One day at a time...

Wow, it is like I blinked and all of a sudden, it is summer. I cannot believe how quickly time flew by!

Here is an update about what happened in the last month or so:

After my conversation with the clinic in Denmark, I was convinced, I had found the right place and I relaxed a little. There was not much I could do but wait. I contacted the US sperm bank and two EU sperm banks to find out how to transport the sperm to Europe. The US sperm bank had a (when not cheap, but at least) decent price for the transport, one of the EU banks made me an offer that was 4 times as much and the last bank took more than 4 weeks to respond at all. Customs never responded.

When I contacted the clinic again and asked them to sign the forms for the US bank so that I could transport the sperm to their clinic, they refused. After a few emails back and forth, they said they could not sign it, because there is a law that says they could only use sperm from a EU clinic. Interesting! When I had my skype consultation (which I recorded) the doctor said "yes, yes, yes" they would sign all the forms from the US bank, no problem. Only if I had a problem with that US bank did I need to contact an EU bank.

I was shocked and disappointed. The fact that they had said, I could use my US donor was one of the deciding factors why I had wanted to do IVF with them and now it all fell through. My mom and my best friend were very critical about importing sperm anyway, because of all the risks involved with the transport. I did not know what to do but I knew I could not afford the high price the EU bank wanted. I was so busy with work and only caught about 4 hours of sleep a night, because I had signed up for some extra workshops. While I was dealing with all of this, my US donor sold out. I felt numb from all the stress and could not really deal with it for a week or two before I got back on track.

When I got back to thinking straight, I thought about what had just happened. Did the doctor consciously lie to me on skype when she said she would sign everything but then didn`t? Or did she really not know? But isn`t it her job to know these things?

Right after my consultation, one of the clinic workers sent me a contract to sign. The contract did not have an amount listed of the costs, which I found strange, but I did not sign it anyway. The doctor had said she needed and ultrasound from the month before I would start the IVF to see if everything was OK. So, I decided not to sign any contracts before I had not done the ultrasound and knew that I could go on with IVF this summer. I did not want to be bound by a contract and then never be able to  do the IVF treatment (apart from the fact that I needed to transfer money to Europe first). When I told the clinic worker that, she said it was no problem and I could wait before signing. Then, a week ago, when I checked their website again, I saw they had raised the prices - just a week after that email exchange with the office worker. I could not believe it! She had never mentioned that during our email exchange.

I was really mad. I mean, first the false promise about the US donor and then this sneaky price increase! I was starting to doubt if I should use that clinic. But at that point it was already mid May and I was running out of time. I wrote to a few more clinics, but except for one, all that answered me had scheduled a 2-week summer break right when I was planning on doing IVF. Bummer! The one that did not wanted me to schedule a free skype consultation but the clinic worker that I called was quite rude and she ended up giving me an appointment so late in June that I am not sure how that would leave me enough time to get started soon enough. I wrote the original Danish clinic and asked why they had not told me about the price increase and if their original offer for me was still good. They said "yes"- at least something.

Due to time constraints, I might now be stuck with that Danish clinic I had originally picked. When I listened to the skype conversation, the doctor really sounded nice and (so far) they have patiently answered all of my many, many questions. There are some miscommunications, though...

Another problem that I am trying to handle right now is my cycle. Whenever, I am super stressed out and/ or on a diet like now, I do not get my period or I would get it late. This makes planning for IVF quite difficult. So, I wrote the Danish doctor and asked her what I should do. She said, she could help me plan the IVF procedure and I should just take the pill on the first day of my period. Excuse me? Apart from the fact that I do not have the pill and have never taken it, the problem is that I do not get my period and therefore also cannot take it on the first day of it. So, I exchanged some more emails with her until she got it. Now she wants me to get an ultrasound done.

So, I called around to find a place where I could get an ultrasound done without being a patient and without having to go through a consultation first. One place quoted me that consultation at up to $360 and I do not even know for what, since I do not want their consult, I just want them to do what my Danish doctor requested. Oh the troubles! I finally found a place that was willing to do it. They called me back on Friday, saying that they are willing to do it, but did not leave me a quote on my answering machine. When I called back after work, they were already closed. In addition, I would need official doctor`s orders from my Danish doctor for this and I am sure they will not understand...

So, right now, I am just trying to take it one day at a time and one step at a time. Ultrasound next. First quote, then orders. Then keeping my fingers crossed that everything is okay. If everything is okay, I might start stimming as soon as 2 weeks from now. After all of this, how nice would it be if something worked out smoothly for once!

Denmark - here I come?!?

At the beginning of the month, I had my first skype consultation with a Danish clinic. After a lot of internet research, I found a clinic that I liked and that I thought might be right for me to do IVF with.

I decided for a European clinic, because they offer refunds if the IVF process has to be cancelled at certain points during the procedure (e.g. before egg retrieval or after retrieval but before implantation). Most American clinics asked patients to pay the full amount upfront and did not offer any refunds.
Also, the Danish clinic I found offered a package deal with 3 IVFs and 2 FETs for about the same cost that a single IVF treatment would have cost me at the clinics in my area. Unlike many American clinics that make package deals only available to women that fulfill certain criteria (age, hormone levels, BMI etc.) the Danish clinic offers the deal to all patients.
And finally, I was planning on spending my summer in Europe anyway. Being off work and having the time to travel to a clinic for monitoring and treatment makes things just easier. So, seaking treatment in Europe just seemed the logical step.

The skype consultation went very well. I really liked the doctor. She was super nice and answered all my questions patiently. So, I believe, I will go with this clinic and I am currently aiming for trying IVF in July.

If everything works out as planned, I have to get an ultrasound in June to check that everything is okay. I am a little bit worried about having suddenly developed a problem, in the last half year. That would put my IVF plans on hold and I could not try it this summer in Europe. I would be so crushed! So, let`s hope and pray that there are no polyps or cysts or other bad things that could cause a delay.

Then I have to figure out where to order my meds. I will compare prices in the US and in Germany and I hope that I will find the cheapest, easiest solution.

I also have to figure out how to pay for the treatment (e.g. transfer money to Europe). But I am not as worried about this as I am worried about a polyp or a cyst or a fibroid.

Finally, I should decide which sperm I want to use. I had my heart set on the American donor that I used for my last two IUI attempts. He is exactly what I always wanted. However, I am worried about transferring the sperm safely to Denmark. How do I manage that the sperm will arrive safely and that customs won`t keep it too long, or x-ray it or something? I also found a Danish donor who I really liked, but I don`t like him as much as my American donor - partially because I do not have that much information about him. So, what shall I do?

Questions over questions and so many things left to plan and left to organize. If only it could already be July!

What just happened?

I'm freezing. Even though I am wearing a shirt, a blouse and a knitted cardigan, I am still freezing. My toes feel like little ice cubes and I think I lost all feeling in my fingertips.  I do not want to be here. I want to be in a place that is warmer.

It is quiet and am all alone in the small consultation room at this new doctor's office. It is 15 min. past my appointment. Just a second ago the TV was blasting in the waiting room so that the receptionist and the nurses could hear it even when they were in their little cubicle around the corner. But now there is no more TV, everything is quiet and cold.

I am nervous. For a second, I am thinking about leaving. I could just pick up my purse and coat and make a run for it. I look at the door and right that moment it opens. A man my father's age with grey hair, glasses, and a stern look enters the room. He introduces himself: My new doctor. His hand is much warmer than mine. His smile is not.

He looks into my face and asks me about my TTC experiences. I look at the pile of papers that he brought in with him. Did he read all the questionnaires I had to fill out? Did he read the medical records from my last doctor that I had worried about getting released in time? Before I can really care, the words tumble out of my mouth. I tell him about my IUIs, the things that worked, the things that didn't, what went wrong, how I did not like the lack of communication at my last doctor's office. I tell him about the meds I took, the sperm I used, the tests they did and everything I can think of until there are no more words left inside of me.

Then he opens his mouth and his words come out. But they do not tumble, they shoot like straight arrows targeted at my soul, my deepest dreams, my hopes, my future. He tells me what he thinks went wrong, what he would have done, and how he has all the answers. Only that his answers do not match my questions.

Every once in a while, he gets a grin on his face and drops the title of an article he wrote or mentions the results of a study he did. Before I know it, it is all about him. He has more experience than other doctors, he has higher success rates than other doctors, he has better insights into the subject matter, he has a spouse, he has six children, he has a grandchild and he has another one on the way. He wants me to understand: He has it all and he is the one - A divine gift to all infertile women... And he has a boat. An effing boat.

I look at him.
Speechless.
Is he still talking to me? Or is he talking to himself? Should I say something? Ask something? Does he know, I am still in the room?

He looks at me.

I look at him.

The central heat kicks in. 

I take a deep breath but before I can exhale, he says:

"Injectables.

We are going to put you on injectables. If my wife... if my daughter... even if my 2 year-old granddaughter came to me, I would put them on injectables...

Or IVF. We can do that here, too, you know. I am great with IVF. It is up to you. Stay here, the nurse will bring you some info material."

And with that the door slams shut behind him. I stare at the door.

What just happened here?

New year - new doctor?

I did it. I finally mustered up the ovaries to call a new doctor and made an appointment for next week. Yay!
It took me some courage to go ahead. I am still disappointed by Dr. Stork and my trust in doctors or in the whole process of IUIs has really suffered. But I knew that doing nothing would drive me crazy, too, so I had to do it.
I am so excited! Finally something to look forward to again. :)
The doctor even had a deal for a complimentary second opinion. So now, I only have to get my former doctor to fax/ send my files to the new doctor. I hope it will work out in time for the appointment and with the holiday in between...
Still, I am excited.

Update from Europe

After my IUI#4 failed, I have to decide what will happen next. What will be my plans, what should I do next? Here are some of my options:

a) Stick with my RE, get an HSG and hysteroscopy, and keep on trying
During my last ultrasound, my RE said she saw a tiny polyp in my uterus. She did not think it was big and said she wanted to go ahead with the IUI, but if it did not work out, she wanted to do a hysteroscopy to check out the polyp. I definitely want to get a second opinion about this polyp before I pay for an expensive test. And what if it is a polyp? Do I then have to pay for surgery to get it removed? If she is okay with doing an IUI now, why wouldn't she be okay with doing another IUI later?
She also wanted to do an HSG since this seems to be standard procedure at her clinic if you do not get pregnant after 3 medicated IUIs. the HSG test shows if my fallopian tubes are blocked or not. The usually are blocked as a result of bacteria from STDs. I never had one. There is really no reason why my tubes should be blocked. There are other reasons why I think my previous IUIs did not all work out so well (e.g. the nurse who took forever to insert the cath for the IUI.
So, there are two tests she wants me to do, before she will let me continue on trying. My insurance won`t cover any of the costs and she quoted me about $800 for one test and $500 for the other. Since I have not been to happy with her and her clinic, I am not sure if I will really want to pay that much more money for tests that I am not convinced I will need. Plus, I really wasn`t happy with her and her clinic and the service they provided.

b) Look for a new doctor and continue IUIs with him or her
I was recommended a new doctor and I am almost ready to make an appointment with him. However, if I switch doctors, I will probably have to repeat all the blood screening tests and he might also require an HSG test. There is no guarantee that he will be nicer and things will work out more smoothly.

c) Try ICIs at home.
From another local SMC, I found out that there is one sperm bank that sells sperm without requiring a doctor's signature. I could order sperm from them and try it at home. However, the banks number of sperm donors is not very high and you do not get that much information from them. So, I am not sure if I want to go that route. Plus, it is a little less expensive but not that much. However, the chances to get pregnant are significantly lower than with IUI.

d) Find a clinic in Europe and do IVF there next summer.
I think this would be the best solution at this point, but it is also the solution I worry most about. How can I plan such an important step from a different continent? What if they have requirement (e.g. weight) that I do not meet? Are there hidden cost I am not aware of yet? Is it true that you have absolutely no say in who the donor is going to be? What if work prevents me to come to Europe for the procedure? So many uncertainties, so many questions.

So, I am currently trying to make a decision what to do next.... Even if giving advice is difficult in a situation, any opinions are always highly appreciated.

It is Christmas and I always hoped that I would be telling my parents and family this Christmas that I would be expecting. I had it all planned out in my mind. Instead, my cousin`s wife, the most obnoxious person in the whole wide world, is pregnant... again. Having a really hard time getting into the Christmas mood at the moment....

Two Week Wait - My list of distractions

In the SMC forum, somebody posted a link to a list of things to do during the two week wait. I loved that list, it was so funny. So, I thought I would like to come up with my own list for my two week wait.

During my TWW, I will be on break from work. Even though, I always have work at home, too, there are less distractions at home. So, I think I need some routine and some daily projects to keep me from getting too impatient.

One of the challenges when it comes to writing my TWW list is that half-way through my TWW, I will travel to Europe. Maybe I will try to take my first pregnancy test in a plane over the Atlantic. Yikes! So, we will see how this is going to work out.

Anyway, here are some things I plan on doing as a daily routine:

* In the morning: A Bible Study
It is always a challenge for me to stick to a bible study until the end, but I have a good study and that I wanted to do for a long time. So, I think I will split it up in 14 parts, and do it during my TWW.

* During lunch: A good book
My bookshelves are full of books that I wanted to read for a long time. So, I picked a book that I want to tackle during the TWW.  Dividing the book up into 14 parts should work out pretty well. I am thinking, maybe I will tackle "The next best thing" by Jennifer Weiner.

* At night: A TV series
Every year on black friday, I buy DVDs with TV shows when they are on sale. However, I have not always the time to watch them from start to finish. So, I am thinking, I will pick a show that I have not finished yet, and I will watch 1 or 2 episodes at the end of the day. That way, I will make it through a season before I will fly home.

So, these are my routines, but then I should also try to find a special activity for each day. So far, I only have today planned:  A Taizé worship. We will see what comes up tomorrow.

The Mama-Bear-Mobil

When I picked an RE for this adventure, I chose one that is in the next bigger city. Since I wanted a good doctor, I did not mind the drive. But I always wondered, if it would be ideal to sit in my car for an hour or an hour and a half driving right after an IUI. I know they usually let you lie on their table for 15 min. or so after the procedure, but still.

So, I considered taking a hotel room for the day. Just so that I would have place to lie down for a little longer. But that just seemed awkward. And I might not find a room that I could move into right there in the morning.

So, if I want to lie down a little longer before I'll drive home, it has to be in my car. There is a huge parking lot in front of Dr. Stork's office and it is never really full. I could park my car on the side and lie there for a while. And so began Operation Mama-Bear-Mobil.

Here are some features of my Mama-Bear-Mobil:
* comfi seat that can be brought almost into horizontal position,
* extra soft and fluffy pillows to snuggle with while the swimmers race for my eggs,
* a thermos with yummy iced tea or ginger ale
* a good book about single motherhood to enhance positive thinking
* my iPod with relaxing music
* a diary and pen to capture the moment and jot down whatever comes to my mind right after the insemination

... there might also be some chocolate. For the nerves. I'm thinking creamy chocolate with nuts. Maybe...

Okay, okay, I'll admit it. I packed some Nutella. Who says, cravings can't start right after insemination?

Socks!

On one of the SMC online boards, the ladies posted pictures of the "lucky socks" they wore during their IUIs or IVF procedures. They called them insemisocks, which is short for insemination socks.
So, of course, I had to go online and search for some socks that I would like to wear during my IUI. This was a nice distraction during the waiting time and it kept my mind from worrying too much about all the things that might go wrong.

Since I am the worst person ever when it comes to making decisions, I asked a few friends for help. Cameron insisted on these socks for my IUI procedure because they feature little swimmers:

I thought they were cute, too, but also a little ridiculous. Not sure if I will wear them for the actual procedure.

My favorite pair was this one:

I liked the letters and hearts and I thought I might wear them once I go in for delivery which also goes with the theme of the socks.  (Yes, I know that is a long way down the line, but I really needed some distraction and some positive thoughts.)

My dentist knows - kinda...

I have had a slight tooth ache for the past weeks and decided I wanted to go to the dentist before it got worse. Plus, I wanted to get my x-rays and dental treatment out of the way before I`ll get pregnant.

Since I moved last summer, I needed a new dentist and during my first consultation, I told her that I was trying to get pregnant and that I wanted this to be taken care of as soon as possible. I wanted to be honest with her, because I wanted her to act quickly and not let me wait for an appointment for weeks. But also, I did not want to lie.

On the new patient form, I had marked that I was single. I did not wear a ring on my left or right ring finger. During the consultation, she never bothered to comment on me being single and trying to get pregnant. She explained to me that she would get the x-rays done today, but that I could have treatment even during my pregnancy as long as it is not during the final weeks when it gets hard to lie on your back.

However, when I finally got into the chair so that she could check my teeth, the assistant immediately asked me if I had met my husband here, where I live right now. I said: "No."
Then the dentist shot the next question and asked, if my husband was from Europe like I am. I said: "No."
Before I even had the time to explain,  she asked if my husband had the same job as I did. And I said: "No."
And I finally said: "I am not married."

The dentist let out a loud and long "Ohhhh." that sounded more like sigh than a critique. But I did not offer a more detailed explanation.

I am not sure what she thought. She might have thought that I lied to her, or that I was trying to get pregnant with a boyfriend or whatever. It was a weird situation.

I am still trying to figure out what to tell the people around me, when I finally get pregnant. It is a little bit like being gay and coming out of the closet I guess. Maybe this was a little bit like a test run. I usually have no problem sharing my life with others. I am always very open and never shy to even admit my flaws (something that might not be a good strategy in life but I can`t help it).

But this is not a flaw.

I am actually very proud to try to become an SMC. It is one of the most courageous things I have tried in my life - even more so than moving from one continent to another where I had no friends or family and did not speak the language all that well.

I am not ashamed about trying to become an SMC but I know others might not see it that way. My friends were very supportive but not everybody is. Do other people even have to know about this? Even though, it is not a secret, it is also not exactly their business. So, I think, eventually, I will have to come up with a plan who, when and how I will tell people... but not today.

Paying and Planning

This week, I got a bill from Dr. Stork listing all the things that my insurance did not cover and that I have to pay myself, now. Ugh! It was a pretty steep bill and my insurance should have covered these things, but they said it was the way that Dr. Stork's office coded them. If they had coded them differently, then I should have been covered.

So, I called Dr. Stork to find out what the issue was, but her nurse, let's call her Nurse Nancy, told me that the doctor makes the decisions and that she only goes by what the doctor decides. So, no chance that they will try to submit them under a different code. Great! Also, I was charged for an ultrasound that should have been part of my yearly exam. Wonderful! I was a little angry and talked to Nurse Nancy for quite a while. I am about ready to switch doctors, but would like to at least try my first attempt with Dr. Stork.

Finally, Nurse Nancy said that since I had such good results during the exam last time, I would not need to have another ultrasound next time I came in. I had 22 viable follicles on day 12 (I usually ovulate on day 17-20) and she said that was a really good result. Woohoo! At least something.

Nurse Nancy said, I am ready to move on to the next step. I have not lost enough weight yet, but she did not say anything about that being an issue. I also asked her if they received the report from the counselor and she said they did and that would be all they required. It sounded almost like they did not even care what the counselor really wrote.

Then Nancy asked me if I had already picked out a sperm bank. I have not. I am going back and forth between two banks and I am still trying to make a decision...

She also said that Dr. Stork had offered me the option to take an oral fertility drug and she asked me if I had decided yet, if I wanted to do that. I am not quite sure about this either.

Ideally, I would like to start my first attempt in June. This gives me a little more time to lose some more weight and if it works the baby would be due at the end of March which I think would be great!


So, here is my plan for the next two months:

Within the next week: Decide on a bank and sign up with the bank.

After AF arrives in May: Send documents to Dr. Stork to sign so that I can order the vial once I am ready.

Mid May: Upgrade membership so that I can find out more about the donors.

Memorial Day: Wait to see if they have any specials for Memorial Day and place order. (I heard sometimes they offer holiday specials like free shipping or a free vial.)

Beginning of June: Go in to get my day 3 testing done and decide if to use fertility meds.

Mid to end of June: Hope that I will ovulate and give this my first and best try.

Learning by Heart

A few weeks ago, my friend P.L. suggested that I buy a onesie for the future baby and place it somewhere where I can see it every day. I could keep it as a motivator and a reminder of my ultimate goal to lose more weight and make it to my first IUI. People sometimes do it with their skinny jeans if they want to lose weight and I could do it with a onesie.


But I didn't. I think having a onesie without a baby, a babyless onesie around in my house would depress me without end. I have often bought baby clothes for friends and kept them in my house until a birthday or Christmas or Easter came around so that I could send them. It always made me sad. The view of a toddler's overalls without a toddler or a little dress without a little one to fill it with giggles and joy is unbelievably depressing. I started avoiding the baby clothing sections in the stores I regularly shop at.

But yesterday, I fell for a trap and bought something for the baby. It is not a pair of overalls, a little dress or a onesie. No, I found a book. It is called "Poems to Learn by Heart" by Caroline Kennedy. It has the most beautiful watercolor images and is filled with poems fit for almost every occasion. And these are not the typical children's poems and nursery rhymes, but works by Langston Hughes or William Carlos Williams, by Shakespeare or Silverstein. I love it!

Of course, I would love to dress the baby in cute outfits, but to be honest, I do not care too much about what that kid is going to wear. But I care very much about what will go into its heart. I would love to see my future child's heart being filled with poetry.

Negative

Last Tuesday, I suddenly got a phone call from Dr. Stork's office. The nurse called me to let me know my blood test results and it turns out, everything is negative. Well, in case of the STDs that certainly is a good thing, but when it comes to my blood type and CMV status, maybe not so much...

I did a little research and it turns out that only 15% of all people are Rh negative. If the mother is negative and the father is positive, there is a chance that the child could be positive, too. This in turn could cause complications if the blood of the mother and the baby got interchanged during the pregnancy or birth. There are ways of reducing the risk with shots etc. but there still is a risk and mothers who are negative should consider to buy only sperm from donors that are also negative.

I talked to P. L., my friend the Power Latina, about it. She said that the same was the case in her family, where her mom is negative and her father is positive. Her brother is positive, but it all turned out okay. This was more than 35 years ago in Mexico, so she thinks, I should not worry too much about it.

But it is not only my Rh factor that is negative, but also my CMV status. CMV is a flu virus that almost all people have been exposed to in their life, usually via chicken pox, cold sores, or mono. Even though I had chicken pox as a child and I believe I also had cold sores before, I tested negative for CMV. I don't have any antibodies in my blood. Should I get exposed to the virus during pregnancy, or if the sperm is CMV positive, the baby could have developmental problems, and be born blind, deaf, etc. So, this is a serious risk to consider, too, when I make a decision about the sperm donor.

I really seem to be a rare kind of breed with a negative blood type and a negative CMV status. One of the sperm banks I looked into has about 300 donors, but only one of them has a negative blood type and a negative CMV status. He is not an open id donor and is brand new to the bank, so no pregnancies have been reported, yet.

It is already hard to find a donor that is negative in one area, but one that is negative in both areas drastically limits my choices. So, I will spend the next weeks trying to figure out what is important to me and which risks I am willing to take in all of this. I definitely have to look into more sperm banks.

Upcoming appointment

Tomorrow is my first R.E. appointment and I am so nervous, I do not know what to do with myself. I can barely hold it together.

Since I have never been to an OBGYN or an R.E. before, I have no idea what to expect. I am worried about the exams and tests they will run. I am even more worried that there is some problem and I might not be able to have kids. I do not even want to think about this possibility.

I have tried to think many happy thoughts over the last weeks. I searched for a sperm donor online and read success stories from SMCs who got pregnant on their first or second try without any problems.

But unfortunately, there are not only happy stories out there. For every mom that had a child without problems, there is at least one other mom in the online forum who has tried everything in her power and still cannot get pregnant.

I watched Harry Potter tonight and I feel a little bit like stepping in front of the sorting hat. Tomorrow morning, I hope it will sort me into the sure-you-can-have-kids-without-problems house and not into the sorry-but-you-will-never-have-kids-and-die-alone house. I am not sure what is going to happen if the sorting hat chooses the second house. Since I started this journey, something changed inside of me and I do not think I will ever be able to change back.