Tuesday, September 21, 2010

Identified Adoption

Wow. I am actually at a loss for words. My friend was just over. Her son and my son are best friends, and she is moving with her son, and her one year old daughter to New York in a few short weeks. I've been sad for my son and to a lesser extent sad for myself that we won't be able to visit as much as we had been. Really I'm more sad for my son just because this is his best friend-anytime we do something fun, he always wants to know if this friend can come with us. He asks about him all the time when it's been a few days since we've seen him and so now I am trying to prep him for that friend leaving and us not seeing them for months at a time. He knows that A is moving to New York. He knows it will take us about 8 hours to drive to Niagara Falls to see them. But those trips will be so worth it because none of us have been to Niagara Falls, so we will plan to make it like a 4 day vacation and actually see some sights while we are there. I don't think it's really hit him yet though.

Anyway, these friends came over to hang out for a little while today. My friend looks at me and Archie and says, "I have to ask you guys a question." I'm thinking to myself, well, I know she's not asking if there is any way she can stay with us when she comes back to visit because I told her earlier today she would always have a place to stay with the kids. So what in the world does she want? Maybe she wants us to help her move to NY. Ha!

She told us that her younger sister is 12 weeks pregnant and not in a position to keep the baby and her sister knows this. Her sister has been talking about placing the baby for adoption. My friend told her she knew the perfect people, told her who we were, and that she would talk to us. My friend "C" thought that this would be great because then she could see her neice/nephew, but her sister was wondering if we would be open to her being able to see the baby. I explained that when we were planning to go forward with adoption we did want an open adoption and that it would be fine, but that honestly I had no idea how identified adoptions work, what was involved. I had no idea what we would have to expect cost-wise, and that in a month and a half we would be doing another IVF/ICSI cycle and if it worked there would be no way we could afford to adopt. I told her that most likely we couldn't afford whatever an identified adoption would cost at this point anyway, but I would look into it.

Anyone out there in blogland that can shed some info on this subject, I'd like to hear from you. "C" seems to think that her sister can just have something notarized that says she gives custody to us, but I told her it's not that easy and to be completely honest I would want the legalities iron-clad. I told her you could either go through an attorney or an agency, but that an agency may be better because they provide counseling for the mom and that is important. Help!

It's funny because a year ago I would have died to have this chance. It just so happens that this coincides with another IVF cycle for us that we are lucky to have insurance mostly covering, and so financially that is the better option for us. Go figure!

Ok people, spill it on the identified adoption. I need to know so that at the very least I can pass the info and options onto C's sister. Thanks!

Friday, September 17, 2010

Initial Consult for Cycle #3

I have to say I felt slightly anxious once we got to the waiting room, but on the drive in, Archie and I just talked about normal random things, not even anything related to the appointment. It was great! I know that I have a tendency to get myself really worked up if allowed to, but we didn't even try to focus on something else. Once we got into the waiting room, I found myself drawn to read things that they had on the table about their 2009 rates of pregnancy with different options, eSET (elective single embryo transfer), etc. All it did was fuel my questions, LOL.

I was a tad bit irritated with my doc's apparent 180. After our last cycle being such a flop, he had said he couldn't recommend doing another antagonist cycle again. Then yesterday we are in the office and he is saying that he thinks we could do that cycle again and it would be possible to get different results. He said that he thinks my estrogen was not high enough and that I respond better with an estrogen above 1500 (he said most wouldn't have a problem, but I need it), and that he thinks my eggs were starved for FSH. I honestly want no parts of that antagonist cycle again. He said my first cycle did not get cancelled (although it was threatened a few times!), and we could do the lupron again. I asked if antagonist was something that could be added in if we found that I was overstimming and he said yes, they have done that a few times. I asked if we would expect it to be detrimental to the cycle or to send me back the opposite direction by adding it and he said it was possible, but he hadn't seen it happen before.

We talked about genetic testing and they explained that they would test me first, and if I came back as a carrier for anything, they would then have to test Archie. Archie and I talked about this and to be honest, just because we are carriers for something doesn't mean our child would definitely have the disease or disorder. Secondly, we don't know that we'd really want to have PGD (pre-implantation genetic diagnosis) done on our embryos. We've never had good quality embryos, and I just feel like we shouldn't mess with them more than we have to. We also know that we would have taken Jack regardless of the things he MIGHT have had and just dealt with them as they came.

I did bring up eSET and they really trust the embryology lab at Shady Grove to give us the recommendations they feel have the best chance of working. One of the things that has changed is that instead of where previously we would go in, and Dr. M would call us after our fertilization report and set us up for a day 3 transfer (our first cycle was day 3). Now, they tentatively set you up for a day 3 transfer, but the lab looks at the embryos that morning and decides which ones are declaring themselves. If they think they will continue to go to day 5, they will schedule us for day 5, if they think they might teeter out, they go ahead with the day 3 transfer and as our IVF nurse put it yesterday, "Let them feel the love." Heck, they even said they could go as far as a day 6 transfer-I highly doubt that will be an option for us, and if it is, prepare for me to be a nervous wreck! The 2009 rates showed that in people my age who elected to do eSET, there was a 62% pregnancy rate (it didn't give the live birth rate), and 1.4% rate of twins (embryo splitting). In people my age who were favorable for eSET, but still put back 2 embryos, there was a twin rate of 42%. I saw that and my eyes about popped out of my head! Dr. M says he would probably consider me to be less favorable because we have had a failed cycle, and he showed me the chart they use to make their recommendations, and he said for someone like me, the recommendation would allow for up to two to be put back. Sounds good to me.

I am feeling better about the prospect of twins. It would make things very difficult for a while absolutely. I emailed one of my friends who had a little girl shortly after Jack was born (also an IVF baby, not great quality embryo), and she had done another IVF cycle and put back two fragmented, so-so looking embryos, and is now blessed to have 3 little girls. She told me it is absolutely hard having twins with a toddler running around, and that the first 6 months is rough, but that it gets better as they get older, and I can see where that would be true. She said as far as affording it, there is always hand me downs, consignment stores, etc. And she had her twins when her oldest daughter I believe wasn't even two. I am lucky enough that if that were my situation, Jack would almost be 5. She said her oldest is now more of a helper than she was, and that does help.

Yesterday I left Jack with a good friend who has 1 year old twin boys. She was nice enough to help me, and Jack is really an easy kid, pretty well behaved, and she said she was surprised at how well Jack shared with the babies. She said she doesn't think most preschoolers share too well, but he was great, he helped entertained the boys, and was really very easy to watch. I was so glad to hear that because I felt awful calling her the day before to beg her to watch Jack while we went to our appointment. He loves babies, has to check out babies everytime we go out somewhere, and still asks if I am going to have another one in my tummy.

Today our financial coordinator called to let us know our coverage. We will have a deductible and our copay that will come out of pocket. The deductible I believe is for our ultrasounds, etc. (I was half asleep when she called). The rest of it should be covered. I also found out from her that our insurance covers the freezing of any embryos we might have leftover up to 80% ($1250 to freeze, so we'd be responsible for about $250)! This was great news. We would have to pay for storage ($360/year) ourselves, but when we did our first cycle we were looking at paying alot more for that at our previous clinic. The other problem was that our embies would have to be frozen at our previous clinic and then we'd have to have them shipped or drive them ourselves to Fairfax for storage as they would not be able to store them on-site. It adds up, trust me. I think if we had anything to freeze, we probably would because at that point we wouldn't know if I was pregnant, and if I ended up not getting pregnant, it is a heck of alot cheaper to do a frozen embryo transfer (FET) than a fresh cycle again. What we would do with our frozen embryos if I was pregnant is another story, and it's one alot of people unfortunately have to decide about. Destroying them, embryo adoption, or embryo donation. That's a whole other blog post in itself, and I'm just not there yet to think about it or bother myself with it. I have enough to think about!

I will tell you that I find myself being excited about this next cycle and that scares me. I'm afraid for the giant letdown we may have to face, but I can't help feeling excited. The process is finally starting, and I feel like it could work. I'd rather know that I was positive and excited than dreading it and feel like it could be my fault that something didn't work.

Up next in the process: Wait...go figure. I have to wait for my next period to start, and then call them so that I can get my labwork done. Then 5-10 days after my period arrives I will have another HSG (that miserable the first go around, but it will be fine, at least this time I don't have the fear of the unknown!) to look and see the status of my fallopian tubes and uterus, and to check for any abnormalities. Then when I get my second period from now, we will start on birth control pills and this third IVF cycle will officially be starting. Look for that in early November!!!

Please pray that nothing unforseen will creep up financially for us. I would ideally like to have our copay, deductible, and funds for potentially freezing and storing put aside before we start our cycle in November, and with my luck, that's enough time for something to happen and zap our funds!

Wednesday, September 15, 2010

Tomorrow

Well, in just over 13 hours I will be going back to my doctor's office. I made the mistake this week of just changing Jack over to school Mondays, Wednesdays and Fridays instead of Tuesday through Thursday. I conveniently forgot about our appointment, which meant that Jack would have to go with us to our appointment tomorrow. This is a problem obviously as fertility clinics want to be sensitive to their clientele, and of course, that clientele are infertile patients...not good to have people with their children in the office. Nevermind the fact that he is a result of fertility treatments and could give them hope, but when you're in the thick of it, it can be hard to see past the trouble you are having and have hope in your future.

I called around to see if anyone could take Jack for a couple of hours tomorrow morning and luckily one of my friends is going to take him. I felt bad asking her as she has two little twins (they were patients of mine when they were born prematurely and we met and became close during their stay), but Jack loves to play with babies, and he is a good, well behaved kid. We'll pack his favorite movies, dvd player and some trains and he'll be good to go. I told her to put him to work-he loves to help with things.

I will update after our appointment tomorrow. Wish me luck, and please pray for Dr. M (who isn't really warm and fuzzy) to have sensitivity when we talk about the hard things from the last cycle, and for us to be able to have pretty clear heads when we go in to see him tomorrow.

Monday, September 13, 2010

A Song I Find Inspiring

I love this song. A friend shared it with me (L for those of you who remember her from previous posts), and I find myself listening to it, reminding me that He is here for me.

Sunday, September 12, 2010

Interesting Reading

Today I was looking through my packet for the new fertility clinic. One of the things they give you read in that packet is about twins. It's basically meant to educate the patient as to the risks of twins, as well as try to dissuade them from putting back more than one embryo. Those of you who have been following me for a while or know me, know that when we did our last cycle, I had a hard time wrapping my head around putting more than one embryo back.

I asked Dr. M what he thought about just putting one back. His response was that he felt that we should put two back in the hopes that we would end up with one baby. Twins were my fear then as they are now. We did not have good quality embryos, and I have a friend who also did not have good quality embryos, and it didn't matter, she still had twins! Little did we know that it would not be an issue as we wouldn't have any normal embryos develop last cycle.

I'm reading this information about twins, the fertility center's take on it, etc. Of course, fertility clinics don't want high amounts of multiples because it's not healthy for the mom or the babies, and they want their end results to be live births. Anyway, it turns out that this fertility clinic that my doctor is now a part of recommends elective single embryo transfers. They recommend transferring one embryo back for women who are younger than 37 (I am), people in their first IVF cycle or ones with a prior IVF pregnancy (me), normal uterine cavity (mostly me), and 1 or 2 Day 5 blastocysts available for transfer...I have never been able to get my embryos to day 5...they all fizzled out and ceased to develop further, hence the reason we never had any snowbabies-nothing made it to the point where we could freeze them.

It sounded good in theory. I want to ask Dr. M what he thinks about it if we were to have decent embryos this next cycle. At least I'll know where we stand and what to expect. I doubt we'll have decent embryos since we never have before, and since in his words my egg quality has greatly declined. But it could happen right?

That brings me to the next thing I'm wondering about. If we had any embryos that made it far enough, would we freeze them in case we did another cycle? Last time we said we would. But last time we also had a greater amount of money available to us through our insurance to pay for frozen embryo transfers. This next cycle is going to use up that money. All things to think about I guess, and things to ask about.

Anyone have any other ideas of questions I should ask Dr. M on Thursday? Now that it's come time to ask them, I can't think of many!

Wednesday, September 8, 2010

One Step Closer

Oh my goodness I am freaking out. In the process of calling to make Jack's 4 year pediatrician appointment, my urology appointment, etc. for this fall and winter, I figured I'd better make my appointment with my fertility doc. My thought on this was that it would take a few weeks for us to get in. So you can imagine my surprise when the receptionist asked if we could come in tomorrow at 11:30. "Oh my God!" was what flew out of my mouth. I just wasn't expecting that and I'm not ready! I thought I'd have another month to mentally prepare myself for the appointment. Going back to the office, seeing my fertility doc is going to bring back alot of mixed feelings (not necessarily good ones) and even thinking about it makes me anxious and want to cry. I looked over at Archie and asked, "Um, does tomorrow work for you." His response? "Oh my God!" LOL. Lucky for me, it's his 34th birthday tomorrow and he's going golfing with some buddies, so I have a week to prepare myself for that appointment. Don't get me wrong, we totally want another child, I just dread the appointment, getting started again, and unfortunately getting started again means talking about what went wrong last time, and that's hard for me.

Our appt is now next Thursday.

I just keep telling myself to breathe.

Tuesday, September 7, 2010

Anticipation

Wow, it's been almost a month since my last post. Not much has been going on. I feel like I've been less affected by pregnancies around me for the most part which is good. As I think about the fact that we'd like to be doing another cycle in as little as two months from now and how I feel like that cycle will go I have a whole mix of feelings.

I feel anxious about whether we'll be able to get the copay together in a month. That's right, a month. They told us to call about a month before we want to cycle, and if we want to cycle in November, that means we need to see Dr. M in October. That's a little scary simply because I haven't talked to that man since I got clarification of "genetically abnormal" after our last messed up cycle. I have alot of questions for him, and to be honest, I am not sure I want the answers to some of those questions. I am anxious because the fertility clinic mine merged with has a higher rate of multiples. I know we will be able to handle it because others have, but I also know what that means as far as increased risk for me and the babies.

I feel like if we can get the copay together in a month, and can get through the tough initial meeting with our doctor, that this could actually work. Dr. M has already said that he couldn't repeat our last protocol given how bad the cycle went, that we would likely go back to our first protocol which resulted in the little boy we love more than anything. I actually believe this next cycle could work. That scares me because I haven't even started the cycle and already I'm emotionally invested and I tried so hard to avoid getting my emotions going during our last cycle. I actually did a decent job of staying relatively unattached to any hopes last time until our fertilization report. It was all downhill from there. I guess perhaps feeling optimistic already is better than feeling bad about the cycle. I do believe to an extent in psyching yourself up.

My last feeling is generally one of excitement. That in about a year we could have another baby or two is so exciting. A little scary about the thought of having double the temper tantrums, double the whininess (or triple as the case may be with 3 kids), the financial impacts, etc, but with double or triple the trying times a parent experiences also means double or triple the most awesome moments in life. It's funny, Jack will be so whiny some days and I think, "are we really thinking we want more of this?!?!?" And then in the next moment my heart melts at something he says or does, and I cannot wait to have soooo much more of that. It makes all the hard times infinitely worth it.

How in the world infertiles don't end up psychiatric inpatients with all of this stress and all of these feelings is beyond me. Somehow we seem deal with all of it, not always in the most constructive ways, and for sure we've all got battle scars somewhere whether they be physical or emotion, but somehow we all find a way to cope. That in itself is amazing.

New Blogsite

Hey all,

It is bad enough that I feel guilty for feelings I sometimes experience on this rocky infertility road, but it's even worse when people can pass judgement on you when they've never even been in that situation, and when they don't even talk to you or ask questions to try to understand those feelings you have. People talk to others about your feelings, judge you based on your innermost private feelings, and you don't even have a clue that they are doing so or have a chance to defend yourself. People who really know me know that I'm a pretty open book, pretty honest, sometimes to a fault. If you ask me a question about something I'm going through I'll tell you, just like if you have a problem with something I say on my blog or don't understand why I said something, talk to ME. I'll respect you more for it, and I'd appreciate some respect in return.

I know who some of my followers are, but I don't know who all of you are. I emailed those that I could contact via email and let them know that I began another blog, simply for more privacy where my feelings are concerned. I provided the address of the site to them, and I do not have it listed on my profile. If you want to continue to follow my blog where more private matters are concerned, please email me at sweetrn621@msn.com for the blog address. Please tell me how you found my blog or know me. I know many people started following my blog during our adoption process. Adoption is not off the table completely, but is currently on the back burner due to another opportunity for IVF to be mostly covered by our insurance (a huge financial difference when compared with the costs of adoption). If it fails, we will at some point proceed with adoption. This blogsite will continue to have random things posted, but not most of the deeply personal things we are going through.

Thanks for your understanding and I hope to see you on my other blog!