We met with our lovely RE today (have I told you how happy I am that we switched REs and that we're not still with this guy?). I've said this before, but my RE reminds me so much of my father's family - my uncle, to be exact. Just a tall and lanky old British dude with a fabulous sense of humour, who is incredibly knowledgeable and very patient.
Today was the first time that Devon had met him, as it's usually just me for the non-IUI procedure visits. Devon has missed as much work as she can for our appointments, and after the first ultrasound, I didn't feel she needed to be there for every one, or for a quick meeting with the RE. But today was important, and I was so thankful she was with me.
We basically told him that we're frustrated and need to make a long-term plan, because IUI after IUI after BFN after BFN is maddening. He went through our options and was very honest about everything.
Because I have no known fertility issues, and that I have age on my side, he was quite surprised that we haven't got pregnant yet - or that we didn't keep the one that we did get pregnant with. From what I understand, although Clomid helps with increasing the odds with more follicles, it is more helpful for people who actually have trouble ovulating, which I don't.
As I have responded very well to Clomid treatment, in the sense of mature follicles, he is discouraging us from going the superovulation and IUI route. I am already producing 2-3 good mature follicles with Clomid, and with superovulation, I imagine they would cancel the insem if there were much more than that anyway. I had no idea that the rate of multiples with superovulation and IUI can get as high as 30%. A superovulation cycle will run us about $2,000.
He mentioned switching to Femera to avoid the thin lining conundrum that comes with Clomid. He wanted us to do our research, as Health Canada (our FDA) has not approved it for anything other than use in breast cancer treatment. He told us that decision was based off a very small clinical trial that showed defects in babies born to mothers who used Femera for ovulation, the results of which have been disproved since. Motherrisk, who I see as the Godfather - or rather Godmother - of all things drug and pregnancy related, does a very good job of giving the facts here. The interesting part is that the drug will probably be covered by my healthcare plan if it is not used (on paper) as a fertility medication. So silly. And, paying $50 is nothing compared to the other costs of this. The most important thing to note, however, is that when it comes to actual pregnancies, Femera and Clomid - for my situation - are essentially the same and Femera won't necessarily be better for us.
So, basically, we found out that there is not a heck of a lot to try between IUIs and moving to IVF... and IVF is what our RE ended up, in a roundabout way, suggesting. He was very understanding of our frustrations around time and money, but suggested we consider IVF after one more failed IUI attempt. At my age, the medications would "only be" around $2,000 and the procedure would be about $5,000. Add another $1,000 for sperm/shipping (just one sample) and we're looking at a total of about $8,000. And that's the absolute minimum. The costs can creep up easily.
With IVF, our pregnancy odds will be about 50%. Here is where I get tripped up: Where the hell do you go after a failed IVF attempt? After you've spent $8,000 on one cycle, where does that leave you if you end up with a BFN except in a ridiculous amount of debt? And yes, I want to feel positive about our chances, but I have to let myself go here as I sort through this stuff in my head. In what other situation can you think of in the entire world would you pay that much money for something that may or may not work out - a 50/50 chance? It's the emotional investment, as well as the financial one.
Somehow I feel better about throwing out our $1,000 a month that we spend on IUIs. But of course, so far we've almost spent the amount of money on IUIs that we would spend on an IVF treatment. It's hard to not go into this process thinking you're going to be that couple that gets pregnant on the first attempt or two. Now we know different.
**Can anyone please educate me on a second round of IVF? Specifically what you wouldn't have to pay for the second time around, using the same embryos from the first time. I imagine you wouldn't have to pay for the medications (?) and obviously some of the lab costs. Is it significantly cheaper with subsequent attempts?**
Devon and I managed to grab a coffee after the appointment and have a quick chat before returning to our respective jobs. This is what we've decided for now: We have two samples left of our donor that are paid for, so if we go ahead with two more IUIs, we would be paying for the procedures only. Two more months of IUIs will cost us $400, which is a relatively low cost. So we will commit to two more months of this. I refilled my Clomid prescription, and if this next one is a BFN, I may switch to Femera for the final month.
By May, we will have a better idea of whether our condo has sold (going on the market tomorrow) and a better idea of where our finances stand as a result of that. Ideally, we will be able to make enough money to pay off our existing debts so that will free up about $700/month that we are paying to our bank loan and the $200/month that we are saving to pay back some other money we had to borrow from other sources. Whether we apply for a line or credit, get another bank loan, or cash out my RRSPs, we haven't decided, but somehow, we will have to find a way to pay for the IVF.
I can't take much more than two more BFN, so it feels like the way to go. However, I am having trouble getting past this sinking feeling in the pit of my gut that we will never be able to get out of debt AND that's it's not a guarantee. Of course, a family is worth the costs, but it is tough to carry around the weight of debt with every step you take.
Another thing that I need to get over with IVF is the fact that our baby will not be conceived inside of my body. I don't know why I have such a mental block over that. Don't get me wrong - there is nothing wrong with it and know that it is necessary in a lot of circumstances, but there's just something warmer about it all happening within.
Then again, there is nothing warm about recurring BFNs.