One Prairie Outpost...

Just when I thought everything was finally going smoothly... the rug, is once again, yanked from beneath my feet. It really makes it difficult to retain an optimistic mindset at times. Much has happened, so you may wanna get a drink and a comfy spot or just skip this altogether. It's gonna be lengthy, so it's your call. I know there are some folks who actually have been wondering what's up with me and I've also made the decision to start trying to write more candidly about this experience. I find the act of associating honest words to the feelings coupled with the physical act of weaving those thoughts and feelings into a coherent literary tapestry quite cathartic. This is MY journey and I need to claim it. That being said... here we go:

So Danny and I decided, after meeting with our RE and coming to the decision that our next step would indeed be IVF, we would take the cycle after our IUI off. We were told I'd have to undergo yet another hysteroscopy and do a Mock Transfer beforehand, so we thought taking a cycle to absorb everything would be a good idea.

The days got away from me a bit, what with my mom having knee replacement surgery and family visiting from out of the country, so by the time I called the IVF Administrator, I was already on CD 4. I wasn't terribly bothered because I knew we still had our IVF consult to do yet and there was no way they'd be doing anything with this cycle before that was done.

So I have my first call with Janice (IVF Admin) and she sees that I have Aetna insurance. She informs me that Aetna follows a "lesser then greater" rule; meaning that they require a patient tries less aggressive treatment before moving on to the more aggressive. This is news to me, as my previous RE's office certainly never informed me of this fact, but it makes sense.

She sees records from my most recent IUI and I tell her that I'd done 3 others with another practice. She asked if they were on injectables as well, to which I replied "No. Two were natural and one was on Clomid."

Silence.

She finally says "I'm gonna be perfectly honest with you... they may not accept that. Generally speaking they want to see 3 IUI attempts with injectable meds before granting approval for IVF." My mind starts to race. She says she'll call Aetna on my behalf, see what they have to say and call me back.

While I'm waiting for the return phone call, my face starts to burn. I start thinking about the 2 natural IUI's we'd done and how it appeared they weren't going to "count" in the eyes of my insurance company. I started to feel angry with my previous RE's office for not being as thorough as my current one.

I thought back to the appointment I'd made with my previous RE after our failed IUI with Clomid, where I specifically asked about adding injectable meds to the next IUI... and he dissuaded me telling me it wouldn't help and that IVF should really be our next step.

Well, if we'd stayed in his care with the intentions of following his advice... we'd have been S.O.L. because Aetna would NEVER have approved an IVF cycle after 2 natural IUI's and 1 on Clomid... as I had just learned during the FIRST phone call with the IVF Admin BEFORE she even made any phone calls. It was literally like she looked at my file, saw the name Aetna and her brain said "Ah, they have blah blah blah requirement" I mean, why didn't anyone at my previous RE's office know that?

Janice called me back about 10 minutes later. She told me that she'd explained my situation and Aetna wanted to see my medical files. She asked if Danny had a semen analysis done, to which I said he had. She asked if it was normal and I said it was. She asked if I'd had an HSG, to which I said I had. She asked if it was normal and I said it was not.

I explained that my first HSG revealed a blocked right tube which led me to have laparascopic surgery, during surgery my left tube was found to be tangled and folded over on itself as well, so all of that was corrected before we began with our IUI's.

She told me this could possibly work in my favor, as they have a tendency to make exceptions to the treatment requirement if there are or have been other "problems". Um, Yay...? She said she was sending my file over and that she'd have an answer for me in a day or two. The next day, I received a phone call telling me that Aetna had determined that I'd been through enough and that they had approved my IVF cycle!!

She scheduled us for our IVF Consult on Sept. 7th at 9:30 am, told me the contracted rate for IVF is $7950 and that our portion would likely be about $1500 (20%). I was so elated and happy!! My spirits soared and I felt the mixture of excitement and anxiety beginning to build. I thought about the increased shots I'll be taking and how sore my ovaries felt after our last IUI. If I felt that sore after that little bit of stimming... I knew I was gonna be in for it with IVF.

But as has been the fashion with this journey, hopes are often built only to be dashed in the blink of an eye... Two days later, I received a phone call from Janice. She was looking over our coverage and was concerned that I thought we had more coverage than we did. NOT what I wanted to hear.

I told her the Aetna rep told me we had $10,000 in coverage for IVF when I called to change practices... She was seeing that we had a little over $3000 left. She said she'd email me what she was looking at so that we could call Aetna and find out what was what. I was so depressed, I couldn't even bring myself to open the email and call the insurance company for another 2 days.

To make a long story short, our coverage wasn't explained to me properly... until a few days ago. Naturally. That $10,000 IVF benefit? Yeah, that's a lifetime pool of money for ALL Assisted Reproductive Treatment. So all 4 of the IUI's we've done...? Including the 2 stupid natural ones... they've all been coming out of that $10,000 all this freakin' time!! So instead of being able to do IVF for about $1500, we're now talking about closer to 5 grand!

I know there are plenty of women out there who have to pay all of it, and I'm glad to at least have coverage... but to see what you think you had evaporate right before your eyes...? That's a kick in the teeth. Add in the fact that I'm angry because, had we known our insurance had a treatment requirement and that all ART procedures were coming out of that $10,000, we would NEVER have consented to two natural IUI's. Period.

Can nothing about this be easy? Have I not been poked, prodded and dilated to high heaven? Have I not jumped through quite enough hoops? Can't I catch a freakin' break?!

We had our consult on Friday and got the entire breakdown of what protocol my dr. is prescribing for me. The list includes birth control, Lupron, Gonal-F, Menopur, Estrace, HCG trigger & Crinone... so at least we know what meds we're looking at.

We discussed cryopreservation of any extra embryos, which would be $1000 for the initial freeze and first year of storage... she thought it's about $850 per year after that, but said she'd double check on the exact figure for us.

Should we decide not to use them in the future, she said we could have them thawed and discarded. I asked about embryo donation and she said that was also an option... that we could donate them to an embryo bank, which would be my personal preference. I always wanted at least 2 kids, but at my age... it's likely our family would have to be complete with 1 child, and I would love nothing more than to be able to give another infertile couple a chance at their dream.

We discussed some of the insurance problems we've encountered and talked about a few options. Danny will be a permanent employee at the end of October, which will entitle us to new benefits. We decided that he would look into the insurance options at work and find out if they offer any ART riders with their policies.

If they do and the coverages would be an improvement to what we currently have, then we'll likely drop our COBRA and wait for the new insurance to start. I'm aware that Blue Cross might have some "requirements" as well, but I'm hopeful they'll look at my medical records and factor in all that we've done already. If not, at least we'll be working with a fresh set of funds and an RE's office who will actually monitor my coverage, not just my ovaries.

 It was suggested that we consider ordering our meds now. Since we've already paid our COBRA payment for the month of September and won't really be using it for anything... she thought it might be worthwhile to at least use the prescription benefit, since the meds can be stashed in the fridge and saved for our cycle. We agreed and she said she'd make some calls.

I'm hopeful that December could be our IVF month... but at this point, I'm really hesitant to put any dates or expectations on anything anymore. I mean, just when I think we're moving in the right direction, we run smack into yet another road block. When I think about everything, I go from seething anger over the information I wasn't given and the choices we made based on the information we were given to such disappointment about where that has left us now.

If the new insurance doesn't offer any ART riders, then we're stuck keeping COBRA. We'll need to save up the 5 grand or so that the cycle is gonna cost us, all the while continuing to make the nearly $1000 monthly COBRA payments. As if the prospect of IVF weren't overwhelming enough... throw in all of this.

I haven't had it in me to get on any message boards... in a way, I kinda feel like almost everyone I had established any kind of bond with has moved on in one way or another and I just feel out of place. Everywhere I look, literally, I see bumps or full on bellies; every TV show finale is someone else being pregnant and it's a twist of the knife every time.

So yes... one prairie outpost you are how I feel, alone in a flatland 'tween the dream and the real; the irony, ask me "where have you been?" I don't know, I don't know... because I don't know where to begin.