Released from the NEDC

As I've previously grumbled about, the process of tapering off the POI has been a bit of a headache. Last Thursday I was due for a final blood draw of my progesterone and estrogen levels to confirm that my body was doing its job in the absence of the medications. I had a doctor’s appointment the same day so I figured I would take advantage of the “big city” Atlanta facility who could actually run the tests STAT rather than going to my local hospital which takes several days to process the results.

I had my blood drawn on Thursday, July 24^th and by Monday July 28^th the NEDC still had no results. I was back at the doctor on Monday anyway so I stopped by the lab to check on why the results had not been sent. They told me they were not sure if the results had ever been sent but that they would put in a request to have them sent.

Tuesday morning they finally sent results to the NEDC, but instead of sending the blood results they sent urinalysis results from my 9 week OB appointment. After multiple phone calls to multiple people (many who were less than friendly), I finally found a really nice customer service person who had my results sent over. Vinessa called me a few hours later to tell me that my levels looked great and reminded me to send them information on the birth of our babies.

I love the staff at the NEDC and I feel so blessed to have been able to work with them now twice, but it really feels like a huge milestone to be fully released from the NEDC. 

1st Beta Today

I had my first beta drawn this morning a little after 8 a.m. I was so nervous, I found my hands shaking all morning.

The lab at the hospital said the results should be to the NEDC no later than 1:00 p.m. today, so I am hopeful that I'll get "the call" from the NEDC early this afternoon. Though, based on my loose calculations, pretty much everyone from the 7-day May NEDC cycle should be due for either their first or second beta today (due to the long weekend). This could make things a little crazy.

As we wait on my beta. I'll tell you what I do know....

Saturday (6dp5dt) - After 20 Minutes

I gave into testing on Saturday (6dp5dt). I was not going to test until Sunday, but I just could not help myself. Since I know the dollar store tests are more sensitive (20+) I started with one of them. I started the test and after a thirty seconds to a minute it was clearly just one line. Leland woke up and not wanting to look at the one line any long I went right in to him. When I came back 20 minutes later, to my surprise there was a second line. The test says not to read it outside 10 minutes, so I considered this inconclusive. 

A little while latter, I worked up the nerve to try a Clearblue Digital - which are less sensitive (50+). It took a long time for the test to run and then I got a glaring "Not Pregnant". Still I felt hopeful  - a line is a line, right???

Sunday (7dp5dt) - After 3 Minutes

Sunday, I tested again. I got a very, very faint line. This time I waited and the line appeared after about three minutes. It was so faint I was feeling a little discouraged. Still, I braved the Clearblue digital again and I got a wonderful "Pregnant" this time.

Sunday (7dp5dt)  - Digital Test

So, today, we are hopeful. We have overcome the first hurdle in that we are pregnant! (I did another digital test this morning for a little reassurance and it too was positive). But as my seasoned ladies know - this is just the first hurdle. Knowing my HCG level today and whether or not it rises on Thursday are our next hurdles. Then of course an ultrasound, if we are blessed to get that far. 

I am hoping for a level of 100+ - this is based on my non-scientific theory that if I tested positive two days ago on a test that reads only 50+ , seeing a level of over 100 today could kind of indicate doubling. Again, not really scientific.  

Also, assuming a good level today, I am very excited about calling our donors. This is a new experience for me. Although we have an open relationship with Leland's genetic parents, the initial contact was managed through a social worker - we actually did not have direct contact until Leland was over a year. This time all the contact is direct (there is no social worker since we matched through Miracles Waiting). I have not shared our positive tests yet because I want to limit any emotional roller coasters for our donors by waiting on more conclusive information - as in the beta results. 

Thank you for all your prayers and support through this process. I know four other ladies who cycled this month, all of which have betas today. Here are two of their blogs if you want to show them some love today: Baby on Mind and Chronicles of an Adoption

One Week! (7dp5dt)

It's been a week since our transfer. Two more days till my beta. 

This time - in comparison to last time - waiting has been really hard. I thought it would be easier because my beta is on day 9 rather than day 13. But last time, we spent 8 of those 13 days on a cruise ship - a wonderful distraction. (Though POI injections on a rocky ship are no fun!)

This morning at church we had a baptism - the little brother of one of the girls in Leland's Sunday School class. It was such a blessing to be there to witness the baptism. To be reminded of God's faithfulness. To look back on Leland's baptism. To look forward to - hopeful - future children's baptisms. 

All in all - I feel pregnant. But then again I've never done this and not been pregnant so I really would not know what it felt like to compare (i.e. if this was just from the hormones). My "symptoms" are a fullness in my lower abdomen and increased blood flow - sometimes it's like I can feel my pulse throbbing throughout my body or even just in my abdomen. I've also been dabbling with the HPTs, but my beta on Tuesday will tell. 

Please pray for the several ladies who are cycling right now. Prayers for their hearts and for their babies. 

Babies on Board

Here are our precious little ones!

My transfer was scheduled for 11:45 am this morning. We got a slow start to the morning and ended up getting a quick bite to eat at Starbucks around 10:00 am - Oatmeal and juice for me! I drank lots of water, took my Valium, and arrived at the NEDC about 11:10 am.

After getting changed and signing some paperwork, Carol (the embryologist) came to talk to us. Our four embryos were stored in two straws, with two embryos in each straw. Carol explained that she had thawed all the embryos, with one embryo surviving from each straw. The two surviving embryos were excellent quality - 4AA (top) and 5AA (bottom). 

We are very hopeful that these precious babies will implant and grow! They sure are beautiful!

Tennessee Bound

We leave today for Tennessee! I got a pedicure and manicure yesterday at lunch. I also spent the day yesterday glued to my phone, hoping to get the call about my transfer time. No such luck - I guess they will call sometime today. After a little more packing, we home to head out around noon!

PIO Day 1

Today marked day one of what will hopefully be a few months of POI injections. Looking for a refresher online I came across this funny photo showing where the injection should go in the muscle. It made me laugh.

I hopeful that this time I can combat the knotted sore bottom with a heating pad and some luck. Last time, my rear hurt even after I had given birth. I was also hopeful that the new compounding pharmacy was sending the 50mg/0.5ml PIO - but I actually got the 50mg/1ml PIO. The 50mg/0.5ml PIO is a higher concentration (same amount of medicine in less oil). The benefit of the higher concentration is that less oil has to be injected (so hopefully it is less painful. But instead, I received the 50mg/1ml PIO. :(

UPDATE: I thought I was doing pretty well with the first day not hurting. Then, in the afternoon, I ran after Leland in the yard. And - ouch - that muscle sure hurt!

Four days till transfer!

Lining Check

I had my lining check today. It measured 9.4mm with a “triple stripe”. I've been cleared for transfer. One more hurdle down. Many to go.

I am especially asking for prayers for our embryos. We have four embryos, frozen in two straws (2 to each straw). They will be thawed the morning of transfer (May 18). I've run every scenario over in my heard about thawing one or both straws – how many survive – grading – etc. And then, I've begun to worry….what if none survive the thaw?

What I do know, is God knows. He loves me. He loves each of those four precious little ones. He knows. And for that I am overwhelmed and thankful. 

To blog or not....

Going into this cycle, I struggled with the idea of blogging through a cycle. I've never blogged while cycling and I'm not sure how I will handle the highs and lows in such a public forum.

When we were going through our first embryo adoption which resulted in Leland I followed a lot of embryo adoption and infertility blogs and drew a lot of strength and encouragement from following and commenting on them. But what I lacked was forming relationships because I had no forum upon which to share who I was in order to connect with these other moms. Honestly, I don't know if they even knew I existed or how much they were helping me at the time. While pregnant with Leland I really wanted to start blogging, but the timing seemed odd. Then, finally, just after Leland was born I actually started my blog.

So for me, I’ve only really blogged the happy ending of my embryo adoption story. The work, time, and heartache of my (pre-Leland) infertility journey took place pre-blogging.

Cycling again is like reopening the portion of my identity – the infertile portion – the portion that having had a child and not yet being ready to try again had begun to shrink. And now it’s reopened. Only this time, we are not secretly infertile. If almost anyone asks we will tell them we are “working on it” and “it’s easier said than done.” And with friends and family, we’ve been even more open about actively cycling right now. And with that, I did make the decision to try blogging through this cycle. It feels so different from last time when only about 8 people even knew we had fertility issues and almost no one knew we were cycling. There is more pressure, but also more support.

So, for now, I’m putting it all out there.

And it that regard…today is my last day of Lupron (!) and my first day of 3x/day Estrace. 11 days till transfer.

Confession

I have a confession.

I've started setting up a nursery. Mostly because we've moved Leland into a big bed and it just made sense to set up the crib - and changing table - in what will (hopefully) be a nursery. I also, may have, bought a really cool diaper pail I found on sale.

It all makes me feel more vulnerable. Like there is more invested, more to loose if we don't succeed. Leland even announced at Easter that he had a baby bed - for his little brother to sleep in. Eek! I quickly added to his announcement, that this is "news to me".

In addition to the crib, I've also been moving everything else baby into that room. Clothes, highchair, baby toys, etc. Rather than stashed around the house in various storage spaces, the room is not officially the all things baby room. Here is to hoping that we use it sooner than later!

Oh...and bring $600 cash

I go for my baseline ultrasound tomorrow morning. It's at my RE's office where I have been a patient for about seven years. Despite several closer practices I drive nearly two hours to their office (we used to live close by) because I really love my doctor.

Thankfully, my RE office will file my monitoring ultrasounds and labs with my insurance. Since I've met my deductable I was expecting the appointment to cost about $30 - $40 total. But I got a call today informing me that the entire Hospital System, including all of it's associated doctor's offices will be out of network after 11:59 p.m. tonight. So....I should plan on bringing cash to my appointment, probably about $600!!!

To say I freaked out is an understatement. I contacted a friend to see who did her monitoring. I called many RE offices - they all declined to see a patient who is not already established and generally could not "establish" me as a new patient until June. I spent an hour and a half on the phone with my insurance company. I accomplished nothing.

So between my two ultrasounds prior to transfer I think our budget just went up $1000 or so. That is unless they work out the contract spat between BCBS and the hospital tonight. Prayers are welcomed.

The (almost) $18 Pill

Today, I almost paid $18.74 for this one little birth control pill. My insurance did not want to let me refill the birth control pills, having not taken the placebo pills. And although I was buying a pack of pills, all I needed was one-more-pill!!!

In the big picture of the thousands of dollars we spend to get pregnant, $18 is really insignificant. But, thankfully, the new NEDC nurse convinced my insurance to expedite their review and in the end they agree to enter an override and pay for it. Even better - today - I celebrate taking my last birth control pill.

Oh, the little stresses and little milestones of this journey.

Beginning My Cycle (NEDC here we come!)

I start Lupron today! Honestly, I can't believe it's really here. We've been working toward this for 9 months....

9 months since we contacted our donors
8 months since I called the NEDC to schedule our mock cycle appointment
5 months since I felt like we officially *matched*
3 months since I first held the signed ODA (open donor agreement) in my hand
2 months (almost) since our mock cycle appointment

And now we are here. So much of this process has felt like a side note in my life. During this time I buried my dad, had my mom move out of my house and out of state, watched my amazing toddler blossom with independence - all in addition to the everyday life of working full-time, serving at church and school, etc.

Having seen so many successes in March - including one of a dear friend - I am excited to have arrived at the beginning of my cycle. And as I type this I find myself repeating the words "my cycle," letting it sink in that it is finally here. Finally time to continue the journey to building our family.

Looking at the detailed, color-coded calendar I created to help me navigate my cycle is like looking at the next few weeks of my life through a film. Each event on my calendar is viewed through the film of what medication I will be on at what point and how that medication may effect me on each day, at each event. I am not too worried about Lupron - I don't remember it being any different than just being on birth control since birth control hormone doses are so low and I basically don't have any hormones or cycle of on my own I'm already having unpleasant symptoms. Now Estrace....makes me so, so sleepy and confused. Especially when I reach three doses a day, I could really just sleep all afternoon and through the night. And then the POI...I find myself scanning the days, ensuring Robert will be on hand for all injections. It's all so simple and so complicated at the same time.

My Cycle Calendar

So, here we are. Jumping in feet first. Trusting God's timing. Thank you for joining me and supporting me on this adventure. 

And so it begins...

Over the last few months we have laid the ground work to get moving towards our next embryo adoption. We did a few things last fall, such as getting on the NEDC mock transfer schedule; but, since the start of the year things feel like they have really started moving along...

- I’ve had my STD testing completed for the NEDC

- I called the nurse to get my medication protocol set for the NEDC mock transfer. I’ll start Provera on February 3^rd (to induce a bleed) and then I’ll start the Estrace on the first day of bleeding - probably about February 12^th.

- I’ve filled my Estrace prescription

- I’ve made calls to the NEDC financial office and my insurance company, verifying diagnostic codes, procedure codes, etc. trying to decide if I should have the NEDC attempt to file with my insurance company. We have BCBS and infertility coverage is limited to diagnostic - Any advice?

- I’ve had two preconception appointments with two different perinatologists, as the first one I met knew nothing about NAIT (my platelet antibody issue).

- I’ve had lab work drawn to test my platelet antibodies and my thyroid levels.

- I’ve had an appointment with a new OB/GYN who is in the companion practice to the first perinatologists I met. I’ve scheduled an appointment with another OB/GYN who practices at the same hospital as the second perinatologists I consulted.

Budget wise, I’ve spent...

$26.70 - 1^st Perinatologists Consult (we had met our 2013 deductible)
$200.87 - Estrace
$315.24 - 2^nd Perinatologists Consult
______
$542.81 TOTAL

So far I have been able to set the OB/GYN appointments up as wellness appointments and I was able to squeeze in the lab work in at the end of 2013, having already met our deductible. Saving money on both fronts!

On my to-do list are:

- Make hotel reservations for our mock transfer trip
- Coordinate childcare during our mock transfer trip
- Remind Robert to complete his STD testing
- Meet anther new OB/GYN (apt. is set for Jan. 30)

And...finally....share some BIG NEWS with you all!!! I know I’ve been stringing you all along with the promise of "big news" for about two months now, but I’ve been waiting on things to finalize before I was ready to share (plus life has been a little crazy lately). It’s now final and I promise to share this week - maybe on Sunday in honor of Sanctity of Life Sunday (hint, hint)!

Thanks for joining and supporting us on this journey!

NEDC here we come...

We are on the path to embryo adoption #2. Unlike last time, we are trying to take things slowly and not stress about the process. This is much easier to do with our blessing (Leland) filling our hearts and keeping us busy.

After making the calls to Bethany Christian Services and Debbie at the National Infertility Support Center, I finally called the NEDC. I was surprised when Angie picked up as I was expecting that I might get a voicemail. Angie quickly answered my questions about cost and immediately offered to put me on the schedule for our initial consult. It was at that moment that it really sunk in - we are really doing this again! We are going to the NEDC in March for our consult!!!

After speaking with Angie I have finalized our budget for the EA. The good news was that we don’t have to pay another application fee and we are only charged the sibling fee. I had wondered about the "sibling" fee since we are not going back for a genetic sibling transfer. All things considered, our NEDC costs will be about $4500 - $5000 depending on the embryo specific costs and whether or not we need assisted hatching.
　
Since speaking with Angie, I have had my initial blood work (STD screens) completed and have my Estrace script in hand to prepare for the March consult. Our hope is to start our homestudy next month. Here is our final budget:

Home Study - $1650
Open Donation Agreement - $1750
NEDC - $5000
Medication / Ultrasounds - $1000
Travel - $650

TOTAL = $10,050

Ten thousand dollars is a little overwhelming, but stay tuned and I will share how God is already overwhelming us with His blessings.

EA #2 - Open Donation Agreement Costs

Once the sticker shock wore off regarding the home study fees with Bethany Christian Services, I called Debbie at the National Fertility Support Center. Debbie is absolutely wonderful. She walked us though our first embryo adoption in 2010 and I was so excited to call her and share the news that we were planning on returning to the NEDC for a second embryo adoption.

After a lot of catching up, I finally asked about the costs. What I learned was pleasantly surprising. Our fees will only be:

$1600 Open Donation Fee (Includes matches with 2 donor families)

AND

$150 Home Study Review Fee

This is much better than I expected. I also learned that if we needed more than two matches or if we returned for a third embryo adoption, the open donation fee would only be $900. These fees are about half the cost as those going for their first EA, which I believe to be $3000 for the open donation fee and $300 for the home study review.

With this information added to the budget, we were up to $3400 total in fees. And, having called Bethany and having called Debbie, the only thing left was to call the NEDC...

EA #2 - Building a Budget

We have begun planning our next Embryo Adoption (EA). As I write this I sense the irony of using the word "planning" for anything infertility related. Our plan is to return to the NEDC sometime next year - hopefully in the summer. Our first step on this EA journey is to make a budget. With that in mind, my first call was to our local Bethany Christian Services office.

Bethany completed our home study in 2010 so it seems to make sense to go back. We chose them originally because their costs at the time were competitive and they were connected to the national Bethany office which was handling the Open Donor Agreements at the time (this saved us a $300 review fee at the time).

The NEDC does not dictate which home study / adoption agency you use, but my though process is that Bethany may be better equipped than some others to handle the nuances of embryo adoption. I am however, interested to hear from other (especially those in GA) if they used another agency other than Bethany and what your costs were.

So here is the breakdown in costs:

$550 Application Fee +  $1600 Home Study Fee - $500 Returning Client Discount

                                      = $1650 Home Study Total

This total came with a bit of sticker shock. Our first home study through Bethany in 2010 was only $1250. To learn that their fee has increased $900 in just 3 years is crazy to me. Fortunately we will get the $500 discount, but wow!

For those who have completed a home study, is this amount consistent with what you have paid?