IVF is not a contact sport

I’m having a difficult time writing this post, and I’m not sure why.  Today was retrieval day, and all went as well as could be.  We didn’t sleep through our appointment (in fact, DH was up at 2 and I was awake by 4, even though we didn’t have to be there until 6am).  DH kept me giggling through the two hours of prep, and my awesome, amazing doctor performed the retrieval.

The procedure itself was a bit weird, in that one moment I was being told “scoot down, scoot down further” and the next, I was back in the room I’d started in, awake and only slightly confused.  (And, honestly, the main point of my confusion was not that I remembered nothing, but the last thing I remembered was the gentleman who asked me my name & social security number was a FORMER STUDENT which freaked me out enough for me to repeat this like, six times to the nurse helping with my recovery.)

I also have perhaps the slightest cramps in the world, and mainly just after I switch positions.  I felt well enough to eat (honestly, for the first time in like a month I was actually hungry), and more than well enough to teach my 5PM class tonight. Which, I promise, I took it easy: DH drove me to campus, and I told my students that I’d just had outpatient surgery, and I was fine, but as I wasn’t to make any financial or legal decisions or operate machinery, it’d be best if the 15 of them took leadership roles during workshop, and I’d just sit in the circle and contribute when I could. And you know what? They did.

Also, it was amazing having the doctor we really like and trust perform the retrieval.  She has been wonderful through this entire process, which we really needed, and I found that I could be honest with her about a whole mess of stuff, like why our post-test results meeting with her was such a trainwreck on our end. She also knows exactly what to say to me: she’s called me young, petite, and she told me that I had superstar ovaries. And she gave me a hug for luck this morning, which meant a lot.

Finally, I know I’m not doing numbers, but they retrieved 17 eggs from me.  Seventeen!  So now it’s all hoping that beautiful little embryos grow from them.

In the meantime, I’m taking the evening off.  No grading.  No packing of any boxes. No answering frantic emails of any type. Just some bad TV, some vicadin, and some sleep.

So, the good news: awesome Josh at the pharmacy informed me that we have been approved, and then powered through my shipment, even though the person who was supposed to handle it was out sick. I got my new injectables mere hours before I was supposed to start them.

The not-so-good news: the shipment was missing three of my medications, the ones for pre- and post-transfer, and by the time I figured this out, it was after 7PM on Friday & the pharmacy was closed for the weekend.

So, new shots! Suddenly, Lupron feels like a baby-shot. Like training wheels for the bigger, longer, more complicated ones. I’m not loving the new ones yet — they hurt a little more, and the pre-mixing & pen clicking is a tiny bit complicated.

I also have 15 follicles, and part of me has no idea what that means, but I feel rather proud & happy about it.

And it’s been two weeks, and we still don’t have authorization for our pharmacy shipment. I’m trying to stay positive, and focused, and not totally freak out, but it’s kind of hard not to.

Lupron is OK; none of the loopy side effects, though it does make me feel rather warm (which, actually, is kind of perfect for this weather). I’m glad I’m doing this during the fall, and not during bathing suit season, as the bruises lined up and down my thighs are just so attractive, and the weather is cool enough that I just throw open the window after my morning shot.

The best part about this week: I’m off the pill. Woo!

My DH is terrified of needles — hates ’em. He dreaded that blood test we needed before our wedding more than anything; the same thing happened when he had to have the infectious diseases blood test before we began IVF.

Me, on the other hand, I don’t really care about the needle itself. It’s the measuring and the syringes and the lack of bubbles and the clean surfaces and the pinching the right place that had me all freaked out.

But my first morning of Lupron injections is over, leaving behind only a light ache in my thigh, and DH slumbers on, far removed from any needle madness.

(Oh, and we still don’t have our Pharmacy order. I’m still dealing with my insurance company issues, and the only reason I have Lupron is because our clinic was kick-awesome enough to lend it to me. Here is hoping that today, the authorization goddesses smile on me, and my order is shipped.)

Got a call from my Pharmacy saying my insurance has been denied. We have a bit of a tricky situation – we don’t have RX insurance, but our medical benefits fully cover IVF, including all medicines and injectables. Problem is, none of the pharmacies I’ve spoken to can bill for medical benefits, only prescriptions.

Clinic’s never heard of this before. Health plan has gone above & beyond, but I still haven’t gotten anywhere yet. I have to wait until 9AM for more pharmacies to open.

In the meantime, I keep repeating: This will not stop us. This will still happen. We will figure this out, and by this time next week, I’ll be shooting my butt up with Lupron, on schedule.

If you’ve stumbled upon this post because you want to know more about the technical definition of an HSG, I’m sorry, you won’t find it here (hell, I can’t even spell the actual procedure — or say it! — which made for a fun phone conversation with my insurance company). Rather, I’m about to detail my own experiences with this essential step in the fertility process, and why for me the HSG was such a positive thing, which I’ve gathered makes me kind of a freak.

Anyway, me & the HSG. Our history dates back to February 2008, when I spent the weekend in NYC with my three amazing girlfriends, all of whom were recent moms/pregnant at the time & all of whom didn’t get the instant results of two pink lines or whatever it is that all those fertile types say happens the minute you stop using birth control (or, my new favorite, the minute you relax). I was introduced to a lot that weekend, but the main thing that stuck with me was the idea that an HSG was a gatekeeper between me and sportsbaby.

For the next year and a half, I was repeatedly thwarted by my insurance company in my attempts to do anything fertility related, including obtaining an HSG – and not to mention my own inability to deal with the issue (see my Why I’m Here post for more on that). Through that all, the HSG became a symbol of what I wanted, and what I couldn’t get on my own.

Once we switched to our new, happy, bright insurance company in July 2009, I asked my new OB/GYN about the HSG, and she told me it’d be part of our fertility markup with Shady Grove, the clinic we’d been referred to. Finally, I was getting somewhere. I hit a small hiccup when it came time to schedule my HSG – Shady Grove was booked for my cycle, and I’d have to find a different radiology center. Fortunately, when I got my first mammogram (incidentally, MUCH more painful and awful than the HSG for me) the week before, I’d asked if they did HSGs, and the answer was yes.

On the morning my HSG, I was a little nervous for the procedure itself. I’d begun taking the doxycycline the night before to prevent potential infections, and it made me queasy. I’d been advised to pop an Advil that morning, but all we had in our house was Aleve. I couldn’t reach my nurse at Shady Grove to find out if Aleve was an accurate substitute (it was), so I ended up digging out a bottle of ibuprofen that expired in 1998.

We reached the radiology center about 20 minutes early, and I sent my DH to his mom’s house to run an errand, assuring him I was OK on my own, as long as he was back in time to drive me home.  In the room itself, I had a chatty technician who helped me prepare. She asked me if I were nervous, and I told her that I wasn’t: I was looking forward to being a mom, and I believed this would help me achieve that goal.

Unfortunately, my candid nature made her comfortable, and she began to open up about her experiences with motherhood, including a truly awful and graphic story about delivering her daughter 18 years ago that ended badly for her own internal organs. She got a look on her face that said, “Oh, crap, maybe I shouldn’t be telling this to a woman who is about to have a camera shoved up into her uterus right now.”

The HSG itself basically involved me lying naked from the waist down on a table, and for me at least, it wasn’t any more painful than a typical pap smear — and it was over just as quickly. Unlike a pap smear, however, I got to look at a computer screen of my ovaries and my uterus, and it was really so very cool. They looked good! Not that I had anything to compare them with, but according to the doctor, everything was normal and there were no visible problems, and I got really excited, because this was the future first home for sportsbaby, and it was ready. Perfect even.

“That’s it?” I said to the doctor when she told me she was done.

“All that worry for that,” she joked.

“Actually, I wasn’t worried. I wanted this,” I told her. “I was excited for my HSG.”

“I’ve been doing this twenty years, and you are the first person to ever say that to me,” she replied.

I tried to explain to her the baby/gatekeeper thing, but she kept shaking her head. It’s a little more than that, too, I realized. When I moved to DC in 2003, I reconnected with my childhood best friend, who was attending med school. During those four years, she got me caught up in her excitement concerning all the cool functions of the human body she was learning about. Now she’s a resident in NYC, and I tried to text her my experiences, but I’m pretty sure those 500 character limits didn’t convey my gratitude for her informal tutorials.

When I was done, DH was waiting in the lobby, and I showed him the CD the technician had made of the images the camera had taken. I left a crazy voicemail message on my mom’s work phone squealing about seeing my insides (she, of course, listened to it on speaker with her boss in her office), and told DH how much fun it was, and how I had no cramping (those ancient Advils must have still worked). Even better, my MIL had sent $20 for him to take me to Starbucks to comfort me after my procedure.

Knowledge that sportsbaby’s home was ready, and a caramel macchiato? How could it have not been a good thing?

Dear (Sportsgirl):

We have received authorization from your insurance company for 3 cycles of IVF AH  ICSI.

Love,

Shady Grove Fertility

***

WOO HOO! And I paraphrase, of course. They put an errant apostrophe in “cycles,” which is really high up there on my grammar pet peeves list (ask my students), but I’ll make an exception in this case & forgive them, because it is such good, happy news. The best news since last Friday, when I learned that my 100% IVF coverage means full coverage for my pharmacy needs, when I’d been going on the assumption since August that we’d be paying for that portion out of pocket.

Also, I should mention that one of my IVF Goddess Friends, when I told her I actually loved my HSG, said, “You better be blogging about this.”

I’m not a numbers girl.

I used to be — I loved math in elementary school, and adored the way my dad would talk numbers, whether it was teaching us about Gogol or how to count to 100 using two hands, and I once turned a crush into a boyfriend by tutoring him in Geometry.  And now that I think more about, I am a numbers girl in some circumstances — when it comes to sports, especially baseball, I appreciate the numbers, though in most cases, I think they are useless without the intangibles, without the real men attached.

Anyway. In this context, this bizarre, strange, off-putting world of IVF I’m now swimming in, I’m not a numbers girl.

A year ago, I made a choice. I’d begun wading into the fertility pool, and the water was not right:  every phone call with my then-insurance company about the topic made me cry; every talk with my friends who were recent moms made me feel inadequately prepared for motherhood; every conversation with IVF survivors convinced me I wasn’t worthy to go through what they’d endured. At the same time, an agent showed interest in my novel, and I giddily signed a contract, ready to put that baby of mine out into the world.

I had a choice: I could focus on the book, or I could focus on my fertility. I chose the book.

Over the summer, it became clear that the book thing was not working, at least the way we were approaching it. The economy sucked (perhaps you heard?), and no publishers were into buying this new, untested voice. My agent decided he didn’t want to be an agent anymore, and left publishing. My DH lost his job, and our health insurance.

The two, unrelated on the surface, became essentially connected.

When I began studying the different health insurance policies offered by one of my (many) part-time jobs, I immediately spotted my new favorite phrase:  “IVF, 100% coverage.” Jeff the agent cut his ties with me, I lost my novel’s champion, but as that dream slipped to the backburner, a new one came forward.

This year’s choice: I had enough time & energy (see: unemployed DH, several jobs) to devote to one of two things done correctly — fertility or book. This time, I chose fertility.

I am admitting this right now: numbers terrify me. I’ve read a lot of them — success rates, follicle sizes, eggs produced, sperm counts, mgs & ius — and I’ve processed them, I promise you. But I’m not going to talk about them here. I promise you that, too.

I’m a words girl. Even if my novel isn’t going to sell today, this month, next year, I believe that it will –someday. When I have the time & effort to find a new agent, or revise, or whatever it is I need to do.

But now, it’s not the book’s turn. It’s sportsbaby’s.

So here, I’ll chronicle my experiences with IVF (& maybe some of DH’s), for people who find comfort in words, too.