Just wanted to say how enormously I have appreciated all of your kind words of support since last week! I was incapable of posting anything for several days after the last cycle ended, mainly because I was just so damn angry. I knew no matter what I set out to write, it would come out as venomous, bitter, nasty....
I have more perspective now. We're concentrating on what the right next move is. It is largely a question of finances, as it is for so many others dealing with infertility. I'm lucky enough to have some insurance coverage, but when it comes to the cost of IVF, it's a mere drop in the bucket.
I have not gone back for any kind of follow up with Dr. D. I know, logically, that the failure of the IUI was not his fault. But for some reason.....I just feel like I'm done with him. I called the Nurse's line at Dr. D's office on Thursday morning to tell them that there was no need for a beta on Sunday, as I was most definitively not pregnant. The nurse said something about not seeing anything written on my chart indicating what Dr. D would want me to do next - did I want to make an appointment for a consultation the following week? And I said, you know what - don't call me. I'll call you. Maybe.
I'm much more energized about meeting with the new doctor next week. I want to lay my whole history in front of him and find out what his perspective is. Does he think IVF is the right next option? Does he think there's any point in doing another IUI? Will he agree to start stimming me at the 150-200iu range? Or will I have to start back at those little drippy doses again, and stim for another 2 months? God forbid.
Even knowing how painful the OHSS is, and knowing that it is highly likely I'll end up right back there again.....I'm still eager to begin treatment again. Every day that goes by I feel like I'm losing precious time. I feel anxious not having a plan. As ridiculous as it was to take 65 consecutive days of shots, mostly without seeing the slightest hint of progress - at least I felt I was DOING something, taking action, following a plan every night at 10pm. There's something darkly comforting about the ritual of shooting up every night in the bathroom. I still catch myself watching the clock at night, counting down until it's time to 'do my shot.'
Ugh.
I guess right now we're concentrating on how the hell to come up with the money we'll need to continue. Weighing our financial options. If we go whole hog, and sign on for the Shared Risk plan, we'll get 6 tries - 6 fresh cycles plus any frozen cycles that come out of those, if we're lucky enough. But, we'll have to plunk down somewhere around $20K - $25K before we can begin.
If we opt to pay for one cycle at a time, we can use our remaining $7K of insurance money, and just pay the balance out of pocket - which would be somewhere around $5K, I think.
OR, we could continue with another IUI, which could be completely covered by our remaining insurance money.
In any and all events - we're all out of pocket for drugs. At my highest doses of Follistim and Menopur there at the end of the last cycle, I was at about a $1500 per week habit. That's going to add up awfully quickly.
So, if we're going to pay the same for drugs no matter which option we choose - I kind of feel like it would be smarter to do an IVF cycle. I would really hate to do 2 more unsuccessful IUI cycles, and then realize we spent $10K or more on drugs that we could have spent towards IVF.
The trick though, is that if we opt for the Shared Risk plan - which is appealing for many reasons, not the least of which is that it relieves some of the intense pressure for that first cycle to be successful - we'll have to leave $7K of insurance money sitting on the table. It's hard to walk away from that. (The rationale is that if you are doing "Shared" risk - you have to personally bear all of the risk on your end without any help from insurance money.)
And then of course, there's the gamble factor to consider: What if we pay as we go, pay $5K to supplement the rest of our insurance allotment, and we're successful. That's a bargain! What if we opt for Shared Risk, borrow against our house or something for the $25K, and then end up having a successful first cycle? That's NOT a bargain, and wouldn't we be so regretful that we didn't just pay out of pocket for one cycle to see if it would work? But what if we get to the end of the 6 tries (and frozen cycles) and we're still unsuccessful? How amazing is it that we could actually get that money back in order to use it for adoption fees?
Oh God, I don't know what the right answer is. I keep going over and over and over this in my mind, and R and I have had at least 4 conversations about it since Thursday. I just don't know what the right answer is? I'm trying to open myself up to feel what the right path is for us, but I'm still struggling to know just what it is that God means for us to do.
I still wonder if we should give up? Are we meant to adopt? Is that what this is all about? People always talk about "letting go, and letting God." I have never figured out how to do that, exactly. Being a control freak, it's a foreign concept. I'm trying to just get - quiet. Calm down and see what thoughts creep in when I open myself up. We'll see.....
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6 comments:
You have some tough decisions ahead of you! I've done the shared risk plan with my doctor, but it was only for three cycles, not six! Six cycles is a hellova lot of cycles and really raises the stakes! Not to give any more to think about on your plate, and I know this is also kind of negative, but you might also want to consider whether you really want to do six IVF cycles. I only say this because I know that after 3 cycles and three bouts of OHSS, I feel pretty burned out. Just worth checking to see what happens if you decide you want to stop in the middle of the process. Hopefully you'll never come to that.
After reading your post, I thought of a quote from a book I read several years ago("If You Meet the Buddha on the Road, Kill Him"): "A man, after all, is only a man. He stands somewhere between absolute freedom on one hand and helplessness on the other. All of his important decisions must be made on the basis of insufficient data. It is enough if a man accepts his freedom, takes his best shot, does what he can, faces the consequences of his acts and makes no excuses."
This quote has been on my fridge for over four years now. For me, it's a reminder not to confuse freedom (and the resulting responsibility) with blame and regret. No one should have to make the decisions you are facing-- it's simply not fair. It's not fair that you should be drained financially and emotionally for what seems to come so easily for others, but here you (and we!) are. Anyway, you have so many options, I just hope you won't get weighed down by trying too hard to pick the perfect one.
Also, at the risk of sounding like a marketing rep for IVM, I just wanted to mention it again as you are weighing your options. My understanding is that it requires markedly less meds, which would save you money (not to mention the main benefit-- avoiding OHSS). Ok-- hope all that didn't sound too preachy.
Wow. What a lot of decisions. Although I can't, of course, advise you in your decisions, it sounds like you've already made one decision already--to go ahead with at least one IVF. The fact that you're still eager to continue with treatments tells me you're not ready for adoption yet. I like your approach--to just stay quiet for a while, and see what jumps out at you. God WILL give you the answer.
I am dizzy from all of those choices. I don't know how you are handling the stress of it all. It is clear that you have mapped them out but would it also be helpful to come up with a list of pros and cons that include considerations beyond money (as in, time that it would take to get through 6 cycles, whether/when/how you should start exploring adoption alternatives while you continue with ART)? And then, like you said, try to sit with the options for a while.
Your decision to try a new RE is a great one....
Not sure how helpful any of my thoughts may be on this but I don't think that I could walk away from the insurance covered cycle. I think I would have to try that first before doing anything else.
And the questions regarding whether or not you are "meant" to adopt would be constant and drive me insane. The one thing you can be sure of is that you are meant to be parents given how loving and giving you are. Might it help to just focus on that for a while?
I am keeping you in my thoughts and hope that you find some peace in whatever you decide.
I'm sorry K. This all so frustrating. I just hope that you find your path.
Letting go and letting God doesn't mean giving up, it's just asking Him to give you strength to go on and asking Him to guide your way.
I remember when my husband and I went through all of these decisions. It was so hard and I really feel for you. We ended up doing the shared risk ourselves. Six tries for 20-25 grand sounds pretty good. Do you get money back if it doesn't work? We paid more like 15 grand but it was for only one fresh cycle and any frozens, but we would get 90% back if it didn't work. This didn't include the ICSI, consults, pre-cycle workup ect ..which added on about another 5 grand and of course no medications are included. It would have cost us more like 9 grand if we had paid out of pocket (not including meds). It's a lot of money and we actually took a 2nd loan out on our house (you can write off the money on your taxes that way). I needed the shared risk b/c I knew I couldn't cope with a BFN and the loss of a ton of money. 6 cycles is a lot and I would think your odds are very good with that many tries. Have you looked into your clinics success rates w/ IVF for your age group? Go to http://www.sart.org/ if not. I would go for it if you can come up w/ the funds and as long as you really believe in this doctor and clinic. I would make sure to compare all of the possible clinics you could go too and weigh all of your options. We thought we were going w/ one clinic until I met Dr. Z and had a wave of calm wash over me. This is also the doctor that Watson from My Dear Watson goes too and neither of us can believe how awesome he is. Compassionate and brilliant fertility doctors are out there...be choosy. Sorry for all of the assvice. I just hate that I wasted over a year w/ my first A-hole RE.
Also- I found that I was able to still submit some bills to insurance. There might be some testing that isn't included in the shared risk and that will eat up the leftover insurance infertility funds up pretty quickly.
I regret doing 6 IUI's w/ injectibles. What a waste of money and energy and tears. Also- think about looking into buying leftover medications ( on message boards) to save money. I've gone that route a few times. I shouldn't be saying that b/c it isn't exactly legal and you are taking some risk but you save a lot of money.
Hang in there- know that you don't have to make this decision today. Make a list of pros and cons. Look at your finances, decide what you can live with. I knew I had to try IVF...even though my first RE said it was a long shot. As I said what an A-hole!
I'm thinking of you and hope you come to peace with a chosen path.
-Faith
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