I knew IVF would be a fairly large departure from the natural course (a lot less fun, a lot more pain, about the same amount of anxious waiting). I had thought, however, that these added complexities would be part of the actual process – the shots, the procedure, the waiting to see how many eggs had fertilised. What I hadn’t realised was the sheer amount of organisation involved, long before the first injection. As a heads up to any of you travelling towards the IVF path, here’s what we’ve gone through so far:
Step 1: the fertility specialist
This one I was expecting – you want IVF, you need to see the doctor. While waiting for the appointment to roll around, my main concern was convincing the doc that we should go straight to IVF, and not try IUI to begin with. Let me explain. For most couples who are having trouble conceiving, the first step tends to be IUI, or Intrauterine Insemination. This is basically a more advanced version of a turkey baster, where you wait until ovulation day (predicted by ovulation test kits), and then the doc squirts swimmers directly into your uterus, bypassing the initial journey, and making conception more likely. IVF (In-vitro fertilisation) on the other hand is when eggs are extracted from the woman, thrown into a petri dish with sperm, and monitored to see which eggs fertilise. One of these is then injected back into the uterus, where hopefully it sticks.
My concern with using IUI first is that we have a limited amount of frozen sperm. Also, the rates of success are much lower for IUI (around 20%), compared with IVF (more like 40%). We would potentially use up a chunk of our frozen swimmers when we could get success on the first try with IVF.
So I had gone in to the appointment with the Doc with my argument in mind. We spoke to her about our situation (husband undergoing chemo, one miscarriage, abnormal shaped sperm, frozen specimens only). She told us that IUI was fairly pointless, as frozen sperm tend to not pick themselves up particularly well. She also discounted regular IVF, for the same reason. Her recommendation, from the start, was to go with ICSI IVF, which is a more specialised form of IVF. The eggs are extracted, the sperm is defrosted, and the best sperm are selected from the batch. One sperm is then injected into each egg using a needle, and the eggs (hopefully) fertilise. They then transfer one (or sometimes two) eggs back into the uterus, and again hopefully they stick. This process has a few detractors, mainly due to the absence of natural selection. A scientist selects the best sperm, not the natural process itself. It does, however, have the highest success rate. Personally, I’m happy to trust the scientists, and the process. It has been used for nearly a decade to provide pregnancy, and studies that I can find don’t show any adverse effects when compared to regular IVF. The biggest drawback with ICSI is its cost. The additional procedure carries an extra cost for us of $800.
Mr Nester and I discussed the approach, and decided we were both happy to use ICSI if it meant success. So, on to the next step.
Step 2: the information session
In which you are bombarded with information on what drugs you’ll be taking, how you’ll take them, when you’ll take them, and the side effects of taking them. Here’s a brief rundown:
Drug 1: Puregon (makes lots of eggs develop) taken from Day 3 of cycle until Day 14, injected into stomach fat (ohhh yeah). Side effects include: abdominal swelling, breast tenderness, mood swings, nausea, dizziness, headaches, bloating, tender ovaries.
Drug 2: Orgalutran (prevents you releasing eggs until the doc says so) taken from Day 8 of cycle until Day 14, injected. Side effects: headaches, nausea, itching, soreness and redness at injection site.
Drug 3: trigger shot Day 15 (makes the eggs spill out of you, basically). Injected. Side effects: nausea, bloating, constipation, breast tenderness, tender ovaries.
Drug 4: Crinone (a progesterone supplement), Day 19 onwards. Used as an applicator up the wazoo. Side effects: all of the above, plus the bonus of cottage cheese discharge. Oh yummy.
These do not include the two scans, multiple blood tests, and day in hospital where they knock you out, stick a bloody big needle in you, and yank out however many eggs you produced. Of course, some of the drugs need to be refrigerated, some not, all must be taken at a specific time, and all of this may change depending on your body’s reaction. Easy.
Step 3: the counsellor
A government mandated session, basically to make you aware of who owns the embryos if one of you dies. We chatted to a lovely counsellor, she was great, this bit was easy. It was also free. Win!
Step 4: the paperwork and the rest
Holy cow the paperwork. Three forms to fill out, sign and have witnessed. A police check for each of us, certified, sent off, paid for, forwarded to the fertility clinic. Child protection checks applied for, received, forwarded to clinic. Blood tests, one for Mr Nester, two for me, one of which was not claimable and so cost $90. Oh, and a partridge in a frickin’ pear tree. Also, as we have Mr Nester’s sperm stored at another facility, we have to pay to have it transferred, then pay again to have it stored.
Step 5: the costs
As you can imagine, this was the gasp moment. It is bloody expensive. Without Medicare (thank god for Medicare), we would be out of pocket by around $12,000. Yes, you read that right. 12K, 12 big ones, twelve thousand bloody dollars. With Medicare, we’re looking at about $6,000. Nowhere near as bad, but still a lot. This is all my working out, so there may be some leeway here, but I’m expecting the worst.
All of this leads to next month. Around the 15th Feb, I’ll be collected my meds and starting the process. We’ve done all of the above (aided by numerous check lists and trips to the post office, police station (to certify bloody EVERYTHING), and bank. We’re ready. Except we’re sooooo not. This is going to be a rollercoaster, and if the side effects of those drugs are anything to go by, I’m going to be the screaming, crying, vomiting one. Lucky Mr Nester.