Thursday, November 29, 2007

Cooper (and next steps)

My posts to date have pretty much brought us up to the current date and time - we are ~1.5 months beyond our failed first cycle and have sort of shelved the whole discussion, temporarily. We got a puppy to occupy our time and distract us while figuring out our next move. Frankly, we haven't had as much time to discuss the whole thing as we would have liked, but the distraction has been welcomed - puppies are a lot of work! We got a Cairn Terrier (same kind of dog as Toto) He is Amish (got him from Amish country in Ohio) We named him Cooper ... cute little guy with very sharp teeth. Anyhow, he has completely taken over our lives ... there are no spare minutes to just sit around on the couch, or surf the internet. The second you do that, Cooper will bite something, or piss on the rug, or poop under the Christmas tree. Anyways ...

We're casually looking into adoption web-sites, trying to learn more about it ... and we're discussing IVF and how to handle that whole situation. Either way, my wife was told to go on birth control pills "to get rid of the cysts Dr. S. created" (his words) ... we weren't told how long she should go on the pills, when she should have started them, etc. More of the same lack of attention to detail from our clinic ... at some point we'll have to call to ask them how long she should continue. It also sucks that she has to take a medication that prohibits the very thing we are trying to achieve - PREGNANCY! We've been told from some people that the cycle immediately following a failed IVF is a great time to get pregnant through natural means since the levels of Progesterone in the woman are so high. That is not an option for us ...

I didn't do much research into IVF prior to our first round. The failed cycle prompted me to hit the internet for a crash course on the process, and to look into other clinics. I first came across the SART web-site, which contains scores of information on infertility clinics across the country. I immediately compiled all of the data for metro Detroit into a spreadsheet, and plotted all of the statistics relevant to our situation. I primarily focued on "# of cycles" and "# of live births". I've also come across TONS of blogs on the topic of IVF, mostly written by people who have not been successful (a bit discouraging) ... but, in the process, I've become more educated on infertility, and how big of an issue it really is. It's good to know there are others out there going through the same thing.

Based on the information revealed on the SART web-site, We've decided to make an appointment with Oakwood Hospital to review our documentation from cycle #1, and to see what the prognosis is from a different doctor. I'm anxious to see if this doctor will outline a plan for IVF #2 similar to that described by Dr. S. I'm doubtful that the information provided in our files from IVF Michigan will be sufficient to make a prognosis. We certainly don't want to go through the gamut of tests again, as they are expensive and time consuming ... besides, all information that can be gathered is already in the hands of Dr. S. We are looking into other clinics primarily because we want to feel comfortable with our decision to move forward with a second round. Frankly, the whole topic of how expensive this procedure is is not discussed enough. For us, the decision to spend $10k on anything is not made easily. Frankly, anything over $50 is debated and evaluated prior to executing the trade. Therefore, moving forward with another round of IVF will not happen before we fully understand, as best we can, our chances for success. If we feel confident that IVF might work for us, we'll move forward with a second round. If there is a great deal of doubt regarding our chances for success, we would opt to instead place the $10,000 towards adoption. I've heard "quotes" on adoption as high as $40,000 ... that's crazy! That's a lot of money! Good thing about adoption is, it is almost guaranteed to give you a child (especially if you go to another country, from what I understand) Again, we're at the low end of the learning curve on adoption (and IVF for that matter)

So, our plans are to talk to Oakwood and re-evaluate our options afterwards. If we leave Oakwood with a good feeling, we'll probably start scheduling or second round. If the feeling is not so good, we'll look into another clinic and further our education on the adoption process. Stay tuned - I'm going to call Oakwood right now to see when we can get in for a consultation. I hope it doesn't cost anything for such an appointment!

Next time: I'm thinking of writing a post on the expense of this whole procedure. Like when do you reach the point where you can no longer afford to do another round? I mean, that point has to come sometime, right? My wife and I fortunate to have good jobs and the IVF funds can be found without damaging our retirement and savings plans, but still, it requires a bit of sacrifice in other areas. I always like to use the example of "how many Kool-Aid packets do you think you could fit into a shopping cart?" Seems like you could always put one more in ... but at some point the whole thing will crumble ... somehow this example needs to be compared to personal finance. I've got nothing ... but you probably get the point.

Thanks for your comments, and for reading. Hoping for brighter days in 2008.


Hekateris said...

Er, Progesterone is not high after IVF - the drugs suck natural progesterone right out of the body, that's why you take progesterone pessaries or PIO shots for the two weeks until your blood test, and if you test positive, for 12-14 weeks after that. Ah, fun times.

Wow, the more you talk about Dr Shamma, the more horrified I've become. It's not that the clinic is bad, but their lack of attention to the 'details' is, uh, well, words can't express my feelings on the subject. Unless 'are you freaking kidding me?!?!?' works for you, along with some expletives.

I can't recall, did you do IVF with ICSI and Assisted Hatching? If they didn't do ICSI at the very least, well, again with the expletives.

As for pricing, that's different from clinic to clinic. I can tell you that we paid $10642 for IVF, ICSI, AH, egg storage for 1 year, plus labs and monitoring. Drugs cost around $1100.

Adoption, unless you're going through foster care, generally costs around $20K, international costs more due to travel costs, and, uh, stuff of that nature. And, there's no guarantee. Let me rephrase, the chances of coming home with a child are of course much higher than ART, but that doesn't mean that everyone does. Keep in mind that many countries (China, frex) do not consider things such as Autism or other disorders to be a health issue.

While Mr Oro and I always considered adoption, to be honest we no longer have the money to do so. In fact, doing FET and another IVF would be cheaper.


Hekateris said...

"...that doesn't mean everyone comes home with a child..."

Brain goes too fast for the fingers sometimes.

Tracy said...

Cooper is ADORABLE.

I've never heard that fertility is increased immediately following an IVF cycle.

Have you read "A Couple's Guide to IVF"? I highly recommend it. I also recommend Adoption Associates. I think they have a location near you. A domestic adoption costs right around $20K, but you can offset your expenses with a federal and state tax credit. Some employers also reimburse for adoption expenses. Foreign adoptions can be more costly and time consuming, but you'll want to weigh all your options. Please let me know if you have any questions.

Again, sorry about your experience with Shamma. I wonder if part of it isn't the clinic's nurses? It doesn't sound like they are communicating much with them. Have you shared your concerns? It might be worth a call. Of course, having gone through 2 failed cycles, we've had concerns along the way that have been alleviated after we've pushed the issue.

IVF really just comes down to a numbers game at the end of the day. It sucks.

Joe said...

Thanks for the comments - I'm obviously getting some mis-information about the post-IVF failure Progesterone thing ... my bad.

I'm sort of feeling bad for ripping on Dr. Shamma. If / when we move ahead with our second round, we will definitely take our issues up with his office (in a kind, respectful way) If nothing else I hope it will help them to improve (how can anyone get better without such feedback?)

Our cycle nurse was pretty cool actually (Erin) - she always had a very genuine demeanor, and was very nice during all of our procedures - always willing to answer questions ...

Still haven't made my appointment with Oakwood ... on my list of things to do for tomorrow.

Tracy said...

Don't feel too bad, Joe. Your gut feelings are legitimate. But I think it is a good idea to bring your concerns to Shamma. Like I mentioned, we always felt better after we did.

Our cycle nurses were relatively cool, too, but we've caught them messing up a couple times. I suppose it's to be expected with the number of patients they see, but on the other hand we're spending a ton of dough on them getting us pregnant, so it's reasonable to have some expectation that they will give us correct information.

Anyway, I also think with the amount you're investing...financially, emotionally, time, it's a fine idea to get a second opinion. If we weren't so far into this, we probably would do the same, but I feel like we're at the "no turning back" stage.

Good luck!

Anonymous said...

We went through 4 Ivf cycles w/ Dr. Shamma. AFter the 1st failed cycle we asked him to do a uterine biopsy to which he replied something like" it doesn't matter cuz i can't give you a new uterus"... AFter the 4th attempt, we got a 2nd opinion from dr. schoolcraft in denver. we did the biopsy and my wife was missing an enzyme. she took meds for 2 months and we just did another transfer 4 days ago.. We find out on sunday if it worked... CCRM is awesome. I highly recommend... Although we are from michigan, the travel wasnt that bad and they get you great hotel rates....

Catherine said...

I am really pleased to read your blog. My husband and I are facing IVF, except hubby is totally opposed at this point in time. I am sure I don't have to explain to anyone reading this the complex emotions that occur in infertility. I wanted to ask you if there were any references/ books you would recommend that I could get him to read that night open our discussions? I don't want to pressure him towards this, but we have to be able to talk about it to work through it... We are also looking into adoption.
Thanks, Catherine

Joe said...

Thanks for the comment Catherine - sorry to hear you're in the same boat, but welcome aboard (I'm sure you've read around the web and found the staggering number of infertility blogs out there)

Not sure what to recommend for your husband ... everyone's different, so not sure what it will take to convince him. For me, it was the diagnosis from the Doctor, and the intense disappointment from my wife at each month's failure. As you've read, we trusted our first Doctor, but always had an uneasy feeling about him. He is an IVF doctor. Not a fertility specialist (disclaimer: this is completely my opinion) I wish we would have gotten a second opinion prior to diving right in to IVF, from a Doctor more focused on the process of exploring the issues, rather than going right for the highest margin option available. But I digress.... maybe that first Doctor was right - after all, we're still not pregnant ...

Have your husband read some blogs. There's a great listing at Sperm Palace JestersIf it's a financial issue (which it was for us, until I took a new, higher paying job) then your options might be limited. Maybe Baby just released a book, from a male's point of view. Looks like they are pregnant. We have a copy of "A Few Good Eggs" that we read together before going into IVF, and we bought a copy of "The Infertility Cure", but didn't really stick to it (actually, not even close)

XBox4NAppyRash (linked from my site) is my favorite male-written blog out there - funny, and insightful.

Good luck, and thanks for reading (and commenting)