Origin of the Species-Perpetuating Drugs

If you've undergone infertility treatment, then you probably already know that most fertility drugs are either derived from human urine or are created in the lab.

Drugs Created in the Lab: Lupron, Cetrotide, Ganarelix Acetate, Follistim, Gonal F

Drugs Derived from Urine: Repronex, Menopur, Bravelle, Ovidrel, Novarel, Pregnyl


The question is: Where is all of this urine coming from? Does anybody know? My bet is that pharmaceutical companies employ cheap foreign urinators. When I was teaching in China, I remember seeing a huge disgusting barrel of what appeared to be urine next to the village outhouse. It was just urine - no other, um . . waste. I wonder.

The reason I've been thinking about this today is because my Big Box o' Fun has arrived! As expected, seeing upwards of 90 needles did help drive home the point that this is really happening.

I had estimated that the copays for all this would be around $700. Guess how much the total actually was? $270.09!! This was a very nice surprise, especially since we've found out the IVF itself will be more expensive than we'd thought.

Here are the drugs:

And the drug paraphernalia:



Oooh, pretty. My original intention was to use the syringes to spell out some clever phrase. Then I realized I have enough to write a whole paragraph and that is just too much work.

I am pleased to see that most of what I'll be shooting into myself was created in the lab rather than extracted from urine. There's something a little disconcerting about injecting yourself with extract from someone else's urine - I don't care how purified it is! I will try my best not to picture that giant barrel of urine while I am doing the injections. Of course, I didn't find any specific information about how the other drugs are made in the lab. I'm sure it's a disturbing process also.

Moving Forward

It appears that part of my New Year's wish is about to come true.

"My hope for 2010 is that this year will involve a lot of needles. First, Follistim to get pregnant and then Lovenox for the duration."

Pity I didn't get pregnant and then get to enjoy all the needles, but maybe this way could work, too.

Last week was the nurses consult. Ultrasound showed that I STILL have the 3 cm cyst that's been plaguing me since April! I got to speak with the actual doctor (!) about this and she assured me that we can plow ahead. She is ready and willing to aspirate it anytime I wish. She even said that if I am tough (and I am!) we can save time and money by doing it in the office without anesthesia. While I do not aspire to be aspirated, just knowing this option is available is strangely comforting, if indeed it can be said that the thought of having one's vagina and ovary skewered with a giant needle is comforting.

Since we are still over three weeks away from starting stims, the hope is that The Pill and Lupron will beat my defiant ovary into submission. If not, we'll be forced to use harsher methods to deal with this insubordination.

Sounds like IVF is really going to happen, though it still seems unreal to me. After all the roadblocks I've encountered I can't help but think some other horrible surprise is just around the bend. Perhaps the Big Box o' Fun being delivered by FedEx today will make it seem a little more real. Yes, my drug shipment is on the way! All this just two weeks after the debacle at The Other Clinic. Let it never be said that I give up easily!

Even though my cyst is currently making its evil presence known, on the whole I'm feeling much happier and more optimistic. I can even see an upside to all the difficult obstacles I've had to overcome just to have this chance. After dealing with such tremendous stress and opposition, IVF will seem like a day at the beach in comparison.

Okay, maybe not - but for now I am enjoying the drastically reduced level of stress.

In conclusion, here are a couple of items I neglected to post previously:

1. I was able to meet up with Angie of I'm Trying to Live with the Loss of Two Babies Within 10 Months. We had a picnic at the park and visited while our kids played together. Stop by her blog and say hi if you haven't before!
2. For the record, I did finally accomplish Goal #2: Clean the whole house (closets, cupboards, windows, walls, everything). I also finished Goal #3: Create a home summer school plan for my kids. Of course they are thrilled about spending precious summer hours learning about what is and ain't grammatical.

Ravings

I know they've all been talking 'bout me
I can hear them whisper
And it makes me think there must be something wrong
With me
Out of all the hours thinking
Somehow
I've lost my mind

Even though we've switched clinics and are cleared to proceed with IVF barring any bad news at Thursday's appointment, I am still upset about last week when The Other Clinic convicted me in absentia of being too nuts to do IVF.

Prior to our last meeting with the counselor, I told hubby that I was afraid of prejudicial treatment simply because we've had so many difficult situations to deal with in a short span of time. Turns out I was right. The counselor views IVF only as an additional stressor and therefore concludes it's "unethical" for me to pursue it. I view IVF as a route to long-term peace and closure, though I recognize it will be additional stress in the short term.

Here's a recap of our meeting: The counselor started by going over the results of our personality tests - the notorious MMPI. I generally see personality tests as little more than an interesting diversion. Call me crazy, but I don't think it's ethical to use them as the sole determinant in making life-altering decisions on behalf of others.

She showed us our MMPI results, which are graphed as in the photo below. Hubby falls entirely in the "normal/subnormal" range. My graph fell completely in the "normal" range except for a higher than average level of "depressed mood".


She then spent a few minutes harping on the fact that both hubby and I answered the following question in the affirmative: "Have you had strange or unusual experiences?" We now know that psychologists see this as a red flag that you are nuts. I contend that most everyone has had some strange or unusual experiences by mid-life and that you are strange and unusual if you have not.

We explained that we are not nuts and have actually had strange and unusual experiences, particularly having to bury two of our children just six months apart. I would certainly hope this counts as unusual. In addition, we noted that we've both had unusual experiences during our adventurous pre-marriage years, including but not limited to:

• swimming with sharks
• traveling full circle around the world
• eating a rat
• engaging in public nudity
• being threatened with a bayonet at the end of a machine gun

Even though it's a great story, I did not mention that I once had an imaginary Chinese fiance because that sounds a little crazy!

Next she pointed out that hubby is very much an extrovert and I am an introvert, but "not TOO much". I definitely got the impression that extrovert = good and sane but introvert = bad and mentally unbalanced. This seems to be a pervasive view in our society and it has always annoyed me. Introverts are good and sane people, too!

Near the end she brought up BMI (body mass index). This apparently is the only area in life where I compare favorably to hubby. My BMI is perfect thank you very much, but hubby has long been afflicted by a gut which is only getting worse thanks to stress-induced overeating. We are both aware that this is not a good situation, but it affects IVF not at all, so why bring it up? I suspect this was an attempt on her part to soften what had been a barrage of criticism about me.

In summary, I feel misjudged, underestimated, slandered, and maligned. Also, I have a much dimmer view of psychology in general. But I am delighted that we flew right over this roadblock at high speed by switching clinics and believe that doing so is ethical, pragmatic, and eminently sane.


I'm not crazy, I'm just a little unwell
I know, right now you can't tell
But stay awhile and maybe then you'll see
A different side of me

Lyrics are from "Unwell" by Matchbox 20.

Analyze This!

Thanks for all the kind comments and emails on last week's post. Today I had intended to finish and email a letter in advance of The Committee's Big Meeting about My Life. Imagine my shock when the counselor called me today to say the verdict is already in and The Committee ruled against me. This surprised me even though I've come to expect that nothing ever goes my way!

Needless to say I am livid, especially since the decision was based entirely on a "personality inventory" graph and not on my actual medical history (which they don't have) or on any of the facts as listed on my last post (which of course they didn't have because of the early meeting).

Ironically, then, I got screwed because of people NOT making me wait. Even though the decision is made, I still engaged in civil debate with the counselor and my only consolation is that she didn't sound so damned sure of herself at the end of the conversation. Hmphf.  I'm not crazy. I've just been in a very bad mood for four years.

But there is good news to be had as well. Hubby and I have learned a valuable lesson from being dealt such a crappy hand in life these last few years . . . Always play your cards close to the vest and have a little something up your sleeve.

As you may recall if you've been following this blog, we switched clinics back in April in an attempt to save money on IVF. So immediately following last week's shocking development, hubby (brilliant strategic planner that he is) suggested simply switching back to our old clinic, referred to here as Clinic One. As of last Friday, we have dates for an IVF cycle! Two can play at this waiting game. Screw you Clinic Two!!

The tentative dates with Clinic One are Lupron starting July 11, Follistim starting July 23, and retrieval around August 2! This happens to work out beautifully with the kids' summer schedule and we could use our current fabulous insurance for the first round of drugs.

There's still the cyst issue to consider, though. I have an ultrasound next week on Thursday, so we'll know more then. A couple of weeks ago the pain got much worse and I was popping pain killers and snuggling up with my massager at bedtime, but it's much better now.

On another happy note, hubby had lot of interviews last week and this week. Next week he has multiple in-person interviews. He may have a job very soon!

What If This Is As Good As It Gets?

What if this is as good as it gets? This is a terrifying thought, especially after yesterday's follow-up visit with the counselor at the fertility clinic. I was expecting to clear this last hurdle and move on to IVF. Instead she says she needs to meet with a committee consisting of doctors and another counselor to decide if it's "ethical" for us to proceed because my levels of depression and worry are above the norm. Duh. Who among us could endure such an abnormal period of pain and loss and still maintain a normal level of cheerfulness and optimism?

My future is in the hands of people who I feel do not have a complete understanding of the situation. I'm so distraught over this! What to do? Perhaps send very clear and concise letter for their consideration?

The counselor waited until the very end of the hour to drop this bomb on us. I had only a few minutes to make my case for proceeding and although I believe it was well-reasoned and well-made, I do not believe she truly listened or understood.

I explained that waiting is the very reason for most of the worry and depression for the past couple of years! It's been 2 1/2 years since we started "trying" again. In that time we've tried for 13 cycles - 6 natural cycles followed by 7 treatment cycles (Clomid, then Follistim). For the other 1 1/2 years I've been on The Pill waiting - waiting for appointments, waiting for tests, and mostly waiting for cysts to resolve. I've spent ten of those waiting months in constant pain because of large cysts, which has led to anxiety about losing my only ovary and with it any chance we may have to complete our family. It could happen anytime - I want to use it before I lose it! I feel I am waiting away both the potential life of a child who could complete our family and my own life. Additionally, all this extremely stressful waiting adversely effects my ability to fully enjoy the life and family I do have.

The months spent trying have been much easier to cope with than the months spent waiting. It is frightening to think that this last chance could be snatched away after I've invested so much blood and treasure in seeing this through to the end. At least when I'm able to try, I am moving closer to the final resolution of this problem. All the stresses involved with infertility treatment are relatively easy to deal with compared to the paralysis of waiting. Win or lose, I need closure so I can put down the burden of infertility and move on!!! Waiting means more aging (I'm 35 in November) and thus more expense ($3K more), vastly more out-of-pocket expense if we don't end up with great insurance, more cysts, more pain, and more possibility of losing my ovary altogether and ending up with a lifetime of regrets. Waiting adds up to more stress, not less!

I need to know I've tried everything I can - whether I end up with a baby or not. Especially since painful endometriosis and cysts mean that I face a lot of pain in my future and very possibly also drastic and destructive treatments. I cannot imagine being able to cope with the pain, depression, sterility, and nasty side effects of more surgeries (hysterectomy? oophorectomy?) or harsh drugs (early menopause with Lupron?) unless I first exhaust all possibilities for completing my family. Pregnancy could give me a baby AND put endometriosis in remission! This is a no-brainer!

Also it would be very helpful if we could at least get the drugs for the first cycle and if necessary aspirate my current small cyst while we still have stellar insurance that covers all of this! Hubby has four job interviews this week (YAY!) but once he gets another job we may end up with no infertility coverage (BOO!).

Their decision about my life will be announced on June 18. I think this will be the most difficult 2 week wait I have ever faced.