Sometimes things fall into place.

While I had mixed feelings on taking a leave of absence this year from my teaching job, I also felt like I needed it. Part of my plan was to explore some of my other interests. I'm working at a store that sells paper and craft goods part time. It's really fun to be able to use some of my creative talents and see what others are doing. I also plan to volunteer at the local animal shelter. I attended my first orientation and will be having my first "training session" soon.

Something else I had considered was leaving the middle school to teach high school. I love eighth graders, but there are things about middle school that are wearing. I also was excited about possibly teaching higher level math.

Last week, I got a call from a friend who teaches high school. A teacher she works with who was pregnant with twins after fertility treatments tragically had her water break at 22 weeks. :( They were wondering if I could cover two of her classes each morning for a while.

I don't know this woman, but I am so, so sad for her. That is every expectant mother's worst nightmare, and especially for those of us who have gone through so much to get pregnant. But it is a great opportunity for me to "try out" the high school. Since it did happen, I am also sure it gives her the comfort of knowing she can stay home and heal while her "kids" are being taught by someone who knows what she's doing. (A lot of times in a situation like this, a sub is brought in who doesn't know the curriculum.)

So I've gone from having nothing to do to being pretty busy! I teach from 7:30-10am and then either come home or go to work at the store. Of course, that means I've come down with a cold and have been running low all week...

Drama from my cousin's upcoming wedding, in which I am a bridesmaid*, is adding to a bit of stress, but I'm confident that in the next few weeks things will settle down again and I'll be able to analyze how I feel about my various new experiences.

My next appointment with Dr. Z is 11/1. It was supposed to be this past Thursday, but was scheduled for 9:30, so when I agreed to teach at the high school I rescheduled. I'm expecting my period around 11/4 or 5... Ideally, if we're doing a frozen cycle next that will be enough time to get going for a November transfer.

Oh, and insurance update- it turns out I CAN go back on my insurance with school (even before this PT high school thing happened), and they even are allowing me to bypass COBRA since on a leave of absence I'm technically still employed by the school system. It will cost us around $7000 for the year to pay for my insurance, but ONE fresh IVF cycle for us costs $22,000 (I gathered all my bills and receipts from the last cycle and did the math) so it is definitely the best option.

I've been bad about posting, though as usual I often have posts in my head that I plan to write out and then don't. I'll definitely update after we see Dr. Z. Thanks for those of you who have stuck with me. :)

*On that note, I'm trying to choose shoes to wear with my floor length brown satin bridesmaid dress. I've fallen in love with a red pair of suede shoes. Red shoes have been okayed by the bride. Can one wear suede and satin together? Thoughts?

Vulnerability

When III and I were just barely engaged, we were on our way to the grocery store when I had a meltdown. I can't remember the specifics, but I do remember telling him "I just feel really vulnerable." He told me "Of course you are. So am I. That's what happens when you love someone."

It's one of things I don't like about being married. I feel vulnerable in so many ways. This insurance situation has brought that feeling to the forefront again. I had to rely on III to figure out some of this insurance stuff, which puts it out of my control. If we spend savings on our IVF, it makes me feel indebted to him, since it's because of his family that we have the money.

Another aspect of my vulnerability in being part of a couple has shown its face today. While III is away on a tactical assignment for his law enforcement work, which leaves me anxious for his safety, a friend of mine who lives far away is losing her husband to cancer. My heart is breaking into pieces for her and her children, but I can't ignore the pain that is brought out by my own fear of "that could happen to me!"

The mail came a good ten hours after III left today. In it, was an envelope addressed to me in III's handwriting. It was a card which on the outside said "love" and the inside said "I was born to love you."

And that's why we agree to be vulnerable and accept the chances of the pain that comes from tragedies like my friend's.

So hold your loved ones a little closer today, and please send a prayer out there for my friend, T, her husband, B and their two sweet babies.

Oh, the money!

The whole situation around this insurance stuff, I am mostly mad at myself. I am a super researcher- whenever I'm buying anything over $100, I go online to determine my best options. I can't believe I was so stupid as to not look into this further.

I cried and cried about it yesterday, but also felt a little guilty. I know so many infertile couples are much worse of than we are. a) We have had insurance for the last two years. b) We actually do have money in savings to pay for a fresh cycle if we needed to. But... it kills me. I'll have to have another post later this week on my relationship with money, because I know that's a big part of it.

So now I am trying to figure things out. It turns out, as some of you suggested, I can go back on my insurance from my job. I can even do it without CO.BRA since I am technically still employed by my school. I spoke to someone today to see how to do it, and it would cost just over $7000 for the year.

Now, if we do that, we will have to first do a frozen transfer with my one lone embryo... so we have to decide if that's what we want. But, researcher that I am, I wanted to see just how much money we are talking about.

I went through my old papers and made a few calls.... The breakdown from our last cycle:

Meds: $5445
IVF: $8300
ICSI: $2500
PGD: $5200
TOTAL: $22,945

We did have to pay $95 of the meds and $225 of the PGD, but STILL. That's a lot of fucking money. In fact, that was probably my take home from my salary my first year of teaching! Considering our savings, III told me yesterday "If someone told me I had to pay ten grand to have a baby three or four months sooner, at this point I'd totally do it." But, crunching the numbers, it's 20 grand and he might have also been saying that to make me feel better since I was laying on the bed crying into my pillow....

With six complete failures of cycles and two losses, we're impatient. Both of us hate the idea of having to try an FET with only one embryo because of the high chance of failure. But... ugh. I repeat: That's a lot of fucking money.

How about that state mandated infertility coverage! Or not...

We've been lucky throughout this whole shitty process to live in a state where insurance coverage is mandated.

Except when it's not.

When I took a leave from my job, III changed his insurance to a family plan so that I would be covered under it. I always knew I liked my insurance better than III's. There were far fewer co-payments and procedure fees, though my choice of doctors was slightly more limited. But it didn't seem to make sense to pay through CO.BRA to keep mine, especially since we're not 100% sure I'm going back to school. (Since we might move.)

Now it seems it might have actually been CHEAPER to stay on my own insurance, even if I had to pay the whole damn thing. Today I called the insurance company, only to be told that they cover 85% after we meet our deductible, except for ART like IVF, IUI, and ICSI.

For real???? Then what's the fucking point?

I was skeptical, though, because I know that we do live in a state where the coverage is mandated, so I called our clinic.

No dice. Because our insurance is through a federal company instead of a state company, we get no coverage.

I want to throw up. I'm so pissed at everyone right now. If I'm going to be 100% honest, I'm even pissed at III, because if he had just fucking called his insurance company this is likely info he could have gotten through them. Then I could have crunched the numbers to see if it made more sense to keep my insurance while on leave and pay for 100% of it then to switch to his, which has no IVF coverage. The PGD alone on our last cycle was $5200!!!! FUUUUUUUCK.

I really, really, really hate my life. I don't understand why NOTHING CAN BE FUCKING EASY for us!!!! NOTHING. I want to crawl into my bed, curl up in a ball, and never, ever, ever come out again.

Fuck fuck fuck fuck.

I need to update...

...and I will... but not tonight.

I do have a question though... not sure if anyone knows the answer. My googling has been in vain.

When dealing with infertility coverage (which I know many people have NONE of) is it better to have a PPO or an HMO? I officially took a leave from work, which means I need to change to III's insurance. He has a PPO, but we have the choice between the two. If you are NOT in a state that mandates infertility coverage (boooooo that we're moving from one that DOES to one that DOESN'T), is one more likely to cover some of the expenses than the other?

Any info anyone has would be super helpful!!!!

Apparently they prefer me crazy.

So things are almost sorted out with the insurance. Seriously, they seem to just want to drive me nuts with their red tape.

Last cycle, Dr. Z wanted us to do a fresh cycle since we had new info and would be using PGD. Big insurance company had other plans. Since they technically denied the fresh cycle, and even though we did a frozen cycle, they put all of my fertility medications on hold. Kind of dumb, since I still needed some meds for my frozen cycle. It is why they denied the endo.metrin last cycle, and we had to change to a form of progesterone that is used for other conditions as well- because then it's not flagged as a "fertility med".

So I'm just waiting for a call back from the rep I talked to, because there is apparently only one person who can take the hold off for me and she was, of course, not at her desk. I hope I hear from them soon, because I need the meds for Friday, so ideally they would get it in the mail today....

Breathing in, breathing out. ::iiiiin:: ::ooouuuut::.....

Goddamn it.

As I write this, please know that I know that we are extremely lucky that our insurance covers anything. That there are so many people who literally go bankrupt trying to have a baby. That there are people who have to stop trying to have a baby because they can no longer afford to do any more treatments.

That said, with insurance comes hoops. And they have us jumping through all of them.

We had to wait a year before we could have any infertility testing done.
We had to do two clomid cycles before we did injectables.
We had to do three IUIs before we did IVF.
We had to have a completely failed fertilization to be approved for ICSI.
We had to have a miscarriage and then additional testing to be approved for PGD.
We had to use all of our frozen embryos before we could do a fresh cycle, even though there was a very, very slim chance of it working (due to the PGD post-thaw).

As we approach the twenty ninth month since beginning trying to have a baby, I get a letter from our insurance company saying that we are approved for the IVF, the ICSI, and the PGD.

Today, I call the pharmacy to order the refill of my stim meds, and they call me back three hours later to tell me that, apparently, my insurance no longer covers any of them.

WHAT THE HELL??????????????

Of course, they called thirty five minutes after my insurance company's offices close, so there is nothing I can do about it until 8am tomorrow morning.

But riddle me this- what is the rationale behind paying for the procedures, but not the meds that will help insure that the procedures will be successful? Do they want me to do the IVF cycle WITHOUT the meds? (Yes, I know that probably they don't, they just don't want to be the ones to pay for them, but FUCK THEM.)

III's away all week and I'm stuck home dealing with this alone while I'm jacked up on Ap.ri.

I hate my life.

Update and apologies.

So I haven't gotten off to a great start, blogwise. I'm feeling a little... burned out? I feel like I'm just rehashing my pile of failures. Meanwhile, many, many women on my blogroll have recently become pregnant. So my first apology is that I've been absent from my blog, and my second is that I've been absent from yours. I want to be supportive, but I'm just in a place where I'm not sure I can read about so many others' successes.

As for my update- I talked to Dr. Z finally yesterday. (We had a "phone appt" at 2:45 but he didn't call until 3:30.) Let me start by saying that, while he didn't directly express this to me, Dr. Z is pissed. I could tell that he is not happy with with the Dr. my insurance company employs to consult on these decisions. He is not at all pleased that they are making us test and use the frozen embryos before we can attempt a new cycle. I think a big part of that comes from the fact that we've now been doing this for close to a year and a half and he feels bad about that...

Two things I am trying to keep in mind, though. 1) We are so lucky to have insurance cover this at all and 2) Dr. Z said that, regardless of the outcome of this cycle, it will definitely give us "genetic knowledge" of what the outcome of our previous cycle was in terms of how the inversion affected the embryos we have.

So, now to the nitty gritty.

Dr. Z will thaw all nine frozen embryos and each will have PGD. Any embryos that “survive” both the thaw and the biopsy will now be blastocysts. The hope is to transfer two blastocysts. If there are any additional blastocysts that survive and are high enough quality, those can be frozen too.

When he realized on what the insurance doc was insisting, Dr. Z a went back to look at other cases of PGD on frozen embryos at my clinic (I don't know if it was just for info or because he was trying to persuade the insurance company not to make us do it... my feeling is that it is the latter). He found 11 cases, and two of them resulted in pregnancy.

I asked if the gap between fresh PGD and frozen PGD cycles was greater than the gap between regular fresh IVF cycles and regular frozen IVF cycles (which, as we all know, already has a lower success rate for frozen) and he said definitely because there is already the possibility that thawed embryos won’t grow, and that the testing increases that chance.

So... It's a strange place to be in. I am certainly glad I won't be shooting up this cycle, and glad that we will be doing this immediately, where a fresh cycle takes so much longer. BUT... it doesn't seem like a very good shot. Kind of like the clomid cycle where we were away so we couldn't do an IUI but "tried" on our own. Ha.

Expecting CD1 around 1/13 (unless this cycle is not back to normal) and we'll go from there. If it's on time, I would expect the transfer to be around 1/30.

Good riddance...

...to 2009. What a shitty-ass year.

To recap?

• It started off with my beloved B-dog being diagnosed with lymphoma. I spent the next six months taking her to and from chemo treatments.
• I had a tough group of kids in my teaching job and an administrator who not only is ineffective, but often makes the teachers' jobs harder.
  
• After 3 failed IUIs , we had our first IVF attempt, only to find something was causing a failure to fertilize- 17 eggs, and none fertilized! They did a "rescue" that ended in a chemical pregnancy.
• In June, B came out of the remission she had been in.
• Labor Day weekend, my FIL had card.iac death and was revived with CPR. They put in a defibrillator.
• The third week in September, I had a miscarriage.
• That same week, we had to have B-dog put to sleep.
• My FIL ended up back in the hospital when his defibrillator went off multiple times in one night. He saw a specialist about the possibility of a transplant. (Though it was decided he's "not quite there" yet.)
  
• We found out that III has a chromosomal inversion which is contributing to our issues.
• Meanwhile, at least three of my friends are pregnant and due and spring/summer.

We flew to visit my in-laws over xmas and it was a really rough trip for me. While III's family is very nice, I don't really fit in with them. This is always an issue when we visit, but this time my reserves were really down and I just didn't have the energy or ability to deal well with it. On top of that, we spent four out of five days with friends and family who have young kids. It's the first time that I had a really hard time being around others' children.

2009 topped off in the baggage claim of the airport coming home on Wednesday. I had barely just turned my phone on when it rang. It was a nurse from the RE's office. Insurance will not let us do a fresh PGD cycle until we use all of our frozen embryos. So apparently, they are going to do PGD on the frozen ones. I don't know why they didn't give us this as an option before, or how that changes our chances of a pregnancy because Dr. Z was not in on Wednesday or Thursday. Hopefully I'll get to talk to him on Monday to get more details. There is an up side to this- no shots or ER this cycle, and if any of the embryos survive and are viable, we'll be able to cycle earlier... but it just feels like another complication in this whole overly complicated process.

So 2010? Bring it on. It has to be better than what '09 brought. (Please!!!)

The cost of IF.

Yesterday, I read about Megan's IF coverage being "maxed out". It got me thinking about my own. In the beginning, I didn't look too much into it because the idea of hitting our limit seemed so far off in the future. As we get further and further into this, especially after a "wasted" IVF last cycle, I figured I should check it out.

The insurance I'm currently on covers a maximum of 6 IVF cycles. This is based on medication, so it does not include FET. So we are at 2. It is a bit of a relief to know that we have those frozen embryos, so we have the possibility of some tries that don't use up our coverage... but I really, really want more than one baby, so chances are we will eventually have to do this again....

Money has always made me crazy. It is my #1 anxiety inducer. But to be perfectly honest... it shouldn't be anymore. III's family is pretty well off, and he had a good chunk of savings before we got married. If our insurance did max out, we would likely have the means to pay for the treatments.

(I'm cringing as I'm typing this. I know some of you probably hate me for it- I can't imagine what you are going through, struggling to scrape together money for treatments, or worse having to make the difficult decision to take a break or completely stop, solely based on financial issues.... keep reading, though... I address this more at the end...)

It also got me thinking about what happens when we finally do get pregnant. Right now, I have my insurance and III has his- a "family" plan is the same amount where there are two or ten of us, so since we both have insurance benefits with our job, we're currently separate. But once there's another of us, we'll likely get a family plan. The thing is... who's insurance??? I definitely have better insurance than III. BUT any maternity leave I take that is not covered by my contract (which is only six weeks) I will have to pay the whole premium for my insurance. I don't know how much time I'll want to take... so it seems to make sense to go with III's insurance, even though it doesn't cover as much stuff. (In general, not IF.)

I don't, however, know what his insurance allows for IF treatments. We live in one of the states that mandates insurance, so I know something would be covered, but don't know how much. Plus, is IF considered a pre-existing condition? So complicated.

I almost didn't create this post, because I feel like such a whiner considering how many of you ladies out there are dealing with IF that is not covered by insurance. So I did a little research... http://www.resolve.org/ is an organization that deals with infertility issues- there are suggestions and help on there for how to make ART "more affordable", but also there is information about how to contribute to the cause of getting IF coverage nationwide. There are currently two Family Building Acts out there- HR 697 and S 1258- that would require insurers to cover infertility treatment. You can find more information on them, and see how you, as a voter and citizen, can contribute here.