Interesting!

A story in the UK Guardian caught my eye today. It reveals that fertility scientists are trying to increase the chance of a successful IVF procedure through more effective analysis of fertilized embryos.

Using mice in a case study, they found that “when a sperm entered an egg, the egg’s jelly-like innards would start to pulsate soon afterwards“. The team leader, Professor Magdalena Zernicka-Goetz of Cambridge University (natch!) said:

The pattern of those movements is predictive of whether the embryo will have successful developments throughout the entire pregnancy…I believe this method has very important potential medical applications, as it provides a totally non-invasive and rapid way of making this prediction of which embryo will have successful and which will not have successful pregnancy

In other words, they are hopefully onto a more effective way to identify ‘The Egg’. The professor adds that they’ll be trialling it at IVF clinics within months.

This sounds like exciting news to me. I mean, IVF will never be foolproof, and we must always be cautious about mere ‘theories’, but this really could be a significant step in increasing the odds of conception. And via pulsations, no less – it’s almost as though the baby were knocking on the door to say “Yoo hoo, I’m the one!”

You can read the full article here

What do you guys think?

The waiting room at my doctor’s office was like one of the worst experiences to deal with.

Seriously.

I will never forget it, not even a year and a half later.

You gals and guys know what I am talking about, don’t you?

The same faces every day (since the visits are often) and no one looks one another in the eye. Not ever. Once I got the nastiest look from a woman who was eyeballing my red clogs. I sensed she was thinking, “Gawd. Who does she think she is?” on the surface. But she REALLY was thinking was, “If SHE gets pregnant and I don’t? I will hate her forever. The bitchwiththeredclogs. Hate. HER.”

Exactly.

I suggest that a book should be in your handbag or knapsack at all times. Don’t bring a magazine. People will think you swiped it from the seating area.

Sometimes the wait will grate on your nerves because not only are you pressed for time or anxious to get things started but the stares and comparisons are uncomfortable. Raise your head, chin up and read your book. Read it well.

Really. It helps.

When your name is called, save the page and look past everyone else and smile. Think of a field of freesias and how pretty a bundle will look in your home, after the baby is born. A nice little treat for yourself. They prettiest scent in the world, too.

Walk past the nasties. Walk past the naysayers. Walk past the wall with the huge assemblage of baby photos sent in by grateful ex-patients…

…and you march in to the room where the stirrups have your name written on them.

No one else matters.

So. I am learning a little bit about IVF grants. I wish I had the insight to study up on it way back when. That would have been absolutely worth any of my effort.

Heck, I’d have run to across the country in my Asics if it meant an opportunity to be granted some financial relief.

My friend, who is now in her two-week waiting period (crossing my fingers and toes!) had gotten her IVF through an IVF grant. She and her husband were told they had just met the deadline and might not be eligible due to their annual combined income.

But? As luck turned out, they were awarded the IVF grant and were awarded a DECENT dream of a lifetime. I’ll say as much. Very, very decent.

I know that it was open to New York patients and along with financial eligibility, my buddy and her husband had to prove through previous testing and records that they had a chance to become pregnant through IVF. That not all hope was lost. And the grant money was going to be used towards the possibility of a future baby. I guess the powers that be don’t want to chance it with a couple who have deeper infertility issues and instead assist a couple who have a shot (no pun intended) at success.

Her RE’s office helped in the information and my guess is that the billing or financial department there sat with them and went over the logistics of applying. And they found out fairly quickly that the IVF grant was approved. A few weeks went by, if that.

That is one concern I’d have had. Waiting for an answer. Jeez, every month that goes by…ya know? Anyway, I was pleased as punch that they were informed so soon after they applied. And that, bonus…well, they got the bonus.

Anyway. I was just curious about grants. I wish the information was more forthcoming at EVERY RE’s office.

Do you think more couples would go for IVF if they knew they had a chance to attain a grant? Do all states have this opportunity? What happens if the IVF doesn’t work out – is the grant good for another go?

I am all sorts of curious.

The little baby is kicking my ribs as I type this so I sense she is curious, too.

So. Part Two. Life after IVF. Bridges crossed. Saying goodbye to a relationship with an RE. Dealing with some sad realities but feeling lucky for the future.

I wanted to tell SO many people I was pregnant. I was so afraid I would miscarry my surviving baby that I didn’t want to jinx a thing. A lot of women (and men) at even 12 weeks of pregnancy start painting a nursery or buying onesies. Me? I was cautious. Cautiously optimistic. So I did nothing but bide my time. I reckon a lot of IVF pregnancies have that commonality. Cautious optimism. You’ve gone THIS far with so many medical exams and treatments and tests just LEADING up to IVF, why take a chance with a jinx? Why not wait a little longer? After all, in my opinion, I waited so long and did so much to be an expectant mother. What was a little more time?

No one ever told me I’d experience patience. Yes, I wanted to burst and blurt it out. But I didn’t feel all that traditional. Parents who had a much easier time in conceiving may not feel that the world could ever harm their chances or their baby. Whereas people like us, those who had loss and disappointment and setbacks felt…cautious. Life after IVF should be joyous and believe me, it is. But there is always a sense of, “what if..” Whereas parents who have yet to go through a roller coaster of issues because pregnancy was seemingly easy might have a much stranger time digesting the, “what ifs.”

I say, “might” because my sister had a close friend who popped out babies like a pez dispenser. And all the while she was nervous and anxious about her particular, “what if…” moments. She had naturally conceived without medical assistance. So it really is an individual’s personality that plays in to the cautious reasoning. However, I do believe, in my heart that having gone through all the crap, molded my usual easy going take on things into a much more guarded person.

I hope I make sense. And that you don’t sense any blanket judgement.

Another thing I had not expected after IVF is the moment I donated my unused meds and syringes to a friend. I thought it would be a simple passing of the baton (I used to run track in high school.) But no. It was emotional for me. I remembered every step of my protocol and the first shot of Lupron I ever took. I grew sentimental. They say, in labor, a woman forgets the pain of her contractions and pushing. That because we are animals, pain is forgotten the second it leaves our body.

Truth? I can’t forget. I have an appreciation for it. I can’t believe it started with a simple shot in the abdomen and became a real, live person inside me. I remember the cold sensation of the alcohol swabs to the cramps I had after my transfer date. I remember the fear I had in taking my first shot to the relief I felt in taking my last shot. I remember it all. And so when I handed over my meds to my friend, I felt a rush of nostalgia, liberation, and gratitude. I FORGOT nothing.

Funny. People say that life is all about the baby now. It is. But it’s also about what got her to this place in my belly. I know I am one of the lucky ones. I am SO lucky. I will never forget it. I am who I am and she will be who she will be because of IVF. Because of what transpired before IVF, during IVF, and after IVF.

I was bullied a little bit in elementary school because I was shy. And because I was shy, I used to kick balls against my garage and jog distances most adults have trouble running even today. But during all of that shyness, I learned to love my endurance and my skills. And one day, I decided to play kick ball on the playground during recess. I KNEW I had skills. When it came time to kick (I was the last one up, of course) I kicked that ball so high and so far that it went over TWO fences and hit the school. From that day on? No one made fun of me. And I became the only girl captain on that playground.

I was ten years old but it made me the person I would become. I was shy for many more years but I had NO problem going for my goals. I just plugged and plugged away. Blinders on. Target ahead. And when I failed, I took it with sad stride. But I knew I had to find another way to reach my goal. I was never going to be the star of the musical or a famous gymnast. But I DID know what suited me best. And what I enjoyed the most.

I will never be Angelina Jolie in looks, talent, or baby making. But I CAN be me. And so here I am, life after IVF. My ball is kicked once again over two fences but only after the loneliness of loss and the affirmation that, I too, could be a great mom some day. I just needed a direction and some assistance.

So, life after IVF for me is not about diapers and “mommy and me” crap that bugged me even before my first RE appointment. It’s about remembrance. And yes, future diapers. And some day watching my daughter conquer HER fears on her own (with my looking secretly from that kitchen window.)

Ya’ know, not many people talk about life after IVF. What happens when the marching band packs it up? What happens after the airplane takes off in Casablanca? What’s the dealio?

I wish I knew some things before the reality hit me. I’ve had IVF, now what?

I was JUST thinking about this today. I was. I was reminiscing. 2 AM. One of those early morning life thoughts. We’ve all had them. Sometimes they occur in the shower. Sometimes in traffic. Sometimes after watching, THE BREAKFAST CLUB. Mine occurred at 2AM. It just hit.

Anyway. AS I WAS SAYING…

After my transfer date, and blood test, and thankfully and gratefully, a positive outcome, I was pregnant. Yippee! Life was just beginning.

For starters? I had NO idea, I’d still be seeing my RE, for weeks following the IVF. Every time I stepped in to his office, I was reminded that life was delicate inside me. That anything could change at any point in time. That I was being monitored. Nothing was guaranteed to grow in me.

As it turned it out? I lost a twin at week six. I know, it happens. Even my RE warned me that it might occur. And it did. NOTHING prepared me for that heartbreak which was EQUALLY replaced by the joy of one beating heart. The sound of my surviving daughter. So, there I was, legs spread on the table, being told one baby had not made it and seconds later, I heard the heart beat of the other. I cried but I didn’t know what for.

The four weeks following were hell. I was SO happy but would the surviving baby live?

So I did what I did during my IVF protocol and tried to relax. I visited friends, I read books, I turned my head during Pamper’s commercials. And I asked my late father to please send me some luck. I did.

I thought IVF was a toughie. Weeks after IVF was just as potent for me emotionally.

At ten weeks or pregnancy, I saw my RE again and everything seemed to be GREAT. Baby was growing and when I jumped off of the table with a smiling, red face (I broke out in tears of joy) I hugged him. He hugged back and said, “Good bye.” GOOD BYE?

So, yes. Another shocking reality after IVF – saying good bye to the doctor I had seen so VERY often for months. Our relationship was over. I was actually saddened.

I remember getting in to the elevator and studying the buttons of each floor and thinking, “This is it. You’re on your own, B.” It was a me against the world with a child in tow. And my magic shield was disengaged. I wasn’t fearful but I was nostalgic and well, it was because I felt in good hands with my RE. But his purpose was done. And he and I moved forward from multiple appointments and treatments to a one card a year relationship. I sent him the best Hannukah card ever.

This post is growing long and so many ideas are crossing my head. I want to discuss more events that happened to me post-IVF. I shall post part two tomorrow when my brain is cleared. And my thoughts are filled. So many moments in my time capsule. So many good and confusing moments. So many. So many things occurred on that bridge between IVF and full on pregnancy mode. It truly was a bridge.

On one side was a woman with disappointment and loss in her memories – JUST starting IVF. Needles and all. On the other side of that bridge, stands a woman who is almost 7 months along. In the middle of that bridge is that undefined moment between that transfer date and first bout of vomiting from morning sickness. The moment where turning my head from a Pamper’s commercial became shaking the actual Pamper’s box in the pharmacy and thinking, “Nicccceeeeee.”

There are some things in life that cost a ton of money:  a new home,  a new car,  a college education. Even a rare, pet bird.  But what about the cost of having a baby? Cha-ching. What about the cost of having a baby through in vitro fertilization (IVF)?  What about IVF cost? Cha-ching, cha-ching!

Ugh.  It doesn’t come cheaply, that is for certain.

Through my research and well, my personal experiences, pockets do get burned with a cycle of IVF.   The costs do average $12,000 but can cost as much as $20,000.  Some insurance policies cover most of of the IVF cost and there are supposedly IVF grants that also assist.  But for most couples, it is standard to pay an average of $12,000.  Ouch, right?

What goes in to the IVF cost?  Why is it SO costly?  IVF drugs are about $3000 – $4000 dollars and most insurance policies DO NOT cover the more expensive drugs in the IVF cycle.

Then there are the costs of genetic testing, ICSI (a procedure where a single sperm is injected in to the egg directly), embryo freezing,   the doctor visits and ultrasounds, blood work, the egg retrieval with a general anesthesia, and the embryoic transfer (once the egg and sperm are fertilized together and create blastocyst embryos.)  Among other expenses I can’t even fathom at the moment.

One way of saving some moolah is by asking your physician if he/she has any drug samples.  You might just have a free week of injectables just by asking this question.  Also, more unconventionally, it might not hurt to ask other couples who went through IVF if they have additional medicine they aren’t using any longer.

In my situation, I had SO much extra AND unopened medicine (not returnable.  Talk about a profit for the pharmaceutical companies, right?) that I donated to a couple who needed it.  Of course, this couple showed the meds to their doctor PRIOR to using and he approved some of it.  Some of it.  Why?  Not every couple uses the same IVF protocol and drugs as each woman is tailored to her program and vice versa.

SO PLEASE CONSULT YOUR PHYSICIAN FIRST. BEFORE USING SOMEONE ELSE’S UNOPENED DONATIONS.

And that goes for anyone posting on a forum on the computer.  A friendly donation through an internet friend is great but please be wary of who is helping you out.  It might not be worth the savings in money because health is wealth, right?

So, yes, speaking of wealth?  No IVF cycle will cause financial wealth for a couple.  But what you CAN do is inquire about those mystical grants I keep seeing through google searches, ask your physician for samples, and ask a friend if they have any meds to donate (with caution.) Those are my personal choices in cutting IVF costs.

And let’s face it,  having a successful cycle is well worth the money.  It’s priceless.  Unlike the diaper costs in months to come.  Or that first bicycle, right?

If we are facing in the right direction, all we have to do is keep on walking.  ~Buddhist Saying

The IVF procedure at work. Sorta.

My friend, K is considering IVF. She’s 41 years old and has been trying for a baby for at least four years now. After 6 unsuccessful IUI attempts, she’s decided that enough is enough.

This January she is going to start her protocol. I am thrilled for K. I sense things will work in her favor.

When she told me she was secretly terrified, I completely understood why. IVF is no over night fix. Nor is it simplistic. Truth is? There are appointments averaging 3x – 4x a week for monitoring and daily self – injections (usually in the stomach region and on a tush cheek.)

So what exactly IS an IVF procedure? What is in store for my friend, K?

In vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the womb, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.

I read the above on Wikipedia. (I LOVE Wikipedia, by the way.)

What this means is that some time, during the process of undergoing IVF, a woman will lay down on a table, and experience a procedure by her RE. Her developed eggs will be taken out carefully.

At the same time, the male partner is in another room, releasing his sperm for collection.

Once the eggs are taken out and the sperm is collected, they are mixed together and an Embryologist carefully monitors them. If all goes well, in 3 to 5 days, the couple is called back in to the RE’s office, with embryos ready, willing and able to be transfered back in to the woman. In the United States, four embryos are the limit per IVF protocol. Octomom was a very RARE occurrence…

After the transfer date, the waiting game begins. I was asked to return in 12 days for my blood test. Every day I waited, I wondered, “ARE WE?” All couples ask themselves that question. Trust me. If Fonzie was waiting the 12 days, he’d still be cool. But he’d be cool with sweaty palms and raised eyebrows.

And viola! Pregnant or not, the question is answered with that blood test. Nerve-racking, eh?

But not as nerve-racking as what happens BEFORE the retrieval of eggs or transfer of embryos. Needles. YES. Many needles.

Now, before I really scare anyone, please know, the needles are NOT that painful. The first injection is always the most nerve-racking. And after that? It’s just routine. I was told to take my injectable in the evening between 6p – 10p. But every patient will be told when to administer their meds by their RE’s office.

I started my protocol (after a month of birth control pills and five days in combination) with Lupron.

What does Lupron do? It overstimulates certain hormones in the body. and shuts down the production of hormones. Testosterone is greatly reduced. And premature ovulation is suppressed.

I am not a doctor, so I am explaining what I think I know. Let me just state that before continuing on.

Now, once I was on Lupron, I saw my RE every two days or so. I had a blood test and ultrasound EVERY time. And was later called by the nurses once the blood work was read that afternoon. My Lupron dosage was never changed to higher or lower and so I continued on it until told otherwise.

I forgot how many days passed but it seemed to be around a week when my RE decided I was ready for the next step – stimulation of my ovaries. Time to make some eggs.

Gonal-f, like Lupron, was an injectable and also was taken in the abdomen. Both had to be taken in the same window period so
I started with my Lupron and waited about twenty minutes. Then I took my Gonal-f.

My dosage of Gonal-f changed a few times, based on my blood work and ultrasounds (based on those RE appointments )

Okay, so now I was controlling my ovulation situation and making eggs. I had my nightly shots. I was on a roll.

I believe I did the Lupron and Gonal-f cocktail for one week or so before being called by my RE’s office. It seemed my blood worked showed I was doing well and was ready for the next step. Egg retrieval time!

So the nursing staff told me NO more Lupron and NO more Gonal-f. I was instructed to take ONE shot of something called Novarel. I had to take it at a very specific time because 36 hours later, my eggs were coming out.

Novarel was taken in my tush. This shot is commonly known as the trigger shot. It induces maturation in whatever eggs the woman has produced over the weeks and it loosens the eggs from the follicle walls, making for a successful retrieval. A VERY important shot to inject, right?

And after Novarel and prior to that, the Gonal-f and Lupron – I went out for a wonderful, Italian dinner. No wine. No cigars. No chances on that. Just some elegant pasta and a warm, chocolate dessert.

I suggest everyone do the same.

A reward comes in all forms – medals, trophies, and even those big checks endorsed by Ed McMahon. But no reward is sweeter than a relaxing moment after the injectables are disposed of and the retrieval is hours away.

And no, there is NOTHING odd in buying yourself flowers either.

I hope this helps my pal, K in understanding what IVF is going to be like. Every woman has her own protocol with own meds and own doses. No one woman is alike. But I am hoping my experience serves as some sort of example.

What were your experiences like? I am so curious to hear all about them. And if like my friend K, you are in the pre-IVF stage, I wish you all the best. And loads of warm, chocolate desserts.