Intro from 3T member jumping(?) into IVF - Please talk me off the ledge! - UPDATED

DharmaChick

UPDATE:
So, after all of this freaking out over IVF... Today I got a call from the RE's office saying that my insurance requires 6 attempted IUIs before they will cover IVF.  We had 5 IUIs, and one additional medicated cycle that we had to move to TI due to travel.  On one hand, I am incredibly frustrated that the RE's office wasn't aware of this before starting me on BCPs (I have a very common insurance carrier for this area) - and annoyed that there is a delay in the process.  On the other hand, I feel like this may be a blessing in disguise.  I have been hoping and praying for guidance and assurance that we have done everything we could before IVF.  This may be our opportunity to try our best at doing everything "perfectly" for IUI and, if it doesn't work out, it should help me to be more comfortable with moving on to IVF.  (I hope!)

_____________________________________________
Hi there!  I've been on the 3T board for about a year, though I have returned to mostly lurking this summer due to depression and a crazy schedule.  I see that there are many familiar names here. I hope that you can forgive me for starting off with a total freak-out.  For the short version, just read the bold parts.

History:  TTC for 2 years.  I have "lean/atypical" PCOS - no insulin or weight issues, but the other fun symptoms and almost never ovulating on my own.  DH has very mild MFI issues, mainly lowish motility.  We have had 6 medicated cycles, 5 with IUI:  3 Clomid + Ovidrel + IUI cycles, 1 Letrozole + Ovidrel + TI cycle, and  2 Letrozole + Ovidrel + IUI cycles
This summer, my RE said that she would recommend IVF next, b/c she is worried about me overstimming on injects alone.  Alternatively, we could continue with Letrozole/IUI cycles - but she warned that it should have worked by now and, especially as we are now in the "unexplained infertility" category, our odds may be decreasing this way.

********BFPs very briefly mentioned (not mine)********

This summer/year has included a lot of stress, as well as many friends who have had their BFPs (many on their 2nd or 3rd), and I just had my 34th birthday, so I jumped on the opportunity to do IVF after trying one last IUI (https://forums.thebump.com/discussion/12422684/updated-bye-bye-iui ).  It felt like such a relief to move on to something with significantly better odds.  I started BCPs two weeks ago to get things started.

Yesterday, I finally had to acknowledge that I am unsure that I am comfortable with moving to IVF.  I completely broke down and feel like I have been either crying or on the verge of tears ever since.  (Seriously, my eyes are burning and swollen at this point.) I called the RE's office indicating that I may have some reservations and asking whether it would be feasible to put the breaks on things.  The nurse called back, answered a couple of questions that I had, and indicated that it may be difficult to work things out with the insurance company (which thankfully covers IVF) if I wanted to back out and do IUI.

Unfortunately: 1) We were communicating via voicemails, so I didn't have the opportunity to have an actual conversation with the nurse and 2) DH is traveling with friends (AGAIN) this weekend.  Which means that I am alone this weekend with my little breakdown.

I feel SO stupid for starting this process before fully checking in with my emotion.  Has anyone else dealt with a change of heart with following through with a method?  How did you (and your insurance coverage) handle it or convince yourself to continue with it??

Part of me really wants to ensure that we try anything we can (acupuncture for me, meds for DH, etc.) with the method I am significantly more comfortable with (IUI), but I also have this HUGE fear that we would be wasting our time.  I am absolutely terrified that, either way, I will make the wrong decision and regret it deeply.

Are there any other methods, meds, etc. that I should ask about?

If anyone has feelings against IVF, please share them with me only via PM.  I do not want this thread to make anyone uncomfortable, as dealing with IF is uncomfortable enough.

Also, an etiquette question:  If I do move back to IUI, is this board the wrong place for me?

Big thanks, huge hugs, and a giant double chocolate cookie to those that read through all of that!!

DharmaChick

IFinTN said:

So my question is what scares you the most? The process, the chance of failure despite going through it all?

The idea of ER freaks me out a little but, mainly, it's the uncertainty about how to handle any unused embryos.

IFinTN said:

Another thing to consider, if you want more than 1 kid, making embryos with 34 year old eggs is better than waiting any longer. You would hopefully get some frosties and they don't age while you will.

Right! We may want two children and, at my age, that actually was probably what most made me jump on the IVF option. However, the dilemma is over any remaining frosties.
How common is it for there to be many others?
I can't seem to get comfortable with any of the options for what to do with them.

ETA: I have a good reserve, and have shown a lot of tiny/immature follies in each medicated cycle, even though I have only had one mature one in each Clomid or Femara cycle, so my RE expects that I would respond strongly to injects.

AngM123

I have no advice but wanting you to know you are not alone in your feelings. I'm sitting here waiting for some euphoric moment to come over me to pull the trigger on IVF. I'm scared I will end up in your shoes when I do. Sigh. ((((Hugs))))

tifga

Loss mentioned


When we started trying for a baby I was flate out against doing IVF so we start with natural cycle IUI.
Then in march I lost our baby, after that we had one poorly timed IUI and one canceled because I ovulated too early, I realized time is not on my side.
When I get pregnant and give birth I will be 1 year from AMA and that scared the daylights out of me.
I did IVF just to bank embryos for later children, personally right now I would go back to IUI to conceive but husband aganist it.
It is scary as hell but if you think you'll want more then 1 baby it is worth it.

DharmaChick

IFinTN said:

One more option-can they freeze your eggs? So if you get 10 eggs then you can try to fertilize 3 of them and freeze the remaining 7. Then you have only theoretically created 3 embryos but you would have the other 7 if you needed them? Just a thought. Note that Egg freezing is fairly new and not all clinics have success with them. ETA: I totally want that cookie now!

That is a good question!  I will ask.  Yes, you absolutely deserve that cookie!!!

IFinTN said:

If none of these options sound palatable, you may want to ask your RE about a low stim ER where the goal is 2-3 eggs similar to what you would get with IUI but you get the benefit of IVF fertilization and transfer.

I do know that my RE wants to start with a low dose, but she still noted a goal of about 10 eggs. She wants to do a single embryo transfer, which is also the most that my insurance will cover.

IFinTN said:

Does your clinic knock you out for ER? Any surgery is not to be taken lightly but it was not that bad for me. I was knocked out. Some don't get knocked out and it can be painful but it is quick!! I hope some of this helps!

Yes, I would be sedated for ER. Strangely enough, that also makes me anxious! I have never been sedated. Even when I had a wisdom tooth removed, I opted for local anesthesia over being knocked out. Thank you, yes, having more info and being able to discuss this does help.
At least I can go back to my RE with some direct questions about other options, rather than just tears over rushing into things.

DharmaChick

AngM123 said:

I have no advice but wanting you to know you are not alone in your feelings. I'm sitting here waiting for some euphoric moment to come over me to pull the trigger on IVF. I'm scared I will end up in your shoes when I do. Sigh. ((((Hugs))))

Thank you.  Based on my current situation, I'm wishing that I took that time to process things.  Instead, I was swayed by that stupid biological clock ticking in my ears. *Hugs* right back at you.  I hope that you find the decision that is right for you.

I suppose that I need another consultation appointment with my doctor.  Right now, I just feel like no matter what choice I make, it is going be wrong in some way.  That just leaves me absolutely miserable.  IF sucks!!

DharmaChick

tifga said:

When I get pregnant and give birth I will be 1 year from AMA and that scared the daylights out of me. I did IVF just to bank embryos for later children, personally right now I would go back to IUI to conceive but husband aganist it. It is scary as hell but if you think you'll want more then 1 baby it is worth it.

I am so sorry for your loss.

The AMA thing is definitely what pressured me into this, too. 
If you don't mind me asking, why would you go back to IUI and why is your hubby against it?  If you would rather send a PM, or if you prefer not to answer that at all, I understand.

Mrs.Ess

I think @IFinTN‌ covered everything I would tell you in terms of your concerns over any extra embryos. I have thought a lot about that as well and am focusing on the fact that I can't predict how many I will actually have. Many ladies end up doing multiple subsequent FETs just to get pregnant so it's not unheard of to end up going through all the embryos. Or to be surprised and not have any to freeze. Also if you want to have more children in the future you could do future FETs.

In terms of the ER, it's just like the rest of this IF crap, you have to keep your eyes on the prize. You can do it!

Lastly, the fact that you have insurance coverage is HUGE. That is amazing and I hope you take advantage of it if you can find peace with your concerns.

I wish I hadn't waited so long to start IVF. DH and I had similar diagnoses as you except my DH has terrible morph so we need ICSI. We didn't do as many IUIs as you but we did try acupuncture for 7 months along with many supplements and more "natural" methods. I don't want to say I regret it but realistically now that we know more about the sperm issue I feel like we wasted a lot of time and Money. DH and I never thought we would do IVF but here we are. I still have my freak out moments but overall I'm looking forward to knowing we did everything we could.

Good luck with your decision, it's not easy

DharmaChick

emilee871 said: 

Maybe if changing to an IUI is going to be difficult for insurance you can take a break to give yourself more time to decide?

Thank you for sharing your experience.
I try to remind myself that I was upset about doing IUI when we first started, and I'm fine with that now.  However, IVF also brings the whole multiple embryo issue into it, which is so hard to process.
That is not a bad idea.  If it turns out that insurance will only do IVF at this point, taking some time to calm down and wrap my head around things may be for the best.

Mrs.Ess

Would your RE do a mini IVF? I have heard they can use clomid or letrozole to produce fewer follicles than traditional IVF but I don't know much about it or the success rates. It might be worth asking about though?

DharmaChick

Mrs.Ess said:

Lastly, the fact that you have insurance coverage is HUGE. That is amazing and I hope you take advantage of it if you can find peace with your concerns.

I know! After getting to know so many wonderful ladies on 3T who want to do IVF but don't have coverage, I feel like I am ignoring a blessing if I don't take advantage of it!

Mrs.Ess said:

I wish I hadn't waited so long to start IVF. DH and I had similar diagnoses as you except my DH has terrible morph so we need ICSI. We didn't do as many IUIs as you but we did try acupuncture for 7 months along with many supplements and more "natural" methods. I don't want to say I regret it but realistically now that we know more about the sperm issue I feel like we wasted a lot of time and Money. DH and I never thought we would do IVF but here we are. I still have my freak out moments but overall I'm looking forward to knowing we did everything we could.

Thank you for sharing this. I am torn between those two aspects: making sure that I am not wasting more time and ensuring that we truly did all that we could.

DharmaChick

Mrs.Ess said:

Would your RE do a mini IVF? I have heard they can use clomid or letrozole to produce fewer follicles than traditional IVF but I don't know much about it or the success rates. It might be worth asking about though?

I have never heard of that, but will certainly ask.  I haven't produced more than one mature follie on each of those, though, so I'm not sure if they would do it.  Perhaps a larger dose, though?

Thank you.

Mrs.Ess

DharmaChick said:

Mrs.Ess said:

Lastly, the fact that you have insurance coverage is HUGE. That is amazing and I hope you take advantage of it if you can find peace with your concerns.

I know! After getting to know so many wonderful ladies on 3T who want to do IVF but don't have coverage, I feel like I am ignoring a blessing if I don't take advantage of it!

Mrs.Ess said:

I wish I hadn't waited so long to start IVF. DH and I had similar diagnoses as you except my DH has terrible morph so we need ICSI. We didn't do as many IUIs as you but we did try acupuncture for 7 months along with many supplements and more "natural" methods. I don't want to say I regret it but realistically now that we know more about the sperm issue I feel like we wasted a lot of time and Money. DH and I never thought we would do IVF but here we are. I still have my freak out moments but overall I'm looking forward to knowing we did everything we could.

Thank you for sharing this. I am torn between those two aspects: making sure that I am not wasting more time and ensuring that we truly did all that we could.



I completely understand. In my experience, the acupuncture and supplements did make a huge difference for me (also lean pcos). However DHs issues did not improve or really change at all. But it certainly does help with stress and overall health. Maybe you could take 3-6 months to do acupuncture etc and think about your plans. That way you Give it time to "work" and also give yourselves time to get comfortable with other options if you find yourself left with this decision again. Waiting is hard but if you will still have the insurance coverage that could be a good option.

gnl42

Everyone above has already given lots of great advice. To echo what PP said, you start out with a lot of eggs and that number decreases along the way. I started with 23 eggs which resulted in 12 frozen embryos (8 of which looked great). We transferred one, which was sadly a chemical pregnancy. We then decided to do CCS testing and had 5 normal embryos remaining (the others had chromosomal abnormalities not compatible with life). I was only comfortable with single embryo transfer, but due to several events, we ended up transferring 2 per several doctors' recommendations. So now we only have 3 left and even if this cycle works, we know we want to try for siblings in the future. Most people do not do the testing, but it's just another thing to think about. Not every embryo that you freeze is genetically normal and viable. Even without testing, you never know how many you will lose along the way.

I come from a physician's perspective, so I was always comfortable donating any remaining embryos for research. It is the research that has allowed all of us to get this far and still have a chance to have a baby. Contributing to the future of this field to help others is a good option for me. I understand that it might not be for everyone.

If you are truly uncomfortable with all of the options, including donating to other IF couples... Then I would talk to your RE specifically about the concern for leftover embryos. I think the goal of 10 eggs is a standard. If you express your concerns, there may be another protocol that the RE could recommend to get less eggs (as others have mentioned). That being said, you have to be comfortable with the idea that a smaller amount of eggs may result in you having to go through another IVF cycle all over again if you don't get lucky right away.

As for ER, I understand it can be scary and the concern for anesthesia. So many of us on this board have been through it and would do it again in a heartbeat if it meant taking home a baby. A lot of things with IVF are very intimidating, but so many women have been through it and come out of it on top. One day at a time and it will be alright.

Sunny B

I'm just kinda re-iterating things that people already posted. The only time I've ever been put under, aside from ER was for my Wisdom teeth. I have to be honest, ER was my favorite part of any of the IVF/FET cycles I've been through. It was by far the easiest.

As far as having too many embryos left over, what is your AFC? We were so blessed to have 6 frosties from our fresh cycle. We used one for our FET and got a BFN. We have 5 left, and I'm definitely terrified at the possibility that it may not work with any of them. I'm not trying to minimize your concern of having too many leftover and @IFinTN gave you great advice regarding only having a certain amount of eggs fertilized. I guess that H and I were more in the mindset of not worrying about what to do with any excess embryos when the time came.

I had always thought about our 6 embyros as our 6 little babies, but something about our BFN kind of shifted that thought for me. IVF can be a wild ride, you never know necessarily how you will feel abou things until you are in it. 

I'd go for it (especially with coverage), but it's a really personal decision that no one can make but you and your partner. All the best to you!

Toriables

Welcome over and what I wouldn't give for that chocolate!! I had a serious case of buyer's remorse after enrolling in a shared risk program. I had done it feeling pretty confident, only $20k and I can get it back. Yada yada yada. Then I realized that I've done monitoring for 2 cycles and drugs for everything and I've spent wellllllll over $15k on these incidentals. Oh crap. What if this works? I'm $35 in the red. That's $35k I could have put toward paying off student loan, mortgage, vehicle. And I'm not done yet. And i don't really know how this story ends. I don't have a grand total price tag dangling from my baby's toe to start selling my body parts on eBay for. But I do know that this commitment to each other and our family has been surprisingly good for our marriage, and bringing us closer. I've learned a heck of a lot about myself and DH. I've given more injections than a heroin addict. But if I didn't take that first step I would still be back sitting at the desk top crying into my coffee about not knowing what to do. At least I feel like I'm doing something. And it's not that bad, it's really not that bad at all. And I keep on keepin on. I hope whatever way you go is good for you and your story is happy. Best of luck.

CML11

@DharmaChick‌ not that this should rule your decision, but if your insurance is like ours it might be something to consider. (We are also covered completely). Once you got approved for IVF, that cycle gets taken away from your lifetime allowance/max. We are allowed 6 fresh cycles (FET do not get counted).

Hugs to you for being unsure about going into this.

LO95

DharmaChick Oh, this post brings back a lot of memories.

We did not go through IUI, but I didn't find out until we started the process of IVF (MFI issues) that in addition to my Endo, it is very likely I have polycystic ovaries (without the syndrome part) due to a very high AMH level.  I became FREAKED! out when I learned that if I overstimmed and got OHSS my insurance would not cover any treatment in the hospital because it is related to fertility treatment, which of course the asshats don't cover anyway.

I called my office and told the nurse the doctor needed to call me that night.  I wasn't sure what he would say, but his exact words were that the insurance company was full of "bullshit" because pregnancy is related to fertility treatment and that will undoubtedly be covered.  (He's right. Several girls at my work are pregnant after fertility treatments without any problem.  Case and point.)  

I then brought up my concern about my low body weight and high AMH.  He told me, very confidently, that I was not going to overstimulate because he wouldn't let it happen and if it would happen on some freak chance I would do a frozen transfer the next month before he would risk me being hospitalized due to a fresh transfer.

I didn't know how it would go, but I can tell you the doctor I went with did a very good job with OHSS-prevention. I was on what they call an "antagonist protocol".  I did LOW doses of everything- 100iu Follistim for ten nights with some monitoring in between for good measure.  Ganirelix happened for four days to prevent me from ovulating on my own.  And then a single trigger shot two days before retrieval.  My treatment was VERY conservative- to the point that I was almost like, woah, wait a minute, what?  But we did retrieve 9 eggs and 5 fertilized- which is a very healthy number for OHSS prevention.

As for egg retrieval, it wasn't pleasant. But after two days of laying around, I was okay.  Genuinely.  Looking back at my first experience I will say the entire thing was surreal.  Is still surreal to me.  But I'm very glad my doctor talked me into it and I do think he's very good at what he does.

I would ask your doctor very specifically 1)what meds will you take, 2) how many monitoring appointments will you have, 3) does she prescribe Dostinex or a related drug after egg retrieval if your estrogen is high (overly high estrogen can be a marker of OHSS but Dostinex can help with preventing any problems).  

Hmm... I'm trying to think of what else.  Honestly, I'd say the scariest part of IVF for me was the beginning- all of this stuff.  You don't know what to ask because you're new to it and it's all overwhelming.  And then I'd say the second hardest part has honestly been NOT having shots to give myself every day.  I felt like I had control of the process at that point.  Now I'm left to the universe and God and every other random thing that can happen- as is any "normal" fertile.

Good luck to you.  Honestly, this is a good board.  You'll have your questions answered here.

LO95

Toriables said:

Welcome over and what I wouldn't give for that chocolate!! I had a serious case of buyer's remorse after enrolling in a shared risk program. I had done it feeling pretty confident, only $20k and I can get it back. Yada yada yada. Then I realized that I've done monitoring for 2 cycles and drugs for everything and I've spent wellllllll over $15k on these incidentals. Oh crap. What if this works? I'm $35 in the red. That's $35k I could have put toward paying off student loan, mortgage, vehicle. And I'm not done yet. And i don't really know how this story ends. I don't have a grand total price tag dangling from my baby's toe to start selling my body parts on eBay for. But I do know that this commitment to each other and our family has been surprisingly good for our marriage, and bringing us closer. I've learned a heck of a lot about myself and DH. I've given more injections than a heroin addict. But if I didn't take that first step I would still be back sitting at the desk top crying into my coffee about not knowing what to do. At least I feel like I'm doing something. And it's not that bad, it's really not that bad at all. And I keep on keepin on. I hope whatever way you go is good for you and your story is happy. Best of luck.

Holy cow I relate to this.  For the OP, that is the honest reality of "shared programs".  You don't realize when you sign the line for that big dollar amount that there are a lot of non-refundable things.  But as this chick said, I do feel closer to my husband now than I ever have in 9 years.  It has brought us together as problem-solvers.  No one is helping us and so we rely fully on each other-financially, emotionally, everything.  I would rather have been normal "fertiles", but I am thankful for my husband and for the fact that I do not take him for granted.

brlee225

AngM123 and @DharmaChick‌ when I was 30 I found out that my tubes needed to be removed and my only option would be IVF.  After 4 long years of feeling sorry for myself and telling myself that I didn't think IVF was for me.  I jumped in.  Is it easy, no.  Is it scary, yes.  And it is also exciting at the same time.  Deep down, I knew I wanted to try it, I am just a bit of a control freak and do not like meds at all.  And to be honest, I really didn't want to start it for it to fail.  But you know what if you don't try, you won't know.  And from reading all the stories on the infertility message board.  I wish I would have just done it at 30. 

You have to do what you are comfortable with.  GL to the both of you.

I started my Stims last night.  I go to my RE tomorrow for BW

DharmaChick

I cannot truly express how grateful I am to you ladies!  Thank you so much for sharing your experiences and info.  There are so many unknowns in this process, which is always something that makes me anxious and frustrated, but gaining some insight from your experience helps so much.

@katemonster1 - I remember you from your old screenname on 3T.  Thanks for the pep talk and for the reality check regarding the frosties.  It is a crazy mind mess that , of course, I would love there to be a ton of frosties available for any future transfers but I also don't want any to weigh on my conscience.  Couldn't there just be a miraculous two embryos that grow - one now, and one when we are ready for a second?!  Lol.  I know, if any of us had that amount of luck, we probably wouldn't be here to start with.

@gnl42 - Thanks for the reality check regarding the numbers.  Good luck with your cycle! We would be most comfortable with donating any unused frosties to research.  I guess I just want to confirm with my doc how they are used, so that I can get a little more comfortable with it.

Sunny B - Again, thank you for this info about the numbers.  It does help to have a better understanding of how this process goes.

@Toriables - Thank you for the words of encouragement.  That's true, crying over my keyboard certainly isn't going to move things along in any way.

@CML11 - That is very good to know, thank you!

@LO95 - Thank you so much for all of that info.  My RE is fortunately very conservative with meds and procedures.  She has indicated that she will be starting me on a very low dose to be wary of overstimming. 
It's probably foolish, but I didn't realize that there would be recovery time after ER, aside from that day.  The RE made it sound like I would be fine the following day.
This experience has certainly been a rough one for me and DH, but I agree that it has forced us to communicate better with each other and has brought us closer.

@brlee225 - I can certainly relate to being a control freak and not being a fan of meds. Good luck with your BW!  I hope that it went well today!

lebradford

I hope if you need to move on after this last IUI you'll feel more at peace with your decision. (But I'm hoping you don't need to move on. Good luck!)

DharmaChick

lebradford said:

I hope if you need to move on after this last IUI you'll feel more at peace with your decision. (But I'm hoping you don't need to move on. Good luck!)

Thank you!