Contingency Planning
About the Author:
Steph and her partner, Jose, are a military couple that recently moved to Annapolis, Maryland after living in Hawaii for three years. Jose is a Seaman for the United States Coast Guard and Steph is going to school to obtain a graduate certificate in special education. They have a very fluffy calico cat named Mazikeen. In their free time, they enjoy hiking and finding hidden restaurant gems. Steph created the blog, www.ivfyou.com, and has been sharing her story and using it as a platform for all topics related to (in)fertility and IVF. She is a huge advocate for change so all couples can have access to the treatment they need. Below is her story!
So much of infertility is thinking that you have an answer or that your plan is going to work…
But life swings from the top of the pendulum and knocks over all the tiny, delicate pieces you worked so hard to put together. We’ve had our baseline date set in stone for months. During initial contact our nurse, Beth, wanted to make absolutely certain that Jose was indeed going to be present on egg retrieval day. Typing out my email response in confidence, I stated that Jose wasn’t set to go on TDY (temporary duty) until later in the year and his being able to produce a fresh [sperm] sample wouldn’t be an issue. If only the military cared that I had larger priorities.
We were at Buffalo Wild Wings for a date night. “Now that we have some beers, there’s something that I need to talk to you about.” Jose started.
“Okay,” I replied casually, leaning in closer. I didn’t anticipate anything in particular, but I was ready to listen to what he had to say.
“I looked at the list for Marine Science Technician training (or A-School), and due to people either getting tired of waiting or the potential vaccine mandate and jumping ship, I’ve moved up on the list and I might be going in April.”
The blood suddenly left my face, and my skin turned electric with the tingle of panic. Was I still breathing? No. He can’t go in April. I need him here.
“What are the chances of you being able to leave for egg retrieval?” I asked, masking the shaking behind my voice. My lip did its best to not start quivering. I had to be supportive of his career but I also had my own selfish gains from him not leaving so soon.
“I don’t know. I just now found this out.”
If he left in April, that would mean he would be gone for 13 weeks for training. While his specific training for MST would be in Yorktown, VA, about 3.5 hours away from us, he may not be guaranteed a day’s leave for a medical appointment that’s not his own.
No. This wasn’t how it was supposed to happen. We had made our payment, everything was booked, and I had my protocol and calendar. I know that Walter Reed stores frozen sperm samples, but would using a frozen sample throw off our protocol? Our chances of success? Would we have to sign a new contract for the change in protocol? How much extra was this going to cost? Would we no longer be financially cleared to start by making this change? I found myself trying to stay composed as he told me more information, but all I could do was calculate was how to fix the issue.
And yet, this was only a possibility. He won’t know until today if he’s going to be going that early or not.
I texted my RESOLVE group for advice. They assured me that switching to a frozen sample wasn’t going to be a huge issue. It felt good hearing from some more veteran members that have already gone through IVF.
I then reached out to an MST Facebook group to see the possibility of command letting Jose leave for a day. I got either “No, they won’t since it’s not a life threatening medical emergency” or “it depends on what they’re training for that day and if he can make it up.” Not entirely helpful, but at least it wasn’t a definite “no way in hell.” I was happy that people took the time to respond.
Jose and I debated back and forth on when to let the clinic know. I wanted to call them ASAP. We’d have to drop off a semen sample, pay the cryo fee, and possibly redo our paperwork. I had in my head since we would incur additional fees, we would lose our spot for May 9th because we would no longer be financially cleared. He wanted to wait until as late as possible lest they cancel the cycle all together. Since it’s a military hospital that still has the highest restrictions for COVID, he wasn’t sure if they would even let him give a fresh sample since he would be coming from out of town.
We each had good points, but the hardest part was knowing that we weren’t going to get any answers at 7pm after having dinner. The next day (Friday) I left a message for my nurse, and she called me the following Monday morning. Beth assured me this was a common occurrence for service members (of course it was! I knew that deep down). We were able to get a frozen sample ready to go.
Now, the next plan to make. Am I going to be able to keep my transfer?
I’ve learned after listening to many different podcasts and following enough of you on Instagram that a fresh transfer would be cancelled if my estradiol is too high or if they collect more than a certain number of eggs. Since I have a high AFC and my AMH is also elevated due to having PCOS, I might have to switch to a frozen transfer should that be the case.
Since Walter Reed is a military hospital that runs on grants, they are limited in the number of transfers they can do per year. Plus, I would probably need a cycle anyway to recoup before a frozen transfer, so if we do retrieval in May, we’d have to wait until July to do a frozen embryo transfer. But wait, Jose leaving for school… when do we go to our next duty station? Which of us is even going to be here in July?
Since he is going to A-school, once he graduates we’re going to move to our next duty station shortly after. If he’s gone from April-June, we’d be moving in July or early August. If he leaves in May and we can only do one FET in July, that just leaves us with one transfer. I’m spiraling trying to piece together how many transfers are even going to be possible now. I had in my mind that’d we be able to do at least two, if not three.
Let’s say we move prior to doing two transfers. Well…one option is I can store the embryos here and fly in for transfers. We have a friend that I might be able to stay with if she’d let me. But she has her own life and I feel that’s a tall order to ask. How long would I have to stay?
Or assuming we end up near one of the few military hospitals that can do a transfer, we can have the embryos shipped (we are completely out of pocket, so going to a private clinic isn’t an option. Walter Reed isn’t free for us, but it’s heavily subsidized). Of course, this comes with its own risks, but according to another military spouse in NC area, the risk is minimal and if you calculate travel, lodging, and food, the costs tend to even out.
All of this would all be fine if he wasn’t in the military, yet it’s because he’s in the military that we get to go to one of the best hospitals in the country. I was curious to look up if my old insurance in Hawaii would have paid for IVF, but looking in hindsight isn’t helpful for infertility. Otherwise, I would go back in time and go straight to IVF instead of doing three failed IUIs.
I had to stop myself from researching my chances of developing OHSS due to the fact I have a high AFC and AMH due to having PCOS. Yet, statistics can only say so much because since this is my first time going through stims, we have no idea how my body is going to react. Walter Reed knows I have PCOS and I know they’re going to do their best to mitigate the risk of my, or any patient, being over stimulated. I also know that a freeze all cycle may be the best option for myself and our chance at success, but that doesn’t mean I’m happy about it.
As much as I beg the universe for any little sign, there’s no crystal ball to see how this is going to turn out…
This just fucking sucks.