as the fertility window closes for this cycle, i feel confident that we did our very best.
ovulation days: 12, 13
attempts: 11 (p.m.), 13, 14
can't do much better than that. of course, it will be a long two-week wait this time, since this is one of my longer cycles. so we're looking at about a 28 or 29 days, total... meaning my period should come by the end of next weekend. hopefully the time will go quickly and i won't dwell on it too much. i haven't obsessed much these past couple of months, but given the fertility doc's optimistic stance and our diligent efforts i think i'll do a bit more anticipatory toe-tapping this time around. the hubby, too... which is cute. he's been very conscious of my cycle and asked a lot of questions about how everything works. things i feel like i've explained to him before, but whatever. it's nice to see how much he's bought into the process now, rather than just being dragged along with my "i'm getting old!" freak-out. my therapist says all of this matters in the grand scheme of things. it's hard for me to believe that there's truth in that, but she in convinced that if we both weren't ready, it wasn't the time. and we're better than we've been in years... maybe, ever, honestly. if nothing else, it makes the struggle easier to handle. and so... we wait. but together! which is progress. :)
Monday, January 24, 2011
Tuesday, January 18, 2011
cycle 12, day 9: blessings from the medical profession
it's sad that i've forgotten that doctors are supposed to be helpful and a good use of our time rather than a necessary hassle. i have come to think of my ob/gyn as a freak of nature in the medical profession, but i was reminded today that this should be the norm.
i am so glad that we (i! let me give myself credit where credit is due.) decided to see a fertility doctor. our consultation was this morning, and i realized within the first five minutes how much i was rushing to make sure that i got to say everything i needed to say before i slowly started to see that this guy wasn't pushing us out the door. this was so unlike most of my interactions with doctors in the recent past. he engaged us in conversation for over a half hour, going over both of our medical histories and our lifestyles and how we've been TTC so far. he was so helpful, and so nice, and truly seemed to want to work with us rather than just checking off some boxes on a form and shuttling us off for mindless procedures.
we shared the results of the hubby's semen analysis, and he said that from his perspective he's not seeing why it should keep us from conceiving. it seems that my ob/gyn, not being an expert in the boy stuff, may have simply looked at the percentages when he went over the initial results and didn't take into account the fact that the total sperm count is way above average (which is pretty much what the urologist and our common sense said). the fertility doc said he feels the high concentration of sperm outweighs any negatives and that even though the morphology is on the low side, he doesn't think it should matter. he said by the end of our talk that he actually doesn't think it's "male factor" infertility at all, and he's curious to see what else may be going on with me. sigh.
so get this -- even though today was scheduled as a consultation, we got to do some initial tests! i was shocked by this. when he started talking about our next steps, I assumed I'd have to make another appointment to get things rolling, but we wasted no time. after our talk, we went into an exam room where he did an ultrasound to showed us my cervix, uterus, and ovaries and explained what everything was and how it was supposed to look. everything looked perfect. he said the ultrasound allowed him to see that there wasn't any obvious endometriosis, but that may be something we'd have to revisit later. he also did some cultures; i'm not exactly sure what they were all for, but i'm guessing they may have been STD-infection kind of tests. which i know i've been tested for in the past, but it doesn't hurt, i guess. and then he prescribed me some prenatal vitamins and folic acid, and wants me to get some other vitamins that will improve my egg quality. whew.
this week is ovulation, so he wants us to "try our best!" (obviously) and if we aren't successful, we start a "full fertility workup" when i get my period (probably around the beginning of february). the workup normally includes a couple of things we've already had done (the semen analysis and the hysterosalpingogram), so we won't repeat those. but we will do a bunch of other things. it looks like this:
1. 3rd day of period i have a blood test... a big one. 17 vials of blood, they said. yikes.
2. soon thereafter: i have a hysterosonography, which checks the uterine lining for polyps and fibroids.
3. next: we have a post-coital test, which is an exam 9-12 hours after intercourse to see how my body is dealing with the sperm and such. (the hubby will likely feel a lot of pressure about that specific timeline... we might need some strategies there...)
4. when i ovulate again: i have an endometrial biopsy to check my the quality of my endometrial tissue.
5. when we have a discussion appointment to go over all of the results. all of this will happen within my next cycle... assuming we don't get pregnant this time.
but maybe we will! he was rather optimistic, which i suppose we should be. so we'll do our best this week... i should probably ovulate within the next few days. all in all, it just feels like the right thing to do to have this expert on our side and for us to stop jumping to conclusions that the internet or a pay-service lab suggests. all of these tests are totally covered by my insurance, so we can get as much information possible before we start making big decisions. maybe it will turn out that IUI is still a great option for us, but in the meantime i do not feel badly about taking our time with this most-important process. and now it's a week of "trying" to look forward to... woo hoo!
i am so glad that we (i! let me give myself credit where credit is due.) decided to see a fertility doctor. our consultation was this morning, and i realized within the first five minutes how much i was rushing to make sure that i got to say everything i needed to say before i slowly started to see that this guy wasn't pushing us out the door. this was so unlike most of my interactions with doctors in the recent past. he engaged us in conversation for over a half hour, going over both of our medical histories and our lifestyles and how we've been TTC so far. he was so helpful, and so nice, and truly seemed to want to work with us rather than just checking off some boxes on a form and shuttling us off for mindless procedures.
we shared the results of the hubby's semen analysis, and he said that from his perspective he's not seeing why it should keep us from conceiving. it seems that my ob/gyn, not being an expert in the boy stuff, may have simply looked at the percentages when he went over the initial results and didn't take into account the fact that the total sperm count is way above average (which is pretty much what the urologist and our common sense said). the fertility doc said he feels the high concentration of sperm outweighs any negatives and that even though the morphology is on the low side, he doesn't think it should matter. he said by the end of our talk that he actually doesn't think it's "male factor" infertility at all, and he's curious to see what else may be going on with me. sigh.
so get this -- even though today was scheduled as a consultation, we got to do some initial tests! i was shocked by this. when he started talking about our next steps, I assumed I'd have to make another appointment to get things rolling, but we wasted no time. after our talk, we went into an exam room where he did an ultrasound to showed us my cervix, uterus, and ovaries and explained what everything was and how it was supposed to look. everything looked perfect. he said the ultrasound allowed him to see that there wasn't any obvious endometriosis, but that may be something we'd have to revisit later. he also did some cultures; i'm not exactly sure what they were all for, but i'm guessing they may have been STD-infection kind of tests. which i know i've been tested for in the past, but it doesn't hurt, i guess. and then he prescribed me some prenatal vitamins and folic acid, and wants me to get some other vitamins that will improve my egg quality. whew.
this week is ovulation, so he wants us to "try our best!" (obviously) and if we aren't successful, we start a "full fertility workup" when i get my period (probably around the beginning of february). the workup normally includes a couple of things we've already had done (the semen analysis and the hysterosalpingogram), so we won't repeat those. but we will do a bunch of other things. it looks like this:
1. 3rd day of period i have a blood test... a big one. 17 vials of blood, they said. yikes.
2. soon thereafter: i have a hysterosonography, which checks the uterine lining for polyps and fibroids.
3. next: we have a post-coital test, which is an exam 9-12 hours after intercourse to see how my body is dealing with the sperm and such. (the hubby will likely feel a lot of pressure about that specific timeline... we might need some strategies there...)
4. when i ovulate again: i have an endometrial biopsy to check my the quality of my endometrial tissue.
5. when we have a discussion appointment to go over all of the results. all of this will happen within my next cycle... assuming we don't get pregnant this time.
but maybe we will! he was rather optimistic, which i suppose we should be. so we'll do our best this week... i should probably ovulate within the next few days. all in all, it just feels like the right thing to do to have this expert on our side and for us to stop jumping to conclusions that the internet or a pay-service lab suggests. all of these tests are totally covered by my insurance, so we can get as much information possible before we start making big decisions. maybe it will turn out that IUI is still a great option for us, but in the meantime i do not feel badly about taking our time with this most-important process. and now it's a week of "trying" to look forward to... woo hoo!
Tuesday, January 11, 2011
cycle 12, day 2... an update
after spending the past several days making a zillion phone calls between my ob/gyn's office and the lab to have records faxed and get details on IUI procedures, plus reading online and in books and talking to folks who have firsthand experience in such matters, it was the insurance company that finally pushed me to actually think about our current course of action. go figure.
i called aetna this morning to find out about our deductible for fertility assistance; i knew we have $5000 per calendar year once said deductible is paid, but i wanted to make sure the deductible itself wouldn't cause us to go broke. and the representative i spoke to on the phone not only spent way more time and effort than i expected in our conversation about deductibles, but also offered me some advice about the whole situation. he kept saying throughout, "i mean, i'm just telling you what i know from my position, but you can do whatever you think is best..." but, in the end, i'm listening to the insurance guy.
for those of you who have been following along, you may remember that in the fall my ob/gyn referred the hubby to this private lab that doesn't take insurance for his semen analysis. it was only $125, and my doc suggested them, so we went with it. when those results came back iffy, my doctor proceeded to refer us to a urologist for next steps. this guy also wasn't covered by insurance (not just our insurance... ANY insurance) and was considerably pricey for even a consult. at that point i looked online for urologists the hubby could see that might actually be covered, but found none. i kind of shrugged and figured that fertility stuff wasn't widely covered and that we'd just have to suck it up and do a lot of our own research. no biggie. we're good at research.
so we did. we read about the sperm dna test and knew that we wanted to have that done. since we already knew what we wanted, it made sense just to go back to the same lab. thus we've been dealing with this lab, with varied amounts of satisfaction, since then... and planned to go ahead with the IUI through them as well. this was based on one very rushed conversation that the hubby had with a urologist who works with the lab. that is the only actual medical advice we've had since the initial referral for semen analysis.
but again... i didn't think we had many other options. we knew once the deductible was paid the rest of the costs would be covered, and it just seemed like the easiest route. in truth, i wasn't thrilled about it... particularly because it felt like we were simply going about it on our own. they're a private business -- you tell them what you want and they do it. of course they have medical knowledge. i spoke to a nurse. (what she told me didn't agree with some things i'd read about IUI, but i was willing to let that slide.) but when i talked with a friend of mine who had (successful!) IUI, she mentioned some other possible issues that we might need to explore, and i started to think that having an actual doctor advising us would be really, really nice. but again, i didn't think we had that choice under my insurance plan.
i have to say now that it does seem ridiculous. i live in new york city and i have fancy university insurance. i mean... really.
which is pretty much what the aetna guy said to me today. when i asked him about the deductible, he told me that the out-of-network one was $575, which is what we'd pay going through the lab. but then he said, "i'm just curious... what's the benefit of using this lab rather than an in-network doctor?" when i told him i didn't think there were any and he asked for my zipcode, he replied, "oh... no way. you're in new york." in an instant he pulled up a list of 111 specialists covered by my medical plan all within 5 miles of my house that could provide us with the same services as the lab. 111, when i found zero! how could this be the case? well, because he knew the correct terminology to plug into the search bar for these sort of things: "reproductive endocrinology," of course. in a thousand years i never would have come up with that. THIS IS WHY I NEED MEDICAL PROFESSIONALS. even medical insurance guys know more than i do.
so in a split second of decision-making, i called one of the offices that had a website i liked and good reviews online (http://www.kofinasfertility.com/index.html), had a pleasant conversation with a woman on the phone, and scheduled a consultation for tuesday morning! the deductible for in-network doctors is only $150. AND they're real doctors! with offices in places like brooklyn, where i actually LIVE!
this means, most likely, that we won't do the insemination this cycle... because i will probably ovulate next week. but, in the end, the advantages of having a doctor to guide us through this AND saving a bunch of money will outweigh an extra month's wait time. i am feeling much more calm and confident about the whole thing now that we're not flying by the seat of our collective pants. i mean, i know we don't have all the time in the world. but we certainly have the time to be smart. right? right.
i called aetna this morning to find out about our deductible for fertility assistance; i knew we have $5000 per calendar year once said deductible is paid, but i wanted to make sure the deductible itself wouldn't cause us to go broke. and the representative i spoke to on the phone not only spent way more time and effort than i expected in our conversation about deductibles, but also offered me some advice about the whole situation. he kept saying throughout, "i mean, i'm just telling you what i know from my position, but you can do whatever you think is best..." but, in the end, i'm listening to the insurance guy.
for those of you who have been following along, you may remember that in the fall my ob/gyn referred the hubby to this private lab that doesn't take insurance for his semen analysis. it was only $125, and my doc suggested them, so we went with it. when those results came back iffy, my doctor proceeded to refer us to a urologist for next steps. this guy also wasn't covered by insurance (not just our insurance... ANY insurance) and was considerably pricey for even a consult. at that point i looked online for urologists the hubby could see that might actually be covered, but found none. i kind of shrugged and figured that fertility stuff wasn't widely covered and that we'd just have to suck it up and do a lot of our own research. no biggie. we're good at research.
so we did. we read about the sperm dna test and knew that we wanted to have that done. since we already knew what we wanted, it made sense just to go back to the same lab. thus we've been dealing with this lab, with varied amounts of satisfaction, since then... and planned to go ahead with the IUI through them as well. this was based on one very rushed conversation that the hubby had with a urologist who works with the lab. that is the only actual medical advice we've had since the initial referral for semen analysis.
but again... i didn't think we had many other options. we knew once the deductible was paid the rest of the costs would be covered, and it just seemed like the easiest route. in truth, i wasn't thrilled about it... particularly because it felt like we were simply going about it on our own. they're a private business -- you tell them what you want and they do it. of course they have medical knowledge. i spoke to a nurse. (what she told me didn't agree with some things i'd read about IUI, but i was willing to let that slide.) but when i talked with a friend of mine who had (successful!) IUI, she mentioned some other possible issues that we might need to explore, and i started to think that having an actual doctor advising us would be really, really nice. but again, i didn't think we had that choice under my insurance plan.
i have to say now that it does seem ridiculous. i live in new york city and i have fancy university insurance. i mean... really.
which is pretty much what the aetna guy said to me today. when i asked him about the deductible, he told me that the out-of-network one was $575, which is what we'd pay going through the lab. but then he said, "i'm just curious... what's the benefit of using this lab rather than an in-network doctor?" when i told him i didn't think there were any and he asked for my zipcode, he replied, "oh... no way. you're in new york." in an instant he pulled up a list of 111 specialists covered by my medical plan all within 5 miles of my house that could provide us with the same services as the lab. 111, when i found zero! how could this be the case? well, because he knew the correct terminology to plug into the search bar for these sort of things: "reproductive endocrinology," of course. in a thousand years i never would have come up with that. THIS IS WHY I NEED MEDICAL PROFESSIONALS. even medical insurance guys know more than i do.
so in a split second of decision-making, i called one of the offices that had a website i liked and good reviews online (http://www.kofinasfertility.com/index.html), had a pleasant conversation with a woman on the phone, and scheduled a consultation for tuesday morning! the deductible for in-network doctors is only $150. AND they're real doctors! with offices in places like brooklyn, where i actually LIVE!
this means, most likely, that we won't do the insemination this cycle... because i will probably ovulate next week. but, in the end, the advantages of having a doctor to guide us through this AND saving a bunch of money will outweigh an extra month's wait time. i am feeling much more calm and confident about the whole thing now that we're not flying by the seat of our collective pants. i mean, i know we don't have all the time in the world. but we certainly have the time to be smart. right? right.
Wednesday, January 5, 2011
cycle 11, day 20
well, happy new year!
here we are, nearing the end of cycle 11, and i can hardly believe we've been TTC for so long. obviously we're in the two-week wait right now, but these past couple of months haven't been very hope-inspiring. we've done a good job trying, but i think we're just not expecting that it will work anymore. and while this may seem pessimistic, it's made life a whole lot easier to live. i don't worry very much about drinking, and not even a tiny bit about coffee or medication or anything else. i hardly think about it, which is such a lovely change of events.
but this week we decided to start thinking about it again.
in the past few days, the hubby and i have booked two spring trips. which we are VERY excited about. but when i perused the calendar, i realized that two peak fertility times in a row will fall during our travels in March and April, which isn't ideal for diligent trying. so we made the decision to start the IUI process rolling, so that we can at least feel that we're not losing the entire spring.
today we called the lab where he had the semen analyses done, since they also offer insemination services. i also spoke with my ob/gyn to make sure he agreed with our decision. the nurse at the lab was very helpful and said that she'll take a look at the hubby's results while she's waiting for my doc's office to send over my records. after she's had a chance to look at both of our details she said we'll make a plan. but it seems like the general idea is to take one go at it without using any kind of hormone treatment, which i am not unhappy about. i will continue to use the ovulation monitor, and when it indicates ovulation i will go into the lab for an ultrasound, which will make sure that i am actually ovulating properly. then they will do the procedure. luckily, my job is flexible enough that i can scoot out of work if needed, and the lab is also open 7 days a week. now i just need to check with my insurance company to see how much of this is going to be covered and how exactly that works. i hate the red tape, but i'm thankful that we won't have to pay for everything out of pocket.
and, again, having a plan is calming. even though i feel like we're nearing the end of our most favorable options, i like progress. tra la!
here we are, nearing the end of cycle 11, and i can hardly believe we've been TTC for so long. obviously we're in the two-week wait right now, but these past couple of months haven't been very hope-inspiring. we've done a good job trying, but i think we're just not expecting that it will work anymore. and while this may seem pessimistic, it's made life a whole lot easier to live. i don't worry very much about drinking, and not even a tiny bit about coffee or medication or anything else. i hardly think about it, which is such a lovely change of events.
but this week we decided to start thinking about it again.
in the past few days, the hubby and i have booked two spring trips. which we are VERY excited about. but when i perused the calendar, i realized that two peak fertility times in a row will fall during our travels in March and April, which isn't ideal for diligent trying. so we made the decision to start the IUI process rolling, so that we can at least feel that we're not losing the entire spring.
today we called the lab where he had the semen analyses done, since they also offer insemination services. i also spoke with my ob/gyn to make sure he agreed with our decision. the nurse at the lab was very helpful and said that she'll take a look at the hubby's results while she's waiting for my doc's office to send over my records. after she's had a chance to look at both of our details she said we'll make a plan. but it seems like the general idea is to take one go at it without using any kind of hormone treatment, which i am not unhappy about. i will continue to use the ovulation monitor, and when it indicates ovulation i will go into the lab for an ultrasound, which will make sure that i am actually ovulating properly. then they will do the procedure. luckily, my job is flexible enough that i can scoot out of work if needed, and the lab is also open 7 days a week. now i just need to check with my insurance company to see how much of this is going to be covered and how exactly that works. i hate the red tape, but i'm thankful that we won't have to pay for everything out of pocket.
and, again, having a plan is calming. even though i feel like we're nearing the end of our most favorable options, i like progress. tra la!
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