Retrieval - the whole story, and my Fert Report

I'm typing this up early in the day, while I'm waiting for my fertilization report, and because Jakobe is still sleeping.  

**Update: Fert report is at the bottom, if you want to skip ahead**

So - yesterday's whole story:

I woke up, a bit earlier than we needed to, and then at 7 I started poking Jakobe, because he needed to get up and take a pill before we went.  Besides, he has a morning routine, and He mostly has to make it through the entire routine before we can leave...  even if it means leaving later than we should.  So we get up, and get dressed.  We decided Thursday night not to shower until after Jakobe's first trip in the the clinic (it's only about 15 minutes away from our house, so we didn't have to stay there all day.) and we would instead come home and shower in between.

When we got out of the house, and started driving in the car, I was checking my e-mail on my phone, and Jakobe looks at me sideways "you're not blogging right now are you?  I don't want you to be typing '7:30: we're driving to the clinic for Jakobe to deliver his sample.'  Anyway, I said no, I wasn't blogging (because I wasn't yet - I waited until I was alone in the waiting room and bored!)  But every time I started typing on the phone, he gave me a funny look.  Maybe I should respect his wishes more - but this is my thing... and I need it.

 In any case, I got a text from work - one of the server's was down, and since the other server guy is on a medical Leave, I was their only contact.  Thankfully, it wasn't bad, and all they needed was a password for that server.  I ended up talking to work twice yesterday, because then they needed to find a file, and I was the one who knew where it was.  It kind-of feels nice to be needed.

After finishing up at the clinic, we stopped at Jack in the Box for Jakobe's Breakfast (which he then had me carry on my lap - the whole drive home.  Soooo not fair.) It smelled so good, and I was hungry, so hungry that after we got home, and he ate, I was still having tummy growling moments while we were in the shower!  Once we finished killing more time at home, we drove out to my best friend's house to pick her up.  As she came out the door - the following conversation ensued:

ME: I assume you showered this morning.
HER: Of course.  
ME: and put on deodorant?
HER: Yeah
ME: Um, could you go wash it off?
HER: ...
ME: The doctor doesn't want us to have any scents on our skin, he says it's bad for the eggs/embryos.
HER: Oh, Okay, be- right back.
(wait a couple of minutes)
HER: Alcohol on your underarms is *cold* in the morning!

Then we were off.  I forgot to bring our consent forms (which we still hadn't signed) and so we grabbed them at the front test and started waiting.  The TV was on, and while it was The Price is Right, we were all okay, but then The Young and the Restless came on, and we had to change the channel - Jakobe grabbed the remote and switched it to supernatural - which I wasn't in the mood for, and besides, he just found a show he wanted to watch, and wasn't thinking about either of us...  I stole the remote from him, and we ended up with Fraggle Rock!

Then we got called into the back for Prep.  And you all saw the picture of me in my awesome gown.  That was before they tried to put in the IV.  Thankfully it only took about 20 minutes, and two pokes.  I ended up with the IV in the crook of my elbow.  More bruises!  Yay!  Talked for a bit, got post retrieval instructions, and then the anesthesiologist got me and brought me back.

I don't remember much of that part, just getting into position, him warning me that the drugs were coming, the oxygen in the mask starting to small funny, my face tingling, and waking up in recovery - where my feet we cold.  Actually, all of me was cold, and I was having chills, but that's a pretty normal response, and I wasn't worried.  We talked, waited, I ate crackers and drank juice so I could take my Tylenol #3, and the nurses came by to check my vitals several times.  The first one said that they got 3 and all were mature (which sounded off to me, I don't think that they could have known that yet?  Could they?) and my regular nurse said that they got 3 and that we'd get more information today.  In any case, after another stop by Jack in the Box - this time for Everyone, and where I ordered more food than I needed, because I was still hungry, we headed home.

I spent the rest of the day in bed, watching TV shows on my Laptop, and feeling uncomfortable.  It wasn't so much that I hurt from the retrieval, although there was a bit of pain from that, but it was mostly that this whole process has made me very gassy, and yesterday I couldn't pass gas.  THAT HURTS!  Thankfully, everything has resolved itself this morning, and I'm feeling pretty good - Physically anyway.

Got my Fert report while writing that last line:  Not great.  Of the 3 retrieved, only 2 were mature, and of those 2, only one fertilized.  We've got one.  And gods damn it, I hope it grows, and divides, and makes it - cause we've got only one egg in our basket.  I think we'll probably be doing this again in a couple of months.  Maybe we'll get a better result.  A girl can hope.  She can also cry.

R-Day

It's here. Today is the first day of truth, when we start getting a bit in the way of hard numbers, and we're really on the way. Since Leigh (I promise to link later, she's hornmonacoaster.blogspot.com, IIRC and I had the same blog title by chance last night, and because all day updates may keep me from feeling as hungry, I'm following her lead and I'll be updating all day.

0645 - Wake up, stare at clock, try to go back to sleep for a bit. Poke Jakobe to start him waking up.

0745 - At the clinic, it's waaay emptier than usual, just the tail end of morning clinic. Nothing for me to do, just wait. After this we're headed back home to shower and make sure that we have no scents on us (It's a no deodorant day, yikes). I know I haven't mentioned this much lately, but I'm wondering if they ever decide not to do ICSI on the day of? Food for thought.

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The Fish and the Egg

I went out to my sister's house today, because we were going to look at and possibly buy a recliner for my dad that I found on craigslist in her town.  He has really needed one, and the furniture in his apartment is undersized for him, uncomfortable, and just not right.  Turns out that the recliner we found for him was just perfect, so we bought it, and then took it to his house as an early birthday present.  And then - we couldn't get in because my sister didn't have her key, and he was gone to Montana for the day to go on a date (Go Dad!!!)  Sis called him up when he got home and they brought it up for him.  He loves it.

Also - today I got to explain IVF to my nephew - after my sister told me "He knows about the egg and the fish."  Mostly because this was the second time in the past couple of weeks that he asked me if I wanted a baby.  I said yes, and then he asked how people get babies.  So the discussion involved how people only usually have one egg at a time, but I was going to the doctor so that I could make lots of eggs (Nephew: "there was this dog, and it had lots of babies, so it had lots off eggs." Me: "Kinda like that, but I'm not going to have lots of babies, only one or two.")  And then how the doctor was going to take all the eggs out of my tummy with a needle, and then put Jakobe's fish in the egg with another smaller needle, and then watch to see which ones grow the best, and then put only two of them back.  I don't know that he'll remember the conversation, but it was interesting to try and explain.  And I can just imagine the mental imagery.


{Begin bitch session}

My cousin is pregnant again.  The one who has 3 girls, and whose husband didn't want any more kids because they're walking a financial tightrope as it is.  The one who just has to look at him funny and gets knocked up.  The one who told my sister she should just have another one now so that they could be pregnant together.  Yeah.  It makes me so angry, and sad, and jealous.  I am not rational about this.  But even my sister, her best friend, thinks that this was not probably the best move she could have made - and she did it on purpose.

Enough whining and bitching on my part.  I think.

Anyway - still waiting for maintenance to start, still spotting, still cramping, and still not getting to have sex with Jakobe.  Grr.  (Shit, I forgot I was done whining.)  So there's no further movement on the IVF front.  Just more hurry-up-and-wait.  My new schedule at work starts tomorrow, so I don't have to be there until 8:30.  It's going to be a bit strange going to work that late, but it's better than using up more of my non-existant sick time (I've been sick a lot this year).

Straight up Potholes

For those of you who live in places where there is a regular freeze/thaw cycle all winter, you will be familiar with the bane of winter driving otherwise known as the pothole.  The city I live in is notorious for its absolutely horrendous pothole problem, and right now it’s at its worst.  To help you understand exactly how bad our pothole problem can be, several years ago on my way to work, I hit a pothole.  It bent the suspension and frame of my car (I can’t say that the car was all that rugged either…)   Why am I telling you all about potholes?  Because my unexpected bumps in the road from the other day weren’t just bumps… they were the cracked pavement right before a giant pothole appears in the street.  On Saturday, we had our pothole.

 

Turns out, my car overheated because the cylinder gasket was failing.  Apparently the clue was that it looked like someone had vacuumed out the air/water in the upper radiator hose.  I took a picture of it, because I thought it could help them diagnose it.  I was right.   This is not a good thing; in fact, I think you can find it in:  The Book Of Bad: Car Edition on page 1 or 2.  Without the gasket, your car doesn’t work.  It overheats, and dumps exhaust into your cooling system.  Plus – the gasket is in the middle of your engine, so you have to take the engine half apart to fix it.  And, if that wasn’t enough, there’s the possibility that you’ve warped your cylinder heads and that they have to be machined.

Needless to say, fixing this problem isn’t cheap.  We had $12,500 in our IVF fund, and were expecting about $3,000 more this week, bringing us very close to the $16,300 that we needed to be able to pay up front for IVF.  But – fixing the car will be about $2,000, which is a lot more than we had hoped.  I have been trying all this time to be able to pay for the majority of our treatment with cash and reimbursements, and now that’s a little bit out of reach.  Especially since the amount I’ve quoted above doesn’t include any of the medications, or the anesthesia… it’s just IVF and ICSI.  We have enough available credit to forge ahead anyway (mostly because the total balance on our credit cards is less than $300), but it wasn’t really what I wanted to do.  It sucks.

I had a really hard time Saturday afternoon; because after the mechanic called Jakobe said that we needed to talk and that we shouldn’t make any decisions right away.  I thought he was talking about postponing IVF, and I had a mini freak-out in my head.  Turns out that what he meant was that we had to decide how we were going to pay for it: with cash or with credit…  I think we should pay with my new rewards card, and then we should pay off the rewards card with our cash.  Keeps us out of the hole, and gets us frequent flyer miles.

One of the things I said to Jakobe while we were talking is that now that we’ve started the ball rolling, I don’t think I can stop.  Postponing things again would be extremely hard for me.  In response he said that even while we were on hold, I couldn’t let go. So we aren’t changing our plan to go ahead with the April IVF cycle, just having to re-think how we’re paying for it.

Damn the torpedoes, full speed ahead.

4 million!!!

Jakobe had his repeat SA and the results showed marked improvement.  OTOH the nurse was quite surprised at my excitement - she kept saying "You know this isn't good, right?" and I had to tell her that it was so much better then before I had every right to be excited.

I don't have the full report, but here are the highlights:

Semen - Normal, no White blood cells, no agglutination, PH normal, liquefaction Normal

She didn't say anything about volume or concentration

And now for the good stuff!

Morphology: 3%
Motility (rapidly forward): 50%
Total Count (my guess): 8 million
Total Motile: 4 MILLION!!!!

That's a damn sight better than 20 thousand funny shaped sperm that sit there and wiggle.


Apparently the plan is still to continue with IVF with ICSI  - but when we get a little bit closer, I think it's something we'll want to talk about.  Is there a way to split the difference?


In other news:

• I decided against ICLW this month, September is always really busy for me, and my night classes start today.
• We now have about $7500 in savings, even after we had to put $1100 of work into Jakobe's car.  Oh well, you gotta know that things like that are going to happen.
• I'm still unmotivated and a little depressed - and what's worse, I can't seem to work up the motivation to do something about it either.
• We graduated from couples Counseling - at least until we start treatments, when we might need it again. 

Money

Last week as I was wandering the blogosphere I came across a lot of posts about the amount of money we all spend in infertility.  And it's a lot of money.  No so much us personally - I've managed to get a lot of stuff covered by my insurance because it was basically for something else, and not for infertility specifically.    In any case, because I'm kind of an anal-retentive, details-oriented person, I just had to sit down and figure out not only what we've spent on infertility treatments/diagnosis/etc. already - but the possibilities of costs for IVF.  I think that posting our costs is a good idea in general.  It gives others an idea of what they might be looking at if they're just facing this themselves.  It also allows us to look out at others in this world and see where we are on the continuum.


I still have couple of other things to add - but I was thinking of adding them as they happen.  It's still possible right now that we're done.  Jakobe's worried that he won't feel ready to move ahead or make a decision as much as a year from now, and until then I'm in limbo.  For now - I'm just including the definite costs and estimates.

Here's the scary part:  The absolute cheapest it could be - for IVF/ICSI alone - If we were completely optimistic (And - we were right) is $13,260.  That number is more than my car and Jakobe's car put together.  It's more than our wedding was.  It's more than we owe my mom for 10% of our house.  And, if I'm honest, we're not that hopeful or optimistic.  The universe has spent enough time shitting on us that I don't think that it's about to stop and all become sunshine and roses.  So, more realistically, if we hedge our bets a little bit, the smallest amount of money we're going to spend on IVF/ICSI is $19,400, and likely to be more than that.

If you pop on over to the Money page you can see the complete breakdown.  It's big, it's bad, and it's a whole lot of "I don't want to think about that."  But I have to - because you have to walk onto the path knowing where it might lead.  And it could lead to spending a whole lot of money we don't have right now - and still having to figure out how to live our life without this dream.

And the Verdict is...

IVF with ICSI.

If we want to have biological children - that's our only option.  Dr. R thinks that we're very good candidates.  Given my age, and my FSH values the last time they were tested, he thinks our chances are about 60% if we did one cycle and a better than 90% chance if we did 3.  ( doing the binomial probability thing bears this out).  Our chances without IVF:  "As close to 0 as you can get without actually being 0."

He looked at Jakobe's SA and said that the volume really didn't matter, because everything else sucked. He described the motility as "every so often - one of them twitches."  I guess we've got twitchy sperm.  So - Jakobe wants karyotyping because Dr. R brought up the possibility of mosaic Klinefelter's syndrome. He doesn't think that it's likely - but Jakobe wants to be sure.  Thankfully - it looks like most of the screening tests are covered under insurance.  They don't have an infertility code attached at all - including the karyotyping.  So - Insurance should cover it.

I did my CD3 blood work again today - so we'll see what it looks like this year.  While we were there - He did a basic exam - determined what size catheter to use on my cervix, and got some good shots of my ovaries and uterus with the ultrasound machine.  I don't have any idea what look was on Jakobe's face during the actual exam - but he thought that the ultrasound was pretty damn cool.  I really just felt uncomfortable.  Exams during my period are a lot more painful for me than usual - so it was even further on the "not fun" side of things than usual.

The plan: We don't have one.  The cost figures didn't even start to sink in for Jakobe until we were sitting there in the office.   It didn't really matter that I had told him how much I thought it would be - it wasn't real for him until he saw it in black and white on the piece of paper there.  It's making him very hesitant.

We talked a bit at lunch after the appointment, he feels like I've already made up my mind.  In a way I have - I know that I want to do.  I also Know that what we do has more to do with what we both want, and what we can both accept.  I don't get to make these decisions on my own.  We're a partnership, and we have to make them together.

It turns out that Dr. R does have a shared risk program.  It's a 3 cycle package (no refunds) where you pay for slightly less than 2 cycles upfront - and you can have 3 fresh cycles. It doesn't include the cost of anesthesia, medications or ICSI, which we would pay for at the time of each cycle - but I think that if we go ahead with IVF - the 3 cycle option is what we'll do.

I'm thinking that now may really be the time for us to take advantage of the EAP (Employee Assistance Program) and maybe a see a counselor.  Hopefully there is someone in our area who has some experience helping people to make decisions like this.

For now - we'll keep thinking, and trying to figure out what we're going to do.  And - maybe I'll have a good cry.