The 24-Hour Rule

In the words of Florida Evans, “Damn! Damn! Damn!” Yeah, unfortunately, there’s really no other way to express how I feel right now. The worst possible scenario played out yesterday. At 10:15 yesterday morning, I got the phone call from the doctor’s office that my lone embryo had not survived. It stopped dividing on Saturday, meaning it essentially died. And that was that. No little miracle baby. We didn’t even get a chance to transfer the embryo and see if it would take.

The news was the hardest I’ve gotten in a long time, probably since Mom died. And what made it worse was dealing with it alone. Most couples that get this news have each other to find comfort with. I called Keith and talked to him about it a bit, but I spent the entire day alone, crying, in my apartment. Back when Mom and Dad were around, they would have been there for me. When I had the crisis with my Comps at BC and called them, upset, Dad said, “We’ll be there in 3 hours.” And they were. And there was never any doubt that they would be. No matter what was going on, when I needed them they would drop everything for me. There’s no one like that anymore in my life. That’s not a slight on the people that I know care about me, but there just isn’t anyone who would (or could) drop everything to be there for me. If I had never had that, maybe I wouldn’t feel the lack of it so much now. But I did have it. And yesterday, I wanted that more than anything – someone to say, “I’ll be right there.” Someone to give me a hug and say it’s going to be all right, even if I didn’t want to believe it in the moment.

But lamenting something I can never get back is pointless, as is wallowing in the heartbreak and disappointment of yesterday. That is to say, yesterday was all about wallowing. But that ended at 10:15 today. See, I have a little rule about heartbreak and disappointment, which I call The 24-Hour Rule. Basically, you have 24 hours to be completely devastated about a major loss or disappointment (deaths get more time). After that 24-hour period, it doesn’t mean that you are no longer upset or disappointed. But, now you have to regain perspective and decide what to do moving forward. 24 hours of wallowing, and then it’s about action.

So, I took my 24 hours. I wallowed. I cried. I acted like the world was coming to an end. Now that time is up and I look to the future. What’s next? I’m not entirely sure. I know I can’t do another IVF before the end of the year. Then I’ll be in London at the start of January. But, I should be able to start another cycle mid-January.  I know that I have to do at least one more cycle with my own eggs – I can’t just do a “one and done” because everything can’t hinge on one attempt. But the reality is that I may not do any better than I did this time. So, I’ve decided that the next step after that is to try one or two cycles with donor eggs. If that doesn’t work, then I will consider adoption. In the meantime, there is a chance that I may be able to do one last IUI in December. I have to ask the doctor. It may be worth taking the shot on the off chance that something could happen. As I move forward, I know that finances are going to be an issue, but I also know that selling my place and moving to Riverdale is more of a reality now anyway (and one I am comfortable with), so I’m not really that worried about it. This is all going to cost me a bloody fortune, but it’s worth it in the end. And I know I have fallback positions that will keep me out of the poor house! (on that note, during my 24-hour wallow-fest, I did actually apply for a new job).

So, onward. Yesterday sucked. But today is a new day, full of promise, and 24 more hours to work toward making my dreams come true.

Autumn Harvest

Well, as detailed in my last post, I have a bit of a brown thumb when it comes to growing things. But, all is not lost. On Tuesday, I went in for Egg Retrieval for the IVF, and we ended up with the predicted two eggs. Not exactly a bumper crop, but at least something came of the harvest. Of course, that was only the beginning. I still needed to wait and see if either of the eggs made it to a healthy embryo, after mixing and mingling with James Bond. The average rate of fertilization is about 50%, but with only two, it was a long shot.

All night Tuesday I tossed and turned, and I was a basket case on Wednesday, just hoping I could manage one embryo, especially given that this may be the best that I can do. I pretty much felt physically ill through my first couple of classes on Wednesday. Finally, I got the call during my 1:00 class. I had it on vibrate and did not answer, since I was teaching, but I heard it vibrate and really couldn’t focus anymore on Elements of Drama. I finally let the kids go fifteen minutes early, and went outside to check the voicemail.

And it’s all for one and one for all! I have one embryo. And yes, one is all I need (twins are even still a possibility as the embryo could still split after transfer). But I am still a bit of a basket case, I guess. Because I worry that something will happen to the embryo, or it won’t develop well, before Sunday’s transfer. I know, I know. But what can I say? I’m not happy unless I’m worrying about something. Two more days of worrying about whether the embryo will make it to transfer stage. Then, Sunday, I get to worry about the discomfort associated with the transfer (there’s been debate over taking a valium or no – I prefer no).

Then, of course, the worry shifts again. I get to worry for about a week and a half more before they do a pregnancy test to see if all of this worked. In the meantime, I get to keep jabbing myself, only this time, it’s not in the belly – it’s in the bum, with Progesterone. Never say I’m not committed to this plan – what says commitment more than baring your bum for a nurse you just met to draw black circles on it with a Sharpie? Gotta say, my flexibility is worse than I thought – reaching back there with a needle is no easy task! Oh, and the needles are massive! Well, two more days of jabs, then transfer. Then more jabs. On so on, and so on…

Oh, and despite my brown thumb when it comes to growing things, rest assured, I do not worry that it will carry over into the actual raising of the child (just through gestation). After all, Cali and Brooke are still here!

Ch-ch-ch-chia!

Hey, kids! Get ready for the exciting new product from the makers of Chia Pet – it’s Chia Ovary! Just add water and it grows! OK, so it takes a bit more than water. It takes a ton of expensive, injectable medications that turn you into a human pincushion. Oh, and maybe it doesn’t grow so much. Yes, apparently my brown thumb when it comes to all things gardening extends to trying to grow eggs in my ovaries.

I’ve been trying to write this entry for about a week now, but every time I sat down to do it, something changed, and the direction of the entry seemed to change. It started as a reflection on being a human pincushion. Then it was going to talk about the overall process of medication, bloodwork and ultrasounds. But then I started getting results, and didn’t know what to make of it all. Because, of course, there’s been another setback. Apparently, when taking these medications (Gonal F and Menopur), you should grow at least a half dozen follicles on each ovary. Me – I got 2. Total. On the right side, too, which means doing IUI instead would be out because that’s the side with the blocked tube. There are a couple of smaller follicles too, but the doctor doesn’t feel that they’ll mature in time for retrieval.

So, here’s the deal – going to egg retrieval with only two follicles is a risk. I might not even get two eggs, and if I do, they might not become viable embryos. And if that’s the case, I’m out the money. If I cancel the procedure before retrieval, then the package I paid for will carry over to a new cycle. The problem? Oh, there’s more than one. First, if I cancel now, I’d have to delay until the end of January because of the lead-time needed for the process, the holidays and the fact that I’m going to London in the beginning of January. And, Dr. K. has been pretty clear that, given my age and egg reserves, this may be the best I can do anyway. In fact, in a future cycle, I could do worse. On the other hand, he said that two 39-year-old eggs are better than two 45-year-old eggs, so there’s more hope than if this were even a couple of years down the line.

The long and short is that I’m going ahead with the retrieval, probably on Tuesday. It may be a waste of $12K, but I know two things – 1. I don’t want to wait up to three months to try this, especially if there is little likelihood that I’ll do better in producing eggs. 2. If I delay, and the next cycle turns out worse, I will always (ALWAYS) regret not doing it now.

All my life, I have tried to live without regrets. And the few regrets that I have all have to do with things I didn’t do, not with things that I did. Even when I have done things that did not work out the way that I hoped (and I pray that this is not one of them), I have always at least had the comfort of knowing that I tried. It’s when I back down and get scared, and choose not to take the risk, that I end up wishing that I had. And this is too big to chance regrets. So, maybe I’m about to blow $12K, or maybe I’m about to get pregnant. After all, two eggs is one more than I really need, right?

Did We Really Just Have that Conversation?

So, a little late, I admit – that’s the reality when there’s literally hundreds of papers to grade, I’m afraid. Not to mention, all the paperwork I’ve been reviewing and filing in order to create my firstborn (hope I didn’t actually somehow sign away my firstborn, thus negating this whole process!).  In fact, such are the vagaries of grading papers and filling out paperwork, that this entry started on Wednesday, and it’s now Sunday. Oh, well – onward.

I promised to outline the process, and that began with attending an IVF class. Apparently I have to do that every cycle, although next time it will be ½ price. By the way, every time I list a price, feel free to mentally (or verbally) shout, “Ch-ching!”, or something similar. So, the class cost $150 for the two-hour session (go ahead, I’ll wait.). In it, we went through a PowerPoint about the IVF process and then watched part of the IVF lab video I mentioned in the last post (the video kept freezing, so we had to stop). Then we went through the litany of medications that I’ll need to take. Most are injections, so it’s soon to be pincushion time.

Meds:

Gonal F, Menopur, Centrotide, Ovidrel, Medrol, Azithromycin, Progesterone

That's a lot of Medication!!

Oh, and since my insurance won’t cover any of this, they told me that the meds will cost me between $4000-$6000 (all together now… “ch-ching!”). I applied for assistance with the cost through a program called Compassionate Care (LINK), but that nearly fell through since they lost the email that I sent with the enrollment information. After being encouraged by Keith to “make a stink,” given that I had applied in time, but they lost the stuff, a very helpful woman by the name of Shamika was able to fast-track my application, and I got the approval just in time on Friday. When I picked up the meds on Saturday, I found myself quite grateful for Keith’s urging and Shamika’s efficiency, because the reality is that, although I got 75% coverage on most of the medications, the total out of pocket was still $3000 (and, “ch-ching!”). Of course, that means that, without the coverage, it would have been much higher than they originally quoted me.

Of course, the meds are only the beginning. There’s monitoring, blood tests, ultrasounds, and of course the extraction, fertilization and implantation. At that, boys and girls, costs even more money. About $10K to be precise for one cycle (Holy “ch-ching!”). RMA directed me to another company, ARC Fertility (LINK), which offers packages and financing. Despite the large price tag, though, I don’t want to finance because finance charges will just make it even more expensive in the long run (even though my credit score would put me on the lower end of the financing charges). Technically, I have the money to do it, by taking money out from the beneficiary IRA. I pay a high tax penalty (sigh, “ch-ching!”) on those withdrawals, but I still think it’s better than stretching out payments with finance charges over time. Plus, it’s one less line of credit to worry about, especially if I need to shop for a new apartment any time soon.

ARC offers what they call “Cycle-plus” packages. Which basically mean that you pay them and they cover however many fresh and frozen cycles are in your package. So, for a One Cycle-plus, it’s one cycle with freshly fertilized embryos and one cycle with frozen embryos. That package costs $12,900 (yep, “ch-ching!”). So, here’s the thing, if I don’t get pregnant on the first cycle, and there are embryos left to freeze, then the second cycle will end up being a lot cheaper than if I pay RMA directly, cycle by cycle. However, if I get pregnant the first time, or there are no viable embryos to freeze, the cycle is considered complete, and I’m basically out the extra 2,900 bucks. Of course, as Keith pointed out, if I get pregnant the first time, then I won’t be too upset about the money because I’ll be happy that I’m pregnant. Fair enough. But that money is another month’s mortgage, maintenance, cable, electric, garage… Still, I can’t plan on it working the first time, so I have to hope there are viable embryos and that they can freeze them. Then I’ll be happy I took the package, which was the decision I ultimately made. The other downside is that, if I get pregnant, and then lose the baby, the cycle is still considered complete, and so any further frozen cycle would not be covered. Also, if there are no embryos worthy of freezing, I don’t get a refund either.

So basically, between Friday and Saturday, I spent about $16,000 (“ch-“ oh, forget it!). That’s a boatload of money to spend in two days. On the bright side, I put it all on AmEx, which means more points for another trip somewhere – kid or no kid. It also occurred to me that my perspective of looking upon it as an investment is ever so slightly flawed. Investments bring a return, if you’re lucky. And, yes, this investment will hopefully bring the return of a healthy baby. But, it occurred to me that this is the only type of investment that, if successful, will actually cost you more money for the next few decades!

Then, of course, we come to the title of this entry. This refers to a (mostly) joking conversation that Keith, my sister-in-law Angela, and I had at his birthday dinner last week. We were going over the costs that I’ve just outlined, and discussing the clinical nature of all of this. My darling brother decided it would be appropriate to point out that, for that kind of money, I could have paid a male escort to get me pregnant, and it would have been a hell of a lot more fun! Further discussion addressed the merits of Craigslist classifieds and stalking a certain Scottish actor. Ah, if only…

I have to say that, as much as I love how close Keith and I are, I couldn’t quite believe that we were having that conversation. Not what you would typically discuss with your brother. Of course, if I were totally honest, I’d have to admit that Mom, Dad and I would probably have had a similar conversation in jest if they were still around. Yeah, my family’s got a twisted sense of humor. But that’s what gets us through the sludge and muck on the road of life (especially since I don’t really drink!).

So, no, I don’t get to do it the fun way, especially since I don’t want to be arrested for stalking. Oh well. If this is how it has to be, then OK. So they grow my kid in a lab. Doesn’t make the kid any less special, or any less mine. Of course, it will make our “Where babies come from” conversation a bit different from the kid’s little school friends.

“When a Mommy can’t meet a Daddy, but she really wants a baby, she goes to a lab….”

Did we really just have that conversation?