This picture is worth $9,004.38

I picked up the last of my medication for our IVF this evening and had a sudden, shocking realization about how much this is going to cost us. It's one of those things people wonder, but never ask - how much does it cost? It depends on how much and what type of medication you need, how long you stim for, what your insurance covers, what types of intervention you need (i.e. genetic testing), and what your clinic fees are. In our case, my insurance covers zero IVF medications, but will cover things like antibiotics, steroids and even the letrozole (Femera). But the most costly medications, which in my case is Gonal-F, Luveris, and Cetrotide, are not covered. Luckily, we can coordinate benefits and hopefully upwards of 80% of the medications are covered by Derek's benefits and we will be reimbursed in a month or so.

In addition to this, the fee for our IVF with the Victoria Fertility Clinic is $9,500. This includes the egg retrieval and associated twilight medication/IVs, sperm collection, embryo culture, biopsy (for PGS - genetic testing of the embryos), vitrification of the embryos (freezing), our first year of cryostorage, and our first frozen embryo transfer. This does not include the PGS itself, which will be an additional $2,000 to $3,500 and is performed by a lab in the U.S. All ultrasounds and lab work is covered under our provincial health care, so no out of pocket costs. We also have travel costs to Victoria, as well as accommodations and food.

Known costs for this IVF: $20,500 -  $22,000 (not including travel and accommodations).

Pro Tip: All medical costs not covered under provincial health care or insurance in excess of around 3% of your total income can be claimed on your income taxes. In general, you should receive around 25 - 30% of your claimed expenses back.

It's a very, very expensive process, and we are lucky we can afford it as many can not. Regardless of the ability to pay, it's still a punch in the gut when you add it all up. Hopefully, in the end, it's all worth it.

Here we go again

Last Thursday we had our scheduled consult with Dr. Hudson with the Victoria Fertility Clinic. Originally, our plan was to cycle in October or November, in part so we could enjoy the summer, and I also had a few cycling goals, which I met (yay, upgrade!). During the call with Dr. H, he asked where I was in my cycle. I was expecting my period over the weekend and said as much, and also mentioned that my cycles were becoming irregular after two decades of almost textbook cycles. Based on that, as well as some of my blood work results, he thinks I might be treading in to diminished ovarian reserve and poor egg quality territory. Then he said 'You know, based on your medical history and what's going on with your cycles, you could and probably should start right away.' A little bit terrifying, but we're ready, so here we go.

Today is cycle day four, and I'm downregulating until the end of August. On September 1st, I start injections. I will be starting with a high dose of Gonal-F and Luveris, which I used for our first IVF. The difference this time is that I'm starting at a high dose, whereas during the first IVF we started low and ramped it up quickly due to poor response. I ended up stimming for longer than normal, which may have overcooked my eggs and resulted in poorer egg quality. This time we're starting with the big guns.

Interestingly, I will be taking Femera at the same time. Femera is also used for hyperovulation, but usually on it's own, and usually for timed intercourse or IUI. From the limited research I've read so far, this should do what I'm referring to as 'slow cooking' my eggs in a way that slightly counteracts the high dose of Gonal-F. This will hopefully result in many high quality, mature eggs.

Starting on September 6th I add Centrotide to stop my body from ovulating and keep things cooking. We head to Victoria to finish things off on September 7th with estimated egg retrieval somewhere between September 12th and 15th. Using a combination of natural fertilization and ICSI (where they take a single sperm and inject it in to the egg - see image below), they will culture the embryos until day five. Each embryo will be biopsied before being frozen and the biopsy cells will go to the U.S. for Pre-Genetic Screening (PGS). This will be done to determine which embryos are genetically normal and ready for transfer, which will take place, if everything works out, sometime before Christmas.

Fingers crossed it all goes smoothly - here we go again!