Down in a hole...

I've heard some of you describe it that way, when you've received bad news about another failed cycle, or a canceled course of treatment, or some other setback on this journey. That is a perfect description of how I feel today. Let me endeavor to bring you up to speed:

Last week I ordered another batch of drugs, and when it arrived on my doorstep the invoice indicated my credit card had been charged for more than $700, instead of the $50 co-pay I had expected. Further investigation revealed that I had exceeded the calendar year limit imposed on infertility prescription drug coverage by my insurance provider. I quickly calculated that regular out-of-pocket costs for my current consumption of Follistim and Menopur would cost me almost $1300 per week. That's expensive even for someone with normal functioning ovaries, who might be on the drugs for a week or maybe two. For someone who's now been taking daily injections for 60+ days, it's a bloody fortune, and a luxury I knew I couldn't afford to keep up.

So, I despaired and cried and screamed and generally felt, by turns, immensely sorry for myself, royally pissed off at my insurance company for hiding this calendar year limit in the fine print, outraged with my ovaries for their stupefying laziness, and then sorry for myself again, around and around we go, etc.

I made an appointment for this morning to meet with my RE. I wanted to impress upon him that if my husband and I were going to have to borrow money to finance our treatment, that I wanted to be sure it was the most aggressive form of treatment, the wisest use of our precious funds. I wanted, in my innocence, to announce that I was ready to move on to IVF, please, and don't spare the horses.

In the comfortable leather chair of my RE's office, after delivering the above rehearsed speech, I took a breath, and braced myself for what I thought would be a lecture on the fickle nature of polycystic ovaries. I was expecting admonishments from Dr. D that just as he could not predict how quickly I'd respond to IUI doses of gonadotropins, neither could be predict my response in an IVF protocol, and that I could expect to spend just as much money on drugs in this next, and final, level of treatment. That we could convert this long and laborious IUI cycle to an IVF cycle, but that even with larger doses of drugs, we couldn't expect my ovaries to respond overnight, and that I'd have to continue to be patient.

What I got instead left me breathless, and savagely biting the inside of my bottom lip to keep from breaking down in front of my RE: "K, I'm sorry to have to tell you this, but I really think it might be time for you and R to start considering adoption."

Basically, he thinks that I have unresponsive ovaries. He said he had seen a handful of cases of ovaries as resistant as mine in his 27 years in reproductive endocrinology, but they have been few and far between. Based on past experience, he would be willing to continue attempting ovulation induction with gonadotropin therapy, but he doesn't really have a lot of hope that it will work. It should have worked already, and the longer it doesn't work, the more bleak the probability of eventual success.

Dr. D said that for what it was worth, before I made this appointment, he hadn't been ready to quit just yet. If money weren't an issue, he'd have recommended continuing for at least another 2 or 3 weeks before throwing in the towel - but, it's now up to me and R to decide. We agreed that I'd continue at least until the drugs I've already purchased are depleted. That gives me about another week. At that point, R and I will have to decide whether to spend another $1400 for one more week....or quit.

Needless to say, I have been a complete wreck today. I came home after my appointment this morning, opting to work from home rather than drag my swollen and bloodshot self into my office. There's not a tear left in me right now. Neither is there the energy required to go into all of the labyrinthine thought trails I've been down today in my head - and with my husband - about adoption, mourning the loss of a biological child, the wisdom (and fortitude) to seek a second opinion, etc. etc. etc.

I'll be back tomorrow to get all of that out, and perhaps more. Right now, I feel like I've been run over by a truck. I'm sadder and more devoid of hope than I can ever recall feeling since my father died when I was 17 years old. So, I'm going to bed.