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.

partygif

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.

Straddling the state line.

So the last week has been another roller coaster. I think I mentioned in my last post that I was traveling for work. Again. And I was due to get my period during that trip. Again. And I did. Again. So that ruled out another month of having the preferred window open for an internal ultrasound/bloodwork, but I called the doctor’s office, and they were able to squeeze me in for an appointment a week later than the preferred date, and they said they could likely get a good baseline blood panel done and the ultrasound wouldn’t show exactly what they’re hoping, but that it would work.

We are now really narrowing in on the date that we mentioned at the beginning of this process back in January/February that we wanted to get started with our first try, and we feel no closer to that ability to try than we did back in February from a financial perspective. I have been replaying every detail of every conversation in my mind with the insurance company, and the financial woman from our clinic, and I have a really uncomfortable feeling about how everything played out. Personally – I like the woman from the clinic who works in finance, but I don’t feel as though we are being advocated for – but I also don’t know if that’s a fair thing to even ask of her. She disclosed to us during that face-to-face meeting in their office last week, that she has been doing [fertility financial advising] for a year now, and I casually asked what she did prior to that (just making small talk) and she mentioned a short variety of things. At the time, it didn’t really make a difference to me, but looking back – I wonder: is she really knowledgeable in all of this? Is she the BEST person to be working with? With potentially $15K on the line, I want to ensure that we are working with the MOST knowledgeable person, and if there is ANY hope of getting the insurance company to cover any part of this, I want to go ALL IN to find that person who will help us to get that.

So: back in February, we made an appointment with a 3rd fertility clinic (which we subsequently cancelled because we liked this one so much) but that clinic is located in the state in which my wife works (which is also the state that has the insurance mandate) and I think we may want to consider making an appointment there, as their finance staff may be more well versed in the process and the mandate (which happens to be the same place that my wife’s coworker uses, and I am now starting to wonder if the clinic is the reason that she is not having any trouble pursuing coverage, and not necessarily the fact that she isn’t gay).

I mentioned in my last post, that we called a lawyer last week – they finally got back to me and referred me to another lawyer (coincidentally also in the state where my wife works). I should point out, that said state is literally a literal stone’s throw from the town where we live, but perhaps state boundaries can really make a difference here.

So we’re in the air about cancelling the two appointments scheduled next week with our clinic (one for me on Monday for blood work and ultrasound and the other for both of us which would be a regular consultation) and making them with the clinic in the state where my wife works, instead.

On one hand, some of the tests we have already done may need to be done again – which could raise a red flag for the ins co. The doctor we are working with now is also renowned in his field and his success rates with IVF are really high. On the other hand, if we proceed as is and miss an opportunity to potentially work with a clinic that has more knowledge in dealing with our particular insurance company – especially with regard to this mandate – I don’t know if we could forgive ourselves. We want to give ourselves that fighting chance to have as much of this covered as possible.

At the end of the day, we could just throw in the towel and pay the 15K out of pocket. If we knew that it was a done deal, 100% chance of getting pregnant, I think we would just bite the bullet and do it. But all of these unknowns are causing us to want to push just a little harder to make sure we’ve explored every resource before pressing onward, as we could do so much with that $15K with a little one, and if we can save ANY of it, we would like to at least try (especially since we recognize that 15K can turn into 25K very quickly if try#1 is unsuccessful).

So right now, it’s Saturday. And we can’t do much with either place, so we wait. And hopefully next week everything becomes more clear. Because in the meantime…

another lesbian couple we know (outside of the blogging world) just announced their pregnancy on Facebook this week (so I am debating reaching out for their experiences/advice – but always wonder if that’s too forward and invasive – thoughts?). Each announcement, though, especially when it is other lesbian couples, both gives us hope, and makes us wish we started sooner because we now both have really intense baby fever (with three nieces under 2, can you blame us?).

It’s pretty adorable, though. My wife always wanted children, but never had any desire to carry them, and always thought of herself as awkward and cold around babies. Since our nieces were born, though, she has become the “baby whisperer” and our second niece, M, will immediately reach her arms out when my wife walks into the room (regardless of who is holding her or around – including her parents) and it is the CUTEST thing. Watching her become an aunt has erased any tiny doubts I once had that she would struggle as a mom – she is loving, easy going, patient, and just so sweet with our nieces. I can’t wait to experience motherhood with her – now, if only we could get the finances figured out…

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.