What the hell is wrong with Gonal F pens?!

What the hell is up with these creepy drug manufacturers of the IVF meds?! I cannot believe that you can not reset the Gonal F pen. If you pull it out too far then there is NO WAY TO RESET.

Good news is the pen is not wasted. Each click is 37.5. So all you have to do is figure out how many clicks is in your dose (7 for me) and only push the top of the pen that many clicks… it’s a pain in the ass but you haven’t wasted the meds.

Crap on toast. There really needs to be communication between manufacture and end users.

And I did call CCRM to see if I was just being an idiot or if there really was a way to reset the damn pen… no way to do so. Good plan.

Random IVF male issues … that I never thought about.

I just wanted to give a huge thanks to all the men and non-hooch probed IVF partners. I had no idea until we were signing the paperwork yesterday how challenging it can be to “shoot sperm into a small cup” in a random office with bad porn. I’m also grateful that my huzz hasn’t sprained his elbow with the rigors of masturbation because evidently this has been hard on him.

When I suggested that he bring his own porn with him into the office he flat out refused and bristled at the suggestion. Who knew? I think he was bummed that there wasn’t deli paper on the furniture and mentioned that he finds himself getting freaked out every time thinking about what goes on the room with every other man who has spent time alone in there… then these thoughts distract him from the task at hand (no pun intended) and he has to start over. Who knew that we had so many issues?! I can now add another point of comparison between Conceptions and CCRM and it goes along the lines of things are just better at CCRM. No sticky pages and a “little better” quality “material”… I dont even want to think too hard about it.

My husband had me laughing this morning when I was complaining about everything IVF and the “gonna kill you” factor. He wondered why there wasnt a clause about spontaneous death resulting from vigorous masturbation… maybe that one hasnt happened. I’ve been so focused on all the things that I have to “do” for IVF that I gave little to no thought on random rooms, sticky pages and small openings of containers.

Summer slow and a pause from the IVF rush

I’ve been doing a lot of research on egg health and all of the various ways that the universe thinks that you can improve your egg health. Much of the info out there put’s a 90 day cycle on eggs and that during THIS time is when you can affect their health in either direction – healthy or unhealthy.

Conceptions recommends that I start DHEA right away then go right into my 2^nd round of IVF after 8 weeks of DHEA and Co-q10. These are the only supplements that they are recommending. Won’t know what CCRM has to say until this Thursday.

I find that I am leaning towards a summer of taking supplements and just trying to ease off of the stress and worry, with an eye toward either a Sept or Oct start to the 2^nd IVF. This way I will have been on all supplements for more than 3 months prior to retrieval (in the hopes that we get there). Maybe I can find a way to enjoy running again. Right now it just feels like one long slog.  I keep thinking “not dead, cant quit.” Maybe I should find a more “placebo positive” mantra.

I’m on day 9 of my detox and it’s just starting to get easier. I am thinking it’s time to take it summer slow. Whats the rush? My eggs are either going to get better or they are not. It doesn’t really feel like it’s up to me. No one will be pulling them out before August any way.

This leaves me with a new #1 goal this summer of enjoying my summer without the stress of IVF. I’ll have to think about what that means. Some how I expected this decision to feel better. Maybe I am just postponing the suck part.

Which came first the pre-authorization or the RX

Since I have time on my hands before we even start round #2 of IVF I thought I should go back and double check all of my fertility billing against my EOB’s (explanation of benefits) from my insurance. This process left one Dr.’s office owing us $20 in over billed co-pays (not that $20 is going to make or break this process) and another glaring question of which came first the pre-auth or the script?

Lets reflect for a moment on Saizen. This is a human growth hormone that “allegedly” helps with egg quality. No debates on this one but rather the use of this drug in any type of fertility treatment is considered “off-label” and there for NOT covered by most insurance carriers. Off-label means “the medication is being used in a manner not specified in the FDA’s approved packaging label, or insert” – like Saizen for IVF but I digress, we had to pay $1500.00 out-of-pocket for our 2 vials of Saizen and I wanted to know if this went towards our deductible. I have since found out that my insurance deductibles and my Rx deductibles are NOT the same deductibles. As a matter of fact I had no idea that I had a deductible for Rx’s… This whole process has been so enlightening.

After 3 phone transfer’s and 20 minutes of round about dealing with folks I finally ended up in the “pre-authorization” department where I am now told that there is no request for a pre-auth on file and that’s why we had to pay out-of-pocket. Upon further detective questioning as I have found out that my Rx company does not like to tell you what you need to do to have a prescription covered they simply decline and say that it is not covered. A great example of this was an Rx that I had for the only round of IUI that we did. It was 10 pills but my Rx company turned it down because the script wasn’t written for a 30 day timeframe. How the hell am I suppose to know this? I also found out that my copays are different for 30/60/90 scripts and are much cheaper if purchase the 90 day supply with only one copay.

My Rx company will cover back dated claims up to 12 months if there is an approved pre-auth on file. Conceptions cant/wont put in a pre-auth request unless there is an “actual” script request… there was one in March… I am left wondering why this one doesn’t count.

So which comes first the pre-auth or the Rx? I now have a pharmacy calling me wanting to fill the new script but I cant talk to anyone at Rx company until Monday to see if the pre-auth has been requested.

Right now we aren’t doing anything different than we did the last time I had script filled for an IVF with Conceptions. Where is the pre-auth? We all know what happens when you do the same thing and expect a different result.

AND if this gets declined on the pre-auth front then it stays as an out-of-pocket expense with $0 going towards the deductible… so wrong in so many ways.

To DHEA or not DHEA

Well that is the question.  Most online info out there shows about 1/3 of the fertility clinics are using DHEA supplementation as standard protocol for DOR or PCOS.  I am struggling with this one. Will DHEA make my body “more fertile”? Will I have this level tested BEFORE the protocol starts? Do my adrenals need attention?

The supporters say that DHEA will help with:

• Adrenal Fatigue / Poor Adrenal Health
• Increase Egg/embryo Health
• Premature Ovarian Failure
• Low Libido
• Infertility due to diabetes

It is claimed by several clinics that DHEA can  also:

• Increases IVF Pregnancy rates and number of eggs/embryos
• Reduces the risk of miscarriages
• Shortens time to pregnancy
• Improves cumulative pregnancy rates in patients under fertility treatment

Damn I feel like I should find a way to sleep in the stuff. I just know that there is no magic bullet and screwing around with hormones still scares me.  Hell if you are on this stuff too long you may get aggressive with acne, facial hair and have your voice deepen. None of which appeals to me.

Most all of the studies I have come across online have a control group of only 35-30 people. We know nothing about these folks… where there other factors that contributed to their pregnancy rates? Was DHEA the only thing that they changed in their protocol?

Dr. Sher is confident that DHEA supplementation in older women with DOR and PCOS should not be done as it can MOST LIKELY do more harm than good.  The defining factor here is “most likely”.

So the question is still to DHEA or not DHEA.

The hard and soft costs of IVF

I woke up this morning thinking of the costs of IVF and the process of it. Wondering what I can honestly say about them? We haven’t experienced any “success” in terms of taking home a healthy baby but we know so much more than we did before.  For myself IVF has had a very high cost both emotionally, physically and financially. It has been a personal struggle and rather isolating. I envy those that have a strong and giving support system but all I can do is roll with the hand I’ve been dealt.

In order to determine my costs for IVF I find I have more questions than answers:

What am I willing to pay on all levels for round 2?

Can I shift my thoughts to a more positive direction?

Can I keep focused long enough to do so?

Would I pay almost any price for a positive outcome but regret it if there is no success…

Advice for anyone dealing with a round of IVF

Double Check you Rx’s – period. Not just what they write down and/or what comes on your bottles – get a copy of the Docs original request.

If you have a smart phone video tape the injectable instructions. It helps to have to refer back to esp when you finally start to give injections. Also my duh moment was not realizing that the rubber on the vials is split in two places so you can easily see when a vial is empty when it is turned upside down… not every IVF nurse covers this.

HUMANS make ERRORS – Be your own advocate – never assume that who ever you are working with is on top of what you need or what your next test should be or what the “numbers” are suppose to say. While everyone responds differently it’s really good for you to have an understanding of where the number are suppose to be going.

If you’ve had a miscarriage and are Caucasian get tested for the MTHFR gene – I had to request this but something like 40% of this population has it.

Know that you can always talk to a pharmacist – either at a pharmacy or where you purchased your scripts.

Always ask for a copy of your records for your files – you’ll find some of the staff comments funny.

Invest in all ways that you can reduce your stress – yoga, acupuncture, more laughter, a better diet, more sex, sleep and water – in whatever order is best for you.