All this, for four eggs.

I am completely deflated.

They aren't sure if all the follicles they saw on the sono's were just duds- or if the ovidrel didn't work.

To add insult to injury, California Cryo apparently shipped a dud for our sperm (2.3 versus their guarantee of 10) and the clinic just called us to ask us how we would like to pay for ICSI.  I have no idea where exactly we are going to get $1200 by the transfer as it wasn't budgeted and we don't get paid until next Friday.  I'm sure we'll figure it out. 

Thanks so much to Heidi and N for pointing me towards Vee and Jay's blog.  It makes me hopeful.

Psych Evals aren’t so scary Part 1

So ARCC expects people going through IVF to have a psychological evaluation. I’m not sure if it’s all couples going through IVF, or just those using known egg donors- but I know we had to. They didn’t tell us we had to get the evals until right before I was going to start stims. The nurse is just like “have you gotten your eval yet?”. Um, big fat no. I didn’t know I had to have one/didn’t budget for it/and am a little pissed off at the insinuation…

So I get over all of that and go back into logical, “treat this like a project” mode. First she gave us a referral to an infertility therapist. We called, got the price estimate- holy hell people it was out of control. After crossing that option off the list I called and asked for an example of what they were looking for so that I could procure another therapist. The question list was even more offensive to me.

Example: Candidate reports having no emotional attachment to her donated genetics or the child to be. ___Yes ___No

Needless to say, I emailed the nurse that sent the questions over and politely went off. Per these questions, I’m definitely not a fit egg donor. The questions also go against the legalities we will establish when we move towards a second parent adoption… :::proceeds to rant aimlessly:::

So anyway, the nurse email’s me back and says that whomever we go to can customize the evaluations to our situation. At this point Janet’s called a few people, I’ve called a few people. Responses were either non existent, or they couldn’t get us in for weeks. I luckily turned to the Family Equality Council Dallas yahoo group for a referral and got a response within 24 hours. It turns out that De’An Olson is part of the aforementioned group- and not only could she perform the evals and get them completed on time, but she also works with the lawyer we will be using for our second parent adoption. She performs the home studies and evaluations for those. So, not only did she work us in within a week, so also made a deal with us by which the amount we spent on our evals can count towards her eval/home study fees when I adopt baby(ies) Gabber.

For anyone else in the DFW area needing a same sex or non traditional family fertility psychological eval, second parent adoption home study, or general therapy, I highly recommend her!
De’An Olson, LCSW
(214)-676-7920

Tomorrow- more thoughts on the eval itself.

The e2 vampire couldn't get me

This morning was my first sono since starting Follistim. Just like the last visit, they also attempted an E2 draw. I say attempted because apparently, my intake of only coffee before 10 am is not compatible with their need to draw blood. After three attempts they handed me a cup of water and sent me in for the sono.

Sono: 14 Follicles:
Left- 7, ranging in size from 8 to 12
Right- 7, ranging in size from 7 to 8 (mostly 8's)

Post sono and 12 oz's of water chugged- the vampire got her breakfast. Based on the E2's they'll email me my next doses of the wonder drug.
My next appointment is Saturday at 8:45 am. I got a big kick of calling Janet and informing her that she would be seeing 1/2 of her future unborn children at that time.
Boring protocol update 2 after the email from the Dr's office.

Protocol Crap- Feel Free to skip

For my sanity, I'm going to log protocol details and E2 levels.  I know its boring.

9/26-Stim Day 1- 175 iu Follistim (Puregon), 5 units Lupron
9/27-Stim Day 2- 175 iu Follistim (Puregon), 5 units Lupron
9/28-Stim Day 3- E2 Level 55, 200 iu Follistim (Puregon), 5 units Lupron
9/29-Stim Day 4- 175 iu Follistim (Puregon), 5 units Lupron
9/30-Stim Day 5- 200 iu Follistim (Puregon), 5 units Lupron

10/1-Stim Day 6- E2 Check?

They said the E2 level was good, but in reading online, it looks like of low for two days at that level of Follistim.  Opinions?  Trying not to be obsessive.

Dear Fertility Clinic,

Before you spend time developing a protocol for your patients, you might want to make sure you have asked all of the rel event questions- like, is Janet still on the bcp's we gave her to take so that we could delay the surgery to remove her polyp- that we then told her to stop taking?
Assuming that she was still on the BCP's you told her she could stop taking was probably a bad plan. We are disappointed to have to wait at least another week to start. While we understand that sometimes mistakes happen, we look forward to your more thorough attention to our charts in the coming weeks.

Thanks,
The irritated Girls Seeking Gabber

Finally a TTC update!

:::does happy dance to fertility deities:::

We finally got our property tax refund (part of the IVF cost) and I'm now comfortable taking a 401K loan for the rest (arrrrrrrrrgh!).

Janet has a polyp removed on Friday- shouldn't be a big deal, but I really don't want to see her in pain :c( We're planning on a homebody weekend full of couch snuggling, old movies and crappy food. Anyone have any experience with polyp removal they want to share? We've been told it's like a very crampy period.

With the polyp removed and the amount of time that it takes for the 401K loan to process, I'm thinking we will be on the September cycle- perhaps earlier, but I would rather be less optimistic.

I need to schedule my battery of FDA mandated tests for egg donors. I think its so funny that men can donate sperm to their wives for iui and not have to go through an FDA panel, but I do to donate it to my wife (yes, I know, Texas, USA doesn't consider us married). Lets hope the track marks don't disqualify me ;c). I wonder how many of the FDA tests I can get my insurance to pay for by just asking for them as part of a routine physical?

Advanced Reproductive Care of Irving

I can make the declaration now- we've found THE clinic and THE doctor.

First the fun of getting there- I couldn't find the building and Janet got stuck in unmoving traffic while on her way, so we initially didn't know if the appointment would even happen. I actually walked in the Baylor Hospital, not realizing that the clinic was a separate entity- the GPS didn't help either.

Our appointment was with Dr. Haas. He was super nice and thorough without being condescending. He drew out on paper what our cycles would look like, differentiated between the drugs and tests we would each require, etc. (Being the LEAN business geek that I am, I'm considering creating Visio flow charts for him so he doesn't have to draw it out for future clients.)

Now comes the amazing part- the cost! ~$8,000 including meds! I nearly did a happy dance in the office. We can "afford" to make a baby and eventually feed it too!

Afford is a relative term however- we can't honestly say that I have $8000 sitting in a checking account (and yes, I know that I should).

Janet had a histosonogram yesterday- they seem to require it for all patients- and they found a polyp. Apparently the removal procedure is pretty easy, but I still feel bad for Janet- she's already had a fibroid removed. From what she told me, it doesn't sound like its a big deal fertility wise though.

Ohohohohohohoh- and another super cool thing that made me/us happy- Nurse Christy, one of the nurses we liked at UTSW, is now at the clinic managing the IVF patients. She stopped by to see us while we were waiting to find out the cost "stuff". She was known for crossing her fingers for us after every IUI. Its so nice to have a familiar face around.

We are thinking we will start our cycle in August. It will give us time to get finances in order and get all the tests, ordering of "specimen", and legal paperwork in place.

That reminds me- I found it interesting that we can go to our own lawyer to get the paperwork drawn up for the egg donation and embryo ownership. We went to Lorie Burch for our wills- I'm wondering if she can create these documents as well. We're pretty sure we'll use Suzanne Bryant for our 2nd parent adoption...which to choose... Heck, it might not even be a choice, one or the other might not choose to perform those kinds of agreements...did I mention we both love Lorie and her being here in Dallas versus in Austin...

Shopping Around and Being a Drama Queen

So last week we had our "financial consult" with SIRM Dallas...

For for me to donate my eggs to be used for Janet to have IVF we are looking at the following costs:
Single Cycle with Ovum Donor, Gestational Carrier, or Ovum Donor & Gestational Carrier

$11,550.00

Included:
Office Visits
Venipunctures
Serum estradiol hormone tests
Ultrasound exams of uterus and ovary(ies)
Egg Retrieval including procedure room fee and surgical supplies
Culture and fertilization of embryos
Embryo Transfer (ET) with ultrasound guidance and supplies
Two (2) Beta hCG pregnancy tests

Not included:
Meds
Anesthesia Supplies
Anesthesia Provider
Assisted Hatching
ICSI, etc
(you get the picture)

Given that after our first meeting I wasn't exactly in love with Dr. Saleh- he wasn't capable of performing a miracle with my wife's beautiful ova- and using donor eggs is a fairly basic, fertility clinic procedure- We/I decided we needed to shop around. Doctors Le and Haas in Irving will work with lesbians (where one wants to donate an egg to the other- or at least that is what we've heard) and their fees appear to be SO much less! We have a consult with Dr. Haas this Thursday.

Due to my PCOS, Dr. Saleh asked me to come into his clinic for a day three FSH test and a glucose tolerance test. Not wanting to go to some fertility clinic where I lacked relationships, I opted to call my most favorite UT Southwestern. On Friday I did the glucose tolerance test and this morning I did the day three FSH. My favorite nurse Jennifer just left me a message with the FSH test results:

FSH: 6.9- good
E2- 88- not so good.

Jennifer said she was going to check with Dr. Wilson to see if she wanted me to come in to see if I have cysts, which are known to cause elevated E2 levels. Well my friends, I have PCOS- so of course I have cysts (or at least I did 2 years ago when I was diagnosed).

I'm now off to frantically search the Internet to find out what can be done to get the E2 levels down even though I have PCOS or at least determine if I should be worried- because right now I'm having a little coronary.

Loss and Hope

Loss and hope are what we are feeling in our household after phone consult over the phone with Dr. Saleh of SIRM.

While Janet had filled out lots-o-forms pre-consult, her actual records from Dr. Wilson's office had not yet made it over. We couldn't answer the specific questions like "what was her FSH level on day 3 and on day 10". All I could say was that I remembered she had been borderline.

Consult thoughts/feelings:
Dr. Saleh was about 30 minutes late in calling. Not abnormal for a doctor, but for some reason, waiting by the phone made both of us more anxious than if we were in the office. He was apologetic and patient as I conferenced Janet in. As was previously mentioned, during the chart review, he didn't have much to go on other than what we could recall. Who knows why charts take so long to get from point a to point b in the day and age of digital medical records... He was blunt but kind about our state of affairs which I appreciated. He was a bit remedial in explaining the details of ovarian reserve, declines with aging, etc, but I'm sure patients at the beginning of the process would have been more appreciative. When I disclosed my PCOS status as a potential egg donor, I didn't like that he questioned whether or not my PCOS diagnoses was real or not- I didn't go to a some backwoods doctor- I went to an expert in the field who gave me thorough review. Overall, he a little condescending but confident, competent, and straight forward.

During the consultation he expressed surprise that Janet had been encouraged/allowed to do 9 medicated IUI's at her age and hadn't been immediately encouraged to do IVF while she was still 44. I didn't really know how to respond. Dr. Wilson wasn't pushy and we weren't keen on the expense. In hindsight, it might have been worth it- aggregated cost of 9 medicated IUI's, sonograms, sperm would have probably equalled the cost of one IVF... Oh well.

The net of the overall conversation was that Janet has chosen to use use my eggs. This is where the sense of loss comes in. I can't imagine, for Janet, how it must feel to be told that you can't use your genetic material. I know that she must have some fantasies about her baby- his or her natural traits, etc. My heart weeps for her, for us. I think I've mentioned it in blog posts before, but I have dreams of our sturdy little boy or girl with her brown almond shaped eyes and round rear end- The little boy or girl with the silent but deadly sense of humor and the mischievous glimmer of the eye and an affinity for all things athletic.

On the hope side of the scale, we now have hope that we could have a baby this year, or at least she could be pregnant with one. I started to write "complete hope", but that isn't exactly true. I have PCOS impacted eggs- we have no idea how I'll respond to drugs, how the eggs could be impacted by insulin exposure, etc. We also don't know exactly how much all of this is going to cost and how we can pay for it. I have a feeling we are going to go the much advised against route of borrowing against the 401K's- at least we would be paying interest back to ourselves.

So, next steps with SIRM:
- Chart review with the IVF nurse: J & M
- "Financial" consult: J & M
- FSH testing: M
- Fasting insulin & glucose test: M

After we meet with the IVF nurse I'm sure I'll have more updates on the treatment protocols.

9th time wasn't the charm

For those that inquired about our status- thanks for the prompt.

I've been avoiding blogging, for fear of not being able to say anything positive- in fact, I wrote an entirely bitter and angry post that I subsequently deleted, but at least I got the words out of my system.

After Janet peeing on what must have been $80 bucks worth of pregnancy tests, aunt flow came raging in. My heart broke for her every time the pregnancy test said "not pregnant". There are only so many times you can laughingly add "yet!" to the statement.

I called SIRM and Janet has a consult with them next week. Depending on what the doctor says, on to IVF we go. Now we get to figure out where the money is going to come from as well.

Sorry for the morose post.

SIRM

MBW's brother and wife are attepting to have a baby via IVF and have stumbled upon a new Doctor/Clinic after a poor experience with CAR.

The new clinic is the Sher Institutes for Reproductive Medicine and they are seeing *I think* Dr. Walid Saleh. In first going through their website, it looks like they are going to be gay/lesbian friendly based on reason five here.

Does anyone out there have experience with SIRM? If you had an experience, how was your patient experience, did you find it to be more or less expensive than other clinics, etc?

The New and/Revised Plan

Alright, so finally, a post related to what this journal was originally created for- TTC'ing!

We're on a new plan of action- or at least a revised plan of action. After two months off, figuring out what we were going to do, dealing with my mother related stuff, our dog stuff, and generally attempting to save money, MBW is on day 3 of her cycle and we are planning on an a triggered clomid IUI this month. We are going to do without formal monitoring as we've never had any issues with follicles not developing or lining thickness- and I swear, I'm not going to freak out on day 11 and spend $233 on a sonogram prior to her insemination.

What if number 9 doesn't work?

We have plans for that too!

After going back and forth, MBW has decided to go forward with an IVF using her own eggs. (Did I mention that there is really nothing more I want in this world than little boy and girl versions of my beautiful wife?!?!) We're still trying to figure out how to pay for it, but she wants to be pregnant by the end of the year or not at all. Disappointing to me, but if I were turning 45 in a few days, I think I would feel the same way.

If IVF with her eggs doesn't work, before the end of the year, we'll try with my eggs- and even if we don't end up trying with them, I think I still want to have embryo's frozen. My fertility will start to decline soon- and I really don't want to face this much time/heartache if there is any way to have an insurance policy if you will.

For IVF with her eggs we will be able to stay with Dr. Wilson at UTSW. For her to have IVF with my eggs, we might have to go to Dr. Le, or we might be able to stay at UTSW depending on if they get their legal documentation in order by then. I would truly love to be able to stay at UTSW and we've gotten so used to the wonderful nursing staff and doctors there- here's to hoping they get their legal stuff in order so I could donate eggs there.

Anyway, just sent an email over to MBW to make sure she had a Clomid script and knew went to start it. Its odd how after two months off, I don't remember when to remind her ;c)

Not this month

To start off with, a few things that made me happy today:

1. I initiated a refinance on the house. For our current payment, I can refinance the house house for 15 years instead of 30. Score!
2. My blog was part of the latest post on LesbianFamily.org, one of the first websites I found when I started researching the pregnancy process.
3. I enjoyed a tortilla with local honey for dessert.

MBW had jury duty today- I didn't think she would actually be picked. I'm not sure I've ever met anyone who was selected for a jury- but then, I count amongst my friends a high number of lawyers and book throwers. She was picked- for a case involving sexual assault of a minor. I don't know details of the case- and I'm not sure I want to unless, after the case is over it will help her process. Given the nature of the crime she will be rendering judgement on- and the psychological/psychosomatic impacts it may have, we decided tonight it would be better to not inseminate this cycle. I'm some mix of relieved and let down. There is something thrilling about seeing the ovulation line on the OPK and the third bar on the CBE monitor, followed by the excited call to the doctors office. On the other hand, I'm relieved to not have to confront a potential negative ending for another month as well- or the thought of the 6 to 10 k cost of IVF later down the road. We have one more vial of our hunky East Indian Scotsman on ice- just waiting for another chance for success.

What good things happened to you today?

Just because I'm still in a mood...

The email I received from two different reps from CAR:

Thank you so much for contacting the Center for Assisted Reproduction. We do treat same-sex females who wish to become pregnant using donor sperm with IVF as well as IUI. However, we do not treat patients using a gestational carrier for social reasons. We only use that treatment when it is medically necessary (when the woman does not have a uterus or cannot carry a pregnancy. Therefore, we would treat either you or your partner using donor sperm. However, our clinic policy would not allow either partner to donate eggs to the other. Please let us know if you have additional questions or concerns. We wish you the best of luck!

My response:

Thank you for your previous responses. I'm trying to better digest those responses so would appreciate your response to the below.
My partner is 44, soon to be 45 . It was judged that she has less than a minimal likelihood of pregnancy with her own eggs. Our doctor recommended that she pursue pregnancy through donor eggs.

Per your website: http://www.donoregginfo.com/html/recipients/faq.html

What features are important in selecting an egg donor?Ideally, the donor should be a woman less than age 30 who is anon-smoker, has no history of prior infertility herself, is of normal body weight, and has an unremarkable medical and genetic history. A known donor between the ages of 30 and 35 may be selected by the couple if she is a suitable candidate. Assessment of the donor's ovarian reserve with antral follicle count and ovarian volumes by ultrasound are used as predictive tests for both anonymous and known egg donors.

It appears that if my partner were my friend, and I met your normal egg donor assessment (I'm 27, with normal test results as outlined above), I could donate to her. However, because she is my domestic/same sex partner, I cannot.

Please validate this distinction. My friend is also considering an egg donor and I would like to know if your policy would preclude me from donating to her, should I meet the criteria.

Needless to say, I haven't heard back yet. I should probably drop this, but I feel the point needs to be made. If they are going to refer to one situation as utilizing a gestational carrier (Same sex partner) and simply a donor egg situation for another (friend), I would appreciate it if they would just admit that they have a social bias.

:::End Negativity:::

On a positive note, the fertility monitor went up to the two bar mark today, so we know that yet another opportunity for a miracle is in the works. My wife is an amazing, positive, laid back and warm person. I'm so lucky that she wanted to go and continues to go on this journey with me. We are both so lucky to also have found support and help at UTSW with Dr. Wilson and the rest of the staff at the clinic.

Long A$$ Post

The "state of the business" is fine. Dr. Wilson didn't have any concerns about me donating eggs to MBW. She did know that they couldn't do it there due to legal paperwork- I don't think they handle donor eggs at all, regardless of same sex couples. She initially referred me to Dr. Doody's Clinic- The Center for Assisted Reproduction, because he also practices at UTSW. Jennifer, Dr. Wilson's nurse (and the best nurse EVER!), called me this morning to let me know that Dr. Wilson had talked to Dr. Doody and they will not take us for "social reasons". I'm horrified, pissed, and feeling a bit activist. They are willing to allow single women to use donor eggs, but god forbid it be a same sex couple.

Luckily, Jennifer recommended another clinic- Dr. Sy Le of Advanced Reproductive Care Center of Irving. I called their office and asked up front if they had issues working with same sex couples. The immediate response was "absolutely not". I was very relieved and look forward to making an appointment there.

Now to the prior issue. In Texas, unlike California, I'm not sure if we have any legal recourse. Janet is calling a friend who is a lawyer and professor, we will see what happens. I'm also going to contact the Dallas Voice and every other venue at my disposal to convey the discrimination.

One Year, Six Tries, Maintaining Hope

After sucking oodles of information from the internet, blog rolls and books, I think it is time to contribute something back to the internet.

My partner and I have been together for four years and were married in 2007 in Canada. We reside in Dallas, Texas in an ever evolving craftsman bungalow with four dogs and two cats. We’re lucky to live in very gay friendly, family friendly, diverse community.

I knew we were forever when I started daydreaming about raising children with her. Is there anything more intense than the thought of a partner willing/committed to raising little humans who may need years of therapy once you’re done with them- or- a partner who views your genetic material as something good enough to use to create new life? Perhaps I take these things to seriously, or maybe I’ve just thought way too much about it!

We started our trying to conceive journey last January, with Dr. Ellen Wilson of UT Southwestern Medical Center. She had been recommended by one of the Dallas parenting groups and I had a previous good experience with her related to PCOS treatment. My beautiful wife (henceforth MBW) was to be the first carrier, due to age, immediate desire, and accommodating work environment. With MBW’s age being over 40, Dr. Wilson’s prognosis for pregnancy was not bright, but she was encouraged by the outcomes of the initial sonograms and Clomid challenge.

We selected our donor from the California Cryobank (They have awesome Customer Service!) based on his RH factor (MBW’s RH negative), height, SAT scores, athletic ability and ability to infuse humor into something so clinical as a sperm donor profile. Our first order was supposed to arrive in time for a January insemination, but, due to shipping debacles on the part of FedEx (did I mention I had to call FedEx and let them know that the tank contained “human specimen” and they needed to get it here fast), it didn’t arrive in time, which turned out to be a blessing! Janet scored a new, wonderful job at a local not for profit hospital and was slated to start in February. FMLA doesn’t kick in until you’ve been on the job for a specific period of time, so we knew the stars must have aligned for us.

Since then, MBW has been inseminated six times via IUI. The first cycle was natural, no drugs, just our wonderful Clear Blue Easy Fertility Monitor. The next five were medicated with Clomid and monitored via vaginal sonograms. Four of the medicated cycles were at 25 mg of Clomid and the last cycle the bumped the Clomid up to 50 mg. We’ve used trigger shots for three cycles as well, but they are primarily for our convenience versus necessity. Also, for anyone else TTC’ing in DFW, the trigger shots are least expensive at the Las Colinas Target (Think ~$70 versus ~$100+ at most other locations that carry them)

This month will be try seven. We went in for the day four sonogram this morning and as per usual, everything looks great. We did have a more frank conversation with the doctor performing the sono and nurse Jennifer (the best nurse in the office!). While not easy, we are starting to think of IVF with my ova/eggs but her carrying. It is hard for me to consider. One of the things I would love most in the world is to have a little MBW in the house, regardless of gender. This morning we went so far as to price the process, but we won’t stop trying business as usual.

We try to keep our hope alive each month we find out we aren’t pregnant by viewing it as the beginning of yet another opportunity to create a new life.