Ready. Set. IVF

I've been debating whether or not to start publicly writing about our experience trudging through infertility these last few months. My two biggest hesitations being the taboo around bedroom talk (because we all know how glamorous assisted reproduction is 😜 ) and also the possibility we would conceive quickly.

Well, here we are. I'm neither pregnant nor shy about discussing our infertility.

So, how did we get here? Matt and I have been trying to add to our family for two years, August marked two years of no success. As most of you know, Scarlett was the result of all the stars aligning mixed with a little bit of inebriation. Infertility runs in my family down my maternal line, I always thought that I would possibly need reproductive help, and Scarlett proved that wrong. I assumed that when we planned to have another child it would be as simple as having a night out in Chicago with Lindsay and Andrew. But alas, one of my biggest fears slowly became a reality.

One in eight couples struggle with the inability to conceive. I am officially part of that statistic (and part of an incredible sisterhood as a result). In the last 3 months Matt and I have done extensive testing. Including, but not limited to; blood analysis, diagnostic US, egg/sperm quality checks, hormone levels and blasting of fallopian tubes, but I digress. Everything came back......NORMAL! Not just normal, I have the egg quality of a 20 year old and a reserve to match. The only abnormality to be noted is the teratoma (a collection of totipotent cells that go haywire and make things such a teeth, hair and etc) on my left ovary that has been monitored since I was pregnant with the Bug. The ovary itself is still functioning, but not as efficiently as my right. However, this shouldn't cause any of our issues.

All of this is great news, because of our lack of obvious issues we are labeled "Unexplained Secondary Infertility". Essentially this means we were able to get pregnant (1st shot, holla!) without any issues, have not been able to conceive in over one year and have no structural, hormonal, male or female factors that would explain infertility. While all of this is fine and dandy, the biggest hurdle is that there is something wrong because we can't get pregnant, but no obvious reason for it. This makes it difficulty to treat. Because if it ain't broke, don't fix it.

I am the patient of Dr. Jacobs who practices out of Fertility Centers of Illinois. He is one of the most notable reproductive endocrinologists in Illinois and has been practicing longer than I have been alive...which he has reminded me. Not only are his credentials impressive, he is truly a wonderful man. I couldn't have asked to be under the care of someone better. How I came to find him is a story I took to be a sign from the ER higher powers. I was caring for a patient in the ER who was around my age and we started talking about her struggle with secondary infertility. I brought up our own struggle (this was early in the year before we decided to seek treatment) and my hesitation, she told me about Dr. Jacobs and her own success conceiving her daughter with the assistance of his clinic. She told me FCI had a family feel, not just the MD, but the nurses, phlebotomists, US technicians, financial and office staff and how they were an integral part of the team. She told me how Dr. Jacobs went the extra mile and was always available via email at any time.

I was sold.

Matt and I talked for A LONG TIME before we decided we needed help. We have literally tried everything, I'm talking Western, Eastern and even holistic remedies. We tried to relax (I swear to baby Jesus if one more person tells me to relax I will hit them). We took trips. I changed my diet. A whole lot of nothing was the result. I was very adamant that we would be married before seeking professional help, and when that became blatantly obvious last December we had to make a decision. We planned and got hitched in the span of three and a half months. A lot of people assumed we were pregnant and thus getting married quickly...because you know, we did that the first time around....that was not the case, but rather because it was something essential before we sought assistance to expand our crew.

We waited a couple months after we got married, thinking that maybe since all was right in the eyes of God we would finally get pregnant. No dice. I consider myself lucky. In the two years we have been trying we have had no miscarriages, I simply cannot get pregnant. And while this in itself is difficult, it is way easier then having to handle the loss of a pregnancy.

We officially started our journey using reproductive assistance in June. I naively thought this would be a simple and quick process. False. Oh so false. It was a month of testing before we could begin treatment in July (and a lot of frustrated tears). Dr. Jacobs allowed us to be as conservative or as aggressive as we wanted, especially given the normal testing and 2 years without conception. Matt and I talked long and hard on how we wanted to proceed. Unlike women who have issues such as polycystic ovarian syndrome (PCOS) we knew I was ovulating monthly and had blood work and US to prove it. With the guidance of Dr. Jacobs we decided to do Femara and Inter Uterine Insemination.

Femara: A breast cancer treatment drug that inhibits estrogen and increases progesterone. Side effect is increased stimulation of the ovary with more than one follicle and totally not FDA approved for fertility use, but damn good at making babies.

Inter Uterine Insemination (IUI): Sperm separated, cleaned, wined and dined before being transported in a syringe attached to a catheter that is then fed through the cervix and launched into the uterus where they hopefully find the egg in the fallopian tube. (Your classic turkey baster baby)

Femara is supposedly great, it has less side effects than clomid (the other baby making drug) and has less problems with the development of cysts in the uterus and issues with endometrial lining. While the medication worked effectively for me, I also was insanely sick. Like couldn't be far from a bathroom, thought my intestines were going to exit my orifices, kinda sick. This went on for a week while I also had to be a mom, a nurse and an overall functioning human being. 

I was cautiously optimistic about the IUI. I really was. I honestly thought because we are young and healthy, that if we increased both egg and sperm we would absolutely have success. We had two rounds of IUI, in July and in August. Six days ago I found out that my second round of IUI was unsuccessful.

When we initially came up with our "protocol" with Dr. Jacobs we opted to go three rounds with medication and IUI before we considered IVF. My poor, wonderful, and tolerant husband was the one who put his foot down. Like I mentioned, I was sick. Real sick. And anyone who knows me knows I am the worst sick person ever. I straight up can't even. And while I can't even, I complain about WHY I can't even. Bottom line, I was the essence of misery and Matt picked up the slack, while that was tough what was harder for him was that he had to watch me go through medication induced disembowelment and not be able to do anything. That's hard for a guy like my husband. He's a fixer and there was no fixing with me.

We opted not to do a third round of IUI. Fun fact, IUI only has a 10% success rate. We were a part of the 90%. For Matty the success rate was not great enough for the suffering. And while I do agree, I whole heartedly wanted this to work.

So here we are friends. Six days ago my blood work came back "not pregnant". We stopped our IUI protocol. A week ago, while in Rockford for trauma specialist certification and in my car, I consulted with Dr. Jacobs. We talked about the pros of cons of IUI (OMG I forgot my ER trip for my ruptured hemorrhagic cyst...but that happened too and was so not fun) and how the cons outweigh the benefits in our case. We made the solid decision to move forward with IVF.

So what is IVF?

This is the "test tube baby" as it was marketed back-in-the-day. Like late 1970's early 1980's, back-in-the-day. Essentially what IVF is is that the woman's ovaries are hyper-stimulated to produce a ton of a eggs (in my case we're shooting for 15-20) instead of the one it normally does during the menstrual cycle. They surgically go in and collect the eggs by going through the uterine wall and into the follicles and "sucking out" the fluid which includes the eggs. These eggs are then separated from the fluid by an embryologist and are then placed in a medium with the man's sperm to be "organically" fertilized. They are then allowed to divide for 4-6 days before they are either placed back in the woman's uterus or frozen for future use.

The explanation of this is pretty simple, but it is actually pretty labor intensive for the woman. In that case, me. It means a lot of balancing hormones, medications, injections, blood work, ultrasounds, minor surgery, lifting restrictions and even more weight gain. This all happens in the span of 6-8 weeks.

Today I got clearance from my insurance company that we are APPROVED financially for IVF. IVF is hella expensive, I'm talking 10-20k per round of IVF. Due to Matt not putting me on his insurance like he was supposed to after being married for 30 days (another reason we got married when we did, his insurance is better than mine) it lapsed. I panicked. My insurance sucks and I pay out the wazoo for my coverage. I called them in a panic when we decided we needed fertility assistance literally in tears over what this would cost. I was given the greatest surprise, and my word does God work in mysterious ways, fertility treatments are 100% covered by my insurance once I hit my deductible. While this may seem trivial, this is nearly unheard of in the fertility world. Although my insurance sucks in every other way, they fully cover fertility treatments 👏.

So this brings me to today. 

While in Rockford for my class I had to call and make my IVF nurse consultation. When I called to make our appointment I was denied based on my lack of insurance verification. When I was transferred to my financial department where I was told they had an issue with my insurance and had to make some calls, but my deductible is high and I may be denied for coverage. I panicked. For the last nearly 4 months I have been told I had the creme de la creme of insurance for fertility, and suddenly that was taken away. The realization that we may have to put down the equivalent of a down payment for a house to have a baby was like a ton of bricks. How the hell does anyone do IVF, I mean seriously?

But I got the greatest news possible. The total cost for our IVF treatments this year based on my deductible?

THREE HUNDRED AND TWENTY FIVE DOLLARS.

I lost it. I was trying to figure out how many more hours a week I would need to work, how we would take from our savings, what we would need to give up or sell to make our dream a reality. I feel like a 20lb weight has been lifted off my chest. We can go forward with IVF.

We have an appointment this Monday with our nurse, Matt is coming to this appointment too. I've been given my prescriptions for the injectable, dermal and oral medications I will need for the egg retrieval, and we are all set for ago. Friday I go in for my monthly baseline US and blood work. As long as the is normal I will start birth control. Contraindicated, right? Wrong. It allows the ovaries to shut down for two weeks, which they need after all that stimulation with IUI. After the two weeks I will begin my 1.5-3 week stimulation of my ovaries. This includes injected and dermal medications several times a day. It requires close monitoring by Dr. Jacobs while they grow and mature my follicles. When they reach the right size I will inject with a medication to halt everything. 36 hours after that injection I will go under sedation for the retrieval and then fertilization. If all goes well we will have embryos frozen for a transfer come November.

This is the hard part. The most current research shows more successful pregnancies with frozen embryo transfer (FET). The reason for this is that after the retrieval my hormones will be all wonky, asking my body to be ready for an embryo 6 days after all of this stimulation is hard. There has been greater success with allowing the body to rest and preparing for transfer the following month. While this is insanely hard for me (c'mon the little baby is right there!) I trust Dr. Jacobs 100%, I mean he's been doing this longer than I've been alive. We are also doing only 1 embryo, the reason for this is simple. Matt and I are young and healthy, we have had a successful pregnancy resulting in a healthy beeb. My chances for a successful transfer and pregnancy is 60%, which is great in the fertility world!

So there we are, friends. A lot going on here. But Matty, Scarlett and I are gearing up for IVF, a challenge we are accepting headlong and with a lot of love...and some science.