Monday, April 23, 2012

Infertility Coverage researched by Kurt

One of the areas which can make or break IVF is having insurance coverage or the financial means to cover these health services.  This week I am focusing on insurance coverage for IVF.  Since we do not have any insurance coverage towards IVF, we have learned a lot about this topic.  Since my background is in health insurance, I am very familiar with this topic as well as many other insurance aspects which have helped us understand the coverage we have.

Here is where I would start for mandated insurance coverage:

This webpage is from the regulatory industry for insurance.  If nothing is stated, then you will most likely not have coverage for IVF.  If something was stated, you can see how much variation there is between the states.  Please note that you may still have coverage for other fertility services, just not IVF, so please contact your insurance company or consult your benefits manual to see what coverage you may have.

From that website you can go to either the American Society for Reproductive Medicine or RESOLVE webpage for more information on this topic as well as many others.  These are both great resources for many infertility topics beyond just insurance coverage, so please consider reading them further.  I hope this helps on your journey to find the missing piece of your puzzle.

Monday, April 16, 2012

Why can't I see it?

A number of people have made comments about how brave I am or how amazing it is that I'm doing IVF for the 3rd time.  Or how they could never do it or how hard it must be.  I even had a very wonderful friend make me my own Certificate for Being Awesome and Rocking (thanks Cassie!).

I always give them this quizzical look, something like "huh?".  I just don't feel that way.  And maybe I don't because I don't want to build it up in my mind as something that's really difficult (even though it is) and therefore build up my anxiety.  I'm partially afraid of losing my nerve and calling the whole thing off.  It takes a lot of fortitude to stick yourself with needles multiple times a day or to trust someone else to do that to you.  And it's not helping that I have a lot of time to think about this before we get started.

And maybe I don't because there are people who have had much more heartache and gone through much more than I ever had to.  I've been very fortunate to never have experienced a miscarriage, and I'm also very fortunate that I have a fairly good idea of what is causing our infertility.  Many couples have experienced both, and my heart goes out to them.

I'm no hero, and I'm definitely not in line for sainthood.  At the end of the day I'm just like any other person trying to build their family and find that missing piece to the puzzle.

Monday, April 9, 2012

Man's Thoughts

I am not one to normally talk about my thoughts or feelings on this topic, so this is a unique experience for me.  One area I have struggled with is the male part of this process.  While compared to Olivia's requirements, my part is easy, as I have been reminded a few times.  (I cannot disagree with her thinking, because it is so true!)  I struggle knowing she has so much to do in this process, and I do not do very much at all.

For me, the amount of testing a male goes through is very simplistic compared to all of the tests Olivia has to go through.  The initial testing for all men is a semen analysis.  (For more on this test please go to )

My take on this test is do you have ample swimmers, good swimmers, and strong swimmers.  Since it only takes one swimmer, having millions of them helps the odds.  Amazingly, with all the math and science it takes to make a baby, it is still very much luck of the draw.  To perform this test you are usually in the physician's office with a cup and some reading material.

My numbers came back low, but not out of whack.  With this knowledge, it makes me wonder why I cannot do "the job".  In order to do "the job"right for us, we have used ICSI and will use it again.  Olivia defined this earlier, but I will say it again, my sperm are put directly into the egg because they cannot swim to the target.  I still do not know why my numbers are low, just that they are, and we needed assistance to complete the task.  I plan to investigate this further before our next attempt to see if more can be learned about me.  This will not alter our attempt, just helps learn more about why this may be the case, and will hopefully help us find that missing piece to our puzzle.

Monday, April 2, 2012

In life there are no guarantees

When you do IVF, no matter if it's your first cycle or your third, you are always reminded that in life there are no guarantees.  Even though this technology has been around since 1978, it has not progressed to the point where a doctor can say with 100% certainty that it will work.  There are still a lot of unknown factors, and differing opinions on what works the best -- which are the best drugs, what is the best drug combination, when is the best time to retrieve, when is the best time to transfer, and so on.

Even with something as simple as bed rest vs. no bed rest post transfer there is no clear answer.  My first clinic in Madison, WI was not a bed rest clinic.  My doctors felt that moving around got my circulation going and blood flowing to the right areas.  And it also meant that post embryo transfer I was allowed to carry on my normal activities (no exercise or other um, "adult activities" of course but anything else was fine).  Of course it's hard to do that when you know that you have these tiny little embryos floating around inside you but I did the best I could.  I was still working then so I went on with my work life as usual as well.  Two weeks later I got the news that it had worked!  A vote for the no bed rest team.

The second time around I was with my current clinic, and their thinking was that bed rest for two full days post transfer offered the best chance for success.  This time was a little more complicated because I had a toddler to care for but with support from my family, I spent two of the most boring days in bed post transfer.  Once again, two weeks later, we got the news that it had worked!  A vote for the bed rest team.  (It also means I will spend another two boring days in bed sometime this September.)

Clearly there is no solid answer as to which way works better.  The arguments both ways are very convincing.

I've heard from several people in different ways the assumption that I will get pregnant this time.  When I express my own doubts, I get the reply, "Oh but it worked the last two times. It'll work again this time."  But there are no guarantees that it will work this time, just like there were no guarantees it was going to work the last two times.  Is it a little negative to think that way?  Maybe.  I see it as being realistic.  There are just too many unknowns, and no way to know how those unknowns play into the success of a cycle.

But as I like to joke, if they told me to do 10,000 jumping jacks and stand on my head I'd probably do it.  Hunting for the missing piece of our puzzle is a bit like doing a scavenger hunt -- each step brings us a little bit closer to finding it.  But I'm also realistic enough to know that the final step is the hardest and completely out of my control.