Moving right along.

So far, so good.  I went in for a baseline u/s on Monday (CD2) and learned that 1) my small endometrioma did not grow this month 2) I have no new cysts 3) I have 10-12 follicles.  So, all in all, it was good news and we were given the first green light.  It’s a little anti-climactic as this green light really just means 3 weeks of birth control before all the action starts-we are on an ‘overlap’ protocol (vs a f’lash’ protocol), which I believe references the overlap of the birth control trial with the beginning of the Lupron.  We start the rest of the meds on June 13th. Still, it’s the first step in the process and it means we’re. on. our. way.

The clinic actually mandates a little class for all IVF candidates and, while I was skeptical at first, M and I actually found it really helpful.  The clinic staff give a really thorough presentation of the process and all the medications, along with how to mix and administer the injections.  Everyone has their personal calendar as a reference and it was a nice forum for asking general questions and clarifying info, particularly about the meds.

The meds: Wow. I had a sense of what to expect (thanks to all of you) but I find myself still a little shocked every time I review the long list of crap that one must fill themselves with as part of this process. It’s a bit overwhelming. Not to mention the cost… Sadly, I did not qualify for the Compassionate Care program at the drug company which would have covered a lot of my meds.  M and I were just outside the income guidelines, which is especially frustrating because they only base it on last year’s tax returns. Not an accurate picture of our current situation. Argh. Still, the nurse coordinator at the clinic has been wonderful and continues to search out various coupons for free follistim cartridges and so on.  She also said the clinic will accept medication donations and that she would put an APB for any that came in. Every little bit helps, that’s for sure. She snuck in a reference to her lady partner this last visit which made me love her more (not that it should matter, of course).

Overall, I am hanging out in the positive zone. I spent the weekend at a cabin with friends and spent a full day soaking in hot springs and natural saunas and reading by the river.  M’s birthday party is this weekend and we will celebrate with lots of friends, rollercoasters, marscapone cake and karaoke.  I am Alice Domar’s book (shout out to you Boston IVFers) which is very very very hetero-focused but does have some helpful tools/reminders related to relaxation and mindfulness.

And now, I give you the muppets for this month’s inspiration and giggles…

‘Moving right along in search of good times and good news/

With good friends you can’t lose/

This could become a habit/

Opportunity knocks once, let’s reach out and grab it/

Together we’ll nab it…’ la, la, la, la, la!

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In the mean time…

If nothing else comes out of this journey, I have become incredibly proficient at whipping out baby gifts for the many, many, many babies in my life.  At the urging of a few of those giftees (especially the fabulous libberal  and ruby and rose), I have-rather self-consciously-made a little Etsy shop to hock my wares.  At times, I feel a little bit creepy that my shop consists of baby things when I am so, sorely, lacking a baby.  Also, I feel that the title, ‘lovely panoply,’ leaves me with options for when my crafting migrates in new directions (as it always does.)

Unsurprisingly, Etsy has a wee bit of learning curve so my shop is bit barebones at the moment.  I’m also working on rigging a lightbox of some sort so that I can get better pictures of my items at home. Still, I am proud of myself for managing to get it rolling at all. If you have the time and inclination, please check it out.  I’m very open to feedback about price, designs, etc.

SO, without further ado, I give you  lovely panoply

Warning… It’s a long one.

It’s not that anything has changed, per se, but I have spent the last few days gluing myself back together and am, tentatively, feeling less shattered.  Back out from under my covers, I was able to talk in depth with M, explore my options with OHSU and, finally, talk with my Dr at ORM (who I love).

What I learned is:

1) OHSU does have national shared risk programs for which I may very well be eligible. However, the price tags for the programs are exorbinant and, upon inspection, not a very good deal.  A friend directed me to this site: www.sart.org and I learned that ORM’s success rates are, literally, 20% higher than OHSU and ahead of many clinics in the country.  I researched further and found out that ORM’s embryology lab is advanced for the field, which is probably one of the reasons their rates are so high.  So, in essence, I could pay more and be insured for more cycles but also be much more likely to need them at OHSU.  While this doesn’t take away the financial stress, it does help instill me with further confidence in my clinic, which helps a lot.

2)  We had a long talk with my parents who have been very supportive and become very emotionally invested in this process with us.  They are not financially in a position to throw money away either but they are able to help a bit and want to do so.  I feel the same sickness about wasting their resources if this doesn’t work, but having a little cushion takes away my deep anxiety about depleting our entire safety net in the middle of a somewhat financially unstable part of our lives.

3) I had a long talk w/ Dr B who I trust a great deal and who always takes the time to talk with me very directly and explain things thoroughly.  She explained that AMH is an indicator of antral follicle count/ovarian reserve.  It is a fairly new measure in the field but they believe it is a strong predictor and so use it as part of their standard measure for the shared risk program (along with the typical other measures).  The range is from 0 to 2.5 (with 2.5 being a gazillion eggs).  For someone my age, 1 would be normal level and, while .73 is not great, it is good enough. My follicle count has been 10-12 which is fine. She reiterated that she thinks I have very good chances for success and acknowledged that the parameters for the program are ridiculously high. Okay, she didn’t say ridiculously (but I did) :).

4) I was reminded that, assuming we get enough eggs (which is a big IF), we could follow a fresh cycle with a FET which would be affordable.  So, there could potentially be 2 tries, not just one.

5) Long state of the union talk with M. We are both committed to moving forward and taking a leap of faith which is something that doesn’t come easily to either of us. I am deeply thankful that we have managed to stay connected and close through this process.  That feeling reassured me that we will continue to face this together, whatever comes, baby or no baby.

All this to say, we are holdingourbreathfingerscrossedeyessqueezedshut and leaping…

Bursting with PRIDE.

We just found out that M earned a graphic design scholarship from the PRIDE foundation!  There was an extensive and fairly competitive application and interview process so she is thrilled to have won.  While it is not a huge amount of money, it certainly helps and it’s a great honor.    I am so so so so proud of her and flooded with relief at having some good news for a change…  Today we celebrate!

Speaking too soon.

And, just like that, it all falls apart again.

The clinic nurse called me at the beginning of the work day today to tell me that I have one sub-par hormone level: AMH at .73 (instead of > 1).  This level automatically disqualifies me from their shared risk program; ‘Our Promise,’ it’s called.  She said she has seen many people with lower levels than that achieve pregnancy but that the insurance program has stringent requirements.  She said even if the level changed, I would still never qualify because I tested at this level once.  This means I must pay for treatment cycle by cycle plus, of course, meds, and all the rest. If it doesn’t work, then I’m out the 16K and out of options unless I can save up enough to try again someday. There will be little saving happening in the next 2 years as M finishes school so…

Enter sobbing. And deep anxiety.

So, the clinic thinks I am too big of a risk to insure but not so big a risk that I shouldn’t give them my entire savings on the grand hope that it works the first time. There’s a good chance it will work on the first try and, then again, a good chance that it won’t.

The universe allowed me one freaking day to feel hopeful.  One day. I swear, I am starting to think I was some kind of monster in a former life because what the f*ck??  I’m a good person. I’m loving to others. I work with the dying, for christsakes. CAN I PLEASE GET A BREAK?????

Back to a puffy tear-stained face.  Lucky for me, the weather is back to grey and raining so, at least, I can take comfort in a world that matches my mood.

UPDATED with ‘The Options’:

1) The other fertility clinic in town, OHSU, accepts 2 national shared-risk IVF programs.  I spoke with one of the programs that thought their company may not use AMH as a disqualifier if all the other levels are good (which they are).  I have to speak with a financial counselor  at OHSU on Monday who should be able to give me more info. Lots of Ifs but a sliver of hope.

2) Do it anyway.

3) Adopt (and start a whole new heartbreaking rollercoaster).

4) Accept that I may never be a parent and take a trip around the world instead.

You people are magic…

…because that cyst is GONE! Between all the powerful thoughts from all of you and all the acupuncture a girl could ever want, it never stood a chance.  Today’s mid-cycle ultrasound and mock transfer showed, collectively, a normal follicle count, a clear, straight cervical passage and no size change in the little endometrioma. Deep sigh. Keeping all of our fingers crossed that no other cysts appear, we are good to proceed as planned!

For those of you following along, the plan is this:

Baseline ultrasound on CD1 of next cycle (in about 2 1/2 weeks, end of May?)

2 weeks of BCP, followed by combo of BCP and IVF meds (extended BCP because of my endo)

Followed by retrieval and transfer at the very end of June assuming (a word I have come to dread) that all things progress as we hope.

I met with the financial counselor to discuss our options.  I am opting to apply for their ‘Insurance’ program which essentially means that we pay a higher overall ticket price but are covered for 3 fresh IVF and 3 FETs and, if nothing works, we get 70% of our money back. (Meds not included, of course).  Given my endo odds, it makes a lot more sense to me to try for this path.  My Dr thinks I will likely be accepted but, again, fingers crossed. The financial counselor bragged that their success rates are so high, that they have never had to refund a single patient. Seriously?! I guess that is 6 cycles so the odds are pretty high but STILL.  I am on to being excited, filled with a new rush of possibility and hope that, eventually, this is going to happen.

What’s more, we are at the brink of summer and our weeks are growing warmer and are increasingly filled with lovely distractions and celebrations.  We are planning a weekend away to a cabin in the mountains with friends in 2 weeks that will also involve hikes though old growth forest and soaking in natural hot spring pools.  These are the times when Oregon feels like heaven to me :). The week after that is M’s birthday and will be punctuated by a day at Oaks Park, a 100 year old amusement park (yes, the rides are updated) and lots of fun.  I will get to ride a rollercoaster other than my emotions! I am actually comforted that these are things I can fully enjoy because I am NOT pregnant.

Hooray for May!