Celebrities and IVF

Celine Dion is pregnant with twins after IVF#6 and credits her success to acupuncture.   

Yes, #6.  I cannot even imagine what it must be like to go through so many hormones in your body (and the fun side effects it comes with).  Also to go through so many IVFs mean the heartache of many cancelled or failed cycles along the way.  It must be hard to remain hopeful and stick with the program to believe that the IVFs will be worth it in the end.  It always amazes me how strong we can become in the face of adversities.

Then there is the cost (for us regular people).  It’s probably a drop in the bucket for her but I guess her insurance doesn’t cover this?

All in all, I’m happy for her.  More so because she has been so open about her struggles with infertility and IVF that it helps educate others about ART (unlike some other celebrities who have fraternal twins and come out to say that IVF is unnatural).  I think it’s great when people, especially celebrities, are open about their struggles and not try to project a perfect life — mainly because of the reach they have and not say stupid things that others may disagree with.  It makes us appreciate them more and helps us feel less alone in our own struggles.

Disclaimer: I am not a fan of Celine Dion’s music

FET#1 update (scan #1)

My 9:30am appt finally happened at 5:15pm.  I’m not entirely sure if the visit was necessary — but fine, I will go with the flow.

5 mins and a scan later showed that I have a 11mm cyst on my left ovary.  Solution?  Stop the BCP today, rescan next tues to see if the cyst has gone away.  If it hasn’t gone away by then, we will wait a few more days and see if it will go away.  So back to the waiting game.

S$165 (~US$120) for a 5 min visit.  Not bad on a per min basis.

Don’t get me wrong.  I really like my RE but I think today, neither of us had our A game on.

FET #1 underway

Well, I guess technically I am on a delayed IVF#2 but let’s call this FET#1.

To recap, we held back on transferring any of our embryos during IVF#2 because my lining was acting up again — less so than IVF#1 but we didn’t want to take the chance of putting in good embryos to a sucky, over-medicated home.  Part of the decision was to preserve our good embryos (after all, we only had 2 good ones from ivf#1) and part of it was to keep my sanity — I’m not sure going down the same process and ending up with another BFN would be good for my soul. 

Luckily, the long lupron protocol seems to work better and we have 7 popsicles (6 if we exclude the one that collapsed). 

And it just occurred to me that FET is well on its way since I’ve been on BCP for the last 10 days or so and topped up with a nice shot of Lupron in my butt on Thursday.  The lupron depot was the mother of all needles — having stuck myself with many needles in the last few months but this just took it to another level.  The Lupron Depot is a long acting one that serves the same purpose as the others I’ve jabbed myself with daily – to quiet the ovaries/system down.  Honestly, given the one shot deal vs. the daily shots, I think I might be happier taking the daily shot — that’s how bad the needle was.  Fine – call me a wuss. 

So my first scan will be on Tues, 25th, and I will be medicated to stimulate a cycle and the transfer is targeted around mid June.  Will share more on the medicated FET cycle once I get more clarity on Tues. 

I hope this is it but at the same time terrified if we get another BFN. Positive thinking.  Positive thinking.

Paying for IVF

Going through IVF not only hits you emotionally, but also your wallet.  This is even more so since most insurances does not cover treatments (for the most part, they don’t even cover my annual visit to the gynae).

 

Each IVF cycle with the medication, procedures, etc. cost around S$13,000 – 14,000 (around US$10,000) in Singapore in a private hospital.  I’ve read that it’s a bit cheaper with the public hospitals but we just went with the Dr. we met that gave us the most emotional comfort.  Fortunately in a, we can use part of our CPF pension (the medisave portion) to pay for IVF if you are a PR or citizen upto a lifetime limit of S$15,000 over 3 cycles – $6k, $5k, and $4k.  Unfortunately for us, we haven’t been PRs long enough that we drew down our whole medisave savings of S$3,000 during IVF#1.  At least some help is still better than no help.

Mileage Credit Card

Rather than paying directly out of our savings, we have accrued a lot of miles.  So far, we have managed to charge all our medical expenses to our mileage credit card – the Singapore Airline Krisflyer card to be exact (one more place Amex is accepted).  Heck, if we going to pay for this we might as well get additional perks in the form of free tickets.  And the large payments have helped us hit certain spending limits which gives us bonus miles on top of the regular rewards (definitely not a good thing but at least we get something to show for it).  So far, we’ve accumulated enough miles from the cycle for 1 free roundtrip ticket to Europe from Singapore.  Also, by putting the charges on the credit card gives us 1 month of free credit before paying the balance out of our savings.  

Guess given the circumstances, this ain’t a bad “side effect” huh?

Follistim/Puregon vs. Gonal-F

Honestly– there wasn’t a big difference having tried both – although not with the same protocol so I don’t have a proper control.  I can’t say that one was better for me or not. 

Gonal-f vs. Puregon (Follistim)

Overall:

Application: both were easy to use pen applicators with one time use needles that easily screwed on and off.  The pen works with a dial in the back for the dosage and you click (like a pen) to inject the dose.  Detailed differences:

Puregon/Follistism: 1 pen with a case.  The pen is reusable and inserting the medication vial is really easy.  The

Gonal-F: pen preloaded with the dose (300IU, 600 IU, and 900IU).  Once you are done, you throw the pen away.  The only issue I have is that it seems quite unenvironmental.

Cost: About the same.  Puregon/Follistim cost S$410 (US$300) per 300IU which has enough for 400IU.  Gonal-F costs S$900 for 900 IU (US$655).  Standard dose of Gonal-F is 225IU while Puregon is 200 IU.

Side Effect: no observable side effects other than Gonal-F seems to burn more when injected.

IVF#2 recap

Our IVF#2 Summary:

• 13 birth control pills
• 28 shots in the tummy – wow, especially since I did more than half of them this time
• 4 shots in the butt (trigger, pregnyl, and 2 painkillers post ER)
• 4 blood draws
• 10 days antibiotics and baby aspirins
• 1 IV (with this nasty bruise on my hand)
• 1 egg retrieval surgery (30 min of the sleep)
• 2 puking incidents (related to painkillers in the butt)
• 7 progesterone sticks and 10 progresterone pills

= 7 blasts on ice out of the 19 eggs retrieved (16 mature, 14 fertilized)

Fert Report#5 (Final)

Our final fert report, also known as our freeze report:

• 4 good looking blastocysts
• 2 very average looking blastocysts – however, 1 collapsed during freezing and may not recover at thaw
• 1 average to good blastocyst

So, all-in-all we have 7 embryos on ice (or popsicles) – enough for 3 transfer attempts before sticking myself with needles again.  Yay.

After the rollarcoaster of emotions since yesterday, I have not had the chance to let the news sink in.  2 months of hormones and emotions all holed up is not a good thing.  But the report is much better than the 2 popsicles we were expecting and only time will tell.  Finally a sigh of relief and hopefully we’ll be able to get away for a super long weekend next weekend for a much needed break.

Can’t wait to see if our popsicles prefer somewhere warmer back where they belong.  Frozen transfer attempt #1: coming up in June.

Fert Report#4.5 (5 days post ER)

Our embryologist called this afternoon to give us an update.  Our embryos are not doing as well as reported and we are only freezing 2 instead of the 4 we were expecting today.

The update:

• Freezing 2 of the 3 good looking blastocysts today
• 1 of the 3 good looking blastocyst is not developing
• 1 average blastocyst have not progressed in the last 4 hours – unlikely to make it
• 2 embryos are still cavitating and not in blast stage – so no change in status since this morning and will be decided on tomorrow

I’m feeling really sad about our little embabies.  I was so hopeful this morning that we’ll have 4 blasts on ice today that now we are looking at only 2.  If we are really lucky, we might have a few more.  I hate how this process gives us hope and then takes it all away again so quickly.  I just want to go home and crawl into bed but work is kicking my butt right now on top of this so I can’t even do that.  Great.

Fert Report and ET decision (5 days post ER)

Our fert report today:

• 3 good looking blastocysts
• 1 average looking blastocyst
• 2 cavitating embryos (between morula and blastocyst) – expected to be good blastocyst tomorrow

We had another lining check this morning to make a call if we would do our ET this afternoon (cutting it a tad close I guess).  Although the lining looked ok (dense, around 8.7- 10.5), Dr. N recommended that we keep our embryos for a thaw cycle given the progression of my lining during this IVF cycle.  He’s not convinced that the current lining is an ideal bed for our embaby and he rather have a separate cycle where our focus is on the lining (and not on producing eggs).

We completely agree with him.  We only have so many embryos/possibilities at this stage and it seems a waste to put them in where it’s harder for them to stick.  The analogy I have is to try to grab onto a wall slicked with oil.  Not easy, huh?

So – 4 blastocysts are going to be vitrified (ie glass-like flash freezing, think Hans Solo from Star Wars) today and hopefully 2 more tomorrow (fingers crossed).  I’ll go through the remainder of the cycle until my period and hopefully be clear of cysts to start our FET (frozen embryo transfer) in June.

Medication: Duphaston 2x daily (for 10 days)

Fert Report#3 (3 days post ER)

Bright and early at 9:06am this saturday morning:

• 7 good looking embryos: 6 at 8 cells and 1 at 7 cells
• 3 so-so embroys: at 6-8 cells but the cell sizes are uneven
• 4 not good looking embryos: at 2-4 cell stage with fragmentation (not viable)

Next fertilization report on monday since there is unlikely to be any significant developments from today to tomorrow (plus it is labor day after all).  Work away little embabies — please stay strong and grow.