My IVF stims were here and the day we were waiting for finally arrived, we couldn’t believe it! After so many months of waiting, researching, praying and trying to plan as much as possible, we were stepping into our first IVF appointment! Jeremy and I were overwhelmed, to say the least. I was a ball of nerves the night before our appointment and asked my mom to come with us to be another set of eyes and ears. I’m sure this seems odd to you reading this but we were putting everything on the line and were already so attached to IVF that it helped to have my mom there as kind of an outsider looking in. Don’t get me wrong, my mom knows everything and if you remember from the beginning of my blogs, I talk to her every day. As much as she knows about IVF, she isn’t consumed in it like we had been for the last two months. Back in October, Dr. F gave us a little IVF book that my mom asked to borrow when we were done with it. Note: for future IVFers, this was helpful because my mom was able to pick up on the jargon. We were putting everything we had into IVF and we wanted to make sure we weren’t missing a thing.
We met my mom at the clinic that morning at 9:30 with another box of donuts from Donnie’s Donuts for the girls and Dr. E this time as Dr. F was at the main office. No big deal, I’d had Dr. E countless times and was willing to see different doctors if need be just so I could assure that Dr. F would do my retrieval. Spoiler alert: this was the first of many times during IVF that I got my hopes up.
I knew Crystal wasn’t going to let me get away with telling her my weight this time so I had to step on the scale before having the rest of my vitals taken, and wouldn’t you know it that my blood pressure was through the roof! The two of us headed to the next room to draw my estrogen levels where my mom and Jeremy were waiting for us. (Estrogen, or E2, is drawn at every IVF monitoring appointment, either to make sure it’s low enough to start medications or that it’s rising appropriately.) Next, the four of us headed into an exam room just before I had to empty my bladder and then assume the position waiting for Dr. E. My uterine lining was nice and thin as it should have been, but there was on one thing that wasn’t right – I had a cyst on my right ovary. What? I had never had one before and now had one after being on birth control! BCP is supposed to prevent cysts from developing. Even with PCOS, this was my first cyst ever!
Dr. E warned me that this could potentially increase my E2 levels but we would know for sure based on my results. *E2 needs to be under 70 at an IVF baseline appointment before starting stims. Although we saw Dr. E that morning, we had to wait for the go-ahead from Dr. F, which was fine; I was ready for that phone call because I had a bone to pick with him about my cyst! Before we could even get to that call though, we were headed into Susan’s office to go over the contracts one more time, sign in 27 different places and then go to the front desk for payment.
We didn’t have many questions for Susan as I had called her and Dr. F several times over the weeks asking questions here and there, but there were a few things we wanted refreshers on. The most important was PGT-A testing which is preimplantation genetic testing for aneuploidies, where we would find out if our embryos were genetically normal or not. Dr. F didn’t find this to be absolutely necessary as we didn’t match on our carrier screenings for any diseases and we don’t have any family history of any major disorders or syndromes, but as explained he couldn’t tell us what to do one way or the other, this was something we had to decide on our own. I guess we were looking for Susan to give us the answer by asking just one more time. More on this later. After a few questions about logistics from all of us (how often will our appointments be, how long is retrieval, what side effects are worrisome enough to call about, etc), out came the contracts. You may not realize just how much legally goes into IVF, and aside from the fact that I was having surgery and being put under anesthesia, there were bigger things to think about. Such as what would happen to our remaining embryo(s) should something happen to one of us or both of us, or in terms of a separation, and then when our family is complete – would we donate our embryo(s) to another couple, donate to science or discard. These are incredibly personal decisions and no one can fault you, no matter which decision you make, and we decided to donate to another couple going through IVF. Here’s a little bit of our reasoning behind this. We didn’t know who to leave our embryos to such as a family member and we didn’t want to make a decision like that on a whim, plus we know that the price tag of IVF stops so many couples from pursuing their dream of a family. *Spoiler alert: to get the step of having frozen embryos costs upwards of $15K. And finally, we had two contracts left to sign, one about PGT-A and the other about Selective Reduction. The name should clue you in on what this is, but the short of is that you are either willing or not willing to reduce a multifetal pregnancy. Still don’t get it? It’s okay, I didn’t either but I think it’s because I didn’t want to get it so I didn’t have to think about it. Although this is a very real thing that some couples have to think about and go through, I truthfully only know the bare minimum about this as the FIRM doesn’t do Selective Reduction, they refer you out to another practice if needed, and I also don’t want to read into it.
Once all questions were answered and all contracts were signed, we headed to the front desk to make the full commitment, aka pay for IVF. Each clinic is different and can vary with what is included in an IVF package. And just like I have been from my very first post, I want to be transparent now. That day we paid $12,831 for our package. Keep in mind that this is completely separate from the $4628.30 that we paid for my IVF stims to the pharmacy. We went with the single IVF package meaning that we were paying for one retrieval and one frozen embryo transfer, including an average of five monitoring appointments. This also included anesthesia for retrieval, ICSI, cryopreservation of our embryos, and the PGT-A biopsy. The only thing we hadn’t paid for that day was the Next Generation Sequencing number, which is the number of embryos that were to be biopsied – once this happened, we would pay based on a dollar amount per embryo. *The FIRM has a full cost breakdown for all treatments on their website which was one of our deciding factors as it allowed us to know what we were up against cost-wise before our initial appointment. I also refer to it constantly when women ask questions in support groups to see if they are being overcharged, but please keep in mind that every single clinic and state is different, so what we paid can be more or less than what I’ve seen other women pay.
I won’t go too far into our financing details but we were able to take out a low-interest loan. We also opened a 0% interest credit card (for the first 15 billing months) with has cashback rewards that we’re able to cash in against our statement. I also highly recommend having an FSA or HSA if possible. We each have one at the maximum amounts and purposely saved them for IVF, aside from a few smaller medical things here and there. Financing for IVF is a whole different beast and I highly suggest asking your clinic if they have payment plans or recommended lending partners. I won’t go into details about our loan but do suggest taking out a little bit more than we thought we would need to cover IVF for any additional expenses going forward, which based on our experience, definitely can happen.
After swiping our credit cards, our appointment was over and the three of us parted ways. I headed to my office with the intention of a very productive workday before the holidays, but I knew I was kidding myself as I just stared at my computer nervously awaiting a phone call.
Susan: Hi, Kate. It’s Susan from Dr. F’s office.
Me: Hi Susan, how’d I do?
Susan: Well, not too good. Your estrogen is way too high to start stims tonight. Dr. F wants you to go back on birth control this evening and he will call you this afternoon to discuss this morning’s appointment. He would like me to schedule your next appointment for 10 days from now to try this again.
I quickly scheduled our next appointment and hung up just as I felt tears swelling in my eyes. Queue the heartbreak once again. I called Jeremy with so much devastation in my voice that I’m positive he started crying as soon as we hung up the phone. I had never wanted to stab myself with a needle more than I did at that moment. We got so close just to have my body get in the way once again.
A few hours later I talked with Dr. F, and he explained that my E2 was 397 which was due to what Dr. E saw on my ultrasound. (Remember, E2 needs to be under 70 to start stims.) Which definitely could have been a cyst, even with being on BCP, or it could have been a leftover follicle from my last cycle that either didn’t release and shed or my body didn’t absorb it. Either way, it didn’t belong there and was really throwing everything off. That day didn’t go at all how we had planned, however, we had several things to look forward to in the next few weeks! And honestly, we were so used to things not going according to plan. First, we were hosting Christmas Eve for our second year, then Christmas followed by my 30th birthday and before we would know it, we would be back at the clinic to *hopefully* get the all-clear in ten short days.