Change of Plans...Final Update

StacyLH24 · January 2014

We just finished what I thought would be our final appointment before our IUI. I had three dominant follicles on Tuesday with a few others lagging behind. As of this morning, there are 6 follicles that are large enough to potentially be mature. I will know more after my blood work comes back.

If more than two or three are mature according to the blood work, we will cancel our IUI cycle. The nurse said that we could potentially convert to IVF. If we can afford it and it is offered, that is our plan. With the time and money we have into our trips to Buffalo and buying vials, it would probably be worth it. Though I'm not sure we can foot the upfront cost.

Now I just wait for my RE to call back this afternoon. I have already sat out two cycles because of surgery. I really don't want to sit out another cycle, but I'm not taking the chance that all those follicles will turn into babies.

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Update: After a lot of consideration and conversation, C and I have decided that we will do another IUI cycle. We have three vials, so I think we will do two IUI cycles and then move to IVF if we get to the last vial. Financially, it makes more sense right now. We figure we might as well also use the vials as well since we have them. So, now I'm just going to let my body ovulate naturally and we will start again when CD 1 shows up. My RE said that using Gonal-F could shorten my cycle. Right now, I'm hoping it does so that we can get started again. I never thought we would even be considering IVF as a serious possibility. I always figured that would be the one thing we wouldn't do, mainly because of the cost. Now that we're in the thick of TTC, we are both willing to pull out all the stops and throw the kitchen sink at it all Thank you everyone who weighed in. I always appreciate the feedback! We may not end up with a baby in 2014, but I am determined that we will end up with a baby in the long run. This definitely has turned out to be a much different journey that what I had imagined. That seems to have been true for almost all of us.

ATXmommas · January 2014

That sounds like a wise decision, though I hope for your sake that this cycle would work out. I can't speak to the costs of IVF, but 2Mamaz made a really good point recently - we find it completely reasonable to finance a 20-30K vehicle over 5+ years, why don't we for a child? I hope you figure out a plan that works for you soon. Going for the best for you!

ball.and.chain · January 2014

Yikes! I totally agree with your decision not to proceed with IUI if there are 6 follies. I hope either that ends up not being the case or you are able to make the impromptu IVF cycle work. I know it's hard to sit cycles out, but in this case it sounds like it could be the healthiest choice if IVF if not an option. Will be thinking of you -- keep us updated.

KH826 · January 2014

Oh wow - tough decision! I agree that an IUI with 6 follicles is not advisable, but I can imagine that the decision to convert to IVF at the last minute is a really tough call to make especially considering cost. With that being said, the cost of just one fresh cycle of IVF was a lot more affordable than I thought it would be. I hope that you guys can make it work if that is the recommended path from your RE. I will be thinking of you!

Jazibel · January 2014

Six - wow!! It sounds like your RE has some good suggestions and I hope that you can find a solution that works for you this cycle (or next). Fingers Crossed this is just a sign from the "fertility gods" that you will get your BFP soon ;-)

trisholiosboi · January 2014

Omg, trisholio would kill me four saying this, but I would love to inseminate with that many good follies!!

2MamazInSeattle · January 2014

Wow - way to go ovaries. I hope the IVF is a possibility and will be an option. 6 follies ready to go, I wonder if they would stim you a little more for a few days to get more follies for an IVF cycle? Meanwhile, here are a few things to think about...

First - if insurance is paying and you have no lifetime max just go for it and ignore all that I write below.

However, if not - and I know this suggestion sucks - you may want to wait and do a 'proper' IVF cycle. I say this because you might see a greater result, and ideally you only want to do it once. You may not have any fert issues, and suppose an IVF cycle was akin to someone like @KH826 who got 12 embies! There is attrition at each stage - with, say, 6 mature eggs, you'd likely see 3 or less embies from that - and maybe just 1. My egg donor was 31 years old - put out 21 eggs, 14 fertilized and we got 4 embies from the cycle and that was good/expected outcome. Numbers vary, I've seen 12 eggs yield 8 embies, but you don't know what is mature, what will fertilize, etc. With a low # of eggs (6) I'd also talk to your RE about ICSI (where they inject the sperm into the egg directly) - this is often done in a case of lower # of eggs.

If it was me and there were any monetary limitations to my coverage, I'd wait a month and put money on the fact that you will likely respond very, very well to IVF drugs and put out a LOT more than 6 eggs. Not to diss your egg count now, but hopefully you see what I'm suggesting. And - for me - I've used all 4 embryos and have no baby yet - not to be doomsday, but you may need more embies than you think, so while one or two or three sounds good now...it may not be enough to get you a take home baby.

Sorry to rain on the parade but wanted to toss this into the mix. Good luck!

KH826 · January 2014

@2mamazinseattle has some very valid points here. A few questions though - are you still stimming? I think I remember you were on injectibles this cycle, correct? If this is the case, you may have more than 6 eggs by the time of retrieval, if you do go the IVF route. For me, I always showed fewer follicles at monitoring appointments, which made me nervous. Two days before my retrieval I only had 12 visible follicles, but 18 mature eggs were retrieved two days later. For me, 16 of those fertilized and 12 embies made it to day 5. Not to say my experience is indicative of "the norm" ... And I recognize that 6 follicles is significantly less than 12; however, my point is just that you never truly know what you are going to get. If you trust your RE and your RE feels your odds are good, then I say go for it. I don't disagree with anything that 2mamaz said at all. My counter point here is just my own relatively new philosophy to trust the process, trust your doctor and sometimes be a little less cerebral with decision making about this process and go with your gut. No matter what you decide, we will all be here to cheer you on!

StacyLH24 · January 2014

Ok...just got of the phone with my RE.

Yes, I was using injectables. Gonal-F to be specific.

We are definitely canceling my IUI cycle as the chance of triplets or higher is a reality based on my hormone levels.

As for IVF...it would be $4000.00 to convert at this point. Though C and I haven't discussed it yet, with only 6 potential eggs, I don't want to drop that much money.

My RE said that we could do another Gonal-F cycle or we could move to IVF. He thinks that with a proper IVF cycle, I would probably respond very well and have embryos to freeze. He likes to see egg retrival in the double digits and I would agree with him.

C and I have a lot to talk about. IUI cycles are minimal cost to us, IVF would not be the same. We can purchase one cycle for $5000.00, not including the cost of meds, or two for $6500. The $6500 includes two fresh transfers and two frozen in one year. I will have some meds already, but any extras would be out of pocket as my insurance doesn't cover IVF. My RE did say that we would probably have a 60% chance of success. That is very tempting for sure. If we can figure out how to finance it of course.

So, now we have a lot more to process through.

I appreciate everyone's input, so please feel free to continue! It helps me think of all the options and what might be best. Thank you all so much!

StacyLH24 · January 2014

I figured it out, and right now, every injectable cycle would be a minimum of $490.30 out of pocket. This is the gas for us to travel back and forth a minimum of 5 times, plus a minimum of 5 $20 copays and then $300 for a vial...though we do have 3 vials already purchased. All of that coupled with getting up at 4 am five times within a week to be in Buffalo by 7 am and then both of us working full days after (unless we travel on a Saturday or Sunday).

I'm leaning toward IVF if we can swing it. We could lower my Gonal-F dose next cycle and I could still over respond and end up with another cancelled cycle. Which really is wasted money and time...in my eyes anyway and I think in C's as well.

My RE said to refill my Gonal-F script now so that my insurance will still cover it. That will add to what I have leftover and build my med supply so I won't feel the sting of that quite as much if we do go to IVF.

I think I'm sold on IVF, money contingent of course. Now I just need to build my case to C... And get a loan!

2MamazInSeattle · January 2014

First, so sorry you got cancelled...all the build up is just so disappointing.

I'm sold on IVF for you as well

. Two cycles for $6500 sounds like a sweet deal, plus meds is rough though since they can be $3-5k. My donor's were $3300. However, in the scheme of life this sounds doable and I know you'll figure out the money. Good luck and keep us all posted!

StacyLH24 · January 2014

Just bumping up to show my update and our final decision. Thanks everyone for your input!

2MamazInSeattle · January 2014

@stacyLH24 So glad you came to a decision and it sounds like a solid plan! And, agreed, if you'd have told me I'd have a double donor baby when we started I'd have told you "nfw"...i think never say never is a good TTC mantra indeed. Keep us posted!!

ATXmommas · January 2014

Sounds like a good plan. Glad you and C came up with something huh are comfortable with. Much luck to you over the next couple months!

laynesmomma · January 2014

I think that's a great decision. Going straight to IVF could potentially save you some rides on the emotional rollercoaster if you keep trying IUI. GOOD LUCK!!!

StacyLH24 · January 2014

Haha! My friend said that could be the next reality show...two lesbians and six babies. No thanks!

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