The Emotional Roller-Coaster of Infertility

The End

2010-07-09T03:38:00.000-07:00

Last night my husband put an end to all infertility treatment. While this did not come as a complete surprise since I almost expected this at every appointment I would go to, the reality of it now is excruciating. I always thought that even if this journey ended without a baby I so badly want, at least I would always have a husband who loves and cherishes me, which was the most important part. I wanted to add to our family, enhance it so to speak. Again, it appears I missed the memo on his feelings for me as well. Is this simply a mood, or will I be able to say again soon, "When it comes down to it, my husband always says the right thing when I need it most."? I would much prefer to continue this as "Learning how to live child-free" rather than "Starting Over."

New Beginnings

2010-07-02T07:54:00.000-07:00

The day after my BFN, I felt utterly devastated. It would have been a little bit easier if I ended up with a miscarriage instead of a completely negative pregnancy test. I know, the end result is the same, but at least it would have felt that I had more of a chance. So my next thought is that I would go back to the Czech Republic in September for another round. I still hadn't completely paid off this first round, so I was starting to get nervous about money since I would only have the summer to come up with another few thousand dollars to pay for a second round. I mentioned this to a few people and all their comments were, "It's only money, and you'll have plenty of time to pay it off. This is about a chance for a baby!" Yes, that's true, but it's even scarier thinking I could end up greatly in debt and still no baby.

At this time when I could use some really encouraging news, I received some! My husband's company was bought out by another one, and the most amazing thing happened. I was worried his new insurance would cover even less than the one we had so that could potential drive up the cost of medications to around $4000. I called that day, and found out that his new insurance will cover 4 rounds of IVF prior to a live birth, and an additional 2 rounds after a live a birth. I was in shock. I'm so used to hearing, "the company did not choose the option for infertility treatment" or "only diagnosis is covered" that I thought I didn't hear the woman correctly. I asked if ICSI is covered, but this girl didn't know what that meant. She said specifically 4 oocyte retrievals were covered, and that alone surprised me. So I figure even if they only cover traditional IVF and not ICSI, the difference is generally only about $2500, and if I had to pay that, it was still cheaper than going back to the Czech Republic. I felt like I had just gotten four more chances and a new lease on life. It gave me purpose and energy I really needed.

At my weekly mental health check up the following Tuesday, my therapist was stern with me, saying that I couldn't take the negative test and allow it to get me down. She said I had to be pro-active, and simply make plans for the next step. She said it will never work if I let it get me down. She told me to find a new doctor and start making appointments. So I did just that. I looked up doctors who were in both my current insurance plan and the new insurance plan that would not kick in for a month. I took those listed, and then went onto the CDC site and found the ones with highest rates for ICSI, and then looked at where they were located. I immediately crossed my original doctor off the list, but found another one. I called and made an appointment for the very next day. I felt empowered and pro-active, a much better feeling than disappointment and despair.

Heart-Break

2010-07-02T07:04:00.000-07:00

I had my embryo transfer on May 11th. Based on my age, the doctor recommended only transferring two embryos, and we would wait and see if the other would continue to develop enough to be able to be frozen. The transfer was amazingly easy. I know friends have told me it would be, but I didn't entirely believe it at the time. I stayed in Brno for an additional five days after the transfer just lounging around the apartment. I was scared every time I sneezed, worried that I would "knock" the embryos out. I was scared to walk a lot or take the trams for fear of a big bump and lose the embryos as well.

I was lucky that I did not have many problems after the transfer. I did not have any cramps or spotting. The two week wait is the worst feeling in the world, but it's the worst at the end, not in the beginning. During those two weeks, there is no reason to not think it will work, so it's almost as if you can pretend it's truly positive. It's only toward the end that the realization that it could all be for nothing that the despair rises close to the surface.

One thing I was unprepared for, and am rather uncomfortable writing about, are some of the other side-effects that I did get. One is constipation, and that is not something I'm entirely too familiar with in my adult life. Again, I was always worried that anything straining my body at all would cause me to lose my potential babies, so this wasn't such a fun thing to experience at this time. I also experienced bloating at times that made it almost hurt to even walk. The most excessive bloating I felt was on the plane ride home, and I don't know if that had anything to do with it. I felt huge! My urine output was also limited, so the bloating felt even stranger. And the worst side-effect by far were the yeast-infection like symptoms from the Progesterone. In the US I've read they use injections for Progesterone, but they are extremely painful, and not even to be self-given because they are injected on your backside. In Europe, the vaginal suppositories are more common, and the doctor told me they are better tolerated. They are very easy to administer. I had to put two suppositories in three times a day. At first it was easy, but as time went on, some would leak out a little bit, even if I laid down for 20 minutes after, and so you are always a little "moist" in that area. It led to some uncomfortable external irritation that eventually drove me nuts. I started eating lots of Activia yogurt and bought Acidophilus tablets, but after a week, I was still very uncomfortable. I figured if I had to take the suppositories for the entire first trimester, I would ask my gynecologist after my pregnancy test what I can safely take. About a week before my test, I couldn't take it anymore and spread some Monistat externally and that was heavenly. I did that for a couple days while eating the yogurt and taking the Acidophilus and eventually I felt normal again.

I was very good about not taking any home pregnancy tests and finally went for my official one at my gynecologist's office 15 days after my embryo transfer. I still had no pregnancy symptoms, but I was definitely a bundle of nerves. The staff at my doctor's office is so wonderful that they were all hugging me and wanting to know all the details of my trip to Europe. They were very supportive and I feel very lucky to have that during such a stressful time. The one nurse told me to call the next day early in the morning and she would call the lab for me if she didn't have my results. The doctor told me to call early in the afternoon, however, because he said he wanted to go over the results with me personally and discuss any questions I have.

The next day my husband and I were both home from work, and my phone rang at 10:30 am. I was so hopeful that it was the nurse calling me since it was my doctor's number on the caller id. But from the tone of her voice asking me to wait for the doctor, I just knew. Sure enough, the doctor got on and just said he was so very sorry, but the results were negative. I had to try so hard to get through the call before the hysterics came on. When I hung up, I just bent over on the couch and started bawling hysterically. I know my husband must have been at a loss as to how to comfort me, but I went over to him and just cried in his arms. He had a hard time believing it was negative because I had no signs of my period. He said he was so sure it would be positive. I then told him I had a clue it wasn't positive because I broke down that morning and took a home test and it said negative, but I was praying that it just wasn't sensitive enough.

I stopped the Progesterone and within 2 days I got my period. The day after the BFN I didn't feel up to going to work, and wanted to mope in the worst way, but my husband recommended I spend the day with a good friend of ours. Sometimes my husband says the right things at the right time and knew what would be good for me. So I followed his advice and spent a girlie day with our friend. It's kind of hard to be all weepy when we went looking at wedding dresses for her. Then we went to the movies and out to dinner where I wanted to eat junk food in the worst way. The junk food didn't satisfy me the way I hoped it would which is a bit of a pleasant surprise, but I felt like the day was a good distraction. Unfortunately it was a holiday weekend, and looking back, I wish I had taken the next day to just mope alone in my bedroom. I'm hoping in the future I won't need to go through this again, but if I do, I'm prepared.

A True Roller-Coaster Ride

2010-05-10T12:41:00.000-07:00

Yesterday between 1 and 2 pm I had to call the clinic to find out the status of my embryos. My husband and I went to Prague for a couple of days before he was scheduled to fly back to the US on Tuesday morning. We arrived at the main train station in Prague around 1:15, so after we got off, we found a relatively quiet spot for me to make the call. I was simply a bundle of nerves. I was trying my best to tell myself that even if none of the three were good enough and this cycle was ended, I would be no worse off than if the round failed at the time of a pregnancy test. On the other hand, if the embryos weren't any good, then I really should make plans to head home early since I would have no reason to spend the rest of the week overseas.

I made the call, and the doctor told me that all three eggs yielded good embryos, and he would see me on Tuesday at 11:30 to do the transfer. I couldn't believe it. I was so relieved at the good news that when I hung up, I started shaking, and cried on my husband while at the same time I was so happy. I couldn't tell if I wanted to laugh or cry.

So tomorrow morning my husband gets picked up at 7 am to go back home, and at 11:30 I have my transfer. I know I will be crying hysterically in the morning; it was so wonderful when he showed up and I know I'll be back to being lonely here, especially since I won't be able to walk as much and therefore not get out to the Old Town area much. I can take the tram, but that will still require quite a bit of walking. My husband didn't offer to stay an extra day, but with all the plans already in place, it really doesn't make any sense. Emotionally it would be wonderful, but maybe it's better to get my crying done before the transfer!

I'm here for another 5 days after that and that's a bit much, except we can't plan to the minute how much time I will need. It was a potential for my transfer to be on Thursday instead of tomorrow, and in that case, I wouldn't want to go back until Saturday to give myself some rest. Since the egg retrieval was a day earlier than I expected, it could have meant that my transfer could have been as late as this coming Friday and that would have been perfect for my timing. Since we don't know until we're here, this is the best I can do. I'm trying to remind myself that I'm not a work, so I should just relax in this lovely little apartment.

The next question is how many embryos the doctor is going to transfer. I don't want more than two, but somehow I was under the impression the doctor wanted to transfer all 3, which also happens to be the maximum they allow here, and also is considered a failed attempt. The thought of triplets is a bit terrifying, but I guess the doctor will be able to give me the best advice tomorrow.

Egg Retrieval

2010-05-08T02:08:00.000-07:00

Three hours ago I had my egg retrieval. I was extremely nervous as I didn't know exactly how I would feel afterward. There are a few things I learned from this experience.

First is that American hospitals and clinics could really take some lessons from the ones here in the Czech Republic! Our instincts are to think, "Eastern European, dated, backward, not up to our standards." Actually, it's the other way around! Upon arrival at the clinic, my husband and I were taken to "my room". It was a really nice hospital room! It was large, with large windows across the one wall, with two beds with nice blankets and pillows on them. There were two white fake leather guest chairs and side table between them. There was also a full bathroom and Ikea-like lockers. The room itself was clean and almost inviting. There was none of the scary disinfectant smell or just hospital like feeling that we're used to. I wouldn't stay it was not "sterile" because it was definitely clean!

My husband was called off to do his part, but I was still waiting for my turn when he came back. Shortly thereafter they took me across the hall to the operating room. I was rather nervous by this time. I was feeling skeptical about the anesthesia when suddenly I felt it and went "wow!" before drifting off. The next thing I know I was woken up and taken back across the hall. The anesthesia wore off fairly quickly which was a surprise. I tried to sleep although I really wasn't all that tired or out of it. Listening to the birds chirping helped me relax. I felt twinges of cramps, but nothing too terrible. Not long later the nurse came in to ask how I felt and to remove the IV. A little after that, she came in with hot herbal tea and chocolate wafers for me. I was really taken aback by their kindness.

Then came the shock. The doctor came in and told me I only had 3 eggs! I had 8 large follicles on Monday, but only 3 grew large enough to use. I felt devastated. When he walked out of the room, I burst into tears, but this is when I learned my next lesson.

Not that I didn't know this already, but my husband can really be exactly what I need when I need him. So I just need to remember to always trust in him and his love. I was terrified that with only 3 eggs, I'll have none to freeze and I'll never have a baby if this round doesn't work. My husband came over to me and hugged me and said that he agreed to three chances and if he needs to come back, so be it. I felt like my whole world opened up again and that all was not lost and I can be happy no matter what. The love and gratefulness I feel to have him are indescribable.

So my lessons learned today are that egg retrieval is not the worst experience, the medical clinics here are really so much better than back home (so take that, clinic near my house!), and to always have faith and trust in my husband.

The Day Before My Egg Retrieval

2010-05-07T13:45:00.000-07:00

Today is the day before my egg retrieval, and my coordinator here took my husband and I out to lunch. She took us to an authentic Czech restaurant that looked like a traditional cottage. At this lunch she also brought her grandmother, a lovely woman who reminded me of my aunt back in Hungary, and another woman from California.

This woman has secondary infertility herself. She had one child naturally, then went to a clinic in Zlin and with only one round had her second daughter. She and her husband would like to have a third child, so she went back to Zlin, but that first round for her third child failed, and for whatever reason she decided to give the clinic here in Brno a shot. It does give me hope that I can possibly have a successful first round.

Tonight in the apartment we had to fill out some forms prior to the surgery tomorrow. The most important ones ask what we will do with frozen embryos in certain situations. The Czech Republic does not allow frozen embryos to simply die, but specify they must either be used by the couple who's genetic material it is, donate them to science, or donate them to other couples experiencing infertility if the woman who's egg is used is under 35.

After much discussion, we decided that if we don't use the embryos ourselves, we would want ours to be donated to other infertile couples. I am thrilled my husband felt this way as that was the way I was leaning myself. If I could help another couple experiencing what we are, that would make me very happy.

Another decision was made in the event one of us dies and leaves behind the frozen embryos. My husband said that as far-fetched as this is, but if I were to die, and he were to get remarried and his future wife wants children and can't conceive, he would want my child next. I'm not sure how another woman would feel about that, but that also made me feel good inside, thinking that he didn't want to simply let the embryos be donated. In fact, he again said after his own possible use, the next best thing would be to have them donated to infertile couples. I put down the same decisions in case anything were to happen to him.

I always love those moments when my husband surprises me and they make me feel, "Yes, and here's yet another reason why I married him." If nothing else, this trip to the Czech Republic renews my feelings of love and friendship with my husband which is always a good thing. Again, it could be the hormones making me feel so gushy, but it's a good feeling so I won't question it.

Now if only I could get past my slight nerves to tomorrow's procedure! My friend who's gone through two rounds said that it's not bad because of the anesthesia, and she's even more scared of needles and doctor's than I am, so I'll just try to think about that!

Self-Injections and IVF...Truly Not Worth Worrying About!

2010-05-05T16:15:00.000-07:00

If you're anything like me, you hate anything and everything that has to do with needles. I was that child running around the doctor's office screaming my head off hoping to avoid a vaccination. Thank goodness my mother had my ears pierced when I was a year old because I never would have had the nerves to knowingly have holes put into my body unless I were knocked out. Also as a child, I hit my dentist when he injected the novocaine into my gums. As an adult, while waiting my turn to have blood drawn, I heard the woman ahead of me go "My goodness that's a big needle!" and nearly ran out of the hospital. So when I found out that I have to give myself injections for IVF, I did my best to block it out. I assumed my husband would help me out, but I'm guessing unless it's a life or death situation, he wants no part in sticking any needles in me. He doesn't care for needles himself. I guess that's one of the many things we have in common! After the fact, however, I will say that if at all possible, I don't think I would ever want another person injecting me. I realize that it's easier on me to do it myself than hope the other person doesn't jab me the wrong way!

I ordered the medications at the end of March, and a huge box filled with medications and lots of needles arrived at my home. I put it all in the fridge as instructed and did my best not to think about what I will actually need to do with those. My coordinator sent me a video on how to inject the meds, but I didn't bother to look at that ahead of time. I was a bit in denial and just ignored it. I considered asking a couple of friends for help when the time came. One friend went through two rounds of IVF herself so she offered to show me, but I just had to find the time. Another friend used to be the nurse at my gynecologist's office, and since she's drawn my blood before, I figured she might be able to help me out with this. In the end I didn't ask her because I didn't want her to think I only wanted to contact her for selfish reasons.

When the day finally arrived, I realized that having someone show me wouldn't help all that much unless they conveniently lived next door. I had to do it every day at the same time. I chose 8:30 am since it would be right before work. I watched the video and it didn't seem like a big deal, except for the sticking a needle into your skin part. I had a hard time watching the actual injection in the video.

So I followed the instructions to a "t". I put my laptop on the kitchen table with the video set to go. I followed it as if I were following a cooking show. For every step they did, I would then pause the video and do it myself. I put down paper towels on the table just in case my surface wasn't clean enough. I washed my hands and brought the medications, needles, alcohol swabs, sharps container, and a washcloth to the table. The washcloth was my addition and I have it here with me in the Czech Republic. I followed the video until it came time to inject. At that point I folded the washcloth, and then stuck it in my mouth so I could bite down on it. I then pinched my skin and stuck the needle in. I stared at it in disbelief. I didn't feel a thing!! How in the world is this possible?! I finished the injection, pulled out the needle and then stumbled over to the couch about to pass out. I felt so lightheaded I had to put my head between my legs because I had worked myself up so much that I made myself sick. I was in utter shock that it truly did not hurt at all! The hardest part of injecting yourself using the Gonal-F Pen is the prep work, which takes less and less the longer you do it. I've been doing it for 9 days and it's cake.

I wish I could say the Cetrotide injection is as easy, but that prep work really is a pain. Especially since I have to do it alone without knowing for sure it's right. I followed the video the same way I did with the Gonal-F. For this injection, you have to mix it and then load it back into the syringe before injecting. That was the hardest part. But I did feel I did it without screwing up. This injection was a little less comfortable than the Gonal-F. The needle is slightly longer and bigger, but the syringe is smoother to push down on so I guess it's a trade off. Surprisingly my skin did get irritated at the injection sight and was a little itchy and red. I looked up side effects immediately and it said that irritation is common but short term. Sure enough, probably within a half hour I didn't notice it at all anymore. There's no sign no, later on that day that I ever injected myself. Luckily I only have that particular shot one more time.

Tomorrow is my grand finale in injections. I inject myself with the Gonal-F for the last time in the middle of the day along with the Cetrotide, and then tomorrow night at 9 pm I inject myself with Ovidrel, which is a prefilled syringe without mixing. And then I get Friday off before the Egg Retrieval.

Regardless, as much as I hate needles, it's completely worth it a million times over if it results in my dreams coming true! My fingers are crossed!

The Start of IVF Round #1...Arrival in the Czech Republic

2010-05-04T16:11:00.000-07:00

I signed paperwork to try IVF in the Czech Republic six months ago, and now the time has come! My egg retrieval is scheduled for four days from now, and in perhaps a week or a little longer, I'm praying a couple of embryos will be transferred to my uterus, and two weeks after that, I'm praying for a blood test to confirm my biggest hopes and dreams!

This is such an emotional experience. I don't know if it's more the hormones or what, but the tears are a little annoying. I'm not much one for praying to God, but if that's what it takes, I'll do it! It's close to Mother's Day, and I can't help but wishing that mine could be here with me. My mother didn't have an easy time conceiving me, and she always would tell me "You have no idea how badly I wanted you!". In the worst way, I wish I could tell her, "Yes Mom, I finally do understand!".

Everyone is telling me to take this time to relax and de-stress. It's so important that I don't feel stressed out, but with all this time on my hands, I have all the time in world to worry! I'm quite the adept worrier. Because of Glenn's limited vacation time as well as his general disinterest in Europe, I planned this trip so that he could spend only a little more time here than is absolutely necessary. Ideally I'd make a travel lover out of him and we'll have wonderful memories to share with our future children the trip we took to have them. Unfortunately, this means without him here with me, anything can still go wrong!

I went to the doctor yesterday, and it went so smoothly! He looked over my paperwork, he did a vaginal ultrasound and pointed out that my uterine lining is where it needs to be, and showed me all the follicles that are growing in both of my ovaries. And they are large enough so that he said he doesn't need to see me again before the surgery! So my medication is kept where it is, and things couldn't be better. Whatever is regarding my own body is as good as can be. I tried to find out how many follicles are needed for successful IVF, and a clinic in Chicago showed a graph where successful pregnancies for women under 35 with 7 or more follicles had a 69% success rate. That is absolutely phenomenal. And here I am, under 35 and was pointed out 8 follicles! Granted it's not uncommon for there to be 12 or more, but I still fit into a good category, and the clinics here in the Czech Republic have equivalent rates to those in the US. Sounds good to me!

Of course, with Glenn home, I'm worrying about a disaster. I heard through the grapevine by im'ing work that my father was in the hospital and he was the one supposed to watch our pets! Glenn doesn't have enough time or flexibility in his schedule (or patience for that matter) to deal with spontaneous changes. Luckily it turned out to be nothing, but it still gave me hours of worry and expensive phone calls to calm me down. I talked to my father this morning and he was upset I even knew about it! Give me time, and yes, I will worry!

So my next worry is that Glenn will miss his flight, but we planned on him coming a day earlier so that if he did miss it, he could still make it the next day and be here in time. Until I know he's on that plane, I'm going to be a mess. I thought I would have a relaxing time alone in an interesting country, but to be honest, it could be better. Maybe I just miss my husband...that's not entirely a bad thing!

So there's not much going on at this point. Patience seems to be key with IVF. It's not a time consuming process, so it's a shame that it's so expensive at home, and it's a shame I'm not sight-seeing the way I could be. I am getting a decent amount of walking done, so I don't feel guilty about not being at the gym. I've been avoiding public transportation since I'm in no rush to get back to this apartment, but I can only walk around aimlessly for so long. My shots are scheduled for right in the middle of the afternoon thanks to a miscalculation on my part of the time difference, so my day is cut in half, and even though I could very easily take a tram to the more interesting part of the city, call it laziness if you will, but I've only headed out a couple times. The weather has been rainy, otherwise there's a small park right around the corner I could spend time reading in! If next week clears up, I will need to take advantage of that after my embryo transfer.

I'll post next how the surgery goes. I'm a little nervous because I don't know how I'll feel afterward. I need to be good to go the next day because we're running off to Prague! Yes, things could be much worse!

Poly Cystic Ovarian Syndrome

2010-02-17T13:15:00.000-08:00

I had never heard of PCOS before beginning my journey through infertility. I still feel it is a label that is overly used to those of us who do not ovulate regularly. The common characteristics associated with PCOS are obesity, insulin resistance (or Diabetes), excessive facial hair, anovulation, and multiple cysts in the ovaries.

Once I was diagnosed with PCOS, I became worried and researched it. The more I read about it, the less I believe I have it. Odd as this sounds, but I would rather have unexplained infertility than be labeled with this. In my research, I found that if a woman were to lose weight, exercise, and eat properly, the symptoms disappear. This is not the case for me. I was not overweight to begin with, and I've always eaten rather well. I currently exercise moderately, have perfect weight, and hardly ever eat junk food and don't drink excessively, and yet my period is not any more regular than it was before. Odd, no?

I found that a friend of mine is also diagnosed with PCOS, only she was diagnosed with it while it was still referred to as Stein-Leventhal Syndrome. Her symptoms are different than mine, and also not typical of everything I've read about it. She is also not obese, and not only that, she does not have excessive facial hair at all. Her biggest problem was that her periods were so highly irregular that when she would get it, she would hemorrhage and twice has nearly bled to death. After having two successful pregnancies while on Clomid, she remained on the birth control pill until menopause.

After the diagnosis, I discussed this with my primary care physician, and it was a relief that he does not believe I have this issue at all. After scouring my bloodwork, he was unable to find evidence of this problem with the exception of my anovulation. He says he has many patients with this problem, and I do not present the same symptoms. It help reaffirm my feeling that this diagnosis is handed out far too freely.

Similar to the over-diagnosis of Bipolar Disorder these days (yes, I believe people have mental health disorders, but the umbrella term of "bipolar" has become rather vague.) I believe PCOS seems to be the easiest way to diagnose a woman with infertility. While it is good to rule it out and to learn how to be healthier if the symptoms do describe what you are going through, I feel it is equally important to learn your own body and and to leave the doctors who really do not care to truly try to help you and to find one that will.

Frustration and a Horrible Experience with One Clinic

2010-01-31T11:30:00.000-08:00

I have been battling infertility for over three years now, and I am still not ready to admit defeat and embrace "child-free" living. As soon as I found out that my husband has a low sperm count and my regular gynecologist would not give me any medications to help me ovulate, I had no choice but to look for an infertility specialist.

I didn't really know what my options were yet at this time. All I knew was that my husband, like many men, was not yet convinced he needed to go to a urologist himself, so I needed to find a way that would help us conceive with as little effort from him as possible.

I researched the closest clinics to me, and either emailed them or called them. The one I ended up choosing was the one who called me back first. I was so very hopeful the first time I went. I was told up front that my insurance would not cover anything beyond diagnosis, but I didn't really want to think about that. I was hoping something as simple as IUI would still be a possibility, and that couldn't cost too much for me.

I went to my appointment, the doctor performed another vaginal ultrasound, they drew more blood, and she looked over all the test results I brought with me. She told me our only option was ICSI and her staff would go over the pricing with me. She wanted my husband to have another sperm analysis done, and my husband and I would go over all the new test results and our options at our next visit.

When I met with her staff, I was given the bad news. As my only option was ICSI, and my insurance did not cover either the procedure or medications, I would be given their special discount plan. Ha! The discount meant the procedure would run $12000 and the medications would be an additional $4000. And this would be for one try. They recommended I shop around for new insurance. They kept telling me to look into New Jersey Plus and also told me that any company in New Jersey with over 50 employees are required to cover four IVF attempts.

The downside to "shopping around for insurance" is that if you buy it privately, no insurance company will cover IVF. So unless my own employer has more insurance options, it wouldn't work.

The "New Jersey Plus" plan turned out to be a health plan for NJ state employees and is not one you can simply purchase or be a part of, so they gave me some pretty bad information there as well.

Finally, I was rather excited about the 50 employee company thing because even though we were not yet married, my husband and I were planning on it, and he worked for a very large company that I assumed would fall into this category. I made the mistake of assuming because again they gave me false information! I assumed that a doctor's office that deals with infertility would know what insurance plans covers it and would note the experience they've had with their patients, but apparently they prefer to charge outrageous prices and don't care to give you accurate information. If your insurance does not cover IVF, you work for a company that is not state run, and there are no other alternative health plans offered, there is no way IVF will be any cheaper.

The staff also went as far as to suggest we mortgage our home to cover this! She said many patients take out home equity loans or second mortgages to make their dreams come true. I fully believe these clinics take advantage of the emotions of people who want a baby and coerce us into financial ruin.

Knowing that medications might not be covered by my insurance, I had done research online for IVF medications and found sites that offered them much more cheaply than a regular pharmacy. I printed out the information and brought it with me to the appointment. The staff informed me that the doctor will not give me treatment using those medications because they were in the European packaging and they only wanted it from the sources they endorsed. I was in shock that they would not work with me on this one. They wanted me to buy $4000 medications when I could get the same exact ones with a different unit of measure for about $800. It was so absurd that I didn't realize yet that they were not flexible and would not try to actually help patients if it didn't help their bottom line.

As I did not yet know all of the facts about health insurance, I was still hopeful when I left the office that day. I felt I was finally doing something to solve our problem. I was so excited about the prospect of getting treatment that I even recommended the clinic to a friend of mine. I'm happy to say that her health insurance miraculously does cover IVF, but at this point in time I don't know if she has had success with it or not. Her first round did fail, and she has been myserteriously quiet about it ever since.

The clinic required my husband to have his sperm analyzed by them only. They claimed to be more accurate than the hospital where my husband had it done the first time. I now realize this is pure nonsense, and feel they do this to yet again rip us off. Insurance did not cover this second semen analysis, and I had to shell out $300 for it hoping my husband would not ask how much it was. The test results were even more disastrous than before, and only test for sperm count, motility, and volume whereas the hospital report had much more information on it.

When my husband and I went for the follow-up, the doctor gave us no options. She did not offer any suggestions for my husband except to see a urologist, and that was pretty much the end of it. After we got married and I went on his insurance plan, I did go for one more consult. This
time the doctor was brutal with me.

They had just moved into a brand new beautiful building. Right away I should have realized I would not leave happy. The staff was unbelievably rude to me. I had dropped my insurance at work and switched to my husband's. I wanted to use his for this visit, and gave them the new card. I didn't know that my old insurance was not yet dropped even though I had requested that over a month earlier. The staff automatically called my old insurance instead of the new even though I told them not to use the old one anymore. Angry words were exchanged and I refused to pay the higher copay of my old insurance. The insurance company agreed with me in the end, but it never would have been an issue to begin with if the clinic staff had only listened to me.

When I walked into the doctor's nice new office, there were framed pictures of her own family all over her desk and shelves. I sat down and she proceeded to tell me worse numbers and percentages than earlier in the year even though she was looking at the same results as before, and then ignored my questions of alternative solutions such as storing my husband's sperm and trying IUI with mulitple collections of his sperm. She went off on me saying that I have PCOS and that I will have diabetes soon if I don't exercise and I'll end up with a heart condition. She was so harsh with her diagnosis and manner of discussing it that I left the office in tears.

Back to the staff. I told them of their inaccuracies of what to do with insurance (the NJ Plus and companies with over 50 employees) and they tried to deny ever telling me such information. I had taken notes when I met with them last time and told them as such. They did not feel any remorse for false hope and false information that I was just disgusted with the whole operation. They are so obviously only interested in making money and conning people vulnerable people into spending outrageous money on something that doesn't cost nearly as much.

My husband refuses to finance something what he claims should happen naturally so the health insurance problems only deepened my heartache. Instead of being a happy newly-wed, I was a miserable barren woman wondering how I was going to make my life meaningful when all I wanted was my own family.

Male Infertility

2010-01-29T20:15:00.000-08:00

I've mostly researched secondary male infertility because that is what Glenn and I have experienced. (Secondary means that there were sucessful pregnancies prior to the current attempt.)

The most common cause of male secondary infertility is varicocele which is basically a varicose vein in the testicles. It is most common in the left one, and is fairly easy to spot because there will be a size discrepency between the two. The increased vein size in the testicle causes the temperature to rise and kill off the sperm. Surgery can be performed to treat this and while it is not guaranteed, it has a fairly good success rate, and is in fact not a difficult surgery. Unfortunately, thanks to Google, I also found out that varicocele can also be an indication of kidney cancer, and I was a wreck worrying that my husband had more than simple infertility.

Glenn's urologist concluded (the same as what we both suspected) that his infertility is not that simple. It did not appear that he had any varicocele. I'm not sure if I'm relieved about this or not because I'm sure he would not have the surgery to fix this, but it would be nice to know the reason behind his low count. His doctor prescribed Clomid for him to take for 3 months because Glenn's testosterone levels were on the lower side of the normal range. It takes 72 days for sperm to grow, so if the testosterone levels were the cause of his low count, we would see results at that time.

The second infertility specialist I saw was surprised Glenn's urologist did not order more bloodwork. It turns out there are several possible easy solutions to low sperm counts. Unfortunately, it's a different medication to fix each of the problems, so all must be looked at. Clomid is technically not proven, but it is seems to be common enough practice to prescribe it to men with low testosterone levels. Like women, if their LH or other hormone levels are out of balance, there is a different medication that can be taken to correct the levels, and after 3 months, sperm production can possibly be restored. Glenn's bloodwork all came back normal, and while we didn't go for a third semen analysis, it didn't appear we solved any of the problems.

Other causes of male infertility are accidents causing injury to the testicles, and high fevers. Glenn is positive he has not had a very high fever in his life, but I can't imagine what else it could be since the doctors are certain there is nothing else wrong with him.

Yet another one that is possible was ruled out immediately by Glenn. If a man does not have sufficient semen volume, it is possible that he has retrograde ejaculation, and his semen actually end up in the bladder instead of being released in the opposite direction. This is also not uncommon and easily repaired with surgery. This was ruled out for Glenn since all of his semen anaylyses showed an excessive amount of volume of semen with almost non-existent sperm.

The end result is that male infertility is very difficult to diagnose and fix. Glenn's count is so low that only ICSI is a possiblity for us to have our own biological children.

What to Do If You Think You're Infertile

2010-01-28T19:43:00.000-08:00

Here is my story of how I became diagnosed as infertile, and some "tests" you can do yourself to help you come to that conclusion at an earlier time. The younger you are, the easier it is to overcome infertility. Not that I condone lying to your doctor, but if you do your homework properly, you really shouldn't need to wait over a year just to have your doctor diagnose it. If you are lucky, however, your doctor will be willing to work with you and believe you when you suspect you have issues. If you think you want to have a child someday, it doesn't hurt to know even before you're "ready" what kind of journey you can expect.

I suspected that I was infertile for the majority of my adult life. I didn't think anything of it, but my cycle was never the regular 28 day cycle that it's supposed to be. I thought of the 28 day cycle as more of the ideal, but not the same for everyone, and assumed I was "normal". The only time I ever thought I could possibly be pregnant was thanks to my Human Sexuality class while in college. My professor at the time said that if we were late, beyond 28 days, and we get our periods and they are heavier and more painful than usual, then it is possible that we could have been pregnant but it terminated naturally on it's own. My cycle was never only 28 days, so in my young mind I wondered if I ever had been pregnant.

I learned that a typical cycle for me was between 35 and 42 days. There were times I would go 63 days between periods, and I didn't think too much of it. I tried to think of myself as lucky for not having my period as frequently as others. Again, thanks to my class, I learned that the longer your cycle is past 28 days, the greater the chance you have of getting uterine cancer. I didn't like the idea, so I put it in the back of my mind. Since I wasn't interested in starting a family and was really young, I didn't think it was worth worrying about something that could happen when I was middle-aged.

When I was 27, I finally got around to asking my gynecologist about my risk for uterine cancer. He said that it was not a given that I would get cancer, but it would be healthier for me to have more regular periods, and so I went on the birth control pill. Most women I knew were on birth control pills to prevent pregnancy, but I honestly went on it to simply regulate my cycle.

I was a little concerned when friends of mine could get pregnant so easily and I never had that scare. My friends could miss one pill in a month and end up pregnant. I tried to blow off my concerns, especially since I was still only in my twenties and didn't even have a serious boyfriend. I would tell people I didn't think I was very fertile, but had no concrete proof.

After I met my husband, although this was before we started trying, I discussed with my doctor (finally!) that I didn't believe that I ovulated prior to being on birth control because my cycle was so irregular. He told me that when the time comes that I want to try, if I don't ovulate, he can simply prescribe Clomid for me and everything will be fine. I figured it would be a quick and easy process.

When my husband and I finally decided it was time for me to go off of the Pill, I didn't track anything for the first month. I started to the second month because my cycle became completely irregular right away. I was told to take my temperature every morning and chart it to determine whether or not I ovulate. So I went out and bought a bbt thermometer at the local pharmacy. I found a blank BBT chart online and started my temperature taking. I also bought a saliva microscope that I saw in the pharmacy. It's a neat little device that only cost about $10, and if you do it properly, your saliva will contain hormones that show a fern-like appearance at the most fertile time in your cycle. It's not a good stand-alone tool, but it's a good cross-checker.

For the next three months I charted religiously, used my fern microscope, and was happy to have about 3 months of semi-regular periods. I found the site FertilityFriend and was really pleased with their charts. It allowed you to put in all sorts of secondary fertility signs to better predict your days of ovulation and based on your cycles, it will tell you when to take a pregnancy test if you haven't gotten your period yet. I learned what fertile cervical mucus was, and learned that for me, it's a better indicator than the saliva microscope to predict fertility.

We started trying in November, and by July after no success, I started bleeding. I bled fairly nonstop for weeks, to only start bleeding again after a brief break. Not only was it impossible to track any cycles because I wasn't sure when one ended and the next began, I wasn't having nearly enough sex to even make pregnancy possible. That was a simply miserable time.

After a few months of this happening, I finally went to the doctor. My husband and I hadn't been trying for quite a year, but I couldn't take the bleeding and wanted to just get on to the medication and get pregnant. My doctor first did an endometrial biopsy (one of the worst things a woman can go through! Imagine a D&C without anesthesia and that's fairly close to what it's like!) and ruled out I had any sort of cancer of the uterus. Then he ordered transvaginal and transabdominal ultrasounds to verify that I didn't have any fibroids or ovarian cysts that could mess with my cycle. Finally he ordered a hysterosalpingogram. This is yet another absolutely delightful procedure. (Please pardon my sarcasm!) For this procedure, they dilate your cervix with a long thin rod similar to the one used in an endometrial biopsy. At the end of this rod is a balloon that once in your uterus, it is inflated to expand it. Then they inject dye into your uterus while doing an ultra sound and if the dye empties out into your abdomen, it means your fallopian tubes are clear and there should be no problems with your eggs releasing. Again, there's typically no anesthesia for any of this, but the upside is that some women suddenly start ovulating normally after having this procedure. I wasn't so lucky. I did come across a clinic that offers this with anesthesia, but it's not covered by insurance, so I'm not sure I would go for that if I had to go through it again. My doctor offers Valium for procedures that make me extremely nervous, and that seems to get me through these.

There are a couple more tests that are quite typical when testing for infertility. One is to have bloodwork done on the third day of your cycle to make sure your hormones are in order. Neither my regular gynecologist nor the first clinic I went to seemed to find this necessary, but I finally had this bloodtest done in order to have my IVF done in the Czech Republic. My bloodwork came back normal, but bloodwork is so simple that I don't see why it should not have been done anyway. Another test I've heard about is the Clomid challenge, and that pretty much tracks your hormones when you take a trial regimen of Clomid. Since my husband has a low sperm count, I wasn't given this test because it doesn't actually matter if I were to ovulate or not because I still wouldn't get pregnant.

So my tentative diagnosis was PCOS, but I'm not entirely sure I buy that. Typical PCOS (PolyCystic Ovarian Syndrome) symptoms include obesity, diabetes, and excessive facial hair. While I do have more than my fair share of hair, I'm also Eastern European, and that's not exactly uncommon. I'm not obese, I'm not even close to being pre-diabetic, and last but not least, I only have 2 known Ovarian Cysts and they are within the completely normal range. I sort of believe that I have more of a simple unlucky cycle. Irregular ovulation. I ovulate with minimal amounts of Clomid, so I don't believe my issues are all that terrible.

If you suspect you're infertile, go ahead and chart your cycles. Buy a fertility monitor if you don't want to take your temperature. I did that for a long time and it was worth the investment. I would also suggest you have your partner's sperm tested as soon as possible because I may not have had all of these tests done if we knew my husband had a low count.

We all know our own bodies better than anyone else, so just by paying attention to yourself, you should be able to come up with a quick conclusion. Thinking about it, I would love to meet someone who thought she was infertile and then find out there is nothing wrong with her and she gets pregnant very quickly. I would be jealous, of course, but a happy jealous if it possible.

Our Background

2010-01-28T07:23:00.000-08:00

Hi, our names are Susan and Glenn, and we are a married couple living in Central New Jersey and are dealing with infertility. I (Susan) am 33 years old, and my husband is 47 years old. We met four years ago, and have been married for a year and a half. This is my first marriage, and my husband's second. He has a daughter from his first marriage, and I have never so much as had a hint of a pregnancy in my life.

We met when I had just turned 29 and Glenn was 43. We met online, and could very easily be one of those couples featured on those tv commercials for online dating success stories. I had only been in a couple of serious relationships in my life, but they were short-term and I never really lived with anyone. I was used to being alone and tried to act proud of being self-sufficient. I honestly wasn't looking for a relationship for anything beyond face value. I still felt young enough that marriage and children were a nice thought for someday, but not anything I was looking for immediately. Glenn was already divorced for a few years by the time we met, but had just gotten out of another long-term relationship with a live-in girlfriend a couple months before. When they say that loves strikes when you least expect it, it certainly is true. I was tired of the online dating scene and had decided after this last round of meeting people I would go on a dating hiatus for a while. Glenn was at the end of a two week, super intensive, dating a different girl every night routine and was just plain tired. We met, and very quickly we realized that our relationship was different than anything either of us had experienced before.

Glenn always spoke very fondly of his daughter. One of his attractions for me was that he has this sweet expression on his face when he talks about what it was like raising her when she was very young. In my opinion, I would say the happiest time in his life was coaching his daughter's softball team, or a trip to Disney World when she was young. Whenever he told me those stories, I hoped that someday we could create our own happy memories like that. I thought to myself, "Wow, this is a man every single woman my age hopes to meet! A man who isn't scared of the concept of family."

As a single 29 year old woman, I always thought men would be scared off if I were to say that I would like children someday. I guess I met the wrong men prior to Glenn, but it was hard enough to get a man to willingly call me his official girlfriend, nevermind discuss wanting to get married and have children. The most recent of the two prior serious relationships I'd had involved a divorced man who said his ex-wife was so obsessed with wanting a baby that he didn't even want to have sex with her because he felt that if she could suck the sperm out of him to fertilize her eggs, she would do it at any chance she had. That may not be a typical male reaction to women, but it was fresh enough in my mind that even expressing a desire for children was something I felt to be taboo. I also still felt young enough that I scoffed at the mythical "biological clock" and even tried to tell myself that I wasn't sure I wanted children anyway.

Glenn told me fairly early on that one of the reasons that he wanted to meet a younger woman like me was that he wanted more children. That immediately put him in a different category than 99% of the men I had met. It was such a relief for me to meet a man where this wasn't off limits to discuss. I still felt like I had time, but he said he would prefer to have children sooner rather than later because of his age. I officially went off of birth control 8 months into our relationship and although I didn't expect it to happen right away, I thought it was something that would happen within the following six months.

After a few months of "trying", I went online to www.FertilityFriend.com to start tracking my cycle and help increase our chances. This is a great site for anyone just starting this journey. It teaches you so much about your body. By the time I went to my gynecologist about our unsuccessful attempts, I felt more knowledgeable about what was wrong with me than my doctor! I don't ovulate regularly, and my husband has a proven track record of successful procreation, so I assumed it was entirely my fault it wasn't happening. Once I started bleeding fairly non-stop for months on end, I figured it was blatantly my fault. My doctor performed the typical, awful tests for me. I had an endometrial biopsy to rule out uterine cancer for my bleeding. I had a hysterosalpingogram to make sure my fallopian tubes are in good working order. I had uterine and abdominal ultrasounds to rule out other various tumors or cancers. I came back clean on all those tests. There was one last test to get done before the doctor would prescribe Clomid for me, and by this time I was so impatient I was already getting tense. My husband finally had his first sperm analysis about a year after I first went off of birth control. The test results came back as a complete shock. His sperm count was so incredibly low that my doctor would not prescribe Clomid to me and he said my husband needs to see a urologist.

We've learned that infertility is that much harder to deal with when it involves both the man and the woman. It is very difficult to find the cause to a man's infertility, especially if it's secondary, which it is in our case. My first thoughts were fear. What if he has cancer of some sort? I was terrified. The internet can be such a terrible thing because it lets us find the most obscure, awful diagnoses and allows us to jump to conclusions. I was worried that if I pushed him too hard to get checked out, he would change his mind about children. I was always waiting for him to say "I already have a daughter. I really don't need anymore children. I'm tired of all this." I was becoming desperate for some miracle to happen.

Once I found out that my husband has a low sperm count and I don't ovulate regularly, if my husband didn't go to see a urologist, the only way a we could have our own biological child would be through IVF, and ICSI to be more specific. Since he doesn't have much sperm, they would inject a single sperm into one of my eggs. I made an appointment at a local infertility clinic, IVF NJ. I found them online, but later on I noticed billboards everywhere for them. If you are in central NJ, please do yourself a favor and do not go to them unless you have money to waste or great insurance! My less than stellar experience with Dr Y is one that deserves its own post!

After finding out that my insurance doesn't cover IVF at all, including medication which is $4000 by itself, and finding out that IVF NJ does not whole-heartedly try to help you find cheaper medications, I looked for other places. I googled all infertility clinics in the area. I went for a consult at the Princeton Center for Infertility and while I liked how the doctor is a straight shooter, she didn't sugarcoat the pricing either. It was similar to the quote of $16000 from IVF NJ. I called Reproductive Medical Associates in Somerset NJ and while their prices were the same, they do offer a program that guarantees the procedure. ICSI costs $16000, so for double that amount of money, they will guarantee a live birth, and if it doesn't happen after 3 or so attempts, they will refund a portion of your cost. I think if we needed traditional IVF and not ICSI, I may have convinced Glenn to try this, but he doesn't believe in financing what happens naturally, so it was time to dig further.

I found another clinic with locations in Northern New Jersey and New York City that offers ICSI for around $5000. I emailed them hoping for more information, and perhaps if they ever responded, I may have tried it through them. While waiting for a response, I went on the CDC web-site and researched all the area clinics and their success rates. I found that the clinic in North Jersey did not report their success rates as required by the CDC, so I became a little wary of them. I still would have gone to them if I had no other options for that price, but Glenn understandingly is worried about my safety and wasn't happy about what the CDC said about them.

My family is from Hungary, and during my research for IVF I found that Eastern Europe has surprisingly high success rates for IVF. Both the Czech Republic and Hungary have equivalent rates to the United States. I talked to my gynecologist about this, and he was extremely supportive and urged me to take the opportunity to have it done overseas if it made more financial sense for me. I emailed a clinic in Budapest, and hoped that my father could travel over there with me and we could stay with my relatives while having treatment. I needed my father for this plan because I unfortunately do not speak Hungarian, and my relatives do not speak English, and after my mother's passing, my father is my only link to my Hungarian family. I know that they would help me out in a heartbeat and put me up, but I felt that if my father wouldn't translate for me, I would be too worried about imposing myself on them. My father is older, and unfortunately at the time felt unable to travel, so he declined to travel with me to Hungary. I guess it's for the best as that is really something that is more for a mother and daughter to do together.

I found two other sites that are dedicated to medical tourism in the Czech Republic. They offered 2 or 3 week "IVF Vacations" and for $5000, I can have ICSI done, with all the possible extras like freezing embryos. I asked Glenn for this last chance to have a baby. I told him that for this price, it's a bit of a bargain, and if it doesn't end up working, we at least will have memories of a trip halfway around the world and not just disappointment down the road from our house. Glenn agreed. The day he said I can go ahead and book our IVF vacation I was the happiest I had been in a very long time. My dreams were finally a possibility.

I can't say which of the sites offers a better service for IVF in the Czech Republic, but I ended up choosing the one that called me back within hours of my request for more information. I figured if they were that interested in my business, I guess they were the way to go. The second site took about 4 days to return an email to me, and that put a sour taste in my mouth even though it looks like they offer a good program too. I guess it depends how impatient you are. After 2 1/2 years, I'm extremely impatient!

In a little over 3 months we are scheduled to travel to Brno, Czech Republic to have the opportunity to have what everyone seemingly takes for granted; the conception of our much desired child.

With this blog, I would like to share the story of our journey through infertility, and hopefully offer useful information on the treatment process with the hopes of making it a little bit easier for others to go through this.