IVF Math

When you are going through IVF you turn into a bit of a mathematician. You are constantly calculating cycle days, bank account balances and medication dosages. Today, I am calculating how annoying and persistent I will be with my clinic. (Yes, there is a formula for that)

Yesterday, (Wednesday) after our morning appointment, there was a bit of confusion with our patient portal and I thought we were through with our Follistem medication. I was happy on one hand because that meant two less shots every day. On the other hand I was really sad because there were three unopened vials sitting in my fridge. At $500/ vial, that was $1,500 essentially wasted. This made me really thankful that I had decided to only order four vials this time (I had 1.5 left over from my Feb. cycle) instead of the seven I was prescribed. When we did IVF in 2014 I had no clue what I was doing and had no data to go off of and ended up with two and a half unused vials that I tossed nearly three years later. It was so hard to throw that much money in the trash, so I just kept it in the fridge. Not sure what I thought I was going to do with it.

After speaking with our IVF nurse I was relieved to find out that we will continue our shots through at least tomorrow morning (Friday.) This got me to thinking and I started worrying that I was not going to have enough medication in case I had to continue shots. In steps IVF math. (I always liked word problems in school)

Q: I have 2 full vials @ 600 units. I have one opened vial that has had 225 units used, so I have 375 units left in that one, for a total of 1,575 units. I know I have to do 150 units tonight, so that leaves me with 1,425 units after tonight's shot. 

I have to have two shots daily for a combined 350 units/ day. Based on these numbers, how many days of shots do I have left in the fridge, and do I have to order more? 

A: 1425/350=4.07
I should have 4 days of shots left in the fridge, not counting today. That, based on the current dosage gets me through Monday. There is .07 for sure left in the vial and there could be a little over fill as well, so I could, in theory squeeze out about a half a dose or so if I needed to.  

Here is the kicker, I HAVE to know if I will need to continue shots past Monday no later than 3pm (cut off for shipping of medications from the pharmacy) on Friday. Typically, I do not get that information from the clinic until 4pm or later. Yesterday it was actually 6pm. Also, the pharmacy does not ship to deliver on either Sunday or Monday, so in order to have my medications for a potential Tuesday morning shot, I HAVE to have my order in before the Friday deadline. I also have to pay a $20 rush fee to get the over night delivery on Saturday. I think I would rather pay the extra $20 IF I need the medication than to pay $500 now and NOT need the vial.

I will go to my appointment tomorrow and remind them that I have to know ASAP, and as the time gets closer to the deadline, will become more persistent. If I have no answer by 2pm, crazy lady will be released, and she will get the job done. That is how you calculate your annoying factor when doing IVF.

Another calculation you do during IVF is appointments. WILL we or WON'T we have an appointment on __ day, and CAN we make plans? You are provided a basic calendar of events but told that it could change based on appointment results. However, during a cycle, "Ultrasound and blood work appointments will be scheduled for days 5,7 & 9 and then every day or two until you take the trigger injection." This tells me that I should have a Sunday (day 9) morning appointment, but no one knows for sure (yes, I have called them already...).

So, will we or won't we get to go to spend Easter with the cousins in western Oklahoma? If we do get to go, I have to know before the shipping deadline so I can change the delivery address and have the medications shipped to Cam's parent's house or someone else in town that will be around to get it for us.

This is just a little bit of the constant mental stress that goes on during IVF. Nothing is an island and it seems every SINGLE thing in your life is connected to IVF. For example, just going to appointments is stressful. Most of the time Cam is able to go, but there have been a couple of times he can't go, so I have to ask someone else to go with me to watch H while I get my ultrasound. Children are not allowed to go past the waiting room, so someone has to watch him. My options are limited as I have to pick from a selection of people who are both a) not working and b) physically able to watch and control my son in an environment where he is expected to be quiet and not run out the automatic doors and into the busy Tulsa streets.