since you've done some research.

 

[Hiker1]

Neener, Hi! and Welcome!
Sorry I didn't see this page of posts when I just responded a few mins ago. You sound a bit like me with around when you got married, started TTC, got in for treatment and got new insurance that included IVF. If I were you, I'd call the new place ASAP and explain the situation. When I switched docs in May (yes I liked my old docs but I had to switch because there facilities were too limiting) and called my new place, they initially told me 3 month wait as well. But after keeping them on the phone a while and explaining the situation, they changed their tune and got me in like a week later! I think because I was already in the process of getting treated somewhere, then I wasn't considered a "new" patient exactly. You may want to try that.

As for the IUI thing...I don't know. I guess it depends on how much they charge and if you can afford paying out of pocket. It may not work, but you'll feel better knowing you gave IUI's your fair shot. And then again, it may very well work!!

Regardless if it does take 3 months to get it, I agree with Bronte, do what you can to prep for that cycle: lose some weight, exercise, eat well, cut way back on drinking, start Ubiquinol and high quality DHEA (both have shown to improve egg quality). You may want to read "It Starts With the Egg" to read about the research behind a lot of supplements and lifestyle changes that are said to help improve your eggs. Like Bronte said, you want to start doing those things 2-3 months before your IVF cycle. (...come to think of it, I only just switched from plain old CoQ10 to Ubiquinol a few weeks ago and to better DHEA about a month ago, so if this cycle is a bust, maybe in September those supplements will have caught up and the eggs from that cycle will be better because of the better quality supplements I'm taking now...)

Nice meeting you and let us know what you decide!

 

[BronteForever]

Oh to follow up with what Hiker said, my clinic also had about a three month wait for the first appointment, but I got put on a "waiting list" if they had cancellations. They got me in within about 2 weeks then.

 

[star_e]

Hiker congrats on the genetic blood tests results. that's great news. i am sending you tons of wishes and positive energy that you are able to transfer the one. so today is the day they check it? will they call you? if its still going strong today then you have to wait two more days to see if it makes it to day 5? oh hiker, im rooting for you! please keep us updated! fx!

afm - had my appointment yesterday and still no growth. i didn't ask her how long we would stim for. how i forgot to ask that i do not know.

i did inquire about the effectiveness of uping the dose to get more eggs; i also told her that i was hoping to freeze the leftover eggs if we are lucky enough to have any leftovers. or even any eggs at all.

in response to upping the dose she said something that i didn't really understand. she said that the number of eggs i have is predetermined by the cycle and that uping the dose would not give us more eggs.

then she went on to say that if we wanted to up the dose more we would have had to do that at the beginning of the cycle. did not really understand that either, especially given that we are uping the dose from 75 to 100 now given that i still have had no growth. i was in a rush to leave b/c they were running way behind schedule so i couldnt stick around much to ask further questions.

i also asked her how many eggs she thought we'd get and she said ideally we would want 8 to 10. but she said pcos is tricky and that we could get like 20. she also told me that a higher number does not necessarily mean good. she said if i got like many eggs like 30, its possible only 2 would be good eggs. she sort of made it sound like if there are too many that is not good b/c they are prob bad quality.

i've learned a bit about good quality vs bad from this thread and things that can be done to improve egg quality, but it seems like those things (i.e. supplements) take time to take effect. if i started taking some this cycle it prob would not help much.

 

[BronteForever]

That is correct that usually too many eggs means bad quality for a lot of them. That's why studies have shown that 13 is apparently the sweet spot between having enough and still having decent quality eggs.

Glad she's upping your dose just a bit. My question to her would not be upping the dose to get more eggs but to get them to the growth they need to be at within a reasonable amount of time.

I've not heard of really long stimming protocols. Doesn't mean they don't exist and your doctor might have very good reasons for doing it. But if it's close to the 30 days you mentioned before that just seems so long and I'd be curious what her thought process is for doing such a long time. Whatever it is, I really hope it works for you. I'm following because I'm curious to see as well.

Hiker - fabulous news about the genetic tests. So glad to hear that!!!!!

 

[star_e]

thank you bronte for suggesting a question for me to ask. i will try to make the connection between length of stimulation/protocl and size of follicles at the next appointment, which is monday.

the problem with my clinic is that i get the sense that they get frustrated with too many questions and that makes me feel pause to ask more. i need to work through that though b/c this is very costly and i just want to make sure that i do everything i can this cycle to make it effective.

i have this feeling it's going to be a long stimulation. i mean no growth at all with 7 days of stimulation. maybe by monday i'll have some signs of growth with the slightly higher dose.

 

[Hiker1]

Well guys I got the update that amazingly it's still progressing normally! Transfer is scheduled for Monday! Last time my 2 slowed growing after day 3, so I'm trying to prepare for that possibility. But still trying to be hopeful.
Star e, I hear you about the clinic getting annoyed with questions. I feel the same way. Actually the doctors are worse and seem more impatient than the nurses, but I try to tell myself that I have every right to ask as many questions as I want. It's my body and definitely my money, so if they want to get annoyed and impatient, that's their issue, not mine. Who knows, they may be overworked, overstressed, ot just hate their job! Try to ignore them and keep asking away for your sake. You may ask to schedule an appointment with a nurse simply because you want to be better informed. They may just do that for you and be more patient with you if the time is carved out for that purpose alone.

I keep having this issue with one nurse. We have an online portal where they send your test results and instructions. A good idea, but not helpful if you are like me and have further questions. I've spent many days and too much time trying to email back and forth when a simple 2 minute phone call would have sufficed. The last straw was when my beta results showed a negative result my last ivf cycle and they sent me a freaking portal message. How impersonal! I requested to be called from now on, for if nothing else, a human connection through all this. And all nurse but this one will call me. No matter how many times I ask or they put in my notes, she still sends me messages. Case in point, the news today about my Embryo was from her in a portal message. Really? You can't call me? I has questions about the embryo and it's development I would have liked to ask. I want to call and complain but my husband says let it go.I still may here in a second...

 

[star_e]

Hiker! OMG, this is fantastic news! i know you still have to wait, but this is looking good. i am going to say a prayer for you and hope that monday is your day! fx as tightly as can be!!!!!! i wish the nurse would listen to you and give you a call!

with regards to asking questions. i mean i would be seriously proud of myself if i could become a bit of a stronger advocate for myself. i feel bad when i let their frustrations prevent me from getting information. and my clinic does not even have a portal. i never know any of my numbers. i never know anything. i asked them once for my medical records and they looked shocked and said they would give them to me and never did. i really should try to get this information as well. i have no idea what my hormones are like or amh, or anything. cause they tell me nothing.

and in terms with difficulty with nurses. it took me a very long time to advocate for myself after a nurse had treated me poorly and after observing extreme negligence by the nurses.

it started with the nurses complete failure to be able to draw my blood. they always had difficulty, but it got worse and worse. every time they drew my blood, two nurses would have to try. i would be stuck several times with each time resulting in them digging around inside to find the vein. i started to bruise horribly.

i grew to hate the blood draws and i found my frustration with ttc morph into a distinct sickness. i had been frustrated before, but never had i been sick of ttc. and to think what tipped me over the edge was the blood draws! not the fact that i had been trying for months to ovulate. i felt hurt, bruised and just sick of it all.

one of the times i was stuck over 10 times, including on my forearm! i've been stuck on my hand as well. she kept going in and out and digging around once inside and i was crying as she tried to mop up my blood with gauze. my veins had already been bruised from her countless failures earlier in the week, which compounded the pain. when she finally did find the vein and started drawing the blood, the relief of knowing i would soon leave came to a sudden halt when she dropped the blood tube on the floor, forcing the needle to be yanked out of my arm. she had to go in again! it was awful. i was crying and could hardly move my arms. add to this the fact that when i first sat down on those seats, that are lined with paper, that they do the scans in, i didnt look at the seat when i sat down, and when i got up i saw there was blood on the seat. they had not changed the room! so i sat on someone elses blood. it was so gross. and completely unprofessional.

and i told no one at the clinic about any of this.

then when i came back a few days later with my arms black and bruised from her failures, i told her i was very hurt and sensitive and she said
oh come on how painful can it be? i was in SHOCK when she said that. didn't she know how painful it was from seeing me cry and hearing about my fears of it and from all of the bruises. she was the one who had to recommend a special cream for me to use to minimize the bruising. up until that point i had taken all the negligence, her insensitivity, the complete lack of professionalism with not cleaning out the room that one time and said nothing about it. this was the last straw for me. I decided to tell the doctor everything that had been going on, including that the nurse once told me in response to me saying that the blood draws were difficult for me that i don't know anything about her or what problems she has or what she has to go through.

i now get my bloods drawn at a different lab, which makes ttc even more time consuming during the work week b/c i have to go to a different lab and then go to the clinic for the scans. its been very stressful. but the nurses at the new lab are fantastic. they are amazing and get my vein on first try. i could not be more thankful to be in the hands of truly skillful nurses.

 

[BronteForever]

Hiker - I'm so excited your embryo is going strong. Such positive news. I'm keeping my fingers crossed so much for you.

It's hilarious to me to here you complain about the portal because all I've been complaining about is the phone calls. I never seem to get them at a good time and you have to drop everything to answer or else you get a message and have to call back and play phone tag. I'd prefer some stuff via a portal because I'm very visual and would rather get it in writing to look at. But I totally could see the frustration of having more questions. Hopefully they are fine with phone follow ups or messaging back.

I just think no matter what it's probably a hard thing to communicate so there's definetly not an easy way to do it. Hope you can get some answers though.

Star - you can do it. Just make yourself. They can deal with it. I've had to learn the hard way to stick up for myself and it's taken along time to be able to do it and sometimes I still don't. But you are paying them a lot of money the least they can do is sit down and answer your questions. I actually ask the nurses most everything as well. Because the only time I saw my doctors were via appointment. So maybe setting an appointment up to get more info with either the nurse or doctor is a good idea like Hiker mentioned. If they are too rushed during your appointments that means they are scheduling too close together so don't feel bad about asking then either because maybe it will get them to understand they need to spread it out a bit more to give proper time to each patient.

Your nurses sound completely insensative. Incredibly frustrating. I'm harder to draw blood from as well because of my veins and I bruise easily. It does hurt when they have to take so many attempts. Especially when you are getting them done so frequently. They should be more sensitive. It's already an incredibly emotional process.

Luckily I've had amazing nurses and ultrasound techs. My doctors I could live without a few of them. But hopefully when my doctor returns my next cycle will be a completely different experience. It does make it harder without good care.

 

[star_e]

Bronte - yea the nurse was super insensitive. i'm that i spoke up. i'll try to continue to speak up and if its not working than it might be a good idea to set up an appointment dedicated specifically for that as hiker and you suggested.

 

[lemon_tree]

Hiker, I'm so excited and optimistic for you.

My RE's office is super hard to reach by phone. I leave messages and they take forever to call back. It's so frustrating.

Hoping this transfer moves forward and goes well so you get your sticky bean and you can be done with this crazy process and all the stress that comes with it.

Star, that nurse and whole experience sounds awful, I'm so sorry. I think Bronte's suggestion of dedicated appointments is a good one. They owe you answers and patience.

Bronte, you totally inspire me with your fierce drive and determination. I'm glad I met you on here.

 

[BronteForever]

Lemon - that's so sweet of you to say. I'm so glad I met you as well and I'm getting super excited to cheer you on with your first IVF cycle soon.

I am pretty determined now but it's taken me quite awhile to get to this point and merely because I know I don't have a lot of time left, especially if I would like more than one biological kid. Hopefully it didn't take me too long to reach this point and we can make it happen. We'll see.

 

[star_e]

Hiker, any news?

afm - went in for an appointment. still no growth. but estrogen level did go up a little bit. she said there are about 20 follicles that look nice (not sure what nice means though), but they are all <10mm. we are upping the dose to 125iu. as of today, i have been stimulated for 10 days (7 of those days i was on 75iu and 3 of those days were 100iu). my next appointment is wednesday and she says she really thinks we will start to see some in the 10-12mm range by then. its hard to tell when retrieval will be, but i guess if she had to guess, she thinks it would be by the end of next week. im worried though...long time to go without any growth. the stimulation has been long and im just hoping i have chance.

 

[lemon_tree]

Hiker - been thinking of you. I hope you had a your transfer today.

Star - 20 is a nice number! I'd love it if they grew a little faster for you, but don't lose hope. Everyone and every cycle is different.

 

[BronteForever]

Star - she's obviously worried about overstimming you because of your PCOS and 20 follicles, so I'm sure that's why they are going slow. I wouldn't worry about it. They are the experts and there's probably a good reason they are doing it slow in your case. Glad she upped it a bit again, and it sounds like she's keeping an eye on everything closely, so hopefully you will be good!

Hiker - I'm thinking about you as well and curious for an update. Keeping my fingers crossed you got to transfer today!

 

[star_e]

Fx for you hiker!!