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

Champs.

My beautiful, strong, amazing wife made it through her retrieval today with flying colors. They pulled a really solid number of eggs, and we are waiting on a call tomorrow morning from the embryologist to find out how many of them were fertilized. I don’t know why, but I thought we’d leave knowing more – like how good the eggs looked, but we’ll know so soon that it’s not too bad.

We arrived at the clinic at 7:30 for her 8am appt, and we knew I’d be taken back at 8:30 for bloodwork and ultrasound. She signed in when we got there, and I set up my laptop to get work done – assuming we’d be waiting a bit, and my wife walked away to use the bathroom and a nurse came out and started calling my name. Since I hadn’t yet signed in myself, I didn’t respond and someone else then came out to ask if I knew my name was being called. They later explained that the doctor had a few moments before going back to start the two retrieval procedures he had lined up, so they wanted to take advantage of our earliness to squeeze in my ultrasound before he was tied up. I was so confused at that moment, though, and I didn’t know if I’d see my wife before her procedure. I just wanted to kiss her goodbye and tell her I loved her and was being escorted through one door for my ultrasound as she was being escorted into another across the room to wait for her procedure, and we were being separated while waving to one another like a scene in a sappy love movie.

After I composed myself, the doctor (not our usual guy, unfortunately) came in for my ultrasound. He popped in the wand with record speed and told me immediately that my uterus looked beautiful and that the fluid that had shown up on my last ultrasound was gone and my lining was at 10mm (which he was very pleased with). After he wrapped up, I met with a nurse who drew a blood sample and discussed my new medication calendar (which included the introduction of an oral steriod to prevent my body from rejecting the embryo) and progesterone in oil (a viscous liquid that is injected intramuscular-ly with a very long needle) in addition to my estrogen pill, prenatal vitamin, and baby asprin (a regimen I’ve been on for a few weeks, now).

I ended up back in the surgical waiting area with enough time to see my wife before her procedure (which was AMAZING) and after about 45 minutes of waiting (only about 20 of which were for the actual procedure) the doctor came out to tell me the results, followed by a nurse who brought me back to see her.

She was groggy for the first few minutes, but otherwise great. No major pain (just some abdominal cramping, which we expected) and she’s been chugging water and gatorade all day to try to keep herself hydrated and prevent the OHSS. She also has to monitor her weight as a key indicator of OHSS is rapid weight gain due to water retention, so I am keeping a close eye on her (not that she needs me as she’s tough as nails).

Tonight, I had my first progesterone shot (which I described above). We watched several videos on administering the shot, and followed tips that we found from fellow bloggers and online forums:

  • Iced the area for 5-10 minutes prior to injection
  • Warmed the bottle of the medication in a cup of warm water (it is an oil-based shot, and typically oils are more viscous at colder temperatures and become more thin and pourable at higher temperatures). That being said, we used warm water – not hot – as I wasn’t trying to cook my muscle tissue with hot sesame oil.
  • Laid down on the bed with some relaxing music (which was Rhianna for me tonight, haha)
  • Rubbed the area for a few moments afterward

I wanted to take a picture from my perspective of the shot, but my wife yelled at me because she was nervous so – no photo. Then I got nervous and began to dread the shot in the seconds leading up to it piercing my skin – though I’d been feeling fairly nonchalant about it all day. Turns out – the seconds of worry were for naught, as I literally could not feel the shot. Like – I kind of felt it pierce skin, and then I asked her what she was waiting for because I was starting to get nervous and she said, “I’m done!”

I totally thought she was kidding, but it was so easy and painless (and I am a HUGE baby when it comes to pain). I honestly think the ice helped a lot and where she injected the shot as well. They say you can inject the shot into any muscle, but the upper, outer quadrant of your buttcheek is the best place. Sooo…that’s my story. Hope the details help someone else to have a painless shot, too.

(Though I told my wife I’m partially nervous that she injected it into the wrong place and I’m going to end up with an issue from the oil in the wrong part of my body…but she swears it’s right).

So….5 day holding pattern. Monday is the big transfer and I don’t expect that much will happen between now and then.

We still have our eyes on that house, but are sitting tight to see how this all pans out, first. Still thinking of everyone else out there and hoping for good news for you all.

embryosinfavor

Tomorrow’s the day!

It feels like we just started this journey – literally – February feels like YESTERDAY, but here we are – on the eve of our retrieval, trying to calm our nerves and keep our fears at bay, and fill our hearts with the hope of a bunch of healthy, thriving little embryos.

I thought that it might be nice to honor my rockstar of a wife (whose experience I haven’t blogged very much about as she’s generally more private and less eager to write than I, but who is also the one going through this egg retrieval process, so that her eggs with our donor sperm can help to create our future baby) with a little co-authored entry in Q&A fashion. I’d seen this done in another blog a while back and thought it was a great idea, so I’ll ask her a few questions about this process and transcribe her response into text for you all (whoever “you all” are) as well as for us and posterity 🙂

How do you feel heading into the retrieval tomorrow? 

Excited and nervous: I’m excited to see how many eggs we get, but really nervous that I’m going to develop OHSS [Ovarian Hyperstimulation Syndrome – a condition that can happen more frequently to women with PCOS and with which symptoms include:

  • Mild to moderate abdominal pain
  • Abdominal bloating or increased waist size
  • Nausea
  • Vomiting
  • Diarrhea
  • Tenderness in the area of your ovaries
  • Sudden weight increase of more than 6.6 pounds (3 kilograms) (borrowed from the Mayo Clinic website: http://www.mayoclinic.org/diseases-conditions/ovarian-hyperstimulation-syndrome-ohss/symptoms-causes/dxc-20263586]

How have you felt – in general – throughout this process? 

Other than being pretty bloated, not bad. And uncontrollably emotional these past few days. 

Okay, so that’s the physical part: how do you feel emotionally about all of this? 

I just don’t want to let you down if something goes wrong. I also don’t know if I could do this again. I just hope we have a ton of embryos in the freezer [when this is all done] so we don’t have to worry about that. And I’m pretty sick of being fat [she isn’t – she gained a few pounds – probably partially water weight – and looks amazing, but I’m telling it like she’s saying it…] 

What do you want to tell people who might be getting ready to go through this? 

Be super patient with [your spouse] and start saving money. And don’t watch too many IVF blogs or watch too many vlogs, because you’re going to freak yourself out. You just gotta do it. 

What was your favorite part of this entire process so far? 

I actually like the ultrasounds daily at this point and seeing how big my follicles got. I like to see progress. 

What do you wish I knew about how this process has been for you? 

You can be more emotionally supportive. 

What else do you want the blogging world or families to know about any of this? 

I feel very lucky to have a wife who would give up everything to carry my baby, and I don’t know anyone else who would do that for me. (We’ve discussed this a lot. I literally cannot wait to do this – it doesn’t feel like a chore, or a burden AT ALL.)

I’m not going to lie, the one about me being more supportive hurt my heart a little, but it didn’t come as a surprise as we’ve talked about that pretty extensively over the last few days. This last week has been tough – I’ve been low on emotion and she’s been high and its usually the COMPLETE opposite, so we’re both struggling to figure out how to manage these feelings and how to tease out what is related to the medication and what’s related to the overall process and how overwhelming this all can be.

Overall, I think we balance one another out well, and I think I mentioned previously – I cannot imagine another human being by my side – this woman keeps me calm when I’m going crazy, pulls me in when I’m floating away, and makes me feel safe when I’m terrified. Tomorrow is really scary. We’re hopeful because the doctor told us at her appointment yesterday that our case seems to mirror another co-ivf case that he did a few weeks ago that yielded GREAT results for the couple, but we really do read and watch so much online and can’t help but get sucked in by the horror stories. All we want is one perfect embryo to transfer (at this point, it is looking like Monday) and a few solid embryos to freeze for the future or in the event that this first attempt doesn’t work as planned. Prayers, positive thoughts, good juju – whatever you believe in, please! And as always – back at you ladies. I have so much respect for ANYONE going through this retrieval process: you’re all rockstars and your partners are so, so fortunate to have you. What is it that the TTC community says so often? Baby dust….baby dust for all!

See you on the other side of this retrieval process, tomorrow.

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.

 

 

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.