Assisted Reproduction Technology

IVF vs. Invocell vs. IUI

I am feeling slightly out of my mind with the thought of moving forward with IVF. We definitely don’t have that kind of money. Neither of us have talked to our parents about this whole babymaking (or is that gabymaking…) thing we are doing over here. Even if we did neither of us want to trouble our parents to ask for help financially with this. In light of that we will be pursuing IVF by financing the procedure. I truly, truly hate the thought of that, as we are still working through many years of student loan debt. I *just* paid off my car. And it looks like we will be financing IVF for roughly the same cost per month. Sigh. It’s just so damn expensive!

In light of that and at the RE’s encouragement we have been researching whether to do IUI or Invocell. I feel like there are drawbacks and benefits to each but at the end of the day they are both a gamble. With IUI, our odds of conception for each attempt are somewhere between 14% and 30% likelihood of conceiving after 4 procedures. These percentages came from my RE and from a research study on women in the over 35 age bracket. My RE thinks I’ve got a pretty good shot at conceiving with IUI because my AMH was 2.66 which is great for my age. Personally, I don’t like our chances with IUI at all. Four IUI’s would run us about $12,000 over the course of 3-4 months and at the end of that I have a 30% chance of being pregnant. $12K for a 30% chance seems like an awful lot of money. BUT on the off chance it worked the first or second try that would *almost* be affordable without any financing. Which would be SO NICE to not go into debt just trying to make a baby. Ah, tempting to entertain that nice, rosy thought. But these rusty raisins I have for ovaries are a little too geriatric to be hanging that kind of hope on them functioning just right, methinks.

Invocell is interesting. I hadn’t heard of it before the appointment with my RE. Basically, if you aren’t familiar, I would do a minimal stimulation protocol followed by an egg retrieval procedure. It would be pretty similar to what I would do for regular IVF except there is less monitoring prior to the retrieval and the meds would be different. Following the retrieval, a small capsule would be filled with my eggs and the donor sperm. This small plastic capsule would be inserted into me like a tampon and held in place for 5 days with a diaphragm. Basically, I incubate my own embryos. Following that, the device is removed and an embryo or two is transferred into my uterus. The cost is about half of an IVF procedure which is nice. One of the reasons for the reduced cost is that there are no fees from the embryologist since I do the incubating part. Another reason is a lighter med schedule is used with less monitoring prior to the retrieval.

All of that sounds pretty great and the odds of conception are in fact near what you would expect to get from IVF. My major, major concern with this procedure is that there is a big possibility that after a minimal stimulation protocol I may not have any extra embryos to freeze… which means if it doesn’t work the first time I’ll be going through another retrieval and then IVF (because who wants to waste another 9 grand on something that didn’t work!). So if I do this and there are no embryos to freeze and it doesn’t work, I will have just threw away $9000 with nothing to show for it. Comparing that with IVF, if it didn’t work the first time and I had to come back for a second transfer my odds are much, much higher that I will have frozen embryos left from the retrieval. A transfer without a retrieval procedure is around $4000 so you can see that over time with multiple attempts the IVF would be cheaper. Now, if I knew Invocell would work the first time then that certainly would be my choice at half the price.

Another thing that concerns me is that this is a brand spankin’ new technology. UCSF is still doing clinical trials on it. So that means for $9K I basically get to be a guinea pig. I think, if the price tag was lower or there was more information about the efficacy and the likelihood of extra embryos I might feel more confident about making this gamble. As it stands I’m pretty nervous about putting all of my hopes and dreams on a new technology without a lot of real-world data behind it.

I think we are going to take a month or two off in order to figure out how to best proceed. I’m excited but I feel so absolutely out of my mind to even be considering something like IVF with that sort of price tag. It’s so. much. money.

Well, if any of you readers out there have used Invocell I’d love some insight. How did it go for you? Were there embryos left over to freeze? I would consider Invocell more if I knew there might be some embryos for another transfer later. Or how did you ultimately decide for or against IVF? What factors tipped the scales for you?

 

 

Fertility Center

Things are Looking up

No, I’m not pregnant. 😛

 

I might be if I’m super lucky. I am 8DPO so I will be testing in a couple of days but I’m not hopeful because the timing was off on my last attempt. Anywho, enough about that. It’s old news. And whatever happens, happens.

What I wanted to share is that K and I signed the consents to begin working with a cryobank. And we met with the RE to discuss IUI vs. IVF. We point-blank asked her what she recommended for us and she strongly recommended IUI first. Because of all the barriers to actually doing inseminations (polyp removal, scheduling issues, etc) we figured out that since the polyp was removed (attempts before that don’t count), there has really only been one well timed attempt. She felt like based on my numbers that I had a good chance for IUI to work for us. That’s good news.

She also told us about a new type of IVF called INVO cell. Has anyone heard of this? Basically, we would do a typical egg retrieval with minimal stimulation. The eggs would be collected and then placed into a small plastic container along with the sperm. This little capsule would then be placed inside me like a tampon (it’s much smaller) and I would “incubate” my own embryos. So Sci-fi! At the end of 5 days the embryos are removed from the capsule and one is transferred into me and the others are frozen. It’s significantly cheaper than IVF so that’s a plus. But it’s also a new procedure so that concerns me. She gave us a lot to think about so now we need some time to research and crunch numbers to make a decision.

We are excited to finally feel like we might get somewhere with this whole baby-making thing. And in a few days we *might* have some good news about this cycle (but don’t hold your breath).

:::shaking pom poms with gusto:::

Sperm Exposure

Here We Go Again

I had my ultrasound today and I have 3 or 4 follicles in there. Two are 17mm, one is 13 and there may be one more smaller one, I can’t remember. The doc wants me to trigger on Saturday but this poses a problem for us since I am unsure if we can ship overnight on the weekends. It’s being looked into now so we will see.

To be honest, this cycle just feels like going through the motions to me. I feel empty and a bit sad. I am having a hard time being happy for others and their progress and success, instead I feel sad for us. It feels like we are stuck in a holding pattern with no real progress. I have had so many thoughts of quitting recently. It’s just hard to go through all of this and have no end in sight.

I haven’t talked about it a lot on here, but the year leading up to and the year or two after being diagnosed with MS were straight up traumatic. It was never ending pills, shots, appointments and uncomfortable procedures. In some ways this journey is similar only at some point it will theoretically end and when it does it will be a happy ending. At least in theory.

 

Anywho, cheers for cycle #4.

::::Halfheartedly shakes a pom pom and lets out a lukewarm cheer::::

BFN

CD2

I bring this month’s episode of “Fuck everything!” from the hotel I have been sharing with my mother in Washington state. Oh ya, that’s right I was temping and sneaking into the bathroom at the crack of dawn to take pregnancy tests so that I wouldn’t have to talk to my mom about the joyous topics of known donors and at-home insemination techniques. That was fun…Tests were negative and then I got a big temp drop. I was still hopeful thinking “maybe it was an implantation dip!” But then the next day my temp was also low and I knew that any second I would get my period.

 

As luck would have it, my mom and I were taking my nephew to a water park. We had a good time and it was a great distraction from the fact that I really wanted this cycle to work because now we really do have to make a decision about continuing to use our donor or going with a sperm bank. And whether we want to try more intervention such as IUI or IVF. This was my 3rd attempt, so in 3 more attempts without success I will get the lovely label of infertility. I’m feeling the pressure of time.

 

Anywho I’m sitting here sucking down the biggest cup of tea that Starbucks sells, contemplating a sushi lunch and trying not to rage quit TTC.

Sperm Exposure

Ovidrel Trigger

Ok, so I took my trigger shot yesterday morning at llam. Since then, it’s like my abdomen has steadily filled with… something. I am really uncomfortable at this point. My ovaries feel like they are the size of baseballs. My stomach is visibly larger than normal. I read through the side effects and it seems it’s all normal, but damn. I’m ready for my ovaries to shrink back down to raisins thank you very much. 

Anyone else out there end up with baseball-sized gonads using the Ovidrel trigger shot? Did anything help?

In other news, the timing for the inseminations has been really good. My temp rose yesterday morning after an insemination the night before. Then it went back down some this morning so I’m undecided if I have already ovulated. If not then the timing is even better! One more insemination tonight and then I head back home tomorrow. I’m so ready to be home! But I’m really happy with how everything is working out this cycle.

Sperm Exposure

Ultrasound Update

Yesterday morning I saw the RE for my ultrasound and I had two mature follicles. One was 22.9 mm and the other was 17-something mm. There were two other small ones, so 4 altogether that were measurable. My antral count was 9 on my day 3 ultrasound at the beginning of the cycle. After obsessively searching the internet and talking with the RE after my day 3 scan those numbers are low especially since I am taking medication to stimulate my ovaries. From what I have gathered this is more of a concern if I want to pursue IVF. So I am going to try my best to table this concern and deal with it if and when it becomes an issue.

 

But I imagine you all didn’t come here to read about that. You probably want to know if this cycle is going to work out for an insemination or not. RE said I was “triggerable” at my ultrasound so it’s a go, folks!!! I flew to my donor’s city yesterday and did an insemination last night. I triggered this morning. Coincidentally, my OPK before triggering was blazing so I’m hoping that things will go well this cycle. He is coming by later today for another insemination as well as tomorrow. Then I will fly home. Hopefully in 2 weeks I will have exciting news. 😀

Multiple Sclerosis

Invisible Illness

Having multiple sclerosis used to be a big deal. I am coming up on 6 years since diagnosis and I used to reflect upon it with a lot of sadness. It was very hard to adjust to being “chronically ill.” Sometimes I get frustrated because having MS has limited me in some ways. And sometimes those limitations feel unjust because they are limitations that others put on me.

Like when I wanted to learn to SCUBA dive and my PCP made me put in writing that I understood that diving was dangerous and even more so with MS so that she would agree to sign the medical release for me. Or when I looked into getting a work visa in Australia and learned that they would reject my application based on my diagnosis alone.

Despite the fact that on a day to day basis you would never know I have MS, there is a subtle yet palpable loss of agency that comes part and parcel with this diagnosis. And sometimes that is difficult to reconcile when I feel absolutely fine. In terms of making a baby I have run into this a couple of times. For instance, I will be considered a high risk pregnancy. Though that could amount to nothing more than some extra scans and labs it also means my autonomy during pregnancy and birth is tenuous– it’s easier for hospital staff to override my decisions since I am high risk. A home birth is likely not possible.  It’s hard to accept that when I feel capable and strong.

Today I do not feel nearly as capable and strong. I feel frustrated. Because the combination of letrozole and underlying MS fatigue has me couched. Literally. It’s 11am and I have so many things I want to do. My mind is saying get up and get moving but my body wants more time to gather the energy. This internal struggle is maddening. And it gives way to doubt. Will I be a good parent even on days like these? How will I manage fatigue while I am pregnant if just the meds to get me pregnant have rendered me a useless couch polyp? And furthermore, will I survive the newborn phase or will I spend it in exhausted tears?

I am thankful that most days are not like this. Most days I feel fine, normal. I can pretend I am healthy 95% of the time. It’s just that 5% that smacks me in the face every once in awhile to remind me that MS is real, I am chronically ill and that I do in fact have limitations from it.