• About Me
  • Disclaimer
  • Glossary
  • My stats

Hope is something you pee on

~ …trying to survive infertility, IVF and egg donation.

Hope is something you pee on

Category Archives: CCRM

Controlling your (in)fertility

09 Friday Aug 2013

Posted by mybrokenoven in CCRM, Diminished Ovarian Reserve (DOR), Musings

≈ 5 Comments

As I’m sitting here happily drinking my morning coffee I started thinking back to the time, not so long ago, when I wouldn’t let myself drink coffee, or even tea, forget about wine/beer/margaritas. The time when I was eating kale like it was my job. And blueberries and pineapple (only the center) and avocados and avoiding anything with sugar or corn syrup. I was doing fertility yoga, avoiding nail salons, doing meditations and spending hundreds of dollars a month on supplements. I was driving myself crazy. I have some thoughts on that time, from the other side, for those of you who are there now. For me (this may not be true for you) this was what was going on…

  1. I needed a sense of control. Infertility takes away your control over your body and over your future. These measures, however silly they may seem, were a way for me to exert some control over my life.
  2. I needed to DO something. There’s lot of waiting involved when you are “actively” dealing with infertility. You’re waiting for your cycle to start, waiting for your appointment, waiting for the cyst to go away, waiting for the blood results to come back, waiting for a call from the doctor… it was something to DO.
  3. I wanted to make a “deal”. I was raised to believe that if I was good enough, tried hard enough, did well enough I could do whatever I wanted. Generally, this has been true. So I felt like if I did everything, tried everything, ate perfectly, exercised properly and consistently, avoided anything potentially harmful – if I made myself the perfect vessel I could have a baby. I just needed to figure out what all the right things were, and then I could have my family. I wanted to make a deal with the universe – “See, I’m perfect. I did everything right. Can I have my baby now please?”

And it didn’t work (obviously). And so I started getting into this very emotionally damaging cycle of “it must not be working because I’m taking the wrong brand of supplement” or “I must not be exercising/eating/mediating enough”. Eventually this morphed into a general “I’m not good enough.” Even though I knew (logically) that I had a medical condition and even though I understood very well the odds of us getting pregnant I still felt like I could make a deal, if I just tried hard enough. After all, I had read the well-worn stories we’ve all read about the woman from Europe who took the supplements and suddenly had lots of healthy eggs, or the woman who started doing yoga and got pregnant naturally after years of failed fertility treatments. If they could do it, why not me? I know now (and knew then too although I didn’t want to admit it) that for every “success story” there are thousands of “failures” (although I don’t like to think of them that way anymore – now I think of them as “the ending we hope for” and the “road less traveled”).

I’m not trying to take away your hope,or telling you not to try every single thing you can, especially if it will make you feel better in the long run to feel that you did everything you possibly could. What I’m saying is cut yourself a break. Your fertility doesn’t hinge on one glass of wine. Eating one more pineapple isn’t suddenly going to create the perfect viable egg. Missing one yoga class doesn’t mean you’re not “committed to the process”.

I’m still dealing with feelings of shame and inadequacy because of my infertility. There’s still guilt. But it’s getting better. The unwavering love and support of my husband, my parents, my sister and my friends is going a long way towards healing those wounds. And I finally recognize that no perfect supplement cocktail, no magic pineapple, no perfect down dog could have cured me. My infertility isn’t a result of anything that I did, and nothing that I can do will fixed it. And it’s a relief to let go of the responsibility.

a6bb110d943fc3c5f14686dd17c93765

CCRM info

28 Monday Jan 2013

Posted by mybrokenoven in CCRM, Diminished Ovarian Reserve (DOR), IVF

≈ 4 Comments

Tags

CCRM, CCRM insurance, CCRM ODWU, fertility cocktail, fertility supplements, male fertility supplements, poor responders

So, a while ago I promised I’d put up “fertility cocktail for poor responders” from CCRM. But first let me say that you should get checked out by a doctor before you take any of these, in particular I think folks with thyroid issues should be careful. So, that’s my disclaimer. I’m a doctor, but not that kind of doctor! I was also prescribed DHEA – 25mg x 3 day. Also, at the bottom I talk a bit more about the financial side of CCRM and our ODWU. Finally, I’ve linked to the particular supplements that I used – hopefully this will give you a starting place when you’re looking to get supplements. But please, investigate the quality of any and all herbal meds or supplements that you take. They are not all created equal! The quality of different brands can change through time, so what was great for me may no longer be the best option. However, these were the ones I found that were the best quality for the price.

Poor Responder Supplement for Women **Ideal supplementation 3 months prior to retrieval

  • Myo Inostol 2gm (twice a day)
  • Melatonin 3mg (at bedtime)
  • Co Enzyme q10 400 mg (twice a day)
  • Omega-3 fatty acid 1000mg (once daily)
  • Vitamin C 500mg (once daily in the AM)
  • Vitamin E 200IU (once daily)
  • L-arginine 1000mg (twice a day)
  • Pycnogenol 100mg (once daily)

Male Fertility Supplements

  • Co Enzyme q10 200mg (3 times a day)
  • Omega-3 fatty acid 1000mg (once daily)
  • Vitamin C 500mg (once daily in the AM)
  • Vitamin E 400IU (once daily)
  • L-arginine 1000mg (twice a day)
  • Pycnogenol 100mg (once daily)
  • Folic acid 400mcg (once daily)
  • Centrum with minerals (once a day)

We also got back our insurance reimbursements from our ODWU at CCRM. We have CIGNA, and they are AMAZING. With our hometown RE everything is covered except a few of the blood tests and the office visit copay ($30) so each of our cycles has ended up costing us <$1000 out of pocket, which is incredible. CCRM is out-of-network for most insurance companies – the lady said it had something to do with their proximity to a hospital? I didn’t understand, but whatever, for almost everyone it’s expensive and it’s out-of-pocket. We paid ~$5000 for our ODWU, and after submitting all of the reimbursement forms we have gotten $1000 back. So that’s $4000 for one day of tests even with our amazing insurance. Not trying to disuade anyone, but be aware.

{In this particular post my brokenoven is a participant in the Amazon Services LLC Associate Program, and affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com}

Decisions decisions

03 Thursday Jan 2013

Posted by mybrokenoven in CCRM, Diminished Ovarian Reserve (DOR), Donor Eggs

≈ 4 Comments

Tags

CCRM, donor egg, IVF, sister

I’ve made a few decisions.

  1. I don’t want to cycle at CCRM. They’re great and all and we’re going to finish out all of the testing that they advised and take the supplements but it’s too expensive, too far away and our chances (even with them) are just too slim.
  2. I’m going to cycle one last time with my RE here. She has advised against it, but reluctantly said she’d do it if we were set on it. I’m going to set up a meeting with her later this month to discuss it further and to discuss the possibility of using my sisters eggs. I feel like I need to do one more cycle using my OE. Maybe because the last time it worked, maybe because I’m stubborn, but I think I need to do it for my own peace of mind.
  3. I’m going to ask my sister to start moving forward with all of the tests that she would need to be an egg donor. I’m secretly concerned that she may also have DOR (both for her sake and for ours) and so I don’t want to absolutely get my heart set on her DE as an option. She could also change her mind, and I would completely understand. I would be a little crushed, but I would understand.

I’ve been reading and thinking a lot about DE, and I worry most about the effect that it would have on her. IVF is a painful, long and invasive process, and I hate to think about her having to go through it. I also worry about the long-term emotional ramifications. I’m pretty sure that I know how I feel about it, and S has been on-board from the beginning but I worry about how she would feel in the long-term. It’s a complex, confusing and emotional process.

I don’t know if I would consider DE if they weren’t from my sister – that genetic link is critically important to me (as it turns out). What if the baby looked like my sister and not like me? I could live with looking down at my baby and seeing my sister’s eyes, trust me. But could she?

I read something this morning that has fortified my resolve. Someone said “The donor provides the blueprint, but you build the house.” I like that.

Donor soul?

31 Monday Dec 2012

Posted by mybrokenoven in CCRM, IVF, Musings

≈ 8 Comments

Tags

AMH, CCRM, donor eggs, sister

So much has happened that I don’t know where to start. This isn’t the beginning but it’ll have to do for now.

As I’m driving with my sister over the holidays she casually asks what our next steps are going to be with the fertility stuff. I briefly fill her in on not being able to afford CCRM, my new AMH (CCRM called on Dec 21 and told me my AMH had fallen to <0.1 – Merry Christmas, you’ll never have children!), that I’m feeling lost and hopeless, that I’m starting to consider adoption. She’s quiet for a minute and then she says “I don’t know how you’d feel about this, but assuming everything is fine with my reproductive system, I’d like to donate my eggs to you. I’ve looked into it, I know what’s involved. The shots, the 60-70 hours of doctor visits, the procedures. After all, we have the same DNA. We could do it this July, if you want.” I promptly start bawling. It was such a kind, selfless, incredible gesture. I couldn’t (and can’t) wrap my head around it. Here’s my baby sister – the one I tormented, teased, played with, fought with – offering to give me the greatest gift in the world. offering to go through a good deal of trouble and pain and suffering to help me fulfill my dream. Offering to allow me to carry and to raise a child – her child, OUR child. I can’t put my thoughts (much less my feelings) into words. If her kidneys were failing I would donate her one of mine without a second thought. This felt like her offering to give me a part of her soul, because she could see that my soul was failing.

S was equally shocked and awed by the offer and ultimately has left the decision up to me. I don’t know if we’ll take her up on it, we very well might. What I do know is that the gaping black hole of despair and hopelessness that I’ve been carrying around inside of me has shrunk. The edge of the abyss has retreated. I am forcefully reminded that my life is good – I have people who love me, family who will do anything to help me. I am reminded that infertility doesn’t define me – I am greater than the sum of my ovaries. I also realize that I need 2 children, because wow, everybody needs a sister.

my-sister-quote-jamart-photography

CCRM visit

19 Wednesday Dec 2012

Posted by mybrokenoven in CCRM, Diminished Ovarian Reserve (DOR), IVF

≈ 4 Comments

Tags

CCRM, Dr. Brown, insurance, ODWU

It wasn’t what I expected. Mainly because (as it turns out) we are out of network so insurance will only cover about 30%, as opposed to at home where it covers 95%. If we decide to go the CCRM route we’ll have to take out loans which I’m not ok with. And man, they’re expensive! The cost of the ODWU alone was $4750, not including travel expenses. (Only about $1500 of that will be reimbursed by insurance)

We arrived at midnight the night before so we could make our 7:30 am meeting on time. At 7:30 me, S and 6 other couples went into a big conference room where we got a huge binder and a nice lady talked to us for an hour about IVF, CCRM and the reproductive cycle (and told us not to blog, or read blogs). Then we checked in at the desk. S went to do his duty in a cup, then checked in at the desk. Then I got the dildocam where they checked my uterus (fine), blood flow (fine) and resting follicle count (not fine. 2 resting follicles, both >10 mm on day 5. She thinks 1 was probably a cyst. Not fine at all). Then checked in at the desk. Then we went to the business office where they gave us the bad news. Then we checked in at the desk. Then a meeting with our Dr. Then checked in at the desk. Then a meeting with the lab business office where we had sign all the weird paperwork about who gets our embryos if one of us dies, or what we do with them if we divorce, etc. Then lunch. They are nice enough to give each person a coupon for $5 at their snack shop which covered our sandwich and chips. Then checked in at the desk. Then a meeting with the nurse where she gave me a new list of supplements (I’ll post later) and went over procedures and medications and we watched a movie about chromosomal testing. Then checked in at the desk. Then a horrific hysteroscopy with Dr. Brown (more below). Then checked in at the desk. Then blood work (7 vials for me, 4 vials for S) and then it was 3:45 and we checked out at the desk and left for the airport, exhausted.

First, my follicle count. I’m clinging to the belief that the low number of follicles is somehow due to the Clomid cycle last month. More likely, however, is that I’m still recruiting follicles waaaaay early and so by the time they start looking for them (CD3-5) all of the little ones are already gone and so we don’t actually know my resting follicle number. The other alternative is that my DOR has gotten much worse over the last few months and there aren’t many follicles, or much hope, left. I had hoped that the supplements would have helped a little with the early recruitment (by magic perhaps?) or at least given me a few more resting follicles. But who really knows?

Second, the hysteroscopy. I’ve already had an HSG and figured it would be like that. IT’S NOT. First, she had a hard time threading my cervix (after the HSG and IUI’s I’ve had that done a lot, and no one has ever had a problem. In fact, several people have commented on how easy my cervix is to navigate, which is a strange thing to know about yourself but I digress). Also, she didn’t put any numbing agent on my cervix before she gave me the shots (I know it exists, my other doctor uses it) and so they hurt quite a bit. By this time my uterus was painfully cramping. Then she filled my uterus with CO2 so they could move the camera around more easily. She said “You may experience some minor cramping with this, and when you sit up the gas may make your shoulders ache. Holy mother of god, that is not minor cramping. After she was done (everything looks great!) I had to lay on the bed for a while because apparently people often faint. When I sat up, I immediately started to feel an excruciating aching pain in my right shoulder. My right arm curled up and in on itself, and I couldn’t move my hand. The nurse said that’s due to the gas escaping from my fallopian tubes and settling in my shoulder joint, compressing the nerves. Of course, I immediately picture those plastic waving guys in front of the gas stations and imagine my fallopian tubes waving wildly about in my stomach. The shoulder pain continued for about 20 minutes an then it was just gone. BUT, after several hours I started to get a terrible shooting pain under my ribs, like a stitch from running only across a bigger area. The only way I could get it to go away was to lay on that side with my arm stretched out. Turns out that’s from the gas too, and is super common. That lasted all night long.

Finally, the money. We’re very fortunate to have had insurance cover the cost of treatment thus far. I know most people don’t have that. We can’ afford to spend $20,000 on a treatment, especially a treatment that may or may not work. Dr. Brown said she thought our best bet was egg banking – going through several retrievals and freezing the embryos – so that when we do the chromosomal testing etc we only incur the cost once, and we have enough eggs that it’s likely at least one will be viable. But that’s $50,000, at least. I don’t know what to do. S says we need to go for it – then we’ll have the piece of mind that we tried everything. I feel like $50,000 is a huge risk, and we may still end up with empty arms. We should save that money and start looking at other options.

Right now, we’re gonna wait and see. Start the supplements she recommend, wait for the results of all the tests, and see what her final thoughts are. I think we should go back to our old RE (read here – free) armed with all of the new information and see if she’ll cycle with us once more (for free(ish)). Then we can decide about CCRM.

CCRM phone consult

13 Thursday Dec 2012

Posted by mybrokenoven in CCRM, Diminished Ovarian Reserve (DOR), IVF

≈ 1 Comment

Tags

CCRM, Dr. Brown, phone consult

We talk to Dr. Brown from CCRM (Colorado Center for Reproductive Medicine) today. I LOVE HER. She was personable, down-to-earth, easy to talk to, easy to understand AND she never once suggested donor eggs or said the words “advanced maternal age”. Yessssss

The conversation started by her asking us to go through our past reproductive history. She clearly had our records in front of her but I think she wanted to get a feel for how much we knew or understood about the process. Then it was the standard questions about allergies and surgeries and all that. I asked a few questions (For example, “Do you have a minimum requirement on the number of follicles need to go forward with retrieval?”;  “No. Obviously if it’s very low, like 1 or 2, we’ll have a conversation about the risks and your chances but ultimately the decision is yours and your husbands”.  ) and then she went through our one day work-up (ODWU). They want to redo all our tests in their lab (standard operating procedure when you change clinics) and then do the litany of tests CCRM is so famous for – doppler in the uterus and biopsies of the endometrium and DNA analysis of the sperm and whatnot. Yes, CCRM test us! Figure this out! Help me make babies! Test all the things!  DO ALL THE THINGS!doallthethings

She said our case is by no means hopeless, but she’ll know more after they get all the lab results back (obviously). She said they have very finely tuned protocols for poor responders (in particular she thought EPP might work for me) and since my resting follicle count is pretty good (8-11) we have the possibility of getting more eggs. And hopefully, one of those eggs will be the good egg we’re looking for.

She didn’t have any comment on the supplements (I don’t think she could actually advise yet as we weren’t officially patients at that time) but said she would help me tweak those after we got the lab results back.

I feel good. Better. I know it’s still a long shot but it’s nice to have someone believe in us and be willing to help us. Cross your fingers – here we go!!

UPDATE – As it is CD1 for me today (Dec. 14) I called CCRM to schedule our ODWU. Appointment is Monday!!

Something is better than nothing.

29 Monday Oct 2012

Posted by mybrokenoven in CCRM, Diminished Ovarian Reserve (DOR), IVF, Stimming (Taking Ovarian Stimulation meds)

≈ 8 Comments

Tags

Co Enzyme Q10, DHEA, herbs, Infertility, Melantonin, Myo Inositol, Vitamin D

Gulp!Well, I said at the beginning of this that I would share everything, so I may as well share what I’m up to now. But first a disclaimer – I know you’re not supposed to take medicine that isn’t prescribed to you (even herbs). My RE specifically told me not to take certain medicines and herbs (In fact she said the people that did were “Desperate people grasping at straws”). I am, at this point, knowingly and willingly choosing to ignore all that advice. I am also (without a doubt) a desperate person. And so.

S and I have decided to change clinics.  We’re exploring the options but CCRM http://www.colocrm.com/ keeps rising to the top. After a little bit of searching I was able to unearth the “female cocktail” that Dr. Schoolcraft (from CCRM) prescribes to his DOR patients. I found a lady a year older then me with similar AMH and FSH numbers and I am going to follow her protocol – after all, the longer you’re on the herbs the better they’re supposed to work (to a point). So as of yesterday I’m taking…

2g Myo Inositol 2x/day, 200mg Co Enzyme 10 2x/day, 3mg Folic acid, 25mg DHEA 3x/day, 3g Melatonin at bedtime and Vitamin D every other day. This is in addition to the preNatal vitamins  and B-12 supplements I was already taking. *I got everything on Amazon but checked out what brands were best. Important to get MYO-inositol, and micronized DHEA (from what I’ve read, but I am not an authority).

Some of the journal articles about these meds are linked below.

Effect of the treatment with myo-inositol plus folic acid plus melatonin in comparison with a treatment with myo-inositol plus folic acid on oocyte quality and pregnancy outcome in IVF cycles. A prospective, clinical trialhttp://www.europeanreview.org/wp/wp-content/uploads/780.pdf

List of publications about MI, FA and Melatonin (and Inofolic, which is a premix combo of these things) http://www.inofolic.it/drupal/?q=en/node/45

From the folks who began using DHEA for infertility http://www.centerforhumanreprod.com/dhea.html

And some warnings http://journals.lww.com/co-obgyn/Abstract/2012/06000/Does_dehydroepiandrosterone_have_any_benefit_in.4.aspx  http://www.advancedfertility.com/blog/coenzyme-q10-and-fertility/

Maybe there’s something to it, maybe there’s not. But it’s better then doing nothing. And the Melatonin sure helps me sleep!

Enter your email address to follow this blog and receive notifications of new posts by email.

Archives

Follow me on Facebook

Follow me on Facebook

Follow me on Twitter

My Tweets

Top Posts of the Week

  • How old would your child be now?
  • A tale of two sisters

Categories

  • 2WW
  • Betas
  • CCRM
  • Clomid
  • Diminished Ovarian Reserve (DOR)
  • Donor Eggs
  • fear
  • Guest Post
  • Infertility and step-kids
  • IUI
  • IVF
  • Miscarriage
  • Musings
  • Pregnancy
  • pregnant after infertility
  • prenatal depression
  • Results
  • Stimming (Taking Ovarian Stimulation meds)
  • twins
  • Uncategorized

Enter your email address to follow this blog and receive notifications of new posts by email.

Website Powered by WordPress.com.

  • Follow Following
    • Hope is something you pee on
    • Join 210 other followers
    • Already have a WordPress.com account? Log in now.
    • Hope is something you pee on
    • Customize
    • Follow Following
    • Sign up
    • Log in
    • Report this content
    • View site in Reader
    • Manage subscriptions
    • Collapse this bar
 

Loading Comments...