Saturday, April 17, 2010

Moving to IVF...Slowly

Over the last few weeks we've been thinking about alternate options to pregnancy. We looked into international adoption options, domestic adoption options (private and foster-care), and the idea of just not having children.  We had our IVF consultation earlier this week (more on that later) and afterwards it felt really strange to me that it was so scientific and lab-like.  That's when we considered just not having children.  It's kind of tempting to skip the whole kid idea - we could do a lot of fun things and have a lot of freedom without a kid.  After a couple of days I changed back, though.  Ultimately, if I make it to be old and grey, it is more likely that I will regret not having children than I would regret having children. Mark concurred.  So, that's how the decision was made to keep trying.

We also considered adoption pretty seriously.  To be honest, I am much more comfortable with the idea of adopting out of the foster care system than any other way.  I guess I just know those kids and feel a responsibility to them.  However, Mark wants to bond with his child in the first two years of life, and doesn't want a special needs child, so adopting out of foster care is highly unlikely to work out.

We then looked at international adoption, starting with China.  China is enticing because we if we had our way we'd like a girl (Mark only wants one child and if we have a boy I'll want to try again for a girl) and we think (maybe naively) that it's easier to get a girl from China than from other countries.  It seems that in international adoption most people want to adopt girls so there is a longer wait for them than it is for boys. That said, the current wait for an infant from China is 4-5 years and may never even happen.  I then looked at other countries, but the wait times are similar for the babies and I don't want to adopt from a country where they don't sign on to the Hague Convention.   In the midst of all of this, the whole Russian child fiasco went down and it seemed like maybe the timing of that was meant to tell me something.

So we considered domestic adoption.  The local adoption agency that has the best reviews on line is hideously expensive ($25,000-$30,000 minimum - that's if a birth mother picks you and doesn't back out - if one backs out it's about another $10,000).  They have a great success rate - they don't take many families at once and the reviews I found online were all matched within 3-8 months.  That said, they also require you to hand over the last $9,000 at the hospital when the baby is being discharged to you, and that just felt like baby-buying to me.  I didn't like that at all.  So, we won't be doing that.

Back to IVF.  We went for our consultation.  Dr. Sparrow explained the process again, and said he'd be using IVF with ICSI (see my first couple blog posts for explanations) and implanting 2 embryos if we grow enough healthy eggs and they fertilize properly.  We would have a 25% chance of getting twins.  We talked about starting in May, but I've decided to push it off until June because things at work have been really crazy and I also have a short trip planned that would directly interfere.  Here's the process:

Day 2 of Cycle:  Start birth control pills.  I'll take them for three weeks.  I will be a horrible, crying soppy mess during this time as I have never dealt well with birth control pills.  One time when I was working at a different company (not as an attorney) I had just gone on the pill a few days before and the CFO was attempting to explain a complicated spreadsheet to me.  I was having a hard time following him but instead of asking rational questions, I just burst into tears.  Poor guy practically ran away.  I'm expecting this to happen frequently.  In court.  During negotiations.  It's going to be a mess.  Dr. Sparrow asked if there was anything that had helped me deal with that in the past and my answer was, "Yeah, I stopped taking the pill."  Not an option for this process.

Day 22 - Stop the pill.

Day 24 - Suppression Check - the whole point of taking the pill is to sort of stop my cycle and take control of it.  This is the day they check to see if it worked, with an ultrasound and blood-draw.  This is also a day when they might call the whole thing off.  I read a lot about people getting ovarian cysts and then having to stop their cycle until that's taken care of and then start again from Day 2.

Day 25 - Start the cycle by taking injectible medications, morning and night.

Day 29 - Start blood draw/ultrasound appointments.  These are going to happen pretty much every other day.  I have to go to work and get a form for my doctor to fill out so the time off of work will be protected by the FMLA.  Otherwise, it's a ding against me at work to be gone at the last minute for so much time.  Once the follicles have grown to 14 mm, I go on another injectible.

Day 34 - They give me what's called a trigger injection in order to force ovulation.  I can stop that extra injectible medication on this day, and then get instructions about the others.

Day 36 - Egg retrieval - they knock me out for a minute with conscious sedation, extract all of the eggs they can find from all of those follicles they've been growing, then wake me up again.  While they're doing that to me, Mark provides another sample.  After I wake up they'll be able to tell me how many eggs they retrieved.  They'll then try to find the fastest, healthiest little sperm they can find, pick them up individually in little tiny needles, and inject them into the eggs.  I go home and sleep it off (they say it's going to be painful).

Day 40 - Start progesterone injections.

Day 39 - They might to a transfer of the embryos on this date.  It depends on how good they look.  If they only have 2 and they're not looking so great, they're going to transfer.  If they have more and they look like they're doing well, they will wait two more days to try to let them grow a bit more and let any embryo that isn't going to make it die off before transfer.

Day 41 - Hopefully we transfer two embryos. Hopefully we have left-overs to freeze.  The instructions we received say that I'm supposed to have two "quiet" days - the day of the transfer and the day after, but I don't know what that means.  I hope it just means I shouldn't go crazy at the gym or something but that I can still go to work.

Day 56 - Pregnancy test.  Crazy!

Monday, April 5, 2010


I haven't posted anything because we haven't really been working on baby stuff ever since I got annoyed with IUI.  I finally called Dr. Sparrow's office last week and told them that I want to start IVF in the next few months.  Joy said that I would have to come back in to have another consultation with Dr. Sparrow.

I'm pretty annoyed about having to have another consultation.  We already went in for a consultation.  Before the first consultation, they told me that we would get a tour of the lab and all of that kind of stuff.  It sounded interesting back then, but instead we went to the meeting, I explained everything I knew about IUI and IVF, Dr. Sparrow said that I had clearly done my homework and then encouraged us to try IUI because it is inexpensive (comparatively) and might work.  No one offered to give us any kind of a tour, nor did we really need one.

Now they tell me that I have to go back in for the tour and information about IVF.  So, that will be another $200 by the time all is said and done.  I think this is really stupid because I don't care about the tour.  Just give me a timeframe when we might start, tell me when to start the meds, and let me figure it out as I go along.

Maybe I'll be pleasantly surprised at the tour.  Maybe I'll learn important new things.  I suppose I should have a more positive attitude.  In general, I am a person who likes to set the goal (have a baby), then figure out the steps to reach the goal (Meet with doctor, Try IUI, Try IVF, Reassess, Consider Adoption, Reassess, Go Childless), and then start working on each step.  I'm extremely linear. I feel like this second consultation is taking me several steps backward.  If we're going to do it, let's just do it and stop talking about it.