I’m not experienced enough to offer advice but best of luck! 
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I didn’t really do anything different. Mucinex probably won’t do anything since the IUI bypasses the cervical mucus anyway.
The one IUI I did that worked (temporarily) I went in the morning, taught a day of class, and gave a presentation to my department in the afternoon—which I totally forgot about until I saw the date of the file one day. Then I had another busy week before getting on a plane to go to a conference and got the positive at a hotel after the first conference day, lol!
Do what you normally do unless what you normally do is mass amounts of cocaine.
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This makes sense: I was doing some reading and was starting to suspect this would be the case, so glad to have it confirmed. My mucus situation is a little confusing, so glad we’re starting with something that avoids mucus complications.
LOL! Truly, if only. 2021 Bern is a lot less fun than 2009 Bern.
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Happy new year, TTC buddies. May this be the year your eggos (or embryos) make you preggo.
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I was convinced I was having early pregnancy symptoms, and this morning I realized it’s probably a UTI, lol. Whatever!!
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Nooooo
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Dreamed about HCG testing. Woke up and remembered I haven’t even ovulated yet… 
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I think we are going to legit start trying this month…I’m already taking a drinking break so it makes sense? 
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I think my travel debacle delayed my ovulation. I normally would have ovulated around CD13, but that was the day I had a canceled flight and I had no signs of it. But maybe it was already on its way to being delayed before that because I wasn’t getting positive OPKs. There was one day where it looked like it was ABOUT to be positive, but then back to negative after that. But now that I am home today, I am feeling some ovulation pain and getting a positive OPK, at CD16. Temping laughed in my face this cycle, with time zone changes, holiday drinking, having a heater blowing on me, weird interrupted sleep, and all kinds of stress.
We’ve managed to GOF every day except the one we spent on the airport floor, 6 out of the past 7 days, so maybe we’ll get lucky? But then again, we also ran out of our supplements a day before leaving and haven’t had any in like 4 days, so if some of them are supposed to be helping our DNA bits, that didn’t happen during this last stretch.
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Also: TALK TO ME ABOUT IVF!
I probably won’t get lucky this cycle, and I promised myself I would start seriously looking into IVF in the new year. So far, I have figured out three very rough steps:
- Get a list of expected costs and stats from various places
- Decide on a place
- Set up my GoFundMe
But what should I ask places, aside from costs and success rates?
My insurance isn’t going to cover shit, so do I even see my regular OBGYN beforehand to let her know I’m planning to do it? Is there a benefit to trying to find a place whose doctors are on my insurance group even if it’s not covered (record-sharing, etc.)?
What are the steps? Like, OK, I know that there are some tests they will need to run? On Swan too? Will they accept my existing test results from my hematologist about the antiphospholipid shit and thyroid and whatever, or will they want to re-test me for everything from scratch? Does it vary or is there something standard there?
And then, after tests, what happens next? What kind of timeline am I looking at, if I manage to get a first appointment sometime this month? Presumably, it’s tied to my cycles but is there usually a waiting period of some kind?
All I really know is:
Pay gobs of $$$
Tests
???
Transfer
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Let me get to my computer. Type-y type lol.
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What to ask:
research ahead of time helps with this a lot. There’s SART and CDC data on most clinics. You want to look for own egg (if that matters to you) success rate for your age bracket.
https://www.sart.org/patients/a-patients-guide-to-assisted-reproductive-technology/general-information/success-rates/
This “predict my success” tool is also very useful to know going in: SART IVF Calculator - Home Page
And the CDC one: ART Success Rates | CDC
I wouldn’t bother seeing your OB about it unless you need a referral. I don’t know if some clinics require it? Since you have no insurance coverage, no worries there, although you may have some labs covered if you go the right place. A call to insurance is well worth it on this front. Since you’re in a large metro you may have enough choices this makes a difference- I didn’t so it was a moot point for me.
So, basic steps. I’ll include costs as I remember, I had two clinics- one small cheap small town one, one doctor, one big internationally accredited one in Portland. I had no insurance coverage, so all this is OOP.
1- preliminary consult. Mine IIRC were $350 at the cheap clinic, $590 at the better clinic. This involved me and husband both. Lots of health history, although they have you fill out this paperwork ahead of time, but you go through it with the doc. Make a plan.
2- initial testing. They definitely will re-do things like progesterone, estrogen, FSH, AMH that you’ve had elsewhere, but mine honored prolactin and thyroid results from elsewhere. I think the biggest thing is a, do they vary a lot and b, is there large lab differences- if tests have different generations, like AMH, clinics want to be sure they’re comparing apples to apples from their own metrics. So I don’t know specifically for hematology if they’ll have you re-do or not. They’ll also definitely want to do their own ultrasound for antral follicle count and anatomy. Likely their own saline sono or hysteroscopy. They’ll have you do an HSG if you haven’t (that was $550 and was done off site at a radiology clinic).
3- most clinics have you do an IVF class. These are probably all online now. What meds when, how to do shots, what to expect, chance for questions. Clinics assign a nurse to you that you can contact at any time with questions.
4- usually testing takes a full cycle, then it depends on what type of IVF cycle they want you to do. You’re older, so they might have you do long lupron, where they use a med called lupron to supress your own egg recruitment and development. (I had long lupron because of my shit reserve). This take a little longer, I was on a full month of daily lupron shots before my stims. Next up you move into the egg growth stimulating medicine (stims). This is the most intense part where you’re in for ultrasounds and blood work a lot, like every couple days. This lasts a week or two depending on how your eggs are growing. When they get big enough, you use a “trigger” to stimulate ovulation. As the eggs all get ready to ovulate, they swoop in instead for the “egg retrieval”. This is the surgical part. I was put under, woke up, recovery is a little rough for a week or two. From there it depends on if you’re doing a fresh or frozen transfer. Fresh happens right away- the day 6 embryo, say, is put back in 6 days after they were retrieved. Or, it’s all frozen (genetically tested if you’re doing that), then put back another time after your hormones all reset.
All in all, I think it was 2-3 months from when I had my first appointment to embryos existing.
Next up, COST. This is kind of like buying a house lol. The cost isn’t the whole picture. Take my first clinic for example. They had a clinic cost of only $6k. (That’s typical of a cheap clinic). That gets you the procedures, the ultrasounds, the in house labs. It doesn’t get you the prep work testing, the meds (that was another like $7k?), the genetic testing ($8600). I know all in my first cycle cheap clinic was $17k, my second was $16k. My third cycle was going to be at Nice Clinic, and it was going to be $35k all in.
Uhhhh that’s a start. It gets more complicated with cycle batching, three cycle guarantees, stuff like that.
Ask me anything. I can dig out old price stuff if you want specifics, too.
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Wow, thank you so much for all this info! I will start digging in!
I was preliminarily looking at some of the multi-try guarantees, and it seems like everywhere I saw either won’t guarantee shit for 40+ or, at one place, I would have to be finished all my tries before I stop being 40. Which stresses me out since I have only 9 months of being 40 left, haven’t started anything yet, and am not sure how often I would be able to try? I feel like if I started the process a year ago, I’d be in better shape for that. But, a year ago, I hadn’t even gotten my cycle back after my first loss, so it is what it is…
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Yes unfortunately most of the “guarantees” they make sure the house wins lol. I wouldn’t have qualified for many clinics based on my AMH. They reject for that, age, weight, all sorts of stuff. So if you qualify for one, statistically you’re likely to succeed with just one cycle anyway 
Is my understanding.
Other things you can ask about is their financing options. My first clinic didn’t advertise it, but they offered 0% APR financing just from in-house stuff on pretty long payment terms. I think a lot of clinics have in-house stuff like that, and others have agreements with organizations like care credit.
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Some of the things to start educating yourself on right now that will help guide your conversation with your reproductive endocrinologist would probably be looking into whether you want to consider embryo genetic testing, whether you would be more inclined to do in a fresh or frozen transfer (although your body might override your choices there anyway), if you’re doing a frozen transfer if you want medicated or natural cycle start, and your feelings around donor eggs. I know some clinics really pushed on her eggs on Women as soon as they hit 39 or 40, and so going in with some information about your own odds to get a feel on if the clinic is just trying to push that for their own success rates or if it’s actually in your best interest is a really good idea to kind of wrap your brain around ahead of time.
ETA:
And they’ll talk you through all of this stuff. I just feel like it can be really overwhelming if you’re not familiar with it and you go in blank. And some of the big clinics really feel like they’re just trying to sell you on stuff and kind of put you through a profit process- not all by any means, but some. I feel like it helps especially when you’re a little bit of an outlying case to have a good grasp of all the factors so you can have a little bit more of an informed conversation and not waste the time that you do have for talking to the doctor.
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Honestly, the only thing I am super hesitant about donor eggs for is that I’ve read it’s a lot more expensive. It’s less important to me that my genetic material be in the mix than it is to Swan’s that his be, so if it came down to donor eggs, and I felt like I could make that happen without bankrupting myself, then I would be fine with that. Obviously my own eggs would be ideal in a perfect world, but I lean toward at least TRYING to get my own to start with and then seeing what happens.
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I’m finding this quite a helpful read- https://www.fertilityiq.com/ivf-with-donor-eggs/deciding-between-own-eggs-and-donor-eggs#medical-factors
I’ll keep digging in and come back once I have a better sense of specifics
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I’d be curious how it breaks down cost versus odds though, for say 2 own egg retrievals versus one donor egg cycle.
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