The two week wait.

I am struggling to find the right words to capture both what I am feeling tonight, and what transpired over the last few days.

When I last wrote, my wife had just wrapped up her egg retrieval and I was hesitant to document how many eggs we got. I follow so many blogs of other couples who are attempting co-IVF like we are (some of whom seem to be flying over each hurdle effortlessly, and others who appear to be struggling with this process). I also follow a lot of heterosexual women who are on this IVF journey because they truly have no other choice – many of whom have gone through this process several times over with empty arms, heavy hearts, and hopes that the next attempt will be the one that works.

So I am hesitant to dig into some of these details for two reasons:

  • I do not want my joy to EVER cause even a small twinge of pain for my fellow IVF-ers (or women on this journey via another assisted reproductive channel). I truly want us ALL to have healthy babies.
  • Our journey could still end similarly and I could be getting excited only to have my heart broken later in this process.

I also know that the more I read of others’ stories, the more I feel like I have a community. I read some of your blogs and feel like we are old friends – I wait eagerly for the next chapter and my wife and I smile at so many of our similarities with you all. I feel like I owe it to the part of myself who feels connected to the other blogs, forums (however old they may be) and articles that have gotten us through these past few months, to share it all. I also think we owe it to the friends and family who will (hopefully) read all of this later to better understand this journey.

So I will continue to share: good and bad. And I will continue to look to you all for support in those rough moments, and to share joy in the great ones.

Back to the matter at hand….retrieval day.

So doctor came out to gleefully inform me that he retrieved 40 eggs from my wife. Yes, 40. All of our research on PCOS allowed us to predict this with relative accuracy (in fact, my wife actually guessed that it would be 40 the night before her procedure). We approached the news with caution, as our research also advised us that when it comes to PCOS and high retrieval counts, very often: many of the eggs are not mature or able to become viable embryos.

So on Thursday, we received a call from the embryologist that of the 40, 29 were mature and able to be ICSI-ed (fertilized) and of the 29, 24 appeared to be continuing to develop normally.

The weekend passed by relatively quickly and effortlessly as my sister, brother-in-law, and two nieces were in town (they are 4 months and 20 months) and we spent a lot of time together. That helped to keep my stress at bay as well. My wife and I have been facetiming with them pretty often so that we can see our nieces and vice versa since they all live about 2 hours away, and this was the first time that my niece really clung to me for a large portion of the weekend. She gave hugs freely, and even put her arms up to be picked up and then snuggled her head into my shoulder for a few minutes. It may have been because my mom (“mom-mom” who is literally her FAVORITE person in this world) wasn’t home at the time, but I’ll take hugs and snuggles any day from any of my sweet nieces.

So by the time Monday arrived, it kind of felt like any other day as the weekend had been so busy. I set my alarm for 4:50am so I could take a quick shower and prepare myself for the appointment at 8 (which was an hour away and we needed to be 45 minutes early for), but I got up at 4 to go to the bathroom (for some reason, the progesterone shots make me pee about 3x/night) and couldn’t fall back asleep.

I was advised to drink 60 oz of water before the procedure, so I started drinking about 20 minutes into our car ride, and I felt pretty comfortable until I sat down in the chair in the waiting room: then it started to hit me, and I began to get irritable waiting to go back.

We were taken into a changing room, and I had to put on a gown, hair cap, and slipper socks, and my wife had to put a yellow apron over her clothes, booties over her shoes, and a hair cap over her hair as well.

We were then brought into a staging area, and the nurse asked me to sit in a reclined arm chair and then draped a warm hospital blanket over me. She went over all of my discharge instructions (very light activity for the first day and absolutely no work, followed by a reduced activity level for the rest of the week: light walking, no heavy lifting, and food/drink as if I am pregnant (i.e. no alcohol, tylenol for pain, etc.)

After she wrapped up, we waited with bated breath (and a very full bladder at this point) for the embryologist. By the time she came in, I was irritable and ready to get on with the procedure, and she sat down and showed us a picture of our embryo on paper. She explained that it was a grade ABA (more on the grading here: http://www.advancedfertility.com/blastocystimages.htm)

She also showed us how the cells were beginning to rupture through the cell wall, indicating that the embryo was “hatching”. We didn’t get a copy of the photo, unfortunately, and I meant to ask her to email us a copy and forgot. I am going to try to call tomorrow for a photo.

Anyway, we then asked how many were going to be frozen, and were taken aback when she said, “we have ONE ready for the freezer.” My eyes immediately started to well up, and I was struggling to comprehend how we’d gone from 24 all the way down to 2, but when we asked about any others she said we “may have two more for the freezer tomorrow. It depends on how they do.”

At this point, my bladder was about to look much like the hatching embryo and I was sad and frustrated. Even my stoic wife – who literally never gets emotional – turned away and started to cry after the embryologist left the room. She felt like it was her fault, and we were both so sad because this procedure cost so much, and we know we can’t afford it again, so we so desperately wanted all of this to work and to have backup embryos in case the first try fails.

So the nurse popped her head back in, and asked if we needed anything. At that point, I was standing with the blanket wrapped around me as I was in too much pain to sit, and she escorted me to the bathroom and handed me a cup and encouraged me to fill it twice and dump it so that I could be a little more relaxed during the procedure. I was too afraid that my lack of control would hinder the doctor’s ability to get a good read on things, so I filled 3/4 of one cup and waddled back to the room just in time to chat with the doctor.

She was not our normal doctor either, but I really liked her. She was calm, direct, and just a tiny bit funny. We told her how sad we were about the embryologist’s news, and she told us not to worry – she said that the drop off we experienced was normal for such a large retrieval, and that the quality and ability of this embryo to succeed and turn into a healthy baby was not related to the fact that so many died off. She got us excited and ushered us into the surgery suite to start the procedure.

I walked into a room surrounded by windows, and laid down on a table with the largest, most cushioned strirrups I’ve put my feet in, to-date. My wife sat by my head and we held hands as they inserted the speculum and pressed down on my bladder with an external ultrasound wand. I asked the doctor if she’d ever been peed on during the procedure to which she responded, “What answer do you want?” “No..” I hesitantly laughed. “No, then,” she told me. Then, the embryologist told us to glance back over our shoulder to see our magnified embryo on the screen. I started to tear up a little at that point.

Then, the doctor washed my cervix (don’t ask me what that entailed – all I know is that I had the speculum and about five pounds of pressure on my slightly emptied but still-painful bladder) and a moment later, the embryologist came in with the embryo in a catheter, which we were able to watch on the ultrasound as it was placed in my uterus (a tiny “flash” on the ultrasound monitor). Everyone was so wonderful and excitedly pointed out what everything was on the screen. I think images on that screen are FINALLY starting to become discernible to me (after what? 10 ultrasounds, now?).

After that, the doctor pulled everything out, and said, “I can’t lie to you. Now that we’re done, I will tell you: I’ve been peed on.” I tried not to laugh, and silently gave thanks that I wasn’t on that list. They then gave us five minutes to lay there together before they came back to escort us out. More tears, and a general feeling of disbelief. I have literally wanted to experience pregnancy and have a child for longer than I can remember, and here I was – possibly at the beginning of that process. Here WE were, possibly on the first day of becoming “moms” (even if it is to a tiny embryo), and I just couldn’t believe it. I still can’t. (and that feeling is scaring me a little as I just cannot fathom any of this being real. It just feels like something I have wanted and hoped for, for so long and if I allow myself to give in to the excitement, then maybe something will go wrong. I know it’s horrible, but its honestly how I feel).

So after we walked back, they ushered me to a bathroom where I had a surprisingly difficult time trying to pee. My back started burning and my legs were shaking, and I was able to go a tiny bit before a wave of nausea washed over me (which – LITERALLY – never, ever happens) and I had to stand by the toilet for a few moments swallowing that saliva that you know your mouth is only producing as your stomach is ready to turn itself inside out. Fortunately,  I didn’t vomit, and after a few minutes I recovered enough to finish going to the bathroom and get dressed. I fell asleep in the car, and for a while on the couch when we got home, and woke up to a yellowed sky due to the solar eclipse, which added to the overall surrealness of the day. We wrapped the day up with some slow cooker pulled pork that I set up the night before the procedure so that we wouldn’t have to worry about cooking and could have a semi-healthy meal, and then fell asleep to a netflix movie after my progesterone shot.

We did get a call this morning from the embryologist, though, and she left me a message letting me know that we had FIVE embryos that were frozen. We were ELATED as that was SO much better than we’d expected the day prior, and she called me later in the day to say that a sixth survived as well. So final results are as follows:

Wife has PCOS. Went to retrieval on 8/16 at which point 40 eggs were retrieved. She did NOT develop OHSS.

Of the 40, 29 were mature and 24 of the 29 fertilized normally. We dropped down to 16 for our Day 3 count, and had 1 implanted on 8/21. Of the remaining embryos to be frozen:

  • 1 is grade 5AA
  • 1 is grade 5AB
  • 3 are grade 5BB
  • 1 is grade 6BB

 

So now….we wait. Did any of you take a pregnancy test during the 2WW? If so, are you happy that you did or do you regret it? Any advice for not going crazy?

In the meantime, we are wishing, hoping, praying and trying to put good energy and love back into the world (God knows, it needs it right now). Hope you’re all on the verge of great news. ❤

BFP

Life is funny, but unfair.

Ya’ll: life is so unfair sometimes.

But before I get to that, I want to backtrack and cover the last 24 hours which were equal parts exciting and comical, which ultimately took us a step closer in our journey to becoming moms.

Yesterday, I was scheduled for my mock transfer and hysteroscopy (which replaced a test of a similar name that I was supposed to have at a local hospital, but there were no available time slots in the near future so my doctor ordered this one instead). These were intended to chart the path that the doctor will take with the catheter on the day of the actual embryo transfer, as well as scope my uterus for potential imperfections that would prevent the embryo from being able to adhere and find a cozy home.

The only time they had available was at 9:30, which is 1.5 hours into my work day, and I manage a team of seven people so continuing to sneak out for doctor’s appointments is starting to get challenging (but obviously that didn’t stop me from doing it anyway). I also work with two family members (long story – they are in other departments), so I’m REALLY trying to be sneaky, as we’ve elected to hold off on telling our friends and family until we have a healthy pregnancy to announce. So, I came into work, got my team set up for the day, and ran around putting out figurative fires and answering questions, before I realized that it was almost 9am and I was supposed to have consumed several glasses of water to fill my bladder for the mock transfer, so I promptly started throwing water back, and rounded up my belongings before *quietly* running out the side door of our building. I made it to the edge of the parking lot in my car when I attempted to call my wife – only to realize I’d forgotten my phone in the office (which I wanted to keep close by in case anyone needed me while I was gone). So I snuck back in and almost walked right into one of the people on my team who had a question about something so entirely unrelated to anything that is going on in the remote future, so I walked and talked with her – completely flustered – until I got to the door, at which point I began galloping to my car and racing out of the parking lot.

When I arrived at the facility, I spied a “breaking news” notification on my phone about the dingo-in-chief’s latest tweetstorm about transgender people not being allowed to serve in the military, at which point I could visualize the blood racing to my face and smoke billowing out of my ears like an old Looney Tune’s episode.

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(Small rant: WTF?!? Dude was a draft dodger and claims to want to protect our country, and trans people are SO STRONG: physically, emotionally, mentally, and so on. and he wants to ban THEM?!? I can’t. I literally can’t. His dumb smug face makes me levels of angry that I never knew I could experience.)

So…that’s how I started my appointment.

So I race inside, and my amazing patient wife was waiting for me – she had checked us in and taken care of our paperwork (at least…I assume there was paperwork. I suppose I never asked, but either way – she was there. Present. Standing in for us as I was running about 5 minutes behind due to the phone incident). The woman at the counter says, “Mrs. _____, I just wanted to let you know that the full payment is due today.” I was expecting that – my wife and I had discussed over the weekend, and agreed to put the bill on my AMEX card so we could at least collect the points and buy something for the house: tiny blessings from a MAJOR bill. Of course, my purse is in a state of complete disarray from all of the traveling I’ve done recently, and I had to dig through piles of receipts to retrieve the card, but I found it and proudly slapped it on the counter, eager to get going with this process.

“Um…we don’t take American Express.” This lady literally could have said, “your dog is dying” because I immediately burst into tears and even though I knew it was my fault (they probably told me and I forgot with all of the craziness with the insurance company) so I kept blubbering, “I wish I knew. I could have planned better. You never told me!” (which I apologized for before I left.) Fortunately, one of the AMAZING finance ladies happened to be there (not grouchy Denise) and she jumped in after I agreed to put half on my other credit card and pay the other half with a check, and suggested that I pay half on my other credit card and then pay off the balance over the weekend, and pay the rest when I come back in for an appointment I have next week. Ugh. That lovely angel woman. I need to send her a fruit basket or something.

So we’re going to do just that (and pray that nothing happens to screw it up between now and next week).

So after the credit card debacle of 2017, I parked myself by the water cooler and drank two more cups of water – which did little in the required time to put any additional pressure on my bladder, before they called us back.

I’m not going to lie – it was a little weird having my wife there, as I am used to all of my lady-doctor appointments being solo, so she held all of my belongings as I hiked up the dress I was wearing, removed my undies, and got my feet ready in the stirrups for the doctor to join us.

He came in with a nurse and excitedly welcomed us, before dimming the lights and asking if I wanted to move my dress any higher so that it didn’t get ultrasound jelly on it. I was surprised at the external ultrasound (it was my first) and he began to explain each procedure as I profusely apologized for not drinking enough (which he seconded, and suggested I start earlier, the day of our actual procedure). He showed my wife and I some pictures of the embryo transfer catheter moving around, but I was super uncomfortable at this point while the speculum was inside and he was doing – what felt like – rooting around for buried treasure.

My wife was standing by my head and stroked my arm to which I growled “DON’T TOUCH ME” and the doctor immediately backed away and told me that he had to in order to finish the procedure. We quickly clarified and my wife finds this story hilarious and I know it will be one of the first she shares with our friends and family once we tell them. I don’t know why I said that, but there was just so much pressure down there, and he was spending so much time trying to help her see what was on the screen which I appreciate and adore, but I just wanted to speed things along, as I was starting to feel the need to go to the bathroom and absolutely hate a crowd around my lady parts – especially when I’m in pain (I know, welcome to labor, etc. etc. I’m sure I’ll look back one day and say, “I had it so easy back then.”) If we’re fortunate enough for all of this to work, of course.

So doctor now wraps up the speculum portion and leaves in the catheter so he can inject a saline solution to look at the walls of my uterus and make sure that everything looks smooth and clear for baby. I asked if I would experience any pain similar to the HSG test, to which he responded, “no, nothing like that. Maybe just a little cramping.”

This is why I need a woman doctor.

The pain was: EXACTLY. THE. SAME.

scared gif

(and if you have followed this blog for a few months, you know how much I adored the HSG test). So at this point, I’m white knuckle gripping the exam table as he almost gleefully shoots several rounds of the saline solution into my uterus and he, my wife, and the nurse watch the reactions on the screen. (Ok, maybe that’s a slight exaggeration, but that’s what it felt like when I was at that level of pain).

Finally, he wrapped up and I sat up feeling a mixture of nausea, intense cramping, and a serious need to pee and my teeth started chattering uncontrollably as I raced for the bathroom.

After a few minutes, the cramping subsided, and by the time we finished filling out a bunch of consent forms and leaving the office, I felt like a relatively normal person.

The good news is, he said that everything looked beautiful and he was excited to see us in a few weeks for my wife’s egg retrieval.

The bad news is: I have an extraordinarily low pain tolerance and a tendency to be dramatic (hey – at least I know myself), so I’m unsure how I’m going to survive nine months of pregnancy, not to mention labor. Pray for us my wife.

Next steps are blood work and additional monitoring, and the introduction of two new pills for me next week (estrace and asprin?) Lupron is still going well. I’ve graduated to shots in my belly, delivered by my wife. Her shots will commence in two weeks, I think.

So I mentioned at the beginning of this entry that life is unfair. In addition to the complete and total political nonsense that is happening in this country and the garbage that my wife and I had to go through with the insurance company, and every other unfair, horrible thing that is happening on this planet, a dear friend of ours who is going through IVF with her husband for different reasons than ours, got word that her stims aren’t working and she doesn’t appear to have healthy developing follicles and they may have to pull the plug on the treatment that they’ve already invested a lot of time and money in (they did a lot of pre-genetic testing because of family conditions that they were concerned about). Even though we are fairly certain that they had a different insurance company experience than we did, at the end of the day – it didn’t matter. Life still appears to be yanking away their ability to be parents, and I know they’d be good ones. It breaks my heart and TERRIFIES me because we still don’t know if we’ll be in a similar boat. All signs point to “no” but we’re not in the clear, yet. But in the meantime, friends of ours have breaking hearts and I wish we could do something. I told my wife previously that I felt pretty confident that I would consider donating my eggs (provided they’ll still take them since I’m 30+ as it is) if we walk away from this process with multiple viable embryos that we could use in the future, and we’ve since discussed donating any additional viable embryos we have that we do not implant (provided we are that blessed). I have read so much from people who feel a connection to the embryos – they can visualize the babies’ faces after holding their siblings, and can’t imagine giving any away or destroying them, but as of right now, we both feel really strongly that we would donate potential “extra” embryos (again, if we happen to be so fortunate). Maybe that will change. But I don’t think so. Maybe it won’t even be a decision we have to make. Who knows. But it’s funny – we had to sign forms indicating what we would do with any leftover embryos in the event of our unexpected deaths (God forbid), and before we knew what was happening with our friends – we both looked at each other, and suggested that we put their names down for who we would want to have “custody” of them, because we knew they were in our IVF boat and would make great parents of them, if needed (or make a good decision, if not).

There are so many shitty, shitty parents in this world. I wish everyone who truly ached for children, and wanted to give them loving homes and supportive lives could have them, and those who didn’t want them or wouldn’t take care of them – couldn’t. But that’s not our world. That’s not life.

In the meantime, my wife and I have decided that before we bring children into this world, that we want to bring good into it, so we’ve made a list of volunteer projects that we’d like to do together. We’re going to cook breakfast at a home where families stay when their children are in the hospital (my wife majored in culinary arts, and loves opportunities to “treat” people to her cooking skills, so it’s a double bonus). This world can be so bad, and mean, and ugly – but we can spread as much good and love as we can, and bring children into THAT space. So that’s what we hope to do. And that’s what we’ll work to create, regardless.

Love and positive wishes to you all.

Birthday shots.

In my 20s, birthday shots had a slightly different meaning, but this year – on my wife’s birthday, I took the first of – at least a few weeks of – lupron shots. So far, so good. I am giving them in my thigh (the other option is in my stomach area, which really freaks me out for some reason). No bruising, no side effects – yet. I’m fairly certain that our nurse indicated that this shot is supposed to put me into temporary menopause so that I am not producing eggs and my body is ready for the transfer eventually, but don’t quote me on that. The meeting was four hours long, and I did my best to write down and follow as much as I could – but anything I forget I just call the office about as it comes up.

Our nurse made us a beautiful calendar which maps out each medication that I have to take each day (bless her heart), so the chances are slim that I will miss anything and my wife is AMAZING with keeping track of the little details. When I traveled recently, she sent me emoji reminders of my pill times via text as she knew I’d be attending work dinners, and she wanted to keep me on track without taking me away from work. I’m REALLY lucky. I am not sure how I’d make it through this process with any other person by my side.

We heard back from the insurance company  and they gave us the final denial of coverage,  with the reason for denial listed as “no diagnosis of infertility”. The woman from the clinic called and said that they told HER it was because of lack of exposure to sperm, but since the reason they us was the lack of infertility diagnosis, we plan to follow up with a letter our doctor provided us with details on my wife’s PCOS diagnosis. Fingers crossed. We’re hopeful, but certainly not holding our breaths.

We are taking a loan for a bulk of the procedure, and using part of our savings for the rest. We didn’t want to deplete our savings entirely, because we are also hoping to relocate within the next year or two and would like to have cash available to do so, if needed. We currently live in a small condo, with just enough room to expand with a baby, but we have little storage space, and close neighbors so I’ll probably feel guilty on a regular basis thinking that I’m keeping them up with the late night symphony of baby wails. We aren’t searching seriously at this point, but keeping an eye on the market as we want to be ready to jump if something that really fits our needs pops up.

When Denise (finance lady) called to advise us of the denial of coverage, she first left me a monotone voicemail, and when I called back for a bit of clarity (notably upset) she informed me that “they did everything they were supposed to do” and when I told her I felt as though they didn’t entirely advocate for us and that we felt as though we may need to evaluate another clinic before proceeding forward, she suggested that we need to do what we need to do. Not so much as an “I’m sorry. This sucks.” I’m not expecting us to be best friends, or even cordial acquaintances, but when you are delivering heartbreaking news, you could at least muster a compassionate tone of voice, and a “this stinks.” Maybe I’m expecting too much. Maybe they DID do everything exactly right, but folks: we have gotten SO many different stories from people with the same insurance company but different situations, people with the same situation and a different employer, people who work in medical billing, etc. that we really didn’t know what was true and what wasn’t and couldn’t have forgiven ourselves if we didn’t try. And she was argumentative from appointment #1 so I don’t feel too bad about pushing back on her.  We pushed so hard and fought so vehemently, because:

  1.  Regardless of current law, what the insurance company is doing is wrong (but legally they can do it anyway).
  2. If there was some sliver of a chance that our fighting could help us hold onto a few thousand dollars that we could use ON our new family and not to build it, we wanted to at least try.

But, the cards fell, the answer was no, and while we are appealing it, we feel confident that the answer likely won’t change. So rather than continue to be consumed by this, we want to press forward – biological clocks are ticking, and we are simply hoping and praying right now that the one egg retrieval and two transfers that we will get with the package we are purchasing will result in a healthy baby. If not, we’ll head back to the drawing board.

I did mention to the doctor that I was disappointed by our interactions with Denise (since she plays such a crucial role in the process, and everyone else has been so kind and warm) and he thanked me for the feedback and vowed to pass it on. Although the practice isn’t tiny, I am fairly confident that they all talk (when I call to ask a nurse question, I hear from finance a few minutes later and vice versa), so I probably now have the reputation of the mean lesbian lady, but I’m trying not to care.

Right now, we’re targeting a retrieval sometime around the 3rd week of August, with transfer shortly thereafter.

This coming week will bring my mock transfer and hysterosonogram, and the following week my wife and I each have appointments (blood work, I think). My wife also got news that she has elevated levels of a thryoid hormone so she’s been put on syntheroid to regulate that. Hopefully we don’t have any unexpected guests in the near future. Our counter currently looks like a small pharmacy, and the number of open bottles seems to be growing by the day.

Positive vibes to you all for good news – wherever you are in the process.

 

 

The countdown is on!!

Way back in January, my wife and I discussed starting the journey to a baby around August/September. Back then, I felt such an intense ache for everything to speed up – for time to pass more quickly, even though I knew our year was jam packed with life events and activities that would keep us more than occupied throughout that span of time.

Little did I know that my job would throw us a wrench and add in a LOT of unexpected traveling, so this time seems to have passed even MORE quickly than we could have anticipated, but I’m still no less eager to get started.

Throughout this time, we’ve gone back and forth with the insurance company, pored over donor websites, and thought long and hard about how we would proceed: IVF? IUI? At-home attempts? After talking to some new friends and old, reading numerous blogs, watching numerous vlogs(?), and doing extensive research, we decided that no matter the cost: IVF was our chosen path forward. That being said, we are submitting one last formal request for insurance company coverage (especially after learning that my wife has polycystic ovaries which could potentially make this process slightly more challenging) and we are awaiting the results of that request – we will hopefully know with certainty on Tuesday.

Regardless, we cannot be too upset as our clinic worked with us to put together a multi-cycle package that will give us two attempts to get pregnant (assuming, fingers crossed, prayers, good wishes, and positive thoughts) that we walk away from her egg retrieval with more than one viable embryo for less than we had initially thought we’d pay for one (via co IVF – if you’ve read the other posts you know all of that drama). We also picked up all of the meds for our first round yesterday and after copays, we walked away spending a whopping total of $250 and change (which seems like a lot, but for IVF meds is AMAZING!!). We are counting our blessings and considering ourselves immensely fortunate.

IVF MEDS

(This doesn’t include a ton of stuff that we elected to not remove from the fridge for the photo)

Yesterday, we also had our nurse consult during which we learned how to administer the many shots we will soon have to give each other (well, mostly give ourselves but there is a big, bad intramuscular injection that my wife has to give me in the butt….I’m sure there is a good joke in there somewhere that I will appreciate when I look back on this one day, but I’m honestly just a little terrified of the needle at this point!), and discussed the timing. Initially, the nurse asked me to call on the first day of my next period to schedule my baseline blood tests and ultrasounds, but after learning that I was on day 4 of my current cycle, she snagged the ultrasound tech, and got everything done while I was there, and sent me on my way with instructions to begin birth control immediately, which is how my cycle will ultimately be synced to my wife’s. We’re now waiting on her period to start, as well as for a call back from the clinic to get a sonohysterogram and mock transfer scheduled so they can make certain that there are no issues with my uterus, and so they know exactly how they will be implanting the embryo when we get to that date (which should be sometime toward the end of next month if all continues to move according to the plan we assembled with her, yesterday).

Our nurse was kind of amazing – we were with her for almost four hours, discussing every detail of the process and getting my testing and ultrasound done (which was an unexpected surprise!) She encouraged us to call with any question or unknown symptom we may encounter throughout this process, and made us feel so comfortable. Her kindness and warmth was a stark contrast to the head finance honcho (we’ll call her Denise for the purposes of this blog) who we had the displeasure of meeting with again yesterday. We thought we made progress with her the last time we saw her a few weeks back, and she was just as ornery as ever and seemingly forgot everything we’d discussed during the last visit. She is the sole reason why I feel very confident that we will not be seeing any coverage by the insurance company, but either way – we’ll be happy to be finished working with her (hopefully very soon!)

The ultrasound tech confirmed that everything looked good, and found a total of 21 egg follicles (to the 18 the doctor found the last time) and although that isn’t super pertinent to our current situation, it just reassures us that we should have a smooth journey to baby# 2 should we elect to conceive via IUI. We ordered what we were advised by the clinic would be more than enough donor sperm (7 vials) to pursue this round of IVF, plus several rounds of IUI in the future.

So, folks: we are ready. We’ve never been praying so hard for an expeditious period (as well as good news from the clinic on a date to do the mock transfer in the very near future!) and we’ll be getting this party officially started.

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We got the goods.

So today was kind of a momentous day.

After Friday’s appointment with the doctor, we spent the evening checking out potential donors (I mean, let’s be honest: we’ve been looking at donors for the past few months, and finally got serious on Friday) and narrowed our list down to a short few. We then purchased a subscription to view more information on the cryobank’s website, and – through process of elimination and our most most basic gut instincts – found the donor we pretty much knew was “our guy”:

  • His ancestry is a combination of parts of each of ours
  • His personality is similar to both of us, and he seems like someone we would generally respect and appreciate as a human being (which is important, should our future children ever want to get in touch with him)
  • He is open to being contacted one day (which we felt was really important)
  • He’s intelligent

We also found out after reaching out to our clinic today that my tests from last week came back and I am CMV negative (which I NEVER thought I would be as I’ve done a lot of reading on it and was exposed to a lot of the things which are thought to be linked to CMV as a child) and fortunately – so he is, which made our lives a lot easier as it is suggested that CMV negative carriers utilize CMV negative donors. We also found out that my AMH level is 4.4, which the nurse said is above average and makes sense considering the follicle count that the doctor advised us of last week. So I have a green light should we elect to conceive baby#2 via IUI. So I placed an incredibly expensive order for sperm that will be stored until we are ready to proceed (we didn’t want to risk losing out on this person since we felt there were so few individuals who met all of our criteria: and this guy did, and THEN some!)

I really wanted to tell someone, but we are staying tight lipped about this process until after we successfully conceive, so for now…our dog knows all of the exciting details (and we hope she won’t tell).

We then got the disappointing news that our clinic appointment – which was supposed to be tomorrow – got pushed out by two weeks (to be fair, they were ready to meet with us next week, but I’ll be traveling again). So we now have to wait for any additional info about the costs of the actual procedure (including how much all of the medication will cost as we still don’t know which medication we’ll be taking and are supposed to better understand all of that during our appointment) and I’ll have to come up with ANOTHER excuse to duck out of work for two hours, as the one I had given my boss for tomorrow won’t work again in two weeks. Ugh.

Part of me thinks I should tell my boss now, but I am also another few days away from learning more about the fate of my current role, so I don’t want to say or do anything that will affect my ability to keep this job beyond this year.

So many things to think about, but at the moment: we rest, and celebrate overcoming another big hurdle today, and patiently wait another two weeks for the next step in this process.

Wishing you all good luck wherever you are in the process!

Silver linings.

My apologies in advance – this isn’t my best or most descriptive writing, but things are now transpiring so fast and furiously that I am just trying to get as much of the detail transcribed as possible before I forget.

So the last few weeks have been rough. Work has been stressful, we have gotten bad news after bad news about how much this IVF treatment is going to cost, and my wife and I have just felt like a grey cloud has always been lingering close by (which is kind of partially true since we’ve also had a lot of rain).

Earlier this week, I had a conversation with the manager of the IVF Finance team for our fertility clinic (I don’t know if that’s her exact title, but you can gather what her role is…) and she seemed kind of argumentative, and my wife and I were speculating that perhaps she wasn’t the biggest fan of same-sex couples. Nothing she said or did was blatantly homophobic – it was just a feeling we got. So, we went into yesterday’s meeting with the doctor (and subsequent meeting with her)…guns blazing, if you will.

Before we get to her: the appointment with the doctor was…interesting. He provided us the results of my wife’s bloodwork and internal ultrasound, and dropped a slight bomb on us (I say “slight” as we’re still doing research on exactly what this means for us). He advised that she has polycystic ovaries (we had previously known that she had benign cysts, but the term “PCOS” never came up before). He explained that she showed approximately 50 egg follicles and an AMH level of 10.9. He further explained that I was showing approximately 18 follicles – which he said is a very healthy number – and that although my AMH test was not yet finished, that there should be no problem with my ability to produce eggs should I need to now, or in a few years.

He said the fact that she has polycystic ovaries means that she is at an increased risk of “overcooking them” (his words). He said she’ll have to be monitored more closely once she starts the medication that will help her to get the eggs ready to be harvested, as she could be overstimulated if not. He said that he is not concerned, and simply wants to keep a closer eye on her.

On my side, everything looks good. The only major concern that we have is the fact that my work travel schedule is expected to continue into the near future, and when I am away (which is expected to be 4 days at a time going forward), I won’t have a way to manage the injectable medications (which – he confirmed – will be going into my rear). He said that he could put me on an injectable for 7 weeks, and then switch me over to a vaginal form of the medication at that point, but that there is no way of getting around the injectables for the first 7 weeks. As it stands right now, I’ll be traveling once more the second to last week of July, and then twice in August (evenly spaced out). After August, I’m hoping it drops down to a monthly or EOM cadence. My wife said she could take off of work for a week and come with me for one trip, but coming every other week would be really challenging – even with the flexible job she has. I would consider telling my boss, but my company went through a huge change this year and I just started working with her back in February. I work at a satellite office we have (a 2 hour direct flight from our headquarters) but there has been a lot of pressure over the last few years to transition my role from that office to our corporate headquarters, and so far I have successfully evaded it (although the question was raised again about 2 months ago). I am fearful that if I explain that I am trying to get pregnant, that they will start to look for someone who is willing to do my job in the state where they want the position to be located. I was hoping that by this point in the year, things at work would be more settled, but every day seems to bring new big challenges and “what-if’s”.

So, aside from the injection dilemma (which I would love thoughts on if anyone has any!!) and the PCOS diagnosis (which – again – we are still unsure is truly an “issue” or not), the meeting with the doctor went pretty well. He recommended we move forward with a consult meeting with one of the nurses at the practice who would help us identify the best day to start, and would help us get our medication ordered so we can begin to figure out if any of it is covered. That meeting is scheduled for Wednesday of next week, so in the very near future we should know a lot more about how things are going to proceed as well as the timeline.

After we wrapped up with the doctor, we sat down to a meeting with the woman in charge of finance. She works out of an office that’s about an hour from us, and told us when I spoke with her earlier in the week that she’d be making a trip to “our” office to go over everything. Before she came in, I could hear her talking to another couple (husband and wife, from what I gathered) and her told of voice seemed pushy and cold. My heart started racing and my hands started shaking. I was ready to argue.

On Thursday night, I  sat down and mapped out all of our questions in a word document (which I subsequently printed). On it, I made a table with two columns: one for the regular IVF multiple cycle package that they offer, and one for the co-IVF “package”. I mapped out the costs, services mentioned in each, and made separate boxes for the differences: both cost and service. At the end, it came down to an approximate $8000 difference once you factored in that added value (an additional frozen cycle transfer, cryopreservation of embryos, and anesthesia primarily) of the multiple cycle package that they offer to women who are using their own eggs/bodies.

When Ms. Pushy entered the room, I pulled it together and smiled pleasantly and thanked her for taking the time to meet with us. If this meeting gets hostile, I reasoned to myself, it won’t be on my accord. My wife is the stoic type and she’ll interject as necessary, but she knows that I am very direct, relatively articulate, and thorough with all of my facts – so in situations like this she usually lets me loose to do my thing, and backs me up when she needs to.

So we commenced the meeting discussing the “pre authorization request” that she told us our insurance company requires prior to treatment. I explained that we were told by several representatives of the insurance company that there is no required pre-authorization, and she told us that they ALWAYS require it for our particular insurance company or they won’t get paid. I asked her if that was a routine procedure, why we would have gotten back paperwork after our first visit that said, “No prior authorization required for IVF or IUI” (word-for-word). I slid the paper across the table, and she looked up, narrowed her eyes, and spit out, “well we’ll just call that a mistake.” She handed me the “sheet” that needs to be filled out, and after taking a look at it, I realized that it isn’t a prior authorization, rather, it is form that we have to sign acknowledging that we meet the criteria under the mandate for an egg retrieval (which we are happy to sign as we do believe we meet the criteria of not being able to get one another pregnant). I told her that I thought our confusion was around the name of the form, as I was told that no prior authorization was required and that this technically wasn’t a prior authorization, so I thought we were all on the same page, and at that point, she started to smile (just a little!) and we seemed to turn a corner. I then explained to her that – in the event that the insurance still doesn’t pay the claim (which it very well may not) – that we wanted to discuss the self-pay options and the huge discrepancy in cost/service between the multiple cycle package for a woman carrying her own embryo, and the co-IVF package. I tried explaining my calculations and she told me “I lost her” at which point I showed her the table I typed out the night before, and highlighted the overall differences in the packages and she said, “you know, this is all really new for us. We’ve had co-IVF couples before but this isn’t something we are completely used to. I actually helped create the co-IVF package, you know.” I explained that I understood that, and certainly didn’t expect to pay the SAME as someone who was carrying their own embryos (due to the additional paperwork and monitoring) but that I also couldn’t justify an $8000 difference. She took another look at everything and said, “Listen: I can do a multiple cycle package for you.” (at this point, my jaw was beginning to look like the grand canyon and I just about had to pick it up off of the floor).

She said that it would cost more for the synchronization of our cycles since we are a couple, but that she’d honor a package. In fact, she said they have higher packages with money back guarantees if any of this goes wrong and offered to get us prices on those as well!!

Even though the conversation was headed in a more pleasant direction at that point, I was still ready to defend us. When she said that, I didn’t know what to say. I was still waiting for her to take it back. When she looked down at the papers again, I looked at my wife and snuck her the biggest smile I think I may ever had. The price dropped down to only $500 more than than the package that a heterosexual couple would utilize.

Lesson learned, here: ADVOCATE, ADVOCATE, ADVOCATE!!!! I don’t think I would have gotten the same answer if I hadn’t made that comparison table and mapped out everything piece-by-piece, so do your homework. It’s worth it.

So at this point, we are going to meet with the nurse and determine our schedule, see if the medications get covered, and then pursue coverage of the egg retrieval with the ins. co. If that goes well, we’ll continue to try to get everything covered (even though we were told it would not be) and if it gets pushed back, we now have a much more reasonable amount to fund out of pocket, which we don’t think will completely drive us into bankruptcy.

By the end of the conversation, all three of us were smiling. My wife said afterward, that she sensed that our prior assumptions about the finance lady were correct, but that during that meeting – either my attention to detail or passion for our cause won her over. I don’t know – maybe she’s been having a bad week, and the fact that our case was more complicated made it worse – either way, I don’t feel that sense of bad energy when I think about the practice and I am getting excited to take the next steps forward in this journey.

Fingers crossed, prayers, positive wishes (whatever you have!!!) that the good news continues and that the insurance company pays for the two visits I had this week, and the medication we order next week (I would ask for the same for my work situation, but don’t want to be too greedy :))

Hoping everyone else had some good news this week, too. If not, you have my thoughts/prayers/crossed fingers and positive wishes.

These dreams go on when I close my eyes…

This time last year, I was having a lot of nightmares about our wedding. When brides before me used to say they had “wedding nightmares” I envisioned burning churches, wedding serial killers, or some Stephen King iteration of the big day. My nightmares were less dramatic, albeit slightly more terrifyingl: several times I visualized a grey and lifeless version of our venue, void of family and friends: they couldn’t make it, they forgot, they didn’t want to come…the list went on. Sometimes we sent the invitations out with the wrong date. In one dream, our guests came but there was no one around to help us get ready so it was basically an ordinary day with family and friends – no white dresses, no makeup, no DJ.

Don’t get me wrong: I recognize that those things don’t make a wedding. Our wedding was the pictures we took, the laughs, the hugs, the dancing, the food and drinks we enjoyed with our favorite people in this world. But, the DJ and the makeup may have helped to add that magical touch.

So the day came (and so did our guests) and we got married at a venue on a lake surrounded by about 120 of our family and friends. We are both Catholic and although we don’t go to church EVERY Sunday, our religion has played (and continues to play) a significant role in both of our lives. Although we knew that we would never marry in a church, we attempted to incorporate elements of our faith, and the year before – we attended an Easter vigil ceremony at which my wife’s sister-in-law was baptized as an adult. The church had a beautiful candlelit ceremony during which the candidates for baptism lit the candles of the church members nearest them, and the flame was passed on until the darkened church was filled with the light from about 200 candles. It took my breath away. My mother-in-law helped us to write a poem about the light my wife and I were sharing, and how it lit up the room in much the same way that its bearers lit up our lives, and we re-created the church scene in our secular venue, surrounded by people – many of whom didn’t understand our relationship in the past, or perhaps even now – but loved and supported us in spite of it, and in some cases because of it. And the day was perfect. Not at all grey. Not at all empty.

Now that the wedding is in the rear view mirror, the nightmares involve sad baby-less dreams. Last night I dreamed that we had arrived at our “implantation day” (I guess we fast forwarded through everything else) and the doctor casually inserted some sort of catheter-like device, pushed something out of it, and told us to come back the following day for a check up. It felt rushed, and impersonal, and…kind of grey. Can something feel like a color? Does that even make sense? Needless to say, we weren’t pregnant when we went back for our “magical 24 hour later” appointment and the doctor couldn’t seem to understand why we were upset.

I think this dream have been prompted by a rather disappointing visit I had with the doctor earlier this week for my internal ultrasound. Unlike my HSG appointment, I didn’t feel quite as rushed and was taken much sooner (not surprising since I was at the office at 7am). After stripping down and waiting on the table with a white paper gown over my lap, nervously sweating despite the chill that the air conditioning left in the room, I was relieved to see the doctor come in (and – even though I am accustomed to having female OBGYN doctors – I wasn’t a fan of the extra lady who had to accompany him in, but it is what it is). Before he started the procedure, I double checked (I really need to stop doing that) that he would be getting a “good” read on…well..whatever he was trying to get a read on, since I wasn’t come in on Day 3 of my period, and he stopped, looked really confused, flipped his notepad, and said, “well, wait…what day are you on then?” I reminded him that he suggested that I come in during the “first half of my cycle” (his email to me which was confirmed by his nurse when I called) and he asked what the plan was to get pregnant, and I reminded him that we wanted to use my uterus, my wife’s eggs, and a donor. “Uh, yes…” he started, nervously as he flipped through a few papers on his clipboard. “That’s perfect then”. He mentioned something about counting my follicles and checking the lining of my uterus, and then uttered my most loathed words at such an appointment, “now if you’ll just move down and put your legs up here..” as he motioned to the stirrups.

I hate internal exams. I hate the speculum only slightly more than I hate that little device they use at the dentist office that scrapes the plaque off of your teeth and makes your gums bleed while it emits a noise that is reminiscent of nails on a chalkboard. I REALLY hated the HSG test (which combined that plus an injection of dye that felt like it was made out of needles), but the internal ultrasound: not bad. Not bad at all.

So he showed me my uterus and said it looked good, and said that between both ovaries he counted about 18 follicles (I still don’t know exactly what it means and if that’s good or bad, but he sounded happy so I’m guessing it’s not awful), and he said that we could likely use my eggs or my wife’s without any issues. He then took some measurements of my uterus (or the lining – I mean, I don’t know how people can see a baby on those things let along a solid grey uterine mass that just looks like white noise on an old TV) but he then said, “If we get you pregnant, this is where the baby is going to go.” Hold on. Wait a second. Slow down. Dear Sir…I know this isn’t guaranteed and all, but I’m going to need you to demonstrate a LITTLE more confidence than “if” we get you pregnant.

So there was that.

And then after the appointment, I met with the clinic’s financial person (who I learned is a general financial adviser? consultant? Not sure on her exact title) and the lady we worked with at their other location was the IVF-specific adviser, and I explained to her where we left off and she stopped and asked what I did for work and suggested that I look into advocacy work as she was moved by my passion for our cause. She offered to follow up with the insurance company and triple-check that everything we’ve been told is correct, which was a fruitless effort as she called me back about 2 hours later to inform me that there is now some kind of form that has to be signed that verifies that we understand the stipulations of the state fertility mandate and that we are seeking care anyway (or something like that).  Keep in mind that back in February/March, TWO CLINICS verified our benefits and said that we didn’t even require prior authorization let alone a formal document that had to be signed, so I’m calling BS here, but I’m honestly getting tired of fighting.

I think that’s why I ended up having that dream. So after all of that, the IVF adviser’s boss (so, if you’re following this blog…at all…is the boss of the woman from two entries back who we met with in the city) called me to confirm that we truly wanted to sign this form and confirm some of the specifics of our care, and I asked her point blank, if she thought that we were correct in pushing this given the experiences of our friends and the fact that the insurance company has given us so many different answers. She hesitated, and said she wasn’t really sure what I meant/wanted, and that our friend’s case was different because they had a medical need for IVF, despite not having demonstrated the “attempts” required by the mandate. (I would argue that we – too – have a medical need…I mean, we have no sperm, lady!) but she went on to say that if someone had a damaged tube (or something like that…I was kind of annoyed at this point so things began to blur) or low sperm motility, pursuing a less costly method of pregnancy such as IUI first would be fruitless, and thus – would warrant coverage due to the mandate. I was now livid, and feel kind of sorry because my frustration was misdirected at her, but I asked if a heterosexual couple in which the man had low sperm motility would automatically be granted IVF coverage over being required to pursue a sperm donor (which is much less costly for the insurance company although shitty for the couple) while we wouldn’t be entitled to IVF OR IUI coverage – even if we go out and buy our own sperm – she said, “yes, I believe that’s correct.” WHAT. THE. ACTUAL. F&$K.

So I stopped arguing at that point, because it felt pretty pointless. It would have been nice if she ended it with, “I get it. It sucks. I’m sorry.” but she went on with some clinical bullshit, so I told her we’ll just have to sink further into our research on self pay options, and hung up.

I also found out (which may be common knowledge but it wasn’t to us) that although we have a separate prescription company, that those companies typically verify benefits with the insurance company before offering coverage, so we would also likely be denied coverage for any of the required medication which we are being told will be another 3-5K or so (please share your secrets for securing them less expensively!!)

So it was a rough week, and it left a sour taste in our mouths about both the doctor and the billing team at our clinic, and depending on what the outcome is of our consultation with the doctor on Friday (during which we were supposed to be discussing our next steps forward) we may elect to check out another clinic before deciding who to pursue treatment with.

At this point, I just feel kind of sad and alone about this entire process (aside from my wife – who has been amazing and supportive but equally sad and frustrated with this process). I wonder if I am wanting something that is unreasonable or unfair, and if not – if it even matters as it now appears pretty clear that we won’t get what we want.

We plan to forge ahead with the self-pay options, but even that is frustrating with the differences in the co versus regular IVF packages (which we are discussing with the doctor on Friday).

So I was feeling pretty bummed about all of this, and then the dreams kind of freaked me out a little bit, and as I was sitting down to write this, the song “Dreams” from Heart popped into my head. In all likelihood, it was because I was thinking about ACTUAL dreams, but I like to think of it as some kind of positive sign. One night, a few years ago, my dad and I were driving and that song came on the radio. He smiled nostalgically and told me that it came on often when he and my mom would drive to her doctor’s appointments when she was pregnant with me, so maybe it’s my mind’s way of apologizing for it’s midnight shenanigans and letting me know that it thinks that this will all work out okay.

Yeah. That’s what I’m going to go with.

Planes, trains, and….insurance companies.

I really do need to be more consistent with writing. Sorry in advance for this novel…

The last few weeks have flown due to my work schedule. I had been flying out to our corporate headquarters every other week for a big project I am involved in, and was bummed really excited to find out that the last trip was cancelled due to another big meeting taking place over the same time which would have pulled a lot of people away from the project I am working on, so I have had a glorious three weeks soaking up my wife’s company. Every weekend we have had formal plans: a college graduation, our niece’s first birthday party, a wedding, and this past weekend two days of birthday festivities for different family members with a family dinner at my parent’s house in between. Tomorrow we are headed to a baseball game to celebrate my brother-in-law’s birthday, and then Sunday I fly out again for the week. During the week, we are usually so tired between our weekend plans and work, that after dinner (which my wife – who has a background in culinary arts – prepares every night without hesitation or complaint) we just lay around like sloths until bedtime. I wish there was a way to put those lazy moments on slow motion: when the dog is curled up on our feet, we’re watching one of our favorite shows, and don’t have any plans, because as lazy and comfortable as they are, they seem to zip by more quickly than anything else we do.

Since we have been so busy, we both took off on Tuesday and extended Memorial Day weekend out to four days, and took the train into the city so we could have lunch and meet with the financial coordinator for our fertility clinic – who works out of one of their larger offices and just consults for the small facility we go to in the suburbs where we live.

We are still hashing out of this insurance nightmare, but at this point, I think the value in sharing our experience outweighs my fears that any of this could somehow be used against us because: A.) I know in my gut that they are wrong, and B.) if someone else has gone through this, I’d love their insights.

Basically, my wife’s employer is based in a state that has an infertility mandate which dictates that all employers that meet a certain size and a few other criteria, are required to offer infertility coverage as part of their overall insurance benefits (which her employer does).

Back in February, when we first started this whole process, I called the insurance company and was told by a representative (after filling her in on our relationship as a same-sex couple and what we were trying to do) that we had full fertility coverage with no apparent exclusions due to our sexual orientation. Good, check. We then met with the first fertility clinic (that we elected not to utilize) we were told by the clinic (who does a preliminary review of benefits with the insurance company to advise you of your coverage) that we had full fertility coverage for IUI and IVF with no apparent limits and no prior authorization required. They remarked how amazing our benefits appeared to be and how lucky we were for having them (which didn’t surprise us, as my wife has pretty great health insurance coverage across the board). They said they did not see any reason why we could not pursue co-IVF (a situation in which I would carry an embryo created with my wife’s eggs and donor sperm so we are both connected to the process). Good, second check.

These benefits were confirmed – in writing- by the second fertility clinic – who also remarked how amazing and extensive our benefits were. (Third check!) They had a special IVF representative reach out to us to start discussing the particulars, and she recommended just to be doubly sure that there won’t be any issues, that we touch base with the insurance company and inquire about whether or not there are any exclusions for same-sex couples. At that time, I placed a phone call to the insurance company for another unpaid claim that my wife had from a year ago for a completely unrelated issue (which we ended up having to pay for out of pocket, but that’s another story for another day), and the representative kept me on hold for about 45 minutes for that issue, and another 45 for the IVF exclusion question. When she returned back on the line the last time to confirm our coverage, she explained to me that we did not – in fact – have full coverage, and that our coverage complied with the state mandate ONLY (something that was never mentioned when either clinic inquired, and something that was NEVER said to us on the phone – even though we were aware of it due to our own research). The representative apologized and said that unless we could demonstrate that we had “tried” to conceive for one year by having unprotected intercourse. I said, “you do realize that isn’t possible, right?” to which she continued to apologize and genuinely seemed sad to share that news, but kept reassuring me that there was nothing she could do. We would not – she informed us – be getting coverage for IVF, IUI, or any diagnostic testing or treatment related to either because we had not been able to demonstrate a year’s worth of straight sex. (barf)

Now, that’s all good and fine – state has mandate. State is being discriminatory (more than likely because it hasn’t caught up with the times, but still). Insurance company is following state to pay out as little money as possible. I get it.

HOWEVER: my wife and I are friends with a lovely heterosexual couple (the wife works in the same office as my wife and use the same said insurance), who are currently experiencing infertility issues themselves. They had been “trying” for about 6 months after they got married (and heck – maybe longer before…that’s really none of my business) when they started seeing a fertility clinic. They told my wife and I that the clinic determined their issue to be a blocked fallopian tube and their recommended course of action was some type of surgery or IVF treatments, which they have been subsequently advised by the insurance company would be covered (at least, that’s what they told us and I really don’t see why they would lie about that). They haven’t yet started their treatments, so I don’t know how this will shake out, but they told us that they got confirmation of coverage for their IVF treatments (and I’m fairly certain that they submitted no videos or spreadsheets of their bedroom action…), but their diagnostic tests were covered – that I know for sure.

To be fair, my HSG test was apparently processed and paid out by the insurance co (we thought we’d test the waters), but we are still waiting on my wife’s internal ultrasound and blood work to be paid (which she had done before my HSG test), so it’s a little strange that it hasn’t been paid, yet. We haven’t yet tackled the reverse tests (the HSG for her and the ultrasound for me) because I’ve been traveling EVERY SINGLE TIME I’VE HAD MY PERIOD FOR THE LAST THREE MONTHS (can you tell that really irritates me?) and if I’m not home to make sure she does things – she…doesn’t do them. To be fair, she’s amazing with so many things (such as making dinner) so I can’t complain – but I’m definitely the “let’s get shit done” boss lady in our house. Doctor needs calling? I’m on it. We got overcharged at the grocery store? Give me the receipt, I’ll go complain. Car needs an oil change? I’ll do it. (haha, just kidding…but I’ll totally make the appointment to have someone else do it).

For what it is worth, the reason why we are each doing each test is because the clinic *thinks* the costs will be covered (again – see above. We’re cautiously optimistic), and suggested that if perhaps they find a genuine concern (such as the blocked tube) we can use that as leverage to pursue the same coverage for IVF, EVEN THOUGH the law is clear and says that the diagnostic testing is only paid after you demonstrate the 12 months of “trying” (which neither us, nor the other couple appear to have done). If they are going to balk and offer the coverage because of a different issue, I think that OUR different issue is just as important and should be considered coverable as well.

Soooo….all I can think, is that between the difference in messages once we pointed out our situation, and the stories we’ve heard from our friends, it feels like discrimination to me. In addition, the financial lady kind of scolded me when this all first went down, because she thought my final call to confirm the exclusions may have caused them to scrutinize our case and “realize” they have a legal loophole to exclude gay folk. My problem is: if you aren’t routinely scrutinizing ALL cases (such as our friends’) then don’t scrutinize ANY.

So we took the train into the city to meet with finance lady face-to-face (who I actually adore especially after she started out the meeting telling us how much she admires how much we are advocating for ourselves and encouraged us to “never stop fighting”) and she said that while she believes in our cause, she also doesn’t know if we will get any meaningful movement or payout from the insurance company in the time we would want to start pursuing treatments (basically now as we’d hoped to try to have our first – hopefully only – pregnancy attempt in August). Her recommendation was to pay out of pocket, which we can likely afford if we finance it (but it will make moving out of our condo and into a bigger home a bit tough in the foreseeable future). She provided us with all of the out-of-pocket estimates a little over a week ago when we spoke (I literally talk to this woman all the time – I feel like I should know her birthday so I can send her a gift), and we made peace with the fact that they have a package that is approximately $12K when all is said and done which includes one egg retrieval, two transfers, cryopreservation of any additional embryos, and ICSI (injection of the donor sperm into the eggs to form embryos).

After we rehashed all of the insurance company info during our face-to-face visit, we asked a few questions about that package so we could finalize our expectations as far as the cost (as there were a few small things we weren’t sure about) and she advised us, that the packages they offer are for transfer of your own embryos into your own uterus (so, not co-IVF/reciprocal-IVF). I’m thinking, “Um, lady: I really like you and all, but you KNEW we were lesbians when this all started, and I told you like 10x that we wanted to do IVF particularly as we wanted to go through the process TOGETHER. Why the $%@^ did you think I wanted to do a regular old round of IVF?”

So she said she didn’t realize that, and pulled us out their co-ivf package paperwork (a crappy sheet of paper with a list of all of the treatments instead of the beautiful brochure which highlighted the IVF packages in neat, detailed columns, with photos of cute babies and happy couples on the cover), which is basically 1.5 times the price (around $15k when all is said and done). Ok, so the clinic is doing extra paperwork because we are talking two people instead of one, but…IT’S THE SAME PROCEDURE!! HOW DID WE JUST SUDDENLY JUMP ANOTHER 3K? AND, now the sheet of paper loosely defined as a “package” covered a single round of “fresh” IVF, one retrieval, and no cryopreservation (we are waiting on a call back about the ICSI as she didn’t seem to think that was included in that “package” either as it wasn’t on the page). So in addition to the crappy price, it covered about 1/2 of the items.

Now, I started to tear up in front of this woman (who shouldn’t have been surprised as I called her and began ugly cry hiccuping the day I found out that the insurance company wouldn’t cover any of this), but held it together and didn’t full out sob…for now.

So we took their paperwork, and said our goodbyes, and agreed to touch base in a week or two after we had time to digest things, and she gave us a few other suggested options (asking the doctor if they can honor one of the packages for us as a kind gesture, etc.).

We then left and had dinner at a local market (Indian food for me, which is like…my favorite cuisine ever. And chicken and waffles for my wife…who hates anything remotely spicy and flavorful Indian food. And then we found donuts because…

  1. They are my favorite.
  2. We were near a really spectacular donut place
  3. We kinda had a rough day.
  4. Donuts. Do we really need another reason?

So that kind of made things better.

The next day, I called a lawyer recommended by a friend from college, as I am curious if there is ANYTHING we can do, so I am currently waiting on a call back. The receptionist listened patiently to my story and as I got to the part about being required to have heterosexual sex she gasped, and by the time I mentioned our friends’ situation, she interrupted me to shout, “OH FOR [HEAVEN’S] SAKE, THAT’S DISCRIMINATION!” Which made me feel so…not crazy and almost kind of vindicated for calling. Even if we have no legal recourse, I at least felt like a human being who was worthy of feeling enraged at the situation. Bless that lady’s heart. Fingers crossed for good news…

I am really trying to persuade my wife to pursue IUI instead of IVF but she feels really strongly that she wants to have a biologically related child (she was literally floating the first time we officially heard that IVF was a covered benefit), and she doesn’t feel particularly inclined to carry (and also had some past health problems that make her a little wary of it as well), and I am not quite as committed to the biology aspect but have wanted to experience pregnancy for as long as I can remember, so this just feels like a perfect fit. She said she would consider each of us independently carrying, but she would want to do it first as she is very concerned that by the time we have baby #2 (God, willing), her ovaries will be shriveled up like raisins, her uterus will turn to dust, and she’ll be incapable of getting pregnant (or something like that), so she is insistent that if we do that – she carry first (which is super selfish of me, but would be really disappointing as I have literally held my breath all year for the moment we can get started as I really want to experience pregnancy). I don’t know – IVF is just so ideal. It is the closet we will ever be to a baby that is OURS (raised in my body – feeling my heartbeat and warmth, and sharing my wife’s amazing DNA).

Anyway, I have so much more I could write, but this is probably already obnoxiously long, so until next time.

Even more confused.

We met with the doctor we plan to use to help us conceive yesterday. Oddly, I wasn’t nearly as worked up about this appointment as I was for the first (probably because I traveled for work last week and work in general has been so hectic and preoccupying me quite a bit), but overall it went well and we are actually getting ready to take some finite steps forward in the next few weeks.

We told him in the prework that it was our desire to do reciprocal IVF as long as it is financially plausible (and according to the preliminary paperwork we got back from their billing staff, we think it is – we have a call tomorrow to confirm some information), and I expected a lecture when we sat down for the consult and he was surprisingly frank about the fact that he thinks it is a fine way to conceive and he has no qualms about assisting us with that without first trying IUI. I think his exact words were something along the lines of “this is great. We have two sets of uteruses, two sets of ovaries – I mean, we have options. You carry her egg. She carries  your egg. Whatever. We’ll get you pregnant.” We’d beern told that he has a dry sense of humor and he lived up to our expectations to a “T”. We felt incredibly comfortable with him (much more so than doctor #1). The only thing I didn’t love is that when I asked if he recommended a specific sperm bank, he said “they’re pretty much all the same. Just pick a guy who you think would be a good father to your kid.” Um…none of them, thanks. Our kid will have two moms. Then he made a comment about how if my wife’s eggs didn’t work for some reason, then I “could be the mom”. Again, I get where he is coming from but it felt like the first of many time that I had to point out that regardless of the biological link or the uterus used to grow the baby: we will BOTH be the moms. 100%. Full stop.

He told us that in order to begin this process, we would both need to come in for internal ultrasounds and bloodwork (during our periods as he said it would be easier to see our egg follicles or something like that – I don’t completely understand the science behind it and it kind of grosses me out to be laying on an exam table with my period, but he’s the expert so onward we march). Then I think he said that I would have to do a “mock implantation” to survey the layout of my uterus to determine how the actual implantation would commence, and then I *think* we are in the clear until we are ready to start the process for my wife’s egg retrieval (which will require her to self inject hormones for a two(?) week period with monitoring every-other-day until the date of her egg retrieval. After that they would inseminate the eggs, wait for a week or two for them to mature (I think its a week, but I honestly forget – I took fewer notes than I planned to as I forgot my good notebook and only had a few tiny sheets of paper – plus I was really excited and listening and not really eager to write). Then we have to decide if we want to do any kind of genetic testing which is not covered by my wife’s insurance (unless medically necessary – which is interesting as I’m honestly not sure what would constitute a need. Perhaps a known genetic condition? Not sure.) We’re still up in the air about this process which a few other people recommended and we’ve been doing some reading on, as it will cost somewhere in the ballpark of $5k.

Overall, he said that we will want to get started about 3 months before we are actually hoping to conceive (and he warned us that success rates for IUI hover around 20% and IVF is around 50% so he suggested that we be open to the fact that the first try may not go as planned) so since we were targeting August for implantation (for the reasons mentioned previously) we plan to go in April (within the next 2 weeks) for our “period ultrasounds” and then we’ll go from there.

I was already overwhelmed by all of that, and today I got an email (randomly) from one of two sperm banks that I created an account with and was notified that they were having a 2 day “sale” (yeah. Sperm banks run sales on sperm, evidently. Who knew??) It’s 20% off for 4+ vials (which we would likely require as we plan to use one for this round and perhaps several more in a few years if all goes well, as we’d like to conceive the 2nd time via IUI and have two biological siblings (one each genetically linked to my wife and I). We thought we had our bank narrowed down but this threw an interesting wrench into things (as that changes the overall price dynamics of one compared to the other) and then I started doing some google research and discovered a 3rd that we may want to check out. Initially, we were thinking that we’d wait until closer to the date to select our donor, but now knowing that sales are a thing, and that this process will likely begin to pick up more quickly once we get going with the initial testing, we are hoping to narrow down our “guy” sooner, so we are going to dig into some heavy research this weekend.

I’m almost glad that we set a pretty firm date (well…month, anyway) for our first targeted implantation, as I think if this were all a freely moving process, I’d really be driving myself crazy with the details at the moment (as I tend to do with a lot of things in my life such as our home search 2 years ago, and a lot of our wedding details). Knowing that we are not on a time crunch and can breath and relax through this process makes me feel so much better.

Here’s to continued baby steps (pun intended), and a narrowed down donor in the near future.

Donor decisions.

So we are cancelling one of our two upcoming fertility clinic appointments as we think we’ve narrowed down our search to the place that will (hopefully) help us make a baby in the near future. My best friend happens to work for the hospital with which this particular clinic is affiliated and highly recommended it before I began any of my online searches (did I mention that my best friend is a nurse practitioner in the women’s health field and her fiancee is a gynecologist? She is my go-to for all lady issues and has been AMAZING during this process because she seems to always know the answers to my questions before I know the questions themselves. More on her later…)

In addition to the fact that the bestie works for the hospital with which this clinic is affiliated, my own gynecologist recommended them (I go to a different practice than the one at which my friend works – I love asking her questions, but I think it would be weird opening my legs to her…though she’s told me plenty of times that “a vagina is a vagina”), and the lesbian couple with whom my wife and I had dinner a few weeks ago used this practice and got pregnant on their first try with this doctor (after trying for a while at home). We’re pretty stoked about the upcoming visit, and feel pretty confident that this is the practice we’ll be using to have a baby.

In the meantime, I’ve been casually perusing (read: incessantly searching) the database of the sperm bank we think we’d like to move forward with, and have about 20 favorites flagged to do more research on. We plan to reach out to the bank once the date gets closer for more in-depth info on our choices.

When we first discussed the possibility of having kids, we always knew I’d be the carrier. I’ve wanted to experience pregnancy for as long as I can remember (it was never NOT an option, really), and my wife is the total opposite (she says its a body sacrifice that she isn’t willing to make). We considered the idea of asking one of her two brothers to be our donor and attempt at-home inseminations or in-clinic IUI, however, one of her brothers who initially offered before we got married changed his mind (he and his wife just had a baby and I think they are afraid that it will complicate things for their daughter which I can certainly understand) and we aren’t terribly close with her other brother and we felt funny asking. So we began to discuss more and more the possibility of using donor sperm. At first, I was completely averse to the idea: I wanted my babies to understand from where (and from whom) they came and understand their complete family history, genetics, etc. What I didn’t realize, though, is how much of that is available through donor databases and now that I have been searching, I’m kind of excited by the idea of getting to select someone who has certain traits and characteristics and a particular background to help create our kids. It’s like…match.com, but for genetic traits and characteristics. And baby pictures. SO. MANY. BABY PICTURES.

I mean, if you’ve seen a bunch of baby pictures of someone, and you know about their hopes and dreams, and you know a little about their background and genetic makeup…you KIND OF know them right?

Then I tell myself: it doesn’t matter. This baby will be mine, and my wife’s. We will raise it, love it, nurture it, and support it: where it got 50% of its genetic makeup doesn’t matter. Or does it? I’d love to hear the perspective of someone who conceived with donor sperm. Am I crazy? Did you ever think this? Did it completely dissipate as your baby grew?

The other thing I am stuck on now, is whether or not to fixate on the idea of identifying an “open” donor or not. So sperm banks appear to have truly anonymous donors, as well as “open” donors with whom the child could have at LEAST one (more if both parties agree) communication with the donor when they turn 18. I like the idea that if my kid ever wanted to, they could at least ask the questions and perhaps get an answer or two – if not a relationship with this person with whom they share DNA. Again, I’m not sure if this matters. I don’t know anyone who was the offspring of someone who used donor sperm (nor a I close with anyone who was adopted to ask) so I don’t know if this is just me in my own head, or if it’s a realistic fear.

Another thought that’s been floating around my mind heading into tomorrow: St. Patrick’s Day. My family is predominately Irish (especially on my dad’s side) and I have always felt a connection with Irish-American culture, and I wonder if my sharing of that culture of my children will be enough if they don’t also share that blood-link to my Irish roots. If we go the route of reciprocal IVF (where I would carry my wife’s embryo) and don’t select a donor with a similar ancestry as me, my kids very well may NOT be Irish by blood – but will they still feel that connection to Irish music and food? Will they still feel that sense of belonging at Irish celebrations? And again…does it matter if they feel loved? I’m really torn.

Would love some insight, here.