I received the call from my resolute, mighty fertility specialist, Dr. Shomento, this morning. Of the 17 harvested eggs, 9 are ready to carry forward. For context, 6 are the default amount for one possible child.
When I came to after Monday's procedure (which boggles my mind that it was just yesterday), I had "18" with a heart written on my left hand (the total amount is actually 17). The doctor who did my egg harvest said they'd write how many eggs were "harvested" for me to see when I woke up. 18 eggs. The team was very compassionate and excellent. I was crying happy tears as I was laying on the procedure table and thanked them for making this possible before the sweet anesthesia whisked me away.
Cramps. I've never had cramps before. Wow. To all the woman who get these monthly, you have my profound awe and I will bring you whatever you need. I am very tender today. My abdomen is swollen and I'm walking at a 30' bend. We should all take cramps more seriously. They twist you when you are relaxed and made me pull in deep, steady breaths. For an egg harvest, an ultrasound probe is inserted into the vagina to identify follicles, and a needle is guided through the vaginal wall and punctures into the ovaries. The eggs are removed from the follicles through the needle, which is connected to a suction device.
It was wild getting Sunday and Monday to be focused only on my egg harvest. I didn't think of chemo or cancer or my port. My mightily tender dad came to my house Sunday morning at 7:00 a.m. He cooked breakfast for me just like when I was 14 years old. We had the whole breakfast to ourselves and spoke earnestly and honestly. Then, my road trip began with my mom and oldest sister, Erin. In Bozeman, a quick blood draw to make sure my hormonal levels were ready for Monday's procedure. I was able to see Mike and get buoyed by his love, and we all dined at the Bozeman delight of Storm Castle for a hearty brunch. Then, the road to Billings flew by (probably because I slept from Livingston to Billings). I had a wonderful girl's weekend with my mom and Erin. We shared a great dinner date. Before bed, I reached over to Erin, touched her side, and was able to say "Good night. I love you" like when we shared beds as kids.
I'm so grateful I got to share this experience with my mom and Erin. My own mother, and my sister who showed me first the raw, powerful beauty of motherhood. Erin has always been a maternal power. She left notes in my lunches cheering me on for my high school games. She has a way of making everyone feel special. With each of her three kids, she has shown me that children are never ours, and how to show them the magic and truths of this world, and guide them however they need as they become themselves. I love that she and my mom were with me on the day my eggs were harvested and perhaps my path to motherhood began. Again, what a wild, mighty hope was made possible through egg harvesting, and oh, the love of science and healthcare experts continues to lift me up.
Chemo starts tomorrow. I'll be sitting for 6.5 hours and hope I can comfortably do that with my tender abdomen. After last Saturday's hike, I feel ready to adjust to whatever new rhythm chemo brings. I don't know how I will respond. There may be pain and weakness. I am not ready to lose my hair. I am trying to find ways to embrace that. But I may also lose my eyebrows and eyelashes--will I look like a potato with lips and eyes? TBD. At least once my hair is gone, that is done. And I will track my symptoms and know on what days I should drop everything and go live brimmingly alive. And days when I know I should embrace rest and shared meals.
PERSPECTIVE: We need to make egg/embryo/sperm freezing easier and a viable option for all women and men. Here are some take-aways:
I have not yet heard of a single insurance that covers fertility support for any person--whether you are going through chemo or not. I am still waiting for Blue Cross Blue Shield to clarify their rejection.
For me, egg freezing was work. But I never questioned if I would do it and take whatever steps because I would not tolerate mourning potential children and simultaneously navigate all the impacts of cancer and chemo.
When I say "work," I mean that I spent hours on the phone trying to get coverage clarification from my insurer (customer service and my BCBS case manager), and asking them to mark all pre-authorizations as urgent, because it is. I cannot start chemo until I freeze my eggs or there would be no point. Chemo goes after quickly multiplying cells, like eggs. All denied. I still want clarification on how this is not medically necessary. Or, is it the cancer or the chemo that is my elective?
I spent hours on the phone with multiple pharmacies trying to confirm and coordinate shipment for my fertility drugs. Like all things, many drugs like pregnyl/hcg are backordered. Some pharmacies are in programs like the Livestrong or Heartbeat programs that help fund treatment for oncology patients. Not all are in these programs.
My experience will be different than many others because my timeline was so accelerated to allow me to get chemo as quickly as possible. I began on 3/4 at my very first appoint (hour 96). By 3/10, I was giving myself stomach injections. On 3/16, I began a third shot in the morning. On 3/14, 3/16, 3/18, and 3/20, I had estradiol labs to test my hormonal levels. On 3/20 at 12:30 a.m. (in the morning) I was told to give myself the trigger injection. From there, a 36-hour clock began that ended in a 12:30 pm egg harvest on 3/21.
Egg freezing is expensive. How much so? It cost $5,475 for the procedure and medical guidance. There is no payment plan and full payment had to be received before the harvest could happen. I put it on three credit cards. I spent over $1,300 for medications ($239 for chorionic gonadotropin and $1,155 for leuprolide acetate and follistim). Two years of storage is $550.
$7,200 is much more than I paid for my vehicle. And time is of the essence. Each drug must arrive on a balanced schedule. Some must be refrigerated immediately. In my case, each needed to arrive so I could bring them for a week of treatments and testing in Bozeman on 3/14. The logistical coordination of syncing pharmacies with my timeline, trying to get insurance to clarify their support/denial, and maintaining some ability to work and do my necessary appointments was a rollerblading juggling act on downhill gravel that I am glad I have completed. No pressure. The timelines, money, and insurance's lack of support made this complicated to manage while I was also working to clarify my treatment plan.
When my chemo is done and perhaps once my second phase of immunotherapy IVs are done, I want to make the above information common knowledge. No woman who is facing chemo should have to make such massive decisions without support of the medical insurance system. The reality is, women who cannot juggle $7,000+ will be forced to forego motherhood simply because they don't have enough money, and no system really thought that they may exist and warrant support. And then they will start chemo. This cannot be undone.
Finally, there are grants that can provide assistance. I haven't had the time yet to write a letter on why I should be selected, but I may work on this tomorrow at chemo when things feel much calmer. I also think it's twisted to require a letter. Who should get it more than myself? Or less? Ick. Will I bump another woman out of line?
We can do better. So, we must.
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