Tag Archives: MFI

i’m not here, this isn’t happening*

Ye gods, but I’m depressing.

I’m starting to feel that familiar drawing away again.  Wanting to stop being present as things happen.  And even as I write this post my stream of consciousness is doing this:

I should write a post about the Smearing of Trayvon Martin and how it relates to the Slut-Shaming of Sandra Fluke (who is, of course, alive while Martin is dead so of course it’s not a comparison that should imply equality of experience) but that wouldn’t really fit in with the usual tenor of this blog and besides, people smarter than I am have already done this so what would I be adding to the conversation?  This post is supposed to be about IUI #3, which was this morning and while we were in the waiting room we heard that someone had won that Mega-Millions jackpot and what would I do if I had all that money?  I could pay down our debts, buy a house, pay for ALL the rounds of IVF (that’s mine and yours, ladies), put my nieces and nephew through college, secure my mom’s retirement, start a new ensemble, and then I get lost in what to do with the rest of it.  Human rights, health care, arts funding, education of women and girls, scientific research.  So much money, so much power, so many people I could help.  But this post is supposed to be about IUI #3, which was this morning and tomorrow I have to finish doing our taxes which are extra complicated this year because of the grant my husband got last fall and I am crossing my fingers that the accounting for the project is good enough even though I know we made a few mistakes with it.  But this post is supposed to be about IUI #3, which was this morning.

I am having trouble focusing on that.  That’s why How to Disappear Completely seemed like a good theme song for today.

I’m not here, this isn’t happening.

Some true facts:  My HSG showed clear tubes and no scarring.  It also showed an arcuate uterus, which was not obvious on the image from 2009 due to all the fibroids.  As usual my Google-fu is lacking (largely because I am not smart enough to read medical research) but it seems to me that people with arcuate uteri can and do make babies in them.

More true facts:  Today’s sperm count was 23 million (holy shit, husband!) with 37.7% motility.  Post-wash numbers:  40 million, 21.7% motile.  With a .5 ml volume used in the insemination, that’s 4.34 million sperm hopefully making their way up my tubes with another 15.66 million just hanging out.

I’m not here, this isn’t happening.

No facts here:  We have started to talk about how many of these we are willing to do.  How many is too many?  How many is enough?  Why is no one looking at the sperm morphology and what difference does it make?  Why have I never been pregnant, not for one minute, in three and a half years?  If we do IVF, how will we pay for it?  When do we tell my in-laws what is going on?  How many of these do we do?

I’m not here, this isn’t happening.

It’s hard for me to focus on this.  I feel like infertility has become a moving target and I’m just too slow.  I don’t know what I think, I don’t know what I want, and I don’t know how many more of these I can do.

you guys are awesome

Thank you so much for all the comments on my previous post.  I really appreciate all the feedback and it helps me to get a good ballpark for what this is going to cost.  They were not able to give me a straight answer at the clinic yesterday — they’re just going to charge piecemeal for each visit, ultrasound, and blood draw, and tally it up at the end.  Boo.  Since we’re doing Clomid, at least the drugs are cheap.

Regarding what my husband did to get his numbers up — this is what we’re looking at:

  • 7.9 million (up from 3 million)
  • 58% motility (up from 13%)
  • 4% morphology (up, but I don’t remember the old number)

We don’t have any hard evidence for this, but we suspect it has to do with him going off Prozac and Deplin.  He has cyclothymia and has been on one antidepressant or another for over 10 years, and from time to time has combined them with various mood stabilizers.  Over the past few years his cycles have gotten much milder and less frequent, and he made the decision about 4 months ago to go drug-free.  Since stopping the Prozac, his libido has definitely been much higher (lower libido is a known side effect).  After getting the latest SA results I did a little bit of poking around online to see if Prozac or Deplin have any effect on fertility.  It looks to me like this just hasn’t been studied.  I found one tiny little study that seemed to indicate SSRIs could decrease sperm count, but I can’t find where this has been studied on any kind of significant scale.

I asked our RE about this as well, and he said he just doesn’t know if there’s a link there.

That’s our best guess, and if we’re right it should mean that he’s doing even better now than he was last month, since it takes a while to produce sperm and it takes a while for the drugs to leave the system completely.

Here’s hoping!

 

baste me

Last month we went to see our new RE.  He wanded me, did some blood work, and had the Husband give a sample.  Then he gave us the Best News Ever:

Husband’s numbers are up, and we are now candidates for IUI!

The RE actually called me himself to give me the news, which I thought was nice — instead of having a nurse or receptionist do it — and he told me to call on my next CD1 to make an appointment for CD3.

I am some kind of Patron Saint of Bad Timing, because CD1 happened over Christmas weekend, and the clinic was still closed on CD3, not to mention we were out of town anyway.  Knowing this was likely to happen, we talked about changing our travel plans, but I called the clinic to check to see what we could do and since they were going to be closed anyway I figured we didn’t need to change our plans.  After all, after 3.5 years of waiting, what’s another month?

Today is CD1 again, which means I should be able to go in on Wednesday and (hopefully) get started with something that, I have heard tell, can occasionally result in pregnancy!  Holy crap.  Clearly rejoicing is in order.

But.

As I think I have mentioned before, my insurance is not covering one red cent of this.*  That first office visit + testing has set us back $608 so far, with another $165 likely after the insurance company denies the claim for the SA (for some reason the clinic thought it would be a good idea to submit that one and have it be denied rather than just have us pay out of pocket).

We have decided that at least for now, we’re going to just go ahead and spend what we need to spend.  We don’t have a lot of extra money, of course , but my husband has a good job, I just started working, and frankly I don’t know how much longer we can wait.  We have very little savings but excellent credit, so we’re going to go ahead and be financially irresponsible and put this stuff on the credit card.  We figure we would rather spend years paying off the debt than spend the rest of our lives never having tried.

So what I’m trying to figure out is, about how much should I expect an IUI cycle to run out of pocket?  Can anyone who has done this help me understand if this is in the ballpark?

  • I figure at least four office visits, two with ultrasound (one on CD3 and at least one to monitor follies, then the actual IUI and the beta).  Each office visit is $278; I’m not entirely sure if they charged us an additional $165 for the ultrasound or if that line item was for some of the blood work.  So that part will probably be somewhere between $556 and $886.
  • The actual IUI procedure is (I think) between $300 and $400.
  • Some quick googling gave me a figure of $1000 for meds — what do you think?  Is this too high?  (Tell me it’s too high.)
  • I assume they will charge separately for the sperm washing.  More googling — $200?
  • $165 for the beta.  (And another $165 each time I have another one — assuming it’s good and I start looking for doubling!)
  • Giving me a grand total of somewhere between $2,221 and $2,861.

Does this sound right to you?  Has anyone paid out of pocket for IUI?  Obviously I’m going to ask the clinic about this, but they were not really very straightforward about the total cost of the first visit — I was not expecting it to be as high as it was, and I’m afraid there will be hidden costs they don’t tell me about.

Like I said above, we are fucking doing this regardless of the cost, but if it’s really going to be close to 3 grand for 1 cycle, I don’t want it to be a surprise.  Especially if I get a giant bill out of the blue after a failed cycle.  (If it’s a success, I will GLADLY carry the debt, of course.)

I hate that I even have to think this way.  I hope it goes without saying that having a baby is more important than the cost, and that as far as I’m concerned this kind of life event is what credit cards are for, but still … I would like to know what we’re going to be looking at.

* They also didn’t cover my husband’s emergency room visit last month.  Tell me again why we’re giving them several hundred dollars every month?

empty

My house is empty.

This is not a metaphor for infertility.

Two weeks after arriving in our new home, we are still camping out on the floor.  The moving company we hired still hasn’t delivered our stuff!

It was supposed to be delivered last week, but on the promised delivery date I called our move coordinator, who informed me that all of our stuff was still sitting in the warehouse in our previous city!  Worst of all, my credit card has been charged.  I have paid in full for this move, and I’m sitting on the floor here.

I called the moving company’s customer service line and they told me that they would not refund our money, but they will reimburse certain expenses.  We have bought an air mattress, a card table, a cheap chef’s knife and a cutting board.  Technically the knife and cutting board are not reimbursable — they will pay for dishes and silverware but no cooking implements — but my husband is just itching to yell at these people, so we’re going to try to get them to pay for it.

Our new delivery date is tomorrow.  Fingers crossed!  If they don’t make delivery, I feel like they should reverse the charges on my credit card.  Any advice on how to approach this?  It just doesn’t sit right with me (to say the least) that they have my money AND my stuff

***EDIT:  I just heard from our move coordinator.  Our stuff will not be delivered tomorrow as promised.  Next week at the earliest.***

My house is empty.

This is a metaphor for infertility.

After a hiatus of nearly a year (last urologist appointment was last December), I’ve made an appointment with a new clinic.  Unfortunately our new insurance is even worse than our old insurance — we used to have coverage for office visits and testing only, but now we don’t have even that.  They won’t even cover the initial office visit.  The office visit is going to be $278, the SA is going to be $165, and any testing they decide to repeat on me will be out of pocket as well.

$443 just to get in the door.

And then after that, unless my husband’s numbers are a lot better than they were the last time we checked, we will be looking at IVF.

I wasn’t kidding when I wrote these posts.  I don’t want this.  I hate the idea of it.  It feels wrong, and unnatural, and risky, and HARD.  I’m not sure I can do it.

But the alternative is never.  And here’s where I start to sound like a selfish bitch.

I know I can be a parent through adoption, and I know that if we do adopt I will love that child to the end of the earth. 

But parenting is supposed to follow pregnancy.

I want to be pregnant.  This is not about the child — whom I will love and care for even if he or she was gestated on Mars — it’s about me.  I want this.  This is something my body is supposed to be able to do, and I want to do it.

I hate and fear the idea of IVF, but I want to be pregnant more.

Selfish, no?

When I think about the resources it will take, the emotional mess I will be, the debt we will incur, the only thing that makes it feel like anything other than a wasteful display of excess is that adoption would cost just as much.

i hear it’s windy

For those of you keeping score at home, yes, it is 4:00 in the morning again.

My last post was a long-winded lead-up to the talk my husband and I had last night.  It started out being about my job; my husband thinks my job is the root of all my problems, and he is constantly trying to get me to march into my boss’s office and tell her where to go.  Unfortunately if I were to do that, neither one of us would have a job and we would be on the express train to living in my mother’s spare room.

And no one wants that.

Anyway, he sees me tired, frustrated, and literally sick with worry, and he figures I should solve the problem by just quitting.  But that wouldn’t do it.  It would be moving in the opposite direction of my uncle’s fantastic advice to “put family first.”  Regardless of the obvious idiocy of quitting the only job in the household, it would put us even farther away from the possibility of parenthood.  We went back and forth on this for a while last night — he says he can’t stand to see me like this, I say I can’t imagine how much worse I would be if I didn’t know where the rent money was coming from.

He asks how he can help me feel better; I tell him that the number one thing he can do is try to find work.

He tells me he feels like I don’t want to spend time with him; my heart breaks a little because it’s so, so not true.  We both agree that the last six months have been very, very bad for our relationship and we can’t keep going like this.

He says he’ll find a job and then I can quit without worrying.

Yes, that’s exactly the idea.

I tell him about my secret plan, which I haven’t mentioned to him at all before because I was afraid of his reaction.

In my secret plan, I expand my neverending job search outside of our current city.  He does the same.  In the ultra top-secret version that I don’t even let myself think about too often, we both actually find jobs and move to Chicago.

Alert readers may or may not be aware that Chicago is in fact located in Illinois, which is one of the magical states that mandates insurance coverage for infertility treatment.  (Do they really exist?)

My plan has been a secret for a while now because I haven’t wanted him to feel pressured.  This spring his priority, and by extension our family priority, has been getting him through his degree.  He did it, and I’m so proud of him.  But now it’s time to put family first.

Becoming a parent is definitely at the top of my emotional list, but we haven’t done a goddamn thing about it since we got the bad news from the urologist last fall.  And as you may or may not know, I am in fact getting older every single day!  Sometimes I think I can actually feel my eggs aging.  We can’t fuck around for another three years (has it really been three years?).  There can be no more “wait and see if it happens.”

My husband acknowledged for the first time last night that IVF/ICSI really is what we will need to do to get me pregnant.  He has been extremely optimistic so far, thinking if we just keep trying it will happen naturally, but I think he’s starting to see just how long we’ve been trying and how well that’s (not) working for us.  As for me, I’ve been working through my issues with IVF, and while I still viscerally don’t want to do it, I think it would be much, much worse never to try and to be eighty years old wondering if that would have been the golden ticket.

So I trotted out the secret plan.

I was very, very nervous about telling him because I know he has strong ties to our current city and I didn’t know how willing he would be to make active plans to leave.  He has really found a place for himself here as an artist, and I don’t ever want him to feel like I am trying to take that away from him.  But he can see how unhappy I am, and have been now for what seems like forever, and he did ask me what he could do to help.

He said he would be willing to move, provided we were able to find work, of course.

So as soon as I get back from the festival I’m doing in a couple of weeks, I’m going to expand my neverending job search, and he will hopefully do the same, effective immediately.  Unfortunately I am just about the least-employable person imaginable, so I have no illusions that we will actually succeed at this.

But at least we will have tried.

neverland

So as you may have gathered from my last post, the verdict is in from the urologist.  My husband is very upset about it; as I think I’ve mentioned before, this whole mess hits him a lot closer now than it did when I was the one with the problem.

That phenomenon doesn’t work in reverse, though:  I certainly don’t feel any better now.

For the first time I’m staring into the yawning gap of never.

Even if we manage to scrape together the money for IVF (from my piggy bank, of course), we’ll have one shot and one shot only, barring some huge change in our circumstances like moving to a state with mandated insurance coverage.  Will I be able to live with myself if I fail?

I don’t want to do it.  My instincts are still screaming no, but for the first time there is another voice.  One that says never.

Never pregnant.  Never giving birth.

And that’s the voice that will win the day if I don’t try IVF.

Can I live with never, and can I live with taking away my husband’s only chance too?  Because the thing about IVF/ICSI is that it’s made for people like us:  he has some sperm, and all the RE would need to do is pick the very best ones.  I don’t have an ovulation problem, so I would be a good candidate to get to retrieval at least.  My husband wants this.  He wants to be a father.

But if we try it, and I fail?  I will have literally mortgaged our future and we will still be looking at never.

I am not cut out for this shit.

he’s a good man. and thorough.

Just in case anyone is still reading, I have an update.

Today we saw the urologist.  We were really impressed with him.  He’s well regarded in the field and is an active researcher, so he’s up on all the newest developments.  He’s a specialist in fertility issues and works closely with our RE.

It was my husband’s turn to be poked and prodded, and I really felt for the guy.  He’s not nearly as used to dropping trou for medical professionals as I am and I think he felt pretty awkward.

They (the urologist and his resident–remember, teaching hospital!) took some blood to get hormone levels and had him give another semen sample.  We also talked over his history and the numbers from the previous tests.  What we heard was that there’s no real doubt that there is some MFI.  His numbers are low; the questions now are how low, and is there any underlying hormonal cause?  They’re confident there is no structural cause (like a blockage) and no varicocele.  We’re going to look at one or more additional data points to try to find his baseline numbers since the two tests were so different, and the bloodwork may or may not show anything useful.

If the first test (from Dec. 09) turns out to be closer to what we’re dealing with, we may be candidates for IUI.  If the second test (from this past August) turns out to be more like it, it’s going to be ICSI or nothing (which is what our RE told us back in August).

What feels a little frustrating, and the urologist was very open about this, is that we may never know what is causing his numbers to be so low.  According to the doctor today, about 60% of cases of MFI are unexplained.  It feels really different from the experience of going to the RE, where the mindset seems to be that they will keep testing and testing and testing and testing until they find out what’s going on.  What we’re hearing here is that they’ll try to make more sense of the numbers we’re seeing, but that there is only so much testing that will be useful since there is no anatomical problem.

My poor husband was very nervous about this appointment.  He was very worried that there would be invasive tests to look inside his testicles, and I think he was relieved that all he got was groped.*

Looks like it’s time for more waiting.

*He tells me that the fact he was groped by two different guys (the urologist and the resident) is KEY.

Oh, and by the way, it’s CD2.  First fibroid-free try was a big FAIL.  Maybe I will post about that later.