Well, after a meeting with our GYN here back in June, then having two consultations with different Reproductive Endocrinologists in the Phoenix area, we have ultimately decided to move forward and plan on doing IVF (in vitro fertilization). We will also be doing ICSI (intra-cytoplasmic sperm injection) and more than likely PGS (preimplantation genetic screening) with it. I’ll briefly explain what are three procedures are, then answer a few questions that I have been asked.
IVF- Basically, it’s the process of taking the women’s eggs that she produces out of her body with a long needle and putting them into a lab dish with sperm in hopes that they will combine, then transferring an embryo (or embryos) back into a woman’s body. Now it’s much more complicated that that, haha. There are various protocols for different doctors, but a women is typically on birth control from 2-3 weeks to shut down her ovaries and control her cycle. A few days after the last pill is taken, she should have menstrual cycle (I was told it could be very light), and then monitoring via ultrasound and blood work begins as she starts on medication. Injections are then added to the mix to help produce lots of eggs. The woman is usually put under during the retrieval of the eggs.
You can either do a fresh or frozen cycle. If it’s fresh, the embryos are put back inside 3-5 days after the retrieval. If it’s frozen, you don’t do the transfer until the following cycle. I’ve heard that more and more doctor’s are doing frozen cycles as they are more successful overall (this is what both of the RE’s we spoke with do), but there’s obvious success with both. The woman is NOT put out during the transfer, but is supposed to take it easy for a few days (and sometimes even be on bed rest) in hopes that implantation will occur.
ICSI- ICSI is simply used in combination with IVF. The meds and montoring are done the same way, but after the retrieval, the embryologist actually directly injects a sperm into an egg instead of just hoping they will combine in the lab dish. This is more effective when you have a male factor involved (as we do) or if the woman does not produce many eggs. Yes, it costs extra, but it’s obviously worth it!
PGS- This is a screening that is sometimes controversial.One or more cells are removed from each embryo to check for any chromosomal abnormalities. When an embryo has a chromosomal abnormality, there is a high chance that it will not implant; thus, the IVF cycle will obviously fail. However, it if does implant, it will often times lead to miscarriage. There’s the whole debate between people on how embryos are already considered a form of life and shouldn’t be messed with. I’m not here to discuss this issue. At first I didn’t think twice about this screening as it’s pretty pricey (about $3,000-$5,000 extra on top of the IVF/ICSI), but Tyler was all for it as it will decrease our risk of miscarriage and increase our chances of a live birth. Only embryos that pass the screening will be transferred back into me.Hopefully that makes things a bit more understandable about the process 🙂 You can read about why we chose to go the IVF route HERE.
I’ll save our tentative plan for next time, but here’s a few questions that I’ve been asked lately:
Does your insurance cover it? No, Tricare does not cover IUI or IVF. Basically, anything that is not being done in conjunction with timed intercourse isn’t covered. However, there are a few military bases across the country that do these procedures at a discounted rate. The closest one to us is in San Antonio, and I was actually referred there by my GYN but was denied as they were not accepting new patients then. There are a few reasons why we chose not to go to a military hospital that offers treatment. First of all, you have to be there for about 3 weeks total. That’s a long ass time and you obviously have to pay for travel and lodging expenses. Tyler wouldn’t need to be there the whole time with me, but still. Secondly, each hospital does the IVF in clusters and they only do the cycles 3-4 times a year. I understand the concept to it, but what the hell. Also, they do fresh cycles and do not do the PGS. So there’s that 🙂Where will you be doing this? I spent weeks researching RE’s in the Southwest cities that are within driving distance from El Paso and Fort Huachuca, AZ- Albuquerque, Tuscan, and Phoenix. I looked into Colorado Springs, but that’s almost 12 hours from Huachuca and that would be God awful sitting in a car for that long feeling like shit on stims or sick after the retrieval. Plus, I need to be able to do this drive on my own if need be, and I ain’t driving that far 😉 After viewing websites and reviews, I found a few doctor’s in Phoenix that caught my eye and narrowed it down to two. The facility we are doing this at is in Gilbert, AZ- and the ironic part is that the building is literally right next door to the apartments I lived in back in 2008/2009. Like I could see my old balcony from the office, haha.
We dropped off our medical records before we met with another RE in early August and were both highly impressed with the facility, New Direction Fertility. After a mix-up about a phone consultation two weeks ago, we were able to rescheduled for last Friday night. Tyler and I spoke with the doctor on speaker phone, and he answered everything thoroughly and then some. This doctor was the only one that found that I have elevated AMH levels which is a sign of PCOS. I have been told for almost two years that I don’t have PCOS (no multiple cysts, no facial hair, high testosterone levels, not overweight, not resistant to insulin), but elevated AMH levels can make it more difficult to conceive. My AMH was 7.62ng/ML, so while it’s nothing out of this world, it’s not within normal range for my age.
The doc also seems to work well with out-of-state patients making it as easy as possible. IVF is a very time consuming, emotional and physically challenging procedure, so anything that will help me understand and relax is appreciated. Him and his wife suffered from infertility and they now have two sets of twins from IVF which he did himself!
Why are you going straight to IVF and not going to attempt IUI first? I mentioned that in my previous post, but to be more specific, it’s due to success rates and finances. The RE we are seeing does IUI’s for a pretty good price and said he thinks we could get pregnant in 3-4 rounds of it. Key word is “thinks”. While we know that IVF is not a sure thing, the chances of success are about 70-75% (with PGS) compared to the 7% with IUI. We also had to think about traveling to Phoenix for each round and the emotional stress of it. Plus, IUI might not work and then we would proceed to IVF so we’d be paying more in the long run.
That’s all I’ve got for now, but please don’t hesitate to ask any questions! 🙂 Also, I understand that everyone has their own different views and opinions not only about advanced reproductive procedures, but about our journey as well. While I’m willing to discuss it all as I know it’s a sensitive, taboo, and sometimes embarrassing or shameful topic, I just want it to be known that it’s still hard for me to wrap my mind around it all. We are more than ready for the next chapter in our lives (not just meaning pregnancy and parenthood), and I’m both scared and excited about what the next several months will hold for us 🙂