You are currently browsing the monthly archive for January 2010.

>Thanks to everyone who commented on my blog during the past week. I very much appreciate and value the support, and it’s so helpful to hear from other people that are in similar situations. It’s good to get other perspectives, too, from people who have moved on in one way or another. I don’t always have time to participate in ICLW, but I’m glad when I do.

I called my health insurance company this morning. They said that I need to get pre-authorization for infertility treatment, and that once that happens, they will send the approval on to my prescription company. Until then, they said, the prescription plan will deny it. I’m hoping he knew what he was talking about. I called my doctor’s office this morning and explained the situation, and they are going to have someone in the insurance office call me back. It’s a little frustrating, since they were supposed to request pre-authorization in October, but they didn’t. I am guessing they probably wait until they submit a claim that won’t be covered without the pre-authorization, but I need it now. When I talked to the nurse on Tuesday, she said something about pre-authorization, but she seemed to think it would all fall into place when I went to fill the prescription. I suppose that would be possible if my health insurance and prescription plan were from the same company, but they’re not. Instead, I’m trying to work with my doctor’s office and two separate companies, none of which are being horribly cooperative.

So, we’re waiting. I don’t know how long this whole process will take, so we have to decide if we’re willing to pay for the medication out of pocket. I don’t know if I have enough time to wait for all of this to pan out before my next cycle begins, and we’ve already skipped the last two cycles. I don’t want to miss another one!

At least it’s Friday! 🙂

Advertisements

>Before I get into this, I’ll say right away that I know I am lucky to live in a state that mandates fertility coverage. In my previous marriage, I dealt with infertility in one state that did not mandate coverage and one that did, and the difference was incredible. I now live in a different state that mandates coverage, and in writing, the coverage should be better than it was in the other two states I have lived.

I have a health insurance plan, but my prescription plan is separate. The prescription plan allows me to use a local pharmacy, but they also have a mail-order option. If you can get medications through their mail-order service, it’s a lot cheaper. Obviously, that doesn’t work if you need to start taking a medication right away. You have to go to one of their preferred pharmacies, which covers most of the pharmacies in the area.

I logged into the prescription plan’s website to see what is covered for my upcoming medications, but I got a series of confusing messages. The letrozole wasn’t even listed in their database, which seems bad, but I did find Follistim. The messages, though, were confusing. It says it’s not covered, but then at the bottom of the screen, it says to call the specialty branch of the pharmacy, in case it is covered (that, in itself, is confusing). I called the company (the main prescription plan group – not the specialty branch), because I thought maybe they would be able to give me some information. I swear the person on the phone knew as much about it as I did, and in the end, she really wasn’t sure. She said it seems like the prescription plan doesn’t cover infertility, and asked if I knew if my health care plan did. I told her they do, but I thought my prescription plan was separate. She said it said “not covered under plan,” but then she said it also said “contact medical insurance; pre-authorization required.” She said I could try a local pharmacy, but she said to give them my medical card, instead of the prescription card. At the time, I thought that seemed reasonable, but then I remembered my experiences at my local pharmacies, and decided that may not make the most sense. I think I need to know what’s covered, rather than going there and just hoping they’ll work it out. The other issue is that I’ll order it elsewhere if it isn’t going to be covered, because it will be cheaper (as much as $200 cheaper, my dr. said).

So, now I need to decide who to call next…my health care plan, the specialty pharmacy that’s listed on my prescription plan’s website, or a pharmacy that specializes in online orders of fertility medications. I’m thankful that I have insurance – and especially insurance that’s supposed to cover infertility – but this is rediculous!

>So, I saw my dr. this afternoon, and it went well. The nurse was surprised by my stellar lab work, which would be great except for the fact that it doesn’t really help me. She said even my cholesterol is great (I swear they tested me for everything under the sun)! She talked about the possibility of running more tests, but since I saw an RE in my previous marriage, it’s sort of awkward. I already had a HSG and a test where they looked at my uterus, but it’s been a while. The nurse went back and forth about the possibility of repeating those tests, and then talked about my medication options. It was essentially more Clomid or Femara and Follistim. Eventually, my dr. came in and said she thought Femara/Follistim was the way to go. So, that’s the deal! I’m supposed to take Femara cd 3-7, and then start Follistim. She said I’ll take that until they tell me to stop, but said to schedule an u/s for somewhere around CD 12-14. I’m also supposed to get a shot of HCG, which they’ll administer at the office.

Overall, I think it was good. It’s mildly frustrating to have no one know why I’m not getting pregnant, but I’m glad my dr. is taking a somewhat aggressive approach. I try to keep reminding myself that having good hormone levels is a good thing, and that we’re doing all we can. I love how much time the nurse and dr. spent with me, and that makes me glad that we’re sticking with my ob/gyn for now.

Now I just have to start making phone calls to see where I should get all this stuff! My prescription plan is a little weird, so wish me luck!

>As some of you know, I was notified a few months ago that I was going to be laid off in March. I was lucky enough to get a new job with another department a month or so ago, right before a hiring freeze was issued. I am really fortunate, because most of my old coworkers are still out of work.

It’s been a trying couple of months. We thought about relocating, but things didn’t work out with a new job for M. Both the industries we work in have been affected greatly by the economy, so there aren’t many opportunities for either of us. He only applied for two jobs, but when they didn’t work out, we decided to stay. We live in an area (like most people) where home values are down, so we can’t sell our home right now. That, on top of the fact that I have one more year to be vested in my retirement plan (and can leave with my employer’s contribution) and that we live in a state that mandates fertility coverage, means that staying where we are is the right thing to do. It just doesn’t always mean that we’re thrilled about it.

My new job is fine, but it’s hard to imagine what it will lead to. I had a job where I was using my master’s degree, and I was getting a lot of great experience. I was meeting people in my field, and I even got to be the official reviewer for a book related to my field (my name is on it!). So, it’s been hard to switch gears and do something else. It’s especially hard because I feel like I don’t have a choice. I saw the perfect job last night – 30 hours a week, working primarily from home, on projects related to my field. I was and still am sooo tempted. The problem is the job is based in another state, so I would lose my fertility coverage. M has insurance, too, but his company is based in another state, and his insurance doesn’t cover anything fertility-related. I would most likely make less money, would lose my employer’s contribution to my retirement (4 years worth of $), and would lose my fertility coverage. So, I think I just have to stay. But that job is sooo tempting…

>One of the things I don’t like about having to travel for work is that I end up tired and lazy on the weekend. But, I suppose that’s what weekends are for. 🙂

I had a frustrating conversation with my mom yesterday about fertility treatment. I don’t even know why I found it so aggravating, but I did. She asked me if I had seen the dr. or if I had taken any injections yet, so I had to explain that I’m not starting that now until February. I said I’ll see the dr. this week, and she’ll tell me more about the plan. I told her, though, that Feb. could get tricky, because we are going out of town to see them, and I also have to take another trip for work. I’ve already thought it all through, and I’m hoping it will work out that I can start treatment again. I know, though, that there’s a chance it just won’t be possible. My mother is very caring, but she’s a real problem-solver. She’s the kind of person who says, “You’re not upset, right?” instead of really asking how you feel. If I am upset, she usually tells my why I shouldn’t be. This time, she was giving me 9 million options for how to make sure I can start injections in February. It’s nice and everything, but doesn’t she realize I’ve already thought it all through? I know she means well, but I just find it aggravating. It feels like it minimizes the whole process, because it makes it seem like there’s an easy solution to all of it. I’m probably just feeling overly sensitive, but I can’t help it – it’s just not what I want to hear.

We had a good weekend overall, though. I am fighting my husband’s cold, which is super lame. I’m hoping I can fight it off, so wish me luck! My doctor’s appointment is tomorrow afternoon, and I’m really hoping it goes well. I’m curious to hear what she has to say!

>Well, I hate to say it, but I am already behind on this month’s ICLW! I had to go out of town for work on Tuesday and didn’t get back until last night. That, combined with two 12-hour work days in a row, didn’t really leave a lot of time for posting and commenting. But, now I’m back! Welcome to those of you who are new, and thank you to all for stopping by.

Here’s a little (condensed) background about me-
I’m 35, and my husband (M.) and I have been ttc for over a year (I think it’s around a year and four months, give or take). So far, we have unexplained infertility. This is my second marriage, and I went through quite a bit of testing with an RE with my previous husband (we also did two cycles of Clomid/IUI). I’m currently seeing an ob/gyn, but she seems like she’ll do a lot more than your average ob/gyn, in terms of treatment. I had been thinking about moving on to an RE, but I think I am going to stick with her for now. I’m meeting with her next week, so I’ll see how I feel after that. I’m also thinking about trying acupuncture. We’ve done two cycles of Clomid, and I believe the plan is to move on to injectables next cycle.

Welcome! 🙂

>I finally heard from the doctor’s office on Friday afternoon. Apparently, I need to make an appointment to see the dr. again and talk about next steps. It’s sort of frustrating, because I could have made an appointment to see the dr. weeks ago! I only took December-January off because I thought I was moving right on to injections, and knew I wouldn’t be able to do it with holiday travel. So that was sort of annoying, but I guess that’s a lesson learned for me. I should have called in December to check in.

I’m still torn about sticking with my current dr. (an ob/gyn) vs. seeing an RE. There’s only one RE in the area, and she only takes patients by referral. Her practice is actually an hour and a half to two hours away, but she also sees patients here at an Ob/Gyn office. It’s not an entirely typical situation. My current dr. said they usually try Clomid, injections, and some IUIs, and then refer patients to the RE for IVF. I feel like that’s sort of unusual, too, because most ob/gyn’s seem to stick with Clomid. I think I’m going to stick with my current dr. for now, but I’m definitely conflicted about it.

I’m planning to call one of the acupuncture places in town, too. It seems like it’s worth a try…I just hope it’s not too expensive.

I had horrible AF cramps this weekend. I felt like I was going to be sick on Saturday, and I was totally wiped out. It always feels like salt in the wound when I have bad AF cramps…isn’t it bad enough that I’m not pregnant???

>AF did arrive yesterday afternoon, and I didn’t have time to call the dr. until 4:45. I would say that realistically, the chances of me starting injections this month are slim. It’s already CD2, and Monday will be CD5. Since that’s a holiday, I would need to get my medication tomorrow (since UPS and FedEx won’t deliver on Sunday and holidays). I called the dr. yesterday, but a nurse has to call me back. I don’t know where I am going to get the medication from yet, because I don’t know what it is they want me to take. If the company that’s affiliated with my prescription plan covers it, I would get it from there. If not, though, there are probably cheaper places I could get it from. So everything is sort of on hold, until I hear from the dr’s office. Even when I do, I’ll have to call my prescription plan, and at a minimum, find out what I need to do to place an order. Then, I’ll have to call the dr’s office back with instructions. If the plan doesn’t cover the medication, I’ll have to make more calls. Either way, to have the medication arrive tomorrow, I think this would already all have to be in place today. I think we are probably out of luck this month, and honestly, I don’t know if next month will be any better. Between a work and life, making all these phone calls and getting medications to arrive on time is a royal pain.

So, unless things magically fall into place, I think we are taking a break again this cycle.

I’m torn about what to do, honestly. Part of me still has reservations about taking medication for something that hasn’t been identified. I ovulate on my own and have regular cycles, so I do wonder why I’m even going to take these medications. I’ve considered asking for a referral to an RE, but I don’t know if that will solve anything, either. I saw an RE in my previous marriage, and while he did do a few more tests, the results of my tests were all fine. Other than that, we did Clomid and IUIs, and then would have moved on to injections and IUIs. I could give the RE here a try and see what she says, but I’m just not horribly optimistic about it. A friend of mine saw her a few years ago, and they also had unexplained IF. She did 4-6 months of Clomid, some with IUI, and then moved on to injections & IUI. Nothing worked, and they never got any closer to an answer.

I don’t want to give up, but I’m at a little bit of a loss. I just don’t know if this route is for me, but I feel like I have to do something. I have been looking for an acupuncturist, but I was having a hard time selecting someone. I saw yesterday that an acupuncturist in town is giving a talk at the local community college in March. I don’t really want to wait that long, but I am thinking that she must be ok if they invited her to speak. So, I’m thinking about giving them a call. I’m starting to wonder if that’s the direction I should go, at least for now. Maybe this is all a sign that I should be doing something else.

>It feels like AF is on its way…either today or tomorrow. I had some hopes of getting a BFP this cycle – being one of those people you hear about – who take Clomid, take a break, and THEN get pregnant – but it seems I am not one of those people. So, we’ll be moving on to injections…as long as I can get the timing worked out.

This will be my first cycle of injections, but I have a lot of questions about getting started. I’m still seeing my ob/gyn for now, and I need to call and let them know that I’m ready to move on to injections. I’m totally confused about my prescription plan and what it will cover, if it will cover anything at all. From what I can tell, it looks like I have to go through a special mail-order company that’s affiliated with the prescription plan company. It says they ship overnight, but that’s all I really know. I’m not even sure how to actually get a prescription to them, since this is all new to me. Here’s my other dilemma: Today is Thursday, and it may end up being CD 1. Tomorrow could be CD 1, too. I don’t know yet if I have to start taking this stuff on CD 3 or 5, but I am guessing 5. Since Monday is a holiday (and I am assuming FedEx and UPS will be closed), I would need to get my medication on Saturday. If CD 5 is on Tuesday, that’s not so bad, because I could get it delivered that day. How I am going to sign for it when I have to be at work all day is beyond me. It seems like I would be better off just having it delivered on Saturday, if that’s possible, either way. That pretty much means that I have to call my doctor today, because I don’t know how long this is all going to take.

I had a moment of panic yesterday when I realized that Monday is a holiday, and I have to go out of town for work at 7:30 am on Wednesday. I won’t be back until Thursday night. The next few months will be a real challenge, because I have to go out of town for work in January, February, April, and May. That, combined with the fact that I have very little privacy in my office to make phone calls, creates an awkward situation all around. I wish this was all easier!

>I really don’t have much to say right now…I’m just waiting for AF to arrive at the end of the week. I’m somewhat hopeful, but I would be totally stunned if it turned out I was pregnant. I would love to not need to move on to my next medicated cycle, but I know that most likely, that’s where I’ll end up.

I saw someone’s status in face.book a few days ago that said this-

“Put this as your status if you or somebody you know has suffered BABY LOSS. ♥♥♥ The majority won’t put it on, because unlike cancer, baby loss is a taboo. ♥♥♥ Break the silence. ♥♥♥ In Memory of all the ~Angel~ babies gone too soon but never forgotten.”

I am always glad to see attempts at increasing awareness, but I didn’t add it as my status. Of course, I know people who have lost babies, but since I haven’t personally, I just felt kind of odd about doing it. I felt like I should have, though, and I kept going back and forth on it. I clicked the “like” button, which also didn’t seem appropriate. Had I been thinking more clearly, I may have posted a message saying something like “Thank you for posting this,” or something to that extent.

Today, I saw something almost identical, except infertility was also included. It struck me as strange, because I wondered who had either removed infertility from the statement in the first place, or who had added it later on. It doesn’t matter, but I wondered. That one said-

“Put this as your status if you or somebody you know has suffered BABY LOSS or INFERTILITY. ♥♥♥ The majority won’t put it on, because unlike cancer, baby loss/infertility is a taboo. ♥♥♥ Break the silence. ♥♥♥ In Memory of all the ~Angel~ babies gone too soon but never forgotten, and the babies who were not possible.”

One of the things that always bothers me about infertility is the lack of awareness. It seems almost completely ignored by the majority of the population, and while I don’t know if it’s really “taboo,” it isn’t something that a lot of people know about or understand. Most of the population assumes that if you don’t have children, it’s because you didn’t want them. TV commercials talk about a “family” as only something that includes a child, and so many aspects of our society revolve around children. The cost of fertility treatment and lack of insurance coverage is appalling, and I think it just demonstrates how little attention it receives by the general public.

So, you would think I would have copied the face.book status that appears to have the goal of increasing awareness, but I didn’t. Part of the issue is that I don’t know if posting a status in face.book really does increase awareness, and the other issue is that I don’t want everyone on face.book to know necessarily that’s why I don’t have a child. Posting it doesn’t necessarily mean that I am infertile (the people who posted those messages both have children), but I think it would make people wonder. I realized that’s why infertility is such a difficult issue…I want awareness to increase, but I don’t necessarily want to be the one to do it. I want others to feel supported, but I don’t want people to feel sorry for me or to jump to conclusions. I’m not super private about it, but I don’t want too many people to know, either. I feel like I should take a stand, and be stronger and more courageous. Maybe when this is behind me, I will, but for now, I just don’t think I have the energy. Maybe that’s part of the problem…until you’ve come to some kind of a resolution, are you really prepared to take on the goal of increasing awareness? I think that for me, dealing with infertility takes a lot of energy. In order for me to continue to have a normal life, I have to protect myself in certain ways. I guess this is one of them.

History

2014
May: BFP for baby #2, due January 2015

2013
July: Our daughter is born!

2012
November: Still pregnant. Fingers crossed! EDD 7/5/13
October: retrieval 10/12; 5dt 10/17; BFP!!! 10/25-hcg=70; 10/29-hcg=391
September-October: IVF, microdose lupron flare protocol
June-July-August: approved! dealing with scheduling issues and most likely starting IVF in September
May: waiting for insurance approval to start treatment
April: laparoscopic surgery to remove endometrioma on left ovary; diagnosed with stage 3 endo
March: RE finds cyst - suspects endometrioma; also high FSH, low AMH
February: consult with RE; bloodwork, hsg

2011
January-February: Acupuncture once per week, vitex and natural progesterone after ovulation; back to charting bbt
March-April: end of ttc
May:diagnosed with severe cervical dysplasia (CIN III)
July-August: L.E.E.P. procedure and recovery

2010
December: Start acupuncture
May-November: Not actively trying/on a break/enjoying life
April: Not actively trying, still waiting for insurance coverage for injectables
January-March: still waiting to start injectables

2009
December 09-March 10: On a break while waiting to start injectables
November 2009: 50 mg Clomid CD 5-9; BFN
October 2009: All tests normal; Take 50 mg Clomid CD 5-9; BFN
July 2009: Ob/gyn asks for bbt chart, S/A, CD3 b/w; plan tbd.
April/May 2009: Switch from OPKs to the Clearblue Fertility Monitor
March/April 2009: Start using OPKs and bbt

2007-2008
Sept/Oct 2008: Stop preventing; 'if it happens, it happens'
Summer 2008: Stop BCPs; using bbt chart to prevent pregnancy
May 2007: Married again! husband #2; no plans for children

Previous Life
Fall 2005: Divorced
Summer 2005: See RE; more b/w, clomid challenge test, sonohysterogram; 2 Clomid IUI cycles - BFN; male factor discovered (he now has a child with wife #2)
Spring 2003: See ob/gyn for IF, get b/w and HSG; All results normal; Husband #1 gets S/A, which he says is normal; results never sent to ob/gyn
Spring 2002: Stop BCPs, begin ttc and charting bbt
Oct 2000: Married to husband #1