The Financial Fuckery Begins

One of the main complaints I've heard about the IVF process is a distinct lack of communication between the actual IVF staff and the financial department. The financial departments of IVF clinics all over the country get slammed for poor billing practices involving incorrect numbers, screwed up payments and noticeably poor communication. Knowing this going in, I spoke extensively with the financial department for each lab/clinic we're working with and quadruple checked my numbers to try and head off any potential problems. I made a valiant effort but apparently it wasn't enough.

When I got home from work this evening around 8:15pm, I found this letter waiting for me from ART, the surgical center in my clinic.

Um, No.

As you can see, there are several mistakes. For starters, it lists my ICSI fee as being for a third cycle - this is only my second. I actually owe them $150 more than the bill says here.

Secondly, they want $3950 for aCGH testing. This is so far off that it's crazy. We did in fact decide to add aCGH testing on, but we're paying Reprogenetics directly and the fee is only $2,250. That's no where near 4 grand and there's no way I'm paying that to ART. All of our dealings with Reprogenetics have been direct, there's no reason SCRC/ART should have any part in fee collecting for them.

Their third and final strike is the $1650 for embryo biopsy. Here the number is correct, but we've already paid it. Before signing up with SCRC, I confirmed over and over again that the fee for embryo biopsy was once due once when purchasing their two cycle plan. As I've already paid them their $1650 when we did our first cycle, we will not be paying it again.

I'm hoping these were innocent mistakes but I admit it really cheeses me off. I went over this with all the different financial departments - SCRC, ART and Reprogenetics and I was so hoping we wouldn't get slammed with the usual financial fuckery. When our first cycle got billed correctly I thought we'd avoided any pitfalls but it looks like I got ahead of myself.  I left a voicemail for my financial contact at ART since it was way after business hours and I sent an email to my financial contact at Reprogenetics.

Your clinic and labs hold all the cards when you're doing IVF - they literally have your embryos, your potential children, the lab has my probe, and SCRC has over $20,000 of our dollars so it's not exactly like we can stamp our feet and refuse to pay if they won't fix the problem. With any luck, I'll get two satisfactory answers tomorrow correcting this estimate because there's no way I can give them another $6,600.

Our Probe Is READY!

Yesterday morning, I went ahead with my plan to phone Reprogenetics to get an update on our probe. I can never manage to catch someone at their desk so I left a message and waited for a call back. They're usually pretty good about returning calls and it only took a couple of hours for their New Jersey caller ID to pop up on my phone.

My rep for our probe process wasted no time in telling me that our probe is DONE! It's ready! We were originally quoted 6-8 weeks but it ended up being less than 4 weeks from the date they got our samples to the date of completion. I was so surprised, this is wonderful news :) I was anticipating a deadline closer to the 8 weeks and was worrying that we wouldn't get results in time to go right into a FET.

Once we conclude this cycle and the lab has received all our biopsy samples, it takes 15 calendar days to get PGD and aCGH results on our frosties.  Those will be two loooong weeks and I'll probably be going crazy but I know we'll get some good results.

(Source)

This is an example of Fluorescent In-Situ Hybridization, or FISH, a quick result type of PGD that we can't use for Fragile X but that is super cool to look at. This one is for muscular dystrophy. Embryo C is a normal male embryo, I believe the light pink is Y, the dark pink is X and since there's only one X in a boy, a single green dot for a normal chromosome. D and F are both normal female embryos, two green dots each, one for each X, the two dark pink dots. A shows a female carrier embryo, one of her chromosomes is affected but the other is okay, two dark pink dots and a single green dot, and B and E show affected male embryos, no green dots.

Hopefully we will have lots and lots of healthy embryos from both cycles but first we need a nice, big haul from this one. I just started up shots again today, this time 4 Menopur and Omnitrope in the morning and 4 Menopur in the evening. Every time I start up another cycle, I forget how much the Menopur burns!

Itchy Sitchy

Today was day two of adding in Cetrotide to my IVF protocol and I have to say it's not my favorite medicine. I've been pretty lucky to only experience a few side effects from the various meds but the Cetrotide is one of the most annoying.

Thus far, I've had:

• Head aches -  I can't tell if these are from the Menopur/Omnitrope or from the insane heat we've been having. I've only had two that were really unpleasant and I'm trying to drink a ton of water in case it's the heat since I can't take Advil
• Cramps - These I think are mostly from my period take two, the withdrawal bleeding you get after you stop birth control, but I've had twinges after every injection as well. They're more in my uterus than my ovaries so who knows what is causing it. My bet is on the Menopur. 
• Numb toe - This one is definitely the Omnitrope. One small section of my right big toe went numb, it was the weirdest thing. I had no idea it was a common HGH side effect.
• Sore joints - Again the Omnitrope. Mostly my right knee and it's only been a couple times, another common side effect.
• ITCHING - ding ding ding, we've reached the Cetrotide! The Menopur burns while you inject it, but the Cetrotide itches for at least an hour after. The problem is the itch is under your skin so you couldn't scratch it even if you wanted to scratch a fresh injection site. Gah. 

Tomorrow is day 9 of stims and I'm hoping these follicles are going to be nice and mature at tomorrows appointment. We only needed 9 days of stims for our last IUI cycle and thus far these follies have been tracking my last cycle almost exactly. Plus, my belly is covered in track marks and despite it's ample and expanding girth, I'm running out of injection sites!

Our protocol now looks like:

CD 1: Nothing
CD 2 - 14: BCPs
CD 15 - 17: Nothing
CD 18 - 22:  600IU Menopur (2 injections), 0.25cc Omnitrope (1 injection) and 1mg Dexamethasone
CD 23 - 24:  600IU Menopur (2 injections), 0.25cc Omnitrope (1 injection), 0.25 Cetrotide (1 injection) and 1mg Dexamethasone

We also need to get the saliva kits shipped out for my mother and sister. They need to be over-nighted there which I'm sure will run us at least $50-$100, and means I need to get them collected and shipped on the same day. This has been a bit more difficult than you'd think since we need to coordinate three schedules and collect samples on the same morning. It's on my to do list for tomorrow so hopefully everything works out.

In the meantime, all my energy is directed at those 9 follicles maturing in my ovaries. Come on follies, grow, grow, grow! I need good, healthy, mature follicles at my appointment tomorrow.