Sadness

 I know I said I'd prefer the bad news because it means less waiting. Be careful what you wish for. I got the bad news. Our lone embryo hadn't reached blast by day 7 and was discarded. 

That makes 15 retrieved, 11 mature, 5 fertilized, 3 blasts, and 1 CCS normal.

I'm sad. Not 'you just lost a baby' sad, but 'this feels like the passing of a nice, badly wanted dream' sad. I suppose the upside of living through all-encompassing grief is that it helps you appreciate simple sadness!

I'm also angry. My clinic is having good success with artificial occyte activation. After my first two rounds both produced 66% fertilization rates with ICSI, I should have requested AOA for this last round. With five mature, we should have gotten to at least a few fertilized and a blast or two. Why didn't I advocate for myself? I couldn't have predicted a 20% fertilization rate on round 3, but it also wouldn't have hurt to try it, based on the growing body of evidence that it helps. I asked the embryologist and she said that the four that didn't fertilize showed no signs of fertilization, as opposed to fertilizing abnormally. AOA should have helped with that. 

We have one last shot. Assuming our nanny doesn't have COVID, I should start my next cycle by next week. In my mind, I vacillate a million times a day between "There are a lot of benefits to not getting another embryo. Life will be much easier with only two living kids. We can focus more on then. We'll retire earlier. I am at peace and if we don't get an embryo, I will accept that and move on." and "We are so close. And I may have leftover meds. We could swing paying for one more cycle out of pocket if I didn't have to pay for meds. Just one more."

I am usually very financially driven, so to help comfort myself in the event that we don't get another healthy embryo, I'm going to put it in writing here what "just one more" would really cost. Below are actual and projected expenses, while making the very generous assumption that our first FET would work:

2020 Medical Costs:
Insurance OOPMax: $10,800
HGH Cost (five rounds, including a cancelled cycle): $4,660
Estimated 'one more' cost: $16,500 + meds.

2021 Medical Costs
Insurance OOPMax (for cerclage and Asherman's surgery): $10,800
FET: $5,400
FET meds: $4,000

Total, if FET #1 worked and we do 'one more round': >$52,690
If we do get another CCS normal, and don't do 'one more round', we're looking at: ~$35,660.
If we don't get another CCS normal, and we stop here, we'll be at: $15,460, plus whatever reasonable medical expenses we're likely to have next year, so perhaps our deductible of $3,000 = $18,460.

So the difference between another kid and not is $34,230-$17,200.

Good grief those numbers are awful. It does help me feel better about reaching the end, although it doesn't ease the sadness at all. Really it just adds sadness for the state of health insurance in our country.