A Plan (of Sorts)

This post is heavy in acronyms, mostly because that’s how I actually speak and think about this topic. I’ve given the full phrases, but few explanations. (That’s what Google is for.)

Two days ago we visited with RE-Man* about IVF (in vitro fertilization). Our objective was to learn about the process and get a general idea of what it will cost. Fortunately, I had done much research prior to the appointment, so there weren’t any surprises. Everyone who does IVF here gets the same basic protocol, starting with birth control to time everyone’s cycle to the one week each month that the clinic does the procedure. We are lucky enough to have great insurance that will cover 80% of the cost of the procedure, start to finish. The bad news is that our lifetime maximum infertility coverage isn’t very high. We’ve already used nearly 1/4 of it, just on medicated cycles with timed intercourse. That means we can reasonably afford one full IVF cycle (stimulation, egg retrieval, embryo transfer), plus one or two frozen transfers. The other bad news is that the process will require 3-4 out of town trips (200 miles one way) within a short period of time for orientation, monitoring, retrieval, and transfer. If it leads to a healthy take home baby, no big deal.

I also asked about IUI (intrauterine insemination). Most of what I’ve read on the subject indicates that IUI isn’t any more successful than timed intercourse for women with endometriosis, because the problem is often that the egg is weakened by exposure to a toxic environment as it passes from the ovary to the fallopian tube. I asked RE-Man whether or not he thought it would be worth trying IUI before IVF. His response was “Of course!” He explained that given my husband’s stellar semen analysis, there’s no reason to think that an IUI wouldn’t be successful. Even one failed IUI would provide helpful information when proceeding with IVF, because if I don’t get pregnant with IUI, that most likely means we have a fertilization problem. In that case, they would go straight to ICSI (intra-cytoplasmic sperm injection, or injecting the sperm directly into the egg, rather than just putting sperm and egg in the same petri dish). ICSI comes with a hefty price tag, which is why they don’t do it unless they need to.

Our basic plan is to try IUI in May, then move on to IVF. (March doesn’t work for IUI, because the potential date coincides with our vacation, and April is a bad month for M to request time off.) Until then, we are doing it the old-fashioned way, with a little boost from Femara.

I feel good about our plan. I still dread IVF and hope we never need it, but now that I know M is on board and we can afford it, I’m happy that we have it as an option. I think my dread stems from the fact that IVF is the final frontier for us, and that by the end of the year, we could very well be coping with never being parents. I know, I know: I’m letting my brain run away with worst case scenarios. I know it’s not healthy and it does no good. Believe me, I’m working on turning those thoughts around. It’s hard work.

*There are three REs (reproductive endocrinologists) at my clinic: two women, one man. I never know which one I will see until I get my appointment notice. There are pros and cons to having rotating REs.

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7 thoughts on “A Plan (of Sorts)

  1. I find that sometimes the mentally preparing for these big questions is more emotionally challenging than the actual meetings to discuss them. I’m glad you got there and have a solid plan that works for you. It’s always a relief.

  2. It’s definitely hard work to avoid thinking about worst case scenarios & trying not to excessively worry. I just recently found out I’m dealing with endometriosis too– good to know a doctor’s opinion about IUI before IVF with that. It sounds like you have a good plan for moving forward. Best of luck to you!!!

  3. Your situation sounds exactly like mine. We have just done our second IUI and to be honest, I worry about it not being successful after reading more about it. We did some femara cycles too and now we did femara with IUI and Bravelle. It’s no fun, but at least you feel like you can rule out that it’s not a timing thing. I too am dreading the thought of IVF and its price tag. I’m sure years from now we will both look back and see it as water under the bridge.

  4. I’m actually a big fan of fleshing out worst case scenarios. I like contingency plans for my contingency plans. Yes, this may lead to anxiety and stress and doom and gloom, but hey. You’re prepared.

    Here’s hoping you won’t need all those back up plans. My bits are crossed for you!

  5. Having a plan is half the battle – I swear by it! Once we had the RE planning our work and working our plan, I felt myself relax a bit! So glad to hear you have some IF coverage – and you may be surprised how far it goes because you should get negotiated rates (much lower than the rates on paper) which saves your funds. We got more than we thought we would due to this!

  6. So glad you have a plan though I agree, getting there is the most difficult part – the looming big questions and worst-case-scenarios are a lot on top of an already stressful ordeal. We’re all aboard the IUI train for our first go round (after 3 cycles of clomid + timed intercourse). I’ll let you know how this maiden voyage goes! (Also, I just can’t help it, every time I see “RE Man”, I think of that cult hit Repoman with Emilio Estevez…ha.) Hang in there.

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