but just maybe things are looking up?
Long-time readers (hi Carrie! hi Rachel! hi Ms. J! Guys, I love having more long-time readers than I can easily name check on a single line - you are awesome) may be aware that I am a bit obsessive. So even though Project 2.0 is still many months and one trans-Atlantic move away, I still thought it would cheer me up to figure out the details when I was back stateside.
Hence began the awful game: IF clinic phone tag.
Extra bonus: Balancing 2 clinics at once, do not dare let this be known be either.
Handicap: A cell phone battery which only lasts about 5 minutes and endless friends/relatives visiting/eavesdropping.
Note: 3+ weeks later we're still waiting to get all of our questions answered.
In brief, the clinic in City Y would be happy to let us cycle with them long-distance. They'll let me know what lab work needs to be done, charge us their low flat rate for the cycle even though I'm a l-o-n-g stimmer, and they are happy to follow our earlier protocol.
Downsides: having to live in City Y for 1-3 weeks (which is to say I am seriously considering crashing on the couch of a single guy buddy of JD's with my fusspot in tow while shooting myself up with drugs. Alone. In a city I have no connection to. Yeah, we're not exactly your traditional couple), having to buy a last minute ticket back up to NYC depending on how long I stim, realizing that we may be a bit more risk adverse this time around (see previous posts on twins).
Big Apple clinic: Happy to take me as a patient, fine with a 'natural inter.c.ourse cycle.' Rates are truly affordable for NYC: $450 for the initial consult. $200 for every ultrasound (and every. single. ultrasound. has to be done at their office - even though I get free ultrasounds elsewhere in the city. They justify this by basically not charging for the consults mid-cycle, which I'm guessing also means you don't actually see the doctor mid-cycle - they supervise from afar while running between their IVF patients with fixed rates per cycle). Still unclear if they will restrict where my meds come from (Po.rt.la.nd Pharmacy is not approved of by all clinics, even though it is full reputable) and will allow bloodwork elsewhere. Estimated cost of a cycle given my stimming history: $3300 plus meds - so around $5000 with meds and co-pays on lab draws. (And yes, we will pay every penny of that ourselves. Whee!)
Downsides: Cost, dealing with a new clinic (nurse dear, if I say that I have NO NO NO cycle do not send me paperwork which calls for CD3 labwork. I have NO NO NO cycle. I will not be able to identify a lovely CD3 for you. And while we're at it, don't suggest I use bcps to 'restart my cycle' when I already noted that I am one of those incredible women who can take standard bcps and not bleed during the placebo weeks. Same for prog.est.er.one to induce bleeding while we're at it. That's why I mailed you my medical file, darlin'. And anyway, pumping your body full of artificial hormones doesn't lead to the most representative lab results, ya know?).
And all seemed to be well in the world. And all of the cosmos were shifting so that early May might just be a possibility (oh how I hope my pox scars have faded by then ...) until chipper down South IVF coordinator says something about "And of course that will be at least six months since you weaned the fusspot, right?"
Screech.
Six months??????
So I called Big Apple clinic to ask their policy. Silence. Followed by silence. Followed by more silence (and yes, that's 4 separate voicemails asking the same question, for the record. Including one left by JD, which cheered me up immensely).
Now given how many of my friends have gotten pregnant while breastfeeding, I know that it is on occasion possible. And LLL has all sorts of testimonials about women who cycled (albeit not injectables while bf). Not that I was dreaming of that (and for the record, don't read their webpages. They are filled with testimonials which read like this: I was 45, infertile, nursing my 3-year-old-conceived-through-IVF and trying to decide whether I should end this beautiful nursing relationship to cycle again when POOF! I got pg on my own. Just like that. And now I can tandem nurse forever).
It's just that I really don't want to have to wean the fusspot alone. Or before she turns 18 months. Or close to 18 months? I realize it's possible and all, but my friends who have had an easy time weaning have used the 'don't offer, don't refuse' method which relies on a handy-dandy third party -let's just imagine husband/partner for many couples- to help break some of the associations, so do things like put the fusspot to bed or take her out of the bath (bathing makes my baby exceedingly hungry. Beats me). And I just don't want to have to go through all of that alone, with a baby pawing away at my clothes (my military friend who weaned when her husband was away said she literally could not take her bra off for a full 2 weeks - in bed, in the shower, or her daughter would go crazy trying to get to the source).
And then there's the whole wild trip to someplace awesome (which starts with an I and ends with an -ndia), which my pediatrician is totally fine with as long as the fusspot is bf.
So here was my fantasy: wean in May, cycle in June. But when you add an extra 6 months in ... it just doesn't look the same.
Clinic #1 has offered to test my prolactin every month and let me start cycling as soon as it's low enough once the fusspot is fully weaned. But since that would mean a full lab work up, than 20 days of bcps, then a bleed and then stims ... we're still looking at a long delay (my original plan was to start bcps simultaneous with full-on weaning attempts on the thought that the meds lower milk production anyway and wouldn't be dangerous in small doses for a month for the fusspot).
Clinic #2: crickets.
But now I have to decide: wean the fusspot while living alone, and pre-big trip, and much, much closer to 12 months than I ever dreamed of. Or deal with a mid-summer start date at the earliest, and a possible delay until the fall. And of course there's the advice of all 3 REs who have treated me to be very careful not to add age into my laundry list of complications. So I love the idea of being able to cycle again before 30. And yes, I'll just admit it here: the thought of weaning the fusspot early on to face months of labwork and canceled cycles has warmed even my cold, barren heart towards the idea of twins just a bit (there I've said it).
Anyway, IF sucks and I unfortunately just finished my candy bar while writing this so I'm off to scour the kitchen for more chocolate. Any other coping techniques/advice much appreciated.
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7 comments:
Good Lord, I haven't the foggiest idea what to say?!
Though Clinic 1 sounds like a better customer service fit for you, and possibly less frustrating throughout the process.
I don't think I'd want to be taking fertility drugs while breastfeeding, but it sounds like their worry is that your breastfeeding may magically guard against pregnancy (LOL - and loudly, and all of the examples you cite are so true -- as a Catholic we know that BF doesn't prevent pregnancy entirely, ha ha ha!!!)
Can you begin some super-pumping so you have a long storage of breast milk, so that at least she is getting the benefits of it? Don't know how this impacts your special trip ... I got lost a bit in your story, but it sound slke you have some tough choices ahead. Grrrr.
I've been dealing with a similiar issue with our own Project 2.5 (can I call it that? would it be Project 3.0?). Anyway, I wanted to steal the name, but it doesn't work as seamlessly for me, obviously. /scratches head/
Anyway, I'm in the same boat that you are as far as weaning and our next cycle. The only real difference is that my next cycle will just be a cryo cycle. I guess that, technically, I could do the cycle sans meds, but it probably wouldn't be as effective though I know that some people do do cryo cycles that way. I did a bit of online research about the meds that I would be on for an actual IVF cycle, and I found a whole page dedicated to how it was doable and generally safe for the nursling to cycle while bfing. However, I have no clue where that is now. It was a panel of doctors that had broken down the risks of all of the drugs used in IVF and their effect(s) on the nursling. That doesn't really help either of us though because it was for a fresh IVF cycle (however, I guess that the stim meds are the same).
I like Ms. J's idea about super-pumping.
I am not as concerned about having the next peanut(s) close in age to the current peanuts, so I will probably stick to self-weaning and then see where we are. Since the embryos are already created and on ice, my age isn't a factor for us. (I am also one of the youngest women to ever go through IVF at our clinic, sad and lame all at the same time.) Or, if they hit three with no end in sight, I might just /gasp/ wean them or convince my RE to let me try while bfing. (I have heard that if you can get them to not nurse within 48 hours of transfer or 48-72 hours of conception that it shouldn't lessen the rate of pregnancy.)
Ugh. I feel your pain.
I too am sad that you won't be in NYC when we are there next spring! What crappy luck!
Wow that's a lot to think about. I definitely think weaning was much easier with someone around to help. T pawed at me to begin with but now seems to have completely forgotten that my boobs had some sort of other function.
Anyway I'll be thinking of you and hope you find a solution.
You're right, having the embryos on ice already is definitely convenient in this sense. I think that I would be leaning more towards weaning them if we were in your shoes. I think that because of the situation we are in, as in, already having done one fresh IVF cycle and not really willing to do another (because I don't have the luxury to be sick with OHSS for another six weeks, going to the doctor everyday for IV fluids, and on bedrest with two toddlers at home), that I feel a lot of the time that this may be it. That our family, whether we like it or not, may already be complete. And, if I were to go through our cryo cycle after having weaned the twins and have that cycle fail, that it would hurt me a lot worse than if I had waited until I was ready to wean or they self-weaned (because I would be mourning the loss of that relationship with the twins and the finality of the cryo failure). Does that make sense?
I can't believe though that they think that age will be an issue with you when you aren't even thirty yet. The whole world of IF pisses me off a lot of the time!
As far as extended nursing, I may restrict them when they get to a certain age. Like, only letting them nurse first thing in the morning, before nap, and bed or something. I have no clue. I have heard that it's sometimes harder to wean twins too because they remind each other (like one will come over to nurse and the other will just follow them). We'll see. I hope to selfwean, but if it gets to be too much or if I get impatient about cycling, it may end sooner than they want.
I'm really considering during my cryo cycle sans meds though. I'm torn about it right now, but it would mean that I didn't have to wean the babies. /shrug/ We'll see.
I always appreciate your comments, Rachel! :-)
Oh man. while I totally empathize with your months in advance uber-planning (I refuse to say obsessive because it sounds oh so familiar to how I process situations!) I would also tend to say that 30 realy doesn't sound like it's too old- despite your medical factors. I personally agree that were I in the same situation I would want to let pumpkin bf for as long as she & I were willing & able. If that means pushing off a cycle for a few more months- so be it. I would rather store up those happy memories and then move forward to make new ones. But I am also in the position of trying to sabatoge the hub's non-interest in ~preventing~ pregnancy right now as ironic as that is! So I am thinking from a completely different place- good luck to you whichever way you decide to go.
Oh- and the super duper trip sounds amazing!!!
Damn, that is a long time. And my assvice is non-existent here.
But we have clinics in my city and you and the fusspot could crash in an actual guest room! Staying with people you meet on teh internet in a city you have no connection to isn't weird, right?
Wish I could offer some coping techniques -- I've definitely been looking for new ones myself. But I had to laugh regarding that LLL story. I got one of their magazines at the meeting, and was cracking up at how over-the-top so many of those "it happened to me" breastfeeding yarns sounded.
The thought of weaning breaks me into such a cold sweat. I NEVER thought I'd like/come to rely on nursing for so much as it turns out I have. It never even crossed my mind it would have any bearing on our own 2.0 plans (which, in my case, we probably had better get on sooner rather than later). Sigh.
Wishing you all the best with this one -- and looking forward to learning more about this, too!
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