Lilypie - Pregnancy

Friday, May 15, 2009

Plans

I'm not even sure where to start with this. Let's just say I was smart to be nervous about yesterday's ultrasound.

I had a big ol' cyst on my left ovary, so we paid about $300 to be told that we won't be doing anything at all this month. Actually, it turned out to be worthwhile anyway, because (after I cried for a bit), the doctor took us to her office for a consultation, which was quite useful because we got to ask all our questions and then some.

First, somehow there's never been a really good test of my husband's sperm morphology. I have no idea how this happened - I thought everything had been tested and was pretty darn good. So we are doing that next week.

Then the doctor said that she would recommend only one more clomid + IUI cycle before moving on. She said that typically you move on after three cycles, but since we missed our IUI in cycle #2, she thought it would still be worth one more shot (if the SA comes back ok).

After that, she suggested two options. First is to move on to IUI + injectables, BUT she would want me to have a laparoscopy first. The other option is to move on to IVF, without the need for a laparoscopy.

Let's break this down, shall we?

Option #1 - Laparoscopy with 1-3 cycles of IUI + injectables. The laparoscopy costs, apparently, about $4000-$5000, PLUS the doctor recommended a week off of work (yikes!). The injectables cycles are also about $3000-$4000 each, with only about a 20% success rate. To get to the same success rate as IVF, we'd probably need three IUI cycles. Total cost (worst case) is $17,000.

Option #2 - IVF. One cycle is $8500, plus meds, another $3000 = $11,500. The package plan includes one IVF, followed by up to 6 FETs (or as many frozen embryos that there are left), and once the frozen embies are gone (but not before), a second fresh cycle. $14,500, plus meds ($3000 to $11,000, depending on how many IVFs and FETs we'd need) = $17,500 - $25,000.

We're both thinking IVF will be the better option.

To make things more complicated, if I'm not pregnant by fall, I was hoping to maybe get my knee surgery done and out of the way. I calculate that between our break month, our last clomid cycle, and I assume another break month before IVF, it will be almost fall by the time we'd be able to get started. I would seriously consider putting off IVF by another month or two to fix my knee. I don't know if it would be a bad idea to put my body under that much stress for several months in a row (drugs and surgery, followed by rehab and IVF), but it would be nice to get it all over with.

It's way too much to think about, and I think I'm going to need some time off to actually do that thinking. In the meantime, I'll be reading Mel's Navigating the Land of IF, and trying to enjoy my time off.

And hopefully training for a triathlon on June 6.

P.S. Advice, while not necessary, is always welcome.

13 comments:

  1. Sunflower, I'm so sorry about your cyst and canceled cycle. It is awful when our fears are realized.

    I won't offer advice--since you didn't ask for any--but I will say that I wish you the best of luck with whatever you decide.

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  2. I'm sorry you have a cyst. I just had 4 cysts (left over from my 1st iui/injectable cycle). I know it stinks having to sit a cycle out, but try and enjoy the time. No early morning b/w & u/s apts!

    I know your decision isn't easy, and I hope whatever you choose works the 1st time so you won't have to deal with it again.

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  3. Wow - what a day! It sounds kind of similar to how we jumped from clomid and a cancelled IUI right into IVF. It sent my head spinning, but it really forced E and I to talk about making some changes to make this IVF cycle our top priority.

    I'm also sorry to hear about the cyst. I had them after almost every clomid cycle and had to sit out 1 or 2 months while they shrank. One month I tried applying castor oil compresses and my huge cyst shrank twice as much as the month before it when I was just taking BCPs.

    And I don't know your thoughts on this, but our RE let us order some of our meds from Europe. It saved us thousands.

    I don't intend for any of this to be assvice so feel free to ignore my ramblings, but I can totally relate and I'm here if you need anything.
    Hugs,
    ~C

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  4. I am so sorry about the cyst.

    The choices you have in front of you are very tough. I was so devastated when we finally got the speech to move on to IVF from our DR. Its a tough road to travel, as you already know.

    My assvice would be this - IVF affords you much more knowledge about your eggs and their quality. I'd rather not waste the money on IUI when you can't tell anything about the quality...

    Just my 2 cents. I don't mean to come across as a know it all or pushy...

    Take care,
    Tara

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  5. What a day you had yesterday! I'm sorry about the cyst.

    I can't speak to the knee surgery timing issue, but I know we opted to go straight to IVF due to morphology issues. We had about a 5% of any IUI working, and when you add injectables into the equation, it gets expensive and invasive. I agree with a previous commenter that the process basically tells you a whole lot more about your side of the cycle, too....basically, a very expensive, extensive checkup.

    Anyway, my assvice. Wishing you peace in figuring everything out. It's a lot of information.

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  6. Having done injectibles + IUI (which we did only because those were covered by insurance, so what the hell, worth a shot), if I had it to do over, I'd go straight to IVF. To add to the 'unrequested advice' column. :) But best wishes with whatever you decide. It's all so much harder than it should be, isn't it?

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  7. Ugh, two cancelled cycles must be frustrating. And you have so many expensive medical needs. I KWYM about the frustration when medical treatment is not covered. It seems the knee surgery and lap should definitely be covered.

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  8. Sorry about the cyst but I'm glad you were able to get some answers today. I know when it came to doing medicated IUI's I did a couple of clomid cycles and then only one injectible IUI and then went to IVF. It seemed like my better option. Good plan also to get the SA done just to double check. What was the reason for the laproscopic for IUI's but not for IVF? Have you had an HSG done or a Saline Sonogram? Just curious. I hope whatever you decide about when and what works out great.

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  9. Wow - you have so much to consider. IF is so confusing and it is often unclear what to do next. My DH and I decided to skip IUI and move straight to IVF. Although my first IVF didn't work, I am happy that we moved to this stage soon because I don't think IUI would ever work for us. However, I have heard of IUI working for some other people. Everyone is different so I would encourage you to do what you think is the best thing for your situation.
    We're here for you! x

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  10. I'm so sorry about the cyst, about things not working thus far, about how hard this road has to be.

    ...it's your decision of course, but I personally would go directly to the thing that gives you the greatest odds (and the greatest information to be quite honest). Although IVF is expensive, so are all the other treatments if you do them over and over and over.

    Just my opinion.

    Hang in there...thinking of you.

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  11. Man, that sucks! I hope you're not into much pain from the cysts. I'm glad you and your hubby talked it over and came to a decision. I hope that makes you feel a little bit better.
    Sending you many hugs!

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  12. i'm so sorry about the cyst :( best wishes to you. i don't have any advice about ivf vs. iui but do what you feel is right for you. i wish every state had mandated infertility coverage!!!!

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  13. Hello. I just came across your blog. I am pretty much right where you are in the infertility cycle. Just experienced IUI#2 bust this morning with the arrival of AF. Someone else asked this but I'm also curious why your RE recommends laparascopy for IUI+inj but not for IVF? Would you mind sharing your knowledge?

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Thanks for sharing your thoughts!