The Co$t of Infertility

My husband and I are filing our taxes this week. I went through all the receipts for doctor’s visits and prescriptions and it was a little surprising to see how many receipts we had, considering prior to starting fertility treatment I went to the doctor once or twice a year. This may be the first year we can write off medical expenses. I didn’t total everything up, but strictly out of my pocket (not including what my husband paid directly or what we used our health savings account on) I paid almost $1,500 on fertility-related treatments. Specifically, here is what we paid for just last year (what wasn’t covered by insurance):

-Hysterosalpingogram

-Interuterine Inseminations (4 times)

-Clomid (10 prescriptions)

-HCG trigger shot (4 times)

-Doctor visits

-Lab tests, including genetic tests and semen analyses

It’s shocking how much fertility treatments costs and makes a lot of sense that some companies offer loans specifically for fertility treatment. It’s also making us reconsider how much longer we want to pursue treatment due to the expenses. I’m not looking forward to seeing what both my husband and our HSA covered. If I had to hazard a guess though, I’d say it’s double what I spent.

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Race Countdown

We’re less than a week out from our next 5k. I’m feeling a bit nervous but I’ve made a bunch of changes in order to prepare better for it.

  • I’ve been following a strict(ish) meal plan. Breakfast all week has been smoothies (frozen berries, half a banana [that’s all I can muster since I acknowledge the value of bananas but still hate them], kale/spinach, greek yogurt, chia seeds, pineapple juice, flax seeds, and almond milk). Lunch has been homemade turkey burgers with provolone cheese on whole wheat bread. Morning snack has been a breakfast bar, with another one typically in the afternoon after I get home from work. Dinner this week so far has been shrimp and quinoa paella, and tomorrow and Friday we’ll have angel hair pasta with grilled chicken.
  • I’ve cut out all alcohol this week. Sorta. The day I decided to go on this meal plan is the same time my husband decided to bring home 4 really good beers. I’ve had literally 2 sips of each and declined having any more. That was hard.
  • I’m also trying to cut out extra snacks at work, although I caved today and had a cookie that my coworker bought from a place at the mall. It was a damn good cookie.
  • Drinking 8 cups of water daily. I’m absolutely terrible with drinking enough water. The last 2 days though I’ve had at least 8 cups and noticed that I’ve been eating a little less. But peeing a whole lot more.
  • Not eating after 8pm. Ideally I wouldn’t eat after 7 but sometimes my husband gets home late or dinner takes a while to make.
  • Not eating out. This one will be easy.
  • Getting at least 7 hours of sleep. I fail pretty hard at this one. I’ve been averaging about 6-6.5 hours of sleep, mostly because I’m in denial that I have to work the next day.
  • Stretching daily. Something else I need to do more frequently. We found a great video on youtube last night that was called “yoga for runners.” Felt great afterward.
  • Making better choices before the race. We’ve declined invitations to go out because it was the night before the race. I also made energy balls for our pre-race snack that consist of a banana, chocolate powder, oats, honey, peanut butter, chia seeds, and semi-sweet chocolate. Last race I screwed myself by having Chipotle for dinner (BAD IDEA) and I paid for it the next morning due to digestive issues. In turn, I had a meager breakfast and nearly passed out just after I hit mile 2.

Hopefully all these things will help. I’ve already lost almost a pound in the last 2 days, which is kinda cool. Plus, my run on Monday went well. I found that running a quarter mile then walking a tenth worked beautifully. I set a personal record for my first mile but keeping a steady pace is still a challenge. Miles 2 and 3 were slower than mile 1, but typically I run faster on race day than when I train on a treadmill. I’ll keep you guys posted on how we do, but I’m shooting for sub-35:00.

Missed Opportunity?

I recently checked my fertility app and realized that due to illness and work craziness, we completely missed my fertility window. I told my husband and initially I felt disappointed, but that lasted all of 30 seconds. I felt a little guilt though because my husband has been taking a slew of vitamins to help increase our odds of conceiving. Meanwhile, my prenatal vitamin bottle has dust on it. I’ve become apathetic about getting pregnant, especially now that we have other things to spend our time (and money) on.

I had some insight into this apathy when we recently went to a theme park where we were surrounded by hundreds of kids. I reveled in the fact that it would be the cheapest we’ll ever go to the theme park, plus we were able to choose whatever rides we wanted to get on without a child screaming their objections. It was also nice to get ahead on some rides because it was just the 2 of us.

It’s been exactly 3 years since my husband and I started trying to conceive and I think this is the first time I’ve felt true peace about it. We’re taking more time to ourselves instead of overscheduling and it feels like the pressure to conceive is off. I’m both astonished and proud of my attitude because it took such a long time to reach this point.

Maybe apathy is the wrong word. I feel content.

Break Time

My period started yesterday morning. I talked to my husband about what to do next and we’re going to stop fertility treatments until April. May will probably be another break since we’re going on vacation for almost a week. We cut it real close last time we went on vacation while in the middle of fertility treatments; I had to do the IUI the day before we flew out when I was supposed to do it the next day.

Anyway, May and actually June and July will be break months too. My brother is getting married next spring and I want to make sure I’m there to make fun of support him. So it’s April, then August for the next rounds of treatment.

Last night I found out that a friend of mine is pregnant (the count of friends who are pregnant/just gave birth is around 10 now). I’m honestly excited for her and suspected for about a month that she may be pregnant. Even though I’ve said before that I’ve accepted that we’re still struggling, it still stung to hear the news, especially since it’s so soon after my cousin announced her pregnancy. My friend’s announcement set off an avalanche of negative, irrational thoughts which soured the night a bit. For one, I felt she was a little nonchalant about it, which I think I would be too because it’s taken so long to get pregnant. Note that I don’t know if she and her boyfriend planned for this kid or if they have been struggling too, but it’s none of my business either way. For two, she showed us a video of how she announced her pregnancy to her parents over the holidays, which was similar to how I imagined announcing my pregnancy to my parents. Then I thought about how I’ve imagined how I wanted to surprise my husband and my dad for their birthdays (they’re in the same month) with pregnancy news for last 2 years. I even bought a father’s day card for my husband 2 years ago as a way to announce my pregnancy, but I finally gave it to my dad last year for actual father’s day. I was able to bounce back pretty quick last night, thanks to several drinks and plenty of distraction by our other friends.

However, I was hit hard this morning. Back to feelings of inadequacy and questioning what we did wrong. I’ll admit, I haven’t been taking my prenatal vitamins. But we were doing everything else right, and I felt like I’ve been taking these vitamins for years now and they haven’t helped. As the day went on I began feeling better and figured I’d start getting into projects that have fallen to the wayside, such as reading and knitting (ironically, my last knitting project was a baby blanket).

I’m over it all of this, but I need to accept that I’m just at the age that more and more people that I know are having children. I won’t say I’m totally hopeless, but it’s about 90%.

Best Laid Plans

Before New Years, Dear Husband and I decided that we would spread our social calendar out more evenly and I decided that I would commit to running more frequently.

It’s 17 days in and I’ve failed spectacularly on both fronts.

Let’s start with the running. I’m less than a month from my next race and I have run once in the last week. Part of that has been due to being drained from work, but also because I’ve been staying up way too late. It’s prime sports season in our house and there have been several late games on lately. On days without games, I think I stay up as a way to delay going to work the next day. Doesn’t make any sense but there’s something about feeling like I can delay the inevitable. During the week I get about 6 hours when I function best on 7 hours. Anyway, since the race is happening so soon I’ll focus more on my endurance versus speed. My endurance was okay last week but I’m hoping to improve it further by doing distance intervals instead of time intervals.

As far as our social calendar goes, DH and I had one weekend open this month and of course that’s the same weekend that a huge event is going on in our city. We still decided to keep the weekend to ourselves but now the weekdays are jam-packed. Tomorrow will be the first day in almost a week that both of us have a free night. Mind you, all the plans are great, especially since I’ve been catching up with old friends the last 2 days. However, I can’t remember the last time I was this busy for 5 consecutive days outside of being on vacation. There’s always next month to try and balance things a bit better.

Onward

I need to trust my instincts more often.

My IUI was scheduled for first thing Saturday morning. I was advised not to empty my bladder so that it would make things easier for the nurse. The first time I had the IUI I didn’t pee first and it was painful. The other 2 times I did and it was fine. Against my instincts and probably because I was so tired, I didn’t and I really had to pee by the time my name was called.

So I’m on the examination table now and because my bladder is so full, my uterus is tilted (!). The nurse kept pressing on my abdomen to help line up my uterus but that just made me have to pee more. And since I was trying so hard not to pee, I tightened whatever muscles are down there (should have paid more attention in my human sexuality class in college), which made it harder for the nurse to insert the catheter. In the end, she tilted the end of the exam table so my butt was lifted and she could complete the procedure.

It hurt like all hell. The nurse was surprised by how painful it was but it was worse than anticipated. Of course it takes all of 30 seconds to actually do the IUI but the emotional effects last a while. I didn’t cramp as much as last time but I had some today. I’ll call the doctor tomorrow to figure out what’s going on because I don’t think I’m supposed to have cramps days later.

TL;DR Pee before an IUI. Advocate for yourself.

On a side note, one of my colleagues just announced her pregnancy after experiencing difficulties with getting pregnant. Infertility sucks but it’s comforting to know that I’m not alone in my struggles. I’m a little surprised by how many women I now know have been having trouble getting pregnant (up to I think 5); however, it just shows the prevalence of the problem and I’m proud of these women for speaking up.

Ugh

We should have skipped fertility treatments this month.

It’s been rough, starting with the roller coaster of taking 150mg of Clomid. DH and I have been wiped from the holidays and work, and our attention is not on trying to have a kid. I still went to my next sonogram appointment and I have 2 follicles that are good to go. The sonographer asked about side effects of being on such as high dose of Clomid and I told her that I had awful mood swings, among other symptoms. She was dismissive, stating that the side effects weren’t “that bad.”

I wanted to tell her that we should hang out next time I’m on 150 but I resisted.

Anyway, I’ve become so ambivalent about getting pregnant that DH had to remind me to take my trigger shot. I took the shot and we were supposed to “baby dance” afterward, but due to a series of events that didn’t happen. DH and I concluded that this month (and I think in general) trying to have a kid has felt more like work versus something that we want to do. My next IUI is tomorrow morning so we’ll see what happens. I’m not at all hopeful considering how many times we’ve done this now, and if it doesn’t work this time I don’t think we’ll do our next round of treatment until maybe April or May.

Taking Charge

This week was rough. It was such a drag going back to work after Christmas. I was exhausted and unmotivated, but was unsure about where this level of exhaustion came from. I checked our calendar and DH and I haven’t had a weekend to ourselves since November 4. Just about 2 months.

We have tried to block a weekend a month for ourselves, but with recent travel and holidays that got away from us. I think my exhaustion also comes from the whirlwind of the chemical pregnancy. I went to the doctor this week for a sonogram to see if I can proceed with the next round of IUI. Everything looked good and I was put on 150mg of Clomid. That high of a dose is hell on earth (typically it’s 50mg), with the worst part being how it’s affected my mood. Case in point:

The pharmacy I go to was unable to fill my full prescription, so the pharmacist gave me a day’s worth and sent the remainder of my Clomid prescription to another nearby pharmacy (it’s a chain). Went the next day to pick up my meds and when I got home, I realized that the second pharmacy only gave me a day’s supply too. I called them later that day and the tech said it was how the order came from the first pharmacy. I called the first pharmacy the next day while at work and the pharmacist said the second pharmacy should have received my full order, not just 3 pills. She suggested I call Pharmacy 2 to check on my order and I asked her to do the same.

I’m pissed at this point.

I went out for lunch and called the second pharmacy while I was out to ask about the Clomid. I made sure I was crystal clear about what I was supposed to be receiving (3 pills a day for the next 3 days. 3×3 =9 pills, right?) and was promised that it would be filled as expected in an hour.

Dear Husband had a half day at work so I asked him to pick up my prescription on his way home. He sent me a text a short time later.

“There’s only 3 pills.”

Now I’m outraged. I called DH (I’m still at work, mind you) and he said he was still at the pharmacy. I asked him to go back to the counter and put me on speaker so we could figure out what the hell happened. The tech gave the same runaround as before and I read them the riot act. I’m so glad DH picked up my meds because if I were there I would have jumped over the damn counter. After some more bullshit, including a dispute over cost, DH received my full order. And he bought me dinner. He’s the best.

Anyway, I was concerned about my level of rage over the medication. I acknowledge that it was a definitely overreaction but it’s been difficult to keep my mood in check, especially since I work with people all day. It’s tiring. This happened all the other times I took Clomid, but now the effects really feel amplified since I’m taking so much of it.

So after the nonsense of this week I made a few decisions: 1) If this cycle fails, I’m taking at least 2-3 months off from treatments because it has been taking such a mental and physical toll; 2) DH and I really need to prioritize our marriage more. We spend a lot of time together with friends and family, but not as much just us. I think part of that is to distract ourselves from our fertility struggles; and 3) I need to prioritize myself and use personal goals instead of using my desire for a baby as a motivator (e.g., running more frequently so I can get stronger, versus running more frequently so I’ll be at optimal health to carry a child).

We’ve already started putting #2 in place. Earlier this week DH and I decided that we were going to take this weekend to ourselves instead of going through with original plans with friends. We also started planning out the next 6 months and decided to limit ourselves to max of 2 social events a month. It’s going to be hard since DH and I are pretty social people, but it’ll be helpful to figure out more things to do together. Today we went to a park and for a section of it, we were the only 2 people around. The stillness was indescribable and more needed than I realized.

We got lunch afterward and decided that we would spend more time doing things around town, which includes less time at breweries. We have our favorite breweries but there are a few we have wanted to go to but haven’t made it there yet. We talked about going to these bucket-list breweries and not go to our usual spots because we have nothing else planned (plus all the visits tend to add up financially). Going to the park today was great and there a few other parks in the area that want to explore, in addition to other things we’ve wanted to try or haven’t done in a long time. We also discussed spending more time at home working on hobbies (somewhat ironically, we started a jigsaw puzzle featuring beers from around the world).

Once I’m done with this round of Clomid I’m looking forward to really working on personal growth and doing more with DH. It’s all about balance.

Moving On

DH and I went for a walk this morning and shortly after I noticed that my walk was different. That my hips were more forward and and I was almost waddling. I texted my currently pregnant friend Jane and she said she’s experiencing the same thing. However, when I showered when we got home, it appeared that my period started.

I honestly felt relieved because now I have somewhat of an answer. But it didn’t explain why I was so late. Jane suggested that I may have had a chemical pregnancy, meaning a spontaneous miscarry super early in the pregnancy. That has to be the only explanation considering I had so many pregnancy symptoms. Ironically, I got a notification that my pregnancy test strips had been delivered right after I told DH that my period started. I’ll test tomorrow morning and if the test is positive, then I definitely had a chemical pregnancy. At least I now know it’s possible to get pregnant and this gives me renewed hope for next month, when we go back to the doctor.

By the way, for those keeping track, here were my pregnancy signs:

  • Period was very late (8 days)
  • Fatigue
  • Constipated for days, then loose stools today
  • Moodiness
  • Nausea
  • Mild cramping and lower back pain daily starting from expected day of period
  • Bit of a waddle when I walked

The Call

Thursday, I waited anxiously for my doctor’s office to call. I was at my desk for the majority of the day watching my phone like a hawk. Go figure that when I left my office for 90 minutes, that’s when they called. I called them back at the first chance I got. I hadn’t been that nervous in a while. I finally got through to the nurse and she said,

“Your blood test came back negative.”

My mind went blank. It made no sense.

I asked, “Well could I take a home pregnancy test later to double check?”

Nurse said, “It wouldn’t matter. Call us next week if you don’t get your period and then we can start you on medication to begin your next cycle.”

I said thanks and hung up. But I was frustrated. The fact that the nurse was so blunt threw me off and in hindsight, I should have asked what my hcg level was or even if they tested that. With research I found out that most ob/gyn’s do 2 types of blood testing: one that says yes or no for pregnancy, and the other to measure how much hcg is present.

Per a friend’s suggestion, I tried to log into my clinic’s patient portal to see for myself what my levels were. After going through the steps of creating a patient account, the next step was to connect to my clinic. I went through my clinic’s website, logged into the portal, went to connect to the clinic…and my clinic wasn’t listed.

What.

I contacted customer service and they were useless, so I’ll call Tuesday to ask about my hcg.

Meanwhile, I started getting a little brown discharge last night and today, in addition to mild cramps that have been present for the last week. I’ve also been very tired, mind has not been as sharp, nauseated the last 2-3 mornings, and today I was emotional over seemingly nothing. This morning, Dear Husband and I went to buy groceries and on the way home, I began crying. A lot. When we got home, DH said he was sorry that things didn’t work out again.

Me: What do you mean?

DH: Because the test was negative.

Me: I haven’t tested again since Wednesday. And I wouldn’t cry over a negative result, considering that has happened monthly for almost the last 3 years.

DH: What got you upset?

Me: Not sure. I think because we forgot milk.

Man, if I’m really pregnant and this how I react to things, then it’s going to be a long pregnancy.

As a side note, I’m now 8 days late. I ordered pregnancy tests (25 for $7!) that should come in today, so we’ll see how it goes. There is still a chance that my period shows up (although I’d have no idea why it was so late) and being this late without a positive test could be explained by ovulating late. I really don’t know at this point which makes things all the more frustrating.