IVF Transfer Plan: Decision Made

I think we finally have a solid plan in place for our embryos. It's been a really tough decision to make but I think we're going to go ahead and give our first frostie, Embryo A, a chance to stick before we go through a third IVF cycle. When Embryo A successfully implants, because they will! and we deliver our healthy baby, we will have to wait a little bit before we can cycle again. I originally wanted to nurse our babies for at least 2 years since I feel really strongly about breastfeeding but that might not be possible since they won't let you cycle while nursing. It will also be a lot tougher to cycle with a young baby and a mortgage since we're hoping to buy a house as well, but I think it's the right decision.

Even though I have a wonderful showing of antral follies, there's no guarantee they could fit me in for an IVF cycle now with the holidays coming up so quickly. And since it's me, who knows if I'll have good follicles next month. The transfer protocol is a little lighter on ultrasounds and easier to schedule right now and they can definitely fit me in for a mid January transfer.  

Another IVF cycle right now would also mean a lot of money.  I'd probably want to order my meds overseas again to save on cost and international shipping is dicey right now with the holidays. We've also far exceeded the amount of medical expenses we can write off this year so we'd get no further return on our taxes. I'm not sure what we'd need to do to try and get PGD coverage for another cycle but I'm sure there's no way we could do it that quickly and storing biopsy samples for long periods of time can lead to degradation. We're just not prepared. 

As soon as the decision was made, E, who knows me so well, suggested I create a flow chart. I'm so glad he accepts my crazy because I was already thinking the same thing. And thus, our IVF Transfer chart was born:

I think it's a solid plan that examines most possible outcomes.  It does make the assumption that a third IVF cycle would yield 2 healthy embryos, which is a big assumption, but not outside the realm of possibility. If/when Embryo A sticks, I'm not sure if we'll go right to a FET of Embryo B or do a third cycle first. Those decisions are still a little way off but I think we're definitely set on a third cycle if Embryo A fails.

Unexpected Decisions

I finaaaally got my period after what feels like forever! I know it's only been one month off but man did it feel like a long month, especially because my period was a little bit late too. Now that it's here and I feel like my cramps are attempting to compact my insides, I gave my nurse a ring and she brought me in for my baseline ultrasound and labwork.

E and I went in together for this visit and took care of the thaw and transfer consent paperwork. This set has to be completed in person with a witness so we had to wait for a day when E had enough time to come in. We also filled out our financial commitment paperwork and gave them all our credit card information for the FET fees.

Everything was going pretty smoothly until we got to my ultrasound. I don't have any cysts or issues that could cause problems with a transfer but when she waved the wand over my ovaries I saw way more antral follicles than I usually have. I asked her to go back and count them and to my surprise, I have 19-20 antral follies! That's a crazy high number for me, I never have that many, it's a basically normal number. I was floored.

I mentioned the high count to my nurse in passing as I was leaving the ultrasound room and the first thing she did after confirming the number was ask me if I wanted to do another IVF cycle. I was both surprised and not at the same time, that's an amazing AFC for me and could potentially yield a really nice number of embryos. But it would mean starting from the beginning again, IVF, medications, PGD, PGS, the whole shebang all over. It would mean putting off a transfer for at least 2 months. Spending all that money right after we finish paying for the first two cycles.

I told the nurse E and I needed to discuss it further and that we'd proceed with the FET protocol for the time being. The first part of the procedure is the same, two weeks of birth control, so we have a little bit of time to figure things out.

I really wasn't prepared for this option. My last cycle was such a junker it didn't occur to me that I might be perfectly primed now. E and I have been waiting so long to hold our baby I really don't want to delay.  Then again, it's likely we'll need IVF again in the future since we didn't get quite as many embryos as we were hoping for to have multiple children, and doing another round of IVF now would be a lot easier than doing a cycle with a young baby and a mortgage.   It's such a tough decision I'm not sure where we'll go from here.

IVF Meds Package!

Look what finally arrived! My first batch of meds for this cycle :) I would have had them yesterday but it was Columbus Day and I completely forgot that there was no mail. Since I have to sign for the package or they won't leave it, I worked my schedule so I could be home today. Then I waited. 

And waited.

Annnnnd waited. 

All Day!

My other two packages from IVFMeds came at 10am and 2pm. This package didn't come until FIVE! I could have done a million other things not the least of which would have been to pick up my Kaiser order which is still sitting and waiting for me at the pharmacy.

This batch of Menopur came in blue boxes labeled "MeRopur". The last batch came in pink boxes labeled "MeNopur", the left overs are in the bottom right corner of the photo. A quick google search told me that it's the exact same medicine, by the exact same company, but its from the lot distributed to Italy where they call it Meropur instead of Menopur. Apparently the word or pronunciation of "Menopur" in Italian translates to something like "Not Yet" which Ferring thought would have a negative connotation. I opened each box to inspect them and make sure none broke in transit and the actual vials themselves appear to be the same vials, with the same med pellet but with different labels. 

The 5 Cetrotide were the exact same as last time, little kits with a vial of powder and a pre-filled syringe. The remaining 43 Menopur vials are on their way from London to New York right now and I'm curious to see whether they'll be Menopur or Meropur. I might call and ask but I don't think it makes a difference either way.

IVF Meds Take Two!

Now that the stim start date is inching closer and closer, I went ahead and placed my order for the next round of IVF! Since we had such good success with IVFMeds.com last time and the meds are SO MUCH CHEAPER, we went with them again. Even with the good amount left over from the extra we had to buy for last cycle I still had to order a tooooon of Menopur.

Thanks IVFMeds.com for saving me a ton!

Last cycle I had some extra Menopur left over from my second IUI and even with that extra, I still used a few of the last minute Menopur order. If this cycle is anything like last time, they expect me to use 90+ vials and stim for at least 11 days so I'm ordering over 80 vials of Menopur. Since I was one short last time, I also ordered 5 Cetrotide injections and hopefully that will be enough.

After the second batch of meds took a bit longer than was ideal to get here last time, IVFMeds.com offered to credit me the difference in cost for the extra vials I didn't use. I was skeptical because come on,  that's really excellent custom service, much more than I would expect from an online company based in another country. Instead of placing my order online, I rang up customer service and got the same wonderful rep that helped me last cycle. He remember me and my order snafu and in just a few minutes was placing my new order with a credit for the difference in the extra vials.  I'm still kind of shocked! It was all quick and easy, I rang them up, rang the bank to authorize the transaction since it got flagged again, and my nurse emailed me the new scripts to upload only minutes later. After all the calling and price checking and back and forthing of last cycle, I never knew the process could be so smooth.  

Impossible to beat these prices!

They're moving like ninjas this time and have already shipped out the first batch of my order, 40 Menopur and 5 Cetrotide. Like last time, I ordered so much Menopur that their pharmacy can't fill it all at once from in store stock so they're shipping it in two separate batches. This order went out on Friday so I'm not quite sure when to expect it. Priority Mail Express International does a lot of things regular Priority doesn't do, it's even delivered by a separate branch of USPS. If the package moves on Sunday, it should arrive in New York tomorrow and will probably be delivered by Monday. If it doesn't travel on Sunday, it'll hit the big apple on Monday and I'll get it Tuesday.  I also have to call Kaiser to authorize them ordering my Omnitrope and needles/syringes. The order was called in on Friday but from past experience I know they won't actually order it until I ask for it.

It doesn't make a difference protocol wise if the Menopur arrives on Monday or Tuesday since I don't need it just yet, but since I have to be here to sign for it in person, I have to plan my schedule around the delivery. Kind of a pain but well worth the savings!