IVF in another city - need logistics advice!

[attached2mason]

I am going this month to meet with our RE at a clinic 7 hours away. When it is time for IVF we will need to be there for up to 3 weeks. We aren't sure when we will be offered treatment . . .they say on average five months from when we go and meet with them. But, we need to be ready every cycle, just in case they call us on day 7 and say "get ready!". We have family in the city we are going to - two sets of aunt and uncles. WE are close to neither of them and they are both on my DH's side . . .I barely know them, really. Also, we have a four year old DS that we need to consider as well. On to my questions . . .


Should we stay with family or should we plan to stay in a hotel (it would be a furnished 1 bedroom apartment) for part or all of the stay? Am I going to be up for staying with family for three whole weeks? If it were my mom or MIL I wouldn't worry at all, but I sort of imagine myself feeling crappy and trying to be a good guest to people I don't really know. But, to stay in the hotel for three weeks would cost us $2200 plus meals. The expense is tax deductable so we'd get about 20% back. On the other hand, it might be helpful to stay with family who could help us out a bit while I'm feeling crappy.

The next question . . . do we bring DS for the whole three weeks? Our options are for all three of us to go the whole time or to have DH keep him at home for part of it (and have MIL come and stay with them to watch him during the day). Three weeks seems like a LONG time for him to be away from home and potentially in a house without any other children. Parenting while staying with relatives is challenging at the best of times, let alone during an IVF cycle. On the other hand, will I want to be 'alone', without my family, while going through this?

Anyway, I guess I'm just trying to get a sense of the realities of treatment ... how will I feel physically, what kind of situation is ideal while cycling, that sort of thing. Any advice you can offer would be much appreciated!!

[nummies]

Honestly, if you can afford it, get the hotel. There will be a lot of emotions going into this cycle and you really can't afford to be stressed out in any way. Now, if you knew the family better I would say stay with them. The question is "do you feel comfortable being at your worst around these people?" I had a lot of pain post egg retrieval and was throwing up for a day straight from all the meds. It wasn't a pretty sight and I can't imagine trying to put on a happy face for family I hardly know. Granted, I think that I just had a really rought time of it and most don't feel as badly.

As far as being away from your child, I would say bring him. If it were me, I couldn't be without my baby for that long. I feel like he would cheer me up when I had a bad appointment or was depressed. Also, would you be worried about him at home? You really need as less stress as possible during your cycle. Added stress does nothing good for your outcome.

As far as how you will feel. That is hard to say. There were days I felt fine and normal. Then there were days that the drugs started to get to me and I felt very depressed and cried a lot. There were days that I just wanted to be left alone and there were days that I need lots of people around. There were moments of panic "my blood levels aren't high enough, will the cycle be cancelled, etc." And like I said, after the ER I was in lots of pain and then got sick from all the pain meds. That wasn't fun. And we did bedrest following the transfer so I can really anxious from being in bed all the time.

Best wishes to you!

[daisie31]

3 weeks seems like a really long time. Could you have some of the monitoring done locally? I have done 2 cycles in another state and stayed 9 days both times. I am actually leaving today to go home from my most recent cycle. This is my 1st cycle since having ds and there was no question about bringing him, I could not stay away from him that long. It helps to have the distraction too. We are staying in an extended stay hotel and it's $550 for 9 nights, it's not the greatest but what we wanted to afford. About the cycling, my clinic only has us come towards the end of the cycle, once we have been on stims for a week. The cd3 u/s and labs are done locally and they don't ask for any other monitoring until you show up at the clinic. Does your clinic do something similar? Do they know you are coming from oot? I think that the longest anyone who goes to my clinic would stay here is a couple days shy of 2 weeks and that would be a slow responder. Perhaps your clinic could help you shorten your stay by working with your OB/GYN. It seems strange that your clinic can't nail down a cycle date for you??? What is their reason for that? I haven't really heard of that and I am part of a very active IVF board (IVFconnections if you are interested). That makes it really hard to plan huh?

As far as staying with little known relatives, I wouldn't even think of it. You are far from your best when cycling and it sounds very stressful trying to keep it together for virtual strangers, especially with a child. I know the money for housing sucks after having to pay so much just to cycle, really sucks. Just being away from home has been really hard on all of us, ds (3y/o) has cried several times because he just wants to go home.

I wish you the best of luck, I bet you will have a bit more clarity after your consultation this month.

Dena

[attached2mason]

THanks for the advice so far!

WRT the length of stay . . . the sample timeline they sent me is as follows:

(for purpose of example, cycle starts Jan 1)

Jan 1 call clinic on first day of full flow
Jan 7 treatment may be offered
Jan 21 Start superfact
Feb 4 baseline ultrasound (can be done by my OB in hometown)
Feb 6 start FSH injections
Feb 10 Day 4 of injections, need to be in Calgary for bloodwork and us
Ditto on day 7, 10, and 12 of injections
Feb 20 hcg injection

followed by ER, ET.

The waiting list is long at clinics in Canada (in the West, anyway) so they are never completely sure when your name will come up. I think the reason they insist on the bloodwork and us during injection time to be done in Calgary is that we just dont' have specialists that are qualified to supervise IVF as well as they can in Calgary. The clinic in Calgary has the highest success rates in the country so I'm guessing they are very careful about cycle management.

It could be as little as 15 days, but then add travel time and bedrest after ET and it gets close to three weeks.

I think you are both likely right about not staying with the relatives. Another option might be to perhaps stay part of it with relatives and part of it at a hotel as a compromise. If we did that, what would be the best time to be at the relatives? Or, is there a good time? I am guessing maybe the first four or five days? That would save us 500 bucks. Although, in the grand scheme of things, I suppose when we're already spending 10K+, what's another 500 bucks

[LisaG]

We traveled out of state for our IVF. We actually did end up staying with family that we barely knew (my SILs dad and stepmom and their 2 kids). Now the difference was, they had also been through IVF and were completely understanding and supportive and overall wonderful.

I brought or bought most of my food - we had a couple meals together. They were really good about giving me my space. With appointments I pretty much was on my own during the day. DH flew out when we had a better idea of my ER day, although that ended up getting pushed back a couple days. I was on my own without him only 4 days.

I was lucky to feel pretty good during stims and after retrieval.

I was gone a total of 2 weeks, including 4 days of driving. I had 2 ultrasounds with 2 blood draws done locally - one to make sure I was properly supressed before starting stims and the 2nd one to see how I was responding to stims. My 2nd one I had done the morning that I left and then was checked again 2 mornings later when I arrived at the IVF clinic.

With my clinic, they gave me a tentative stim schedule, but depending on how I responded I could've stimmed longer or shorter.

For bedrest after ET - my clinic wants the day of transfer and the following day (roughly 48 hours). My transfer was in the afternoon, so I was off the rest of that day and then we went ahead and started the drive back the following morning. DH drove and I had the seat reclined to 45 degrees and my feet up on the dash. I figured I could sit in bed or the car so what difference did it make (and no I didn't ask my RE about this ). When I was reviewing research there's a lot that says more than 24 hours of bedrest doesn't produce increased benefits, so I didn't feel too uptight about it.

As for having your ds with you - depending on how you're feeling, you may enjoy having a break and being able to just take care of yourself - rest when needed, etc. without having to entertain and care for a little one.

Good luck!

[Julia'sMom]

You've gotten good advice so far. I would just note that the time between the trigger and transfer was by far the hardest physically. Also during this time, you are restricted in what you do, such as no lifting or carrying of your child, no intercourse and so on. So, you will definately need help with your son, although I do agree that it would be great to have him along for mental reasons. Also, I assume the relatives can watch him during ER and ET? A lot of clinics dont' allow children to be present for those two processed. In addition, it took a whole day for the anasthesia from ER to wear off, so expect to be out of it and in bed for that entire day, so you need care for your ds and you need someone to be with you to watch you for 24 hours.

Oh, and I concur with LisaG, I was only told sofa-tv rest for the remainder of the ET day. No bedrest required, and I did conceive twins that time. : Now, if you are flying, that may be a separate issue that you need to ask the clinic about since it also has the changes of pressure and such.

[EmmaJane]

I've done 4 IVF cycles out of town, but in the city where I grew up. I do almost all my monitoring at the main clinic, but leave the day after transfer -- so it was about 14 days in the city each time.

#1: before DD. Stayed in friend's empty apartment. Fine.

#2: after DD. Stayed with relatives for the first week, then moved to hotel across the street from clinic. Was going to have DH come out with DD (2 1/2 at that point), but stims went badly and told them to not bother. Made it to transfer, but should have canceled.

#3: brought DD along, stayed in hotel, had MIL come for a few days. Would have had DH come before retrieval, except we canceled.

#4: due to scheduling nightmare, started monitoring on vacation in third state. Brought DD, stayed in hotel, had MIL come for a few days, DH showed up the day before retrieval.

Overall conclusions: staying with relatives you're not comfortable with sucks -- the cycle itself can be so stressful. Bringing DD was way better that not. Physical convenience (e.g. hotel across the street from the clinic, ordering delivered dinners) was totally worth it. Support from helpful people (e.g. MIL, DH) is invaluable.

One issue: if you bring your child, where will he be during your monitoring appointments? I brought mine along for a few -- and felt awful about it. The clinic was big enough that she usually wasn't the only child there, and she was quiet, etc., but I still feel bad about having done that. Once MIL or DH was around, I could leave her with them.

My clinic doesn't recommend much rest beyond the first hour after transfer -- so the two days when support was honestly necessary were retrieval (anesthesia) and transfer, and that's it.

I see you're in Canada. Those with similar issues in the U.S. should be aware that hotel stays for medical travel have deductibility capped at $50 per night, or $100/night if you have someone traveling with you... doesn't do much in a big city!

... good luck!

[attached2mason]

Thanks so much for all the great advice!! I am really hoping we will be able to afford to stay in our own place rather than with the relatives. We just found out that our friends are throwing a fundraiser for us : so that will help a bit.

[lalalola]

Saskatoon or Regina doesn't offer IVF?? That is crappy.

Where did you get the info about Calgary having the best success rates? We are trying to decide between Edmonton or Calgary for our referal...

[attached2mason]

Originally Posted by lalalola

Saskatoon or Regina doesn't offer IVF?? That is crappy.

Where did you get the info about Calgary having the best success rates? We are trying to decide between Edmonton or Calgary for our referal...

Saskatoon does have an IVF program, but the wait list is quite long and we still haven't been called yet.

Calgary's stats are on the Regional Fertility Program website - done by a third party, I think. The national rates are there too. I didn't know that Edmonton had a program . . . it seemed like there were a ton of folks from Edmonton at our info night so I assumed they didn't have one.

We got referred to both Stoon and Calgary - perhaps you could get referred to both clinics you are considering and make the decision in the meantime (or see who calls first if it is a toss up).