Sunday, September 13, 2009

IVF thoughts

I just got my schedule to start IVF. I'm excited about it. So far, it goes like this - I'd love any IVF vets to tell me if this is similar to what you went through:

Sept. 22 - baseline u/s
Oct 15 - start Lupron, 10 units per day (stop BCPs after a couple days of this)
Oct 22 - decrease Lupron to 5 units per day, start FSH at 225 units per day
Oct. 30 - monitoring u/s

That's it - no other appointments as far as I can tell, except my injection classes. It seems like when I read about other people's IVF schedules, they have regular blood and u/s monitoring. This sounds to me like I won't know until pretty much trigger day how many eggs I have, much less if I have any at all.

The other thing we have to decide, and soon, is whether or not to do the "shared risk" plan. The way it works at our clinic is, you either pay $8500 for one cycle, plus meds, OR you pay $14,500 plus meds for one fresh cycle, up to six FETs (depending on how many frozen embryos you have), and then one more fresh cycle, all of which must be used up within one year of start the original IVF cycle. Considering how much the meds cost, it's probably more like $11,500 for one cycle plus $17,500-$25,000 or more for the package deal.

I feel like in some ways, we have a lot on our side. We're young and healthy, and they can't find anything wrong with us. There's absolutely no reason why it wouldn't work the first time. On the other hand, we're unexplained - there's no real known reason why we can't get pregnant and therefore it could be something that IVF can't fix.

One of the things I keep thinking about is the jinx factor. If we only spend $8,500, we're pretty much ensuring we'll need to try again, since we didn't pay for the back-up. If we spend $14,500 as a safety net, surely it will work the first time. Sort of like how you should always wear your seatbelt, because surely the first time you don't you will have an accident - maybe because you weren't wearing your seatbelt. I don't want to have to do IVF more than once because I was so cocky and sure of myself that I wouldn't wear my seatbelt.

I mean, ouch, it's a lot of money. But better to pay the money, have the opportunities, and not need them, than to NOT pay the money, not have the opportunities and be right back at square one, trying to decide which option to do the second time around.

Well, I guess we'll see, and time will tell.


  1. Dr Z. does things differently than many clinics for IVF. He doesn't do labs at all and he doesn't do nearly as much of the ultrasounds. My cost for the IVF with him was about 3K less than the doc in Fresno. That's not including the meds. I think he said that his thoughts on the labs are that unless they are done stat which is an extra charge then by the time you get the results back it's too late any ways. Not much of anyone will be ready to trigger before nine days. It sure made having time off for appointments easier. I had a general idea what they were going to get before I went in and they did get more.
    As far as the money yes it is a lot. If there had been any possible way I could have paid for 2 cycles I would have (then I'm older) but I had to finance with my last bits of available credit to do what I did. I've heard many people talking about the shared risk stuff and the feeling that many have is that if you buy the 2 and you get pregnant the first time it's not like you're going to be pissed about it. Whatever you decide good luck.

  2. Hmm. The shared risk plan is always a hard decision. We decided to go against it because we decided we would rather pay for two cycles than buy into the plan. I would have been way too irritated with the unused cycles. :D It's such a personal thing.

    My doctor explained that the earlier monitoring, starting with your stims, is important because it allows them to adjust your medication if you are not responding or over-responding. He has a lab in his office so, it is not an issue as far as the timing. Also he explained that he's willing to come in every day of the week and do the extra monitoring so that the cycle will be as successful as possible.

    Sending you good thoughts!

  3. I wish we had a shared risk plan here - I am just one of those people that will do everything possible to ensure a good outcome! Even if it means buying into something just as a precaution so as not to "jinx" myself! It's sad that this process has to turn into a financial thing for so many of us, but it does.
    Our clinic does a lot of monitoring with bloodwork and ultrasounds. They have their own lab, so getting the stat bloodwork is not an issue. They too want to be able to adjust meds to get the best possible outcome. But, every clinic, every cycle is different and I am sure your doctor will do everything to ensure you have the best cycle you can!

  4. sound like a schedule similar to mine. once you go for the initial monitoring u/s, i think they'll tell you when to come back depending on the size of the follies. after my first, i think i went back every other day for a few times until it was time to trigger. also depending on what they see, they call you each afternoon to tell you how much of the stim meds to do (i had to decrease a few times). yours may work differently, but that was how mine went.

    good luck!

  5. My doc does the first stimulation check on the 8th day of stims - no monitoring before that. We're dealing with MFI, so there was no reason to think that my response would be anything other than textbook. Problem cases get more monitoring, but then it costs more, too.

    Good luck!

  6. Good luck! It seems like a pretty tough decision whether or not to do the shared risk.

  7. I read somewhere that it takes an average of 3 cycles of IVF to be successful. We're still trying to get insurance coverage for IVF, but it if doesn't work out, we've decided to save for the shared risk program. I guess it comes down to whether you'd regret more not buying enough or buying too many ...?

  8. That shared risk sounds like ZFC..

    Just came across your blog..and after my last year.. I am a surro, and my couple are young and we are going onto 4th transfer.. 1st one m/c at 10 weeks and 2 unexplained chemicals..

    IF treatments are so costly.. and it just aint right.


Thanks for sharing your thoughts!