Walk me through this... (Second child)

[boiler717]

We would like to do another IVF ASAP. My RE recommends one year between pregnancies, which would put IVF at the earliest as 12/2016 but that may even be cutting it close. If I can cycle then, I would absolutely want to as I'll be 35 in 9/2017 and would love to avoid an AMA pregnancy if possible.
I think the odds of us cycling next December are pretty low but I have no idea if we'll have a long suppression protocol again, if BF counts as suppression, what weight I need to be at, etc. But if we can then I definitely want to.
We need to decide soon if we are going to put any money in our 2016 medical FSA, which would not roll over. We would use maybe $300 if we didn't do IVF but the whole $2500 if we did. Is it crazy to call the RE and ask if we could at least pay or partially for our next IVF in 12/2016 even if we weren't cycling until 2017? Then we could even use our 2017 funds to pay for it too.
Is it crazy to call the RE and ask for some info on this? Or are they going to be like "chill out and have your first baby first, then we will talk." Anything else I should consider?

[jessnpaul]

"Chill out and have your first baby..."

Also, I didn't get pregnant for the first time (no IVF) until I was 37 and they treated me like any other patient until I had issues (not age-related). Things are different than they were years ago!

ETA: I live in the metro NYC area and not having kids until you're 35+ is like the norm here. So I am coming from that point of view. 

[boiler717]

Oct 2, 2015 13:43:56 GMT -5 jessnpaul said:

"Chill out and have your first baby..."

Also, I didn't get pregnant for the first time (no IVF) until I was 37 and they treated me like any other patient until I had issues (not age-related). Things are different than they were years ago!

ETA: I live in the metro NYC area and not having kids until you're 35+ is like the norm here. So I am coming from that point of view. 

That's true! But the idea of spreading out $5k worth of IVF over 2 years of tax-free payroll deductions is really appealing!

[whiskeyandwine]

I was 100% committed to trying again right away for insurance reasons. Then I delivered. And my whoooole perspective changed. Not that this would/will be the case for everybody, but I would try to avoid getting too dedicated to one plan just yet.

[dellabear]

I think that AMA is more and more considered to be 40+ nowadays.

I think you have to be finished BFing before you can cycle again, if that's something that might be an issue for you.

And I agree that your perspective might change after you have the baby.

All that said, I'm sure it doesn't hurt to talk to the RE and see what your options are.

[Mushe]

I think they'll say chill out.

You can always ask, but I wonder how it would work for their accounting too, to carry a patient credit balance forward like that.

AMA is not bad, I have to tell you. I understand wanting to knock the child birthing part out ASAP, but there's no bright line that says you'll have issues after 35, so I'd try to relax a bit. I'm 37 this weekend (eep!) and I was pretty bummed at first that this took us so long to get to this point, but seriously, I feel 29, and my doctors have not been a bit worried. The OB was even surprised that I wanted all the testing done.

[ginkgoleaf]

I'd wait and see how the first one goes. It took us almost 3 years to feel like we were ready for another one - being a parent is hard work! Plus like someone else said, you'd have to be done with breastfeeding/pumping and have your cycle return. My DS was 10 months before I got my first PP period. And having 2U2 is seriously no joke. 35 isn't considered that old anymore so I wouldn't worry about being labeled AMA. Might just give you more chances for ultrasounds and really, that's a pro in my book.

[bcarp30]

I agree with waiting a bit. Around 3/4 months you should have a handle on nursing, sleeping, and what your work/life balance is. DD was seriously the easiest baby and even then I just wasn't ready to try again and wanted more time with just her. Obviously, I'm getting more time than I initially planned but it's not anything I regret.

Spreading out the payments would be awesome though. Could you use the FSA for meds so the RE doesn't have to carry a balance?

[boiler717]

bcarp30 meds are a good idea! I don't know if they would the RX that early though. Plus my meds came in with not very long expiration dates.

[loira]

In an ideal world, H and I would wait 6-8 months and start trying for number 2. But I was so sick this time, and I know we're going to be exhausted, and who even knows where we'll be living. I think we'll just wait and see how everything goes. We haven't needed medical help to get pregnant, but I'm very conscious of the fact that it took us 2 years to even get to this point.

[Muddled]

My two cents: take being 35 out of the equation.

[azurely]

Another vote for waiting until after you have baby #1 before making any decisions and just see how you feel when you get to the year mark.

C is 10.5 months and I still haven't gotten my cycle back since I'm nursing, so even if we did feel ready, we couldn't cycle again until that happens. And honestly, I can't imagine being pregnant soon and having another baby in 9 months. C is still my baby and I want to enjoy time with just him before adding another one to our family. It sounds weird, but I feel like I'd be replacing him or taking away from him by having another so soon.

[cactuscookie]

Oct 2, 2015 16:39:41 GMT -5 Muddled said:

My two cents: take being 35 out of the equation.

I agree. Like others have said, there's no distinct line at 35 that suddenly you're a higher risk pregnancy. They treat you as higher risk, but all that means is more information. The risk increases gradually, of course, and 35 is just the marker they use. The only real difference I can think of is that being offered chromosome testing is standard.

That being said, I kind of understand having an arbitrary cutoff. I'd told myself I wanted to be done having kids by 35, just to have it done. But that was more something to aim for (and fail miserably at thanks to IF), not something I'd base major life decisions on.

And that being said, at this point, DH and I plan to start TTC ASAP after having kid #1. Because who knows how long it'll take to have kid #2, and it's just going to get harder and scarier.

[lms]

I agree - don't worry about the age. And like dellabear said I think I read that 35 isn't considered AMA anymore. I'm 37 now and the only difference my doc has said for me is a level 2 anatomy scan with the MFM. There's nothing else he's concerned about regarding my age.

If the delivery goes well we'll try soon for a second baby and by that point I'll be very close to 40.

It would be nice if they could hold onto a credit for you though.

[cactuscookie]

Oct 2, 2015 17:57:21 GMT -5 lms said:

I agree - don't worry about the age. And like dellabear said I think I read that 35 isn't considered AMA anymore. I'm 37 now and the only difference my doc has said for me is a level 2 anatomy scan with the MFM. There's nothing else he's concerned about regarding my age.

Socially, it might vary with geography, but medically, AMA is still over 35. I'm 36, and every doctor I've seen has made reference to doing more testing due to my age. That could still vary by region - I live in a small town where most people have kids <25.

[patbutcher]

Agree with everyone else. Also if you have a c section, the longer you wait between pregnancies the better I think?

We were all gung ho that we would start trying when our baby was 6 months old. Then we had the baby and LOL.

I only started feeling ready to get pg when she was 1 year and really only because it took us so long with Dd that I was scared of going through another 2 years. I was 34 (Turned 35 2 days after having her lol) and will be 37 when I deliver this time. At my last appt my RE said that 36/37 is not really high risk, it's over 40 that they do amnios etc with now.

I say wait to have this baby and see how you go. You really don't know what your delivery or newborn stage will be like or how you will feel.

[lms]

Oct 2, 2015 18:51:57 GMT -5 cactuscookie said:

Oct 2, 2015 17:57:21 GMT -5 lms said:

I agree - don't worry about the age. And like dellabear said I think I read that 35 isn't considered AMA anymore. I'm 37 now and the only difference my doc has said for me is a level 2 anatomy scan with the MFM. There's nothing else he's concerned about regarding my age.

Socially, it might vary with geography, but medically, AMA is still over 35. I'm 36, and every doctor I've seen has made reference to doing more testing due to my age. That could still vary by region - I live in a small town where most people have kids <25.

I've probably been researching things a little too much and got some articles confused. I'm dealing with a MTF and apparently they have a different approach to prenatal care.

[boiler717]

Oct 2, 2015 21:11:59 GMT -5 @cookiemonster03 said:

AMA is 35+.

Are you doing a fresh cycle or an FET?

Fresh

[azurely]

Oct 3, 2015 5:58:54 GMT -5 boiler717 said:

Oct 2, 2015 21:11:59 GMT -5 @cookiemonster03 said:

AMA is 35+.

Are you doing a fresh cycle or an FET?

Fresh

Have you considered doing just a retrieval, then do a FET later, when you are ready? That would preserve your egg quality if that is your main concern, and that would allow you to split the cost.

I think someone on here did this when they did their first IVF (did two retrievals, then froze everything and did a FET) but I can't remember who...

[boiler717]

Oct 3, 2015 9:03:39 GMT -5 azurely said:

Oct 3, 2015 5:58:54 GMT -5 boiler717 said:

Fresh

Have you considered doing just a retrieval, then do a FET later, when you are ready? That would preserve your egg quality if that is your main concern, and that would allow you to split the cost.

I think someone on here did this when they did their first IVF (did two retrievals, then froze everything and did a FET) but I can't remember who...

My RE may even require a FET since I had OHSS last time -- one of the many things I don't know! Ideally we would do it all in the same calendar year as the birth, so paying some in Dec, cycling in Jan, transfer if Feb/Mar, delivery before the end of the year would be 100% ideal. I just don't know how BF works into all that, my suppression time (it was 3 months last IVF), etc. If I didn't have to make a decision now about my 2015 FSA I could wait until next summer to figure everything out, but that's what's starting things now.

[mabillon]

Jumping in from the app. I had wanted to do this before TTC my second (prepay to cross FSA year funds) but it turns it my FSA wouldn't have covered it. The terms of mine state that the expense and treatment/purchase must be incurred first. Same for a hospital-grade breast pump I rented for a year, they made all the reimbursements but only after each quarter was through and with different year monies.

I think talking to your RE never hurts, mine was happy to discuss a potential third in loose terms when I came in with my six-week-old to say hi. We all stayed away from making "plans" though. Only discussed the most general of timelines and care.

[boiler717]

mabillon we used our FSA funds to pay for this IVF and our payment was the month before we cycled.

[boiler717]

Oct 3, 2015 18:00:33 GMT -5 @cookiemonster03 said:

I think it's worthwhile to talk to them. It's a lot of money, and that's a really long suppression so might be nice to know for planning.

I also can use my FSA money through the end of the next Q1 so that might be an option. Or maybe they can order your meds in 2016 even if you wouldn't cycle then. Worth talking for sure!

Oh that's a good point about Q1 2017 to use funds, I will have to check with my plan administrator.

[mabillon]

Oct 3, 2015 12:01:01 GMT -5 boiler717 said:

mabillon we used our FSA funds to pay for this IVF and our payment was the month before we cycled.

That's great!

I think mine would've allowed that too, had the payment and service been in the same year. I just couldn't have been reimbursed until the service was rendered in an eligible year and that wasn't my schedule. Ordering meds would be reimbursed early though because even if I didn't take them, they'd be in my possession. I wish I had thought of that!

[FastHands]

Oct 2, 2015 14:19:25 GMT -5 whiskeyandwine said:

I was 100% committed to trying again right away for insurance reasons. Then I delivered. And my whoooole perspective changed. Not that this would/will be the case for everybody, but I would try to avoid getting too dedicated to one plan just yet.

Word to your mother. Or word to you, mother.

[krystee]

I had hoped to avoid AMA too. But even with a unicorn baby, I am SO NOT READY to do this again for awhile. It's a lot of work, man.

[speyedr]

I am an old TTTC grad but still lurk. Here is my two cents. I had DD who is now 18 months through IUI's. We didn't think we would have success on our own so we didn't use contraception postpartum. I got pregnant naturally at 6 months postpartum. It is hard. I now have an 18 month old and a 4 month old.

Yes we are thrilled we didn't have to undergo treatment or stress about the process but I wouldn't do this spacing again.

[boiler717]

That's awesome speyedr! My doc said it's not good for my endo to not be on BCPs and our chance without IVF is <1% so I don't think we will be on of those lucky ones

[pooh8402]

I thought I wanted to go for FET at the one year mark too. Now he's here and I'm like heeeellllllll no! It's really hard to parent one, I can't imagine having a toddler and a newborn.

So DH and I are waiting at least a year and a half before making decisions. I got an IUD so the decision isn't made for us. I just don't want to wait *too* long because at Oct 2017, we'll have to transfer our embryos to long term storage.

[awkwardpenguin]

I agree with everyone who says not to make any decisions until after the baby comes. You might be ready a year out and you might not be. There's no way to know now and you don't want to lock yourself into a course of action now.

We actually do want to have another baby soon and that hasn't changed since DD was born. So I'm not saying you will change your mind, just that you should keep your options open.