Open Enrollment

It's open enrollment time at my place of employment. I'm considering doing what I never thought I'd do--sign up for Kaiser. You may or may not be familiar with the HMO giant of the west coast. To some it's the devil to others a savior. I won't go into my personal feelings about it, let's just say they're mixed.

The reason I'm thinking of going to the "other side" is that they will cover 50% of infertility services including IVF (at least according the reps, I'll call member services to confirm). My current Blue Cross plan covers 0%. That's a significant difference. My only concern is that there will be a long waiting list or they'll make me jump through a bunch of hoops that I've already been through to prove that I really need IVF. I'm hoping that with two independent recommendations and my demonstrated "failures" with other means they'll let me move quickly to IVF.


Has anyone else used Kaiser for IVF? I'd really like to get some feedback from women who have done both the private and big HMO way. I have to decide by Dec. 12, so I have a little time to do some more research. Thoughts?

Exposed

If you didn't hear Fresh Air today, please listen to the podcast (available at www.npr.org by selecting programs tab, then Fresh Air...sorry, I'm incapable of making links work).

Mark Schapiro spoke with Terry Gross about his new book, Exposed: The Toxic Chemistry of Everyday Products and What's at Stake for American Power. I could give you my interpretation of the interview, but I think NPR has a pretty good synopsis:

Investigative reporter Mark Schapiro explains in a new book that toxic chemicals exist in many of the products we handle every day — agents that can cause cancer, genetic damage and birth defects, lacing everything from our gadgets to our toys to our beauty products.

And unlike the European Union, the U.S. doesn't require businesses to minimize them — or even to list them, so consumers can evaluate the risks. Schapiro argues that that policy isn't just bad for public health: In an increasingly green economy, he says, American businesses stand to get shut out of a huge market.

One of the main reasons the EU is so inclined to look ahead to long-term health consequences of chemicals used to manufacture these products is that European governments pay for health care (it's not just because they're so progressive and environmentally conscious). They actually have an incentive to keep people healthy, what a concept! When you get cancer in the US it's on your dime. Too often our government is more concerned about what's good for business than what's good for people (I know, it's been said a million times, but it's too true).

The crazy about this "bad for business" argument, is that when the EU implemented stricter regulations on chemicals and toxins they did not experience the big hit to business that US regulators and businesses are so concerned about. There wasn't any measurable effect to the market.

Call me crazy, but I strongly believe that these toxins, so pervasive in our modern life, are one of the factors contributing to the rise in endocrine and hormone related problems, including infertility.

Let's stop being afraid to demand more from our elected officials and regulatory bodies. I'm tired of seeing the consequences of inaction.

Culture and conception

I saw a young father and his daughter in clinic the other day. We were finishing up the visit when he asked if I had children. I shook my head and told him no, not yet. In response he said something that roughly translates to, "that's weird".

To this young Mexican immigrant the idea that a married woman of my age would not have children was just that--weird. He didn't mean any offense, he just thought it was strange. On the other hand, I know people in their 30's who are single, or married but not ready for kids, who would be find it equally strange that we're even thinking of having kids at such a young age.

We all make decisions. Which is better? I guess it depends on where you're coming from. At every stage of life and in seemingly every decision, we are influenced by our culture, why should conception be any different.

Shopping

Many mundane and everyday things take on new significance when you're living in the limbo land that is "trying" to get pregnant. For example, shopping.

My sister-in-law is getting married in December. I've been thinking about buying a new dress for months now. Every time I went into a store to look I couldn't stop thinking (hoping), "...maybe I'll be pregnant by then...I don't want to buy a dress I won't be able to fit into." Then I would look at things with empire waists that I might be able to pull off either way (like the one pictured). The thing about this strategy is that you run the risk of looking pregnant when you aren't. I don't want people jumping the gun on me. Besides, if I'm not pregnant I need to embrace my non-pregnant body. I finally decided to go for it and bought a dress this weekend (that doesn't make me look pregnant). By this time even if I were to conceive between now and December 22 I wouldn't be showing. So I figure I'm safe.

It's really happening...

We finally had our pre-IVF visit last week to go over the treatment calendar, medications, etc. I had hoped we wouldn't get to this point, but my ovaries aren't getting any younger, and I'm still not pregnant, so we're moving forward. I do have an appointment for a second opinion at UCSF in early December, but I don't really expect they'll tell me anything different. It will just be nice to have another set of experts review my history and give recommendations.

The IVF consult was overwhelming to say the least. I'll have to be on 9 different medications throughout the cycle including an injection in the morning and two in the evening. I'll have 6-8 appointments for various ultrasounds and blood tests before and after the egg retrieval and embryo transfer.

We left the office feeling a mix of excitement and fear. Excited that we might be pregnant in the next 4-6 months, afraid we won't be. What else can you do though. I guess those are pretty normal feelings.

We decided to wait to start any of the meds until after the holidays. I don't want to be all pumped up on hormones, worried about keeping my follistim cold and staying on schedule while we're visiting family. I can't help but hope that next year we'll be taking a baby to meet the extended family too, but I'm trying to take it a day (at least a month) at a time.

There's always a reason

One thing I still have a hard time getting away from with all this is the need for cause and effect. I believe (I think I've said this before) that some things just happen. There's no reason, at least no good reason. Still, I find my self wondering, trying to pin the blame on something.

Yes, my doctors have given me reasons: my hormones are off, my left tube is blocked, I don't have many antral folicles, I have endometriosis...but why is all that stuff messed up?

"Well, I did have a glass of wine that night...I didn't eat very much today...I have a stressful job...I forgot to take my herbs...it's been a while since I went to yoga...I can't take care of myself sometimes, maybe I'm not ready for a baby..."

In my rational mind I know that none of these things are preventing me from conceiving right now, but when I'm looking for a reason it's easy to go there--to blame myself somehow. It must be my fault. Something I did or didn't do. I don't know if there's really any getting over that feeling. I am working on it though, and it's not as strong as it has been.

It's a hard balance. I know what I do or don't do has an impact, so I want to do everything I can, while at the same time leaving space for the mysterious. As I've said before, a lot of stuff doesn't make sense, and I have to learn to live with that.

Seasons

I'm a little peeved with Lauryl (the acupuncturist). At my appointment this week I mentioned that I'm meeting with the IVF coordinator at the RE's office next week and am still planning to to the IVF cycle sometime in Jan or Feb. She proceeded to tell me how this was not a good idea. It went something like this, "Oh, don't do it in the winter, kindey yang is low in the winter, the spring would be much better...just look at nature."

While a part of me would like to be all earth mother about this, I'm also afraid of waiting too long and missing my chance. Not that another few months would make a big difference, it just seems ridiculous that in the context of something high intervention like IVF the seasons or cycles of the moon would really have anything to do with it. Babies are conceived all the time, every season.

So, I'd like to take an informal poll, when did you conceive? Winter, Spring, Summer, Fall? Is there anything to this seasonal stuff?