Time is Money
“Quality is the ally of schedule and cost, not their adversary. If we have to sacrifice quality to meet schedule, it’s because we are doing the job wrong from the very beginning.” – James A. Ward
Long time no see friends, I can’t believe it’s been almost three months since my last blog post! I assure you things have not been quiet in my world though, not in the least. I have been very busy making changes to and updating my fertility plan in order to get the best outcome I possibly can in my next round of IVF.
I thought the quote above was fitting to encompass what this blog post is all about, hopefully it will make sense by the end.
I’ve gotten a lot of questions lately, understandably, about what I’m doing with this baby making stuff. I kind of hit the ground running and then disappeared a little bit after the results of the last round so it makes sense that everyone just wants to know what the heck is going on?!
Well….as of right now, I’m in a standstill until I can save up the money for the next round.
If you don’t follow my social (that’s okay...just click the links at the top of the page duh!), or even if you do, you may have forgotten what’s happened since my first egg retrieval at the end of April/beginning of May, so I’ll catch you up on what’s gone down:
Genetic testing results came back with one normal embryo, out of four blastocysts, all others are abnormal and unable to be transferred.
I decided to do another round of IVF instead of moving on to IUI, as I had originally planned.
I contacted another clinic in Arizona for a lower-cost option and, after getting some more labs done, had an initial consult with the nurse on July 24th. Not much new info there, they do things roughly the same, just some little differences. After that conversation I was able to schedule a consult with the doctor, which isn’t until September! Ugh, that is frustrating and turning me off of this clinic more. But at the same time, if it’s included in what I already paid, I may as well go through with the consultation.
Had a phone consult with my Reproductive Endocrinologist (RE) at my current clinic and we discussed doing another round of IVF, how the protocol would change, and the outcomes I could expect. This made me feel good, I love my RE and my clinic.
Shortly after that consult I received, from the financial coordinator, the discounted rate at my current clinic for round #2, and was happy to find out that it would be $12,000 (full price is $16,000), not including the $1000 credit I have there, and of course medications, which will likely be a little more expensive the second time around due to a longer protocol.
In comparison to the clinic in Arizona, which is about $9000 not including meds, it’s not that much more and may be worth it to just stay where I’m at, especially considering I would have to travel alone, stay in a hotel for 7-10 days, take much more time off of work, and I’m not loving the less personal service they provide as far as quality of care.
So I’m still debating which clinic I will go to for the next round, but for now I’m leaning towards staying where I’m at. I’m looking forward to my consultation with the other RE though to at least get a second opinion.
I’m still adamant in my decision to do another round of IVF, the only problem is that I DO NOT want to get another loan. So that leaves me only one option of saving up and paying in cash.
I know and have accepted the fact that this may take awhile, but I think it has it’s advantages also:
Motivation to be money smart and put every extra penny towards this goal.
Motivation to get my private practice off the ground in order to make more money, and make good money faster.
Time to improve any habits that need improving like diet and lifestyle.
Time to get more labs and tests done to identify any root causes of infertility (which in turn helps out my nutrition and private practice skills, win win).
Time to dial in my diet and supplement regimen to fix any of those root causes (again, win win).
Time to make any other product and environmental changes that may be hindering fertility (I’ll explain more below).
Finally, time to move back home, another new development, as I decided to move (if possible), before trying to get pregnant, instead of after getting pregnant.
Now I already made some of these changes prior to my first round, but looking at my results, perhaps it wasn’t enough? Not enough change? Not enough time? There’s really no way to know if it was just a factor of age or maybe something more, but I find it fascinating to try to figure it out. That’s the scientist in me, and one of the reasons for the profession I chose.
I made a table to break down the supplements I took before round #1 and round #2 to compare, as well as the cost (because everything is expensive in this process), and a short explanation to the reason why. Unfortunately, Squarespace does not like tables so I had to type it out, sorry. Believe me, you do not want me to get into the science of all of this, just trust that these are all evidence-based recommendations from hours of extensive research and tailored to me and my situation. Read “It Starts With the Egg” for more information, I have a link in the Resources section.
First, is all the supplements:
Pre-IVF #1:
Thorne prenatal - 3 capsules/d
ALL women of childbearing age should be taking a prenatal!! This one is good quality with methyl-folate.
$14.00/month
Ubiquinol (aka CoQ10) Now Brand - 400mg/d
improves egg quality
$37.35/month
Vitamin D - 10,000IU/d
low Vitamin D prior to round #1, can hinder fertility
$3.31/month
Probiotic w/ 10,000 strains - daily
gut health
$6.60/month
Vegan Omega-3/DHA - 300mg/d
vegan-ish diet, DHA is important for fetal brain development
$9.91/month
B12 - 1000mcg/week
vegan-ish diet
$1.59/month
Melatonin - 3mg/d (only taken 1 month prior to egg retrieval)
research shows can improve IVF results
$1.20
Total cost per month = $73.96
Pre-IVF #2:
Thorne prenatal - 3 capsules/d
$14.00/month
Ubiquinol (aka CoQ10) Jarrow Brand - 600mg/d
better quality brand, increased dosage for better egg quality
$55.50/month
Vitamin D w/ K2 - 5000IU/d
better absorption w/ K2
$16.65/month
Probiotic w/ 10,000 strains - daily
$6.60/month
Vegan Omega-3/DHA
$9.91/month
B12 - 1000mcg/week
$1.59/month
Melatonin - 3mg/d
will repeat before next egg retrieval
$1.20
Vitamin E - 400IU/d
antioxidant, improves egg quality
$5.25/month
Vitamin C - 500mg/d
antioxidant, improves egg quality
increased to 1000mg/d during CoVID outbreak to support immune system
$2.60-5.20/month
Thyroid support (selenium, magnesium, ashwagandha)- 2 capsules/d
slightly high TSH (thyroid stimulating hormone), high TSH can hinder fertility
$12.83/month
Total cost per month = $126.13
Gut healing protocol:
Gastromend - 6 capsules/d for 2-3 months, started 7/15
gut repair
$153.10 total
S.boulardii - 1 capsule/d for 2-3 months, started early August
targeted probiotic for gut repair
$5.50/month
Biocidin - 1 capsule/d for 1-2 months, will start in 2-4 weeks
targeted anti-microbial for gut repair
$59.97 total
Possible additions:
Vitamin A
need to research type and amount to take
deficient per labs results
N-acetylcysteine
precursor to glutathione (antioxidant)
borderline glutathione deficiency per lab results, important antioxidant for fertility
Then, all the product and environment changes:
Beauty product changes to non-toxic
Makeup: powder, concealer, bronzer, eye shadow, mascara, lip gloss, brushes
Deodorant
Shampoo and conditioner
Face scrub
Body and face wash
Moisturizer/lotion
Toothpaste
Eye-makeup remover
Tried a new hairspray but it was crap, switched back to the old “toxic” one, still searching for a new “non-toxic” one
Only use glass tupperware, no plastic
Never heat any food in a plastic container
Was already not drinking out of plastic water bottles for the last 2-3 years, instead I use stainless steel reusable water bottles everyday
Bought a Berkey water filter in June (basically the Cadillac of water filters)
Try as much as possible to not take receipts
No air-freshener, make my own with essential oils
Dish soap and dishwasher packets
Laundry detergent, no dryer sheets
Before the first round I stopped drinking at home about two months prior and stopped drinking all together probably a month prior. I stopped smoking weed only about a few weeks prior, when I started my stims. This time around I already stopped drinking at home (I’ll have a drink or two when out with friends and family, which is not often), and stopped smoking weed and will continue that until the next round is done. I’ll stop drinking alcohol completely at least 3 months before.
***edited to add: the CoVID outbreak changed this for the last three weeks, wine and beer was needed! I’ll go back to not drinking at home again once I finish what I have.
I don’t drink coffee, but I do enjoy a chai latte from starbucks often and I’ve cut that down to only 1-2 times a week.
Diet wise, I could’ve been better before the first round, it wasn’t bad, but wasn’t great either. Now I’m just continuing to make small changes like eating out less, increasing veggies, making and sticking to a loose weekly meal plan so that I make more meals from scratch and depend less on processed foods.
I’m continuing to focus on good quality sleep every night, and try to get 8 hours as much as possible. I’m an old lady now, I start getting ready for bed around 8:30pm. I’m trying, key word being try, to decrease my screen time as much as possible, especially 1-2 hours before going to bed.
***edited to add: diet changes and quality sleep also went out the window!! When in crisis mode I am a free-food-itarian and we were very lucky to have the facility feed us for the first two weeks, I took what I could get! Getting back in the groove with both of these now.
This is where I’m at today, all the changes I’ve made up to this point, but there’s still more to be made since I just got back all of my lab results from recent tests I’ve done over the last months, and I just got results for the test I sent in about a month ago. This is mostly what I’ve been waiting on to write this post, I wanted to have a little more info to put it all into perspective. This fertility journey is still a work in progress.
Here are the tests that I’ve done (in order of completion) and the results, along with how my protocol may change:
GI Map: I actually did this test before the first round, completed the test at the end of February and got the results back on March 3rd, but I put off doing anything about it until June.
Results: too many big confusing words to write, let’s just say my gut health can use some repair. It’s not terrible and I have no signs and symptoms one would normally see from the results, but nevertheless it will take some time to repair. Overall, my goal is to decrease any inflammation, and to fix any decreased nutrient absorption issues. See chart above for supplement protocol.
Vitamin D:
Result: 46ng/mL (reference range 30-100ng/mL), Normal, at the low end
Current treatment: 10-15 minutes sun time when possible, increase supplement slightly, increase foods high in Vitamin D (mushrooms, fortified soymilk)
CoVID outbreak protocol change: upped to 10,000IU/d for the time being to support immune system
Thyroid labs:
Result:
TSH 2.60mIU/L (reference range 1.0-2.0mIU/L), high per functional levels for fertility
Free T3 3.1 pg/mL (reference range at least 3.2pg/mL), slightly low
Free T4 1.1ng/dL (reference range at least 1.1ng/dL), normal
Reverse T3 9ng/dL (reference range <10), normal
Current treatment: added thyroid support supplement, diet changes, re-test in 4-6 weeks (may need a medication to get it down lower)
Omega Check:
Result: levels of all the essential fatty acids are normal, however EPA+DPA+DHA levels are low (moderate relative risk), and % arachidonic acid is low and % linoleic acid is high
Treatment: increase essential fatty acids in diet (nuts and seeds, plant oils), maybe increase supplement
MTHFR: this is a specific gene that affects how one metabolizes folate, can greatly affect fertility if you have decreased metabolization due to genetic mutations
Result: only one mutation that does not affect folate metabolism
Treatment: none/no change
Cycle Day 3, re-check:
Results:
Estradiol <20pg/mL (reference range 27-156), normal
FSH 11.0mIU/mL (reference range 3.5-9.0), slightly high
AMH 2.96 (reference for age: mean 1.54, median 1.38), very good for my age and increased from 7 months ago
Treatment: none, nurse was not worried about slightly high FSH and other numbers look very good, continue on supplements and lifestyle changes
Spectracell:
Results:
Deficient in Vitamin A and Vitamin D (which is weird because other lab test result was normal?)
Borderline deficient in Biotin, Choline, Chromium, Glutamine, Glutathione, Oleic Acid, Pantothenate, Vitamin B12, Vitamin K2
Deficient in Total Antioxidant Function, Average in Total Immune Function, Strong in Total Immune Function vs Age
Treatment: free phone consult with Spectracell practitioner for education on results (need to schedule), supplement with Vitamin A (need to research/learn appropriate type and amount), increase Vitamin D supplement slightly, increase B12 supplement, probably add N-acetylcysteine for borderline glutathione deficiency and total antioxidant function
DUTCH: stands for Dried Urine Test for Comprehensive Hormones. I just got these results a couple weeks ago and they are super confusing to read and interpret so I will be scheduling a phone consult with a practitioner ASAP! This test will give me an overview of my reproductive hormones, any hormonal imbalances, as well as my cortisol response (stress hormone) and adrenal function (or dysfunction).
Results: at first glance I may have some increased cortisol issues (I’m really not that stressed I swear), and some other hormonal issues.
***Edited to add: hahahaha well I wasn’t stressed at the time
Treatment: unknown at this time
Are you bored with all the science yet??! Did you scroll right through?! I wouldn’t blame you or expect everyone to understand all of this. Sorry, but I find this fun, I could do this all day! This is exactly what I will be providing for my nutrition clients as well, a root cause analysis for any fertility-related issues, but that’s another topic altogether!
I think my point in sharing all this is to get across how much crap we single mothers by choice and others suffering through infertility have to go through in the name of science. How we have to get poked and prodded over and over again in an effort to get answers. It can be exhausting, frustrating, validating and everything in between.
I’ll leave you with that. Your head is probably spinning, as is mine just about everyday.
I’ve probably gotta get back to one of my four jobs anyway, gotta make that money!
Thanks to those still following this journey of mine. Much love to you all. <3
***The majority of this was written prior to the CoVID outbreak at my work three weeks ago. Since then I have been working 60 hour weeks and have had little to no time to think about anything else. Things are finally slowing down as we find our groove and get our residents and staff through it. However, this outbreak may also be putting more of a hold on my plans than I would like, but I really won’t know anything for at least another few weeks to months, as we know so little about this virus and what is going to happen from here. There’s a lot up in the air now and I’m trying my best to just take it day by day.
P.S. I thought this quote was also fitting for this journey:
“Trials make you strong.
Failure makes you humble.
Challenges make you strive.
Life keeps you going and growing”
― Kemi Sogunle, Beyond the Pain by Kemi Sogunle