Stepping Forward

I hope you guys will forgive all the “moving forward” themed titles for my blog posts, but I feel so good about what I accomplished this week.

So, what’s the update?

Well, as you know, I found out about the Managed Infertility Program on Tuesday. On Wednesday, I actually talked to my case manager, who I will call A (hopefully for AMAZING, but we’ll see, right?). She and I had a nice conversation, although I was kind of on edge both because of the subject matter and because of the fact that I was borrowing a colleagues office to take the call (I am in a cube…sigh.)

So – information so far. This insurance is likely to be better than my previous insurance in terms of out-of-pocket cost. We have a high deductible plan, but my work pays for 80% of the deductible, so that’s great – it’ll be about $600 out of pocket for us (outside of our regular contribution to the plan which is less than what we were paying before). After that it’s 90/10% coinsurance, which means we pay 10% of the negotiated rate of the insurance, up to another interval amount (which work doesn’t help with, so that’ll be a little more painful), and then after that it’s 100% covered.

Unlike my old insurance, they will cover treatment up through IUI. So that means, as many IUIs as they think necessary (so it requires their approval…) but no IVF stuff. It’s possible that they would cover IVF drugs, but I have to find out from the pharmacy people, since A doesn’t deal with that stuff.

Bottom line: it will still cost us money, but likely less than what we would have paid with the other plan, and the coverage lasts for longer.

She also gave us information on their “Centers of Excellence,” which as far as I can tell mean the largest clinics in NYC. One of them is close by work, but the reviews are consistently terrible, and their SART data is worse than the clinic I want to go to (29% v. 36% live births for my age group). There are other, very well regarded clinics in the program, but the transportation issues in NYC are very real – I could spend an hour or more each way,  and I just don’t have time for that, at least at this point. My case manager did make a point of saying that I could get a second opinion at any point, with no hassle – like always, I’d just have to tell her that I have an appointment. So that makes me happy.

Of course, the only time-critical bit of this is that I’m likely to only keep this job until my husband graduates from school – so sometime after June 2015. Hopefully, I’ll be pregnant long before then!! Given all my progress, and my research into the other clinics, I did make an appointment at the facility I wanted – March 20 at 1:30PM. We’re leaving for a trip that day as well, which is also stressing me out, so I thought I would combine stressors, lol. We’ll see how well that works/if it just drives me completely crazy.

The receptionist over the phone was very nice – I just need to bring my medical records (which we requested to be sent to me from the other doctor), my insurance card and my ID. I’m also considering bringing a summary coversheet with all the information – not because I don’t trust him but because I want him to get the full picture, and I know how busy these doctors are. So we’ll see how that goes – if I decide to do it, and what information I decide to include, etc. I feel like it could be helpful, though. I’ll let you know what I come up with.

So – how’s that for stepping forward? 11 days until my appointment!

Oh, and one lat thing I wanted to leave you with – last night, my work had it’s spring fundraiser. I was kind of dreading having to be there, but I ended up having a good time. They presented an award to a volunteer, who is also helping with the capital campaign to renovate the building we just purchased, and he said this at the end of his speech.

When you’re dealing with a big project, as we are with this building project, I have always said: Do what you can and let God do the rest. We have to do our part, as best as we can, and then have faith.

So…what’s the diagnosis?

In the world in my head, I imagine people sitting around discussing fertility diagnoses like they do on those medical shows, where there’s a rapid-fire discussion of symptoms and possible problems that fit. A round of testing, and suddenly, the mystery is solved. Unless of course you’re House, in which case it’s some brilliant bit of deduction (disclaimer: I have watched +/- 1 episode of House)

What’s Been Going On

So, after 12 cycles, almost all of those charting, we have some pretty good info on what’s going on with me.  The good news is that my cycles are fairly regular. The exact day I ovulate tends to differ depending on the month, but aside from that, it’s between 28 and 30 days. Even the three cycles that were longer followed the same pattern – during a time of stress, my body geared up to ovulate, stopped, waited just about ten days, and then ovulated. Which means, that in all 12 cycles, I ovulated. Big bonus.

DH and I have had some testing done, at around 6 months of trying deliberately. I had an HSG, which showed that my uterus is in fine shape, but there is potentially a blocked tube lurking. It’s hard to say without more investigation, but…that’s there. DH’s Semen Analysis came back normal, so as he says “I’m feeling potent!

Things I’m Pretty Sure it’s Not

  1. Male Factor Infertility (MFI) – Since DH’s SA came back normal, it’s unlikely to be Male Factor Infertility. This is important to rule out, since a lot more cases of infertility are caused by MFI than people realize – it’s seen as a “woman’s” problem.
  2. PCOS – This is a big deal, because I’m fairly sure this why my parents had trouble conceiving. Sometime soon, I’ll write a post talking about the family history of infertility, but for now, it’s nice to know that, whatever is going on, it’s not the same as theirs.
  3. Endometriosis – No symptoms, and no diagnosis. Obviously, this one can lurk in the background, but for now, I’m leaving it here.

Things it Could Be

  1. The most obvious – the potentially blocked tube is actually blocked and has just been messing with our timing, and either opening it or just riding it out for a little longer will get us where we want to be. If so, maybe this will be the shortest infertility blog ever.
  2. Some kind of hormone problem. This would most likely be progesterone, but there are other issues that could be there too.
  3. Premature Ovarian Failure – Meaning, my eggs are older than me and getting pregnant will be hard. Doubtful, as I have no symptoms of premature menopause, but it can also be asymptomatic.
  4. Hypothyroidism – My mother and my aunt (her sister) both have this, so I wonder sometimes if this could be it. I am hopeful that the RE will test for it, and if he or she doesn’t, I will likely ask for it.
  5. Something else that I don’t know about yet. And that’s really where this whole thing is going – what else are the doctor’s going to find out?
  6. Lastly – the hardest to understand – “unexplained” – meaning – we don’t know. And maybe we won’t know.

And that’s the thing of it. We’ve only just begun on this journey, and we don’t know what will happen next.

But we’ve started, and we have a direction to go. So that’s something.