Infertility sucks.
It can be draining on your health. It can be draining on your marriage. It can be draining on your social life. It can be draining on your finances.
It's crazy to me just how much it costs to do fertility treatments. Attempts and trials to create life. Some successes and some failures.
I feel like for every failure there should be some kind of refund (even a partial one). Right?
I commend all the couples who have plunked down tens of thousands of dollars on failed attempts. I don't know if I could be that strong. Who knows, maybe we will be.
Recently, I went in for a baseline ultrasound and bloodwork following another failed IUI cycle. When I went to check out with the receptionist, she told me that we had a balance of $XXXX. While I was expecting a balance of some kind based on our previous IUI cycle, I had no idea that it would be five times the amount of the previous time!
I did a double take and asked her to say that again.
I couldn't understand how or why there was such a disparity in the pricing for the EXACT. SAME. PROCEDURE.
Sure, there was a little more monitoring in the way of ultrasounds and bloodwork for this most recent cycle. But in the end, the IUI method was the exact same method.
I talked to the insurance/billing coordinator at the doctor's office to find out what I could about the billing. I was really praying that it was a mistake.
Unfortunately, to my dismay, because the IUI cycle was considered a "Combo Cycle" because we started with straight injectables (Follistim) rather than pills (Femara or Clomid), it was considered an "S-Code" that doesn't get billed until AFTER the IUI procedure and all in one lump some. Some kind of "contractual obligation" to bill that way.
It's a load of insurance mumbo jumbo bull if you ask me. It's how the insurance company gets out of paying for anything and just having this "applied to the deductible".
When I went in for my baseline ultrasound, the ultrasound tech said she saw a cyst, so I figured that meant that we'd have to wait until that cleared. The nurse called me later that day letting me know that I'd be able to start on injections that evening.
Enter the financial conundrum.
Considering that the most recent cycle cost $XXXX, we had to talk about if we could even do another cycle based on the amount that it cost. Yes, we'd get closer to our deductible, making IVF more within reach (if we decided to go down that path)...but seriously, the financial side of this stuff is no joke!
Given our current circumstances, including looking into buying a house, we just can't swing another unexpected lump sum of money...on something that might not work.
I know, I should be thinking "but what if it does work?" and knowing full well that if it were to work, it would have be totally worth whatever we had to shell out.
However, coming from a place of pure pragmatism...it just doesn't seem wise at this time.
It's disappointing.
It feels oftentimes like I have to choose between a house or a baby. We'd like to move to another house for the sake of our future baby. And we'd like a baby.
Too much to ask for!?
Balancing Hope and Disappointment
I know there are tons of quotes about rejection and not giving up.
About perseverance in the face of adversity.
About staying positive and moving forward.
Infertility messes you up.
Not just in the obvious sense of not being able to conceive easily, but mentally as well. It's
I'm pretty sure that after I experienced my miscarriage, I went into a state of depression. I'm thinking that it was on the milder side of things since I was still functioning, still able to get out of bed, and still able to do every day things. I did notice, however, that I didn't have the same drive or motivation to do things as I once did.
My dream of becoming a mother had finally come true, and on our own at that, and then just as quickly as we realized our dream, it was shattered. Into a million pieces.
I felt like I was in a million pieces.
Maybe I deal with grief more gracefully, or maybe I just lie to myself that I'm doing just fine.
Infertility infiltrates your life in a way that you might not even see coming. It lingers like that pimple that just won't go away or mosquito bite that just won't heal.
It seeps into your inner thoughts making you wonder why you should keep on believing or keep on trying. What's the point?
We're looking to possibly make a move and move into a bigger home in a better neighborhood for our future kids. The thoughts of, "What if we never have kids to fill this house?" creep into my head and make me question everything we're doing.
And that's not even addressing the stress that comes with everything it costs to go through and treat infertility. It's not cheap.
It's really upsetting that it is so simple (and inexpensive) to end a life through abortion, and yet it can be ridiculously cost-prohibitive for couples to start a family. I'm not trying to get in a debate about abortion, but I'd like to address the elephant in the room. I think that needs to be something politicians think about.
Every cycle that we go into, I start out ever so hopeful. Like, this could be it. This will be the cycle that gets us our baby. I follow the protocol, the injections, the pills, the medications.
We try to do everything we can to have the best outcome.
And then disappointment.
How do you hang onto hope when you face disappointment? I don't have a clear answer.
I try to turn to gratitude and find the things that I'm grateful for. But I'd be remiss if I said that I didn't also take some time to be sad about it.
I think the key to balancing hope and disappointment is to not remain in disappointment. To take it for what it is and continue moving forward.
How do you hold onto hope in the midst of disappointment?
About perseverance in the face of adversity.
About staying positive and moving forward.
Infertility messes you up.
Not just in the obvious sense of not being able to conceive easily, but mentally as well. It's
I'm pretty sure that after I experienced my miscarriage, I went into a state of depression. I'm thinking that it was on the milder side of things since I was still functioning, still able to get out of bed, and still able to do every day things. I did notice, however, that I didn't have the same drive or motivation to do things as I once did.
My dream of becoming a mother had finally come true, and on our own at that, and then just as quickly as we realized our dream, it was shattered. Into a million pieces.
I felt like I was in a million pieces.
Maybe I deal with grief more gracefully, or maybe I just lie to myself that I'm doing just fine.
Infertility infiltrates your life in a way that you might not even see coming. It lingers like that pimple that just won't go away or mosquito bite that just won't heal.
It seeps into your inner thoughts making you wonder why you should keep on believing or keep on trying. What's the point?
We're looking to possibly make a move and move into a bigger home in a better neighborhood for our future kids. The thoughts of, "What if we never have kids to fill this house?" creep into my head and make me question everything we're doing.
And that's not even addressing the stress that comes with everything it costs to go through and treat infertility. It's not cheap.
It's really upsetting that it is so simple (and inexpensive) to end a life through abortion, and yet it can be ridiculously cost-prohibitive for couples to start a family. I'm not trying to get in a debate about abortion, but I'd like to address the elephant in the room. I think that needs to be something politicians think about.
Every cycle that we go into, I start out ever so hopeful. Like, this could be it. This will be the cycle that gets us our baby. I follow the protocol, the injections, the pills, the medications.
We try to do everything we can to have the best outcome.
And then disappointment.
How do you hang onto hope when you face disappointment? I don't have a clear answer.
I try to turn to gratitude and find the things that I'm grateful for. But I'd be remiss if I said that I didn't also take some time to be sad about it.
I think the key to balancing hope and disappointment is to not remain in disappointment. To take it for what it is and continue moving forward.
How do you hold onto hope in the midst of disappointment?
The Great Follistim Shortage
I was finally able to start a cycle with my doctor's office!
After waiting for a cyst on my ovary to collapse and travel plans to pass, I was finally able to move forward with treatment.
This time around, my doctor had me go straight into injections with Follistim. I was really lucky to have a friend who had some Follistim leftover from another cycle that was not yet expired. However, when I tried to order more, I learned that there was a national Follistim shortage.
How the heck does that happen!?
Considering that Follistim is lab-derived, you'd think that it would be fairly straightforward to keep in stock. Right? Well, apparently not.
When I used up my supply from my friend, and needed more the same night, I let the nurse know that I didn't have any. She sent out the prescription for GonalF, which was it's own adventure in fertility drugs. However, since I didn't have any on hand and needed to inject myself with a dose that night, I was lucky enough to get some Follistim from my doctor's office that had been donated back by another patient.
I drove through rush hour traffic all the way across the city and back, and in the midst of it all, one of my tires was losing pressure and I was super paranoid driving back across town in the event that it might blow out or get flat. Talk about stressful...
It boggles my mind how a pharmaceutical company isn't able to accurately forecast med quantities. You'd think that a shortage would be unheard of...or if there was a shortage that the pharma rep would let the doctor's office know.
And let's now get started on the complete and utter racket that the pharmaceutical companies and insurance companies are. They are no doubt in cahoots with each other for profit. I feel like insurance companies should be a non-profit organization based on principle alone - in order to provide the best care for their customers, instead of gouging them, quoting ridiculous pricing for medications.
I'm not sure how it's possible, but the medication that I ended up ordering through a cash pharmacy was quote to me at almost THREE times the cash price, and that was supposedly the "co-pay". In my experience, co-pays shouldn't cost more than the CASH price of a drug. Maybe I'm wrong, but something just seems terribly fishy there.
As of this writing, Follistim is still in a state of national shortage, and hopefully should be back to normal stock by July.
Our Infertility Journey
Going through infertility is probably one of the hardest things I've had to deal with in my adult life. It's kind of weird because it's not a life-threatening condition, per se, but it is a disease. One that people often suffer in silence with.
However, infertility has also proved to be a great blessing. How? If it wasn't for being on this journey through the waters of infertility, I would have never met the amazing community of ladies who are going through the same thing. We all belong to a club that we wish we weren't a part of, and each wait for the day when our membership is revoked. We can't wait to be kicked out of the club.
I don't think I've shared our own infertility journey, and if anything, it needs a little updating.
We got married in July 2009 and because we dated long distance for three years, we wanted to spend the first couple of years of marriage as a couple. We knew we wanted children, but we wanted to savor the time just the two of us.
In 2012, during my annual well woman exam at my OBGYN's office, I was officially diagnosed with PCOS - polycystic ovarian syndrome. I had the symptoms: trouble losing weight, craving carbs, unwanted facial hair, thinning hair, irregular periods... All "manageable" symptoms through nutrition and exercise, but annoying nonetheless. Since we were not yet trying to start a family, I continued on the pill to regulate my cycles.
In 2013, we were ready to start trying for a family. I came off the pill and knew that it could take a couple of months for my hormones to regulate. We made it to the end of 2013 with no success.
In 2014, after about a year of trying, we saw my OBGYN to try some medicated, timed intercourse cycles. We did Femara/Letrozole and also tried Clomid. I seemed to respond decently to the medication, but no pregnancies.
In June 2014, my OBGYN referred me to a reproductive endocrinologist - the office whose Letrozole and Clomid protocols she was following. I made the appointment and went to my first RE consultation.
I went to the consultation by myself and walked away overwhelmed and unimpressed. The doctor I met with didn't take any time to get any of my history (which I thought was important) and quickly launched into a standard protocol of Clomid and trigger shot.
At the time I wasn't as familiar with medicated cycle protocols as I am now, and I felt like the doctor was not listening to me. My OBGYN had suggested that I had a uterine lining issue (it was thinner than ideal), and told me to tell the RE. Well, he didn't even listen to that. I felt like I was wasting my time if he was just suggesting the same thing I had already done at my OBGYN's office.
I was annoyed. I didn't like that he didn't get to know me at all. I felt like a number and he was just giving me the standard plan of care. I felt like if I was going to have to pay out of pocket for this anyway, I needed to like my healthcare provider.
Needless to say, I did not return to his office ever again.
At the end of 2014, I did return to my OBGYN's office for two more medicated cycle attempts. When our final attempt had no progress, we decided to take a break from medicated cycles. Around the same time, I also started seeing the nutrition testing specialist through my chiropractor. We started supplementing what I was deficient in to help rebalance my hormones.
I continued to see the nutrition testing specialist through the beginning of 2015. I was a lot of vitamins and supplements, and I felt like if I could help my issues in a natural way, that would be great.
After about a six month break, I started to look into a new reproductive endocrinologist. There were a few top offices in our area that I found.
I had a couple important criteria I wanted in a doctor:
- female doctor
- experience with PCOS
- compassionate, empathetic, kind
While I know that male doctors are probably just as qualified as female doctors, I believe that female doctors understand these issues on a level that a man cannot. I feel way more comfortable with a female doctor and it helps when she can empathize (NOT sympathize) with me.
In July 2015, I made an appointment with an RE at a new practice. Based on her online profile, she seemed to fit most of my criteria. The personality component would be determined at our consultation.
Well, long story short, I LOVE our RE! She fits all the criteria and really appreciated that she spent about an hour with us going over our family histories, our personal medical histories, and personally did my first baseline ultrasound. I was impressed. She was kind and carefully reviewed our case to give us her honest suggested plan of care.
In August 2015, while waiting for my cycle to start before we could move forward with the plan of care with our RE, I was on cycle day 40...and I took a pregnancy test. It was positive! I had never seen a positive test before! Coincidentally, the RE's office called that same day to have me come in for routine bloodwork. I told them that I had a positive home pregnancy test and they said they'd do a beta Hcg test as well.
Later that day, it was confirmed that I was indeed pregnant, with an hCG level of over 9,000! (If you're new to beta numbers, that's super high! I didn't really know at the time how high that was). The following week, we went in for our first ultrasound and we got to see the gestational sacs...there were two! But only one looked to be growing. However...based on the date of my last period, it looked like the size was a little bit behind, so they had me come in the following week to check again.
The following week, there was no progress in growth. The doctor seemed to be cautiously optimistic about it, and had me come in the following week. She said that if there were no changes or heartbeat the next week, then we'd have to discuss options.
Well, in September 2015, I miscarried. Our baby stopped growing at about 5 weeks. We never got an accurate reading/measurement and never saw a heartbeat. I opted to take the medication to help move the miscarriage along after waiting two weeks to miscarry naturally. You can read about that here.
After the miscarriage, I had to wait for my cycle to return. My first period post-miscarriage was insanely heavy. Like...crazy heavy. The second cycle was a little bit more normal.
In November 2015 after my cycle started, I had my original testing done (that didn't happen because we took a detour with a positive pregnancy test), and that included an HSG and hysteroscopy. My doctor found a polyp during the hysteroscopy and my tubes were clear following the HSG. I experienced minimal pain with both, but I have a higher tolerance for pain.
In December 2015, I had a hysteroscopic polypectomy to remove the polyp. It was pretty easy. I was nervous about the anesthesia, but it turned out to be an amazing nap. I went home that morning and had another great nap. I felt pretty good the next day.
At the end of December, we tried a Letrozole cycle with trigger, except during my Day 12 soon, I had already ovulated.
We did a Letrozole + Ovidrel trigger at the end of January 2016.
In February 2016, we did Letrozole + Follistim + Ovidrel trigger + IUI.
In March 2016, when I went in for my baseline, they found a cyst lingering on my ovary, after having a super light period.
About two and a half weeks later when I thought my cycle started again, they saw the same cyst, but it was smaller. So I had to wait until it cleared.
My normal cycle started at the end of April 2016, however, because I was going to be out of town and unable to come in for monitoring, we have to wait until the next cycle.
I feel like waiting is the story of my life lately!
So here we are...waiting....waiting...waiting.
I'm a professional at waiting!
#StartAsking and Advocate for Yourself
This week is National Infertility Awareness Week. I know that when I started out on my journey of starting a family, I had no idea what was in store. I never thought that becoming a parent would involve thousands of dollars, endless blood draws, countless ultrasounds (and not the kind in the movies on the outside of the belly....) or even surgery.
Our path has.
I remember when I first learned that it was going to be more complicated to start a family. I was overwhelmed. There was so much information and so little information. And if you don't know anyone who has gone through infertility, you can get lost quickly!
When my OBGYN referred me to a specialist, I was really nervous because I didn't completely understand the process. You'd think that biology and health classes in high school and college would explain it, but it's such a complicated process! When you're not actively trying to conceive, you kind of ignore the details...I know I did!
If you come to the place where you are ready to meet with a specialist, you must advocate for yourself. The first reproductive endocrinologist seemed to be in a hurry. There I was, nervous, didn't understand all the infertility/fertility terms or procedures, and here was this guy spewing all the tests that we had to do. He didn't take time to get to know me or my history. He launched directly into his standard protocol of treatment.
I was not comfortable with that.
I never went back.
Then I heard he left that practice.
When I was ready to dip my toe in the RE pool again, I did my research. I knew that I wanted to find a female doctor (if possible), and hopefully one who had experience treating women with PCOS. I wanted to find someone who would listen to my concerns, answer my questions, and get to know my husband and I a little bit before advising treatment.
After lots of research, I found our current RE, who is wonderful and everything that I could ask for in a reproductive endocrinologist. She has fantastic beside manner, is kind, empathetic, and explains everything in plain English. She is the best!
That experience taught me that if I had gone blindly with the other specialist...who knows where I would be. I know at the very least, I'd be a little disappointed in my care!
This journey is HARD. You must advocate for yourself. Ask questions. Find support.
When you're looking at spending thousands of dollars (with and without insurance!), you shouldn't have to just go to "anyone". If you have the ability to choose your doctor, do so. Even if it means you have to interview multiple specialists. You should feel 100% comfortable with your doctor!
Infertility is defined as the inability to conceive for 12 months or to carry a pregnancy through a live birth
Our path has.
I remember when I first learned that it was going to be more complicated to start a family. I was overwhelmed. There was so much information and so little information. And if you don't know anyone who has gone through infertility, you can get lost quickly!
When my OBGYN referred me to a specialist, I was really nervous because I didn't completely understand the process. You'd think that biology and health classes in high school and college would explain it, but it's such a complicated process! When you're not actively trying to conceive, you kind of ignore the details...I know I did!
If you come to the place where you are ready to meet with a specialist, you must advocate for yourself. The first reproductive endocrinologist seemed to be in a hurry. There I was, nervous, didn't understand all the infertility/fertility terms or procedures, and here was this guy spewing all the tests that we had to do. He didn't take time to get to know me or my history. He launched directly into his standard protocol of treatment.
I was not comfortable with that.
I never went back.
Then I heard he left that practice.
When I was ready to dip my toe in the RE pool again, I did my research. I knew that I wanted to find a female doctor (if possible), and hopefully one who had experience treating women with PCOS. I wanted to find someone who would listen to my concerns, answer my questions, and get to know my husband and I a little bit before advising treatment.
After lots of research, I found our current RE, who is wonderful and everything that I could ask for in a reproductive endocrinologist. She has fantastic beside manner, is kind, empathetic, and explains everything in plain English. She is the best!
That experience taught me that if I had gone blindly with the other specialist...who knows where I would be. I know at the very least, I'd be a little disappointed in my care!
This journey is HARD. You must advocate for yourself. Ask questions. Find support.
When you're looking at spending thousands of dollars (with and without insurance!), you shouldn't have to just go to "anyone". If you have the ability to choose your doctor, do so. Even if it means you have to interview multiple specialists. You should feel 100% comfortable with your doctor!
Some facts about infertility, from Resolve.org
Infertility is defined as the inability to conceive for 12 months or to carry a pregnancy through a live birth
- 1 in 8 couples go through infertility. Yes, that means someone you know is currently going through it whether they are open about it or not.
- 1/3 of the diagnosis have to do with problems with the female, 1/3 is male and 1/3 are both
- Only 15 states have an insurance mandate to offer some form of insurance
Now onto the #StartAsking theme: What questions can you start asking?
- Ask your doctor about tests, diagnosis, medical procedures, and options
- Ask yourself what natural steps you can take to increase your fertility
- Ask your spouse where they stand on medical intervention, adoption, etc
- Ask your friends and family to support and pray for you
- Ask your insurance what coverage you have
- Ask your employer for better coverage for infertility
- Ask your spouse how they are doing
- Ask your friends who are going through infertility how they are doing
- Ask your church to acknowledge infertility
- Ask your congressmen for better coverage for infertility.
#StartAsking the Media
I wish that the media would talk about infertility more often.
The topic is hinted at every now and then, but it's never really a focus of news reports, television shows, or movies.
Every now and then, there will be a brave celebrity who brings up the topic. If we're being totally honest, the celebrity experience with infertility is far removed from the average woman's experience.
Why do I think that?
Often, celebrities have the means and resources to achieve motherhood. IVF - in vitro fertilization - is a common treatment and procedure for infertility patients. It's also one of the most expensive. Many states do not mandate infertility coverage. (Some mandate that it's offered, but not necessarily covered.) As a result, many women cannot pursue this type of treatment because of the financial aspect.
IVF costs thousands and well into the tens of thousands of dollars. That goes for when it's paid out of pocket and even with insurance "coverage." Insurance coverage doesn't guarantee that you're covered for everything. Often, coverage includes only the procedures and not all the prescription medications needed.
What baffles my mind is how easily someone can terminate a pregnancy, and yet for those who are trying to achieve pregnancy, the road can be long and difficult.
I think that rather than fight over abortion rights and all the politics that surround that, more energy should be focused on helping those who want to start their families. It's insane how expensive fertility cost are. It seems that it's the lucky few who either live in a fertility-covered state or happen to have awesome insurance that have access.
I know ladies from my virtual support groups who live all over the country and each one of them has a different experience. Some have great access and coverage, others have none and must pay out of pocket 100%.
I don't think anyone who wants to start a family envisions having to spend upwards of $25,000+ to make it happen.
They find out about it as they get further into their journey. Usually unexpectedly.
I find that the media covers infertility as it relates to extreme and sensational cases - remember the "Octomom" and recently a woman whose mom was her gestational carrier.
Considering that infertility is so common, you'd think that it would hit the media more often.
The most comforting thing for me reading about other cases. Knowing that I am not the only one experiencing this road to a family. My favorite is reading about the success stories of women who have similar conditions and their eventual ability to overcome them.
Thankfully, there is an amazing online infertility blogging community.
Here are some Infertility blogs I recommend, that merely scrapes the surface of bloggers:
Time to #StartAsking
I never imagined that my life would be led down this path. I never thought that infertility would be part of my story.
The experience is both heart wrenching and amazing at the same time.
Infertility sucks. Plain and simple. You want one thing more than anything in the world and yet it's the one thing you can't have. Or it's a lot more complicated and involved to make it happen. You see everyone else around you get what you want. Pregnancy announcements. Baby showers. Pregnancy symptom complaints.
You think to yourself, "I'd give anything to be able to complain about that."
And on the other hand, it's also amazing. Why? The community that I have found through this journey has been awesome. A tribe of ladies who are in the trenches with you. Some with more serious cases of infertility, some with milder cases, some who are in the thick of IVF and on the road ahead of you, and some who are just getting started.
I have to ask though, why is the support mostly virtual?
I've been extremely lucky to get involved in two in-person support groups locally. However, before I discovered those resources, most of the support I could find was online.
So few people talk about infertility. I get it. It's a very personal topic. Society has made it almost taboo. I know that in my own life, I struggle to open up about it. I don't want to be considered "less than" or "not enough". While that's merely a story that I tell myself, I know that it's what so many women tell themselves.
"Why can't I fulfill this desire?"
"What's wrong with me?
"Why is SHE able and I am not?" - I know this is a question I've asked myself so much.
It feels like a matter of our self-worth.
I know it does for me.
While I also know that all these external things - career, motherhood, wife - don't define my self-worth, motherhood feels like it does. My current inability to become a mother makes me feel less than whole.
April 24-30, 2016 is National Infertility Awareness Week, where we have the opportunity to bring more light to this very common condition.
Infertility affects 1 in 8 couples, meaning that you probably know someone who is going through infertility, whether they share their struggle openly or not.
A common practice that I see in the infertility community is sharing your story with others going through infertility, and then once you cross over to "the other side" -- a successful pregnancy, your story can be shared.
But I would argue that our stories should be shared as we walk through it, where we are currently in the process, and not waiting until we find success.
This doesn't mean you have to spill your guts to the Internet or make a public service announcement on Facebook.
It may look like sharing your journey with a close friend or family member. It may look like joining a support group where you can share your struggles with others who are on a similar path. It may look like having monthly check-ins with a friend.
There's one common thing that we all need, especially if you're going through infertility: it's SUPPORT.
I know when we found out that starting our family was going to take a little more work and effort than others, I felt so isolated and alone. It wasn't until I was able to connect with other women who shared their stories both online and off that I realized that infertility is a quite common, though of course undesired, condition.
Having support through this journey is a huge help. Knowing that there are other couples who are coping with similar things reminds you that you are not alone. Being able to talk about topics that only other people who have been through or are currently going through infertility is so important for our sanity. People who get it.
What can our friends and family who have not experienced infertility but would like to be supportive do?
- Be there to listen.
- Ask how you can help and be supportive.
- Show that you care, even though you may not fully understand.
- Check in occasionally, especially if you know that there are some procedures or tests coming up.
- Offer to drive or come with us to appointments if you feel led in that direction.
- Please refrain from suggesting techniques, old wives' remedies, and superstitions that may help getting pregnant. We've heard most of them, and have probably given them a go.
- Understand if we hesitate to RSVP to your baby showers, kids birthday parties, or other baby-centric events. It's not because we don't love you and them, it's because the emotional toll is too much. We'll be happy to send a gift. Please understand, it's not you, it's us.
- If you're currently pregnant, please try not to complain about your pregnancy symptoms in front of us. We'd give anything to be suffering through morning sickness and food aversions. We understand your discomfort, but we're the wrong people to complain to.
For more information about infertility, support groups, and how to get involved, visit Resolve.org
Empire made me cry
I am not the type of person to cry easily when it comes to TV or movies. I can probably list on one hand the number of times that a TV show or movie made me cry. Does this make me heartless? No, I don't think so. My triggers for tears come in other formats.
My hubby and I watch Empire, however since we typically volunteer at church on Wednesday nights, we catch up on episodes on the weekend thanks to Hulu. If you watch Empire and are not caught up, I won't spoil it for you, and if you saw the mid-season finale, then you know what happened.
Anyway, there's a song that Jamal and Hakeem write for their brother Dre, called "Good People". And oh my gosh...like I said, I don't cry easily, but this song, listening to the words made me tear up. Okay, I'll have to spoil just a small detail, but you would have guessed it anyway. Dre and Rhonda lose their baby after Rhonda's accident (where she was pushed down a flight of stairs).
While the song isn't exclusively about miscarriage, it is about loss, and I think this song will resonate with so many people who have gone through loss. For me, I really listened to all of the words in the song and just kept thinking to myself, "Yes. Yes. Yes" to the way I feel and felt about our own miscarriage.
You question yourself, you question God, you question what you did wrong for this to happen. It's likely we'll never know. In fact, 1 in 4 pregnancies end in loss, it's just that most of the time, the loss happens before the pregnancy is confirmed. It appears as a period. I think that's why the stat is so high, but it doesn't seem like it in real life.
Next week is National Infertility Awareness month and the theme this year is #StartAsking. I think that infertility is one of those subjects that feels taboo, or society has made taboo, and in effect, there are SO MANY couples going through infertility and yet they feel alone. I know that as soon as I started to research infertility and support groups I discovered so many others going through the same thing. While I think that the scales are generally tipped in the direction of those who get pregnant easily on my social media feeds, it helps to know that I am not the only one going through this experience.
Today would have been our due date...
I remember when we saw that positive pregnancy test. We were overjoyed. It was probably the happiest moment I can remember since we started trying to conceive. And of course, one of the first things I did was enter my information into a pregnancy due date calculator to see when our bundle of joy would be expected to make an appearance.
April 11. 2016.
Today's date.
It struck me that it was also the date of my grandfather's death anniversary. Twenty three years ago he passed away. I saw it as almost a "sign" that this was meant to be. Kind of like a passing of a torch or something metaphorical I thought up to assign significance to the date.
The days and months following the news that the miscarriage were altered significantly. But it happened in a super subtle way. I felt like the spark and drive that I normally possess dissipated. My motivation evaporated. Things that normally felt easy just felt hard. I didn't want to do anything. I wanted and longed for the one thing I couldn't have.
I think that I didn't really process my grief. I did...but I didn't. Because it happened so early, part of me felt like I wasn't attached, but that was a lie I was telling myself. I now understand the gravity of a positive pregnancy test and that first ultrasound... As soon as I saw that plus sign, I became a mother. My heart doubled in size to carry this new life.
And then it was ripped away.
I went on the for the next few months and I was okay. The memory of the miscarriage tucked away. It would surface when I went to my support group and would tell my story. It would surface when I thought about last summer's extreme highs and deep lows. But I carried on. I tried to focus on other things.
April rolled around. I don't even know how we're already four months into 2016, but we are. I thought about it this weekend. I thought about how things would be different if I didn't have a miscarriage. How this past weekend, I'd either be waiting for labor, in the hospital, or with a new family member that I had prayed for so long.
That wasn't the case. The day came and went. And our arms are empty.
While I didn't spend the day moping around or crying into my pillow, I still thought about the significance that today's date had. What could of been. I know that there's no going back in reverse and the only way to move is forward, but it's definitely something that crosses your mind.
At what point are we at now? Waiting for my cycle to start...again.
I think I've become a professional waiter...as in I'm really good at waiting.
April 11. 2016.
Today's date.
It struck me that it was also the date of my grandfather's death anniversary. Twenty three years ago he passed away. I saw it as almost a "sign" that this was meant to be. Kind of like a passing of a torch or something metaphorical I thought up to assign significance to the date.
The days and months following the news that the miscarriage were altered significantly. But it happened in a super subtle way. I felt like the spark and drive that I normally possess dissipated. My motivation evaporated. Things that normally felt easy just felt hard. I didn't want to do anything. I wanted and longed for the one thing I couldn't have.
I think that I didn't really process my grief. I did...but I didn't. Because it happened so early, part of me felt like I wasn't attached, but that was a lie I was telling myself. I now understand the gravity of a positive pregnancy test and that first ultrasound... As soon as I saw that plus sign, I became a mother. My heart doubled in size to carry this new life.
And then it was ripped away.
I went on the for the next few months and I was okay. The memory of the miscarriage tucked away. It would surface when I went to my support group and would tell my story. It would surface when I thought about last summer's extreme highs and deep lows. But I carried on. I tried to focus on other things.
April rolled around. I don't even know how we're already four months into 2016, but we are. I thought about it this weekend. I thought about how things would be different if I didn't have a miscarriage. How this past weekend, I'd either be waiting for labor, in the hospital, or with a new family member that I had prayed for so long.
That wasn't the case. The day came and went. And our arms are empty.
While I didn't spend the day moping around or crying into my pillow, I still thought about the significance that today's date had. What could of been. I know that there's no going back in reverse and the only way to move is forward, but it's definitely something that crosses your mind.
At what point are we at now? Waiting for my cycle to start...again.
I think I've become a professional waiter...as in I'm really good at waiting.
The Wait Continues
I'm always skeptical when the doctor or nurse tells you that you can test on a certain date. I guess I'm skeptical because I don't fully trust the result. Or, I'm afraid of the result that I don't want. Thus, I wait.
I've become a professional at waiting.
Maybe I should add it to my resume.
We were told that I could take a home pregnancy test on Friday, March 4th. Because my cycle was expected to start on Monday, March 7th, I decided to wait until at least then.
I was so hopeful in this cycle. Things just felt right about it. We made it in a nick of time with my husband going out of town and it seemed like the stars were aligning to make it happen.
I was also really hopeful because that Wednesday was my husband's birthday. I had this dream of being able to present him with an amazing birthday gift...a positive pregnancy test.
Since my cycle did not start that Monday, I decided to go ahead and take the last home pregnancy test that I had stashed away in the drawer. I have always been reluctant to take them without waiting for at least some time past the time my cycle should start as to not "waste" them. I know, other women probably think I'm crazy, but I'm also really pragmatic and frugal when it comes to this kind of thing. And yes, I know I can purchase crazy cheap ones on Amazon...
Much to my disappointment, the HPT was negative. I was hoping for even a faint line. No such luck this month.
The really annoying part was that my period didn't start until that Wednesday and it was really light and kind of odd for my normal cycles.
I called my RE's office to ask about next steps.
I went in that Friday for a baseline ultrasound and if everything looked good we would start straight away on injectables and use the last of my Follistim from the previous cycle.
Unfortunately, to add insult to injury, the sonographer found a cyst on my right ovary. Great. Something else to get in the way of progress. I was given options to take a birth control pill to help move the cyst along or to just wait until my next cycle starts. The nurse also told me that the cyst could be causing the funky period.
Well isn't that nice?
On top of it all, I wouldn't be able to start the injectable Follistim meds...which means that the rest of the vial that I have...that cost beaucoup bucks is going to go to waste. Which hurts my head and my heart from a purely practical standpoint.
And just as the cherry on top to this entire situation, I woke up that Thursday not feeling great, and by Thursday evening, I was running a fever of 102.8 - the highest I've ever seen in my adult life. I had chills, body aches, a slight cough, and a fever. I had the flu. And man oh man, this string of the flu was a doozy. I spent the better part of a week in bed, about 4 days feeling pretty crummy, and finally on day 7, I'm starting to feel normal, but still have a nagging cough.
So yeah, my last two weeks have not been great.
I wish I had more positive news to report, but sadly, I do not.
Just more waiting.
I've become a professional at waiting.
Maybe I should add it to my resume.
We were told that I could take a home pregnancy test on Friday, March 4th. Because my cycle was expected to start on Monday, March 7th, I decided to wait until at least then.
I was so hopeful in this cycle. Things just felt right about it. We made it in a nick of time with my husband going out of town and it seemed like the stars were aligning to make it happen.
I was also really hopeful because that Wednesday was my husband's birthday. I had this dream of being able to present him with an amazing birthday gift...a positive pregnancy test.
Since my cycle did not start that Monday, I decided to go ahead and take the last home pregnancy test that I had stashed away in the drawer. I have always been reluctant to take them without waiting for at least some time past the time my cycle should start as to not "waste" them. I know, other women probably think I'm crazy, but I'm also really pragmatic and frugal when it comes to this kind of thing. And yes, I know I can purchase crazy cheap ones on Amazon...
Much to my disappointment, the HPT was negative. I was hoping for even a faint line. No such luck this month.
The really annoying part was that my period didn't start until that Wednesday and it was really light and kind of odd for my normal cycles.
I called my RE's office to ask about next steps.
I went in that Friday for a baseline ultrasound and if everything looked good we would start straight away on injectables and use the last of my Follistim from the previous cycle.
Unfortunately, to add insult to injury, the sonographer found a cyst on my right ovary. Great. Something else to get in the way of progress. I was given options to take a birth control pill to help move the cyst along or to just wait until my next cycle starts. The nurse also told me that the cyst could be causing the funky period.
Well isn't that nice?
On top of it all, I wouldn't be able to start the injectable Follistim meds...which means that the rest of the vial that I have...that cost beaucoup bucks is going to go to waste. Which hurts my head and my heart from a purely practical standpoint.
And just as the cherry on top to this entire situation, I woke up that Thursday not feeling great, and by Thursday evening, I was running a fever of 102.8 - the highest I've ever seen in my adult life. I had chills, body aches, a slight cough, and a fever. I had the flu. And man oh man, this string of the flu was a doozy. I spent the better part of a week in bed, about 4 days feeling pretty crummy, and finally on day 7, I'm starting to feel normal, but still have a nagging cough.
So yeah, my last two weeks have not been great.
I wish I had more positive news to report, but sadly, I do not.
Just more waiting.
The Cost of Infertility
Sometimes, I wonder if pharmaceutical companies are in cahoots.
Actually, I assume they totally are.
After talking to my RE about next steps, I was prescribed Follistim in a low dose as well as Ovidrel. I remember the first time I paid for Ovidrel and it wasn't covered by our insurance. It was about $175 cash price.
I thought that was expensive.
Then I was introduced to Follistim.
I received a phone call from the specialty cash pharmacy on my way to my doctor's appointment. I asked about my options and when I would need to ship the meds by. Well, since I would need the medication on Monday, and I was talking to them on Friday, they would have to ship on Friday for Saturday delivery since you have to keep the stuff refrigerated.
Then I asked the amount.
I kindly asked if I could call them back after I had been to my doctor's appointment.
After going to the doctor, they instructed me to also give my insurance provider's pharmacy a call. For us, it's Caremark/CVS. Now, I must say that they are great and also not so great. They are great if the medication is something generic and general.
I'm thrilled to say that the Metformin 90-day supply (that I take for PCOS) is $0.36! Yeah, ridiculously cheap. Even the Letrozole, because it's an off-label use is just $0.22. Like, I felt bad swiping a card to pay that little amount.
Now fertility meds on the other hand, not so great. Like flipping expensive...like I imagine how depressing it would be to be going through infertility and then have the barrier of how expensive it is keep you from moving forward. And through Caremark, with some unknown amount of coverage was still more than twice the cost from the cash pharmacy!
I ended up ordering Ovidrel from our insurance pharmacy (since cost was the same as the cash pharmacy) and Follistim through the cash pharmacy.
Out of curiosity, I checked another online pharmacy that carries Follistim...that was another $100 more than Caremark!
My heart goes out to all the people who are going through infertility and doing IVF and have a PLETHORA more medications compared to what I had to order. I can't even imagine paying for all of that out of pocket.
It's pretty ridiculous. Why is it SO expensive to get help to have a baby? And yet it's so simple to terminate a pregnancy? I don't want to get into a political debate about it all, but it just feels like women who need assistance conceiving are penalized over something they can't control. And that premium?
Cahoots.
Tired of Failing
My cycle started last Wednesday.
And I took it harder than I expected.
My RE's office told me that I could take an HPT on Monday 2/8, but me, being ever the pragmatist, waited. I knew I should wait a few extra days, instead of "wasting" an HPT on a negative result. I think I need to get some of those cheap tests off Amazon.
According to my period tracking app, Glow, it said that my period was due on Wednesday 2/10. That morning, I had no signs of it starting. I don't generally experience very many PMS symptoms (I know, I'm lucky), and there were no physical signs. Throughout the day, there was some light spotting, and of course I tried to tell myself that it was implantation spotting...anything but my period starting.
By that evening, it started. And I was mad. I was sad. I was disappointed. I was frustrated.
I keep going back to thinking about how pregnancy is totally not an accident...it truly is a miracle. I know there are women out who blink and get pregnant, but for the rest of us, we pray, we plead, we beg...
So instead of calling my RE's office to report a positive HPT on Thursday, I got to call them to report a new cycle. We talked about getting a little more aggressive in treatment since I had just completed two cycles of Letrozole. One without a trigger shot and one with. They brought me in for a baseline ultrasound that next day and taught me how to inject myself with Follistim.
My doctor prescribed two days of Follistim alongside of taking Letrozole. I go in for a follow up sonogram on Wednesday to see if we can trigger and do an IUI.
I think the hardest part of this journey is that every month you feel like you're putting all your eggs in one basket (no pun with "eggs" intended) and hold on to hope that this will be it.
One the one hand, you don't want to lose hope. On the other, it's exhausting and frustrating and disappointing when you don't get your desired result. I know that I have to remain confident in the path that we are taking and to NOT compare my journey with anyone else. I will just get upset if I think about all the "OOPS" babies that have been conceived and may be terminated. Knowing what a freakin' miracle conception is, I don't take it for granted for one second.
And I took it harder than I expected.
My RE's office told me that I could take an HPT on Monday 2/8, but me, being ever the pragmatist, waited. I knew I should wait a few extra days, instead of "wasting" an HPT on a negative result. I think I need to get some of those cheap tests off Amazon.
According to my period tracking app, Glow, it said that my period was due on Wednesday 2/10. That morning, I had no signs of it starting. I don't generally experience very many PMS symptoms (I know, I'm lucky), and there were no physical signs. Throughout the day, there was some light spotting, and of course I tried to tell myself that it was implantation spotting...anything but my period starting.
By that evening, it started. And I was mad. I was sad. I was disappointed. I was frustrated.
I keep going back to thinking about how pregnancy is totally not an accident...it truly is a miracle. I know there are women out who blink and get pregnant, but for the rest of us, we pray, we plead, we beg...
So instead of calling my RE's office to report a positive HPT on Thursday, I got to call them to report a new cycle. We talked about getting a little more aggressive in treatment since I had just completed two cycles of Letrozole. One without a trigger shot and one with. They brought me in for a baseline ultrasound that next day and taught me how to inject myself with Follistim.
My doctor prescribed two days of Follistim alongside of taking Letrozole. I go in for a follow up sonogram on Wednesday to see if we can trigger and do an IUI.
I think the hardest part of this journey is that every month you feel like you're putting all your eggs in one basket (no pun with "eggs" intended) and hold on to hope that this will be it.
One the one hand, you don't want to lose hope. On the other, it's exhausting and frustrating and disappointing when you don't get your desired result. I know that I have to remain confident in the path that we are taking and to NOT compare my journey with anyone else. I will just get upset if I think about all the "OOPS" babies that have been conceived and may be terminated. Knowing what a freakin' miracle conception is, I don't take it for granted for one second.
Starting Again
I never expected that we'd have to wait so long to get started trying again after the miscarriage. Now, having experienced one, I know so much more and have so much more empathy for all the women who have had one or multiple miscarriages.
Any miscarriage is heartbreaking.
I think it's because you have that glimmer of hope. If you had a positive pregnancy test, there's a special kind of exhilaration you experience when you've been trying for years for this one thing to finally happen.
And then it's all taken away.
In addition to the emotional toll that it takes, there's also a physical toll.
I experienced our miscarriage in September 2015.
My RE then told me to wait until my next two regular cycles.
My first cycle post-miscarriage was the heaviest, longest period I've ever experienced. It felt like a mini-miscarriage minus the cramps.
My second cycle post-miscarriage was still on the heavier than normal side (for me), but a lot more normal than that first cycle post-miscarriage.
So that brought us to November, at which point, my RE had us come in for the remainder of the testing that we never had done when we first met with her because I had a positive pregnancy test...all kinds of crazy.
I had a hysterosalpingogram (HSG) and a hysteroscopy.
The hysterosalpingogram is where they set you up underneath an x-ray machine, inject dye to see if your fallopian tubes are clear. For me, the experience was mostly painless - there was some pressure from injecting the dye, but my doctor talked me through it as she completed the procedure. I felt some cramping, but nothing major, and nothing in comparison to the miscarriage. I have heard from other women, however, who have said that when they had the HSG done, it was a very painful experience. I think it really depends on you, your doctor, and your pain threshold.
As far as the hysteroscopy, you're lying down on a exam table, and the doctor will insert a scope with a small/tiny camera to check out your insides. It takes all of about 2-3 minutes and it's similar pressure and I'd say less painful than the HSG. My doctor did find evidence of a polyp on the back wall of my uterus as well as the site of where implantation had occurred. They call it "products of conception."
Because of the polyp, my RE recommended to have it removed as she suspected that it could have contributed to the cause of the miscarriage. We'll never fully know, but for me, it makes me feel a little better knowing there was some kind of "reason" for it happening.
In December, at the start of my next cycle, I had the surgery. It was a hysteroscopic polypectomy, which is a fancy way of saying that the polyp was removed with a hysteroscope. Thankfully that meant that no incisions were made on me. I was put under general anesthesia for the first time ever, and while I was a little apprehensive about it, it was the best sleep that I can remember.
For me, the surgery was easy. I had surgery on Friday, napped most of Friday afternoon, and felt pretty back to normal by Saturday afternoon. I had to take a week off of exercise/activity until my post-op appointment, but otherwise, everything was back to normal.
So that brings us back to now. At my post-op appointment, my RE told me that the surgery was a success and that she removed the polyp and "products of conception". She asked me what we wanted to do and if we were ready to try again. I said that we were ready. I went in for a baseline ultrasound right before Christmas and started Letrozole. I had a Day 11 ultrasound and it looked like I had already ovulated. They drew blood for a progesterone test, and later that day confirmed that ovulation had occurred. At that point we just had to wait to see what the two week wait might present.
Two days before I expected my period, and on the day that the RE's nurse had told me I could take a HPT, my cycle started.
Sometimes I just want to tell my body to stop being so rude.
So I called my RE's office to let them know that my cycle started again, and I went back in for a baseline ultrasound this past Monday on Day 4. I started Letrozole on Day 4, and I'll go in for a follow up ultrasound on Day 8 - a few days earlier than typical with the hope that we don't miss the ovulation window...because the plan is to trigger ovulation with Ovidrel.
It was weird that I ovulated so early last cycle, but after asking in my support groups, it sounds like other ladies who also took Letrozole experienced some early ovulation as well.
So we'll see what happens this cycle.
