our adoption consult

If you’re reading this it’s because I finally had time to sit down and blog about Monday’s adoption consultation (thanks to 5 hours on a plane last night uninterrupted). It’s been a crazy week to say the least but by the time this post is published I will have landed in Bogota, Colombia. I will spend one day at our head office and then I have 3 days to roam the city and relax. A much welcomed break.

Monday evening we met with our adoption practitioner in our home. I was so nervous leading up to it although I’m not sure why. Shawn spent all day cleaning the house so that everything was perfect and I puttered around making final touches when I got home from work. I should note that we decided to meet with a private practitioner for our consult because I wanted 100% of the attention to be on us and our questions and in the end, we were very satisfied with that decision. I had my list of questions ready for her and we talked in great detail about each adoption avenue. I figured I’d summarize our consult by each avenue.

First, we spoke about private Ontario adoption. I’m talking adopting a newborn baby from a couple that is placing that newborn baby up for adoption. This avenue is not common and in fact, only 22 private Ontario adoptions took place in 2017 and of those 22 a majority of the adoptive parents were somehow associated with the parents who were placing their child for adoption. We can move forward with private Ontario if we choose but the timeline is not guaranteed of when a newborn would be placed with you. There is also a cost associated with private Ontario adoption in the range of $15,000-$20,000.

Secondly, we spoke about public CAS adoption. For those of you don’t know, CAS stands for Children’s Aid Society. The children in CAS’s care range in age from newborn to 18. Timing is not guaranteed on this route either but the more open you are to children outside of the newborn to 3 years of age range, the shorter the wait period may be. If you are willing to take siblings, your chances also increase. Some of the children is CAS’s care come from a wide variety of backgrounds and may have medical, physical and/or mental health issues. From what we have been told so far, this is discussed and disclosed throughout the adoption process. There are no adoption fees associated with CAS adoptions unless you opt to do your home study and PRIDE training privately (which I will discuss later in this post).

Lastly, we discussed international adoption. While the wait times are much more predictable, the costs are a lot higher. Once we broke down some of those costs though, it started to make sense. I often wondered why international adoption was so expensive but just like anything else every time a document has to go to the prospective country or be registered overseas, there are fees associated. Along with that, there are also fees included for visiting the country which, depending on the country, may be once or twice before you even bring your child home. The fees for the home study and PRIDE training are also included in the international fee amount. We still have more research to do on the international adoption route and what countries we may or may not be interested in but in any case the fees are around $30,000+

I have mentioned the home study and PRIDE training more than once now. Basically it is mandatory to complete 27 hours of PRIDE training (which stands for Parent Resources for Information, Development and Education) before you are adopt ready. You must also complete a home study which covers a whole bunch of things like background checks, criminal checks, finances, 5 references, employment letters, etc. This can be completed through the CAS if you are going the public route free of charge but you can also have your home study done by a private practitioner which we have decided we will do instead. So far we love our practitioner and felt a really great connection with her. This is someone who could be working with us for a few years and who has also been doing this for over 20 years. The thing is if you do your home study privately you must also complete your PRIDE training privately too. We are also fine with this as if we do opt to go the international route, it will already all be done.

It was a lot to take in (and I probably missed a lot in this post) plus we still have a lot more research to do but we will likely start PRIDE training in the spring. We will need to wait to do our home study until our home in Aurora is done and we have moved next summer as the home study is linked to an address and we won’t be in our current home by the time we have a child.

We are still proceeding with our final IVF cycle (and any subsequent transfers) in late January but figured we would get the ball rolling on this sooner than later because if our final IVF is not successful, we would like to be adopt ready by the end of next year. Even if our IVF is successful it is very likely we will still adopt one day down the road.

I’ll keep everyone posted on the process as we move through it and as always, we appreciate all of your love and support.

XO

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infertility costs how much?!?

We’ve had to sit down recently to work out some of the finances around our next IVF cycle. I figured while I was at it, I’d do a rough calculation of how much treatments have cost so far.

For each of our IUI cycles it cost approximately $1,650 for 14 days of meds, $750 for the sperm washes and about $100 for the progesterone. Luckily, in Ontario, the actual procedure of the insemination as well as all ultrasounds and blood work for monitoring is covered. We also spent about $450 to have Shawn’s sperm frozen in advance of our Thailand trip so that we wouldn’t have to wait 6 months when we returned. In total, three IUI cycles were approximately $7,650.

Moving on to our IVF cycle we were also fortunate to receive a government-funded cycle from the government of Ontario. Even still, I will break down the approximate cost of an IVF cycle as the cycle we will be starting in January will be fully out-of-pocket. I will also note that the government funded cycle does not cover the cost of medication. 12 days of stimulation meds in advance of my egg retrieval was approximately $5,000 with an additional $350 in progesterone suppositories after my retrieval and another $380 for the meds in connection with my FET cycle. The egg retrieval itself costs approximately $7,500 and ICSI (which we did on our first cycle and will do again) is approximately $1,500. Embryo cryopreservation is around $975 and each frozen embryo transfer is about $2,000. Our first round of IVF including one frozen embryo transfer was approximately $18,000. Thankfully, we were covered for almost all of it between my medical benefits and government funding.

In total, our treatments thus far total over $25,000 and that doesn’t even include things acupuncture which was costing approximately $340 per round of IUI and IVF, counselling (which averages $150-$180 per hour) and the cost of all of the supplements.

The only difference between our first IVF cycle and our cycle in the new year is we will be opting to PGS test (preimplantation genetic screening) our embryos which is approximately $4,000. We are also paying for additional blood work we haven’t had done before which will be between $700-$1500 which means we will be closer to $22,000-$25,000 fully out of our own pockets for this next round depending on how many frozen transfers we have to do.

I’m not saying any of this for sympathy, we are fortunate to have had some time to save up and prepare ourselves (and our credit line) for this part of the journey. I truly just wanted to paint a bigger picture for those of you who aren’t going through this and who have asked us about the costs that are associated.

#aLongRoadToBaby

fresh new beginnings

First of all, HOW IS IT MID-NOVEMBER ALREADY?! I honestly can’t believe how quickly 2017 is flying by! I believe when I last left off I had mentioned we were exploring the possibility of seeing a new IVF doctor/trying out a new clinic. After some research on clinics, and more specifically doctors, we decided on CReATe Fertility in Toronto. There were a number of factors that went in to our decision but I felt based on reputation, location and real life testimonies from people I know (or are friends and family of people I know), that we would be referred and decide from there. The problem with these big downtown clinics – there are really long wait times. I was told to expect to wait 2-4 weeks before they even call for a consult and expect another 6-8 week wait for the appointment once they did call. Last Friday the admin from the doctor’s office finally called to book a consult (just shy of a 4 week wait) and let me know that they would be booking in to late January. I was expecting this but what I didn’t expect was she would figure out that they had an opening just 5 days later at lunch time. I didn’t even think, I took the appointment because it was SO SOON.

That appointment was yesterday. There is still so much going through my brain but overall our experience was extremely positive. I arrived at the clinic just before my appointment time at 12:30 p.m. with a full bladder for my ultrasound. The place is HUGE like an entire floor but what I like is that everything is done in-house (ultrasounds, bloodwork, follow-ups, procedures, PGS testing, you name it and it’s there!). I got in for my pelvic and internal ultrasounds almost instantly and then waited to meet my new doctor. I was nervous because we had been with the same clinic for so long (and two different doctors in a four-year span) so I had NO idea what to expect. The doctor came out right on time (shocking, right?) and we went to his office for the consult. The one-on-one consult time with the doctor was one FULL hour. I had my list of questions and also my file from our previous clinic so I could just hand it all over. He asked me for a brief run down on what brought me to his office and I explained the last 5 years to him. From there, he listed out all of the issues he could think of in terms of our infertility and went through each scenario one by one with me.

I won’t break them all down but will summarize the main things that stuck out to me. Firstly, based on his preliminary review, he is actually questioning my DOR diagnosis. You see, I told him about being at risk for OHSS with my first egg retrieval/stim cycle in July. The two, apparently, don’t go together. He said it’s very rare for someone with diminished ovarian reserve to overstimulate. We decided that checking my AMH levels again would be a good idea as it’s been 15 months since the last check and I’ve made many lifestyle / supplement changes since then. I guess we will have to wait and see. The next thing we looked at were the anatomic reasons I may not be getting pregnant (abnormal paps, chemical pregnancy, etc.) and decided that I should undergo a hsyteroscopy. I had not heard of this before. A hysteroscopy is when the doctor will go in to my uterus with a little telescope to check out if there are any polyps, fibroids, etc. that maybe need to be removed and he can also take a biopsy at the same time. I will be sedated for this procedure (the same way I was for my egg retrieval) and will be able to leave that day. He doesn’t necessarily think he will find anything but it’s one of those things I’d rather just have ruled it. He then went on to tell me that I have “beautiful ovaries” I laughed out loud because my old ultrasound tech used to always say “wow your ovaries are beautiful” and I never really understood what that meant. Hearing a doctor say it (more than once and even told me I could be an ovary model) made me wonder what bad ovaries look like? I decided NOT to google that. Lastly, we looked at male factor and what role that’s playing. I explained the testicular microlialithis (I don’t even know if I spelled that right) to him and he didn’t seem bothered by it at all. He does want to do another semen analysis as well as a sperm DNA fragmentation test which will measure any DNA damage to the sperm.

After we finished up talking about the issues, he made a plan. Shawn’s supplement regimen won’t change all that much but mine will. I will be adding two new supplements to aid with fertility which are DHEA and PQQ. I will also keep taking my prenatal vitamins, CoQ10 and Vitamin D. So then what’s next? He gave us many options but I think the path I am on right now is another IVF cycle. I will likely wait until my January cycle to start stims again and will do a retrieval in early February. Depending on the results, we may do a second retrieval to bank embryos and, essentially, save costs on PGS testing. Oh yes! PGS testing. This is something we did not opt for previously as it is rather expensive but as this is our last shot we are YOLO’ing the eff out of this final cycle. Basically PGS testing is pre-implantation genetic screening which tests specific chromosomal abnormalities before the embryo is transferred back into my uterus.

So after my FULL hour-long convo (along with a few laughs and a corny joke) with my new doctor I left his feeling SO GOOD. I can tell this doctor is results driven and that is exactly what we are looking for. He also seems to have a great personality which is an added bonus. Just when I thought I could be on my way they suggested I start to get some of the blood work out-of-the-way. What does “some of” entail? Well 28 vials of blood, on an empty stomach, to begin with. Luckily I was saved by a large bottle of apple juice and an immediate visit to the closest Thai restaurant after for some delicious pad thai.

CD1 should be next week and while we won’t be moving forward with a stim cycle quite yet, we have plenty of tests to keep us both busy until that point. I should add that as we already received our governement funded cycle (which we are extremely grateful for), everything going forward will be fully out-of-pocket.

It’s SO refreshing and SO nice to feel excited again even if it means starting all over.

XO

life will carry on

As some of you may know, we moved on to our FET (frozen embryo transfer) cycle in October. It started on CD2 with a baseline ultrasound and then Estrace (estrogen) twice a day.  Nothing needed to happen again until CD12 which was a dream compared to my egg retrieval cycle. On CD12 I went back for another scan and my lining was a perfect 10! What did this mean? It meant I would transfer on CD16! On Wednesday October 11th, we transferred our final embaby. Everything went perfectly. I was 100 times more relaxed than during our first cycle and even made a playlist to listen to during the transfer. “Sesame” was successfully transferred and then began the dreaded two-week wait.

The weekend after transfer was filled with farmer’s market visits and friends and brunch. A very easy way to pass the early stages of the two-week wait. I went hiking with my dog and even enjoyed a light BodyFlow yoga class. By 7 days after my transfer, things started becoming not as easy. I had an urge to test. I had already had a couple of tests leftover from our fresh transfer back in the summer so I figured I’d give it a try. Negative. I was a little concerned but then remembered that I didn’t see my first positive test during our fresh cycle until about 8 days after our transfer so I waited. I tested again the next day and the result was the same. Negative. Of course when this happens you turn to Google and every support group you belong too. I read a lot of things about late implantation of day 6 blastocysts but based on my readings and in speaking with other women by 9 to 10 days past frozen embryo transfer (and even with a late implanter) an early response pregnancy test should be able to detect enough HCG to confirm a pregnancy. I was holding, loosely, on to hope but also was starting to accept what I knew was the truth: I was not pregnant. Our final attempt at this round of IVF was over and it meant we were back to square one. I continued to test the next two days and saw the same stark white negative I had seen all week. It just so happened that I had some yoga teacher training to complete over the last few days of the two-week wait and it couldn’t have come at a better time. Not only was it a great distraction, it totally kept my mind at ease. I did make a decision to drop out of my prenatal training as I would have had to wear a pillow to mimic pregnancy and as I knew I was not pregnant, my heart wouldn’t have been able to handle it. Instead I spent that day running errands and just practicing some general self-care.

On the Monday morning I went in to my beta with a smile on my face already knowing what my email would say later that day. I even sent Shawn to work that morning as I felt like I was already prepared for what was coming. It’s like I’ve seen the emails so many times now that they don’t even phase me anymore. Except they do. Reading the words always get an automatic reaction and this time was no different but then, just moments later, I carried on with my work and my day. I went back to the office the next day, because sitting around and feeling sorry for myself gets old real quick, and surprisingly I was okay. People checked in throughout the day and offered to bring us food or take me out. It was all very nice. The surprising thing was that as the days passed, I continued to feel okay. It was like I had no emotion towards what had just happened. We decided the day of our confirmed negative that we would give IVF one more shot. Keep in mind this now means we are fully out-of-pocket (to the tune of about $20,000) and there is still no guarantee. At the same time we also solidified our decision to move forward with adoption. Adoption is something that Shawn and I have talked about since all of this started. We have both acknowledged that no matter how a child comes in to our lives, that it will be our child. So with that, we were referred to a private adoption consultant that friend’s of ours had used for both of their adoptions and we have an appointment with her in a couple of weeks. We also decided on a new IVF doctor and are waiting on that consultation too.

Earlier this week, my emotions took a complete turn. It’s almost as if everything I was trying to bury deep down and not feel came out to play. I currently feel empty and really scared. I cry (a lot) and I wonder if the day will come where I have a child of my own. I know these feelings will come and go but right now they’re just all so raw and very real. To think at the beginning of this year, when we finally started treatment, my biggest fear was having a baby too close to Christmas as he or she may grow up having their birthday overshadowed by the holidays. These feelings then moved on to wondering if our baby would share a birthday with me to then hoping so badly I could be on maternity leave with a few of my closest friends. None of this is currently a reality and as of right now we are at a complete standstill. I was almost asleep the other night and I shot awake sobbing yelling that I wanted our sweet Sesame back. It’s all too much some days and yet others, not at all. We will get through this as we always do because what other choice do we have? This just happens to be our current reality. Our daily, shitty, all-consuming reality. But with any luck, this will not be our reality forever. Life will carry on.

XO