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Hope is something you pee on

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

Hope is something you pee on

Tag Archives: CCRM

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!!

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