The Truth about the Two Week Wait.

First of all it’s not actually two weeks. Most people baby dance and then two weeks later they take a test to find out if they are pregnant or not. We obviously didn’t baby dance, we transferred on a Tuesday and I got a very faint positive on Sunday, 5 days later.  MasterCard would say something like this:

IVF: $$$

IVF with PGD:$$$$$$$

Being able to get pregnancy results after 5 days: PRICELESS.

We could not be more excited and blessed to have received this amazing news! Almost a year to the date of when we went to see my regular OB after trying for a year unsuccessfully we received our BFP! (big fat positive) It’s been a long crazy year and we are by no means out of the woods yet, but we got a BFP!

BUT let’s be honest about the two week wait…we were stressed out, read other people’s instagram accounts/blogs and took a pregnancy test everyday starting on day 5 but we didn’t blog.

We didn’t post or blog during this time and the decision not to do so was a tough one. We started the blog and it was private, to update our close friends and family about our IVF with PGD journey. Once we made the blog public, people from all walks of our life found it and started supporting us.

As you can imagine, when you take a pregnancy test and you’re essentially 5 days pregnant and it’s positive, posting about it on a blog and telling everyone you know is a little scary!  We wanted to be open and honest to this process but we were also hesitant and scared of what was to come.  Basically, our pregnancy test could have been positive and our beta (blood HCG test) could have been really low.  Essentially meaning we did not have a viable pregnancy.

So we chickened out and decided to document the two week wait but not actually blog about it until after. However, I’d like to give a shout out to @lisaivfjourney and many others on instagram for posting pictures of their tests each day because we stalked them and compared our pictures to theirs. 🙂 Thanks for being stronger than us and putting yourselves out there.

Here is what our two week wait looked like:

5 & 6 Days Past our 5 Day Transfer

5&6

7 &8 Days Past our 5 Day Transfer

7 &8

9&10 Days Past our 5 Day Transfer

9&10

Crazy people, we know.

So that’s what we’ve been doing every morning for the past two weeks.  Our 1st beta (blood test to determine how much HCG is in your blood stream) was on Friday morning and it was 173.

Our 2nd beta is tomorrow am. They say your beta should double every 48 hours so ours should be around 700 tomorrow. Fingers, toes and everything else crossed for that.

thanks

 

Keeping Busy.

So I have a cold… and this is what this week has looked like.

sick

Many women, whether they are infertile or not, go through the glorious time period known as the two week wait. It’s hard to keep your mind off of the impending day (Friday) when we will go take a blood test to determine if we are pregnant or not. We decided to take the planning of keeping busy out of our hands and turn it into a little game. We wrote activities on popsicle sticks and when we were bored or stressed we picked one out and did whatever it said…

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My favorite was baking a pie. I don’t bake…but Mike does. 🙂

The next time I write we will be updating you with the results from our blood test and beta (hcg level). Thanks again for all of your support. xo

A pineapple a day…

What do you do the night before you become pregnant? Well if you’re me you cut up a pineapple into 5 sections and prepare to make fertility smoothies! Crazy? Maybe, but we infertiles are willing to try anything!

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No but seriously, pineapple is said to be an implantation aid and the rule of thumb after an IVF transfer is to cut a pineapple into 5 pieces and eat it (core included) for 5 days. Apparently the bromelain in pineapple increases cervical mucus which makes the uterus “stickier”. A large percentage of the bromelain in pineapple is found in the core so that’s what I’ll be eating.

I will also be:

  1. Keeping my feet warm because warm feet = warm uterus.
  2. Eating lots of protein in the form of nuts and avacados.
  3. Continuing to take my estrace pills and my progesterone suppositories, which are so special they deserve a separate blog post.
  4. RELAXING…

Relaxing. That word seems really unfamiliar but I am going to do my best. I took tomorrow off from work and I have a few Bravo shows and Hocus Pocus DVR’d!  Thank you to all of our friends and family for the phone calls, texts, emails and presents!!! You make this process so much more bearable.

XO

 

Goodbye Summer…hello FET!

Hi! I’ve missed you.

It’s been a while since I’ve blogged and to be honest the break from fertility brain has been nice. When you’re going through this process everything from what you eat to what you can wear to what bodily functions you’re having is ALL encompassing. Having some time to enjoy the summer with family friends, and let’s be honest some wine, was oh so nice. That being said one of these two things is happening tonight…

shots and wine

Yes folks that’s right.  Tonight we start our 4 week process of taking Lupron and various other meds for our frozen embryo transfer (FET)!!!

Here’s what we’ve been up to this past month in another addition of “life according to Instagram.”

Our family trip to Newport, RI where both of our families did a lobster bake the day we found out we have 4 embryos!!! 🙂

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An 18 mile bike ride around NYC.

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 The Intrepid.

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Short break and then we stopped by the building where our embryos are!

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Sushi at our favorite place!

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A trip to Maine

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and…Greenwich, CT for wine and Cards against Humanity.

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did I catch a niner in there?

PeeversNewYorkNumberNine-1

Do you believe in signs? I do.

  This is a picture of The Solow Building located at 9 west 57th Street in Manhattan. I usually pass this building in a cab on the way to my RE’s office as well as my acupuncturist office which are both located on 57th street. The other day I was heading to acupuncture and the traffic was horrendous so I hopped off the bus and started walking. Those of you who know NYC know sometimes walking is just faster. Along the way I passed 4 middle aged women trying to take a selfie in front of this 9. They were laughing and joking that they all couldn’t fit in the picture. Instead of just walking past I stopped and asked if they wanted me to take it and I was greeted with a roar of “YES’s”. I laughed along with them snapped a few pictures and kept on my way. It made me feel good to take the picture for them, to help make that memory. I’ve seen/walked past the 9 before and never thought twice about it. Later, I thought about the 9, wondered why they wanted to take that picture and why there was a huge 9 outside of a building but,  never looked it up.

We just got the call that 9 made it to biopsy!!! Is it a random coincidence? You decide, I already have.

Our RE isn’t a talker and their office isn’t the most informative so I only have a little info to share. He said that 9 were biopsied, 7 on day 5 and 2 on day 6. They are BC and BD grade however they use their own grading system for embryos so we don’t really know what that means. I mean the waiting for the call and then the lack on info we get from the call is enough to kill me BUT we got 9! And now we’re hoping for lots of normals

So now we wait… 7-10 days.

xo

Money Talks

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Everyone has their own IVF stories and struggles to share. I asked Mike to write the following (he is amazing and handles the insurance) after we received a few emails from couples who either are or may soon be undergoing PGD/PGS asking about our experience with PGD and insurance as well as the additional emotional and financial stress that it adds to an IVF cycle.


For now, I’ll try to elaborate on our experience regarding the added cost of PGD and how we figured out what it would be.  Please note, while we will be specific with regards to actual numbers, the name of our insurer and the PGD lab shall remain anonymous.

Firstly, IVF-ers should check this site out to see what your state’s insurance coverage is. We recognize how fortunate we are that we live in a state where the cost of IVF including medications is covered, and we sympathize with all those having to deal with the enormous financial burden with minimal or no reimbursement. You should note this is a realization we came to in the middle of our first cycle while seeing others go through the process and pay out of pocket. That being said, we did not realize how truly complex our case would become because PGD was added to the equation. Hopefully explaining our specific case will help others who are in the same boat.

Where to start? That question was really overwhelming and our RE’s office and insurance company were not really helpful in determining what we should do first. I mean NO HELP whatsoever.

The first obstacle was to determine whether or not PGD was covered at all. Though this may seem like a simple question, that could not be further from the truth. After speaking with various customer service representatives from our insurance provider over the course of a few weeks, explaining to each what exactly PGD is… let’s stop there for a second. PGD is so rare and complex that even some of the doctors and nurses at our RE’s office do not feel qualified to discuss it with us. So not only are we infertile but now no one will talk to us about our specific very rare problem. Anyway…after hours, literally hours on the phone it was finally determined that PGD is included in our plan. Terrific news right?!?! Nope… Prepare for a crash course on the true meaning of in-network versus out-of-network.

In-network

In-network is easy. If your RE is in-network, then your insurance company has already contracted a price for any given service from that provider, and they will in turn pay some percentage of that price. In our case, our insurer pays 100% for in-network services.

Out of network

Out of network becomes somewhat more confusing. Reimbursement for out of network service is usually less. In our case, the insurance company “reimburses at a rate of 80% minus our deductible ($500/year).” Okay, but 80% of what? 80% of the total cost of PGD? 80% of what they feel like paying? 80% of a chocolate chip cookie? Turns out this is a very important question.  Again, after hours on the phone, I was told what they will actually pay is 80% of the “usual and customary rate” that they pay for that given procedure. So for example, if you get an x-ray from an out of network provider that costs you $100, but your insurer’s usual and customary rate for x-rays is only $50, then you get reimbursed $40, not $80. And this is of course assuming you’ve already fulfilled your annual deductible.

Here is where it gets really confusing. Turns out that:

  1. there is only one IVF clinic in our area that is in network.
  2. they only use one specific lab for PGD.
  3. that lab is out of network AND furthermore does not accept insurance at all.

Each one gets better than the next, and by better I mean worse and more annoying.  After relaying this information back to our insurance company we were introduced to the concept of “in-for-out.”

In-for-out

This phrase is confusing in itself and figuring out what this actually meant took a few more hours on the phone. Basically, “if a procedure is deemed medically necessary, and there are no in-network providers available then they reimburse as if the provider was in-network.” Based on us being infertile and our both being carriers of CF, IVF with PGD was deemed medically necessary. So we applied for in-for-out and our case was accepted. But remember, this means that they will reimburse 100% of their “usual and customary rate.” Enter CPT codes.

Current Procedural Terminology (CPT) codes are numerical codes assigned to all medical, surgical, and diagnostic services and are used amongst other things to help regulate costs. For our PGD, there are three CPT codes involved:

CPT Code Amount We Paid   (before retrieval) Amount Reimbursed  (eventually)
Probe Creation (81403) $4000 $728.04
Chromosome Testing (81228) $2250 $1690.04
CF Mutation (81479) $3000 ?????
Total $9250 $2418.08+

 

The question marks are particularly curious. When they cut the first check (which as a comical aside was mistakenly mailed to our PGD lab instead of us) the reimbursement for that code was a whopping 4 cents. Pay $3000 get 4 cents back…makes sense. After pointing this out, they assured me this was a mistake, and that they would correct it after reviewing our case again. So after numerous additional phone calls, they still don’t have a number for that code, but they’re “working on it.”

We’re hoping for a least a nickel.

So ultimately, given the rarity and complexity of PGD, although it is covered by our insurer at an in-network rate, we had to front the full cost (with help from our family) of $9250, and have so far been reimbursed 26% of that cost. Oh…and that’s just for the first cycle…

 

Retrieval is tomorrow!

winnie3

Tomorrow at 8am is our retrieval…ahhhh.

What is a retrieval you ask? I’ll be put under a local anesthetic and then a thin needle is inserted through the vaginal wall under ultrasound guidance to aspirate the follicles and retrieve the eggs.  The eggs are removed from the follicles through a needle connected to a suction device. Next Mike’s “specimen” will be combined with my eggs to make embryos. Once the embryos are fertilized they will then grow for 5 days at which point a biopsy will be taken and the embryos will be frozen.

We will find out 1 important thing tomorrow:

  1. How many follicles were retrieved. This gives us an idea of what we are working with. IVF-ers want a large number but not too large. I want 21. If too many are retrieved that usually means they aren’t mature or won’t fertilize.

Saturday we find out 2 important things:

  1. How many follicles contained mature eggs.
  2. How many fertilized. I want 16.

The important thing to realize during IVF with PGD is that ultimately our embryos need to be tested. We need a large number to be fertilized and grow to day 5 so that they can test a bunch of embryos.

Ask, believe, receive.

xo