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.