I thought it might be helpful to explain the year process that it took us to get where we are, or if we were friends, why I would spend two weeks drinking and running and then two weeks not. I’ve written before about the Two Week Wait, but what this timeline doesn’t convey is the emotional investment it takes. The wife likens it to waiting for Christmas morning, where you’re either going to get the best present ever… or punched in the face. So, yay. Here’s how it went.
November 2012 – Prelim Testing
Have OB appointment, explain we are about to start trying, doc gives me a Counsyl test and does the usual stuff. Get a DTaP vaccine (if you are considering a baby, you and your partner both need one!!!).
February 2013 – Meet the Fertility Center
Have initial appointment with fertility center. Send medical records over, get blood work screening, etc… Insurance comes back and denies fertility coverage. Close on our house.
March 2013 – Life gets in the way
Spend the month furiously renovating our kitchen.
April 2013 – Money money money
Finish our 2012 taxes and apply for the fertility center’s discount plan.
May 2013 – Start the ramp up
Get told that we are eligible for a 20% discount based on our income (that doesn’t sound like much, but consider treatments are $280 – $1600). Arrange the social worker visit to discuss conceiving through donor sperm and the implications for our bebeh to be. Do a practice round of ovulation tracking. Start looking at sperm banks and winnowing down choices. Screening says that I am CMV negative, which greatly narrows our choices.
June 2013 – IUI #1
Order donor materials and pick up and give to the fertility center a week before I am due to ovulate. Discover I am ovulating while my mother is in town (who I have not told about this process). Work in office visits around her time with us. 2 IUIs with one vial each time. Be wildly optimistic that it will work on the first try.
July 2013 – IUI #2
Discover that this round was unsuccessful. 2 IUIs, one vial each. Order cheap new ovulation tests once the last set runs out.
August 2013 – IUI #3
Nope. Start using new ovulation test. 2 IUIs, one vial each.
September 2013 – IUI #4 and some drama
Begin viewing menstruation as the enemy. Get a solid line on the ovulation kit. Notice a never before discussed sentence on the ovulation predictor instructions from the fertility center that you received 5 months ago that says do not follow instructions on ovulation kit, call when you have a faint line. Freak out. Call your nurse manager about this, asking why this was never discussed in all our interactions, get a very vague ‘sorry you misunderstood’ voicemail with recommendations for a $30 for 7 day kit made 7 times. (Recommending a brand does not avoid this issue! Also, ovulation testing is supposed to last 10 days) Wife calls, also upset, and gets similarly vague and annoying responses. 1 IUI with 1 vial, since we were apparently still in window.
October 2013 – IUI #5
Still no. Follow the ovulation instructions according to fertility center, have 1 IUI with 1 vial, since you had only 1 left.
November 2013 – Time for a New Plan
This continues not to work. Have a meeting with the doctor (who we have seen once in February, since all IUIs except for September’s have been done at a separate, non-Metro accessible office that does long term storage) the Wednesday before Thanksgiving. She recommends an HCG test and moving to Clomid with 1 IUI per cycle. In between prepping for their lunch Thanksgiving party, nurse manager discusses the new protocol for the test and medication with us up to Day 11. Asks if we want to speak to financial manager, after we’ve been in the appointment for 1.5 hours, while we know Thanksgiving party is taking place. Only discussions of increased costs have been about medication, which should be small, so we say no. Skip any attempts this month so we can have Thanksgiving with family and also for an emotional break.
December 2013 – IUI w/ Clomid #1 and ALL THE DRAMA
Have HcG test, with no issues. Go in for Day 3 prelim screening to see if follicles are growing properly. They are. Front desk asks me for $350 at check out. I am astounded and say that insurance covered the February screening. They say fine, give your copay and call your financial manager. I call my financial manager, who has no idea that we have changed treatments and that we can either do a lump sum payment of $1600 ($1200ish with discount) or pay per treatment. This major change in finances had never been discussed with us before, so I am breathless with anger.
I assume that we will only have 1 additional screening on Day 11, so it makes sense to pay per. He transfers me to nurse manager who tells me I could have up to 5 screenings. I am flabbergasted at the amount that had not been discussed with us in November and very angry. Talk again to financial manager, ask why all of this is a surprise and what my options are. He essentially says that because we did not see him in November, none of these updates were made in system. He also says that we have to decide if we do lump sum or pay per before we begin treatment and I confirm that this means the Day 11 screening. He agrees. This is 2pm. At 4pm (30 minutes before their office closes for the day), I get an email from him saying I need to decide by COB. Go to the office and pay the remaining $1200 and change to the office. Take the Clomid. Have Day 11 screening – follicles have grown but not enough. Come back at Day 13 – follicles have grown maybe enough? Weekend nurse talks to us just in case about IUI plans, discussing two IUIs based off a procedure paper we have never seen befpre, when we had been told one. She goes to check with her doctor supervisor, who tells her that it’s just 1 and if we trigger that night, we get the IUI the following day. Phone call says no, come back tomorrow. Come back at Day 14 (December 22nd), get told yes, today is the day for trigger shot, come in on Tuesday (12/24) for IUI. Respond that this is utterly contrary to what we had been told the day before, what the hell? Get told to hold, get a call back 10 minutes later, saying the doc was wrong and come in on the 23rd. Wife gives trigger shot like a bad ass, IUI with 1 vial. Stay sober for Christmas and New Years. Go on progesterone suppositories.
January 2014 – IUI w/ Clomid #2
Go in for bloodwork pregnancy test. Get told by nurse manager that it “doesn’t look good.” Go off suppositories and have terrible, terrible cramps with my period. Cry. Wonder what, exactly “doesn’t look good” means and if, somehow I was actually pregnant and that was a miscarriage and she was just terrible. Fire nurse manager and get a new one. Send email listing all of the things that I wasn’t sure about from last round that previous nurse was vague and dismissive about to new nurse manager, who consults with doctor and gives us a long, involved email back answering all of our questions. Wonder why we didn’t fire other nurse manager sooner. Day 3 follicle check, all good. Begin new round of Clomid. Go for Day 11 monitoring on MLK day and am told that I have 2 follicles bigger than standard rate and that I will probably need to trigger tonight. Panic because I’d just dropped the prescription off on Friday and was waiting for insurance, thinking I had until Thursday. Pick up prescription without insurance copays. Nurse calls and says to do trigger shot, come in on Wednesday. Doctor calls 10 minutes later because he feels the need to warn us about risk of multiples, despite the fact that this is our second round of IUI with Clomid and doctor had discussed with us at November visit. Wife gives trigger shot like a bad ass. 1 IUI (#10 since June) with one vial, the last vial we had on hand. Start progesterone.
February 2014 – Good News
Start craving nachos and have difficulty sleeping, neither of which are noticed as symptoms at the time. Go in for blood work. Brace myself for another no. Just miss the nurse’s call – her instruction is to call Wife if I’m not there. Call Wife the instant I realize I miss the call in my office. She asks if I’m OK, I ask her to confirm it’s a no, she says, actually it looks good but with qualifiers. My beta levels are where they’re supposed to be (132), but I need to come back in 3 days to see if they’re even higher because it might be a false, chemically based pregnancy. Continue progesterone until they tell me to stop. Freak out. Go in for blood work 4 days later. Nurse calls and says I had a “fantastic rise” to 1000+ and that I need to go in for blood work *again* in two days. Freak out again. Go in for blood work. Chew my fingernails off waiting for the call. Am told again, yes, we’re still good but we can’t confirm if there’s anything in there, come in two weeks for an ultrasound. FREAK OUT. Ultrasound. OMG THERE IS A BABY IN THERE. They show us the heartbeat. I cry. They give us pictures and tell us to come back in 10 days. Nurse manager goes through care instructions, including weaning off the progesterone (THANK GOD, it is not fun!)
March 2014 – Still Pregnant
Wean off progesterone two days before ultrasound (I don’t know why they call it weaning, you just stop!). 8 week ultrasound. It’s still a baby! It’s bigger! It has a heartbeat! We have officially graduated from the fertility center, with prenatal care instructions and stuff to give my doctor. Dance like a crazy person and tell family.
So there you have it. The entire process took over a year from start to finish, including emotional breaks, time off to get finances together, etc… The whole process insemination process cost us just about $8,900, including $4,330 for 10 vials of donor materials. I also tallied how much it would cost us if my company had granted us infertility coverage – all total? About $4,900 with copays, a difference of $4,000. But granting same-sex couples infertility benefits would be too expensive for the institution (NO SERIOUSLY, THAT’S WHAT HR TOLD ME).
I do recommend advocating for yourself if you find yourself in this position, including excessive research. I thought our first nurse manager would do a much better job than she did keeping us informed. I know that we were probably one of the least hands-on of her patients (IUI vs. IVF), but we were also new to the experience and needed a little more hand-holding through the experience than she was wiling to give (as our December experience proved!). Instructions were also given inconsistently and at times, I felt like she had to be reminded who I was while on the phone with her. All said and done, personality is important and if you don’t click with the person who’s supposed to be working with you through the entire experience, for the love of god, get someone else. I wish we’d fired her in September, the other time I felt really let down by her.
Anyway, this is just what happened with me. You will, undoubtedly, be different.