Exhausted (and we haven't even started!)

I had day 3 bloodwork taken on Friday. It was really day 2, but “Day 3” bloodwork can happen between days 2 and 4. They said it was to “check my eggs,” which I didn’t get at all and had to Google. (Do most people research this before they come in? Staff talk about it as if it’s understood; some things I ask about, but others I just go home and look up.) Apparently they can tell if your eggs are in bad shape by the hormones produced at this part of the cycle. Having normal hormones doesn’t mean your eggs are necessarily good, but abnormal hormones definitely indicate an issue that should be looked into.

I was told that the sonographer (I think) was not in to do a Chlamydia and gonorrhea culture, but that I should get it done before starting IUI so I could come back Monday. Really, people? I told them that I’d had to schedule a pap for Tuesday so I would just get it done there. Then the nurse gave me a prescription for Ovidrel, an hcg trigger injection to make sure I ovulate. She gave me a quick rundown of how to administer it and then provided me with a glossy color page of instructions and photos. I know these staff do this all the time, and most of their people are probably on repeat cycles and are already familiar with all this, but it’s unsettling how casually they tell me things like JUST GIVE YOURSELF A SHOT. As if I’ve ever done that in my life. As if it’s a totally normal, everyday activity.

Apparently the sonograms will just tell them when I should ovulate, based on the follicle size, but by the time you actually ovulate, it’s too late to inseminate. So the extra dose of hcg when your follicles are the right size help ensure that you will actually ovulate. I’m psychologically very resistant to doing this, since I was told by the doctor that I have all the signs of regular ovulation and I have tested for it myself. But I’m also not eager to spend $3000 (including sperm) and take any unnecessary risk of failure.

On Monday I called the clinic to ask if they could call in my Ovidrel prescription to the pharmacy right next to them that works with Aetna mail order, keeping the price low while still being able to just pick it up and order only one at a time instead of three. The woman said she would check and let me know. Last time they called in a prescription to that pharmacy (they’re the ones who told me about the place), I’d gotten a call from the pharmacy the same day. So when I didn’t hear back by Wednesday, I called the clinic again. They referred me to the medication coordinator in Patchogue. I called there and got her voicemail because she was on another line. I explained the situation, and she called back five minutes later. She said that Aetna wouldn’t cover the prescription unless the cycle is underway, which isn’t official until I’ve paid. I pointed out that Aetna isn’t covering me anyway since I’m not technically infertile, and she said the pharmacy still won’t release the prescription without confirmation from the clinic that a cycle is underway. Which the clinic won’t give until I’ve paid up. Then she pointed out that if Aetna isn’t covering my fertility treatment, they won’t cover this prescription either. She referred me back to the Lake Success office where I’d first called in order to speak to the billing coordinator.

When I called the billing coordinator, she asked if she could call me back in a few minutes. As soon as we hung up, my doctor called from the same location and I was on the phone with her as the coordinator was trying twice to call me back. The doctor told me that my day 3 bloodwork was normal, and that I do not have prediabetes. What a relief! She said my blood sugar IS still slightly elevated so I should continue to be checked throughout my pregnancy, but there is no reason to be on any medication at this point.

I called back the billing coordinator, who asked me if I was doing a Clomid or injectable cycle. I thought it was an either/or question, but apparently it was a yes or no question. So I said “injectable, they gave me Ovidrel” and she said, “Okay, so that will be $2900, how do you want to pay?” “That will be HOW much???” “$2900. You said you’re doing the injectable, right?” “Yes, Ovidrel, but they just handed me a prescription for it. No one said this would add $1000 to what we’re already paying. We can’t afford to do this, I don’t know what to do.” I was in shock, realizing we’d need to assess whether it was worth another $1000 for a trigger shot when we’re pretty sure I ovulate fine, but what if that’s what would make the difference and we end up having to pay for another cycle instead? It was too much to think about just a week out from insemination. She said, “Hold on, let me check your record" (could you have done that earlier??) and then came back to tell me I’m doing a “natural” cycle with just a trigger injection, which wasn’t what she meant, so that will be $1900. Oh, and $100 to thaw the specimen, do you want to pay that now or later?

The pharmacy then called an hour or so later to say they had my prescription, that will be $79.95, please, and when do you want it shipped?

The amount of office time I actually spent on work yesterday is questionable.