What now????

Sorry for the silence around here lately.  The last two weeks have been unbelievably overwhelming and stressful.  I thought about posting multiple times but each time realized that either I was so overwhelmed that nothing I could say would come out coherently or that I needed to use the time to take a break from obsessively thinking about things.

The following things have happened in the last two weeks:

Election day!  Roo and I stayed up way too late on November 6th.  We waited anxiously, consulting various news channels and websites and alternating between excitement and terror.  When we finally heard the results in Maine and Maryland we giggled and giggled.  It was amazing to watch majorities in 4 states vote in support of marriage equality! And a pro-equality president get re-elected!  I was grateful for facebook (not a sentiment I always feel) as we could sit at home in our pajamas while feeling like we were watching the returns with a whole community of our friends.  And it was fun to hear friends all over the country starting to plan their weddings.

A meeting with Dr. Y.  Our excitement and joy about all of that good news lasted less than 24 hours because the next day we went to BSFC to talk about our next steps.  Dr Y’s recommendation was to move straight to IVF.  He feels that IUIs with injectibles don’t increase the odds of conception all that much (they go from 15% to 17%, according to him).  And they do increase the rate of multiples by a lot (I think it was something like 30% of pregnancies are multiples).  So he feels it’s better to save the money that we would have spent on several injectible IUI cycles and put it towards IVF.

Lots of stress about money.  The idea of doing a treatment that would give us a better shot at making this work sometime before we are 60 is incredibly appealing.  But we have no idea how on earth we could possibly afford IVF.  One cycle would be the same price as a car (and we’re going to need a new car in the not-too-distant future, as mine seems to be failing fast).  Or we could do the shared risk program, which would give us up to 6 cycles for the price of a really nice car.  There’s some financial assistance available, which we have applied for.  And they have financing companies to refer us to.  But I have no idea how we could afford daycare for two kids plus this new car that we’ll need at some point plus paying back a ginormous fertility loan.

Awkward email conversations.  There has been added drama because we talked about our options with my parents, who incredibly generously offerred to help with a chunk of the cost of IVF.  Hooray!  Fabulous, right?  We are very grateful.  But since then we’ve had a very awkward and painful email exchange with them which makes us unsure that we feel comfortable accepting their money.  My relationship with my parents is complicated enough as it is, do we really want to add the compexity of accepting such a big sum of money?  Especially since one of the hardest things about dealing with my parents is their inability to talk about feelings and resolve conflicts? For added fun we’re supposed to spend Thanksgiving with them and a few other family members.   Wheeeee!

So we’re still unsure where to go from here.  It seems like we have at least four options:

  1. Accept the money from my parents and hope that we can work out any awkwardness with them.  We could start with IVF as soon as January sometime.  It would be expensive (since we would still have to cover a part of the cost), but is the route that gives us the best odds of actually someday having another baby.
  2. Continue with IUIs (maybe with injectibles?) with Roo for a try or two more.  We’re out of insurance coverage for this so it wouldn’t be cheap.  And we’re not thrilled with the odds that it would give us.
  3. Switch back to trying with me.  This would be the least expensive option since we would be stating over with 6 IUI cycles partially covered by insurance.  But it would be really hard on Roo to watch me get pregnant again.  And that’s not the route we wanted to go this time around.  Plus I feel exhausted just thinking about starting again with IUIs and their dismal success rates.  I got lucky and got pregnant on our second cycle of IUIs before, but there’s no guarantee that that would happen this time around, especially since my reproductive system is almost five years older.
  4. Switch gears completely and look at adoption options.  This isn’t high on our list, mostly because it involves starting over with an entirely new (and also unpredictable and potentially-expensive) process.

In this time of Thanksgiving I am grateful for many things including Tadpole (who continues to be adorable and fabulous and sweet) and my relationship with Roo (which feels like one solid thing in the midst of the chaos that surrounds us) and my parents (who love us very much even though our way of being in the world is baffling to them).  When I put our lives in a global context, we are incredibly privileged.

But I also feel stuck.  I’m angry that Roo’s and my little do-gooder jobs don’t pay well enough to help us afford to make our dreams a reality.  And I’m so angry that we’re even in this predicament.  This was supposed to work by now, dammit!  Why have we had such shitty luck?

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16 Comments

Filed under TTC #1, TTC #2, Uncategorized

16 responses to “What now????

  1. tbean

    Tough choices, for sure. I remember one of the harder parts of the ttc odyssey for me was figuring out how to see through all the muck and make the next decision. And for a long while, it seemed like every avenue we turned down, we had always chosen the wrong direction.

    Your IVF shared risk options make me think that you might be in our neck of the woods and at the same clinic we used. If you want to discuss more about IVF shared risk (which is what we did), feel free to email me. lookingforalittleturtle at gmail.

  2. A crappy set of choices for sure. And your parents might be assuming that IVF always works. I so hope Roo gets to have the pregnancy she wants; that was HUGE for me, wanting that adventure.

    It steams me that insurance doesn’t really cover family building.

    One, perhaps minor, resource: donated meds. I’ve got some follistim, menopur, ganirelex, and related accessories I can send you if that’s part of the solution. Email: smalltownprofessor, at the same server as tbean.

  3. Those are really difficult choices. I hope that you’re able to find the decision that feels right and make a baby soon!

  4. SIGH. This is really tough, heartbreaking, heart-aching, mind numbing stuff. I guess the only thing that occurs to me is this. While I’m sure there are any number of complicated dimensions to the parental relationship, and I’m not trying to dismiss any of that, maybe it would help to think as a parent. Regardless of how you feel about your I’m just gonna say CHILDREN’s lives when they are grown, I bet you’d do anything for them. And if they had a problem that could potentially be solved by something so simple (I hope you know what I mean by “simple”) as MONEY, wouldn’t you be overjoyed to be able to help? I’m sorry about the shitty luck–you’re right to be angry. But you guys WILL find a path through this, whatever that path may be.

    • Thanks for all of your support and for your perspective. That is a helpful way to think about the situation. In the last few days I’ve been feeling very thankful for my parents and for all of the ways that they show they love us (including the fact that they stick with us and want to help us even when things get rocky).

  5. Hi there,
    I just found your blog through the Lesbian Families list, where my new blog is listed too…
    I’m sorry you are in a really difficult position with TTC. I live in New Zealand so we generally don’t have the insurance side of things to deal with as we have a publicly funded health system. This means very few people have health insurance. That said though, fertility treatment is only publicly funded if you are medically considered to have fertility issues. Which means you have tried for at least 12mths without getting pregnant. So for a lesbian couple that is both hard to prove and often takes more than a year as we might get to try every month in a row.
    Initially we went to a fertility clinic to look at doing IUI as our donor lives in the Caribbean so we wanted to be able to freeze his sperm for multiple attempts. The cost for initial doctors appointments, counselling sessions (complusory) and sperm analysis was in the vicinity of $3000, then each cycle would have been $1200+ and then drugs or monitoring would have been extra, plus freezing and storage fees on top of that. That of course is the cheapest option. IVF is about $10k a cycle and IVF with ICSI is about $18k (without drugs).
    Unfortunately for us our donors sperm didn’t like the cold so wouldn’t freeze so we couldn’t use IUI, and IVF is too expensive. So we had to use home inseminations with fees sperm. Fortunately I have managed to get pregnant twice like that, unfortunately I’ve miscarried both babies at 12 weeks. So 6mths later we have paid to bring our donor back and are trying again at home…in fact I’m lying flat on my back with legs elevated as I type 😉
    That’s a very long comment to say – I can’t help but I definitely emphasise with what you are going through!

  6. A

    Hey there, so sorry you are facing this tough decision and I won’t pretend to have a simple solution for you. I hope that the best path will present itself and you will feel peaceful about your decision. That said, I wanted to add one comment, which might help you or your other readers. I hope this won’t sound condescending or something – just want to pass along the information we got from our RE. She helped us work through (mathematically) the true probability of ending up with a singleton, twins, or higher order multiples, which is really a function of three probabilities – the probability of conceiving at all * the probability of a particular type of gestation (single, twin, or higher order multiple) * the probability of carrying the pregnancy to term (or to 12 weeks if you would consider selective reduction). So, for example, while it’s true that many IUI cycles with injectables result in multiple gestation, that doesn’t mean that 30% of women who do IUI with injectables will deliver multiples (which seems to be what your doctor implied? Or maybe I misunderstood that part?).

    In our case, Dr. T estimated our chance of conceiving at all was about 20% this last cycle (given # of follicles, R’s age, and R’s labs and previous history of 7 IUIs). Then she said that among women with the number of follicles that R had (5 mature ones, and several that weren’t quite mature), roughly 70% would have a singleton, 20% would have twins, and between 5-10% would have higher order multiples. Finally, 25-30% of multiple gestations reduce on their own. So, we used these figures to calculate the probability we’d ever have to make a decision about selective reduction (i.e. we reach the 2nd trimester with a high order multiple pregnancy) – and it turned out to be about 1.5%. So when we put it that way, the risk seemed more worth taking, because there was an 80% of no baby ever, about a 14% chance of 1 baby give or take a little bit due to risk of miscarriage, 3-4% chance of twins, and 1.5% chance of triplets or more. Hope that makes sense. We’ve seen a lot of doctors, and she’s the only one who sat down with us and did the math that we needed in order to make an informed decision that weighed risk of multiples against probability of success. So that’s one thing to keep in mind, just in case you think that the best path would be more IUI with a stronger med regimen. In the interest of full disclosure, we have no interest in being octomoms. 🙂

  7. All of this sounds very, very familiar. Right down to the short-lived election night euphoria and the lamentably shitty luck.

    Our RE isn’t recommending IVF yet (I think I’ll probably be the one to up the ante before she does), but she said something very similar about stronger meds; that they wouldn’t increase the odds of conception but would increase the odds of multiples. Which, we’re not exactly opposed to twins (and higher order multiples are pretty rare even with the drugs), but since that’s not specifically our goal, it doesn’t really sound worth it. I think I’d almost rather go directly to IVF (although, again, the money thing. Sigh).

    I don’t know Roo, and I have no intention of claiming to speak for her, but I can say as someone in a similar position that, for me, giving up on carrying one of our children would be hard. Really hard. And I recognize that it could come to that, and I don’t worry that I would love a second child that PB carried any less because of the circumstances. I do worry a little that I would resent the pregnancy, though. I enjoyed my experience of PB’s pregnancy with Critter (at least for the most part), but I also went through it with the expectation that I would one day be doing the same. Being the non-gestational mom again, knowing that I wouldn’t ever be the gestational one, might feel different, I think. That’s totally just me, though, like I said.

    I’m sorry. I wish I could make it easy for you, and for all of us stuck playing this horrible game.

    • Yeah, I think that once the kid was born it would matter less who had carried him/her. But the pregnancy period would be hard. Roo has mentioned that watching friends and colleagues go through pregnancy (especially if they got pregnant easily) is rough, but that the difficulty isn’t as bad once they have the kid. I imagine it would be similar with us, except that the difficulties would be a million times worse because she’d have to live with the person who was obnoxiously pregnant.

      • I think that, at least for me, there would be the fact that if PB carries our second child because we’ve come to the conclusion that I cannot, then she will be specifically having the pregnancy experience (carrying *our* second child) that I never will. If that distinction makes any sense. So not only would it be the constant presence of the obnoxiously pregnant person, it would be the constant presence of someone having an experience I have very much wanted *instead* of me. Which is even worse to contemplate.

        I get what she means about it being easier once the babies are actually born. I don’t want to steal our friends’ second child, just because they have one and we don’t. He’s *their* baby, obviously. But I was (am still a bit, if I’m being honest) jealous of their pregnancy. (They got pregnant the first try for number 2, had a very early miscarriage, and I think got pregnant (succesfully) the next time they tried after that. They’re the ones I got the phrase “so-not-worth-it post-miscarriage fertility bump” from. You know, that fertility bump we’re still waiting to see. Anyway.)

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