The Ottawa Test Results…. Part A

Super-Secret Post
Originally composed during month 34

Ok — so we only needed this one test result from the Ottawa clinic. Or so we thought.

The doctor’s tone immediately after pleasantries was such that I thought for sure my AMH number was terrible. She had some stuttering and false starts and looked generally like she was going to deliver bad news. (“So… we measured your AMH… and…. well…”).

And in a way it was bad news — the number was high but that didn’t match my low number of maturing follicles from the Waterloo testing. To figure out what was going on, she said she wanted “to do the testing I would usually do if you were coming to me in the beginning.”

Imagining the same full cycle of poking, prodding, and pain I endured in Waterloo, I broke out in quiet sobbing while my husband asked why this was necessary. I already knew why: without enough stimulation, IVF would be a waste of money, and with too much, my health would be in danger and we’d possibly have to cancel the cycle.

However, it turns out she didn’t mean an entire work up. She will be limiting the testing to one blood test and one internal scan, all in one appointment.

And of course, having a good AMH level is… good! I am not running out of follicles any time soon.

We got a timeline of (roughly) August for testing and completing all the consent paperwork. This will be a far more intense process than in Waterloo, with an appointment (and appointment fee) to work through the paperwork together and have it witnessed). September will be for “prep” (I may go on the pill for a month which seems, at the same time, completely reasonable (puts my hormones at a known baseline) and completely hilarious). The actual procedures will start with the cycle start hovering nest the beginning of October.

I also learned about the higher risk of twinning even with a single embryo transfer. Identical, of course: something about the process pokes or prods a blastocyst encouraging it to split. If the embryo is 3 days old it’s a .5% risk; for 5 day old blastocysts it’s a 3% risk.

All kidding about double value for our money aside, twins carry higher risk of complications and the doctor even referenced my small frame (5’2″, 110lbs soaking wet) as an additional reason to only do single transfers. In fact, the additional strain that multiples put on a public health care system is substantial enough that funding a few rounds of IVF in a public health care system in order to control the rate of embryo transfers is theorized to be good financial policy strictly apart from good policy otherwise.*

We also found out that our medication (up to 30% of the cost of the process) will be partially covered by my husband’s shiny new drug plan, potentially saving us thousands of dollars. Along with the tax breaks I can give him from the rest of the costs, we will be a little ahead financially since we’d budgeted for 100%. It was still coming out of our nest egg and necessitates putting off buying a house (at least a 6 month delay for every IVF cycle) but at least the funds are there for the plundering.

We walked out with lots of appointments booked and a clear timeline, but I am awfully depressed at how I can never “get to” IVF. I get closer and closer and then it runs away from me because of weird factors like “my AmH is at a weird level” or “I got pregnant out of the blue [and lost it anyway]”.

Do you ever have the nightmare where you need to call 911 and it feels impossible? You can’t pick up the phone, or you can’t push the right buttons and you have to keep hanging up and starting over, or you dial but then the phone isn’t ringing, there’s just dead air on the line. That’s how this process feels to me… I can’t make things happen the way they are supposed to.

I’ve internalized these delays so that I can’t actually believe that things will happen even if they’re scheduled to. On the one hand, I have this timeline and I need to work around it. On the other hand, I am forgetting to make plans around a pregnancy, and in the long term, I have basically stopped believing I will have children. I am looking into alternatives like foster care before I have finished with fertility and I don’t even realize the conflict. I am feeling like giving up entirely on this entire way of life before I’ve even started.

Hopefully, some therapy will help sort out these feelings. Because it worked so well last time, right?

* In a public health system, the architects should be finding ways to reduce costs overall. Paying for IVF so that it can be closely regulated and reducing pregnancies with multiples might actually end up saving money. I am thinking I might write a longer summary of the issue since one of the Canadian provinces recently had an experiment in this.

And that’s a separate issue from the moral dilemma of only well-off couples being able to overcome fertility trouble.

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