30 June 2013

End Cycle 2, Cost Update

At the end of cycle 2, I thought I'd post a cost update.  You can see the full breakdown from the first cycle here (with the cost of my follow up scan added here).  You can also see the drug breakdown comparison from my first cycle bought direct from my clinic to the Healthcare at Home order here.  For ease, costs have been rounded to the nearest pound.

Previous total cost£6996
Norethisterone delivery from clinic£11
Drugs from Healthcare at Home £584
Egg Freezing Cycle£2800
225 Gonal F from clinic £90

The total for the second cycle came to £3485.  Given my estimated budget of  £10k for 2 cycles, that's pretty much right on target.  It would have even been a bit better if I had known about the less expensive drugs from Healthcare at Home for my first cycle.  And of course I expect a refund at some point from the 10 years of storage since I doubt I'll use all ten years.  I think they refund you £150 for every year not used.

Assuming I go for a third cycle I will be able to shave off a tiny bit more- as the norethisterone didn't arrive in time, I have it set for the next cycle and don't need anymore.  I also would get a 450 Gonal-F pen from Healthcare at home as I believe that even if I don't need both doses, it would still be cheaper than the one dose I had to buy extra this cycle from my clinic.  Although I only have one Cetrotide left over so I'd need more of those, maybe it would work out to the same then.

Egg freezing is not an inexpensive process, especially when like me, you need multiple cycles.  I hope that in the couple of years between now and when I hope to use the eggs the costs may come down a bit as the popularity continues.  In the next month I will need to consider my options for paying for a third cycle.  My mother paid for most of the first two (I think I paid about £1000 of the total myself), but that is all she can afford.  I am going to speak to my step-mother about whether or not she thinks it's worth discussing it with my father or not.  I could take money out of my mortgage, or I could use my savings.  I have enough to cover the third cycle myself, although it would take a substantial amount of my savings at a time when I may need it (I'm finishing a PhD and my funding runs out at the end of the year).

Still, at the start of this process I said I probably wouldn't have done it if I had to pay for it myself, but now I obviously feel differently and that it would be worth my own savings to finish this journey.  I think that's probably worth noting.  I have no idea what the future may hold but it's clear that doing this has given me some sense of confidence or comfort that wasn't obvious at the start.

29 June 2013

Cycle 2: Day 17

Sorry again for the day delay, all due to the stupid phone company.  I'm now borrowing internet from my neighbor!

Facts first.  I got 4 eggs and all 4 were able to be frozen.  I'd like to have a bit more information than that, but I couldn't get my phone to work so instead the embryologist call went to voice-mail.  I assume they were all mature and looked good.  I hope the embryologist calls back today, but I'm not sure they will.  I had a couple of other questions, but I can ask the doctor when I go back in a couple of weeks for a follow up appointment.

The day itself was both uneventful and eventful.  My biggest gripe was that although I showed up 15 minutes early to make sure I was there for noon and I was supposed to be having my retrieval 37 hours past the Ovitrelle trigger at 12:30, I didn't even get in to my recovery room to change until 12:25 and I estimate my procedure was probably at 1:00 or even a little bit past.  This just stressed me out, which is not what you really want when you're preparing for a medical procedure.  I was assured by more than one person that it wouldn't make a difference but I was conscious of how few eggs I had to work with and the thought of losing a single one just gave me intense stress.  This was compounded by my internet based knowledge that some clinics trigger as early as 35 hours before the retrieval and since my clinic goes with 37, that already seems on the "late" side of things.  It just put a blip into my otherwise uneventful day!

So given that I was stressed I changed very quickly and was ready to go.  A bit of 'hurry up and wait'.  I could hear couples (mostly couples) in some of the other cubicles.  This is the second time I've heard a male partner be rude to their female partner during what I assume is an IVF process.  I get that men tend to fall into the 'I want to be able to help or I just get frustrated' category but seriously.  This particular couple, it was obvious she was just out of retrieval and every time she saw him she came to enough to ask how many eggs they got.  He said around 15.  Then she'd slip out of consciousness, come back, and ask the same question.  By the third time he started in with, "I already told you this!".  Charming.

Eventually the anesthesiologist came to get me and we had a nice chat.  I remembered a bit about him from the first time and I think he was amused that I remembered what we talked about.  We chatted a bit more as he got me all set, put the cannula in, put electrodes on me.  The doctor who did my procedure was not my main doctor but what I now think of as my second doctor.  I remember asking about the delay and the impact.  I also remember saying that I really wanted 4 eggs as a minimum and that if I got less I'd get depressed about it but then I'd get over it.  They had me scooting down the table into position and I was alert when the mask went over my face, but not much beyond that.  I think I have a vague memory of being transfered from the procedure table to the recovery bed.  I definitely have a memory of the doctor coming to see me in the recovery room to tell me that got 4 eggs.  Although that was very hazy, I know it happened, and then also turned out to be true, so reinforces that it happened.

Eventually I came to, nice and comfortable in the bed.  The machine on my finger monitored my heart beat and a cuff on my arm did my blood pressure every five minutes.  I came around more fully and the nurse told me my friend was here so I said they could let her come sit with me.  They brought me tea with sugar and I drank that while chatting with my friend, none of which I can remember now.  I know I was starving having not eaten since  about 7 or 8 the night before so I also got some cookies and wolfed those down.  Then I got dressed and we went home where my friend made me a lovely tray of macaroni and cheese for my dinner and for 'comfort'.  Yum!

So today I feel mostly fine.  Less cramping then the first cycle, but then, I had fewer follicles.  I can still feel my ovary, so I know it's still enlarged and will stay like that until my period comes.  On my last scan I had asked my doctor if I could cycle this week in Cambridge but he said he wouldn't advise it.  His reasoning was that although the chance is small for torsion, because I only have the one ovary, his advice was to be super cautious about it and even a small risk was not one he would suggest I take, whereas if I had two ovaries he'd be less concerned.  I thought that was fair, so I'm looking at a week of walking around Cambridge this week.  But that's fine.  I need to get my exercise back on track and walking seems a good way to start.

And so that's it for cycle 2.  I'll update the costs again when I get around to it, and I'll update again when I have my follow up appointment.  I also think I'm going to see the counselor that the clinic offers as a service, so I'll probably write about that as well.  And obviously if and when cycle 3 comes on, I'll be back for that as well.  Not quite done with this blog yet!

27 June 2013

Cycle 2: Day 15

So yesterday was a big day!  Sorry to be a day behind but I got home and the phone company had shut off all the phones in my building which meant no easy internet.

Anyway, yesterday was scan day.  Back to my regular doctor.  Had a good scan and a good chat with him.  The decision was made to trigger, so my collection is tomorrow (Friday).  That's one day short of the last cycle but pretty much the same.  I have 4 large follicles and any further stimulation could cause me to lose them.  I may lose one already but we'll see.  There are also 3-4 follicles just squeaking past 11mm.  Apparently that's the threshold for finding mature eggs.  So they will sweep all of them in the hopes of finding some.  But I guess I should be looking for about 4 eggs tomorrow and anything more would be great and anything less will make me depressed and then I'll have to get over it.

So my appointment is at noon tomorrow.  This meant I took only Cetrotide last night before 10:30 (I took it around 9:30, and I did it in a restaurant bathroom.  Not ideal but it was all rather short notice and I figured that was better than cancelling my plans.).  Then at precisely 11:30 at night I did the Ovitrelle injection.  This was a different system than the one I got on my first cycle.  This one came in a pen just like the Gonal-F so super easy.  Not that the pre-filled syringe wasn't easy as well.  I like injections that are easy.

And now I wait.  Today no injections.  No food or drink past midnight.  On the first cycle my collection was early in the morning, so it was easy not to do food or drink.  This time I have to wait out half a day which is going to be a bit more challenging although obviously not nearly impossible.  Just annoying really.  Also no deodorant or anything so I'll take a shower before I go and hope it's not too warm out.  Oh, and of course there's the lovely Voltarol suppository that I just need to "pop in" before heading to the clinic.  Fun times.

I've arranged a friend to come meet me and go home with me.  Much easier this time as the first person I asked could do it.  And she's super sweet, she asked me what I wanted as some comfort food so she'd make it for me when we get back to mine.  Macaroni and cheese, you are mine all mine!

In other news I learned how I get moved from the procedure room to the recovery room.  Apparently they wheel in the recovery room bed and slide you across.  That makes sense.  I knew it wasn't the same bed!  I also asked about follow up appointments.  Apparently the reason I got charged for the last one is I had a scan.  A talking follow up appointment is free, but the scan costs.  I still find that slightly annoying, especially since I was "feeling" my ovary and I think it's reasonable aftercare to have a look and make sure nothing is wrong.  But this time I know, or rather, expect that my ovary will take a while to get back to "normal" so I won't have a scan after but I will make a follow up appointment to discuss what the next steps are.  If I do get 4 eggs I'll have 10 on ice.  That's really not enough for me to feel comfortable.  But I can probably only afford one more cycle.  So we'll see.

The only differences between last cycle and this cycle other than my taking conception vitamins was one less day of norethisterone prior to stimulation.  There haven't been any other impact factors.  I mean, other than I'm stressed, but I'm pretty sure I was stressed for the first cycle.  And I mean "life" stressed not egg freezing stressed.  Meh.  It is what it is!  I'm doing the best I can!  (Repeat).

Oh, the other thing I talked about with the doctor was in vitro maturation of eggs that aren't mature.  He wasn't in favor saying the results are really generally poor and in fact as a clinic they are so underwhelmed by the success of in vitro matured eggs they don't offer it.  Again, who am I to argue with the doctor?  Their success rates as a clinic are high.  I'm sure that it does work for some people, but I guess they look at it as an overall benefit and don't see it as panning out.  So one less thing for me to consider.  That's fine.  I'm okay with that.

So anyway, depending on when I have home internet again, I'll update with the results.  Nothing to do now but wait! (And drink gallons of water.)

24 June 2013

Cycle 2: Day 12

Had another scan today.  Still at about 6 follicles or so.  Two of them are larger and could be collected but the doctor is hoping the other four will grow and catch up.  I had a good talk with this doctor today.  I said that I was feeling a bit discouraged about the lower follicle count compared to the first cycle.  She told me that I really had no reason to be discouraged.  That it was a reasonable outcome for someone of my age and with one ovary.  And that I was responding well to the medication.  She said that when they usually see women it's because they are having fertility problems, and I don't even know if I have any problems at all.  She reiterated that it's really a lot about the egg quality.  She told me she's seen women who get over ten eggs and none are good quality and another woman who came and only got one egg and then she got pregnant.  Apparently they've also used frozen eggs successfully.  Although they were donor eggs (and so most likely younger than my eggs) there were two frozen and they got a single pregnancy.  So all of that was good.  She also mentioned that I might want to take advantage of the free counseling that the clinic offers.  I mean, I'm not entirely sure what a counselor can tell me.  I sort of know what the deal is, it's just stressful.  On the other hand, I feel a lot better having talked to the doctor and so maybe it would help to talk to the counselor and considering it's free, why the heck not?

I also asked the doctor about the protocol they use compared to the ones I hear about from the other egg freezers I know in the States.  It seems like the UK protocol is much simpler- less drugs and almost no blood work other than the initial blood work.  The doctor told me that they've looked at all the results so far from these procedures and they feel they simply aren't necessary.  Obviously each doctor will have a different opinion but I do feel good that they at least keep up with these things.  My clinic is one of the best in the UK with high results to prove it.  They have to know something right about what they're doing.

In the meantime I continue on the same schedule- 225 Gonal-F and .25 Cetrotide.  My next scan is Wednesday and collection will probably be Friday or maybe Saturday but I'll know for sure after the next scan.  Seems like I'm on the same time schedule as the first cycle.  Oh, and I did say something about how I felt like it was along time and she assured me that this is not a long time.  She said some people take 3-4 weeks, and that's a long cycle!

21 June 2013

Cycle 2: Day 9

So back from my scan and of course I am depressed.  There just aren't as many follicles as last time.  The doctor (not my normal doctor) measured 6 although I think I saw at least one or two more.  One is way out ahead so it probably won't last the duration.  At this time last cycle I think I had at least 12-14 follicles showing and I only got 6 eggs.  I'm steeling myself to get a low collection number.

Of course this is upsetting.  Firstly, it's upsetting because it's all conjecture.  Each follicle COULD yield an egg and I could do just as well as last cycle, I just don't BELIEVE that is what is going to happen.  So that sort of sucks.  If I go on a 50% yield, I'm looking at a collection of 3.  Of course any is better than nothing.

This is what I keep telling myself.  I mean, what am I getting so upset about?  This is where my fertility is at right now.  If I was trying to get pregnant, this is what it would be.  If I wait around for when I hope to have children, it's going to be worse.  The only thing I can be doing right now is this, and this is what my body produces.  Any frozen egg is better than no frozen eggs.  But it is so hard to not want to place blame or look for some sort of 'answer' to why it's not as good as I want it to be.

I recently answered some questions for an interview on egg freezing in an Australian magazine and the interviewer asked me if I wish I'd done this sooner.  Yes.  Absolutely, 100% yes.  It's hard not to feel like I've let my best years go.  Obviously when I was younger I had hope that things would just work out but that's not what's happened.  So now, at almost 39 I just feel annoyed that I didn't know about this sooner, didn't do it sooner, let all those better eggs go sooner....

Not that any of that is productive.  The only productive thing that I can do right now is exactly what I'm doing.  I need to just try to stay focused on that and not let myself get worked up about things that are completely out of my control.

But it's hard.

Anyway.  I'm sticking to the same dose for injections.  Next scan is Monday with again not my usual doctor but not the one I just saw either, instead the one I saw at the start of my cycle (which I think covers all the doctors because I think there is only the three).  I'll update here again after the scan.

18 June 2013

Cyle 2: Day 6

So I just got back from my first scan after starting the stimulation.  As per last cycle, my follicles are slow starters.  The doctor measured 7.  He also measured my cyst, which does not appear to be growing.  I was a bit disappointed by 7 and thought that was less than the last cycle.  He checked and said at the first scan in the first cycle, he had noted 8.  So yeah, one less so far.  He didn't seem worried though and said that I just seem to have slow starters and it's too early to be able to tell anything yet.  He's keeping me on the same drug protocol as last time.  So I guess that means I'm definitely in for a long stimulation cycle.  And I'm preparing myself for a low number collection.

I think what's hard about the medication is how quickly I can get upset.  I honestly don't notice any other side effects of the stimulation drugs.  But when something happens that could possibly be upsetting, I feel like it's devastating.  That could also be because this process is stressful in general.  Obviously what anyone who is doing this wants is the most mature eggs as possible.  It's frustrating to know you can't really do anything about it.  What the scan shows is what your body has.

I keep reminding myself that if I had two ovaries, these would be really good results for someone who is almost 39.  In fact, if I was getting twice the number, I would be pleased.  So it's not really my body at fault.  I'm simply asking or wanting too much from it.  I'm being unrealistic.  I've come across women with two ovaries who have gotten the same number of eggs from their cycles.  I shouldn't be upset.

I guess it's not that I'm upset.  I'm just disappointed.  But then I remind myself, that the very best thing I can be doing right now to address this, is exactly what I'm doing right now.  And that makes me feel a little bit better.

13 June 2013

Cycle 2: Day 1

So I went to the clinic today for my first scan and tonight is my first injection.  I remembered to take the Gonal-F out of the fridge so it won't be too cold.  My scan was fine.  Not with my usual doctor as he's on holiday, but with his colleague who I've seen before.  There wasn't much discussion or information.  Just an 'all good' and a schedule for injections!

I had to pay the big bill today, but since I've already paid for my drugs, that should be most of the money done for two cycles now.  I'll do a cost update at some point with all the costs.  I was paying for the egg freezing and talking to the office manager and I complained about how my follow up appointment was not included and that I had to a) request it and b) pay for, on the last cycle.  She agreed with me that it wasn't good but needs to talk about it with the doctors.  Meaning, she couldn't give me anything for it, but I'm glad I complained.

I was also slightly distressed that my cycle seems to be coinciding with all of the doctors being busy or away.  I tried to schedule my next scans and could only schedule the very next one, and a day after what I wanted.  So my next (second) scan is on Tuesday.  I really wanted Monday morning but there weren't any openings.  This means I need to go up to Cambridge, come back from Cambridge, go back to Cambridge, and come back from Cambridge whereas I really just wanted to go up and come back once.  Oh well.  It's a minor inconvenience really.  But the doctors being away is a bigger one.  I'll find out more on Tuesday about when and with who my next scans are going to be.  Not entirely pleased about it at the moment but I'm hoping it sorts itself out somehow.

Not much else to say yet.  I did pick up a sharps bin from the clinic as I didn't get one with my drug delivery (even though I was supposed to).  So at least that's sorted.

Right.  I guess I better go get it done!

11 June 2013


So my period has arrived.  Full flow started around 4pm or so which makes tomorrow 'day one' according to my clinic.  I will call them in the morning and arrange my first scan for Thursday which, if all looks well, will also be day 1 of injections.  For my first cycle I started shots on the 9th and had the retrieval on the 26th.  This month my first shot will be on the 13th. If my cycle takes as long, that puts my retrieval at the 30th.  I really hope it doesn't go as long this time!  But I have enough drugs ready in case it does.  I'm actually sort of excited to get this all going again.  I don't think I'll do the day by day journal that I did for my first cycle, but I'm sure I'll update with things that occur to me.

I will say one thing of significance which is, this time around I feel much more calm.  I've done this once already so there are less 'unknowns' and questions that I have.  I've also come to terms with how I feel right now about where I'm at relationship wise, with thinking about having children in the future, etc.  I'm also not scared or nervous, although of course I'm a bit anxious because there is always the worry about how many eggs you're going to get.  But that's the only thing I'm worrying about.  Everything else is much calmer this time around.  So that's good.  And a good thing to know if someone reading this is thinking of doing a second cycle.  I think the second cycle is probably a lot easier.

She says at the start.

08 June 2013

F*** You, Post Office

I've had a very frustrating morning.  I only had enough norethisterone for 7 days and then the head nurse said after discussion I could take them for 9 days but they had to send me more.  So I ordered them and they mailed them to me but I was away last week when they arrived so I got a post slip and had to arrange redelivery.  I've waited all morning for it, it's not here and now the post office is closed for pick ups.  This means I will not be on the norethisterone for the 2 additional days.  I'm annoyed about this but I hasten to add, not panicked.  Mainly because my doctor suggested I only take them for the 7 days anyway (when I said that was what I had left from the first cycle) so it was a late change to add the 2 days.  And not by my doctor.  So it goes to show how... 'not rigorous' the process is.  Still, I had in my head I'm going to take pills for 7 days and then the pills don't arrive due to my FUCKING post office people and it really makes me angry.  I should have just not arranged the redelivery and gone this morning to pick everything up.    SO ANGRY.

01 June 2013