Wednesday, January 16th, 2013.  CD2.

Well, if you hadn’t already figured it out, every Infertile’s favorite auntie showed up late in the day yesterday.

I’m pretty much miserable, and more than a little cranky that she showed so early, but there’s nothing I can do about that.  I spoke to the nurse this morning, and the doctor is recommending we escalate my treatment to an injects-only cycle with additional monitoring.

I brought up the possibility of an IUI, and he said that if my response looks good, he would be happy to entertain that idea.  The nurse said that the doc wasn’t concerned with a 10-day luteal phase, even though I tend toward a 12- to 13-day LP in most medicated cycles.  She said that each cycle, even with meds, can be very different and that one shorter LP is not reason to panic.  (Can you guess which nurse I was speaking with?  LOL)

So, I will go in for a baseline ultrasound tomorrow afternoon, and from there, I’ll start Menopur and monitoring every few days.

I was really hoping it wouldn’t come to this, but I suppose none of this is new territory for me.  I’ve had three injectables cycles, four IUIs, hundreds of shots, and thousands of blood draw needles in my arm.

This is just the natural progression, I suppose.

Well, natural for me.


I think people in my life wonder why we’ve been trying these methods for so long, and why we haven’t moved on to IVF or adoption…

First, IVF costs ten to fifteen thousand dollars, and that does not include medications with my doctor.  It also means a long, drawn out process including birth control, gallons of blood work, and invasive procedures.

Second, adoption can cost anywhere from fifteen to sixty thousand dollars, and that’s just domestic adoption of a toddler or older child within the US.  Try adopting an infant from overseas, and you can easily be looking at close to a hundred thousand dollar tab with airfare, hotel stays, meals, home visits, and international legal fees.

Third, both of these options take TIME.  IVF does NOT a guaranteed family make, and adoptions fall through all the time.  You can invest thousands of dollars and years of your life into something that can be undone in a moment.

I guess the long and short of it is that while I am tired and my faith in this process is in a constant state of flux, I am not ready to give up on these less invasive – and expensive – options just yet…

And so, onto the next option, full of hope and with high expectations.

…Same as always.

9 comments on “Escalation

  1. JacquelynandChris Cartwright
    January 16, 2013 at 1:15 pm #

    I understand…after two invasive and physically taxing, unrewarding ivfs, I refuse to go down that road again so diui is all im willing to do. My luteal phase was short this time on an hcg booster so I’m being switched back to progesterone despite the horrible migraines.


  2. ~kboo
    January 16, 2013 at 1:48 pm #

    Darlin’, we need to talk. I disagree with your assessment of IVF. One, having been through 4 of them (at 3 different clinics), my costs were $10-15k *including* meds. There’s only ONE “invasive surgery” but that is not how I would describe the retrieval. It takes 15-20 minutes and you’re up and about shortly afterwards, maybe 24 hours of taking it easy. And not all cycles include birth control, it depends on the protocol you’re on. And even when you do have to take it, “a long drawn out process” of a few extra weeks is nothing in the scheme of things.

    Also, you need to start thinking about how many inject cycles you want to do. They are higher risk for multiples as there is less control over how many follicles you get. Plus, the cost of the meds really add up. Before you know it, you could have paid for an IVF cycle. IVF also provides more answers (again, please ask for your LH to be monitored anytime you do shots — whether injects/IUI or IVF) and IVF does have a higher success rates. As you know, I did numerous injects cycles and really wish I would have opted for IVF sooner…

    I’m not even going to talk about adoption because that always made me angry, you’re a LONG way away from having to even think about that.

    Sorry you’re having to go through this, my friend, but know we are here for you. And I apologize if my words are harsh, but I just want the best for you and wish someone would have pushed me to IVF sooner. I was super afraid and intimidated but honestly, it really wasn’t that bad.

    Hopefully you won’t need any pushing, though, and this new cycle is all you need for your BFP. (((hugs)))


    • Tracy
      January 16, 2013 at 2:31 pm #

      Haha, you make some good points, friend! I guess I was under the assumption that the retrieval and transfer were both surgical – guess I need to hit the books on that, lol.

      IVF pricing at my RE’s office starts at $10K without meds (because my insurance will pay for SOME of them, they don’t include them in the procedure), and is pricier for ICSI, which is what we would want to do. Adoption costs are allllllllll over the map, and generally just piss me off (we are on the same page there, lol).

      I guess my issue with IVF at this point is that no one can tell me if that is truly a better option than what we are doing now. Are the odds that much better for the cost? My doctor doesn’t really seem to think so, or at least he didn’t after my miscarriage. I will talk more with him tomorrow, but I don’t think he will do more than 4 injects cycles without knowing what the problem is. We certainly never expected to do more than 4 injectables cycles, and our insurance doesn’t pay for more than that either, which is why we want to throw IUI at it this time.

      The whole “unexplained” issue is what is holding me back. Maybe before moving forward with any further treatments, I need to pursue further testing… I’ve thought a lot about immunological testing recently, and I know you’ve gone through that, too. It’s still an option, I just want to hold onto hope that the options insurance will pay for can still work. :-/

      Thank you for always being the voice of reason, my friend. 🙂


  3. Erin
    January 16, 2013 at 3:26 pm #

    Your reasons for not trying IVF or adoption are completely personal and no one should question you on it. I have my reasons for not having tried either of them, either, much to the consternation of several acquaintances who think they know what’s best for me and my husband. If it ain’t right, it ain’t right.


  4. Shelley
    January 16, 2013 at 3:28 pm #

    Just wanted to leave my two cents after reading these comments. I have been wondering why you haven’t moved on to IVF and I have to say I agree with kboo, that you should at least consider moving to it. IVF does have better success rates, much better, than IUI – even for people with unexplained infertility like you and like me (15-20% vs. 40-60%). My IUI cycles went well (except for getting too many follicles). I even got pregnant with one (was a chemical), which went to show that my ovaries were working, could pop eggs, my tubes were open, DH’s sperm could fertilize my eggs all on their own, and that embryo could implant itself (and yet I could never get pregnant on my own, wtf!). All good and yet, my RE wanted to move onto IVF fairly quickly because it gave him so much more control over embryo quality and quantity. Of course I had the unfair advantage of having IVF covered by insurance (I know).

    After this cycle, you might also consider just talking to another RE to see what he/she would recommend given your particular history. My RE was always like, we’re not going to keep going down paths that aren’t working, we learn with every cycle and if something isn’t working, we’re not going to waste time, we’re going to move right on to something else (while still respecting the desire not to jump to the most invasive and expensive). I always liked that about him and was always skeptical of other REs (even in the same clinic) who pushed people through multiple rounds of IUI. You have to figure too, it’s the same drugs for IUI and IVF, but how much of that do you want to put your body through. I always felt conscious of that fact.

    And like kboo said, the retrieval is not surgical at all! It’s the exact same thing as an IUI. Very quick, straightforward and relatively painless. Supporting you whatever path you choose!


  5. Tracy
    January 16, 2013 at 3:54 pm #

    You all make such excellent points, and I feel very lucky to have so much support…

    When I think about how long this journey has taken, and the fact that we are four years deep and only just now trying injectables, it seems CRAZY and pretty backwards, honestly.

    However, this path hasn’t been straight and narrow for me. The husband and I tried on our own for a year and half. We were derailed by a crazy OB who was belligerent, and then another OB who was so sweet put me through all the basic testing an RE would, and started me on Clomid.

    After being referred to an RE and waiting the 4 months to see her, we were in the process of moving quite a distance away, and I was starting a new job. I think this is where things took a jagged turn…

    If we had continued with her, despite the distance, we would have moved onto injects in August of 2011. She would have done 3 injectables cycles with IUI, and then we would have moved on to further testing… I would have been offered options for acupuncture, Chinese medicine, yoga and all sorts of alternative and complementary therapies… IVF would have come up a year ago.

    Instead, we made a choice to try a (FREE) clinical study, and I was put on what I assume was Clomid and had 4 unsuccessful IUIs. Yes, I lost 5 months… however, it was worth the attempt.

    We started up with the new RE in Toledo after a month off last summer, and got pregnant the first cycle… Yes, we miscarried, and yes, that short pregnancy has caused me to be stubborn about moving on to IVF, but it was the ONLY glimmer of hope I’ve had in FOUR YEARS!

    I needed that pregnancy, even if it didn’t last… It showed me that my body can, and wants to be pregnant, and it didn’t prove to me that IVF is definitely the way to go… Yet.

    I’m giving injects another shot (heh), and then the husband and I will talk about our options… We are far more stable in our jobs, our new home, and our location than we ever have been in our four years of marriage, so the road is wide open for us for once…

    Where we go from here is not yet clear, but it will be well thought out, thanks to my very supportive and very informed friends. 🙂


  6. Kitten
    January 16, 2013 at 4:18 pm #

    It’s all so overwhelming, isn’t it? And there never seems to be a right answer. Why can’t someone just drop a baby in my arms?


    • Tracy
      January 16, 2013 at 4:24 pm #

      Yes. THIS.

      I think it’s difficult for people who haven’t been through all of this to understand that it’s all-consuming and very depressing to have to have dealt with no answers and multiplying questions for so long…

      All we can do is try what we feel is best, and educate ourselves to the best of our abilities… We are our own best advocates, after all. 🙂


  7. cassiedash
    January 16, 2013 at 6:32 pm #

    I so very much understand your reasons for not moving on to the IVF or adoption routes yet. I really hope that it never comes to that for you. Sorry about the early show of aunt flow…but fingers are crossed for this next cycle!


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