Moving Forward

We were supposed to have a follow up visit tomorrow to discuss all the test results (Even though we know them) and the plan moving forward.  However, it snowed today.  So when I got up and saw that the regular roads were fine for driving (helps to back to a real road in this case!) I called and asked if anyone had made a snow cancellation that we could have.  Luckily, they did, and luckily, my husband was able to move his hours off to today as well so it all worked out.  It helps that the Towson office is really close to his job.

So, we fall into that category of "Unexplained."  Surprise!  Actually, that's not completely true.  Now that we have ruled out everything else, my mysterious pain comes back into the picture.  Dr. K gave us two path options, but recommended we take the path that gets me scoped for endometriosis.  Since this is what another doctor recommended almost a year ago, we are going to go that route.  The reason that this now comes back into play is that the endo dx could help me "earn" more treatment in the fertility area.  

He spent 30-40 minutes explaining the path in detail.  I was trying to keep my mind on the scientific side, and look at it medically - but it's so damn depressing.  This isn't how it is supposed to be.  You're supposed to realize you're late & pee on a stick - not have everything on a calendar and worry about sick days and substitutes and sub plans and scientists!  I did however, learn a lot today and as usual, generic internet reading gave me some misconceptions that have now been cleared up.

So here's the plan - presented in "Board Game" fashion with little to no scientific stuff:

Step 1 - Go directly to your regular OBGYN.  Have her scope you for endometriosis.  If your test is (-), advance one space to step 2pills.  If your test is (+), advance to step 4.

Step 2 
Take out your calendar. In your cycle, mark off days:
3 (baseline ultrasound - make sure you don't have any regular ole cysts, etc.)
5-9(take a Clomid pill to beef up your eggs)
12-14(ultrasounds and blood work- they make sure you have the right amount of eggs beefed up - too many could cause dangerous multiples, and so they stop you here.  If you have the right amount and the bloodwork doesn't show ovulation, then you get a shot to make it happen.) 
16 (IUI - because bedrooms no longer have a place in creating life)
26-28(blood work to see if the whole thing worked - 12% success rate - The "I Did this 4 Times" success rate is about 35%.  From the successful pregnancies, only 5% are twins and only 1% are triplets.) 

Bonus: Make up something health related to tell your carpool mate, attendance secretary, and principal, or finally fess up about what is going on.

Step 3 - FSH (Injection version of 2) - Same calendar as above, but you get to shoot yourself instead of taking a pill.
Plus: Higher success rate of 18%
Minus: Successful pregancy multiple rate: 15% twins, 4-5% triplets. (That is uncomfortably high, in my opinion.)

Step 4 - IVF
This one starts off the same as the others - but instead of doing the IUI, they go in and take the eggs out of you.  The multple rate is lower because they have a choice of how many eggs to fertilize instead of worrying about how many eggs get beefed up from medication.  When we went into this, the line that made me feel most comfortable in the original literature was that very few people need this step.  But now that I've heard everything - this step isn't THAT much scarier than the others.  In our state (MD) you do not qualify for IVF without hitting one of 4 qualifiers - tube problems (don't have them!), problems on the guy's side (don't have those!), endometriosis (seeing the point of step 1 here now?), or you've been trying for 2 years. (We're not there yet.) 

Many people do step 2 about 4 times - My insurance covers it twice.  So there's the financial decision that plays into this as well.  My insurance also covers IVF twice.  It makes me angry that money plays a role, but it is what it is.  It feels like gambling.  If you win - you really really win!  But if you lose, you really really lose, and you don't have the money to spend on alternative options to winding up with a child.  Makes me want to punch something, actually...

Edit: Did some $$ research by lurking on some message boards, turns out that the lab work and the testing and all that is covered, it's just the actual IUI procedure that wouldn't be covered after two times, and that's just a few hundred bucks.  That makes me breathe much easier!!