Initial RE Consults
December 2017 - Consult with different RE
When I started thinking about trying for baby #3, I started to consider another RE. I have a few friends that used another RE and they absolutely loved him and say only great things about him. I thought, hey - let me give it a try. The RE had a LONG wait list. I got on the wait list almost right after I gave birth, just to get an appointment. I scheduled the appointment in July of 2017 to get a December 2017 consult. Things that were really cool about this RE:
- All paperwork was electronic. They gave me an iPad to fill out my new patient paperwork.
- The office is 15 minutes from my house!!! My old RE's offices are 30-40-and 60 minutes away.
- His prices can't be beat. He's a couple grand cheaper than my RE.
- The RE is really engaged and nice. I really liked him, very personable.
Well... a few things happened that brought me concern:
- I had my AMH blood work drawn. They were supposed to provide the results within 1 week. It took them one MONTH to get me the results. Additionally, they used a lab that wasn't covered by my insurance. I spoke to them prior to my blood work being drawn to make sure it was covered (ran into this issue before with my old RE when I switched insurance companies one year, not realizing the laboratory wasn't covered - post here - Sticker Shock). Receiving a almost $500 bill for ONE blood test - sucked. When I called the clinic, they refused to help me and said I had to contact the blood work company. Not helpful.
- I asked them to provide me an estimate of my out of pocket costs. They provided me a quote that did not include my insurance benefit of infertility treatments. I called and the billing lady said that's what the insurance company told her. I had to be very clear that my insurance coverage includes a lifetime max of fertility treatments. After some fuss (and a few weeks), she finally got me the quote. However, the quote was very "unclear." There was a lot of crap on the quote. I just wanted to know what the bottom line was.
- They required a nonrefundable $500 deposit to secure the cycle month. They required this after I had issues #1 and #2 - so I was very hesitant to give them any sort of money that I wouldn't be able to get back. Plus, I had some variables (like weaning) I had to consider and I wasn't sure I could commit to a set month.
After all that, I decided to schedule a consult with my old RE and see if I had a better experience. IVF is way too stressful and I think my old clinic totally spoiled me with how efficient and helpful they are!
February 2018 - Consult with old RE
Going to see my old RE was... refreshing. The office was organized, they were helpful, they were able to provide me quotes and a clear "this needs to happen in this order before starting" - which I felt was lacking at the other RE's office. Most importantly, my insurance/costs were quoted correctly. I decided at that point that I would do my next cycle with my old RE.
Weaning Delays = IVF Delays
The original plan was to do an IVF cycle in June or July 2018. Obviously, that didn't happen! I was supposed to wean my baby by his first birthday, which didn't really go as planned (blog entry coming on that soon). I couldn't start fertility supplements or fertility drugs while breastfeeding, for obvious reasons! So... IVF has been delayed.
The funny thing was, I didn't mind! I started to question if I should really go for baby #3. I ran into some health issues (blog entry coming on that soon) and it made me reconsider. I decided to tackle my health issues first before jumping back into IVF. I also considered the possibility of doing IUI's again vs. doing a new IVF cycle. But I didn't really want to get pregnant "now" - I want to wait until 2019 for a bigger age gap between my baby and potential baby #3. My fertility between next year vs. this year, would seriously decline... So, IVF it would be.
August 2018 - Consult #2 with Old RE
I had another consult with my RE just this week. I wanted to talk about 1) mini IVF and 2) timing. It's funny... In June, I wasn't sure if I wanted another baby. Then in July, I knew I for sure wanted a baby - so I really focused on weaning.
I wanted to talk to my RE about mini IVF because I think that the high dosage of meds just messes me up and maybe that's what resulted in my poor response. I don't know... but I wanted to talk it through. After we discussed it, we chose not to go that route. With my age, we want a higher number of eggs because I'm going to have a higher number of eggs that are not genetically normal.
Can I just say that meeting with my RE is like seeing an old friend! He remembers the names of my boys, he remembers personal conversations we had and specifics. I know he has a lot of patients, so it's very nice that he remembers me and my story. I showed him pictures of my boys. He's such a nice person.
Well... we aren't sure how I'm going to respond to IVF again. Considering that I did the same protocol twice. The first time led to a retrieval with 4 embryos and 1 pregnancy (my son) and one cycle was cancelled for low response. Also, my fertility is way down now vs. what it was back then.
Lab Work (so far):
AMH: 0.75
FSH: 10
I'm not really sure how many cycles I can afford this time... So, I'm not even going to think about that! TTC has so many variables. I'm hoping to be a little more relaxed this go-around and maybe have a little more luck this time too!
Things to think about and consider:
- What if I don't respond well, would I want to do an IUI?
- If I get less than 2 embryos, should I test them?
- If the embryos don't look good, would I defer to a fresh cycle?
The reason these things are important to consider is, that changes my IVF protocol and fertility testing. Since I'm technically not planning to transfer until June/July 2019, I don't have to do some of the other testing now (i.e. saline ultrasound, uterine lining biopsy, etc.). I haven't decided the best course of action... as doing a IUI or a fresh transfer would mean my youngest kids would be closer in age than what I want (if it's successful). However, would I totally waste the cycle and not do anything?
Lots to consider and decide!
The Plan
- Start CoQ10 and DHEA
- Continue taking prenatal vitamins
- Started on Provera to get AF coming (AF needs to start by 8/26 for a September retrieval)
- Call on Day #1 of my period to schedule Day 3 tests and baseline ultrasound
- Egg Retrieval would be the week of September 24
- Protocol: Microdose Flare - same as IVF #2 and IVF #3
- Freeze all and planning to do PGS testing
Yup - SEPTEMBER... like in a few weeks September! Eeek. It's what I wanted... as the other options were: October during Halloween week or December during my Little Guy's birthday week. But geez, talk about jumping right into a cycle! And to think - it'll be almost exactly 2 years from the FET that brought me my son.
My Thoughts
It's funny... even though I had to go through 11 cycles to get my son... I feel so optimistic and excited to move forward with adding to my family. I'm really hoping for a great response to this IVF cycle and that I'll have PGS normal embryos to work with... I'll write more on my feelings in a separate blog post.
But man... trying for baby #3 feels so "right" to me. It feels good. I have absolutely no doubts that this is the right decision.
Next Steps: Waiting for AF to arrive to scheduled day 3 blood tests and initial ultrasound.
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