8; Taking the (Needle) Plunge

Well, long time no talk. It’s been about three months since I’ve updated this blog after starting it and subsequently going balls to the wall with my brain dump, and I truly wasn’t even finished. I had lofty goals about rehashing the events up to this point — breaking out each failed IUI individually, for example — but I realized I really don’t want to. I don’t have the energy, and looking back to a stage I feel moved on from (mostly) sounds 100% unappealing. That’s probably why I stopped for so long.

What I do want is a place to just write out what I’m feeling along this path, when I’m feeling it — and from late October to now, I was feeling like I just didn’t want to think about it. Which was good. Josh and I were able to, despite a few bumps, enjoy the holidays, which came with five extra pounds for me on top of the 10 I gained post-miscarriage, but I’m working on it, OK?

I was also kinda sorta hoping that the miracle pregnancy people told me happened to their great-aunt’s neighbor’s niece right before she started IVF would happen to us, but here I am, which means it did not.

We *did* get to drink fancy warm winter drinks at Tavern on the Green in N.Y.C. at Christmastime, though. #win
Also grabbed a drink at Eataly’s swanky rooftop bar.
And ice skated at Rockefeller Center because it was a bucket-list item for me and not everything we do is alcohol related (unrelated side note, we gave up alcohol this month).

But NOW, this infertility shiz is priority No. 1 yet again because tonight, my friends, is my first dose of stims (stimulation drugs) for our IVF retrieval cycle. Hooray!

So to start — remember when I told you my AMH was .31 and all the details about what that means? Of course you do. Well, I got my blood drawn in December and after three months of taking DHEA, it went up to .79. Which at first consideration is still low, but when I really think about it, it more than doubled. Which is fantastic. I’m hoping by retrieval time at the end of this month/beginning of February, my egg count and quality will have made the four to five months of taking the DHEA 3x a day worth it, even if only in my mind. Good enough for me.

Speaking of shit I have to put into my body, here’s my pharmaceutical setlist for the foreseeable future:

  • Letrozole (more mild – oral stims)
  • Gonal-F (injectable stims – these are the $$$ drugs)
  • Cetrotide (prevents premature ovulation)
  • Novarel (trigger shot to ovulate 40ish hours later)
  • Vivelle dot patch (estradiol/estrogen)
  • Progesterone and oil – More on this fun later once I start it, but if you want a preview, you can read this amazing post by my favorite infertility blogger, Heather (and this one too tbh, she’s fantastic)
The spoils, part I.
Non-refrigerated spoils, a.k.a. part II.

$3,600 worth of drugs, folks, which…I’m relieved about. I never thought I’d say paying $3,600 for one month’s supply of medications would make me say that, yet here we are. I’m relieved because the clinic estimated $5,000 to $7,000, so Josh and I prepared ourselves for $7,000. And I should be getting a rebate from this amazing program my friend Amanda told me about called Compassionate Care, which anyone can register for and then they offer you a percentage off certain medications based on your income. Josh and I “only” qualify for 10%, but 10% off of the two in the above list that it covers — Gonal-F and Cetrotide — is $335! Big chunk of change for us.

To be candid, we applied for two grants and did not get chosen for either one, so we took out a home-equity loan to pay for this which, if we don’t end up needing more meds and do a fresh transfer, is costing us $16,500 out the gate including the meds. If we produce enough good-looking embryos to risk aging to day 5/blastocyst stage and doing the PGS testing with a frozen transfer later, that will add about $4,000 to the total. Each subsequent transfer/”try,” assuming we have embryos frozen, is $5,000 to $7,000, so the idea is that having PGS “normal” embryos to work with will make our chances of a successful pregnancy higher the first time. Our loan was for $25,000, so we have a little wiggle room for now, and time to save up if, God forbid, this journey continues beyond the first try or two.

I’m putting these numbers out there because it’s completely insane that so many insurance plans (including ours) do not offer to help couples struggling with infertility. It’s garbage, and I really hope that changes ASAP. We are in the lucky group who can somewhat reasonably afford it, if not via our ideal scenario. So many people cannot.

Anyway, the plan is to start the stims (Letrozole and Gonal-F) tonight and take them for four nights. Then I have my first follicle-check ultrasound on Wednesday morning to see how those babies are growing. I should mention that on my medicated IUI cycles, I took 75 UI of Gonal-F two or three times, every other day. This time? 300 UI every damn night for what they estimate will be 12 nights. Oh boy.

I’m pretty worried about how they’re going to affect me, physically and emotionally. Josh says he’s ready and not worried because the 75 UI didn’t really have a big effect on my moods, but I don’t think he really knows what he’s getting into. I already asked him in advance to forgive anything that comes out of my mouth this next month and, if I get pregnant, the next 18.75 years after that.

The list of things he does for me is endless. This is us having fun.

There are a few more exciting things going on for me. I got full-time hours at my job, writing for PEOPLE.com, which is faaaaab. I’m very thankful to be working 8 to 4, Monday through Friday at my dream publication and not having to feel the need to seek out side projects. And I’ve rejoined Weight Watchers (sorry — it’s “Wellness That Works” now) and lost almost 5 lbs. these first two weeks back. Overall, I’m feeling good, and like I’m allowed to relax some and move forward.

But this post was mostly to tell you guys that IVF is officially a go, and moving full steam ahead. We’re scared. We’re nervous. But mostly we’re excited — truly. It’s been a lot of waiting up until this point and regardless of how this all turns out, we feel like there’s nowhere to go but up.

5; Being My Own Advocate, or It’s My Ovaries and I’ll Plan If I Want To

If there has been one constant in this ever-changing puzzle called Baby Haupt or Bust, it has been the fact that the only person who is going to advocate for what is best for me is myself. Josh too, of course, but to a point — over the past two years, our idea of what’s best has differed from each other’s. More on those super-fun fights in a later post or seven, but rest assured these experiences have actually made us so much stronger in the long run. Even now, before we have a baby in our arms, we can feel it. Wine helps.

Yesterday, we had a big disagreement — over Google Hangouts of all places, even though once we started this journey, we swore we wouldn’t talk about anything important over email or chat or anything like that. But when you’re married to a writer who can go on forever about things, you learn that sometimes that person has to get it all out through writing — and when that writer is a neurotic psychopath, they have to get it all out through words right. The. FUCK. NOW. (Being married to me is paradise, really. Can’t wait for all the hormone shots! Lucky Josh!)

Our disagreement was over how to proceed with our IVF treatment. We met with our doctor Wednesday to go over some of the basics and here’s basically what transpired:

Me: So doc, blah blah, egg retrieval in January plus PGS (pre-implantation genetic screening) and a frozen transfer in May, right? YAY!

Doc: Actually I think we should do a fresh transfer in January and skip the testing, a.k.a. the exact opposite of what you’re telling me lolz!

Me: …?

Doc: Your diminished ovarian reserve means you probably won’t produce a lot of eggs so we don’t want to put them at risk by testing them, freezing them, defrosting, etc.

Me: OK cool that makes sense.

A little background, which I touched on previously but didn’t go super into: I have something called diminished ovarian reserve (DOR), which means the little ovarian follicles that produce eggs? I have fewer of those than most women my age, and therefore fewer eggs and years of fertility remaining than most women my age. Dr. Google gave me this handy article predicting IVF success rates at this one clinic based on AFC (antral follicle count).

I had 12 at my last scan, which is pretty close to the low end of normal but my doctor says the Anti-Müllerian hormone (AMH) is a better indicator of how my body will respond. Anything over 1.0 is considered OK, with somewhere around 2-3.5 being average for my age. Last blood draw, in April, mine was a freaking .31. Nine months before that it was 1.3, so it dropped like whoa. My doc said that can happen as a result of fertility medications, which…great. Nice catch-22. My ovaries are literally a perfect reflection of my personality, which is the type to throw out shit I might need later based on the self-assurance that I probably won’t need it, and half the time I’m kicking myself because I trashed an important document or something. See also: My nails, which I have bitten since before I can remember, and my eyebrows, which I over waxed/plucked in high school and are now mere shadows of their formerly bushy selves. Josh is even worse — he thinks I’m a pack rat, and I probably am compared to him. But the point is, if he had ovaries, he’d have NOR, which is Nonexistent Ovarian Reserve, which is something I made up. But alas, he’s a man, and his man reserve is fine because OF COURSE IT IS.

I’ve been taking this supplement called DHEA, which is a controversial thing in the medical field. My doctor gave me the OK to safely take it but warned me there haven’t been enough studies to back up its supposed benefits, which are that it could help elevate AMH and AFC. This, in theory, seems absolutely ridiculous because AMH and AFC are indicators of how many eggs you have left and women are born with all the eggs they will ever have, meaning you can’t magically start producing more like Yoshi. But I’ve heard stories from other women who beg to differ and whose egg quality and AFC/AMH numbers have been improved as a result of DHEA supplementation. There have been been some studies that report this, too — specifically for younger women with DOR, like me — such as this one, but I’ve also read it can be detrimental to women whose DHEA is not low to begin with. From everything I’ve read, I think we can assume mine isn’t great. ALSO…my AFC was always around 8-10 before this last ultrasound I had (my first since starting the DHEA, about three weeks prior), which tells me the DHEA might be up to something. Regardless, I’m taking it until my retrieval cycle and going to get my blood drawn again in December. So we’ll see.

Oddly, DOR doesn’t really affect pregnancy rates because you’re usually still ovulating fine. So even though I have this, I’m still a case of unexplained infertility.

Anyway, back to the soul-crushing IVF consultation, with a little aside. This was also a fun convo:

Me: I’m thinking May if we do a frozen transfer.

Doc: Why wait that long?

Me: I’m not trying to have a baby over the holidays, we already have way too many of those plus our anniversary.

Doc: Wow, I’ve never heard of a woman caring about timing before when it’s taken them this long to have a baby.

Me: First time for everything huh? HAHAHAHA. (< I did not say this but I should have, like GTFO I do what I want.)

I shit you not, he used the word “inappropriate” twice. TWICE. Not about this, but in general — and he meant it like “not the right course” more so than “Bitch, what are you on?” (I think). I’m probably the most annoying patient he has ever had but when I pay you $20,000-$25,000 after I’ve already paid you at least $10,000, you will take it. I have learned in the past two years not to apologize for asking questions or for pushing for a certain test or procedure, and I’m so thankful for that. I truly believe it has made all the difference in getting us closer to becoming parents.

So many tangents. I’m going to wrap this up and finish over the weekend with the thrilling conclusion about how I Josh and I decided to move forward and why. Surprisingly, it involves me letting go of some of the control, but it’s not blindly following exactly what the doctor says either — which is something my husband wishes we could do, but we cannot. Not for this much money and not when so many variables are at play.