What Goes In, Must Come Out

On December 6th, I called my doctor’s office to tell them I had very heavy spotting and wanted to know what my next steps were. They said they would call in my birth control and estrogen and that I should start it the following day.

I am not sure why I needed to be on either of these medications, but I was willing to go on blind faith with the doctor’s orders. I soon Googled the reasoning and it appeared to be all part of the process to prepare my ovaries for optimal egg production. Although I do not prefer to rely on Google for pertinent information such as this, I wanted immediate answers and this is not something I receive from the office regularly. It is difficult to get in touch with my nurse. Also I feel like I did not get enough information from my doctor, as the last time I saw him I was still not sure what choice I would be making in regards to freezing my eggs or not. Now that I am full steam ahead with egg retrieval, I feel like I need another Q & A session.

Anyway…

The pharmacy called me that night to inform me that they did not have that high of a dose of the estrogen in stock and they would have to order it. Also they were not getting clearance from my insurance company. Never a dull moment. It would have been too easy to just walk into the pharmacy and get the prescriptions and start them the following day.

Long story short, I received the drugs the following night after many back and forth phone calls with the doctor and pharmacy.

So December 8th was the true start of my journey. I am catholic and that is the day of the Immaculate Conception. So you see, after all the back and forth and waiting to get the drugs, I feel like my journey began on this day for a reason. I do not think that it is a coincidence. To begin my journey on the day Mary was conceived is special to me. Although I know that this path I’m following is not the natural way of conceiving a child, I believe (after much back and forth inner debate) that I will do everything I possibly can and God will take it from there. If it is meant to be, it will happen. I leave it in His hands now.

I try to not be TOO optimistic. There are still so many things that could happen that could end my journey. And then I know that this was not meant to be; that I was not meant to have a biological child. But I am taking every chance that I can in order to make it my reality. Sometimes my cynicism is so strong that it over powers all of the good energy I try to create about the situation I am in. I just want to make sure I prepare myself for whatever the outcome is.

And I know what you’ve been thinking…even if I am able to freeze eggs I am still left without a partner. I still have that piece of my puzzle to figure out. I do not want to go about my life essentially searching for a sperm donor. I want a partner for the right reasons. If someone enters my life in the next couple years, then I will be blessed to have the option to procreate with him. If not then I will look into the options I have of finding a donor and going through IVF as a single woman.

As time has gone on (and its only been a few months) I have learned so much about myself and this process.

My conceptions and thoughts about many things have changed and I know whatever the outcome I will not be the same when I come out on the other end.

I am currently nearing the end of my week of estrogen (125 mg/day). It has made me a little woozy and emotional, but I have been trying to stay focused on the reason why I am doing this and it truly does help. I also try to go to yoga as often as possible to help keep my mind centered and my body well. Focusing on my purpose. Hoping for the best each day.

Of course I am anxious to begin my drugs. But I am also confident that in the end I will have the answers I have been seeking and everything will, one way or the other, fall into place.

I am set to begin my drugs on January 17th.

Shock and Awe

The week of November 14 I had decided to start looking into payment options and if there were different organizations that would assist in the cost. I am literally living paycheck to paycheck and even finding $160 extra dollars is overwhelming let alone $16,000.

Freezing eggs is not something that is covered by insurance because it is still considered experimental. My doctor told me the only way the insurance company would possibly cover the cost would be if I had a disease such as cancer where the treatments would effect my egg supply or quality. Just having bad luck in love and trying to start a family later in life was not considered a case that would be up for consideration to the insurance companies.

The procedure could possibly cost a total of $16,000; 8K for the doctor and 8k for the drugs. Being single and living on my own, I thought that I would qualify for assistance from the drug company. The secretary in the office informed me that the dosage the doctor had prescribed for me would actually only be a little over $6,000 and referred me to two companies; one for Follistim and one for Gonal F. After submitting tax documents and household information I would receive a response; either receiving 25, 50, or 75% off the cost of the drugs.

I received notice within a couple days from both companies that I would only be eligible for receiving 25% off.

THAT’S IT?! Who was more needy than me?!

Not only did I have a relatively small salary, but I live on my own and pay all of my bills on my own. How would I find $12,500 to pay for this procedure? I already had a loan out on my pension that was cutting into my salary for the time being. I had to figure something out, but in my profession it’s difficult to make extra money. In some jobs, the harder you work, there is opportunity to receive more income. But that is not the case being a teacher. I was already spreading myself pretty thin and working a tutoring program and picking up another stipend position. Maybe I would move home with my parents? Maybe I could find another job on weekends? I had to figure something out.

I wrote each company letters of appeal asking them to reconsider the percentage they would be taking off from my drugs.

After talking with the secretary in my doctor’s office about my concerns, she directed me towards a drug company that may be able to help. She forwarded them my number and later that night they called me, asked me some questions, and told me that I would be hearing from them by the end of the week. This was Monday.

So of course Wednesday I called them (wasn’t that close enough to the end of the week?) and they said they were still waiting on a few things and would get back to me soon.

That night I got a call. The woman very nonchalantly informed me that after running my information that the drugs would be costing me $43.

 

[[SHOCK]]

 

Words cannot describe the feeling I had at that moment. I was in shock and disbelief. What a huge burden to be lifted from my shoulders. Never in my life have I been so grateful to a complete stranger. She said she would be sending out my drugs to arrive the next week and that after applying a couple coupons, the final cost was $33.

Suddenly, the $8,000 I had to pay to the doctor seemed like a small amount. I was lucky enough to be able to borrow from a 403B that I had set up and although the monthly payments would be difficult, I would find a way to make it work. I felt suddenly reassured that this was in fact the right choice. That I was making the right decision and that everything would be ok. When all of the pieces slowly start falling into place that seems to happen…

November 22 I came home to a gigantic cooler box on my porch filled with various medication, syringes, and paperwork. It suddenly all became very real and panic set in. But I was still so thankful to have this opportunity. I was eager to start the process. Who knew how much time my eggs and I had left?

I called the doctors office the following day and they said to call when my next cycle began so they could give me further instructions.

More. Waiting….

Don’t Believe the Hype

A week later I went back for that ultrasound I skipped out on and the results of my third AMH test. I had a week to settle down and although I am well aware the results do not really matter, that sharp drop the second time really threw me for a loop. I needed more answers.

Also now that I had decided to go through with freezing my eggs, I wanted to have my mother meet the doctor that would be helping me retrieve my last bit of hope. Although I have not talked about my mother in this blog, she has been very supportive in every aspect of this process. I may not have a partner, but one thing I am not short on is support from my parents and friends. Even though people are not able to fully relate to or understand a situation unless it is actually happening to them, I believe my mother somehow feels every ounce of pain, confusion, and despair I have endured during the last few months.

 

When the doctor entered the exam room, he informed me that my blood work had come back. My AMH was a .9.

 

I felt my face light up. I didn’t want to get too excited because I knew exactly what my doctor was going to say to me. That AMH was not reliable for this reason, it oscillates. That these results were exactly the reason AMH was not FDA approved.

 

And that’s exactly what he told me; that my ultrasounds and FSH were more in line with one of the lower readings. I’m leaning towards the .6 because that .3 was not something that sat well with me.

BUT the moral of the story is do NOT trust your AMH because it doesn’t know what it’s talking about.

Further into the appointment he saw that the cysts were gone but there were some new ones. This supported his initial thought that these were cysts that would come and go with my cycle and would not be anything to worry about.

This appointment went well overall. No great news, but nothing terrible. I felt like things were really starting to make a turn. Or I was just accepting my situation? Changing my reaction? Making the decision to freeze my eggs was like lifting an elephant off of my chest. Although I did not have anything close to a guarantee, it was better than nothing. And that’s what I was holding on to. And that was enough for me.

My mother seemed happy with the doctor. She has this way of reading people that I never felt like I possessed. When I asked her what she thought of his she said “He’s fine” which is a lot coming from her. It put my mind at ease and led me towards the next stretch of my journey….

 

Now where was I going to get that 16k…..

All Aboard…

Monday, November 7th I returned to my infertility doctor (why do I even need one of those??) so he could read me the results of my bloodwork. The FSH had to be tested on the 2-3 day of my cycle so this was the soonest appointment I could get. As I again waited next to the empty chair in the doctor’s office, I was extremely anxious. In the back of my mind I truly was hopeful that he would come in and tell me that ACTUALLY my AMH was normal and that my FSH was healthy and I would have no problem creating life in the future.

 

I really thought that. Really.

 

But when the doctor entered the office he painted a very different picture from the one that was in my mind.

My doctor told me that not only was my FSH was 14 (too high) but that my AMH had come back now at .3.

 

.3

 

.3?!

 

No. These could not be my results. This was not the news I needed to forge ahead and create my happy, healthy family with my (nonexistent) husband.

 

But I still sat, stone-faced I presume, as the doctor continued to ask me if I understood what he was saying.

 

Did I understand? I wasn’t really completely sure at the moment what I was able to understand. I wanted to run out of there and forget about it all. That none of this happened and just live in my naive little world. Just continue living my life believing that I would have my family. Easily. Without any problems.

 

But that was not my story anymore.

 

The doctor wanted me to understand. After not receiving much of a reaction, he proceeded to tell me that with all of these results, there is not much he could do for me.

 

“Your train has left the station.”

“Do you understand what I’m saying?”

 

At this point there was little chance that in a few years time I would still have eggs that would be strong enough to create a baby. Maybe not even that long. Maybe in a year. There’s no way of actually knowing your end date. The day where your basket is empty. And what I had left was not the best batch of eggs. There was no way for him to really tell what I had, how many I had, and what they were like. There are so many uncertainties and unanswered questions with infertility. Many of the choices you have to make are left up to chance.

 

Chance.

 

Was I going to take this chance?

 

My options were freezing my eggs or choosing a sperm donor to try to conceive with and be a single parent.

 

Ohhhhh no. A single parent? No. I can barely afford myself living alone on my salary. What kind of life would I be able to provide for a child at this time? Not the one that I had PLANNED, that’s for sure.

 

I had a lot to think about. And I wanted to get out of there as soon as possible. Although I had an ultrasound to do in order to check on the cysts, I just jetted out of there. And once I got to my car I cried.

 

A lot. Loud. Angry cries.

 

I messed up.

 

Somewhere I had made the wrong choice to put me on this path to where I am now. I’m not supposed to be here. How is this my life? How are these the choices that I am left with? How am I supposed to create my much desired future with these odds and these results?

 

If you are reading this, either you or someone close to you is asking or has asked themselves these questions as well.

 

And there’s no answer.

 

The only thing to do is make the best choices that you can with the information you have.

 

In my mind I only really had two choices.

 

The first would be to learn how to live without the family I had planned. Figure out what to do with my life as a single woman. How would I make my life fulfilled now that I was on a different path than I have ever envisioned?

 

The second choice would be to freeze my eggs. I did not know much about the process. I knew of a couple people who had been through IVF with their partners, but I was not familiar with what the process actually was. I had never known anyone who had actually frozen their eggs. The other side to freezing my eggs was that it was very costly. I was having difficulty making ends meet already. I did not have a savings account. How would I fund this costly insurance policy for my future?

 

The difference between this and an insurance policy is that with the policy, you receive a pay out at the end (or someone does). With egg freezing there are no guarantees. It’s taking a leap of faith. Did I want to take that leap of faith? The doctor informed me that the whole process would cost $16,000 the most.

 

What.

 

I didn’t have any idea where I would get that money. Is this the end? Do I just accept that I just need to be hopeful my eggs last long enough and are strong once I find the right partner?

 

I’m going to spare you a lot of my back and forth and what ifs.

 

I decided to freeze my eggs. Although my parents and a close friend offered to help me with the cost, I really wanted to do this on my own. It was important to me. I decided that living without knowing, “Well, what if I had frozen my eggs?” is just not something that I wanted to do or thought that I could live with. Some people may not think that 20-30% would be enough of chance to take. But my chances weren’t 0. That was all I needed to know. I would take my chances. Living with a failed attempt would be easier than living with the WHAT IF?

 

So I start my journey to freeze the bit of hope that I have left.

Open the Window… Here Come My Plans

Monday, October 3 was the earliest the fertility doctor could see me. Although this was only a couple of weeks from my gynecologist appointment, the time dragged on. Didn’t they know that my eggs were slowly but surely leaving as time passed? Didn’t they know that I had important questions that needed to be answered?!

Didn’t they know that I had life plans that I needed to carry out?

I took off of work the day of my appointment. Surely I would have immediate answers and either need to celebrate or cry in a corner the remainder of the day.

Little did I know that with infertility, immediate and definite answers were few and far between. 

When I walked in I was greeted by smiling faces and a comfortable seat in the waiting room. Not too long after I arrived did I get notice that the doctor was running a little behind. Good thing I had a welcome folder stuffed with information, statistics, and options to read over.

The literature included was vastly directed towards couples. “You and your partner” was the major theme of each informative piece included in the folder that was supposed to comfort me and reassure me that I had options and I was in the right place. This was not the first time I felt like I was in a place where there are not many others like me. Most people did not go at this alone. And although I have many supportive and wonderful people in my life this was something I felt like I needed to face on my own.

After a while the nurse escorted me into the doctor’s office. Numerous certificates adorned the walls behind the doctor’s chair. Clearly he was a well respected fertility doctor with much accreditation from various educational institutions. The nurse seated me in front of his desk. Once she left I looked around and noted the box of tissues in front of me and the empty chair next to me.

Of course usually this office sees COUPLES grieving, looking for answers as to why their numerous attempts to start a family have failed.

I was well aware that at the age of 34 I was well out of the societal expectancy. Yes, I should have had a partner. It’s not as if I had not wanted one or been open to relationships. I try to not think about what I did wrong or what I could have done differently in my life to avoid the situation I am currently in. I can only change my attitude going forward and control my reaction to the information given to me.

I truly believe that you things happen for a reason and God’s plan for me is absolutely perfect. For me.

So, there I am. Alone. Waiting. Looking. Alone.

Did I mention I was alone?

The doctor then entered the room.

He was a fit older gentleman. Knowledgable, experienced, and to the point.

After a brief introduction and review of my medical history I immediately wanted to get to my questions. Should I be worried about my AMH? What could I do to improve it? And what were my options?

After informing me that AMH was not a very reliable test or able to be changed, but that they could use it along with a few other tests to figure out what my situation was. He also offered me some information about my options and stated that I was a little young to be coming to him but that he would gladly help me and answer my questions. He also wanted me to have an ultrasound that day so he could look at my follicles and uterus to get a better picture of my reproductive parts.

In the ultrasound doctor noticed a few cysts on one of my ovaries that he was not overly concerned about. He referred to them as functional cysts and proceeded to look around. He told me news that I was not quite prepared for. He stated that I did have a rather healthy uterus however I did not have many follicles. Although the AMH is not a very reliable test, what he was able to see did validate the results. I was looking at a very low chance of ever being able to conceive a child with my eggs. 20-30% chance to be exact.

But how could that be? I am young, I run, I am relatively healthy. I have only had one other surgery in my life (my tonsils removed). How could I have such a low chance of ever being able to have a biological child? The one thing I was always certain about in my life. I never had a profession I ever felt like I was destined to be in, but I absolutely knew I would be a mother. How could my chances be so low?

 

My heart sank.

 

I panicked. I can’t go back. What’s done is done.

I didn’t cry. Not in front of him. I don’t like to show emotion around others. I held my ground.

He told me we would do a couple more tests in the next month to obtain a more whole picture of where me and my eggs stand and what my choices would be. I’d be getting my FSH tested along with some other genetic testing. I also asked for my AMH to be retested just in case it changed. (hopeful) I needed more answers. Fast.

Late Night Calls

I have always been worried about my eggs.

But this particular journey began on September 12, 2016 at a routine check up with my gynecologist when I asked for if he could just check on my eggs.

 

“You’re young and everything looks great. But I will order the blood work for you.”

This was not the first time I had asked about how my eggs were doing. Since I turned 30 it has been of greater concern for me. I never thought that at 30 I would be single, living in a little apartment all alone. My life was supposed to be filled with babies and dance lessons and soccer practice and family dinners. For as long as I can remember this was always how I planned my life. Living in a comfy house with my successful, charming husband and our countless, adorable children.

If you haven’t already figured it out, life doesn’t always follow your plans.

A few nights later my phone rang at almost 9 PM, which if you know me, is past my weeknight bedtime. I hesitantly answered the “Unknown Caller”.

It was my doctor. The call started out routine as it usually did and he informed me that my PAP came back fine…BUT….

he was a little concerned about my AMH number.

AMH?

I have heard a lot of acronyms in my life, but never this one. Little did I know how important those three little letters would actually be.

My doctor continued to tell me how for a woman my age, (34 at the time) .6 was a fairly low number. He did not want me to be too alarmed but referred me to a local fertility doctor to get a better idea of my situation.

And there it was.

There was no need to worry about the unknown any longer. I did in fact have an egg “problem”.

So I did what every average American does when they need information. I went straight to Google for the answers I was looking for.

 

What is AMH?

How can I make it better?

How did I get a low AMH?

Are my eggs bad? Or do I just not have many?

Or do I have a lot and they are just bad?

Will I ever be able to have a baby?

 

I soon found out that AMH is not an FDA approved test to decipher whether or not a woman in fact has a low egg count. That is what the number claims to show. My AMH of .6 put me in the low category for ovarian reserve; closer to that which you would expect from a woman age 40 or more.

Oh…so this number is unreliable. I’m certain it is because I must have plenty of eggs. Although I was always worried about my eggs in actuality I never thought my concerns would come to fruition. So the number must be wrong and the fertility doctor will do a few tests to put my mind at ease and assure me that I in fact have plenty of healthy, happy eggs waiting to create a big family for me someday.

Boy….do plans change….