What’s going on

It’s been a bit of a whirlwind week since the last post.

The good news is that I got the go ahead to start IVF straight away. I was thrilled, because I thought I would have an interminable wait until the end of this cycle – I was only CD15 when I went in – but Dr Strangelaugh was cool with me to start straight away.

So I got the go ahead to start my Syneral yesterday. It is a drug that basically forces your body into menopause and gives you “a clean slate” as the Dr put it.

It is a nasal spray which tastes terrible and gives an instant headache. It disappears pretty quickly, but some of the other side effects are tiredness, hot flashes, and other menopausal-type symptoms.

Then in about 10 days I start injecting, again 100iu of Puregon – Dr doesn’t want me to overstimulate – which goes for about 10 days.

Depending on hormone levels and follicular development (monitored by blood tests and ultrasounds) I should trigger on about day 11, with egg retrieval (ER) about 36 hours after.

ER involves a light general anaesthetic, during which a long needle is pushed through the vaginal wall to the ovaries, where the eggs are aspirated into a test tube and then fertilised with sperm which is directly injected into each egg (ICSI)

Then two to five days later, hopefully some of the eggs have fertilised and grown to blastocyst stage, and one is transferred back into the uterus.

Not all embryos make it though. An ideal outcome for someone my age, is to collect nine eggs, and have two viable embryos after five days, one of which is transferred, and the other frozen.

So that’s the news.

There is more, but it’s another post when I have time. I am now joining the unwashed masses without a job (my choice) and the government appears to have done some majorly suckworthy things to IVF rebates in this week’s federal budget, but more on that later.

How much would you pay?

The cost of a child is something I think about quite a lot – or perhaps more specifically, what I would pay to have a child. I play a little game with myself about what I would give up in order to have a baby.

I tend to not want to give up very much, and as a result, fell like I am less deserving. As I have mentioned in another post, I wouldn’t give up my right arm, my sight or re-mortgage my house to pay for it. But I could live without a finger or two, a couple of toes, the sight in one eye, or a few gastronomic delights like never eating truffles again or no more champagne. But those games are about as reliable as avoiding cracks in the pavement – hypotheticals won’t get me pregnant, but being able to afford ART might.

Which brings me to the financial  cost of assisted conception, and in this respect, Australia certainly is The Lucky Country.

Thanks to a wonderful little legacy of The Howard Years called the Medicare Safety Net, after we have reached our $1111+/- yearly out of pocket medical expenses (Medicare rebateable) we are reimbursed 80% of subsequent applicable fees.
This means that my next cycle of IUI – the first cost AU$1250 (click here to convert, international readers) will cost about $237 according to the current cost sheet at my clinic.

This includes everything – drugs, monitoring, semen preparation, IUI, all ultrasounds, bloods etc. The only thing that it doesn’t include is consultations with the specialist which are around $80 each – but again, this is almost fully claimable at Medicare.

The full cost of an IVF cycle with ICSI is $5110, however after that magical safety net is reached, the out-of-pocket expense is $941. We also need to pay day surgery fees for EPU and anaesthetist, up to $1700, but because I have comprehensive private health insurance, this is covered (I pay about $120 per month in insurance).

There are a while bunch of variables, depending on the treatment you have, but for us – a professional couple with two incomes – the cost is very affordable. In fact I think it is probably affordable for a majority of Australians.

In the US, however, a full ICSI cycle is about US$11 000 (AU$17 200). I don’t know how health insurance works over there (maybe one of my lovely US based readers can enlighten me on how much you end up paying out of pocket), but at those prices, even professional DINKs on very good wages need to think about how many times they can afford to do it.

In Canada an ICSI cycle appears to be about CAD$4500-$5000 (AU$5460-$6070) and again I’m not sure how insurance works, or whether meds are included, so lovely Canadian ladies???

Over the pond in NZ, the government will fund two IVF cycles for women under 40. After that, or if you don’t fit the government screening criteria (under 40, non-smoker, BMI under 32) you need to go private, where costs start at around NZ$6500 (AU$5100) for an IVF cycle.

Going private in the UK will set you back about £4500 (AU$9900) for ICSI or  the NHS will give you up to three cycles if

• you are between 23 and 39 years of age at the time of treatment, and
• one, or both, of you has been diagnosed with a fertility problem, or
• you have been infertile for at least three years. *source

Of course you need to get on that looooooong NHS waiting list if you want to access the treatment!

So how much do you pay? How much can you pay? How do you decide how much a child should cost? For us, I guess we are in the lucky position if living in a country which makes AC so affordable, and are able to pay for it and it will hardly cause a blip on our financial radar.

It’s awful reading the blogs of my American friends whose major concern is how they are going to finance that next cycle of treatment. Even a drug like Clomid, which costs about $25 for three months here, is ridiculously expensive in the States.

Setting up a spreadsheet to calculate how much your conception efforts are costing is a heartbreaking exercise. Just another tick on the list of infertile unfairness.

IVF Cost is a really interesting blog run by Sue who has done some ridiculously extensive research into the costs of IVF across the globe in order to find a clinic to treat her. It has lots of good info, so check it out if you are interested.

* Lovely readers, these prices were found with a few quick Googles, so I would love it if anyone could give me some more comprehensive information to update this post. Merci!

The follow-up

Sorry this blog has been a little boring of late. I have been super stressed out and busy. I have four half finished posts that I haven’t had the opportunity to spend any time on, and I am afraid that all I have today is a quick update about my appointment with the Dr.

It was all a bit meh. He asked how we were going, what we thought of the treatment, any side effects etc, then signed us up for round 2.

If this is unsuccessful, I think we will be going to ICSI.

So ya, that’s it.

Boring!

Mind Games.

I’m only 2dpiui and already the mind and body games have started.

The excess hormones are making my body do odd things. Apart from the bloating, which has thankfully subsided – I only look 12 weeks pregnant now – my boobs are huge (ok, they were before, but now my cup definitely spilleth over), with rather painful nipp.les, I am still as vague as anything, and I need big sleeps every night. I also have the nose of a bloodhound.

Stupid hormones. And so unfair. Because I know that the odds are not with me, but with all these “symptoms” it’s really easy to get excited and hopeful.

I have become an obsessive googler of male infertility. Stupidly, I have spent two years thinking I was the one with the problem, and when we got my partner’s diagnosis, I was eyeballs up in wedding preparations and end of year deadlines, not to mention Christmas and honeymoon, so it’s only this week I have managed to truly procrastinate at work and get in some decent time with Dr Google.

Did you know that even men with azoospermia – someone whose ejacul.ate contains no sperm – can still father children if a few are found in the testicular tissue? Today I was reading about a man who fathered twins after surgery managed to find 40 sperm. 40! I was upset with our 3.5 million.

Whilst our numbers are good – 55million where over 40 mil is considered normal, the problems are with motility (30% when 50% or more are normal) and morphology (2% normal when 15% or more is normal). We also have antisperm antibodies. However, our DNA fragmentation index was 7.36% when 0-15% is considered normal.

So if we don’t get there with iui, we may have a good chance with icsi. My partner just likes to take one thing, one treatment at time, but I need to be one step ahead and know what is going to happen if we are unsuccessful at each stage. I just like to plan!