Update and More Waiting

As I mentioned in a previous post, I had been instructed to call the clinic with the first day of my period. So when I finally got my period I called the clinic to report this and assumed that I would soon be told to start taking birth control pills in preparation for the stimulation. (Birth control pills are often used prior to the stimulation phase in order to “rest” the ovaries and reduce the chance of ovarian cysts.) Imagine my surprise when I got the call back from the clinic that this time, I would be doing a “no pill” cycle and that I would need to start doing the stimulation injections on the second day of my period. Of course this involves now waiting for my NEXT period before starting because it was already Day 4 of my period by the time I got the call back with this information.

During my first egg retrieval cycle, I had a lot of trouble with the HCG trigger shot (see previous post) so I asked if I could have Ovidrel this time instead of generic HCG. I had trouble getting all of the HCG medication out of its vial and into the syringe. Ovidrel comes in a pre-filled syringe so it would eliminate that problem. (I learned about Ovidrel from reading other people’s egg freezing blogs.) The doctor agreed so I am relieved that it should be an easier trigger shot this time.

When I got the prescription list, I saw that my doctor is making some changes in addition to switching to the Ovidrel: Last time I was on 75 IU Follistim + 75 IU Menopur for the first 8 days of stimulation, before moving to 150 IU Follistim + 75 IU Menopur for a couple of days, and 75 IU Follistim + 150 IU Menopur on the last day of stimulation. This time, I will be on 150 IU Gonal-F and 150 IU Menopur from the start, so double the dose of what I was on for most of my first cycle. And it will be Gonal-F instead of Follistim.

I am very lucky to have insurance that covers the medications. However there is a lifetime limit on fertility coverage of $15,000 and the medications count against that limit. So I decided that it would be a good idea to find out which pharmacy had the cheapest medications so that I would not use up more of that lifetime limit than necessary. This turned out be an exercise in frustration. I called my insurance to confirm that its preferred pharmacies had not changed since last year. They are still the same--one mail-order pharmacy plus the Walgreens Specialty Pharmacy. I asked the insurance guy if I could compare the prices of the two pharmacies for certain medications, and he said I would need to call the pharmacies to do that. I called up the first pharmacy and they said that they could not tell me the prices that would be charged to my insurance plan and that I would need to call the insurance in order to get that information. Of course, when I had called the insurance, they said I would need to call the pharmacies to get pricing information. Frustrating! I did not bother calling the second pharmacy since I would be unable to do a price comparison without any information from the first pharmacy. So my attempt to be a good consumer and find out all the prices was a bust, and I ended up going with the mail-order pharmacy because that seemed more convenient. When my packages of medications arrived, I looked through all the paperwork to see if I could find out the cost of the medications, but all it told me was my copay amount, so I still have no idea how much is counted against my lifetime limit.

I have an ultrasound scheduled for around the time that my next period might start. I explained to the coordinator doing the scheduling that my periods are irregular and that I could not be certain that it would have started by the time of the appointment. She said that was ok and that basically they try to get the ultrasound within 5 days of my period, so even if it hasn’t started yet, I could still go in for the appointment. So my next step is that appointment, and to notify the clinic (again!) when I get my period. For now I’m waiting.

The Waiting Game

Now that I have decided to go with Stanford for my second egg freezing cycle, my job is to wait for my period to start. I am supposed to call the clinic on the first day of my period. Believe it or not, it has now been 35 days since my last period, so I don’t know what the holdup is! It should be here already (no, there is absolutely no way I could be pregnant).

I have always had irregular periods when off birth control,  and in the past I haven’t kept very close track of my cycles so maybe this is normal for me. Still frustrating to be waiting!

Closing In on a Clinic Choice

I feel like the choice of a clinic is being made for me, in that out of the four clinics I’m considering, only one can really accommodate my preferred timeline. It looks like I will be going with Stanford again for my next cycle. Here’s what happened with the other clinics:

• Nova IVF: as I mentioned in a previous post, they don’t have any appointments available for the rest of 2014. I went on a waiting list with them and sent in my registration materials. I emailed them some questions about the egg freezing program to try to figure out if it would be worth waiting, but have not received a response.
• FPNC (Fertility Physicians of Northern California): I have a consult set up for March. They have recently become part of the Palo Alto Medical Foundation (PAMF) and things seem to be changing a lot after the merger; the doctor I will be seeing in March is from PAMF and not from FPNC. I am a bit concerned about that because a big part of the reason I was interested in this clinic was their good SART statistics. I will now be seeing a doctor who didn’t contribute to those statistics, which I’m not so happy about.
• Zouves Fertility Center (ZFC): My consult was postponed AGAIN because my medical records STILL have not arrived from Stanford.

I have mixed feelings about going with Stanford again--it is easy, familiar, I like my doctor there, and I can start really soon. However Stanford’s success with regular IVF is well below the national average, and they don’t have much experience with turning frozen eggs into babies. I guess I am hoping that they will improve and gain experience with frozen eggs before I need to actually use the eggs! I can’t help but feel a little discouraged about it being so hard to complete research on all the clinics.

I am keeping my scheduled consults with other clinics because I may well do a third egg freezing cycle and so I will consider the other clinics for that future cycle.

Waiting for Clinics

Right now I am doing a lot of waiting for clinics. This is frustrating because I am in a hurry to get this egg freezing show on the road. Right now my job situation makes it pretty easy for me to take the time to freeze eggs, but that won’t necessarily be the case a few months down the road. So I want to get this done sooner rather than later.

• Nova IVF: They don’t have any appointments available for the next year (!). I went on the waiting list. So obviously Nova is not an option for anytime soon, but it could be attractive for another egg freezing cycle in the future because it is supposed to be a very good clinic. Nova has the highest rate of live births from regular IVF of the clinics I’m considering, which indicates that it is a good clinic in general, although I don’t yet know anything about their egg freezing statistics. (There are no nationally reported statistics on egg freezing but you can use the IVF statistics reported through SART to get an idea of if it is a good clinic overall. From Carole Wegner’s “Finding a good egg freezing clinic”: “Even though egg freezing is not tracked directly by the CDC, once you identify ART clinics that also provide egg freezing, you can check out their pregnancy and live birth rates using fresh eggs to get an idea about how good they are at routine IVF and by extension, suggest they might be good at egg freezing. Or put another way, having good IVF rates does not guarantee good egg freezing rates but being a below-average clinic for IVF does not lead one to expect exceptional egg freezing rates.”)
• Fertility Physicians of Northern California: I called to make an appointment but their new patient coordinator is out of the office, so I will have to wait until she returns to find out more information.
• Zouves Fertility Center: I was supposed to have the consultation today, but it has been postponed because my medical records from Stanford didn’t arrive in time.

So I am waiting for clinics. In the meantime, I am continuing with my supplement routine. I haven’t been as good about diet and exercise unfortunately.

I also just finished reading Sarah Elizabeth Richards’ Motherhood, Rescheduled: The New Frontier of Egg Freezing and the Women Who Tried It. It follows the stories of four women (including the author herself) who have frozen their eggs. It is a great read, I couldn’t put it down because I was so excited to see what would happen with each of the women in the end. I would definitely recommend this book if you are interested in egg freezing.