Just let me wallow…

Last night I had dinner with my newlywed sister Leah.  She and her husband are about to embark on 6 months of world travelling (so cool!).  She casually mentioned by the time they come home she “could be pregnant” since she’s not on birth control.

It’s everyone, you know?  First your co-workers and mutual friends, then your BEST friends and even your family, everyone around you has a baby.  I’m the LAST one. When Ryan and I got married, Leah was single.  Since then she’s met, dated, and married a guy and will probably be pregnant before me.

Of course, I would never wish infertility on anyone, especially my sister.  She is two years older than me, so technically I guess it’s HER right to go first.  Still, the old infertile pang of jealousy and dread is there.

Years ago my mom was concerned about emotional, middle-sister Leah, who dated non-viable guy after unpromising guy while years passed.  As the steady and pragmatic sister, my relationship with Ryan was healthy and marriage-bound.  Leah and I are close in age and I said to my mom “I always assumed Leah and I would grow up, get married, and have kids about the same time, but I’m realizing that might not happen.”

My mom responded “As you get older you find many, many things in life you assumed will happen will not happen.” And those damn words have haunted me. Having a family, something so common and so human, is impossible not to assume it will happen.  How was I supposed to be prepared for this?

Of course, at the time, my short-sighted, late-twenties wisdom thought Leah might be the unlucky one to not settle down, get married nor have children.  Years later the forecast looks a little different.

Or who knows, maybe I’ll do IVF in January and Leah will come home from her world tour and we’ll both be pregnant at the same time, like the storybook future I’d envisioned.

It’s the million dollar question.  You can’t assume anything, but just take it one month at a time, again and again and again.

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Ethics & Embryos

As Ryan and I have let everything “sink in” I did the inevitable and stuffed my brain with Googlings of pros and cons of ART/IVF and remaining “child-free.” (I’ve always said “childless” but I guess that’s not kosher in the infertility world.)

I’ve found myself reading some PRETTY uncomfortable arguments. For starters, as a Christian I’m personally opposed to abortion, although I would never expect others of different beliefs and backgrounds to agree with me. Fortunately I’ve never been in a situation where I’ve had to consider one.

I’ve also known IVF is a taboo in the Christian world.  The fundamentalists are against all ART/IVF for many reasons, namely that “It’s God’s job to create life, not man.” I disagree, because the same argument could be adapted for many life-saving medical treatments which are widely practiced by all Christians.  Also, I have faith that God gave us science, medicine and knowledge and they are great gifts to be used! (Responsibly.)  However, the fundamentalists and more conventional Christians alike take issue with the extra embryos created in the IVF lab, and equate “destroying” the extras to abortion.  Previously I hadn’t thought much about this because

#1 Substantially all of the IVF stories/blogs I’ve heard/read have not had ENOUGH viable embryos, and IVF becomes a devastating failure time after time.  I didn’t expect the doctor to tell us she estimates we’d get about 5-6 embryos, I thought we’d be lucky to get 1-3 and would give each one a fighting chance.

#2 Those embryos aren’t in the womb.  If I were pregnant and did nothing, I’d grow a baby and give birth.  Abortion is an act to prevent this.  But those embryos in the lab are another story, if I did nothing, they would NOT grow into a baby.  There is no act to prevent life from growing.

However, according to many Christian reproductive websites, all those embryos need is nurturing to grow into a baby, the same way all a baby needs is nurturing to grow into a self-sufficient adult.  This is truth.  I can’t deny that.  If we get 5-6 embryos and I let some die off, I’m preventing life, and that is very convicting.

So what do we do?  Take our chances and hope for a manageable number?  Make the commitment to transfer each embryo if we end up with 5-6? (Ryan, my endearingly fussy husband-child, would lose it if I told him we might end up with 6 children.) At this point all I can “do” is pray about it, think about it, and trust in God.

In actual developments, I learned Kaiser will cover $0 of IVF, not a drug, not a procedure, nothing, so we are better off using the pricey local doctor we visited.  $15,200 is a lot, but at least we’ll save time and gas driving to and from another city.  Also, my FSA will cover $2,550 of the costs, but we have to wait until next plan year, aka January.  Part of me just wants to go ahead and do it NOW but I think it would be prudent to just be patient and use that $2,550.

This gives us some time, too because Ryan and I really need to think hard about this, even the parts that would be convenient to gloss over. Especially those parts.

“Call me when you’re ready.”

She wasn’t so bad.  Definitely the type who in Middle School was super smart and opinionated with no social skills, but we’d been warned, so actually found her sort of amusing.

The vaginal ultrasound showed good news: I have a lot of healthy, big follicles. (After describing my eggs as “Middle aged used cars that have been parked in a garage for 31 years” she was pleased to see I had more follicles than she expected.)  Risks discussed were minimal and very generic, with her positive emphasis that my “young” age is a major benefit.  I am so glad we didn’t wait any longer- 2 years can make a big difference.

The bad news: Doctor told us male factor infertility is thought to be genetic for certain men.  If Ryan carries this gene (to be determined by genetic testing later this month) chances are our test-tube conceived son would be infertile, too.  This was concerning, especially when combined with our preexisting tampering-with-God misgivings of IVF.

All things considered the Doctor estimated we have a 95% chance of success with IVF.  Shockingly high, yes, but this 95% assumes we’ll get about 6 healthy embryos out of the deal, freeze some, and if implantation fails the first round by the time we run through all 6-ish we’ll have a 95% chance of getting pregnant.

Too good to be true? The big shock came at the end when she handed me an itemized pricing list.  All out the door with drugs and embryo freezing: $15,200.  Not including round 2, 3 or 4 (about $3,000 a piece) if implantation fails the first time.  Call me naïve, but I was expecting more like $8,000.  I’d heard IVF could run $10K-$15K but thought that included all the preliminary testing like blood work and ultrasounds and IUI which so far our insurance has covered or we haven’t had to do.

$8,000 I could stomach, but $15,000 gave me major sticker shock.  The Doctor does financing, but the rates aren’t that great.  The thought of a $500/month payment for 3 years is nauseating.  How do we pay for childcare once the baby is born?!

Our other options?  I have $16,000 in a 401K that I’d hate to cash out.  Maybe pull together $5,000 up front, take $5,000 out of the 401K and finance the rest- a discussion for Ryan and I, I know, not the blog.  How does Ryan feel?  Last night he didn’t want to talk about it and was more concerned with his 6am flight this morning (business).  And I understand, it’s a lot to process and think about.

In a way though it’s such a relief to be this close.  To hear “Call me when you’re ready,” and know I could actually be pregnant in a few months.  We aren’t ready to make that call just yet.  First I need to talk to my husband and see where his ever-changing emotions have landed today.  We also have some more blood tests to order.  And research – time to call Kaiser and see what their pricing is, if insurance covers even the drugs, and what my FSA will do for us.  At $15,200 I am looking for any discount out there.

The Monopoly of the Mean Doctor

I live about 1.5 hours from San Francisco, where IVF doctors and medical resources are abundant.  But since insurance has nothing to do with my options I figured it’s best to start local, so I called the ONE fertility doctor in my city and made an appointment for this afternoon.

This doc gets mixed reviews – great statistics, recommended by Kaiser, though the customers on Yelp tell of a perfectly competent doctor with a raging bitchy attitude.  Oh boy!  Baby-making impairment is shameful and embarrassing as it is, and poor bedside manner might only salt the wound.  But so far Ryan is the one with the less-than-desirable test results open for comment, so I’d best quit worrying about my own feelings.   Worst case scenario this will be a total nightmare and we’ll try another clinic further from home.

Today at 3 I go in for a vaginal ultrasound and detailed run-down of treatment, costs, recommendations and risks.  I’ve assured Ryan’s on-the-fence-about-IVF nerves that this is an informational meeting, we are going to gather all the facts before we make any big decisions.  We don’t know enough yet to do anything drastic one way or another.

And I’m assuring my own get-ready-for-some-harsh-truths nerves that I don’t need a doctor to baby me, just give me the facts, this is business, don’t be too sensitive.  Even if she tells me “There’s nothing wrong with you, just lose some weight” as she told one angry Yelper lol…

At least I’ve been warned! 🙂