Lets go

I’m waiting for my partner to do his thing, before jumping in the car and heading of to be serviced.

As I said a couple of days earlier, this cycle feels really different. I don’t have sore boobs, and no abdominal distention at all.

I have two decent follicles which should be 20mm by today, but my oestrogen level was low last week. 420, which would account for the lack of “symptoms”.

I wonder if it has to do with my stress levels. I am so stressed at work.

I think I am about to be offered a role in a much larger company and can’t explain how desperate I am to get it. They called me (headhunted, I believe is the term, although I had applied for a job there in the past), which is promising, but I was meant to go in tomorrow for a chat with the publisher, editor and company owner, but it has been postponed until next week. Oh well, at least I can be confident they aren’t talking to anyone else for it.

And it’s kind of good. I was a bit worried about an interview 1dpiui, considering my first cycle turned me into a rambling idiot.

Anyway, words cannot express how excited I am to have a four-day weekend coming up. I have a 3000 word essay and another assignment to keep me occupied.

Hark, is that the call to action? Must fly!

Medicare up for review?

A little while ago, I blogged about the relatively affordable cost of AC in Australia. A policy instituted by the former government means that currently, when your out of pocket medical expenses (those that are covered by our universal healthcare system Medicare) reach about $1100, the government will rebate 80 per cent of the subsequent expenses.

The Australian healthcare system is widely recognised as one of the best and most equitable in the world. It was used as the model for Hillary Clinton’s model of proposed healthcare reform in the USA and is upheld as an example to other nations who attempt health reform.

So it was a great shock when I learned today that the medicare safety net is a possible casualty in budgetary reforms soon to be put forward by the federal government.

Australia is in bad shape. It’s not as bad as many others, including New Zealand and the US, but we are in pretty dire financial straits.

In the last five or so months, a raft of stimulus packages have been proposed and executed by the federal government, mainly to their core base of “working families” (which my partner and I, being childless are not) in order to put some dollars back into the economy – the rationale being that it was going into the hands of those who are most likely to spend. As a result, the nice, solid financial buffer that had been built up has been eroded.

And the current government needs to cut costs, so something that is allegedly coming under review is that safety net, which costs hundreds of millions dollars a year.  It is all speculation at the moment, but speculation starts somewhere. I have private health insurance, but it doesn’t cover AC.

So I have started writing and calling the relevant people. Predictably the profit driven IVF clinics have seized upon this with gusto, and are urging infertile couples to take action. I am very cynical about private clinics and healthcare, but if it is the only way I can get a baby, I’m going to join the fight.

If anyone wants to help, these contacts were given to me by ACCESS, the Australian infertility network, however any communication needs to be received by this Friday. Please email these people and tell them how important it is that the federal government continues to subsidise Assisted Conception.

The Hon. Kevin Rudd MP
Prime Minister
T: 02 6277 7700 F: 02 6273 4100
Email: alister.jordan@pm.gov.au
Email ankit.kumar@pm.gov.au
The Hon. Lindsay Tanner MP
Minister for Finance
T: 02 6277 7400 F: 02 6273 4110
E: anthony.baker@finance.gov.au

The Hon. Nicola Roxon MP
Minister for Health and Ageing
T: 02 6277 7220 F: 02 6273 4146
E: ruth.kearon@health.gov.au
The Hon. Malcolm Turnbull MP
Leader of the Opposition
T: 02 6277 4208 F: 02 6277 4208
E: josh.faulks@aph.gov.au
The Hon. Peter Dutton MP
Shadow Minister for Health& Ageing
T: 02 6277 4884 F: 02 62778572
E: Peter.Dutton.MP@aph.gov.au

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!

Lapped

At the beginning it’s all fun. You start trying. You know you have friends who might or might not be trying, and soon enough, the pregnancies slowly start to be announced.

It may be a close friend (who promises that it will be your turn next) or a colleague, an acquaintance, or even an internet friend.

But it’s cool. You’re excited for them, knowing that your turn will be just around the corner.

You wait months; each cycle drags on. Months turn into years, and before you know it, bundle of joy number two is on its way for those friends and acquaintances.

It happened to me twice today. Lapped. Just like that.

The first was like a punch to the stomach – like the breath had been knocked out of me. I wasn’t expecting it, and was under the impression that they had finished babymaking. I got over it pretty quickly – it was more of a shock that she was pregnant, not that I wasn’t, if that makes any sense.

The second wasn’t so much of a shock. In fact I was just about to ask my partner if she was pregnant again, before he told me the news – the husband is his friend.

So there you go. Lapped twice in one day! I don’t feel bad, just envious. If life went according to plan, we would be trying for our second baby now too.

Unpregnant

I jinxed myself.

I knew I would. It’s these stupid drugs tricking me into thinking I might be pregnant. So I bought a 20pack of HPTs off ebay. They were so cheap, I couldn’t not, and this morning I did a test.

I was 10dpiui, and I thought it might have been early enough for a bit of hCG to give me a faint BPF, if there was any there.

I have been having a few little cramps over the last couple of days and thought it may have been this “implantation cramping” I have heard so much about. It was BFN of course, which didn’t surprise me, so I thought I would leave it until Sunday – 12dpiui.

But it turns out the “implantation cramps” are just plain old period cramps, because I got my period about an hour after doing that stupid test. Like so.many.times.before. So that made this a 22 day cycle, and completely fucked up my luteal phase, which is a clockwork 14 days, pushing it back to 9.

Is that even right? I don’t even know if I count IUI day as ovulation day. If it was the next day, that would make me only 9dpo. So the nurse was very sympathetic, and now I go back to the doctor.

I have to take this month off, which is totally fine with me. Being a pessimist, I had already booked a date with a 10 course degustation and matched wines at Marque (it was a wedding gift. I have a very nice sister) for March 6. Then I have a Hen’s the next night with the wedding the following weekend.

So now there is no need to sip on soda and lime and avoid possible harbourers of bacteria. In fact I think tonight the sorrows will probably be drowned with a bouteille of the leftover wedding plonk. Veuve? Moet? Lanson? How does a girl decide?

When you bump into an ex.

I saw my ex-specialist this morning when I went into the hospital for my CD21/7dpiui progesterone test. I saw him across the foyer, ummed and aahhed for about 2 seconds before yelling out to him. It was literally PROFESSOR nunny noo yelled across the foyer.

I caught him up on our progress, and threw in a bit of a told you so when I mentioned that I was “a great pregnancy candidate” and it was in fact my partner, whom he declared fit and fertile over a year ago, with the issue. I don’t think he was happy about it, but he needed to be called on it!

Unlike many people, I don’t think doctors are omnipotent beings. I don’t take their word as gospel and I like to be an informed consumer. Hell I could have been a doctor if I wanted. I mean if it wasn’t for not doing maths at high school, or any real science to speak of. But I could have. It runs in the family.

Anyway, I still think he is a decent enough bloke, but wouldn’t refer any of my friends to him. My friends menopausal mothers, yes, but friends with infertility issues, definitely not.

So progesterone test. A very good 40. So good, I didn’t need a Pregnyl booster, which is great. So I’m on my own until my period hopefuly doesn’t show up next Wednesday.

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!

Servicing the mare.

Can I just start out by saying how shiteous I feel.

This morning I felt like I had a couple of kiwifruit swinging around in my abdomen. Now it feels like a couple of grapefruit. I can’t do up my jeans, going from sitting to standing is not nice, and I don’t walk, I waddle. I look 16 weeks pregnant, and I’m acting like it too.

These drugs are doing some serious stuff to my mind. I completely forgot where I parked my car this morning. When I did locate it, I drove around the block for no reason at all.

Then I buggered up a fact on a news story, and didn’t realise until a smug little prick that I used to work with called up to set the facts straight (nevermind that two other colleagues, with a lot more knowledge of the subject, proofed the article before it went live and failed to pick it up), followed by a nonsensical conversation with my partner during which I couldn’t actually form a coherent sentence.

So I’m sitting here, trying to get comfortable, while my abdomen continues to distend. If this is 100iu of FSH, I can’t imagine how painful stimming for IVF must be (and lets hope I don’t have to find out).

So the insemination went well, I guess. Once they had separated the good from the bad, and washed the sperm, we had 3.5million to use. It sounds like a lot, but it’s not. The minimum for IUI is about 2 million, so hopefully the “high fertility potential” sperm that we know are in there, will do their job.

It wasn’t a particularly nice procedure and I didn’t expect it to hurt as much as it did. It was by no means near the pain of a HSG, but it was pretty uncomfortable. I think I must be a wuss. Oh, and I have a long vagina! The first speculum was too short, so my midwife had to pull out the big equipment (she said it was because I was tall).

It went a little something like this.

I lay down on the bed, which was elevated so that my pelvis was tilted about 35 degrees toward the ceiling. She put the speculum in, and then a long, fine catheter with a diametre of about 2mm. Then she fiddled around trying to get it as close to the entrance to the fallopian tube as possible (this was the part that hurt the most) before squirting the good stuff up.

Then I had to stay with my arse in the air for half an hour reading outdated trash-mags (Ricki-Lee “I have found love at last” from 2007) while waiting for sperm to hopefully meet egg.

Went straight to work after. Felt like I was going to chuck a couple of times, and did some low stress editing for the rest of the day.

R. my favourite midwife (there are four at the clinic at the hospital) said that I had responded really well to the drugs and that it looked good. My Oestrogen level was good, follices almost too good, great lining blah blah. But I’m more concerned about the sperm. Of the 3.5mil, there has to be a winner.

I really want to be one of those bitches that is lucky first go on IUI.

Oh and please accept my apologies for the quality of this post. It’s not me, it’s the drugs.

Being Token

You know Token Black from South Park? That’s how I came up with my username. I am the Token friend sans enfants amongst my online friends, and increasingly IRL.

But I’m ok with that. I always thought I would have issues TTC. I thought that PCOS could be a factor. I thought Crohn’s Disease and other auto-immune issues could be a factor. I could never actually imagine myself as a parent. I think I would rock, but it is still something I can’t imagine doing.

I can’t imagine being selfless and loving someone more than myself. I like my independence. I like travel, dirty weekends away, spending $80 on a bottle of champagne and guzzling the whole lot, expensive sunglasses, impractical shoes, unpasteurised French cheese, sushi, day spas and all the other stuff that gets pushed to the bottom of the wants list once a baby comes along.

I’m ready to give it all up, for a while at least, but I have never felt this sense that something is missing – something that a lot of other women talk about – fertile and infertile alike. I want a child purely for my own gratification. To have a project, a little someone to mould into the perfect human being.

I don’t feel hatred, jealousy or any other fierce emotions when my friends announce their pregnancies. Envy for sure, but that tends to be overridden by happiness. I don’t need to be told over the phone or via email, or treated with kid gloves. I want to attend baby showers, and birthday parties and hear every single detail of the pregnancy and birth.

I may occasionally look wistfully at pregnant tummies when I am out and about, and maybe once or twice have felt a lump in the throat, but it’s not something that is on my mind 24/7.

I want a child so much. Desperately, but would I lose my right arm for it? Probably not. The sight in one eye? Perhaps. Hearing? No. To never travel the world again? I don’t think so.

So I often feel like I don’t deserve it as much as other women who would be willing to give up all of this and more for the chance to have a child. I wouldn’t go to India and rent the womb of a poor woman for my chance. If AC was financially out of reach, I wouldn’t re-mortgage my home. I will go as far as I can ( I should say we, because I mean my partner and I) within financial and legal reason, but not as far as some.

Does that make me less deserving?