meds are FINALLY on their way

After numerous calls to precision rx and my doctor (back and fourth) My meds are finally on their way. Precision rx is terribly slow! I have to use them for most of my meds because of my ins. If I go through them it's $40 co pay per med (so todays was $140). If I got my HCG through them it would be $40 but if I go to freedom (I pay a percentage of the cost if I go elsewhere) it was under $10. They will be here Wednesday. Nothing like last minute.

I'm on:
Gonal F
Repronex
Cetrotide
PIO & Estrace in the 2ww. I've filled all but the estrace. I'm pretty sure that since it's a pill it will be under $10 at freedom. I've never been on estrace before.

I've started to realize that most of my stress is from work. I hate my job. I've debated talking to my boss but I think it's to risky. I don't think there are any other positions in the company. As it is they have had to make cut backs. I'm going to stick it out till my IVF is done then I might get a different job. If I end up pregnant by some miracle I might just stick it out through my pregnancy. My boss is very nice (can work from home if I need to). I'm just upset and angry/sad all the time now. My job makes me miserable. I really can't stand working on a team with 2 other people. I'm trying so hard to like it but I just can't get myself to. I guess all I can do is take it 1 day at a time. Once DH graduates and gets a job I might quit all together. Who knows. I really want to stop working and give myself a break when DH graduates but I'm not sure I can justify it. I know DH will let me but giving up the money will be so hard. I'm hoping once I get pregnant this will all be more bearable. Between a job I hate and a body that keeps failing me as a woman I'm miserable all the time. All of these failures is getting to me emotionally. I'm starting to feel like a failure. It doesn't help that I've missed my infertility support group the past 2 times (forgot) I've GOT to remember to go to the next one (every 2 weeks) the last one was on 2/5 so the next one should be next Tuesday. I should call my therapist and let her know I'll be there.

It's been a long day and all I wanted was to come home to a DH that loves me. I feel like such a loser today. I'm always uptight at work and I know people can tell. I feel like they must think I'm a freak. I just wanted to come home to a husband who loves me but he went from a long day at Fidelity (helping them on Mondays - IT stuff- and getting school credits for it) to a TA position of which he also gets college credits. He won't be home till around 9 pm. :( My word I feel like such a loser today. Makes me wonder what people at work think of me. I'm sure I make it out to be worse then it is.

Mentality

It's hard to change my mind set. I'm so used to the mentality that I need more eggs. Here is my reasoning: usually only 50% or less of my eggs fertilize. (if you combine all my cycles my average is 58% fertilization with ICSI). From those not all my embryo's make it to transfer. Usually 1 out of 3 dropped out (never had more then 3 embryo's) by day 3. This time I'm doing a 2dt so it really doesn't matter to much how many eggs I get. I just need enough so I can have 2 good quality embryo's to transfer on day 2. My clinic is VERY picky about the one's they put back. My RE and his embryologist have done a TON of studies on 2 day transfers. She said she can give me all the scientific data I want. Anyhow, I'm sitting here and occasionally I find myself flipping out because I'm only on 150 units of gonal f. In the past I've gotten around 6 eggs out of that dosage. I'd be phsyched if I got 6 eggs this time but I'm so terribly afraid my response is worse. I used to get 6-8 follies with 150 and last time I was on 225 I had 8-9. Could have just been a fluke I guess. I'm still scared and I'm trying not to be. I just can't wait to start stims and get the ball rolling.

I'm trying not to look ahead to my beta. I'm scared that this won't work. This is my 4th fresh IVF and I'm scared to death it won't work. I really don't want to do this again. It's hard when I see so many people around me get pregnant. It makes me crave pregnancy/babies so much more then I normally do. I love my friends and I'm so happy for them. Anyhow, 3 more days of the BCP and 6 more days till my u/s and blood work to start stims! I'm pretty sure I start stims on 2/16.

4 more days

I can't believe I only have 4 more days of BCP. I can't wait. I'm getting excited for my cycle. I'm not overly excited though. I just don't care any more (not in a bad way) My first 3 IVF's I was an emotional wreck. part of it could have been due to the fact that I hated my clinic. This Re's office is GREAT. The nurse is wonderful! His embryologist was GREAT and has me VERY excited for a 2dt. Only sad thing is they can't take pictures of the embryo's in the Portsmouth office but she said if I have a camera phone (which I do) they can take a picture for me. :)

I'm not overly optimistic about this cycle but I sure hope it works. I'm sick and tired of all this crap and don't know how much more I can take. My BIL and his wife are moving here this summer and may live with us for a little while. Either way it will be easier for me to be around my nephew if I'm pregnant. I know that sounds terrible but it makes me sad when I see him doing his firsts...crawling, babbling, standing, laughing. I love him to pieces but I cry on the inside because I want that to be my baby.

Not much going on. Work stinks.

Waiting for my meds. Should have them next week. Not looking forward to spending the $$ but oh well. It's NOT a lot compared to what some people spend.

budget is tight so I wont' be doing acupuncture. :( I want to so bad but can't justify it. I might however do it before and after transfer. My husband doesn't want me to spend the money though so I might not.

I hope I'm not getting the stomache bug going around. I have major heart burn and feel nauseous. I also have a very sharp pain on my left side (my left ovary) I'm scared that maybe the BCP isn't working? Not much I can do about it. I sure hope it's not a cyst though...I doubt it. I mean the BCP is supposed to suppress me and it's never failed.

7 more days

I talked to my RE's nurse today (Jessica) and she is ordering my meds. I also talked to her about my concern over being on 150 iu of Gonal F. She said if need be he will up my dosage. She is also ordering me two 900 iu pens so I will have extra (not to mention what is in my fridge). I go in on 2/16 for b/w and u/s. I think I start stims that night if my b/w comes back ok. Guess they aren't to worried about AF. They bring me in for my first u/s after 3 days of stims. I'm not sure how often after that but I'm hoping every 2 days. If he is going to increase my dosage he's got to watch me carefully. My follies can take off and it could be to late. Sometimes by the morning after day 4 of stims I will have a 14mm.

I also told her I wanted to see a endocrinologist for my Thryoid. She says they don't refer people but my OB could. She said if I needed my records I could sign a release form. She also said they have a list of doctors and if they are on that list I don't need to sign a form...or maybe I miss understood her. Anyhow, I'll be looking for an endocrinologist. I really don't feel like dealing with another doctor and more tests but oh well. I'll try to find one in Portsmouth (where I work and where my RE is) so I don't have to travel far. I just think it's important to get this checked right away. I found places that are accepting new patients but I don't know if there is a wait or not. If there is I might just start with my OBGYN and request all the tests...ok what are the things again? T3, T4...etc etc?

I started my antibiotic tonight. When the pharmasist gave it to me I guess a flag went up in her computer saying I'm sensitive to it. I do have allergies (break out in hives...or I did when I was little: penicillin, amoxycillin and ceclor). I took one tonight so here's to hoping I have no reaction.

but would I be upset if I got hives and had to call in sick from work on a day where we are supposed to get a ton of snow? (tomorrow) probably not. :) NOT that I want hives!!! Work has been terribly stressful. I'm so sick of it.

Good to go.....I think...

Ok so I think I got the insurance thing squared away but I'm very nervous that I'll be stuck with the bill. At this point I really don't want to think about it.

SO I got my TSH checked today. It's a 3.76. They said that is "good" (they like to see it 4 or under). What ever. I called 2 places and both places said I need my RE to fill out paperwork and fax my records over to them. What crap. I don't feel like having my RE fill out paper work. Why can't the specialists office just do all the hormone tests for me? They are going to want to do it anyway.

I'm so sick and tired of doctors. I give up. Why even take my thryoid medication any more? What's the point. Oh my word I'm so sick and tired of this crap. I just might cancel my IVF.

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update: so I've decided to suck it up and call my RE's nurse directly and tell her I want to go see an endocrinologist. I will voice my concern about getting my TSH down to at least a 2 and getting other stuff tested (T3, T4, free etc). I also think I'll mention my concern about my gonal f dosage. He wants to back me down to 150. I don't' have a great fertilization rate with ICSI and I don't think I'll get to many eggs with 150. As it is I had 8 follies with 225 (only 3 eggs retrieved). I personally don't want to go under 225 and I'd like to do 300 (that is what Boston IVF was going to do). But my Re is worried of me stimming to fast. All he has to do is start the ganerellix a day or two sooner then he would. By waiting till my lead follie is 14mm...it's to late. I always trigger 2 days after that. My follies really grow fast at the end. I've always stimmed 8 days (9 on rare occasion) regardless of the dosage of gonal F. *sigh*

I'm trying to relax and just do what he wants me to but there is this nagging in the back of my head "you know you want to call...pick up the phone...call your RE" *sigh*

what do you think? here is my history:

2005-2006 IUI's
#1 = clomid 50mg 3 follies
break/cysts
#2 = 150iu Gonal F. 4 follies (7 days of stims)
(month off in between on BCP due to OHSS/cysts)
#3 = 15oiu Gonal F 12 follies! (8 days of stims)
break/cysts
#4 150iu Gonal F/cetrotide 8 follies

IVF #1 Antagonist protocol 150IU Gonal F (8 days of stims)
8 follies -7 retrieved-1 crappy quality. 6 good/ICSI 3 fertilized. 2 made it to day 3
1 perfect high quality 8 cell and 1 5 cell.

IVF #2 Lupron and 225 Gonal F (oversupressed) 3 eggs/3 retrieved. 1 fertilized and died in lab-abnormal growth rate-10 cells by day 2 and then stopped at 11 cells.

IVF #3: antagonist 225 IU gonal F: 8 days of stims
7 follies over 16mm. (1 at 15 and 1 at 12).
3 retrieved all 3 fertilized. 2 made it to day 3. (2 five cell)

Clomid challenge test: 100mg clomid and I got 3 follies.

As you can see my response wasn't that much better with my last IVF. Should I ask for a med increase to 225 (I doubt he will go to 300). Or should I trust him and do 150? Honestly I could care less about having some to freeze. I've accepted the fact that it probably won't happen and that we have possible egg/embryo quality. All I really care about is 2 good embryos for a 2dt . So should I even care about a higher dosage? all I care about are numbers.

also I still need to talk to his embryologist. By day 2 all my embryos are always alive. it's from day 2-3 that they stop growing. Thus I'm VERY nervous about a 2dt.

also at my last IVF the RE doing the transfer said my 5 cell embryo's were good quality. When I had my after IVF failure "talk" with MY RE (he didn't do the transfer) he said they were poor quality...when I got my paperwork it confirmed it... two 5 cell grade C. however they told me they grade 1-3 with 3 being the best. *sigh*.

Why can't it ever be easy?

So I STILL haven't gotten an approval yet. Just today my doctors office (Sandra is the ins person) got the correct fax number and faxed the form over to try to get it processed. However she mentioned something to the effect of ... well I don't understand and frankly I don't feel like explaining it. Needless to say she needs me to call and verify that certain "codes" are covered. OK...well here's the deal. My infertility plan is "out of the ordinary" it is not something that anthem typically offers. It's something special they made for my company's plan. Thus when ever I called to verify exactly what they covered (IUI's, IVF's how many, restrictions) I got different answers. SO I had them write me a letter. I have the letter and hopefully it helps. However this is what I don't get. My insurance company has approved 4 IVF's with Boston IVF. Why on earth my new doctor is having troubles is beyond me! I have 9 days left and I need to get this approved and get my meds mailed to me. Luckily the place I get my meds through will next day it to me (If I order it before Friday). I think I start meds on 2/16. That gives me 6 days to get my meds mailed...plenty of time though.

Anyhow, I'm grateful for my coverage by why the heck can't it be easy? I'm trying not to let any of this get to me but today I don't feel good. I struggled to make it through work. I've had a headache off and on all day, I'm sore all over, everything I eat feels like a brick in my stomache, sweats and shakey. All I want to do is lay down but if I go to sleep now I'll wake up at 1 in the morning and not be able to go back to sleep. I might call in sick tomorrow but then again I don't want to use up all my sick and vacation time at the beginning of the year. I want to save it for when I am absolutely ILL (IE throwing up etc) or for......morning sickness. LOL...

Anyhow, I'm frustrated but I have faith this will all work out. Looks like I might be calling my previous doctors office to get the approval number...the approval number that anthem gave them when they authorized my 4th IVF (back when I was going to cycle with them again---before I switched to my new RE). I'm hoping they can transfer the approval to my new RE. No reason why they couldn't if my Re is in net work....which they are.

Ok so maybe I shouldn't complain since I have IVF coverage...but I am....

9 more days of the BCP...tomorrow I get my TSH level checked...I forgot to go in this morning.

either that or I'll blow it off if I'm not feeling good. My TSH can wait a few more days I guess.

10 days and counting

10 more days till I take my last BCP. 2 more days till I get my TSH checked (on Monday). I have to admit I'm getting nervous at this point because I can't stop the BCP until my ins company approves my IVF cycle. I called them and they said they had "nothing" from my doctors office. They also said they didn't have record that they approved my cycle with Boston IVF. (which they certainly did) so now I'm wondering if I should call Boston and get the approval number so I can call and prove to them that they approved it. The kicker is they don't know I switched clinics. I just told them I was taking a break and I'd call when I was ready. If I call I'll have to tell them I switched and to be honest I don't want to deal with it. Either that or I can sit back a few more days and pray that they approve it. I really don't want my IVF pushed back. I might lose my IF coverage on 4/1. if I have to wait another cycle I may not complete it in time.

I am very greatful to have insurance coverage for my IVF's but my word are they a pain in the butt. They STILL have not paid for all of my second IVF. My second IVF I didn't have anything to transfer so they billing code was different. They don't "recognize" the code and said "it's not a coverable code" yet I do have the coverage. So I have a $5,500 bill. Luckily Boston IVF says this happens a lot with Anthem (blue cross blue shield) and they won't send it to collections. What a pain! Also my infertility coverage is "out of the box" it's not something that Anthem typically offers so I had to get a letter sent to me with my coverage and prove to them I actually had IVF coverage. *sigh*.

Ok back to this IVF. I'm annoyed that my RE wouldn't process my approval until DH had his SA. I'm also annoyed that he didn't tell me that to begin with because we canceled his first SA and had to wait 3 weeks to get another one. GRRRRRRR. His rational was that he wanted to know if we were doing ICSI so he could have the exact protocol to send to the Anthem for approval. But when he gets my husbands SA results he says it's "ok" but we are doing ICSI anyway due to the fact that I've had poor fertilization with ICSI in the past so he doesn't want to risk natural fertilization being worse. MY WORD...Then why did we do an SA to begin with????

Ok vent over. I've accepted the fact that all doctors have their quirks.

Well 10 days and counting. I'll feel better when I get the insurance approval. I don't' know why I'm scared they haven't failed me yet (all 3 of my IVF's were approved easily but I'm not sure how long it took).