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:

  • 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.