Fertility Update – IVF is Getting Real
By Alina Avery
Right before Thanksgiving, we met with our RE for a follow up appointment to discuss our test results and diagnosis and go over an IVF treatment plan.
We decided that based on our results, we would go straight to IVF. There are a couple of less expensive and less invasive (and less successful) treatments that we could have tried first, but given the length of time we’ve been trying and the fact that our insurance coverage is great, we’re pulling out the big guns and going for it.
We did opt against having PGS done, though. PGS, or preimplantation genetic screening, would mean that whatever embryos we were able to create would be biopsied and frozen. They’d check the biopsy for the correct number of chromosomes and select a “normal” frozen embryo to transfer. This helps to ensure a pregnancy results in a live birth and that the child is free of birth-defects, but most of these chromosomal issues have to do with the age of the parent and the tests aren’t 100% accurate. Since Matt and I are both relatively young, we decided it wasn’t worth the added expense (several thousand dollars not covered by insurance) or the time (several weeks waiting for the results). In the case that we have recurring transfer failures, we can do PGS on any remaining frozen embryos to see if the problem could be chromosomal.
All of our questions were answered, mostly around what we can expect, what the timeline will look like, and what our success rate looks like. Basically, once we get to the stage where we are transferring an embryo, we have a 50/50 shot at a successful pregnancy. Considering a couple in their 20s has a 20-25% chance of naturally getting pregnant each month, and that drops to 15-20% in their 30s, the odds seem pretty good.
After we decided on our course of treatment, I was given an IVF cycle calendar, which lists out how much of each medication to administer each day of the cycle, and we did a demo of each of the injections. I should have taken notes! There are two different ovarian stimulants, an “antagonist” to prevent actually ovulating the eggs I’m trying to grow before the clinic has a chance to retrieve them, a trigger that tells the eggs to mature when they are ready to be retrieved, and then post retrieval medication to get everything ready for the hopefully healthy, growing embryo to be transferred back into my body. I can do a more in depth run down on each of the medications in a future post.
Matt’s concern: is there anything he can do? To which the doctor told him: just show up. Oh, and I’ll need a ride home after the retrieval. He has been very supportive and reassuring throughout the whole process though, so I’m happy I’ll be able to rely on him to keep me grounded if the anxiety over everything gets out of hand.
We signed the consent forms outlining the IVF treatment and risks, and another awkward form regarding what to do with our embryos in case of death or divorce. It’s so hard to talk about your hypothetical embryos, which could become hypothetical children, in the hypothetical situation that you find yourselves no longer married. My one piece of advice for couples who are considering doing IVF is to discuss those things ahead of time because there is the potential for a very awkward conversation in the doctor’s office if you disagree.
I also signed an embryo storage agreement (another weird form to fill out — where will you keep your hypothetical frozen embryos and how much will you pay to keep them there?), paid the 10% co-insurance (around $730, not including medication), and we submitted everything to insurance for pre-authorization. We were told it takes about 2-4 weeks for insurance to authorize treatment, and then once that’s done the cycle is approved and the medication is called into the pharmacy. The pharmacy will then call us to schedule a delivery.
Our insurance authorization went through today, two weeks to the day since it was submitted, and our medication should be delivered this week. The nurse said not to freak out when a box I can fit in arrives on our doorstep. I’ll call the nursing line on the first day of my next period to schedule a baseline “suppression check” and likely start the medication that evening. I almost can’t believe this is all really happening. I’m trying to stay hopeful but realistic, in that there are still a thousand things that can go wrong, but at least we are making progress and maybe it will work.