Starbucks Expands Fertility Benefits -The 411

Employees at Starbucks now have access to broader fertility benefits.

Starting this month, the coffee giant is bolstering its benefits to reimburse for surrogacy and intrauterine insemination not covered by health insurance. Workers will receive reimbursements of up to $10,000 per qualifying event, with a lifetime maximum of $30,000.

Lifetime maximums for fertility benefits are also increasing under Starbucks medical plans — to $25,000 from $15,000 for fertility services, and to $10,000 from $5,000 for prescription drugs. All full- and part-time benefit employees who work at least 20 hours per week are eligible for the benefits.

A company spokesperson told Employee Benefit News, Starbucks wanted to update its Family Expansion Reimbursement program to assist employees whose needs are not fully met by health insurance.

“We made this change to assist partners whose needs may not be met by their healthcare insurance company, such as same-gender couples looking to become parents or individuals seeking fertility services,” a Starbucks spokesperson said in an email.

While nearly all (87%) employers cover some kind of infertility benefit through their health plan, companies are expanding their benefits to cover different services such as surrogacy and egg freezing, according to data from the National Business Group on Health. Of that group, some 71% of employers cover in vitro fertilization, 69% cover artificial insemination and 34% cover egg freezing.

Fertility services are often expensive — the average IVF cycle costs $12,000, according to the American Society for Reproductive Medicine. Benefits that cover some of the cost can help to ease the burden on workers. Large employers including Microsoft, Cisco and MassMutual all offer fertility benefits to workers.

Starbucks has been making big changes to its benefits. Last year the company said it would spend $250 million on new employee benefits including a pay boost for domestic workers, in the wake of the federal tax overhaul. In September, the company updated its employee assistance program with a new long-term initiative that includes an enhanced employee assistance program and mental health training for store managers, which will begin in the second quarter of next year.

“We brought 12,000 store leaders together for an unprecedented session on mental well-being and emotional first aid,” Starbucks CEO Kevin Johnson said in a statement about the updated EAP program. “That was just the first step in a new long-term initiative to take a stand, help break the stigma around mental health, and get even more partners and their loved ones the support they need.”

Starbucks offers a number of other family-friendly benefits including parental leave, employee and family sick time, and backup child and adult care. It also provides tuition reimbursement to workers looking to earn a bachelor’s degree.

“We are consistently evolving our benefits as we continue to listen and learn from our partners (employees),” the company told EBN. “It has long been our belief that when we put our partners first.”

IVF #6 – The Meds Are In – The 411

shit just got realI got back to the condo this morning after being in DC Metro Area for the past six days and boxes of meds were waiting for me from Freedom Fertility Pharmacy for my upcoming IVF cycle !   Things are REALLY getting real now and the fear is starting to set in.   I have to fight the urge to let the “what if it doesn’t work” thoughts from evading my mind !!

IVF 6 - meds IVF 6 - meds2 IVF 6 - meds3 IVF 6 - meds4 IVF 6 - meds5

Ladies and Gentleman….  I present to you… MY IVF MEDS CYCLE SIX !!!  Woot Woot ! (and why do the antibiotic suppositories look like white bullets? lol)

More later…..

IVF # 5 – Stim Day 14 – The 411

ivf 5 - keep calm and stim like a champ

Today is stim day 14… I am starting to wonder if we are ever going to get to the end of stims !  I do not feel the “full” feeling I get when my ovaries are about to burst with follicles.  I can not wait, actually yes I can, to get to that point.  Stimming slow and steady is the best way to get quality eggs so I am being patient.

I have been so stressed out the last few days.  One best friend losing her son and grandmom at 10pm the SAME night on Monday, My godmother and mother both undergoing cancer treatment, and my best friend, actor, Gary Anthony Sturgis, has finally gone public with his mother’s stage four cancer diagnosis.  He finally got his mom to tell her siblings and now he was talked about it publicly, so I feel heartbroken for him, but at the same time relieved that he will have additional support.  Cancer SUCKS rocks !  In the midst of all of this mortality, I am trying to create life.  It seems strange.

In better news, my agent and I are submitting the final (although it is really just the beginning phase) mock ups of my reality tv project.  I am excited about the possibility of this show about my life, my struggles and the fertility struggle so many women and men face that I get to put a face on, being on national television !  I also know what this exposure can do for my career and other projects I want to launch in the future.  I am trusting God to open the right doors to the right people at the right time !

I am so eternally grateful for the opportunity to even be able to take this journey and I would be remiss to not thank God for His faithfulness because there are so many who would not be able to even dream of doing what I have done this past year.

I did my AM injections of Ganirelix, Lovenox, and Neupogen.  Tonight, I will inject 175 units of Follistim and 37.5 units of Menopur.

ivf - menopur  IVF 5 - Follistim  ivf 5 stim day 4 neupogen  IVF 5 stim day 2             Vitamin D emulsion

Tomorrow morning, I have another blood draw and sonogram.  Prayerfully there will be a little growth in the follicles, but not too much of a leap !  I want all the little ones to grow to the same size as the larger ones so that I have plenty of quality eggs to transfer back next week !

In the mean time, I am working on little gifts for the staff at the clinic.  I bough EOS balms and made cute hand tags that say “You Are The BALM!”  Thanks !.  I also got peanut M&Ms and put hand tags that say ” Thank You For Helping Make My Little Peanut (s) !”.  I also had Banana Bakery out of Dallas Texas make medical themed cookies that say thanks on them and they are shipping the cookies to my hotel in Albany to arrive next week and they are already hand wrapped individually.

To keep my mind occupied, I have been making flour with hard white wheat berries and baking and my team and I are working on the launch of Valerie The Pajama Chef, my cooking show.  You can pull up my flour escapades on Youtube that I shot with my cellphone LOL.   https://www.youtube.com/watch?v=o8jkyWBJWp8

I am headed downstairs to my kitchen now to make mile high buttermilk biscuits !  I am craving them, so I am making them and will go get some molasses  🙂   I know I am supposed to be doing gluten free, but one little biscuit is not gonna hurt much !  With all the hell going on around me, I deserve one little biscuit right?  🙂

IVF # 5 – Stim Day 11 – The 411

IVF 5 - Follistim         ivf - menopur   IVF 5 stim day 2      ivf 5 stim day 4 neupogen

Today is the eleventh day of stims, sixth day on Follistim and fourth day on Menopur.   In the morning, I inject Neupogen, Ganirelix, and Lovenox.   I take various supplements and vitamins, and synthroid (which I have not taken since Friday because my TSH plumented to .1) and in the evening, I inject Follistim and Menopur.

Because my Vitamin D level has been low since February, I am no longer taking the pill version.  To raise my vitamin level, I have to take an emulsion at dinner that also has Vitamin K1 and Vitamin K2 in it to help with absorption. (see previous post about Vitamin D levels).

Vitamin D emulsion

I ordered the emulsion from Amazon.com.  It tastes pretty okay.  Not nasty like I was expecting.

I had monitoring this morning and my follicles are slowly growing.  LabCorp had a problem with their machines today so my blood work was not in by the time my RE’s office closed.

ivf 5 - stim day 11 scan

I was instructed to just remain on my same meds and I will get a call tomorrow from my nurse once the blood work is in and they will make adjustments if necessary.

Hope everyone else is doing well !  More tomorrow ~

Saizen (Human Growth Hormone) for IVF – The 411

baby- saizen

Saizen Growth Hormone Helps Infertility

Adequate growth hormone levels are critical for good ovarian follicle development, and growth hormone levels are known to decline significantly with age. Studies show that adjuvant growth hormone treatment during IVF can help older women to beat the odds and have a higher take home baby rate – even when their ovarian reserve is poor and previous cycles have failed – by restoring youthful hormone hormone production within follicles. Some studies show that younger women who are poor responders reap the benefits also.

The results are quite amazing. In one study (1) one hundred women, 40 years of age or older – all of poor prognosis – were studied as they pursued IVF, half received growth hormone with their ovarian hyper-stimulation medications, half did not.

The numbers of eggs, embryos and pregnancies were similar in both groups but the growth hormone-treated women had far fewer miscarriages and a higher take-home-baby rate. Women being co-treated with growth hormone had far less biochemical pregnancies, and a pregnancy rate of 26% compared to 6% in untreated cycles. The delivery rate was significantly improved also, 22% of cycles versus 4% in the untreated group.

During the stimulation phase of the IVF, treated women had higher estradiol and growth hormone levels within the ovarian follicles thought to lead to healthier eggs and higher embryo quality. The researchers of this study (1) concluded that:

“Administration of GH (growth hormone) during ovarian stimulation alleviates age-related decrease in assisted reproduction treatment efficiency. This effect appears to be mainly due to an improvement of oocyte developmental potential, but GH action on the uterus cannot be excluded…”

“In conclusion, this prospective randomized study shows that women aged >40 years undergoing assisted reproduction treatment and co-stimulated with GH achieve more ongoing pregnancies and suffer less pregnancy wastage, resulting in more deliveries and live births, as compared with women of the same age category stimulated with gonadotrophins alone.”

Previously in a study (2) on 20 women who had responded poorly to ovarian hyper-stimulation, 24 IU (intramuscular injection) of growth hormone was given on alternate days alongside gonadotrophin stimulation. The researchers concluded that:

“…in a subgroup of patients who respond sub-optimally to standard ovarian stimulation regimens for IVF-ET and who have ultrasound-diagnosed polycystic ovaries, systemic growth hormone is an effective adjunctive therapy.”

In another study (3) on growth hormone supplemented IVF cycles in poor responders, 159 women were studied as they pursued a total of 488 IVF treatment cycles between 2002 and 2006, comprising 221 cycles with growth hormone and 241 without. Growth hormone co-treatment was shown to increase pregnancy rates in fresh and frozen cycles in all age groups – especially younger age groups – the researchers concluded that:

“GH cycles resulted in significantly more babies delivered per transfer than non-GH cycles… (20% versus 7%). The data uniquely show that the effect of GH is directed at oocyte and subsequent embryo quality.”

Previous studies have shown that the levels of hormones within ovarian follicles – especially growth hormone – are critical for the development of normal healthy embryos that are able to implant. Levels of growth hormone are tightly correlated to an oocyte’s ability to be of high quality, with a high potential for implantation. (Mendoza et al. 1999,2002)

A large study on 100 couples where the female partner was over 40 years also showed benefit. The women were split into two groups, to receive growth hormone treatment (8 IU of Saizen from day 7 until the day after the hCG trigger) alongside IVF or a placebo. The study concluded that:

“this prospective randomized study shows that women aged >40 years undergoing assisted reproduction treatment and co-stimulated with GH achieve more ongoing pregnancies and suffer less pregnancy wastage, resulting in more deliveries and live births, as compared with women of the same age category stimulated with gonadotrophins alone.”

Another similar study (4) on poor responders who received co-treatment with growth hormone with ovarian hyper-stimulation found that:

“…the GH cycles had better performance in terms of the number of oocytes fertilized and the pregnancy rate.”

Different studies have used varying amounts of growth hormone but many such studies concur that co-treatment with growth hormone can give you better odds of succeeding, especially if your prognosis is poor.

This article is purely for educational and informational purposes and is not intended to substitute for medical diagnosis or treatment for which you should consult a physician.

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References:

1. Improvement of delivery and live birth rates after ICSI in women aged >40 years by ovarian co-stimulation with growth hormone. Tesarik et al. Hum. Reprod. (September 2005) 20 (9): 2536-2541. doi: 10.1093/humrep/dei066 First published online: April 28, 2005
Human Reprod. (1991)6(47):526-528 Co-treatment with growth hormone of sub-optimal responders in IVF-ET. E.J.Owen et al.

Growth hormone supplementation improves implantation and pregnancy productivity rates for poor-prognosis patients undertaking IVF. Yovich JL and Stanger JD.Reprod Biomed Online 2010 Jul;21(1):37-39
The value of human growth hormone as an adjuvant for ovarian stimulation in a human in vitro fertilization program. JObstet Gynaecol Res. 1996 Oct;22(5):443-50. Wu et al.

Source:  http://www.bellaonline.com

The Dreaded Wait- The 411

baby- wait

I was not cut out for all this waiting !  My mind races to a million places and I worry.  It is killing me that I only have two embryos hanging out at the clinic growing and worrying if they will continue to develop and grow.

Thousands of dollars in medications, fourteen days of injections, perfect diet, and I get eight eggs and only TWO fertilized?   I really only need two, but hey, it would have been nice to have some back ups for FETs if this cycle did not work or ended in another miscarriage.

The embryologist does not check my embryos again until tomorrow morning .  I will definitely call them tomorrow mid-morning to check on my babies.  Prayerfully those two are great quality and the one being thawed out will make it through the thaw.  I already knew the frozen one was as 4AB so at least it is a great quality embryo.

This whole process is so unfair.  It is so nerve wrecking !!

No one told me that PIO would IMMEDIATELY yield symptoms ! Oh Em Gee !   My nipples are aching already and started hours after the first injection !   I have abdominal cramping and twinges.   I just hope I do not develop any allergies to the oil.   The injections are super easy, not what I expected at all.

I am beyond bored here in Albany !  I wish my mom could have come with me.  I will get out of the room and go to the mall tomorrow and see a movie or something…

IVF #3 Stim Day 12- The 411

baby - bloating

Today is my 12th day of stims !  I feel like I am harboring two water balloons in my pelvis !  LAUD ! I only have hopefully one more injection tomorrow night and then on Monday, I will should be triggering at 9 pm.  #fingerscrossed.  I got in an acupuncture session this morning and will go another on Monday after my monitoring appointments.

I mixed my meds and did my injections while eating dinner at the table and I completely freaked out my sister lol.  It has become so common place that I do these that I just whip out my needles and mix and eat then inject all in one sitting.  My mom is used to seeing me do it lol.

My other sister, who is an RN just got here today to visit with our mom.  I guess my text messages and pleading to COME HOME and see our mom hit a nerve somewhere.  My mom was ecstatic to see the kids and my sister, so I am very happy !  Both my sisters are here at mom’s house and she has all three of her girls and most of the grandkids here.

baby - IVF3 stim day 1

I need advice from you ladies on how I should handle my pursuit of motherhood and dating.  At what point should I even mention it?  I am apprehensive about mentioning my ivf tries because there are no guarantees and I also do not want to run off potential life partners by mentioning something even a married man freaks out over – KIDS !  What would you do?  How have you handled things?

IVF #3 Stim Day 11 and Beyond…. – The 411

baby - waiting

Today, I went in for what I thought would be my LAST monitoring appointment.  Alas, I got the call from my nurse to continue on the same meds thru the weekend, go in for monitoring on Monday and then they should be ready to do my retrieval on Wednesday.

I had to call the hotel, call Amtrak and get an appointment for Monday for monitoring.  I was able to get everything done.  I decided to just stay in Albany the entire week instead of coming back to check on my mom.  Since I leave on Tuesday, there is no point in my coming back on Thursday and then going right back there on Sunday for Monday’s retrieval.  I actually got a $35 refund on my ticket because I changed the return date to a week out.

Currently, I have 12 large follicles and there are still some smaller ones that are growing.  They want to make sure all 12 are maxed out in size before they try to do a retrieval.  They are not in the range they should be yet to get me to the finish line.  My E2 is now 1000, which is good and will surely rise quite a bit between now and the time they check it again on Monday.

I am a tad disappointed that I am not ready for retrieval yet, but at the same time, glad my doctor is closely monitoring me and making sure that we maximize this cycle and work to get the best possible eggs.  By waiting until Wednesday to retrieve, I will have more mature eggs to work with which means better quality, stronger and will likely have more fertilized eggs.

I am in the process of mixing my meds now and will do my injection at 6pm.  I let my meds sit out at room temp for 30 mins before I mix them. I am short on my Menopur since I have to stim longer.  I am short 75 units per day.  The doctor said I can substitute 75 units of Gonal F for the missing Menopur.  WHEW !!  I was about to go into total freak out mode !  lol  Tomorrow I am going in for an acupuncture session and will probably do another on Monday before heading to Albany on Tuesday…. hey… it can’t hurt !

baby - IVF3 stim day 1

IVF #3 Stim Day 7 – The 411

baby - ivf 2 stim day 2

Today is my 7th night of stims.  I am happy to say that I have been doing well and am not bruised up yet !  Maybe because they do not have me taking Lovenox until after transfer this time.

I mixed all my meds and did the two injections and am finally starting to feel the ovarian swell.  My estradiol is only 123 today.  I emailed my doctor about my concerns and asked if we needed to adjust anything to get that E2 up because I am not going through another cycle and peaking at 148 and ending up with immature eggs.  My E2 during my first cycle was almost 400 at this point.  I still have a full week of injections before trigger so I am hoping by Wednesday that it goes up some and that by Friday it is in the 1000’s.

I am starting to become weepy !  UGH !!   I am not sure how much of it is the stress of my mom’s illness and undergirding fear that something could go horribly wrong in a few months… With cancer, you never know.  A lot of that is stimming from my friend Joanne’s passing at the age of 32.  WHY ???   She did have a rare cancer, endometrial, which went to her chest pretty quickly and then ended up in her brain.  I am completely heartbroken that she did not get to have her dream wedding… have children with her fiancee… live her life !!  But who is to say she did not live it?  God, this is soooo unfair !!  My soul cries for her !

I have been having a rough couple of days.  Not sure if any of you have ever had to deal with the elderly, let alone the elderly with alzheimers.  Enter my grandmom !  LAUD JESUS UP ON HIGH !!!

I have BEGGED my sister, who lives in North Carolina to PLEASE come get her.  No one understand what it is like.  I feel saddled once again by my family.  That is the reason I moved to NYC to get away and live a life that did not require that I give up so much of myself. There was no one there depending on me and for the first time, I felt FREE.  I came back last summer to help my mom out with my grandmom who she had to move to VA from NC because she fell ill and it was discovered that she had alzheimers.  The burden of dealing with someone who has dying brain cells, is clinging to a past life they are incapable of now living, and being resentful, sneaky, bitchy, and down right pissed off, is HARD.

With me, I am a more take no prisoners type.  My grandmother is a weak woman.  Still caring the scars of child abuse at the hand of her father and the ignorance of it by her mother.  By the time my mom and her siblings we here, my great-grandfather had found Christ and became a preacher.  He left behind unhealed wounds which he inflicted on all six of those children and they are all broken, hurting people in their old age.  Nothing you say can change their experience.

I have two sisters, both of whom are married.  One lives 50 miles from my mom and she comes to help out when she can, but has two teen daughters.  My other sister moved to NC last summer and has an adult son in CA, and with her a teen and a two year old baby and her husband works out of the country.  Being that the one in NC is a nurse, I felt it would be fair of her, while I am stimming and a complete emotional mess, to come get my grandmom for 2 weeks so that she is not on my heels every freaking minute wanting to HELP me… help me cook… help me clean the kitchen… wanting to check the mail (which she will hide if you let her check it and her bills won’t get paid)… wanting to inject me with my meds (she was a nurse)… she wants to be helpful, but I do not want nor need her help.  It is down right ANNOYING !   Imagine having about 12 pre-teens following you around all day !   That is what it is like with ONE alzheimers patient.  They want to be grown and exert their “grown-ness” but they can no longer do anything.   You let her cook, she doesn’t remember what goes into anything and will make a nasty mess and will leave the gas on the burner and burn the house down.   Dying brain cells coupled with yet ANOTHER UTI !  UTI’s in the elderly cause psychosis !  She becomes beligerant, argumentative for no reason and even more paranoid that she is already !  I find her plundering through things, peering over the catwalk at me for prolonged periods to see what I am doing in the family room  ( I am WORKING!!), or constantly coming in to the kitchen when I am in there and being in my way.  It gets to the point, I have to turn off what ever I am making and just wait for her to finish washing the dishes, putting them away, or what ever other busy work she finds to do.

My sister in NC gave me the ” I am busy… working a 9-5… have a teen and a baby… etc.” bullshit.  People assume that because you do not have children or a husband, you are free to pick up all the slack and I am tired of it. I feel like the dumping ground sometimes.  I work harder and longer than anyone in this family.   Do you have ANY idea how long it takes to write a script, polish it, do a business plan, plan out the film production and then chase down money to make it?   On top of that branding and developing new projects.  I am in the middle of film festival submissions right now and also developing a stage play and a new screenplay.  I need to focus.  I can not do that, cook, keep an eye on my mom, be hell hacked by my grandmother sans the time she is at day care for 4 hrs, and do my work.   I have barely had time to sit and go through possible dates on Match.com let alone EHarmony I am paying $45 or so a month for.

My other sister will be coming out here at the end of the week to sit with our mom and entertain my grandmom.  My mom’s brother is tied up with his daughter who has an eating disorder, so of course, I get stuck with having to be superwoman.

I will be sooooo glad when I am finally pregnant and have these babies.  I planned to move away sooner, but I lost my daughter who would have been born in December on Christmas… so I stuck around the East Coast to be closer to my doctors and clinic and to help my mom.  Now my mom is ill, so I guess God had a way of putting me where I was going to be needed.   I am just ready to do something for myself.   I never get to be as selfish as my sisters and live in my own cocoon.  I get stuck having to pick up everyone’s slack.

Prayerfully, this is MY cycle and I can get this show on the road, have these babies, and MOVE to the West Coast.  Eventually, I want to relocate to Europe.  At least part of the year.  It would nice to spend time in different places before I get too old to enjoy life.

Diez Huevos ! – The 411

baby - 10 eggs

YAY !  This morning I had a monitoring appointment and I currently have 5 follicles on each side and more little ones developing.  My follicles are small and the nurse thinks they should be mature (18-25mm) early next week.  My initial target retrieval date was Friday or Monday.  I am hoping it is not until at least Monday to let the follicles mature properly so that I do not end up at retrieval with immature eggs this time.  My doctor is not on vacation and is closely monitoring what is going on, so I am relieved that he is watching and not the nursing staff.

On Friday, the hospital’s lab did not send my bloodwork in STAT !  I was sooo pissed off because the blood work they did would not be back until today or tomorrow, which means the whole weekend I went along without know what the numbers were looking like.  My clinic and I discussed it and I am going in to Labcorp the rest of the week for the blood work.  The blood work will post to an interface within a few hours of the pick up.

I am anxiously awaiting the blood work results from today.