Wednesday, March 25, 2009

next steps

i  live in a state where you A. must have insurance and B. all insurance is required to have fertility benefits.  i feel very fortunate for this. when i read some of your stories about paying for your treatments, i feel extremely lucky.  i  really don't know what i would do if money were a factor in our treatment decisions.

so now, i have choices. 
 i can continue with a Clomid/Ovidrel/IUI cycle (most likely adding in Metformin for the PCOS)
 i can do an IUI cycle with injectables
i can skip ahead to IVF

my insurance will cover any of these options.  

i'm not sure what to do.  i feel blessed to have all these options, but i'm not sure i'm ready to dive in to IVF.  it seems like a lot more of a process than IUI's, and a lot more time- wise, physically and emotionally.  i'm also not sure about doing injectables.  i'm okay with having to shoot myself up, but i'm worried i will overstim and have to cancel the cycle.  i also realize this will increase our chance of multiples.

here are my thoughts on multiples.  
i am fine with the idea of taking care of more than one baby,  i nannied for infant twins 60 hours a week (from 3 weeks until they were 2), and although i know it's not the same as being their parent, i feel prepared.  i also have a degree in early childhood and was an infant teacher for a few years.  the "what to do with babies" part of motherhood is a non-issue for me. i currently have (6) 2 and 3 year olds in my care daily.
however, i worry that my small frame (i'm 5'1") cannot support the growth of multiple babies in a healthy way.  i also know that my husband would prefer not to have multiples.  we are both short people and he worries that having multiples will mean that the children will be physically smaller.  starting with our already "small" genes, he worries they will get picked on (like he did).  he also has a brother with identical twins.  during their pregnancy, they had many complications and almost lost the babies.  the mom was in the hospital on bed rest from 16 weeks until she delivered at 29 weeks. i think he has a fear of having to go through this with our family.

at the same time, i want a baby. and i'm willing to do whatever it takes to increase my chance of reaching this goal. and if it's going to be this difficult and i want 3-4 children eventually, what's the harm in cooking up a few at once?

i'm interested in hearing your thoughts on what you think i should do next.  i know many of you have gone through some of these other steps and may have good insight based on your experiences.  please comment and share your opinions and reasoning.



Anonymous said...

Hmmmm, a lot to think about for sure. I'm not the best person to give advise because for us we didn't have any options other than IVF, so I never had to make those decisions. We are also paying for everything on our own, so it's hard to say what I'd do you your shoes. If I had insurance coverage, I think I'd be inclined to go straight to IVF, especially if you are concerned about multiples. It's all a personal decision though, and there's no wrong answer. Good luck!

S said...

As someone who has not yet availed herself of any ART (and has no insurance coverage for anything past IUIs), and also is fast approaching 40, my answer to this question might be different than yours.

I know that IVF is a much bigger commitment in a lot of ways, not just financial, but if we didn't have to pay for it out of our own pocket, we'd go straight to it. It has the greater odds of success, and if the idea of multiples doesn't intimidate you, all the better.

I agree, though, with the previous poster: a very personal, individualized decision without a right/wrong answer.

Good luck with whatever you decide.

Mary said...

If I could do IVF, I would in a minute. It is a larger commitment, but you have an extremely higher chance of getting pregnant. Also, I figure that I could go through 4+ months of all the hormones and ups and downs of IUI's and I would rather just get it over with. Additionally, you very well might get some 'frozen babies' out of it so when you want to get pregnant again you can use them without having to go through all of this again. That's just me though.


Missy said...

Can I move to your state?

As others have said, this is a personal decision and only you know what is best for you. But for me, I would do another round of IUI. We are both still early in this process and IVF seems much more daunting and something I'm not ready to go for yet. And since you've only had one round of IUI so far, it's not like your doing something that hasn't worked multiple times already.

B MoM said...

Wow, that's awesome about requiring infertility insurance. I understand anonymity so this is really a rhetorical question, but what state is so wonderful???

Beautiful Mess said...

That's a lot to think about. I'd be cautious with twins, but I think if your proactive and talk to your doctors, you might be able to head off some problems. Sorry about your negative beta. Sending you hugs.

Jo said...

You are very fortunate to not have to deal with the obstacle of paying for treatment. I can't tell you what is right or wrong for you; only you can do that. I will say that if it was ME, I'd go straight to IVF. I say that after having three failed IUI's, however, and not responding well to the injectables. We will be moving onto IVF next (once we get the probably negative beta on our 4th IUI on Friday). . .and while it is a slightly longer process, much of it is similar to doing IUI with injectables. Yes, it IS more involved, and it costs more, but if you aren't footing the bill. . .well, it just seems like a no-lose situation to me.

sunflowerchilde said...

I tend to agree with Missy. You're at the same point that I am at, more or less - 30 years old with one failed IUI, but we have completely unexplained infertility. I don't know much about injectibles yet, and what I know about IVF I know from reading (lots and lots of) blogs. But still, I'd say that it's worth another one or two IUI cycles, with the plan of getting ready for IVF in the meanwhile. At your age, I don't think it's terrible to lose another two months if you stand to gain a much easier process and avoid IVF.

I can't speak too much to multiples - I am a twin, and twins run in my family. I know it was hard for my mom. I've gone back and forth about whether or not I'd want twins, and of course I'd be happy either way. I wouldn't want high-order multiples if I could avoid it, though. For one thing, sports and being fit are important to me, and I would possibly lose the ability to do many of my favorite activities permanently if my body had to endure carrying high-order multiples (again - I would be thrilled to be pregnant and would not do selective reductions, but it does encourage me to just not take the risk in the first place).

Saying all that though - if you do u/s monitoring, you could probably avoid high order multiples. And if there were the possibility, could you convert to an IVF cycle?

sunflowerchilde said...

Sorry, this is getting long, but I just remembered about the insurance coverage part - I don't have it, so of course IUI is a better deal for me. I'm still hoping to avoid the invasiveness of IVF, but if I had insurance coverage for it, I might think very differently.

Anonymous said...

Where I live IUI's and IVF are not covered by insurance, but the drugs I used for my injectable cycle were covered by my work insurance. What about doing an injectable cycle with timed intercourse instead of IUI? That way you might lower your chance of multiples?

pitapocketmom said...

hi i just stumbled across your blog, i am so sorry to hear about your infertility, i wish you the best. i am only commenting about the multiples because you said you are worried about your size and carrying more then one baby. I am also 5'1" i am 105lbs and i carried twins. it was defintly not an easy thing but it is possible. they were technicly 3 weeks early but i went into labor 2 days before my scheduled c section so they were on time in my eyes. and they weighed 6lbs3oz and 5lbs13oz not bad size for twins in such a small space. anyways i just wanted to let you know that someone your size did carry twins and although it was very uncomfortable at the end it is possible. and i defintly know that every pregnancy and person is different just thought i would give you some insight. again i wish you the best in your upcoming treatments and hope you get your baby asap!