Day 1 – IVF Consult with the Reproductive Endocrinologist

Before I even get into the details, let me just say two things – 1) This blog is going to include all the less than pleasant details (including medical terminology), so if that is not your thing, you may not want to read. 2) Holy crap, what a ridiculous amount of information that was thrown at us today. Complete overload.

Dean and I arrived for our appointment ahead of time and had filled out all of our paperwork ahead of time (because, planner). The ladies at check-in were very nice and accommodating. When I advised that they should have received a fax from my OBGYN’s office, it turns out that they had not received anything. A bit of backstory on this: my files are at the old location of my OB’s office, and she now has a separate practice. I requested my files be sent from the old office, and lo’ and behold they were not there when I arrived. I called my OB’s old office and they said they had sent it over, but would try again. These were never sent during our entire 2 hour consultation.

Luckily, I am a planner – and had copies of some of the hormonal testing I had done, and could supply the RE with the rest of the information verbally. Our RE (I’ll refer to her as “Doctor C”) was amazing. She outlined the entire process and gave us a realistic idea of what to expect, going forward. Originally, I had selected her specifically because of her familiarity with tubal defects, but now I am glad I chose her because she has a wonderful personality, and was very kind to us.

This is a basic outline of what the IVF process entails:

1) Birth Control pills to regulate where you are in your cycle and stop the release of only one egg.

2) Ovarian stimulation and monitoring – this is where the injections come into play (2-3 times per day) and ultrasounds will be performed every other day, and then daily for the last few days of stimulation.

3) Egg Retrieval/Sperm Collection – done on the same day. 

4) Fertilization – self-explanatory…I hope.

5) Culturing and Cryo-Preservation – Embryos are cultured to a 5-day old blastocyst before being transferred into the womb, yielding more positive outcomes because they are stronger than day-3. 

6) Embryo Transfer – This is when the embryo is implanted back into the uterus where hopefully pregnancy will be achieved.

7) Pregnancy Test/Pregnancy Monitoring – If the IVF cycle is successful, your pregnancy will be monitored for 9 weeks until you are released back to your OBGYN.

In between all this, there is a lot of blood work that has to be done to monitor my hormone levels to ensure that I am not being over-stimulated, as well as responding appropriately to all the medications. If that happens, they recommend freezing the embryos and attempting a Frozen Embryo Transfer (FET), because the over-stimulation can affect you negatively during pregnancy.

Now BEFORE we can even get to this point, there are several things that have to happen first. The first two, we took care of today – state mandated bloodwork (as well as a hormone panel), and opting to do a Global Carrier Screen for hereditary genetic disorders. They will be testing both Dean and I’s blood to see if we are both a carrier for any genetic diseases. If one of us is a carrier of something, it will likely become a recessive gene and not harmful to our child. If we are both carriers for a disease, we will need to pursue further testing and in fact, depending on the condition, they may even want to test our parents DNA.  This will delay our IVF cycle, by several months until we get the new results back, and we may need to add PGD (pre-implantation genetic diagnosis) to our IVF cycle, to make sure our embryos do not carry the harmful gene that we have in common. This test (to a high degree of accuracy) screens for over 218 disorders that can cause serious health problems in infancy or childhood. Doctor C advised that for people with our medical history, and our age – the percentage of us both carrying the same genetic defect is very low, but it is always better to err on the side of caution, and it is far more cost effective to do this now, instead of opting for PGD. They took over 8 vials of my blood for all the necessary tests. The phlebotomist was so sweet and told me that this would be the most blood I’d have to give at once throughout my experience with IVF. I wont hold my breath on that one.

Doctor C performed a transvaginal ultrasound to see how many antral follicles I had, which is a count of potential eggs I had present in each ovary. My left side had 11, and the right side had 7. Doctor C was very pleased with these numbers, and kept saying how “good” that was for us. I’ll take any victories I can.

The next thing we have scheduled is for next week (March 18th) where I will need to have a Sonohysterogram/Trial Transfer, and Dean will have to have another semen analysis. A Sonohysterogram is an ultrasound technique that is checking on the quality of my uterus and my uterine lining. It shows more detail than a regular ultrasound. These tests going well is absolutely vital for our future attempt(s) with IVF. The IVF trial transfer allows the Doctor to find the best “route” for an embryo to implant in my uterus, as well as to ensure that there are no unexpected road bumps along the way (like an undetected fibroid, scar tissue on the cervix, or other problem that may make transfer difficult). If I have an undetected fibroid, or another anomaly this can count us out before we even begin the cycle. We’d have to seek treatment for that problem before continuing, depending on the size.

Now the moment everyone is REALLY waiting for? The cost.


This is (naturally) the biggest point of contention, because our insurance does not cover A-N-Y-T-H-I-N-G. We have opted to participate in what is called their “Attain” program. You pay more up front, for the security of getting everything done. This photo is of their 1 cycle, 2 cycle, and 3 cycle plans respectively. These costs do not include anesthesia, the medications ($3,000-$5,000 per cycle). What it does include, is unlimited FET transfers. Essentially, if you have any extra frozen embryos from your first “fresh” IVF cycle and you had not achieved pregnancy, they would keep doing FET transfers until you were successful. The “Two-Cycle” option, you can also get up to 50% of your money back, if you have not achieved a successful pregnancy. This was originally where we were heading until I ran the numbers. For the amount of money we would need to be approved to cover the IVF, the monthly payments would be $385 per month, at MINIMUM. So paying that for four years, while also paying the high cost of infant care? That doesn’t exactly work out for us budget wise. As of right now, we are going to attempt the first “Core” option. This includes one fresh IVF cycle, up to 2 egg retrievals, and unlimited FET’s. What scares me about this, method (I need clarification) is that if we do not have any available embryos to transfer from that first cycle – then are we out of luck? How are we getting a second egg retrieval? I’m scared that the entire process ends right there, and we will be paying the debt with no outcome. Their individual pricing for one cycle outside of this plan, is about $11,500, and that doesn’t include any of the FET’s.

I’m really wrestling with the “how much is too much, and what if it’s not enough” semantics surrounding this entire procedure. I’ve been talking to myself and asking questions (yes, to myself) after reading the requirements, “Do I really want to do this twice? Can I even do this twice? That’s a lot of time off work, a lot of mental anguish, and of course – an assload of money.” How much do you give for your dreams? I am willing to give everything we have, but we wont bankrupt ourselves trying to achieve pregnancy. Providing our child with a good life is just as important. If we undertake too heavy of monthly payments, then we aren’t going to be able to give them the quality of life that we want to.

So that’s where we are. More “hurry up and wait”, but things are moving. Most importantly – if all things go well with my procedure next friday, then we can start our IVF cycle next month. Yes, NEXT MONTH. As these things usually go, there is an upside and a downside. Today I am mostly feeling the upside, but it’s a little hard to stay there when you’re faced with such a tremendous decision, an obscene amount of money (this is more than our CAR), with only 47-60% chance at success. It’s an odds game, and we’re about to roll the dice. Wish us luck.