Tuesday, May 27, 2014

Prepping for IUI #1

Previous fertility post: Fertility Center Consultation

Okay, BIG SIGH. Fertility stuff is already wearing me down. I am going to write A LOT in this entry, so grab some popcorn and settle in...

My thoughts:

* Zay and I have been trying to eat healthier the past few years. I got down to my ideal weight and was super active. Zay lost 90+ lbs. I was hiking mountains and Zay was looking all slim & sexy!!! Ha ha ha. It was awesome. I even spontaneously had 7 periods last year. SEVEN. What the??? I've never had that many in a year, ever. And then - with the stress of adoption coupled with my thyroid and my already existing PCOS.... I gained 40 lbs. Ugh. Zay plateaued and hasn't been able to make anymore progress. I went back to never having cycles. Anxiety has been high. Too many stressors. We are slowly coming back from that. I still don't love cooking, although I'm much better at it today than I was even a year ago. I'm addicted to sugar. Trying to lose weight and stay in shape is such an uphill battle for me that I get so discouraged. But I need to be healthy. Not just for fertility reasons, but of course that would help. Maybe. Even when I was at my healthiest, pregnancy just isn't something that happens in my world.

* After leaving the Fertility Clinic, the plan was to finish up the diagnostic testing... starting with an HSG (hysterosalpingogram) or "dye test." I took Provera to start my cycle. Can you say mood swings??? I didn't know what was wrong with me. Zay didn't either, ha ha. But that stopped as soon as I finished the 10 days of it. Whew. I started my cycle the very next day after stopping the pills, so I called the fertility specialist that Monday and scheduled the dye test. I came in a few days later to do that. Basically they shoot dye through my tubes and see if it goes through. I've heard this can be really painful - bad cramping even up to a couple days afterward, so I braced myself. And... it barely tickled. Ha ha. Didn't hurt at all. I couldn't feel anything really, until the doctor asked how I was doing and then I felt a little tickle on my right side and then it was over. Sooooo... whew! I hope childbirth is like that... just tickles a little. Lol. Anyways, no blockages! That's good!

* I went back to some of my first doctors that I ever saw and got all my medical records. It was interesting to read through the bloodwork that was done that was never explained to me. And it was annoying to have a whole page dedicated to "Pregnancy Test: Negative." I don't need a whole page reminder, thank you.
* My bloodwork came back and my thyroid STILL isn't where it needs to be. It explains why I feel super anxious, again. It's very finicky and finding the right dose is gonna be harder than I thought. I switched from Nature Throid to Synthroid (even though I liked the idea of the natural one), because I was having to chop my pills in half to get the right dose. I don't have to with Synthroid. I felt like a drug addict with my razor and my pill dust everywhere! And I could never cut the pill straight, so I was always taking slightly different doses daily. My body wasn't reacting well to that. So, I've got a new medication in a whole pill form (lol) and a slightly higher dose that I begun taking ASAP. I'll test it again in a couple months to see how it's doing. I really need to get to the point where my thyroid bloodwork comes back consistently in the right range. That is going to take time.

* My PCOS diagnosis was definitely confirmed - both with the ultrasound and my testosterone levels (waaaaaay high). On the ultrasound, she said that polycystic ovaries are easy to spot because there are lots of follicles and they're all lined up like a "string of pearls" in a circle around the edges of the ovaries. The only medicinal treatment for PCOS is Metformin. It's supposed to help lower my testosterone, increase my body's sensitivity to insulin, and possibly even lose weight. I've resisted going back on that and wanted to take a more "natural" approach to treating my PCOS, but I'm realizing now that if I take a slow, natural approach to healing the things that are causing my infertility... I'm never gonna get pregnant. My body is too far past a "gentle encouragement" and my biological clock is ticking loud in my ears and saying, "TREAT AGGRESSIVELY." So, I'm back on Metformin. And I'm gonna take it religiously. It's best to let Metformin get in your system for a few months to see the fertility benefits, so I started taking it ASAP. Again, this is gonna be something that takes time.

* Everything else with my health looks GREAT. Down to my cholesterol and blood sugar! So, yay! But then, the bad news... the semen analysis. Not so good. BIG SIGH. Basically she said that if there was nothing at all wrong with my fertility, we still weren't very likely to ever get pregnant on our own. She said maybe we had a 1% chance of getting pregnant per cycle, even if I had ovulated every month for the past 10 years... which I don't think I ever did. So the fact that I rarely (if ever) ovulate on my own and his count is so low means basically a 0% chance. Hence, I've never gotten pregnant no matter how hard we tried.

* So, my plan to get pregnant all nice and easily (ha) with a handful of IUIs went out the window. She advised us to not waste our time trying insemination at all and move straight to in vitro. Not just the average run of the mill IVF, but IVF with ICSI... which means actually injecting one sperm into each retrieved egg rather than just putting them all in a dish and letting them fertilize the eggs on their own. The success rate is really high, especially with women my age with so many good eggs (lol... fertility talk is funny sometimes). So if we want to get pregnant and we want to get pregnant quickly, that's what she's advising us to do. The majority of women who do it get pregnant on the first cycle.

* I've had some ethical hesitancy about IVF and a few weeks ago I was pretty sure I would never want to do it. Now that I'm facing it, I'm considering it. But I'm struggling with that right now.

* Our health insurance will cover 80% of fertility treatments, after our deductible, up to a $5000 maximum lifetime benefit. Sooooo, basically that whole $5000 will be used up with one IVF cycle and they won't cover anything after that. I feel so lucky that our insurance covers anything fertility-related, but that $5000 could be used up so quickly. Depending on what medications we'll need, an IVF w/ICSI cycle can cost between $12,000-$16,000. Even with our insurance, that first cycle could be $7,000-$11,000. And there's no guarantee that it'll work, even though there's a high probability that it will. There are some fertility clinics that will actually do a money-back guarantee on IVF - if you don't get pregnant and bring a baby home, they'll refund you. That sounds great and all - but the price for that starts around $23,000. And that doesn't include medication or anesthesia, which is thousands in an of itself. Anyone got a nice stack of $30,000 just laying around not doing anything? I'd love to take that off your hands. ;)

* All we can really afford is IUI, which is closer to $750 a cycle. But IUIs may be a big fat waste of time if we don't have a higher sperm count than we do. The fertility specialist referred us to a urologist who could discuss our options for treating the hubby and getting his count up. If it's something treatable, then maybe our odds may improve and our options open up. But he'll need to do some bloodwork too... and have an exam. It took 2 weeks of encouragement on my part to get Zay to agree to me setting up an appointment for him. He does NOT want to do it, lol. Of course. Who would? So I called this urologist. He's supposed to be a leading doctor in male infertility and has high success rates in treating it. This guy charges $425 an appointment... and isn't covered by our insurance. That kind of ticked me off. No thanks. Plus Zay isn't too happy about having to have a man fiddle with his junk, sooooo... I made the dang appointment for a few weeks from now, but I just want to cancel it. This guy claims to be the only urologist who treats male infertility in the state, but my insurance says otherwise. So maybe I'll try calling around and finding someone else. But I'm not sure. I'm frustrated. Mostly because treating him AND me is going to be such a pain and take SO. MUCH. TIME.

* Another thing that ticked me off...(this is a long, stupid story, but I'm frustrated and I need to type it out):
Insurance Company says, "If you're pursuing fertility treatments, you get your very own Fertility Caseworker who will help you with anything you need." Oh, that's cool! Fancy. My own caseworker who'll check up on my fertility treatments and help me access all the benefits of my insurance policy. Nice.

I call Fertility Caseworker up and she says, "You qualify for a lovely little program called Parent Steps that gives you a discount on fertility medications during your treatment." Ooh, yay! Sounds good! I'm all excited to see how much of a discount and on which medications. She says, "Just call Parent Steps and sign up for it and you'll have access to a special pharmacy with discounted prices." Yay!

I called Parent Steps - "Hi! I need to sign up for Parent Steps." Parent Steps guy is kind of flustered and says, "You want to sign up? Ummmmm.... well, we don't handle sign-ups. You need to call our partner United Health Allies and they'll handle the sign up for you." Thanks, guy. Seriously? No one's actually called the program and asked to sign up before? I'm confused, but whatever.

So I called United Health Allies - "Hi! I need to sign up for Parent Steps and I was told I needed to do that through you guys." United Health Allies guy says, "Yep! Just go to our website and create an account and there will be a link to Parent Steps." Oh, okay. Easy peasy.

I go to the website and start creating an account. Error, error, error. What the? I called United Health Allies. "It looks like you don't qualify for United Health Allies, I'm sorry. Maybe call your insurance and double-check that this is actually something in your policy." (Talking to me like I'm an idiot or trying to fake my way into a program I don't actually have access to.) I said, "No I'm sure I am supposed to be able to sign up for Parent Steps. It doesn't really make sense that I'm supposed to have access to something when I have to work through something else that I don't have access to."

I call Insurance Company - "Hi! I'm told that I have access to Parent Steps, a discount program for fertility meds, but I have to sign up through United Health Allies first and they say I don't have access to United Health Allies, why is that?" "Well, let's see here. Let's see what your actual policy says... yep, looks like right here you have access to Parent Steps. And here's a number to Parent Steps, why don't you give them a call directly?" Oh, okay. Stupid me, I just have to call Parent Steps directly. Wait, didn't I do that? I can't remember.

I called the number and it turned out to be my Fertility Caseworker... I'm really confused then.  I explain everything to her and she says, "Oh, you absolutely do have coverage! You should have full access to Parent Steps. Call United Health Allies again and tell them you should have access."

I called United Health Allies and they say, "It's impossible to sign up for Parent Steps directly, you have to go through us, and you are not in our system. I'm sorry, it's impossible. That's something that your husband's employer would have to add to your policy. You need access to United Health Allies in order to sign up for Parent Steps."

I called Best Buy's hr/benefits center - "Hi! I'm trying to sign up for something that I supposedly have access to but I really don't - what the heck do I do?" The lady is like, "I have no idea. That's something that would have to come from really high up. That's not something we can change."

I called the Fertility Caseworker again and said, "I can't sign up for the dang program. Nobody even knows what I'm talking about." She finally called United Health Allies and told them that I should be in their system and if I'm not in their system, then something is wrong. THANK YOU, Fertility Caseworker!

They checked and lo and behold, a whole big group of people who were supposed to be in their system was just left out completely. And I was the first person to bother enough people that they looked into it. I wonder how many of those people were seeking fertility treatments and couldn't get the discounted medications that they were supposed to get. They probably gave up 10 phone calls short. But not me - I refused to give up... I'm gonna keep banging my head against this wall until I break through!

Now I'm supposed to wait a couple days until the system is up-to-date and then try to sign up again on the website. If I get an error message, I just may scream.

I left out the part that half the time I was on hold or leaving messages with people who would call me back a day or two later. UGGGGGGGGGGHHHHHH. On a positive note, I may get a discount on those fertility meds that would make IVF so expensive. So we'll see if that helps.

* I don't want to make any rash decisions and throw a bunch of money down the drain. I also don't want to drag this out for years and years. So I'm sitting here stumped about what we should do. The fertility specialist will do the IUIs if we want her to, but the chances of them working out are really low. Higher than trying on our own, but still low. Should we still give it a shot? Should we use up the $5000 towards IUIs and do them as we can afford them? Should we go straight to the option that will give us the greatest likelihood of success and go into debt for it - IVF?

* Side note: I could've sworn when we started the process to adopt that there were all these babies that needed a home. Where are all these babies??? It was all a lie. And why is it so expensive to adopt???... And why can't I make my own dang babies??? (Not that Kal isn't "my own" - he most definitely is. But you know what I mean. It would be easier if I didn't have to rely on the kindness of others to have children. I wish I could just MAKE it happen. I'm still hanging in there for that miracle adoption situation to come up.)

* I'm not really sad about any of this, just frustrated. I've tried to take the emotion out of the fertility process or it would just be too hard. I'm looking at it as a problem that I just have to figure out the answer to. But I'm stuck. That's frustrating. I don't know what the answer is... there's gotta be an answer, right? Knowing what would work would be helpful, but I don't know what - if anything - will... so I don't know what to potentially waste my time and money on. If God came down and told me straight up that it's impossible for me to ever get pregnant, I would breathe a huge sigh of relief and say, THANK YOU. And move on. But since that's not happening, there's this nagging feeling that it'll work if I can figure out what to do.

* We could take the next few years ironing out both of our fertility issues until we get pregnant naturally or with a simple IUI. And for now, that's exactly what we're doing - I'm going to keep taking my Metformin to reign in some of the symptoms of PCOS, keep testing my thyroid and finding the right dose of Synthroid, keep trying to eat healthy and get back in shape... we may or may not see a urologist to discuss options to up the sperm count. But really, I don't know how long I can take this slow approach that may never amount to anything.

* Part of me wants to go into $30,000 in debt and go guarantee myself a baby. Let's do this dang thing!!! Part of me thinks that's completely irresponsible and I should stick with the slow & steady plan of IUIs.

* I was SO ready for this, but now I'm stumped.

Next fertility post: IUI or IVF?

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