Sittin' Tight.

Not much to say....


I've been on my new BCPs for a week now. Thankfully, this past week flew by!! I'm really hoping that this next one does the same.

I return to my RE's office on April 2nd to see if the cyst has shrunk. Until then, I've been keeping busy with projects around the house. I LOVE Piterest! Is anyone else as addicted as I am? :)




Bossy Bud

A bump in the road.

AF finally showed her face Friday afternoon. I've been on Spring Break this past week, and all I've done is wait and pray for her to come. I had three tentative appointments (Monday, Wednesday, & Friday), but I couldn't go to any of them because she hadn't arrived.

I almost cried tears of happiness when I saw red on the toilet paper. I called Mr. Bossy and my mom to tell them the good news. I was so excited to finally get the ball rolling. We had waited 3 months to do our FET. I phoned my nurse and she set me up for a 8:15 appointment on Saturday. I happily set the alarm clock for 6:30 am Friday night (our clinic is an hour away), put out my lucky socks (I'll explain these in another blog), and had my green outfit (Saturday was St. Patty's Day) selected. I was ready. I had to force myself to go to bed Friday night. I felt like a child on Christmas Eve.

Fast forward to Saturday morning. Mr. Bossy and I make the hour's drive to our clinic. We walk in to the clinic where I greet the receptionist with the biggest smile. We take our seats and wait to be called. They called me back for blood work first. Finding a vein in either of my arms is always a challenge for the nurses. I'm not the type that looks away when they insert the needle; I have to look. I don't mind the pinch, and it never really hurts very much. The nurse inserted the needle and MAN, did it hurt! We had to go back to the waiting room and wait to be called back for the ovary check.

The nurse called my name within a few more minutes and we were walking happily toward the examining room. She even commented on my dress, and said that it was the perfect outfit for an ultrasound. She left us in the room to get situated, I put on my socks, and waited on the table. She came back rather quickly and we began the ultrasound. She made a comment that we were looking for a nice thin lining and no cysts. I kept my eyes glued to the screen. Then I heard her say- Ohhh. My heart dropped. It didn't sound good. I looked closer at the screen and saw it. A huge, honker of a cyst. She confirmed it. She said that the doctor on call would have the final decision, but she didn't think we'd be able to proceed with the FET. I had waited 3 months for this? I must be cursed.

Mr. Bossy and I left the clinic and attempted to salvage our day. We shopped a little on the way home. I was in Hobby Lobby (one of my favorite stores!) when the nurse called me with instructions.

The bad news- I wouldn't be able to proceed with the cyst.

The good news- I have to take two more weeks of birth control pills and return on April 2nd to see if the cyst has shrunk. If it has, then I can move forward on the date and I don't have to wait for another period. The nurse also prescribed me some stronger birth control pills.

Mr. Bossy was so sweet. He said if we can wait 3 months, then what's two more weeks?! My mom was also encouraging and called this a "bump in the road." I'm still really disappointed, but I'm trying to look on the bright side. At least, I don't have to wait 3 more months...




Bossy Bud

{Im}patiently Waiting

Period #2 showed up on Feb. 21st. I started BCPs for the FET on the 23rd, and I just took my last one this past Saturday. I had a baseline appointment set for Monday at 9:30 am. Unfortunately, I was unable to go because AF has not shown since I stopped the BCP.

Ugh. The wait is killing me!!




Bossy Bud

Finally!!!

Aunt Flo arrived yesterday!! After cramping for almost a week, she finally showed her face. I have to admit, I was starting to wonder if we had succeeded on our own this cycle. But- she finally arrived, and I'm totally fine with it.

Now, it's time to get this show on the road! I immediately phoned my favorite nurse, and she instructed me to begin my BCPs on Thursday. I will take my last one on Thursday, March 8th. My first appointment for our FET is Monday, March 12th. I'm also supposed to begin retaking my metformin tonight. Who would have ever thought that I would be SO stinkin' excited about Aunt Flo showing AND starting BCPs?! As Mr. Bossy said to me this morning- "It's babymakin' time!"

I am also so excited for my sister buds!

Diva- I think about you every day! You've got this, girly! Sending you tons of positive vibes and sticky mojo. :)

Buckeye- I'm so glad that you were able to meet with your new RE, and you were finally given a diagnosis. What a relief you must have felt!

Curly- Glad to see you and Baby Curly are doing well! I was beginning to wonder where you've been.

Bossy Bud

Med's Arrived

I received the majority of my medications in the mail the other day. I feel like I am mostly ready for this third round of IVF. We are doing a mini-stim cycle so it is more Clomid and less injectionables but it is still pricey over in the US!! In Panama we paid about $1,200 for the full round of injectionables, progesterone, Clomid and all the miscellaneous pills I was blessed to take!!

I am done with BCP's tomorrow and Progresterone pills which is good because my body is whollly confused. I have been spotting the past three days and have had to start taking a double dose of BCP's to prevent AF from coming too early. I have been really crampy and feeling bloated which I will be glad will be over in a few days as well.

My first appointment for the start of this cycle is this Monday. I am going to really go over ways we can ensure my lining is up to par and that we are taking all available measures, since that is something I have a "feeling" is part of the problem that those embryo's aren't sticking.

Strangest TTC thoughts ever

Some of my thoughts the past few included: "Oh crap, did I remember to take my birth control?" and "Come on AF show up now!"

What kind of TTC thoughts are these? The world of infertility is very crazy and can definitely turn you around at times. While these thoughts would definitely be counterproductive to a normal person TTC, for someone going through IVF it is a normal thought. I have just trained my brain to where all this is normal and at least Mr. Planner Bud and I can joke about it. We went out with friends over the weekend and I had to take my pill while at dinner. The husband was thoroughly confused and asked, "I thought you were trying to get pregnant, what happened?" Mr. Planner bud looks at me and says, "Crap, this is what we have been doing wrong for over a year and a half."

I finished taking the BCP on Sunday and am now waiting for AF to show it. This is another crazy feeling. I have been hoping for AF to come for the last two cycles. This is not what one normally wishes for when desperately trying to have a child. Hopefully AF shows her lovely face today; if not, I will have to call the RE's and go in for some bloodwork. I am just beyond excited to start stimming and get this show on the road. Come on I have this huge pile of needles waiting to be used:

IF Whirlwind

It has been quite and interesting few days since I last posted. I have spent the last few days on the verge of tears. There were even a couple days where I didn't make it out of bed. I was beside myself that our treatment was being pushed back so far. I was sure our chances of getting pregnant during 2011 was totally shot.

Then AF showed up two days early on Saturday. It made my depressed mood even lower. It was Mr. Planner bud's birthday on Sunday and I wanted more than anything to give a BFP, or at least some sexy time. I also thought that this completely shot our chances of doing anything this cycle.

This morning I called my office to let them know I was on CD 3 and see if we could do anything this cycle. The nurse told me she would talk to the doctor, but probably not.

Fast forward to 3:30 today. I get another call from the office. It was the insurance liaison saying that our petition for IVF got okayed for three cycles. I was through the roof. I still thought it meant that we would be out this cycle, but at least we had a great plan. I called the nurse to see if we could possible start today, even though I am on CD3 and not CD1. The answer was YES, pick up your BCP in a couple hours. We are beginning this cycle.

I am beyond excited that we actually have a real chance to try for a child. I know that it may not work out time one, but at least I will know. By the end of this year, I will know whether we can have a child or think about adoption.

Everything You Never Wanted To Know...

...about my ute.

Since I'm in the midst of the 2ww (7DPO today), I figured this would be a good time to get you all up to speed on a somewhat relevant bit of my history. Plus, I know when I was wondering what was wrong with me it was helpful to hear others stories. Be warned there may be TMI for some.

First the back story:
In December 2007 I was working outside at my job. Woods in Virginia. On an Army base. Just me and 5 guys. It was my time of the month (no biggie, used to that in such situations). This day was different. The bleeding was so heavy I was going through a tampon AND a pad in about 10 minutes. Clots passing that were quarter to palm sized. The guys were asking if I was OK as I was pretty pale (in hindsight, I was probably anemic). Needless to say we did the bare minimum we needed to do that day and then baled. The rest of my period was fine. I figured it was some fluke thing.

Until June 2008. In mid June I started spotting mid-cycle. I was on BCP at the time and figured it was just time to change the type of pill. So we changed the type of pill. Still spotting. Changed pill type again. Still spotting daily, sometimes pretty heavily. In the meantime at each follow-up appointment I'm being screened for everything under the sun that could cause the bleeding. Syndromes. STDs. Cancers. Stuff that really gets the mind racing. Nothing like knowing something is definitely wrong...but not having anyone be able to tell you what that something is.

There was another incident of extremely heavy bleeding in late August 2008. I remember the exact date as it was at my best friends wedding. Awesome Timing. I spent half the event in the ladies room trying to keep up with the bleeding. I got back from my trip to the wedding and got in to see my doctor ASAP. Enough already.

My normal OB/GYN realizes she's in over her head as the issue isn't being resolved and refers me to a specialist. This was in Sept 2008. THREE MONTHS of constant spotting/bleeding later. This specialist, my first male OB/GYN, puts me on a different pill. This pill actually made a difference with the bleeding. Got it down to about 5 days of spotting in the 3 weeks of active pills. Doctor isn't satisfied with the results. Wants it down to 0 days. I get an unexpected uterine tissue sampling done in his office that afternoon. Cervix manually dilated and they scrape out some tissue. No anesthesia. Not Fun. Sample comes back negative for uterine cancer (woo hoo!). Since there are still no answers, its time to go in and take a look around.

The Resolution:
In January 2009 he performed a hysteroscopy and D&C. For those that aren't familiar with what those procedures are, I'll give you a quick description. In a hysteroscopy, they distend the uterus with either a liquid or gas (in my case, saline). They then insert a contraption called a hysteroscope to look inside. In my case he was looking for the source(s) of the bleeding.

(Image Credit: http://tinyurl.com/4fzpoqo)

Once he'd had a look around, and removed the two culprits, he performed a D&C. During a D&C (aka Dilation & Curettage) the cervix is dilated and then the contents of the uterus are removed. Though most commonly associated with miscarriages, D&Cs can also lessen heavy bleeding like I was having.

The Diagnosis:

Submucosal Uterine Fibroids. One of the least common of the types of uterine fibroids, accounting for 5% of all uterine fibroids*. These fibroids grow on the inner side of the uterus and I had two of the classic symptoms: Unusually heavy or prolonged menstrual periods and bleeding between periods.*

(Image Credit: http://tinyurl.com/4gtvw7h)

I want to note that uterine fibroids are very common and rarely cancerous. My doctor said roughly half of the women of childbearing age have them. Most of those women have no idea they are even present. My type was enough of a rarity that I got to be a case study for my doctor (Go Me!). Unfortunately, that meant he needed all the pictures of the inside of my ute (I know, I'm strange in thinking stuff like that is cool...but how often do you get a photo like that???) To my knowledge I have two fibroids in my uterus still. One was left during the D&C as they didn't have the tools to reach it. Its up at the top of my uterus. The other was found via ultrasound during my miscarriage, its on the sidewall. I've only had two minor bouts of spotting since the D&C. Nothing to worry about really. And honestly, just knowing they are there is more than half the battle. The worst part of the whole unexplained bleeding deal was not knowing what was wrong. Finding out was so empowering.

I've had about 5 different doctors swear up and down that my having fibroids should have no bearing on my ability to get and stay pregnant. Crossing my fingers they are right.

So, there ya have it...everything you never wanted to know about my ute.

Take care,



Reference:

* http://tinyurl.com/4fcr8dp

(To any of the Buds reading. Could one of you tell me the trick to get it to say photo credit where I have the links listed under the images? Thanks!)

Last BCP of 2010.

Today is officially my last day of Birth Control Pills. My Baseline and E2 Ultrasound are on Monday and if all goes well I will be able to start stims next week.

Photography Credit

Looking back on 2010 it is was a rough year for Mr. Blessed Bud and I but, a new year brings a renewed sense of hope and faith that God has our situation under control. Wishing all of the Buds and Bloomin' Babies readers a very Happy New Year!!

Until Next Year,

Spent $600 in 5 minutes!

Hi Buds and Bud readers! Long time, no see. I've been trying to stay away from all things baby for awhile but wanted to submit a quick report.

I had my $600 out-of-pocket hysteroscopy today, just to confirm that my uterus isn't scarred shut or some other nightmare diagnosis. I am happy to report that it looked flawless! I am not happy to report that I wasn't told to take Ibuprofen beforehand and this time it hurt like hell. But it was totally worth it to confirm that my uterus is in good shape for our upcoming frozen embryo transfer.

Speaking of which, I started Lupron last night. I am also on BCPs (for now) and my suppression check is on November 18. I'll begin estrogen patches and supps shortly thereafter. So now it's hurry up and wait until December 17. We will definitely be thawing and transferring 2 this time. Assuming all goes well, we'll still have 3 frosties left for another cycle.

Will get caught up on the Bud reports this weekend.
Take care everyone!

Golden Bud

IVF Update: BCP & Lupron

I feel like my pre-IVF cycle is moving right along!

I am on my 3rd and final week of BCP. The first few days I felt completely fine on it. Then I became an emotional mess for another few days. I think my body has finally gotten used to it. I feel totally normal now!

I started Lupron 5 days ago. Lupron is taken as an injection to my stomach. The first few injections were uncomfortable. The needle itself didn't hurt but the injection site stung for about 15 minutes after. I figured out that if I pinch the skin before putting in the needle and then let go of the skin before I pull it out, the Lupron doesn't leak out at all, which is what I think was causing the pain. Mr. Sassy Bud did my first injection, but he got home late the second night so I did my own. It was actually really easy and I prefer doing it myself. I never thought I would be able to give myself an injection so I am proud of that. I have heard some pretty nasty side effects from Lupron, but so far I haven't had any. I do my injection right before bed and feel totally fine in the morning.

On Sunday I go in for a suppression check. This is to make sure that the BCP and Lupron are doing their jobs. A few days after that I start my stimulation meds, while continuing the Lupron. I can't believe how quickly everything is happening. I should be all finished with my IVF cycle, including betas, by the end of this month.

Today is the last day...

Of birth control pills!!! YAY!!!!

I'm trying this whole "be positive" thing. So I expect to be posting my bfp in a few weeks, okay?

If my cyst shrunk from 4cm to 2cm in 2 weeks, it should shrink small enough to move forward with injections in a week and a half, right!?

So here's hoping that AF starts soon!!! I'll be pulling out all of the white underwear and pants that I own to trick the wench into showing her ugly face.

It's been a nice break, although unwanted. But I'm ready to get back in the game, coach. I've got 2 cartridges of Follistim and an HCG shot in the fridge just itching to be used! I've never been so excited to get a shot in my life. Crazy the twists that life takes...

Wow, my body is CRAZY!

Well the good news is that my 4cm shrunk to 2cm.

The bad news is that it's still too big to proceed.

The worse news is that I have FIVE more cysts ranging between 11mm and 18mm.

Um, what?

She said it's possible they could be follicles and that the birth control pills aren't suppressing me properly. So I have to finish up the 5 remaining days of birth control pills and hopefully get a period and then we'll see what's going on at CD3. If they are still there, she'll check my estradiol level and if it's high, then another month on birth control pills.

Seriously... only I would still get follicles on the pill. I am PRAYING that they are follicles and not more cysts because how on earth did I get FIVE more cysts on the pill!!!

Got anything to spare?

Here I am 2 days before my re-scan on my cyst to see if it's gone or not. I've taken 14 days of the birth control pills so far. I detest them.

If you have any prayers, good thoughts, juju, rain dance, whatever you've got to spare, please send them my way that this little bugger is gone and I can stop taking these awful devil pills. I don't have a good feeling about it but maybe that's me being my usual pessimistic self.

Thanks!

A good CD1

Typically CD1 is a letdown where all your waiting and hoping for the cycle comes crashing down. This CD1 is different for me. It marks the beginning of my first IVF cycle!



I'm going to try to explain the IVF process as I go through it in a way that is understandable to those who have never been through it, so if I seem to "dumb it down" a little, that's why. This pic gives a general idea of the process, although in our case the egg and sperm go through a little different process. Because of our MFI, the RE will be fertilizing them.

Photo Credit

When I met with the RE, they told me to call on CD1 to schedule CD3 blood work. I will be going to the RE this Thursday to do the blood work, and I think they may do a transvaginal ultrasound then too. At that point I believe I also start BCP's. The purpose of the BCP is to suppress my natural cycle until they are ready to stimulate. A few weeks after I start BCP I also take a drug called Lupron which is part of the suppression process.



I am on BCP & Lupron for a total of 3 weeks. Once I stop the BCP, I will get a withdrawal bleed and with that CD1, my IVF process begins. During the 3 weeks, Mr. Sassy Bud and I have to do infectious disease testing along with training on how to do the injections for the IVF medications. Mr. Sassy Bud will be in charge of giving me all my shots. Fortunately for me, he has no issues with needles. I'm not a huge fan of them, but you do what you have to do.

I also got all of the information as far as financing our IVF process. Our insurance covers most of the procedures and medications. I am so fortunate to have this coverage! The total OOP expense came to a little over $2k, which includes our copay of 10% of the IVF procedure, the anesthesia (which may be covered but is not billable) and the surgical supplies (also may be covered). I believe all of our meds will also be covered. The only bad news is that with this IVF we are maxing out our lifetime coverage for IF treatments. If this one doesn't work, we will be 100% OOP for any other treatments we do. That is a scary thought, and the thing that is stressing me out the most about the whole process.

So that is where we are right now. I'll be sure to update after my CD3 appointment.

Nothing new to report.

Just coasting along on the birth control pills.

Devil pills. I hate them.



I forgot just how much I hate these things. Moody, emotional and ZERO sex drive.

And I'm not entirely sure if they are working, which is the worst part.

I had some random bleeding yesterday even though it's been 3 days since AF officially disappeared. I don't normally breakthrough bleed on birth control pills but I figure it's either that or maybe the cyst sprunk a leak? Wishful thinking, yes. I've been crampy for a couple days. I just pray that there is something GOOD going on in there. Shrinking instead of growing, please.

Really hoping for good news on the 15th when I go in for my re-scan.

Can't get pregnant, can't get unpregnant

I don’t want to spend too much time talking about the D&E itself. I will say that if you take away the heartbreak, the procedure is fairly simple and painless. We hadn’t told anyone about the pregnancy except my mom and my best friend, so we only had to break the bad news to two people. My mom had apparently told her friends, so she got to untell them as well.

My RE’s office needed to know if the defect was genetic in origin, so we had karyotyping done. Neural tube defects (NTDs) aren’t typically genetic, and ours was no exception (meaning it wasn’t the donor’s fault). I never did ask if the donor was allowed to cycle again. I did find out the sex of the baby, which I’ll refrain from sharing. (Mr. GB didn’t want to know.) I also received tiny footprints, which are tucked away safe for now.

(We don’t know what caused the defect. They say that NTDs can be prevented with folic acid. I’d been taking prenatal vitamins for years, but it wasn’t enough. At my request I was tested for MTHFR (a disorder that can cause difficulty in absorbing folic acid), and I don’t have that mutation. My homocysteine levels were also normal. I read NTDs are more common with IVF…I always wonder if the lengthy embryo transfer was the cause. I also read that hot tubs and saunas can cause NTDs, and I wonder if sunbathing was the cause, even though I sunbathed after the window for NTDs closed. It was probably just horrible bad luck. I’m taking 4 mg of folic acid now, just in case. I have a 1% chance of it happening again. I hope it doesn’t.)

As I was recovering from the D&E, I was more determined than ever to try again. In fact, I was filled with an odd sense of hope that’s really hard to explain. Maybe it was just a coping mechanism. I did have bouts of sadness and grief, but I was ready for AF to arrive and start a new donor cycle.

Except AF was nowhere to be seen, and my HPTs were still positive. And I was still bleeding, like for a month. Went back to the MFM’s office for an ultrasound but nothing looked suspicious. She gave me Cytotec/Misoprostol to try to flush out my uterus, but nothing happened. Mentioned the bleeding to my donor coordinator, who talked to my RE, who told me to come in for a hysteroscopy to look around. The camera showed that my uterus was filled with cobwebs (aka “products of conception”) and a second D&C was needed. My RE said I could get the procedure done at the RE’s surgical center, but we’d have to wait a month.

So we commenced waiting. Again. We’re talking 77 days between the first procedure and the second.

Surprise surprise, AF arrived 58 days after my D&E. I will spare you the details but let’s just say it was the worst period EVER. My RE still recommended the D&C, but the good news was that I got to go on the pill, which meant I’d finally have control of my cycle back and we were finally ready to start looking at donors again. YAY!

I had my second D&C on August 11, the same day we put down our donor deposit. In the next few days I’ll talk a bit about our selection process (my criteria changed dramatically), a slight setback, and where we are today. But for now, I’ve got to run upstairs for a Lupron shot!

To be continued…

Golden Bud

You're going where to do what???

Planning this trip to Costa Rica and Panama has been a very interesting process. We decided early in April that this was the best option for Mr. CB and I, but there was so much uncertainty about Mr. CB and his work schedule that it wasn’t possible to book everything right away. It was a weird place to be ~ we knew I was going the whole time, but didn’t know if Mr. CB would be there the whole time, or if he would be there half the time and my mom would be there the other half, or if all three of us would be there together some of the time. For someone who likes to go full steam ahead once a decision is made, it was very difficult! We finally made the decision the first week of June that Mr. CB will there the entire time with me. This makes me extremely happy, of course. In a future post I’ll detail our travel plans and the fun exciting places we will be visiting, but I think most are wondering about how this whole IVF in another country works…so I’ll start there.

The doctor I will be seeing is Dr. Ariel Perez Young. His practice is established in San Jose, Costa Rica, and from what I’ve heard, it is THE clinic to go to if you’re struggling with infertility. I haven’t spoken to Dr. Perez at all. Any contact I have is through Mark Semple, the president of Passport Medical. He’s basically my middle man (which is good since I don’t speak any Spanish!) and he has set up all of my appointments and answered any questions I have about the process. If I have a question for the doctor (I was wondering a few weeks ago what his minimum lining thickness was for transfer), then Mark will email Dr. Perez and then get back to me.

I started birth control pills when I started my May cycle. Luckily I started my period towards the end of the month, so I will be on the pill for a total of five weeks. This will suppress my ovaries and allows my cycle to line up with the time frame needed for travel. I stop the pill on June 26, and fly to Costa Rica on July 1. I will have my first monitoring appointment that afternoon, and start my stimming medicine that day as well. I go back for monitoring on July 7 and July 10. Hopefully I have tons of great looking follicles and at this point my egg retrieval will be scheduled.

On July 12, we fly to Panama with Dr. Perez. The reason you have to go to another country is because IVF is illegal in Costa Rica. I did a little research, and basically back in the early 2000’s IVF was banned in Costa Rica because of religious reasons. There are still some artificial reproductive technologies that are acceptable, but IVF is not one of them. So to get around this law, Dr. Perez takes his patients to nearby Panama to perform the actual retrieval and transfer. We’ll be in Panama from July 12-19, and during this week we will have the retrieval and transfer. We fly home on July 19, and then wait a few days before POAS! Any after care I need will be through my OBGYN.

So this in a nutshell is IVF in Costa Rica and Panama. It’s a lot of planning and traveling and uncertainty, but the same can be said for an IVF cycle in the US. What is really different is the price. We had a quote from our local RE of about $14,500 for IVF and medications. We will be approximately $4500 for the same procedure and the same medications in Costa Rica/Panama. The IVF is $2800, three monitoring appointments are $85 each and medication is roughly $1500. Even when we add in our travel costs, we will be well under what it would have cost us here. And we’re going on a vacation for 19 days! You can't beat that!

Hi, my name is Chef Bud and I am BACK!

Hello to all the Bloomin' Babies readers...I know it's been a while and I'm sorry to have kept you waiting so long but I am back and boy has my story taken a different turn!

In my last post way back in March I told you all that our doctor had suggested we move to IVF, and I was looking into the split donor cycle that my RE offered. Shortly after that post, I heard back from the split donor coordinator, and she basically told me that because of my family medical history, I would only be accepted with reservations (and this would be after extensive tests and interviews) and that most likely I would never have a couple choose me to be their donor. It was so hard to hear this...I am a healthy young woman and my RE seemed so sure of this being the perfect fit for us. But I also understand that when a couple makes the hard decision to use donor eggs, they want everything to be as perfect as it can be with those eggs.

So once that option was out, Mr. CB and I were back to square one. The OOP cost at my clinic for IVF is $9300 (ICSI is an additional $1100) plus the medication which could be anywhere from $3000-4000. I was prepared to do anything to make this happen, but I also wanted to be financially responsible. We have worked so hard over the past few years to get out of debt and neither one of us wanted this to put us right back where we were.

While posting on my favorite message board I had seen a post that talked about going out of the country to do IVF. I thought it sounded interesting, so I started doing some research. I found a company called Passport Medical that assists people with medical tourism. I began emailing with Mark, the company's president, and discovered that IVF in Costa Rica/Panama costs $2800 (including super-ICSI) and the medications are half the price of what they cost here. Right away I got on the internet and started pricing out flights, accommodations, rental car and other costs that we would incur over a 19 trip to two countries. I was amazed to find that we could travel to two beautiful places, stay in nice hotels and apartments, see some amazing sights...oh yeah, AND do an IVF cycle...for under $10,000. I was immediately ready to sign up! Photo of Arenal Volcano

It did take some time for Mr. CB to warm up to the idea, and even longer for our families. Once I showed them the statistics for the clinic, and Dr. Perez's credentials and training (he even trained and worked at a top US hospital), everyone was on board. What made me even more comfortable with doing this was that Mark and his wife were going to do their cycle in Costa Rica/Panama in May. He was able to share his experiences and why they felt good about traveling thousands of miles for IVF.

I will say this option isn't for everyone. There are some drawbacks that I will talk about later...let's just say you have to be really laid-back and able to just trust in the system without a lot of questioning. I will say for me, so far so good...I am excited, nervous, hopeful, scared, optimistic. A lot of emotions all rolled into one.

I have so much to tell you about the process but I don't want to bombard you all at once! So over the next few weeks I'll explain how it all works and give details about what went in to planning the trip. Right now I'm on week three of devil pills, which I will take until June 26th. We fly out July 1st and will have our first appointment that afternoon.

In Costa Rica, they use the term "pura vida" as a greeting or farewell. When I looked it up, I found that they use the phrase to express perseverance, resilience in overcoming obstacles, enjoying life and celebrating good fortune. This is definitely our theme for the trip, and our new mantra!

Photo Credit

There, but for the grace of Tampax, go I.

Ah, to be in the house of Dandelion.

I'd love to say that the road to IVF #2 is fraught with blood, sweat and tears - but mostly, it's just blood.

I've been on my favorite devil pills for 6 weeks now. I just started pack number 3 of the desogen. At least I know I only have to take 5 pills from this pack - because my last devil pill will be this friday. Usually, after you stop taking the devil pills, you expect a period. However, i've already been bleeding for almost 3 weeks. Isn't it just fantastic? Usually, the ONLY benefit to BCPs is NOT bleeding. Not in Dandelion land... not this time, anyway. The good news, is that my IVF nurse says I might not bleed like I did last time i came off the devil pills, since i've been bleeding for so long. But I've been through almost 5 boxes of tampons. So, enough is seriously enough already.

photo credit

I had my baseline ultrasound this past wednesday. The good news: my antral follicle count is 11. So - that's not great - but it certainly doesn't suck. Our only question is how many of those eggs aren't geriatric. I guess time will tell. I found this chart (below) online... explains a little bit more about AFCs. I think my AFC last time was 14 or 15.

Total number of antral follicles	Expected response to injectable stimulating drugs and chances for IVF success
Less than 4	Extremely low count, very poor (or no) response to stimulation and a cancelled cycle expected. Should consider not attempting IVF at all. Rare pregnancies if IVF attempted.
4-7	Low count, we are concerned about a possible/probable poor response to the stimulation drugs. Likely to need high doses of FSH product to stimulate ovaries adequately. Higher than average rate of IVF cycle cancellation. Lower than average pregnancy rates for those cases that make it to egg retrieval. The reduction in success rates is more pronounced beyond age 35.
8-10	Reduced count. Higher than average rate of IVF cycle cancellation. Slightly reduced chances for pregnancy success as a group.
11-14	Normal (but intermediate) count, the response to drug stimulation is sometimes low, but usually adequate. Slight increased risk for IVF cycle cancellation. Pregnancy rates as a group slightly reduced compared to the "best" group.
15-30	Normal (good) antral count, should have an excellent response to ovarian stimulation. Likely to respond well to low doses of FSH product. Very low risk for IVF cycle cancellation. Some risk for ovarian overstimulation. Best pregnancy rates overall as a group.
Over 30	High count, watch for polycystic ovary type of ovarian response. Likely to have a high response to low doses of FSH product. Higher than average risk for overstimulation. Very good pregnancy rate overall as a group, but some cases in the group may have egg quality issues and somewhat lower chances for pregnancy.

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Okay - so the question on everyone's mind... what the heck is causing the bleeding? .... what about the fibroid? Here are the answers to those questions....

The bleeding, as far as they're concerned is just an unfortunate and messy side effect of the BCPs. They are 100% sure that it is NOT from the fibroid, because the fibroid "has not deviated the uterine cavity". In other words, my lining appears on the ultrasound as a straight line. If the lining were interrupted, because a fibroid had broken through into the uterus, the line would be separated, interrupted or deviated in some way. It is not. So, Dr Z is NOT concerned at all. Therefore, I am not concerned at all. However, there isn't just 1 fibroid anymore. Now there are 3. Nevertheless, as long as they all stay outside of my uterus, where they are now, Dr Z could care less, and isn't even considering taking them out. Totally works for me.

I also discussed another concern with him. It seems that the majority of girls I talk to have an ultrasound guided embryo transfer and all have had a mock embryo transfer prior to their cycle. I hadn't had either - and I was curious as to why. Mr DB told me just to ask, so at my appointment i said, "Dr Z, i'm in a support group (he doesn't like that I go online all the time, so i figured he'd take it better if I told him this all came from a support group), and some of the girls were talking about their transfer experiences. I was wondering why it seems that some doctors do mock transfers and u/s guided transfers, and some don't?" He was SO awesome with his answer. First of all, I DID have a mock transfer... it's just that mine happened during my retrieval while I was unconscious. That works for me! Then we talked about the u/s guided transfers.

Apparently, they did do them for about 4-6 months when they first came in vogue. However, their pregnancy rates dropped by almost 15% during that time. Dr Z said that it is a matter of learning new technique and personal preference. He said that in his experience, you can focus too much on the picture, and even a minor movement can cause you to lose embryos. Furthermore, he felt t he full bladder was very uncomfortable for patients. He said as soon as he stopped doing the u/s guided transfers, his pregnancy rates went right back up, so unless he has a patient with a particularly difficult mock transfer, he prefers to NOT do them.

As his pregnancy rates are already above the national average, without u/s guided transfers, I say, "if it ain't broke, don't fix it".

What 8 grand worth of meds looks like

So, where we are now:

• Last devil pill will be this friday
• Suppression check Friday, March 5th
• Stims start, at max dosages, Friday, March 5th
• 1st monitoring appointment Tuesday, March 9th
• ER/ET will be the week of March 14th

This time it is going to work - POF be damned.