An interesting comparison

I was thinking about IVF as compared to IUI and my response to the drugs.

I went back to my journals and looked it up. For my first IUI I did 8 days of 75iu, then another 7 days of 150iu and got 2 follies.

Second IUI I did 3 days of 200iu and another 9 of 150iu and got 4 follicles.


So both of those cycles I was on the same dose as I am now on for this IVF cycle (150iu ) of the puregon, and had poorer response after being on it far longer. This cycle after just 5 days of the 150, I have 12+ in development. That is a massive difference. And clearly why last cycle I had 40 on 250/200iu! Yet you can see why I wanted to start that high, given the responses I had on IUI to the exact same drug.

Given I weigh the same now as I did then, the only difference I can put it down to is that with the IVF I have walked 20 minutes every single day that I am stimming. I was even on metformin then to help it all along and am not now.

Surely this is a good thing, that I am helping my body along, not relying on the increased drugs? It is such an enormously different response, it truly intrigues me.

T Minus 3 weeks and counting...

About 3 weeks to go until we commence cycle 2 of IVF. Unfortunately, we had no frosties (frozen embryos) from last cycle, so we are starting from scratch this time again. That means more $$ and EPU all over again. At least this time we are doing a flare cycle and not a down regulated one (which means 4-6 weeks as opposed to 6-10 weeks). We are excited, and still hopeful that we may get our much longed for second child, yet.

I have my script here, and as soon as AF starts (first week Feb hopefully); we are away. Bit nervous, but mostly excited. Will ring up and pay the big bucks soon so that we can have the script filled and the medications is then here ready to go when my period starts.

Need to call nurses day 1 of cycle, and I think start synarel right away. Will find out I suppose! The good part about starting so early is that we will hit the medicare safety net immediately, and subsequent cycles (not to mention any other medical costs for the year) will then be far cheaper. So the earlier the better really.

Just adding some interesting research from as recently as October last year (about when I underwent the acupuncture for last cycle actually!) - new research says its NOT a good idea. Who bloody knows anymore! Read the article here.

Consuming thoughts...

Amazing how many times you can google things like :success with low grade embryo's" and "grade 3 embryo" and "day 2 transfer" and get different stories. Sigh. It seems some babies are born from shite embies, and some top grade embies result in failed cycles. So there is no real way of knowing. Though the chances are obviously lower, doesn't mean there is NO chance. So, we wait. And we wait, and we wait, and we wait. Its hard to go from appointments every few days and being very much in go go go mode, to the epu and transfer and pain and watching for OHSS... to now trying to switch it all off and forget about it. Its SO hard not to let ti consume my every waking thought. It is hard when you invest SO much in so many ways, to try and let it go and ce la vie...

Rationally, I have worked out when we will be able to go again (need a cycle off for the recovery, and to get xmas and first terms school fees over with); so probably February... but am glad that we will be on flare cycles now, not down regulated. This means no pill stage. Once I get a period, its straight to the fsh injections, no pill! So instead of 6 weeks+ cycles, it will be 4ish. Means we can easily get through 4 or more cycles by the years end. At which point its crunch time again if we are not successful. I still believe by end next year, we will be. Geez. I have so said that before...

Anyway, I have made those back up plans, and I know that if this is negative, I will be disappointed, and devastated... but I know I will recover eventually, and get back on that horse. In the meantime... we wait.

The point of no return

The nurse called yesterday to tell me that egg pick up is at 10:40am Monday at the RWH, and therefore, trigger was to be at 11:10pm last night. So very precise, not 11, 11:10pm. Because it takes 36 hours to ovulate, so I get there 35 and a half before and then they can catch them as they mature and ready to ovulate.

The trigger injection is bloody awful. Now, at the start of all this, they told us it was an all in one syringe which pleased us greatly, since at the IUIs it was the vials etc. But, when I collected it all on Friday, she said I have to have the vials again because I am hyper stimulated and that form is more gentle on the ovaries.

So anyway, I had to stay up late (for me, I am old remember); at mix it up. What happens is I have to snap the tops of two, small vials (about 3-4cm tall), and hope they don't shatter. Then I have to be super careful that I don't knock them over, and you'd be surprised how easily that could happen! If either happens, we're screwed, there are no spares.

So, then I attach a large thick drawing up needle to the syringe, draw up the water form one tiny vial (without unbalancing it with the thick long needle!) and then depress the water in to the vial of powdered medicine, swirl it up til it dissolves (again, careful with the tiny vial!!!) then draw it all up again, turn the needle upside down so i doesn't all escape when I take the drawing up needle off and replace it with the injecting needle (far, far smaller!)

Then tap all the air bubbles to the surface, and slowly depress the syringe til the air is out, and a drop of medicine is at the tip, then inject. It is seriously stressful and fiddly. But, I got it done. Ended up being 5 minutes late though, so will tell them that tomorrow. Better late than early.

So, there is no going back now. Tomorrow morning we'll see how many eggs we get, and then the eternally long wait til Wednesday when the Dr. calls to tell me how many fertilised with the ICSI, and how many are developing and suitable for freezing. I feel ill at the thought. I am hoping for 10 eggs tomorrow, 10 good ones. 6 is ok. Less than 6 and i will be disappointed and worried, but as long as its quality... it will be ok. I hope.

I am really pretty scared about going under anaesthetic too. Its scary. Last time I was under a similar level of anaesthesia, was for an endoscopy about 10 years ish ago and it was traumatic. Before that, some operations as a little girl (I got over the needle phobia with all this, but still a bit scared of going under). And its going to hurt. A needle through the vaginal wall to get all my eggs out. Well fark. That doesn't sound fun.

So am sore and tired, but nearly there. Now to drink 3l of water and powerade for the next week to stop OHSS and I might even be okay for my birthday on Friday!

Fuck, fuck, fuck, fuck.

I have 20 fricken follis on EACH side. 40 follis. This is NOT good news. :( Dr says 50/50 chance of cancellation. I drop back to 200iu today and tomorrow and rescan Friday morning. If I have more than 30 still, I am cancelled.
If I have 25-30 I will have retrieval but not transfer. etc..

Sigh. No wonder my ovaries fuckin hurt. J is being positive and saying well we know we can get the numbers next time etc etc...

I am trying not to think about it. Worrying wont change it. Just see what happens Friday, but its not looking good at all. Please send me some "halve what you have" vibes.

IVF Junkie

Hurrah! I commence shooting up tomorrow! Should have been today, but the scan to check progress fell on Cup day so its tomorrow, and scan Wednesday. I talked to her about the very low start dose and told her my IUI history dosage/result and she decided to instead start me at 250. I felt anything less than 200 would be a waste of our time, so was very pleased with that.

So, I collected my second pack now (have one the same from IUI days); of cooler bag, ice brick, pen needle, sharps disposal unit and precious vials and needles. I feel so relieved, honestly. And can you believe my lining was still bloody 4mm?!?! HOW? Stupid period is STILL spotting today. Dr says was definitely right to wait the week given that the period kept going like that, says it would've stuffed things a bit.

I really like my Dr. She listens to me, she's encouraging, realistic and proactive. You really can't ask for more than that when it comes to Assisted Conception, in my opinion.

So, good news. Am already nervous about Wednesdays scan. Am quite certain I will need a lot more beyond that, so its not that. But now I am thinking god if I talked her into a higher dose and I react differently and OVERstim, it will be my fault. Its unlikely... but it will be in my mind til Wednesday. What I expect to happen, is to find some growth, but early days, which will require more stimulation/needles, maybe an increased dose or more of the same. With IUI I injected for 3 weeks and 2 weeks so that is an indication.

Also, I just received an email from the people at www.essentialbaby.com.au which said I had been chosen as a winner for a competition I entered recently. I have won us a copy of this book:

Making Babies: Personal IVF Stories (can click that for more info)

So that will be handy timing, and should inspire and give us strength. Great bonus! Good day!!


ETA: Credit for the term "IVF junkie" which I just love, goes to Adrian B, I have adopted it as my new favourite term.

The worry

Freaking out again. Waiting for this period that won't start. Spotting and thats it. Come on!!! Sigh. Am worried that I will still be bleeding at the scan Thursday. Way to be even less dignified and more embarrassed :(

And then I was stupidly reading stuff on the net about starting doses of puregon and bad results from low stim doses and I know my Dr plans to start me very low in case the PCOS sends me into hyperstim (medically v dangerous). But I responded slow in the IUIs and now am freaking out. Sigh. Its so scary. The chance of this actually working is so bloody low. I'm depressed. :(

Hurrah!

Today is a wonderful day! It is the "take last pill today" day! Kaloo kalay! Have I ever been so excited at the prospect of a period? I don't think so! Cannot wait to get off these horrid things. So from now on its just sniffing synarel for a week, scan next Thursday (changed to 10:45am).

Speaking of which, yesterday I paid the difference between a Stim cycle and an ICSI cycle and then called the nurses to sort out picking up the injection because the information book says to organise it in advance to avoid delay. Honestly, so far they're badly lacking in the impressive stakes. We had this conversation:

Me: When do I pick up the meds etc because I have my down reg scan next week.

Nurse: You'll have a script.

Me: I don't have a script, should I have?

Nurse (in a voice that clearly shows she thinks I am lacking brain cells): No you get it from your doctor at your scan.

Me: Oh ok. And erm.. then what do I do with that? Do I take it to a chemist?

Nurse (now sounding like I am from another planet for not knowing the drill): No, you bring it in to us, and we do it all here.

Me: oh ok. And so do I need an appointment for that or?

Nurse (almost shitty now): No, its just routine, you come here after your scan.

Me: Well no one told me that.

Nurse (now feeling chastised and even more pissed as a result): Right, well thats how it works.

Fond farewells etc. (pfft).



So really, not too impressed with them so far to be honest! They've a lot of ground to make up and so far none has been made up at all. Oh well. Long as they get it right on the day...

Interesting article.

Source: http://news.ninemsn.com.au/article.aspx?id=87188

Twin Babies from IVF Falling.

The number of twins born to IVF mums is plummeting as more women opt to have just a single embryo implanted to fall pregnant, official fertility figures show.

A trans-Tasman report into assisted reproductive technology (ART) shows that fertility specialists are encouraging women to avoid a double embryo transfer.

Implanting two embryos slightly increases the chance of pregnancy but is more likely to result in twins, which are more likely to be born underweight and premature and with a higher risk of birth defects than singleton babies.

New statistics released by the Australian Institute of Health and Welfare (AIHW) show that almost half - 48 per cent - of all ART treatment cycles in Australia and New Zealand are now single-embryo transfers, compared with 28 per cent in 2002.

As a result, the number of twins born has dropped from more than 40 per cent of ART births in 2002 to 23 per cent in 2005.

Fertility expert and AIHW adviser Professor Michael Chapman said these figures could be expected to shrink to just 10 per cent in the next five years as more fertility experts and parents opted for single embryo procedures.

"The end result of this is bigger babies, healthier babies, so it is great to see these numbers dropping so fast," Prof Chapman said.

"I think specialists who are advising parents have been won over to the notion that twins are a bad thing."

Since 2002, the Fertility Society of Australia has recommended that women under 35 have only one embryo implanted. But the single embryo option remains less popular among older women, who are most keen to have a first-time pregnancy success.

The AIHW report, called Assisted Reproduction Technology in Australia and New Zealand 2005, counted 51,017 treatment cycles in Australia and New Zealand in 2005, including 3,356 donor sperm insemination cycles.

The number of ART babies born in the two countries soared from 6,792 in 2004 to 9,764 in 2005, with such births now accounting for almost three per cent of Australia's annual birthrate.

The average age of IVF mums was 35.5 years, slightly higher than the previous year. The proportion over 40 also increased fractionally to 15.3 per cent.

The death rate among IVF babies dropped by a quarter between 2004 and 2005, largely due to the increase in safer single embryo transfers and singleton births.

Only eight per cent of babies born from a single embryo procedure had a low birth weight, compared with 25 per cent of babies born after two embryos were implanted.

The results are in line with a study presented at the national fertility conference in Hobart last month showing IVF twins were a vastly bigger cost to the health system.

A twin delivery cost $24,000, due to clinical complications and post-birth care, compared with $8,000 for a solo IVF baby.


This is interesting as we have been told we will only transfer one, and I was a bit flat about it reducing our chances (or in the very least, meaning we may need more cycles before success). Good to know we aren't alone in the single transfer stakes.

Bugger.

We got Josh's sperm analysis results back today, expecting no dramas and instead were told motility improved, but morphology low (so not many sperm the right shape). Our Fertility Specialist (FS) has recommended we use ICSI in our cycle. This is IntraCytoplasmic Sperm Injection and is demonstrated in the below video. To watch the video (if you've not used youtube before, am looking at you Mum); press play, then pause again, and wait til the red line is filled then hit play again. This will stop it from stop starting as it loads.

In the needle you can just see a little black sperm swimming up and down the length of the needle. Stupid thing swims the wrong way after they pierce into the egg, but eventually swims out and the needle is removed.

This is good in some ways, it means fertilisation is likely, since they will be forced together, rather than waiting for them to decide if they can be arsed doing it themselves or not. It costs a little more, $377 more upfront, but only $75 more overall after medicare rebate. The ICSI procedure has only very, very recently been added to the medicare schedule for rebate so thats great for us.

Its good to know now, and be prepared and have this in place to deal with it - but it has wobbled me a little.. like something else to overcome... Just a bit depressing.

Anyhoo, heres the video:

Are you good at hurdle races? I hope I am.

Feel odd today. Up and down. I am excited, about the prospect of becoming pregnant. I feel confident that this will work for us - in time. Assuming we can remain strong enough to give it a decent try (e.g. 12 months).

Feel absolutely sick with nerves at the scariness ahead though. IVF is basically a series of hurdles you have to get over. Obviously the scheduling was one, though I didn't realise that until it went wrong. From now on, I see the hurdles as thus:

1. Scan on the 25th, needs to show no cysts and thin lining, need to be ready to inject.

IF I am indeed ready to inject the next hurdle is a big one, and one I have real potential at failing.

2. Scan to assess fsh injection affect, i.e. follicle growth. I suspect mine will be slow, and will need longer than the usual one week only. I hope that I do have SOME growth though.

This leads to the next hurdle:

3. Do I have enough follicles EVENTUALLY? Even if slow, will I have a decent number. If not, I could be cancelled and this would be extremely distressing. Any of these hurdles causing us to stumble will be devastating. To not even get the chance... ugh. So, responding effectively.

Assuming I do relatively okay, the next hurdle is OPU.

4. How many eggs are retrieved? We want a decent number. 10 would be brilliant! We only need one to put back, but we want a few to choose the best from, and some may not progress and I would love to have some frozen to avoid another long cycle if this one fails. So number of eggs.

Assuming we pass that hurdle and get a few eggs at least; we then need to:

5. Fertilisation. Need to get them to fertilise, hope that they don;t sit and refuse to socialise with the sperm. Hope like hell they fertilise. Often, many do not. Again, we'd like one beauty to transfer, and a few for the freezer and expect some not to make it any further as well.

After fertilisation, we want:

6. The embryos to continue developing. So cell division, not just not growth... Again, I expect we could lose some here. And it depends what stage of development they reach. The more they grow, the better their chance of sticking. Would love some top grade, beautiful embies. Please.

Assuming this goes ok, we then transfer one and freeze (hopefully) lots more. The final hurdle is the biggest.

7. Implantation. We need any transferred embryo to burrow in and implant into the uterine lining, thereby making us pregnant, as shown by a blood test 2 weeks after transfer.


There are so many chances for failing. It literally makes me feel sick to think about. It will be good to complete one cycle, negative or positive, to tell us whether there are any other issues we didn;t yet know about at the egg quality or fertilisation stage. If not, then we can expect to get there eventually.

I feel exhausted just thinking about it!!! The biggest thing I think, is to get lots of good eggs. If this happens, it makes failing at the latter stages a LITTLE less likely (assuming we've on issues with fertilisation).

So scared.

Sniffy sniffy

And we're off... Sniffing last night and this morning commenced! Ahh the familiar taste of synarel returns... I had forgotten just how charming it ain't! Bleauch! So anyhoo, sniffing that for a week as well as taking the pill, overlap the two for a week, stop the pill on the 18th (does this mean I take the pill on the 18th or not? If I am to stop on the 18th, I think not?) and then have a period and then a scan on the 25th October to see if we are set to start injections.

In the mail today, I got the initial instructions (pre cancellation); which had my dates as start synarel 31st, stop pill 3rd, scan 14th november. My God. Thank GOD I can start now, that is crazy scheduling. I took great joy from shredding that set of instructions and may frame the new ones when they arrive.

I was worried by my reaction yesterday, gave myself a bit of a fright. Thought I was all calm and impressed I had remained patient for those 3 weeks which old Kel would never have done. Then I fell apart at the first hurdle and that worried me. Will I cope with more setbacks (and generally in an AC cycle there are many IME). I don't know how to prepare myself for the unexpected and roll with it all. It is difficult because its so emotionally charged.

Just try my best eh?

Oh the characters!

Man, the people we met yesterday at MIVF were such characters. 2 in particular - such odd people!

Poor J had an appointment for his SA yesterday morning so he had to go and do that, and then meet me in the afternoon for the other stuff. Firstly, we met the nurse. She was very nice, showed us the injections which haven't changed since we did IUI - although their trigger is all in one, ready to go; no vial mixing! Woot! I told her I had been on the pill for 3 weeks and was ready to move on so she gave me the script for synarel and said to pick it up then and there, and that she would call me later with my schedule. It was very straight forward, an envelope of info to read and back to the waiting room we went.

We were then called into accounts. We walked in and sat down and the lady said to me"what perfume are you wearing?" I thought to myself oh i must smell nice, how complimentary! I told her and she said "Oh yes, I thought so. I am deathly allergic. I am going to have to get someone else to do this." She called someone else to take over and said she would start, but every 5 seconds she would complain and say she was going to be ill all over me, or "it huts me right here" gently touching a hand to her head. Melodramatic indeed. Was weird. I wasn't sure what to make of it and began to wonder if there were hidden cameras. She started going through the fees and then abruptly stopped and said "no I have to go. I don't want to be throwing up all the way home. is my eye getting smaller?" I was like... err... not really... and Josh pipes up and says "oh yeah it is..." encouraging her neuroses and having fun with it. he is so evil. "I thought so. yes I can feel it" she says and bolts from the room apologising as she goes. I looked at J like.. wtf??? I felt awful!! I am knocking people down with my scent!!!

Anyway, the replacement lady came in and was lovely, talked us through all the fees and so on. Nothing unexpected there except that going public may not be possible. They would try and fit us in, but there is a chance we will end up at Freemasons thereby costing us another 500 bucks. See how we go I guess. We paid then although it wasn't necessary for another couple of weeks, I just wanted it done with so I am committed and don't need to worry about it. Left that with another pile of reading.

Back to the waiting room for another read of Dog Magazine (!) and Vogue Living. Then we got called into the counsellors office. There is no polite way to say this. When we walked in the room STANK. She had obviously just.. well... been struck by flatulence. It was dreadful. I almost gagged and was wondering how the hell I'd be able to sit there for any length of time, all the while hoping it was her and not my husband!!!! Thankfully, it dissipated eventually. teehee! She went through all the background of our ttc and had we told people we were doing IVF and then all the ethical questions. Namely, in the event of immature eggs or ones that are dodgy and won't fertilise, would we donate them to science (not just research, things like teaching new scientists the methods etc) or dispose of them? Then in the event of one of us dying, did we consent to leave any embryos to our partner to use (fine if J dies and I whack them in, but if I die, he needs a new woman to put them in and wouldn't they want their own if he has a new woman? minefield...) And finally, if we are successful and still have embryos in storage, after 5-10 years we need to decide what to do with them; do we dispose, donate to couples, or donate to research. This one we didn't have to decide immediately, we've much time to do that.

She left to photocopy the consent form and J immediately bursts out to me "Did this place STINK when we came in or what?!?!" Boys! We had a giggle and had to recompose before she came back... A further stack of reading and we were done. We were impressed with the staff though, they were friendly and prompt and extremely knowledgeable. i think we both feel in good hands which is important.

After that we picked up the synarel (cha ching.. another $100 bucks!) And came home. Very uneventful. The nurse didn't call either, so I have just left a message this morning and should hear back before 5pm tonight hopefully. Again, I am not desperate to know or particularly antsy. I would like to know so I have the next point to focus on, but otherwise, I am cruisy. For now...

Emotional freakout

Rambling thoughts... Feeling so strange about all of this. Freakin out about going back to treatment. The pill is making me feel a bit nauseous and off; I feel really snappy and tense already too, more from being a bit anxious than anything else though. I am depressed about the only one embie back thing; most people I know that had success on their first cycle of IVF did so with 2 transferred resulting in a singleton pregnancy. I am dubious of success. Bitter and cynical!

Just feel a bit... I don't know what! Maybe because of that negativity, I am not super excited and so I feel I am putting myself through all this with not much belief in it working, at least not the first time around. So, 3 weeks til the next thing happens, and in that time I will try and get lots of uni stuff done so that IVF ramping up and uni assignments due all at once is not too stressful.

Verdict

That was your hint. How ironic and strange it is, to start assisted conception by taking the pill!!!

Dr. Foster was really good. She asked our history and then asked what we wanted to do, and we of course said IVF please. She said she agreed that was a sensible decision given the mucking about we had already done.

She will only transfer 1. Before going, I thought that with my age and that we knew we CAN conceive, one was best for us anyway, but now shes said it I feel like our chances of it working just halved. I am an odd one.

She asked when my last period was and I said 10 days ago and that I only get them every 80-100 days; so she decided to do a scan on the spot and my lining looked good (she taught me how to read the ultrasound which was great, didn't look like the moon anymore); and then said I could start tomorrow (ie today!).

So, after sorting the $$ - we are away this morning. I took a pill. I told Dad he could have ownership rights over any baby that might be created, especially when it needs a nappy change. :D

Now I have to call the MIVF nurses this morning and tell them I have started. I have NO idea what happens form here. I do know that J has to make an appointment to give a sperm sample but he chickened out of making it yesterday. I was NOT impressed. I have to do most of the hell, he has that one test. Why I oughta... lol.

it is all happening so quickly. Yesterday I was just so overwhelmed and felt like crying and laughing at once. The reality of returning to all the invasive treatment, the finances, the broken dreams seemed to hit a bit. At the same time, I am excited (but to be honest, not overly hopeful). J reminded me that the way to look at it is not that this cycle will work, but that one of three or so will. I like that. I can do that. So here we go!

All systems are go!

Got my referrals all sorted this morning. I really like my GP, she is lovely. She put in that we wanted to go right to IVF and that we had already done IUIs etc. She made it for J and I together and ongoing, and for both Doctors. She included the issues both of us have. Very comprehensive!

So now we are set to go for Tuesday. Nervous as hell.

Decisions, decisions.

Ok, in chatting to other ltttc/ACers both in my little circle and on bellybelly, the amount required for the acup/herbs is too much for the potential affect. I think what I will do is get myself some herbs for complementary meds to the IVF, and have the occasional massage for relaxation throughout treatment. Weekly or fortnightly, depending where I am at. I think that will give me much the same affect, or close to. I would like to do the acup, but IVF will cost a bomb and I don't want to struggle to afford it.

So decision made! Now to get Tuesday over with so I know where we are at... Am so nervous about it. I want her to say IVF lets go... and then for the preliminary stuff to take a little bit of time til we have the cashola in our hands in November! We'll see how we go. Fingers crossed. :)

Acupuncture ahoy!

I made an appointment to start acupuncture tomorrow. The therapist, Margaret, specialises in womens issues etc and certainly knows her stuff. She is also endearingly Canadian, and reminds me of my Canadian mate, Erika, who I spent many fun times with in 01. I love that accent. teehee! When I said I wanted to do it in conjunction with IVF but that I thought I needed to start this first, she agreed and seemed to know exactly what I was on about so thats good.

Anyhoo, I will probably need 8-14 weeks of weekly therapy, then it will scale back. Cost is $50 per 45min session, more for herbs if required. Not a fan of herbs though! Not the gunky funky tasting ones anyhoo! So, bit nervous, but also curious about it - will let you know how it goes, am scheduled for 11am tomorrow!

More stuff

Ballarat is not looking good:

Hi Kelly,
Your initial consult fee do see Dr Bardsley will be $167.00 of which $99.25 will not be claimable from medicare. IVF fees vary depending on whether you have private health insurance. The up front fee will be approx $4,500, you will be eliglble for a medicare rebate the amount being dependant on your medicare safety net. Blood tests will need tobe done through St John of God Pathology and scans through Lake Imaging so I imagine Ballarat will be your closest providers. Hope you can make sense of all this! We can clarify and give you detailed quotes when you see Dr Bardsley.

Bugger. Never mind, if all goes well on Tuesday with MIVF, I will cancel that appointment all together.

Also received this email in reply to another query I had with our PHI -

The item number 13212 is covered under your policy. You have Public Hospital cover with a $400 excess. The item is only covered in a public hospital with the doctor of your own choice.

Which surprised me, although I think our excess will be more than MIVF charge anyway!!

Extra info

I made the appt to see a Dr at MIVF and then realised she was not the Sunshine (closest) clinic Dr. I rang MIVF this morning though, and asked does it have to be that clinics Dr or can I see Dr Foster at her rooms but still do all my bloods and scans at sunshine?

Yes! Dr is irrelevant. Thats good because the Dr at Sunshine is only there Wed arvo and because of small mans school hours, afternoons are not suitable. So I would have had to see him elsewhere at other times anyway.

Also realised that to get to that clinic, its not TOO bad in terms of traffic because I only go as far down the Calder as Sydenham then turn off, and it doesn't get hectic really, until from and after the Sydenham on ramp (as far as I can recall anyway). And if I tried it once and found it was busy, I could always go the back way thereafter, which would be just an extra 10 mins or so. Not so bad after all...

I emailed Ballarat IVF today also, and asked if IVF is required, how do the payment options all work, and I am going to call MIVF accounts later and ask the same. Am hoping one or both, allow you to pay just the gap fee upfront, and bill medicare directly for their share. This would mean the difference between needing to find $3000 (which we can currently do by mid November); and $5000 which would not be possible til Jan/Feb next year.

We will try something before the years end (from Nov) - whether that is IVF or IUI is yet to be seen. Because we already have a child, our safety net for medicare is far lower, at $520 of which we already have $120 toward, and given I am still to see a GP for referrals and have these 2 specialist appointments, we are obviously going to be close to it anyway, so might as well start now. Oh correction, I think we are now on 1029 safety net coz we dont get family tax A anymore, only B. Bugger! Thats 500 less we get back! Oh well. Otherwise, costs are as I imagined, although next weeks appointment just to see the Dr is $170-. Yowsers!