Since I seem to have quite a few fly-by posters thanks to ICLW and there's only so much whining you can hear about sleep deprivation and the flu, here are my current musings on our future IF treatments. To start with, the when question has been answered, give or take a season (or maybe two). I would like to start cycling again late next spring/early summer, and JD is lobbying for late summer/early fall. I say he is lobbying because long-time readers may recall that I make all of our treatment decisions: what to do, when, what risks to take, etc. because JD choses not become informed about our options. On one hand it eliminates any conflict between us over cycling, but on the other puts all the pressure on me to make the right decision. That means the fusspot will be at least 18 months old by the time we start cycling, and weaning her should hopefully not be too traumatic for either of us.
So the big question is what. We're in a bit of an odd position here because we got lucky on our very first injectables cycle and all logical signs would point to trying injectables again. Especially since we have NO insurance coverage. Not one penny for paying our RE, drugs, anaesthesology, etc. What I did have, and hope to have again, is a very sympathetic GP who was happy to write me scripts for multiple ultrasounds and oodles of lab work, ostensibly to 'explore' my amenorrhea, but that only gets you so far. So here are my reservations:
1. I am terrified of twins, and quite honestly pretty sure I would not carry triplets or more. I have several reasons for being quite so scared:
a. My first pregnancy was already labeled 'high risk' and the SIX doctors appointments a week were miserable when I was just working, but the idea of working and possibly dragging the fusspot along to the GD clinic, the supervising ob/gyn, the specialist endocrinologist, the GI doc is pretty awful and I really don't want to add another risk factor.
b. I rather surprisngly really think attachment parenting is working for us, and I don't think I could practice the same type of parenting with twins. Yes, I have found some wonderful examples of women who are able to do so (hi Carrie!), but I also work full time and I do not intend to give up my career (for many, many reasons which have been discussed ad nauseum in the past).
c. We live in NYC. It is inconvenient enough to lug one child in a stroller around the city, but near impossible to leave the neighborhood with two babies (little things like having to fold up your stroller to get on a bus or through the subway entrance gates in my neighborhood, which just happen to be down 3 flights of stairs ...) and one fusspot in tow. And since we have no car, I have to carry all the groceries, etc. home on foot.
2. We had 30 follicles last cycle. So our chances of multiples are rather high on an injectables cycle. And while I do think selective reduction would be the best chance of a healthy outcome if I happened to get pregnant with HOM, I am sure the experience would be traumatic and I would like to avoid that.
3. The great IUI debate. At our last fertility clinic (down South, so almost certainly not an option to use again) they understood that we were charging the entire fun fertility-clinic experience (thanks Amex!) and so they let us skip the IUIs. I have never heard of a NYC-based clinic doing this and I would love to know if any do. The thing is that we were using femara (which unlike clomid does not diminish EWCM quite as much) and we have no male factor issues at all, so an IUI was unnecessary. Not only does it annoy me to pay for an expensive and slightly unpleasant medical procedure, but it would turn our cycles into a big deal for JD's work. If we can use the 'old-fashioned' method of insemination, he does not have to tell his work about our plans at all. If we have to do IUIs, he not only has to tell work but he has to block off weeks that he cannot travel. It's not that he travels all that much, but it is a big deal for him to refuse to travel for weeks on end (and since my cycles are notoriously long -21 days of injectionables last time- it could be anytime). If we're not doing IUIs and he happens to get sent off to S. Dakota for a couple of weeks, I can just hop on a plane and join him at the critical time (don't laugh, in addition to at least 12 ultrasounds, drugs and an RE the fusspot's creation also cost us a $350 last-minute plane ticket ... also put on Amex).
4. Of course, the major downside to eSet IVF is the cost. Although part of me loves the idea of possibly having a few ice-babies in storage (for new readers, despite my fear of twins I would LOVE a large family and hope to both cycle and consider adoption again after next year). One other big advantage of IVF is that we could chose an exact start date months in advance and possibly ask my mother or MIL to come stay with us and help out during the cycle (since I have no natural cycles at all, the start dates are completely arbitrary). JD could also put in for a vacation week months in advance, eliminating any conflict.
So that's where I am. I love how easy things were with just injectables, daily monitoring to deal with my overabundance of follicles, and some good romping at home, but I'm scared that the outcome next time may be a bit more than we're ready to handle. And of course I realize it is quite possible that we won't get lucky with injectables next time and then we will of course move on to IVF whenever our yet-to-be-chosen-from-the-waiting-throngs RE suggests we do so. Thoughts?
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2 comments:
My sister & I are 2-1/2 years apart. think it's pretty perfect. Any closer & her friends could have been my friends too- & that's too much for sisters. Since you have to decide when I figured I'd put my 2 cents in.
That said- I would rather wait until pumpkin is at least 3 or 4 before having another. at least right now I do!
I say you start with what worked for you the first time. I understand that the fusspot is your miracle (mine is sleeping upstairs), but sometimes miracles happen twice & I would start with what worked. Keeping in mind that 30 follicles is freaking scary and that's how reality shows start (like the one all over the news here that drives me crazy!) Either way- you would have to be very monitored- yes? While it is not a happy htought- you could decide to pull the plug so to speak on a too productive injectables cycle & maybe turn it into a FET for future IVF? Just going through some thoughts on a fried & halfway through my 2nd beer brain. (hey- it's saturday night after all!)
Either way- it's your decision & you have plenty of time to weigh the options & make the right one for you.
On a side note- I never really label how we parent because I have found myself quite the go with the flow mommy- but I am pretty sure it falls in line most with attachment parenting & I have to say that it is a really cozy & natural style for us- but I can see how twins would wear me right out!
Having no actual experience, I feel a little silly giving an opinion here, but just wanted to say that my RE (who happens to have most recently practiced in Rhode Island, but is now based in Raleigh, though is a part-timer here) seemed totally, 100% open to being as aggressive as I wanted to be. I told her flat out that I had X dollars of coverage, and while I recognized that there were certain protocol in place for a reason that I didn't want to wake up three IUIs later and no baby and no coverage to continue to try. I mean, other than PCOS, we have no real diagnosis yet, so that may change once we have a better grasp on what we're dealing with, but she said that she knew that in her experience, IVF offers the best chance at taking home a live baby, and thus she was willing to skip IUI if that was what we really wanted (and our diagnoses supported it).
I guess I mean to say that it surprised me that I said clearly what I wanted and she responded favorably. Maybe you'll also find someone (it's NYC-- surely there's many docs to choose from) who will treat you as you would like to be treated. You've still got a while, so you could certainly start researching now, putting in a few calls, etc. It just seems logical that somewhere in NYC, there is a doctor who would understand that due to travel, etc., IUI is not the best option for you.
And yeah. I look at our family planning decisions as MINE, not H's. If he wanted to bother to learn a little more, then I would be more than willing to share in the whens/hows, etc., with him. But he does not, and so decisions are mine to make. I am forcing him, though, to handle the SA portion of the process on his own. The doc has given him all the info he needs to do this- it is up to H to call and schedule.
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