It is soon coming upon the second "reunion" that I have planned with my other fertility warriors. Those who know me well know that I have been conversing for a few years now on a support forum for people suffering with infertility issues. I have become close with two particular groups of women over that course of time. Last year, I took a leap of faith and agreed to meet up with a fairly large group of these women that stretch from all walks of life. I guess that certain struggles in life give you focus, courage, and a sense of self...at least they did for me. I felt empowered to meet these people, as if they were sisters in some sort of secret club that it took a certain degree of suffrage and challenge in which to be included. This is a special group of people.
On this second reunion we will be once again meeting in Mystic, CT. So many of us hail from the East coast (even more so now), and this seems to be a centralized location for most. We have no special plans. We have no special motives. We simply come together to be reunited in our common ground of struggle, perseverance, strength, faith...
Not all of the group is capable of making the trip, as we stretch from as far as Trinidad and Australia. Others simply do not have the time, nor the economic means to make the trip. Once again, we will all be there in spirit. Some of our group are examples of success stories, in that they have achieved the coveted end of parenthood. Others are success stories in that they have stared down the evil of infertility face to face, and they did not succumb to defeat...even though they might never be parents. Others still suffer on the road to an unknown end. In it all...through it all, we lean on each other for support.
I look forward to this adventure (as my husband so lovingly calls it, a "retreat") again this year. These women hold a special place in my heart, as only those who have walked in our shoes can truly understand the separation, anxiety, emptiness, strength, isolation, empowerment...and all the other random emotions that we feel at any given time. We welcome support and empathy in any form in which it is received...but it truly means so much coming from those who have drudged the path that we continue to travel. See you soon, friends....
Tuesday, September 30, 2008
Sunday, September 28, 2008
Hoops and Hurdles
Hoops and Hurdles is going to be our new "update" section. Anytime you see that title...it will just be a brief update on another hoop jumped through or hurdle jumped over on our track to IVF.
Matt had his semen analysis, and we just received the results on Friday. His sperm concentration came back at 207 million. 187 million were motile (moving), which translates to 90% motility. This is read as a "normal" semen analysis...but we think it is better than normal...we think it is pretty great! Matt especially. He claims the state of NJ is going to hold a parade in his honor because his results were soooo good.
Matt and I will both be going for our required bloodwork on Monday.
Matt and I both have to start a required course of antibiotics (Z-Pak) on Wednesday. We only take the five day dose, and we are done.
I will be going into SJFC for all of my other testing on Friday: uterine measurement / trial transfer, cervical cultures, pelvic ultrasound, and sonohysterogram.
Results of all testing will be posted when as we receive them!
Matt had his semen analysis, and we just received the results on Friday. His sperm concentration came back at 207 million. 187 million were motile (moving), which translates to 90% motility. This is read as a "normal" semen analysis...but we think it is better than normal...we think it is pretty great! Matt especially. He claims the state of NJ is going to hold a parade in his honor because his results were soooo good.
Matt and I will both be going for our required bloodwork on Monday.
Matt and I both have to start a required course of antibiotics (Z-Pak) on Wednesday. We only take the five day dose, and we are done.
I will be going into SJFC for all of my other testing on Friday: uterine measurement / trial transfer, cervical cultures, pelvic ultrasound, and sonohysterogram.
Results of all testing will be posted when as we receive them!
Thursday, September 18, 2008
Calendar Coercion
It is an intricate and delicate choreograhpy of multiple items that needs to take place in order for our calendar to be appropriately coerced into suiting not only our social and work lives, but also our upcoming IVF cycle. I have been diligently working on this routine for the past week, and I have certainly made some progress. Things are decidedly falling into place, and I am amused that I have become so good at feeling out and setting up this process. Perhaps bemused is a better description. So many things need to happen at the exact "right times" in order for us to be able to: get all of the screenings done, get the appropriate approval for the IVF cycle, entertain friends coming to town, attend a class reunion, take a company trip to Orlando, AND enter the IVF cycle prior to Christmas. To those on the outside, it might not seem like this would be overly difficult to achieve...however, there is always SO much involvement, not only for the testing portion of all of this but also for the IVF cycle itself, that it can be a daunting task.
I received a call from Kat, the IVF nurse coordinator at SJFC, and she will be helping me to work through and choreograph this process. She had to wait until she had all of our information back from the billing department before she could call me and start the planning. Billing interfaces with the insurance company in order to find out what hoops we all need to jump through while on this course. The billing department notified Kat that in order to even get the ball rolling for the IVF approval process, Matt and I both need to have our infectious diseases bw done, Matt needs to do his SA, and I have to have cycle day (CD) 3 bw done to test my FSH levels. However, in order for Matt to do his SA, he first has to have a referreal from our primary care physician (PCP). See how this starts to get complicated? Well, that is just for starters!
My next cycle is coming up...and in order to move forward with an IVF cycle prior to the end of the year, I would need to have ALL of my RE required screenings done with this upcoming cycle. So, I asked Kat if this was feasible and possible. She said that I need to be sure that I have approval for all of the screenings, so Kat referred me to the billing department. The billing department "thought" that I would be covered for all of the testing, but they recommended that I call Aetna just to be on the safe side. So, I called Aetna...and lo and behold...I am covered for all of the screenings. Several hours and phone calls later into this mission, I now had answers! As long as SJFC can fit me into their schedule, I will be able to complete all of my tests with my upcoming cycle..and this DOES keep us on course to do ER and ET prior to Christmas. It also would allow us to keep all of our committments that we had penned on the calendar prior to reentering the world of IF and IVF.
For those of you who are well-versed in the world of IF and expect these miniscule details, or for those of you who are just simply interested, this is what is in store for this cycle:
Once all of this has been accomplished, AND we have received our approval to do the IVF cycle...the treatment part will actually begin. It can be a dizzying venture, but for old pros like Matt and myself...these pieces of the venture are just simple and necessary evils.
I received a call from Kat, the IVF nurse coordinator at SJFC, and she will be helping me to work through and choreograph this process. She had to wait until she had all of our information back from the billing department before she could call me and start the planning. Billing interfaces with the insurance company in order to find out what hoops we all need to jump through while on this course. The billing department notified Kat that in order to even get the ball rolling for the IVF approval process, Matt and I both need to have our infectious diseases bw done, Matt needs to do his SA, and I have to have cycle day (CD) 3 bw done to test my FSH levels. However, in order for Matt to do his SA, he first has to have a referreal from our primary care physician (PCP). See how this starts to get complicated? Well, that is just for starters!
My next cycle is coming up...and in order to move forward with an IVF cycle prior to the end of the year, I would need to have ALL of my RE required screenings done with this upcoming cycle. So, I asked Kat if this was feasible and possible. She said that I need to be sure that I have approval for all of the screenings, so Kat referred me to the billing department. The billing department "thought" that I would be covered for all of the testing, but they recommended that I call Aetna just to be on the safe side. So, I called Aetna...and lo and behold...I am covered for all of the screenings. Several hours and phone calls later into this mission, I now had answers! As long as SJFC can fit me into their schedule, I will be able to complete all of my tests with my upcoming cycle..and this DOES keep us on course to do ER and ET prior to Christmas. It also would allow us to keep all of our committments that we had penned on the calendar prior to reentering the world of IF and IVF.
For those of you who are well-versed in the world of IF and expect these miniscule details, or for those of you who are just simply interested, this is what is in store for this cycle:
- SA for Matt
- infectious disease panels for both Matt and I
- blood typing for Matt
- CD3 bw for me to test my FSH and E2 levels (ovarian reserve)
- pelvic evaluation for me, to include: uterine measurement (trial transfer), cervical cultures (to check for disease or infection), and a pelvic u/s to check ovaries
- sonohysterogram for me: they will inject saline solution into my uterus through a catheter. they will then use transvaginal u/s to check the uterus for abnormalities (fibroids, tumors, scar tissue, etc.). this will reveal whether or not there is anything in my uterus that could affect implantation or that could cause m/c
Once all of this has been accomplished, AND we have received our approval to do the IVF cycle...the treatment part will actually begin. It can be a dizzying venture, but for old pros like Matt and myself...these pieces of the venture are just simple and necessary evils.
Tuesday, September 09, 2008
Not our first rodeo
Altogether true. Wholly, an understatement. We have been here many times already and have thus far been quite disappointed. Each time is always full of new hopes, anxieties, and excitement, as we allow ourselves to dream just a little. Not too much that a defeat will knock us down and not allow us to get back up, but just enough to make the effort worth it. Each time is filled with a new bit of cynicism, too. We are wounded but not ultimately defeated.
So, to the rodeo we travel once again. I think going back into treatments is somewhat bittersweet. As much as we enjoy the prospect that maybe this time will be THE time, it is hard not to be a wee bit apprehensive. We have been enjoying just being a couple, doing the things that couples do when they aren't worried about black clouds hanging over their heads. Starting this process once again throws us into a whirlwind of unknown and sometimes unexpected emotions. We now have to start planning ahead, changing plans to fit into or around any upcoming cycles. Everything starts to be affected by what we will or may possibly be doing on a given day or during a given week. Everything is affected by how things will or may end up. Some people who haven't walked in similar shoes, albeit unintentionally, start to tread lightly around us because they just have no way of fully understanding. None of this is easy, but ALL of this IS outweighed by the potential reward. We cling to that. We have to.
Today was in someways a "kickoff" to all of the above. I had my initial consult with South Jersey Fertility Center (moving forward, known as SJFC). I met with my new RE, Dr. Van Deerlin to discuss our fertility history and our fertility future. Dr. Van Deerlin was extremely sincere, thorough, and likeable. He made a point to memorize our history prior to coming in to speak with me. This was impressive and the first time that an RE had really put forth such an effort. It was refreshing. The recommended treatment our RE proposes is quite simple: IVF. Getting to that point is a little bit stickier, but it will happen. Here is what things look like for us:
All of this will take at least one cycle to complete, so it will be at least one to two months before we will even begin the actual IVF cycle. The cycle will be a straightforward IVF cycle. Nothing too fancy. Nothing too new. Much more on the actual IVF cycle will be noted once we get closer to that time.
So, we have unofficially blown the dust off of the cowboy boots and are ready to climb up on that bull and get back in the ring. Hold onto your hats...rodeos can be rough...
So, to the rodeo we travel once again. I think going back into treatments is somewhat bittersweet. As much as we enjoy the prospect that maybe this time will be THE time, it is hard not to be a wee bit apprehensive. We have been enjoying just being a couple, doing the things that couples do when they aren't worried about black clouds hanging over their heads. Starting this process once again throws us into a whirlwind of unknown and sometimes unexpected emotions. We now have to start planning ahead, changing plans to fit into or around any upcoming cycles. Everything starts to be affected by what we will or may possibly be doing on a given day or during a given week. Everything is affected by how things will or may end up. Some people who haven't walked in similar shoes, albeit unintentionally, start to tread lightly around us because they just have no way of fully understanding. None of this is easy, but ALL of this IS outweighed by the potential reward. We cling to that. We have to.
Today was in someways a "kickoff" to all of the above. I had my initial consult with South Jersey Fertility Center (moving forward, known as SJFC). I met with my new RE, Dr. Van Deerlin to discuss our fertility history and our fertility future. Dr. Van Deerlin was extremely sincere, thorough, and likeable. He made a point to memorize our history prior to coming in to speak with me. This was impressive and the first time that an RE had really put forth such an effort. It was refreshing. The recommended treatment our RE proposes is quite simple: IVF. Getting to that point is a little bit stickier, but it will happen. Here is what things look like for us:
- Matt needs to see our PCP in order to receive a referral for a SA
- Once the referral is in place, the SA will be done at SJFC
- I need to contact the IVF Nurse Coordinator to get set up for all of my screenings. She will need to coordinate all authorizations and approvals with Aetna.
- We will both need to repeat testing that we had done in the past, namely the infectious disease screening (for HIV, AIDS, Hepatitis B and C, measles, etc.)
- Starting with my next cycle, I will have a plethora of things that need to be done: pelvic evaluation, uterine measurement, cervical cultures, a
sonohysterography (which checks for uterine abnormalities), and day 3 FSH and E2 bw
All of this will take at least one cycle to complete, so it will be at least one to two months before we will even begin the actual IVF cycle. The cycle will be a straightforward IVF cycle. Nothing too fancy. Nothing too new. Much more on the actual IVF cycle will be noted once we get closer to that time.
So, we have unofficially blown the dust off of the cowboy boots and are ready to climb up on that bull and get back in the ring. Hold onto your hats...rodeos can be rough...
Tuesday, September 02, 2008
Red Tape
As usual, there is always red tape to get through in the infertility world. I finally looked into what needed to happen for me to be able to make a consultation appointment with the Reproductive Endocrinologist. I first spoke with a lovely woman on the Member Services line for Aetna. She answered some very general questions for me regarding all of our coverages, referrals, referral processes, and more. She could not offer me any detailed information regarding infertility coverages, though. Luckily, Aetna has its own dedicated Infertility Services department / line for the state of New Jersey. See, NJ is a "mandate state" for infertility benefits. Go, NJ!!!
The woman I spoke with on their dedicated IF line was VERY helpful. Imagine that...a helpful benefits representative! She walked me through the entire process. I need to get "authorization" from the HMO in order to go for the initial consult. The rep handled that over the phone through a brief, yet detailed interview. I am now approved and authorized to go for a consultation AND to have the South Jersey Fertility Center put me through a "monitoring cycle". This cycle will involve bloodwork and ultrasounds in order to show that all looks good and that I am ovulating. After this cycle, the Reproductive Endocrinologist will decide if any more testing for Matt or me is necessary AND / OR what the next treatment steps would be. When we get to this point, all authorizations will be applied for by the RE's office and approved (hopefully) by Aetna. I will personally be out of the red tape loop!
So, our consultation is now scheduled for Wedensday, September 10th at 3pm. I will be seeing Dr. Van Deerlin. I scheduled this appointment, of course, on the only day that Matt was not available. Given that we are "old pros" at this game, we decided it didn't matter, so I will be going solo.
Here is what I learned today about our GERNEROUS coverages:
* UNLIMITED lifetime IUI cycles (artificial insemination)
* Four lifetime fresh IVF cycles (includes past covered attempts, so we have 3 left)
* UNLIMITED frozen embryo tranfers
* diagnosis, treatments, and related meds are all covered
* cyropreservation is NOT covered
* PGD is only covered on a case by case basis, and at this point I would be denied
All in all, looks really great!!! Aetna also uses a "less before more" approach, so you have to exhaust less invasive and less costly treatments before you will be authorized for more invasive and more costly treatments. Given that I have already been through 4 IUIs (not to mention IVF and FETs), the rep from Aetna thinks I will be have no trouble getting approved for IVF right off the bat. All that needs to happen is the RE's office has to fax over my past IUI cycle information / results to Aetna so that they can review them and hopefully approve them (aka:"behind the scenes" red tape). No big deal.
That is the scoop for now.
I am including in this post some general abbreviations for amateurs in the world of Infertility (IF). This will be the last post in which I write out all the big words...just takes too much time, and, after all, this is MY WORLD...you are just visiting it!!
IF = infertility
tx = treatment
dx = diagnosis
RE = reproductive endocrinologist (aka, fertility specialist)
IUI = intrauterine insemination (aka, artificial insemination)
IVF = invitro fertilization (eggs removed / fertilization with sperm in petri dish / embryos grow / placed back into uterus)
PGD = pre-implantation genetic diagnosis (testing of embryos for chromosomal abnormalities prior to being placed back in uterus)
b/w = bloodwork
u/s = ultrasound
pg = pregnant / pregnancy
BFP = big fat positive (positive pg test)
BFN = big fat negative (negative pg test)
OV = ovulation
OPK = ovulation predictor kit (at home)
endo = endometriosis
m/c = miscarriage
s/a = semen analysis
POAS = "pee on a stick" (home pg test)
If we think of any others moving forward, I will try to fill you in!
Stay tuned...
The woman I spoke with on their dedicated IF line was VERY helpful. Imagine that...a helpful benefits representative! She walked me through the entire process. I need to get "authorization" from the HMO in order to go for the initial consult. The rep handled that over the phone through a brief, yet detailed interview. I am now approved and authorized to go for a consultation AND to have the South Jersey Fertility Center put me through a "monitoring cycle". This cycle will involve bloodwork and ultrasounds in order to show that all looks good and that I am ovulating. After this cycle, the Reproductive Endocrinologist will decide if any more testing for Matt or me is necessary AND / OR what the next treatment steps would be. When we get to this point, all authorizations will be applied for by the RE's office and approved (hopefully) by Aetna. I will personally be out of the red tape loop!
So, our consultation is now scheduled for Wedensday, September 10th at 3pm. I will be seeing Dr. Van Deerlin. I scheduled this appointment, of course, on the only day that Matt was not available. Given that we are "old pros" at this game, we decided it didn't matter, so I will be going solo.
Here is what I learned today about our GERNEROUS coverages:
* UNLIMITED lifetime IUI cycles (artificial insemination)
* Four lifetime fresh IVF cycles (includes past covered attempts, so we have 3 left)
* UNLIMITED frozen embryo tranfers
* diagnosis, treatments, and related meds are all covered
* cyropreservation is NOT covered
* PGD is only covered on a case by case basis, and at this point I would be denied
All in all, looks really great!!! Aetna also uses a "less before more" approach, so you have to exhaust less invasive and less costly treatments before you will be authorized for more invasive and more costly treatments. Given that I have already been through 4 IUIs (not to mention IVF and FETs), the rep from Aetna thinks I will be have no trouble getting approved for IVF right off the bat. All that needs to happen is the RE's office has to fax over my past IUI cycle information / results to Aetna so that they can review them and hopefully approve them (aka:"behind the scenes" red tape). No big deal.
That is the scoop for now.
I am including in this post some general abbreviations for amateurs in the world of Infertility (IF). This will be the last post in which I write out all the big words...just takes too much time, and, after all, this is MY WORLD...you are just visiting it!!
IF = infertility
tx = treatment
dx = diagnosis
RE = reproductive endocrinologist (aka, fertility specialist)
IUI = intrauterine insemination (aka, artificial insemination)
IVF = invitro fertilization (eggs removed / fertilization with sperm in petri dish / embryos grow / placed back into uterus)
PGD = pre-implantation genetic diagnosis (testing of embryos for chromosomal abnormalities prior to being placed back in uterus)
b/w = bloodwork
u/s = ultrasound
pg = pregnant / pregnancy
BFP = big fat positive (positive pg test)
BFN = big fat negative (negative pg test)
OV = ovulation
OPK = ovulation predictor kit (at home)
endo = endometriosis
m/c = miscarriage
s/a = semen analysis
POAS = "pee on a stick" (home pg test)
If we think of any others moving forward, I will try to fill you in!
Stay tuned...