Summer Vacation 2012: Puerto Rico

In early May, we decided we were really in need of a vacation.  The past 6 months had been pretty stressful and we really just wanted to get away.  We knew we wanted to go somewhere warm with a relatively short flight time.  After about 30 minutes on Kayak and Tripadvisor, we decided on Puerto Rico.  We spent about an hour researching places to stay and renting a car and that was all the planning we did.  I'm typically pretty Type A, so the fact that I didn't have a minute-by-minute itinerary was pretty unusual.  It seems like having to deal with all of the uncertainty of infertility has been good for me in some ways :)

We stayed at a really cute bed and breakfast called The Blue Boy Inn on the west coast of Puerto Rico in a small town called Rincon.  It is primarily a surfing town, but since summer is the off season for surfing there, it was pretty secluded.  We had planned to spend two days at the end of our trip in San Juan, but after two amazing days of relaxation in Rincon we canceled our San Juan reservations.  We decided we would just rather stay in one place rather than spend a lot of time driving.  Plus, San Juan traffic was INTENSE, so I was fine with staying in the smaller town.  Also, the B&B had nutella crepes every morning.  How could I leave that?!

We spent our days lounging by the pool, snorkeling, reading, and sitting on the beach.  We hiked to a waterfall one day.  Another day we ventured further south to Cabo Rojo which is known for its amazing limestone cliffs and gigantic iguanas.  Most days our biggest decisions revolved around where to go eat or where to go watch the sunset.  It was just what we needed!

Here are a few pics from our adventures:

Relax and Reconnect

We're on vacation this week, so this is probably the only post you'll see.  We're eating good food, lounging by the pool or on the beach, and taking little adventures each day.  The past 6 months have been pretty stressful, so we are really enjoying this time away together.  I'll be back next week with a recap and some more detailed updates, but for now I'll leave you with this:

Enjoying the Wait: May in Review

I'm going to try to do a monthly re-cap of all of the fun things we did in the previous month.  I think this will help me realize that despite a lot of our time being consumed by fertility treatments and waiting, we still do a lot of cool things!  It will also be good motivation for me to plan fun activities, so that I actually have something to write about :)

-Tea at Washington Duke Inn:  I took a girlfriend here for a belated celebration of her birthday.  It was a really fun afternoon.  Both the food and the company were fantastic.

-Girl's Lunch at Nantucket Grille:  I met up with two wonderful friends for a nice Saturday lunch on their patio. The awesome thing about Saturday's at Nantucket Grille is you get a free half slice of their amazing cake when you spend $10.  It was a beautiful day and it was so fun to catch up with these girls!

-Snuggling with new babies:  May was the month of babies!  I had several friends give birth this month.  I was able to visit with the new moms and get in some snuggle time with their adorable little ones.  I can't wait to see Alexa and Lucas (and their moms) again soon.

-Family time:  We are really lucky that my brother and his wife live close by.  They had twins in March and we've been having weekly get togethers to play with the babies.  We also celebrated Mother's Day by hosting a brunch for my mom and my sister-in-law.  It was a really fun day and I'm glad we were all able to be together.

-Memorial Day Get Together: We spent part of our Memorial Day weekend with some awesome friends.  It was a blast getting together at Heather's beautiful, new home.  We got to watch all the kids run around and laugh at their crazy antics.  We're looking forward to when we have a little one in the bunch.

We have quite a few adventures on the calendar for June, so I am already looking forward to writing that re-cap.

The Plan

Today was our meeting with the RE to discuss our IVF plan.  Let me say, that I hope I don't know anyone else who ever needs to see an RE, but if you do I highly recommend mine.  Feel free to ask me for his info if you need it.

I pretty much knew what the basic plan would be since I've been scouring the internet and consulting with Dr. Google on a daily basis.  Before we can start the process, we have a few things to complete. Both of us have to have blood work done and attend an IVF training class.  The class will go into detail about the medications we will be using and we will fill out a TON of paperwork.  I also have to have a saline ultrasound and a mock transfer performed.

The first real step is to start birth control pills which is pretty hilarious to me.  By the way, I want all the money back that I ever spent on birth control pills!  Anyway, the birth control pills calm down any hormones that my body is producing and gives us more control over when we can start the IVF cycle.  I'm not sure at this point when we'll start or how much I'm going to share about the timeline once we start.  I guess we'll just see how I feel.

Once I complete a cycle of the birth control, I'll start the necessary hormone injections, Menopur and Bravelle, to jump start my ovaries into producing a large number of follicles.  I'll do injections every day for about 10-14 days.  During this time, I'll be having blood work and ultrasounds done every 3-4 days to monitor my progress.  The goal is to have around 15 mature follicles by the end of the injections.  Once enough follicles have matured, they will schedule the egg retrieval and fertilize the eggs.  They will be using the ICSI procedure to fertilize the eggs.  This should improve our odds of successful fertilization.  The egg retrieval involves being put to sleep, so I'll have to miss a day of work for that part of the procedure.  We'll have to wait about 5 days from then to see how the fertilized eggs progress.  If all goes well, we'll end up with about 4-5 good embryos.  Based on the quality, we'll decide how many to implant and how many we want freeze for future cycles.  After they implant the embryos, we'll just be playing the waiting game for about 10 days.

So, that's about it. Sounds easy, right?

I already have my next blog post going through my head.  Here's a preview:  WTF do I tell my boss?  I'm going to be missing a lot of work for appointments, acupuncture, retrieval and the final transfer.

We're lucky and we know it

Even though we have struggled with infertility for over 2 years, we really are lucky.  M works for an amazing company that actually offers infertility coverage as part of their standard health insurance plan. They also serve beer on Friday afternoons, which adds to their awesomeness.

We are 100% covered for infertility treatments, except for co-pays, up to $20,000.  Our coverage for prescription drugs is unlimited, so we only have to pay the co-pay associated with each drug.  This is an AMAZING benefit that, unfortunately, most couples don't have.  On top of the stress of infertility and trying to conceive, most couples are faced with the decision of going in to debt for treatments or saving up a significant amount of money before undergoing treatments.  By having so save up such a large sum of money, couples have to put their dreams of having children on hold.  I wish everyone had access to insurance plans likes ours.

So, I've said it's expensive, but how expensive is it really?  If we would have had to pay out of pocket for the last 1.5 years of more intense treatment here's what we would have spent:

Dr. Office Visits/Bloodwork/Ultrasounds:  $4,682

Prescriptions (oral meds, injections, etc):  $12,891

Yeah, it's shocking to me too.  See why we're thankful?  There's no way we could have spent that kind of money out of pocket without a lot of planning and delays to save up money.  

We'll know more after our consult tomorrow, but according to my RE's website, it looks like IVF runs about $11,000 plus an additional $5,000 for the necessary prescriptions.  Crazy, right?

It sucks that we are in this situation, but we are extremely lucky that we don't have to face the financial challenges that typically come along with infertility treatments.

Where to begin?

I guess I'll start at the beginning.  According to The Sound of Music, that's the very best place to start.  Wait, did I lose you already with my nerdy reference to The Sound of Music and the Von Trapp family? Sorry about that.  I promise it won't be the last nerdy thing I write here.


I'm starting this blog as a way to document the ups and downs of my life as I stumble through the world of infertility.  This isn't a new struggle, but I've decided that writing about it might help me put a little bit of perspective on things and could possibly help someone else.  If you are familiar with trying to conceive (TTC) then you know about the dreaded Two Week Wait (TWW).  It's that time after ovulation when you obsess about the possibility of being pregnant.  I've spent many months focusing on the "what-ifs", instead of living the life I have been given today.  Now, I'm really trying to focus enjoying the life we have while we wait, rather than focusing on the things that we don't have.


I stopped taking birth control in November 2009 after running my first (and probably my last) marathon.  I haven't always been a runner, but once I started I was hooked.  I craved running for both the health reasons and the social aspect that it had for me.  Most of my best girlfriends are runners, so most of the time running involved catching up on each others lives.  I had been taking birth control for years and I had just finished a strenuous athletic event, so I wasn't really surprised when my cycle didn't start back up right away.  Finally in the spring of 2010, I mentioned to my OB/GYN that my cycle hadn't returned.  She handed me some progesterone pills and sent me along my merry way.  I took them as directed, but nothing happened.  I called by doctor and let her know that the pills hadn't worked as planned.  She gave me a prescription for another round of progesterone and this time it worked.  I waited a few more months and still no return of my normal cycles.  At this point, my husband and I were ready to start a family, so we became a little bit more aggressive.


My OB/GYN prescribed two rounds of Femara (an oral medication that should cause ovulation), but nothing happened.  Since we have AMAZING insurance coverage, we decided to accelerate the process and transitioned to an reproductive endocrinologist (RE) for further tests and treatment.  This RE diagnosed me with lean PCOS.  Based on that diagnosis we went through several types of treatment protocols including Clomid (oral medication from hell), Femara (again), and Menopur (shots,shots,shots!).  All of this time, I continued to run and workout 5 days a week.  I asked my doctor on numerous occasions if running was an issue and he always assured me it wasn't.  I also asked if it would be beneficial to gain a few pounds.  Again, he assured me that my weight was not what was causing my infertility. After a year with that RE, he recommended moving on to IVF.  We decided that we wanted to get a second opinion at this point which lead to us switching to a new practice.


Upon switching to a new practice in March 2012, we discovered that my diagnosis of lean PCOS was completely wrong.  After meeting with my new RE for about 2.5 minutes, he told me my diagnosis:  Hypothalamic Amenorrhea (HA).  After hours of Googling, I found a blog and a message board that had a thread dedicated to HA.  Through reading this message board and talking with other women with the same diagnosis, it became clear that if I wanted to get my cycle back and conceive I was going to have to cut back on running and focus on putting on some weight.  This has been EXTREMELY hard for me.  As I mentioned previously, most of my friends are runners, so not running meant lost social time with my friends.  Gaining weight has also been a struggle.  So far I've gained somewhere close to 15 pounds.  Actually putting on the pounds actually hasn't been too hard, but the emotional things that go along with it have been rough.  Trying on too tight clothing, not recognizing yourself in the mirror and feeling like I'm living on someone else's body have been draining.


So, where are we now?  We've been through two IUI treatment cycles with the new RE with no luck.  We have an appointment with the RE on Wednesday to have our IVF consult.


While I could focus on the negatives of having to take this next step, I'm choosing to focus on the awesome trip I had with my girlfriends this past weekend. I "enjoyed the wait" by sitting in the sunshine, drinking wine, acting silly and avoiding all vegetables except potatoes.


For now.....So long, farewell, Auf Weidersehen, goodbye. (Last Sound of Music Reference, I promise)