The other thing you will need to get is a Police Check and a DHS Children Check. It is compulsory before you can undergo assisted conception in Victoria. The clinic will let you know how to go about organising it.
Emma, the hardest part for me was without doubt the tww, which in our case was 18 days long because we hit the New Years holidays right at the end of it.
I did a down regulation cycle, but for me that meant synarel nasal spray every 12 hours from day 21 of the previous cycle right through to the day of the trigger shot which triggers ovulation. Mild headaches for a few hours after each spray, but I had no other noticeable symptoms from the synarel (which suppresses your natural hormones). So Teirae had a totally different response to that element of treatment compared to me. FX you'll be more like me there.
Then Gonal F injections, daily, from CD 3 through to the trigger day. Anticipating that was the scariest bit for me, without a doubt, because I just couldn't imagine being physically able to inject myself. DP said that if I really, truly couldn't, he'd do it for me, but I had to try the first one, and he knew I'd be ok. And actually, it was fine. A little scratch, then nothing. Once the needle breaks the skin (which is not even as bad as plucking a hair) I had no sensation of the needle or the contents at all. The trigger shot was pretty much the same, too.
Then after pickup, I was uncomfortable for a couple of days - just feeling flat post-anasthetic and a bit bloated and crampy, as I expected. Transfer was no big deal at all - very, very exciting, and a bit bloated still, but no physical pain at all for a week, just a bit stiff and uncomfortable. Luckily, I got to enjoy Christmas in those few good days.
Then 5 or 6 days after transfer, I started to bloat more - achy, tight, sore to touch belly, painful to cough or sneeze or laugh, hard to roll over in bed, short of breath. It was all fluid, not gas. A bit of fluid sitting in my lungs which I coughed up easily every couple of hours, but really, it was the emotional strain that was most difficult to deal with. All these 'pregnancy symptoms', all of which can be blamed on the luteal phase hormonal support I was on - 2 hcg injections, days 3 and 6 post transfer, and progesterone pessaries twice a day. (I'm pretty sure it was the progesterone that bloated me, as my count was up to high 300s, and as I was weaned of it, after the BT, I started to feel progressively better, and it's now 150-190, with no supplementation for the last 3 weeks or so - much more 'normal'.)
When they warn you that the hormones can cause pg symptoms, I expected the kind of mild cramp, or slightly tender boobs, that I had so desperately tried to find in every other tww. I didn't expect this full blown, debilitating, crippled state I was in, and yet it didn't even mean I was pg. It was so hard to cope with all the pain and be prepared that it still might not be for anything. The not knowing was very, very hard. And you can't forget about it for a moment, becasue the physical symptoms just don't let up. It's like a normal tww, but a million times harder, because you've invested so much more into it - emotional energy, time, drugs, pain, symptoms, and of course, the financial investment. It is so much harder to consider that it might not work, and you might have to go back and do it all over again. (We didn't have anything to freeeze, so it would have been another stim cycle, too.)
It's also harder, because you know, now, that DP's count is really low, so the hope and expectation that a natural cycle might result in a bfp is pretty much gone, whereas, this time, after ICSI, this time there's a real, genuine chance! It's like a lottery that you always thought you had a ticket in, but you didn't really. Well this time, you've got a ticket. AND you know that the first few milestones have already been passed - you know there's an egg, and it met the sperm, and it fertilized, and it was growing. You just don't know it implanted, but you're already emotionally attached to those real, genuine, little tiny embryos. In a normal tww you imagine all that, but this time, it's real.
It's really tough, and I have so much respect for the ladies who go through repeated unsuccesful cycles. We feel incredibly lucky that it worked for us first cycle, but to be honest, we had almost the best chances of almost anyone - low sperm count as the only fertility issue, treated with ICSI, has one of the highest rates of success. Our predictions could only have been better had I been younger (as you are, I'm 37) and had I had a previous successful pg (as you have).
My advice - ask a million questions, read everything you can, and be prepared to take some extra time off work if you need it.
I'm also more than happy to answer questions, or have a chat - pm me, if you want.
Last edited by Pholi; February 2nd, 2012 at 10:15 AM.
We don't quite have a final count yet, as I've just found out there are 2 more items I can claim from my phi, but in the end it's going to be somewhere between $2500 and $3000, I think - $7800 up front and about $4500 back between medicare and maybe another $500 back from HBF. That's the whole ICSI cycle and meds and scan at 7 weeks, and all. In addition, HBF paid $1600 odd for hospital fees and another $500 for anaesthetist fees, directly, rather than me paying and them reimbursing me. We had already met the medicare safety net limit because we had all the procedures right at the end of last year - If you haven't already registered for the safety net, do it now!
I think we're incredibly lucky in Australia that Medicare does fund a large proportion of the fees for AC. I know there are many couples for whom the remaining out of pocket expense still limits when and how often they can have repeat cycles, but given that the real cost is probably well over $10,000 (when you consider all the blood tests which get bulk-billed - I don't know the real cost of these) I think that at $3000 out of pocket for the cost of a good chance at a baby, it's well worth it.
We don't have PHI- so I would have to factor in the cost of the hospital fees and anesthetist.
Might help to look at my clinics website, I'm sure they would have information on there.
Emma, not sure what clinic you are with but without PHI, it would cost an extra $1200-1500 out of pocket for each stim cycle. I would budget approx $4500 -5000 out of pocket for each stim cycle.
Also, re: IUI, I have never done it but from what I know it isn't suitable for severe male infertility issues.
Emma,
Just pays to remember that 'virtually no good sperm' is actually the norm. When you look at an individual's results they look awful - but you need to look at them in relation to 'normal'.
I think that with 4 weeks to wait i would be having big discussions with your DH about what steps he can take to increase his own fertility. Chemicals, alcohol, foods, all those lifestyle things play a huge part in how good a man's sperm results are. And it's honestly 1000 times cheaper and less emotionally draining.
No, IUI isn't an option when they're aren't many sperm to start with. Even IVF, where they just let the sperm swim around the petri dish until they find the egg, isn't a great option with low counts, so ICSI was the only option we had - though he was happy for us to 'keep trying for a few cycles on our own' if we needed the time to think about it. Nothing else in between.
Note that all clinics have different prices, too. It doesn't always relate to the expertise available or to success rates. Not all clinics mention some of the extra costs, which for us, on top of their up front fee, there was the synarel at $95, not on the PBS, the hospital fees of $1600, anaesthetist of $500, and scan at the end to look for the heartbeats at $165. I don't think there's a medicare rebate for any of those. And that doesn't include the initial FS appointments and all the tests he ordered, which came to over $2000 up front, though we got about $1500 back.d
I think N2L's budget estimate is roughly right - it might be less, but I doubt it would be much more. Remember that if you're lucky enough to get enough embryos to freeze, it's significantly cheaper to do frozen embryo cycles, and the chances each time are pretty similar to fresh.
I forgot to say, DP also has some specialised test to see if he carried a gene which causes male infertility, and CF, too. (I also has the CF gene tests. We were both clear on all counts, but I think if there were any genetic issues identified, we would have been offered PGD as well to avoid any embryos with those genes. It was one of those tests on DP which was almsot $500, which medicare didn't cover at all.
Of course, you only go through all that testing once.
Last edited by Pholi; February 2nd, 2012 at 12:06 PM.
Your situation seems very similar...my DH had the same result. He had to do another one which was worse! So we were basically told ICSI or nothing, IUI and normal IVF are not an option. BUT my FS seems very confident and reassuring, and we have just started our first ICSI cycle.
At the appt were the FS viewed the second SA and told us ICSI was the only way to go, I was like...ok - lets do it then..give me the drugs. Haha.
I think sometimes though, specialists forget to tell us important things - I was so lucky to have read so much info on here that it prompted me to ring the FS and ask "hey shouldn't I be arranging a nurses appt as well?" Lucky I did that as I would've had to wait for another appt and waiting times can be for so long!
Good luck with your journey. It's a hard club to be in - I hope your journey is short and successful!
We had a last minute appointment yesterday.
FS has put DH onto double amounts of supplements to increase his zinc.
Another SA in 3 months- then if I'm not pregnant, straight onto ICSI.
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