I Heart My Doctor

Have I mentioned how much I love my Ob/Gyn?  She is such an awesome doctor.  After all of my frustrations about scheduling in the last post, I left a message for her to call me about the necessary IUI appointments.  I got a phone call from her nurse on Friday, saying that my doctor was on-call, but would get back to me as soon as she could.  The nurse then asked me some questions and wrote down the answers to relay to my doctor. 

My Ob/Gyn called me the next day, which was her day off and a Saturday.  We talked about hopefully getting everything set up for the IUI in January, and discussed what the RE had suggested.  She took the time to answer my questions and give me her advice over the phone, so that I wouldn’t have to pay OOP for consultation office visits all the time.  She told me that as long as there was room in her schedule and at the clinic, we’d be good to go for the IUI in January!

As of now, I’m still waiting on my Ob/Gyn to call me back with a definitive yes or no about the procedure.  If it’s a yes, she’ll call in my Clomid prescription to the pharmacy, so I can take it at the beginning of my January cycle.  Then, we’ll schedule the days for the ultrasound, sperm wash and IUI, then b/w. 

While I still want to be hopeful that maybe my husband and I can pull it off the old fashioned way in December, I’m so excited to be moving forward next month.  I can’t believe that in just a few weeks we could have a real shot at getting pregnant!        

Scheduling Frustrations

We haven’t even started a Clomid + IUI cycle, and I’m already frustrated about it.  Trying to schedule fertility procedures is a nightmare.  Obviously, everything is so cycle day (CD) specific. 

Since we’re paying out of pocket for everything, and we happen to have enough money in the bank to cover this procedure right now, we figured why wait?  We wanted to get it started sooner rather than later, since we’re aware that it can take multiple tries to be successful.  Plus, we’d rather know as soon as possible if IUIs won’t work for us, so that we can begin saving for IVF + ICSI. 

But, it just so happens that my next cycle will start at the beginning of January.  My doctor’s schedule and the clinic appointments are so hectic during the holidays, that it’s hard to get everything set up for the right days.  For everything to work out for a January IUI, I need to get my b/w redone sometime between December 31 and January 3, and I need the Clomid prescription ready for the beginning of my cycle around January 6.  Then, I need an ultrasound scheduled for somewhere between January 15 and 18.  Finally, I have to get the sperm wash and IUI procedure done around January 19 or 20.

*sigh*

I don’t have a lot of faith that everything is going to work out for January.  The good news is that February is when I’m due for my annual exam.  If I can tack on all my IUI questions, scheduling, and prep info onto that appointment, maybe I can get insurance to cover it.  Still hoping for a 2011 baby!

Time Out

I feel like TTC and our issues getting pregnant have taken over our lives (and my blog).  I know it’s something that I think and worry about most of the time.  My husband, on the other hand, is a typical guy in that if he doesn’t know how to fix it, he’d rather not dwell on it.  But, I know that he is just as frustrated as I am about our situation.

In light of the holidays though, and with Christmas upon us, I think it’s time to take a little time out and be grateful for the blessings we do have.  We may not have a baby of our own just yet, but we do have each other; and we have a lot of other things in our lives for which to be thankful, as well.

It’s also the season for miracles…so I keep hoping that maybe there’ll be one for us. 

Bank Account = Sad Face

Now that we have a plan, I feel much more in control.  I feel as if we’re working toward something again. 

Thanks to the lovely ladies on a message board that I frequent, I was not completely oblivious to the expenses involved in assisted reproductive technology (ART).  But, it still hits you hard when you hear the costs for the first time.

We’re hoping to do our first round of Clomid + IUI in January or February.  While my Ob/Gyn and local hospital are slightly cheaper than an RE clinic might be, here are the anticipated costs for EACH cycle:

Office visit:  $200

Bloodwork:  $100

Ultrasound:  $250

Sperm Wash:  $150

IUI:  $250

These are the costs without medications.  Clomid is inexpensive, but other medications such as injectables can be additional hundreds or even thousands of dollars.  And, we will pay OOP for everything.  Luckily for us, most places will negotiate a cash discount or payment plan.

So right now, we’re looking at $1000 per Clomid + IUI cycle.  I hope (as does my bank account) that the first time’s the charm! 

Decisions, Decisions

After talking with my husband and feeling really down for a few days, I had to snap out of my emotional breakdown.  Normally, I’m a pretty organized person, and I do well with a plan.  So, it was time to accept what was happening and make some decisions.

First, knowing that both of us were contributing to our reproductive problems, my husband decided not to take the suggested Clomid from his urologist.  Unlike the short duration that women take it, men take Clomid for months in order to have an effect on sperm production.  While there has been strong evidence that it increases sperm count (despite not being approved by the FDA for use in men), he just wasn’t prepared to deal with the side effects.  We’ve both agreed that it is still an option, and we may revisit it later.

Second, we’ve decided to start saving up for transferring to a reproductive endocrinologist (RE).  But, there are no REs in our town, and the closest one is actually in another state.  However, we’ve already been in contact with a fertility clinic from a nearby city and had a phone consultation to discuss a course of action.  The consensus from both my Ob/Gyn and the RE was that our best initial option is Clomid for me and intrauterine insemination (IUI).

At this point, we will be doing Clomid + IUI with my Ob/Gyn here in town.  It’s closer, easier, and less expensive that way.  If that combination does not work for us, we would move forward to injectable medication + IUI under the RE’s supervision.  After exhausting those methods, our last option would be in-vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).

Who would have thought that it would be so difficult for us to have what comes so easily to others?     

Recap

Since I put a lot of information in my last few posts, I assume that most people would just skim through anything with that many paragraphs.  I know I would :). 

To sum up, my husband and I are reproductively broken.  We’re dealing with both male and female factor infertility.  Basically, during each cycle, IF my husband had enough sperm, and IF it was of high enough quality to successfully meet an egg, the egg would be defective.  And, IF for some reason the egg was mature and IF his sperm could fertilize it, then my short LP and suspected thin lining would hinder implantation.  Finally, IF by some miracle it did implant, my (then) untreated hypothyroidism would likely cause me to miscarry.  So, there you have it:  the reasons I have never been pregnant.

After finding out all of this while I was still at work, I was dreading going home.  I didn’t want to have to tell my husband that it was even more unlikely for us to have a baby without medical assistance.  How do you tell the one you love that the odds of getting pregnant naturally are practically non-existent?   

A Little More About Me

As I’m typing this, it occurred to me that I probably should have entitled it:  A Little More Than You Ever Wanted To Know About Me!

All joking aside, this blog entry is more difficult for me to write.  Not only is it strange for me to be publishing such personal information, but simply writing out these words makes them all the more real.  It’s not that I’ve necessarily been in denial about our TTC situation; it’s been more of a naïve fog.  Every month I’d get my hopes up that this would be the month I got pregnant, and then every month I’d be disappointed and upset when we weren’t successful. 

So, now that I’ve told you about my husband’s fertility issues and our history behind TTC, I guess it’s my turn.  My TTC issues pick up where my last blog left off:

After close to a year of TTC, incorporating numerous natural elements, and with a known male fertility issue, we knew it was time to get more help.  My husband and I made an appointment with his urologist to discuss what the next steps should be.  From that appointment, we learned two things:  1) that Clomid can be used in men, and was a suggested course of action for my husband’s sperm count; and 2) that when our insurance stated they did not cover anything infertility related, they meant it.  The office visit to my husband’s urologist, even as an established patient, was not covered by insurance because the purpose of the appointment was related to infertility.  So, we are now at the point where we are paying for literally everything out of pocket (OOP). 

Knowing this, we still needed to come up with a plan and to find out how much all the office visits, testing, blood work, monitoring, procedures, and specialists would cost.  So, I made an appointment with my Ob/Gyn to discuss these things, and figure out what we should do next.  We discussed our options and she gave her medical opinion, and then ordered blood work (b/w) for me on cycle day (CD) 21 or 7 days past ovulation (DPO).  I knew we were already dealing with MFI, and the b/w was more of a precaution before moving forward with additional treatment for my husband.

Except…it wasn’t just a precaution.  My doctor called me back a few days later with the results, while I was still at work.  They were definitely not what I was expecting.  Even before she said anything, I could tell by her tone of voice that she wouldn’t be telling me that everything was normal.  The b/w showed that I had more than likely ovulated, but my progesterone was too low.  My doctor said that this is indicative of “weak ovulation,” meaning that I’m releasing immature eggs that are not ready to be fertilized.  She was also concerned about my short luteal phase (LP), which was usually only 10 days long.  On top of all that, she said that my thyroid stimulating hormone (TSH) had been checked, and had come back too high.  A further diagnosis confirmed that I have Hashimoto’s (or auto-immune) hypothyroidism. 

I closed the door to my office...and then I cried.