Are you considering an IVF Vacation to Costa Rica?

If you are considering, or are planning, a Costa Rican IVF.. please contact me at
David_and_Tracie   at   y a  h oo 

Thank you,
Tracie

ps - HUGE congrats to my dear friends Christa and Adam! (and lil' Ella!)

Christa-Our Update!

We are pregnant!!  Follow our story on http://endoandfertility.blogspot.com/ !!!!

Please continue to give Tracie your good thoughts as they try and get some answers and grow their family!!!!

Update from Tracie

Well, we tried.

Folks, either there's a piece of the puzzle that too many doctors have missed, or I'm the most unlucky person alive. We've officially lost pregnancy #8.
This one hurts. This one stings. This one has kicked us in the ass. Twice, and then some.
While there's a little comfort in knowing I worked my BUTT off to get/stay pregnant, that same fact stings hard. I was on so many meds. I did acupunture several times a week to get ready. I dieted, I skipped anything "bad" for you, good lord, I even (pretty much) quit my beloved wine, in the most stressful point of my LIFE. We packed up our lives and went thousands of miles away to make these babies.

We tried.

But it just wasn't our time.

We don't know what our next move is. My heart hurts so very much, but the pain of never having more kids overwelms the current pain of loosing them. I NEED a good doctor, one willing to hunt and search and never stop until we know for sure if I'm broken, or ridden with bad luck.
I will mother others. I just don't know how.
For the millionth time, I recognize how incredible my daughter is, and how blessed we are to have her. I have a husband who's willing to jump thru these hoops with me, and pick me up when I'm crumbled hysterically in the corner. For that I am lucky.

A friend in my "online mom's group" wrote some pretty poignant words a while back. Robin graciously allowed me to share her personal thoughts here, and in my times of "woe is me" and my moments of "someone shoot me now"... they've brought me comfort.

I am strong.
I guess.

From Robin:
___________________
My full thoughts on going through Infertility (aka "IF")......


I wish someone had told me that IF could change you, and it can be a change for the better. We all know it make us sad, frustrated, angry and bitter. I am still sometimes all of those things, but impossible to see, until many months after my son was born. Once I got past amazement that he was ours, that IVF did work (the second time) that I didn't miscarry or any of the other million things that terrified me the entire 39weeks and 1 day I was pregnant, I was able to get a glimpse of another reality. IF made me a better person.

Imagine that? In a few ways, too.
I never thought I was that determined, until I tried to get pregnant, with a doctor, for 27 months.

I never thought I was that bold, until I had to demand good care.

I never knew I had such tenacity, until our 9th IUI

I never thought I was that sensitive, until I sobbed and sobbed when I found out I had blocked tubes on top of diabetes, PCOS, AMA and hypothyroid.

I never thought I was brave, until I had to give myself upwards of 100 shots, in spite of a fear of needles.

I never thought I was strong, until the day I realized IVF#1 did not work, and we had to do it again.

I never thought I was compassionate, until I started to care for a message board full of women like they were my best friends.

I have been changed for the better and I like who I am, very much. I am a strong, bold and compassionate person, and I am not sure I would have become this person, this Mother to Ethan, if I hadn't followed this path. If I had one wish, of course, I would make it that I didn't have to do it, but since we know that isn't how it works, I appreciate what it taught me about myself. If I had one wish now, I would wish none of you had to go through this, I would wish no one ever had to 'learn' from IF, because as lessons go, it sucks. It isn't fair. But for me, since going through it was a necessary evil, I learned things I am not sure I would ever have known.
I pray that everyone will come out on the other side, with the family they dream of, in whatever way it takes. You are always in my thoughts.

Christa's Thoughts on Costa Rica, Panama and IVF out of the Country

I wish I would've kept my daily journal better than I had.  I have so many things to say about this trip, but I'm sure I'm forgetting a bunch of them.  Here I go.

Traveling with a child/children for a long periods of time- This was something we couldn't avoid on the trip.  I wasn't about to leave Ella (who is an active 22 month old) home for 3 weeks, so it was inevitable that she was joining us.  Having said that, it was one of the most difficult things Adam and I have been through in a while.  She is a good kid, but trying to get her adjusted to things in a different country was beyond challenging.  She was cranky, teething, and couldn't be consoled at times.  Much like at home, right?  Wrong.  Even though we managed to pack a bunch of toys, books, crayons, etc, she got bored, and we know what  happens to toddlers when they get bored. 
  There are also very limited things that you can do with a child.  There were different tours offered in Costa Rica which we couldn't enjoy because it would've been virtually impossible to have a child in tow.  Ella liked the pool sometimes, but got sick of it fast.  She hated the ocean water, so it was hard to relax and swim.

Hotels- We were fortunate enough to have a free place to stay most of the time.  But as Tracie said, it's very difficult to travel back and forth like that for appointments, however, when searching, there are very few cheap (under 100$ a night)  hotels by either of the hospitals we were at, especially in Panama City.   If you do find a relatively good priced one, it's usually booked up. 
  If we hadn't had a free place to stay, it probably would've jacked the price up a good 2 grand for the whole time, but don't quote me on that.

The Doctor- Dr. P is a very nice man.  He is a busy man.  He takes on a lot of patients at once.  He knows very basic English, which proved to be difficult at times, especially if I had concerns about something.

 I think he has a standard way of handling all his patients and is a fair guy.  I also think there does need to be some variance with different patients considering we each need different things.  I had to remind him a few times that I have severe endo, which was scary to me, considering I had to remind him that I needed to fast for 24 hours before ER.  Eeek.
  He does seem to know what he is doing all in all, but I can't say that I felt completely comfortable walking out of every appointment.  As Tracie said, I'm wondering about all the "extras" and whether they were done or not, but I'm not too worried about that.

When I look back on the trip- I'm not sure that I would do this again.  If we were to do fertility treatments again (which we aren't) I would probably save up the extra cash and do it in the U.S. or Canada where I could get a doctor who is fluent in English and would give me a personalized protocol.
  Don't get me wrong, I'm glad I did this trip, I enjoyed some of the experiences I had and had fun doing a little sight seeing.  I would not, however, call this a "vacation".  MAYBE if we hadn't brought Ella it could have been, but you have restrictions on what you can do, obviously because you are going through medical procedures, so that makes it difficult to fully expand your horizons and enjoy the day zip lining through the jungle.
  This IS for some people, not for all.  For those of you who know some Spanish, it may be easier.  For those of you who are better traveled than I, it could be for you!  We got to see new sites, try new food and enjoy a different culture for 3 weeks.  But BOY is it GREAT to be home:)

Tracie’s travel thoughts after our IVF Vacation in Costa Rica and Panama:

Tracie’s travel thoughts after our IVF Vacation in Costa Rica and Panama:


Things to be aware of: everything takes longer, more money, and more hassle than it does in the US.

“Pack half as much stuff, and bring twice as much money. “

Hindsight –

Hotels: I would have splurged and stayed right near the hospitals in a nice hotel. We don’t usually travel that way, but in this case, the stress of traveling from hotel to hotel, and navigating the roads, tolls, and simply trying to find the clinic, lab, pharmacy, etc… was too much stress. (and we are usually “stay in a cheap clean hotel and forage for food ourselves” kind of travelers.) Take a shuttle or cab from the airport, skip renting cars, and just enjoy your time there. Most tours will pick you up. I’m not kidding about the roads – they are truly horrible. And it’s HOT there. You won’t feel like being outside unless it’s in the water. Make no plans prior, and just do what you feel like. We actually did very little “touristy” things, but we had a toddler in tote.

Money: Costa Rica is very expensive. Even buying groceries, expect twice what you pay in the USA for some things. Denny’s for 3 adult burgers and two kid’s meals was $68. Most tours are around $100 per person, and expect to be gone all day, as most are 2-4 hours from San Jose. Most tours are not appropriate for young kids. Rental cars will be at LEAST twice what you are quoted, for insurance. Even if you have insurance thru your credit card. Our quote was $210, and the final cost was $479. Cars are smaller there too… a whole class or two smaller than you’re used to. Mark the previous damage carefully with the agent.

Panama was very much like the US, cost-wise. Some things are much cheaper. The nice resorts are at least an hour out of town, traffic sucks.

One thing we did that I do suggest: we traveled to Puntarenas, CR… to the Double Tree (all-inclusive) resort, during that 1st week stimming. (although you really could start stimming at home and just come to Dr. Perez by day 6) Taking the new toll road the drive is about 90 minutes, and the resort is lovely. We booked about $129 a nite per person (remember AI) and it was well-worth that money. The upgrade to high end booze or building three is not worth it, IMO.

If you want to escape to Jaco for a few days, the ride back to San Jose is about 90 minutes via that same toll road, and I have VERY nice condo to recommend near it all. $90 or so a nite, 2BR, kitchen, pool, etc. from a very nice American couple. I also have an acupuncturist/massage lady in Jaco that I adore. She’s willing to travel to San Jose if more than a couple of you “hire” her.

Knowing simple Spanish will help a lot. Some English is spoken, but not as much as I had hoped. Dr. P’s nurses speak very little English, but I did not need them at all. Remember you are in THEIR country, and they are not required to speak English just because you do. Speak slowly, with simple words to get your point across. We did have a couple times where we felt Dr. P’s English was not sufficient enough to understand what we were saying. When in doubt, ask him to repeat it, or say “tell me again what you mean, please.”



Money:

Bring lots of USD $20, no larger bills if you can help it. CR will take USD, and Panama uses them as their currency. Tips are usually included, check the menu for details. We used our credit card (that does not charge a conversion currency fee) and small bills. Save all your small colonies (local currency) in one handy place if you’re driving, there are many highways that have tolls of 200-500 colonies ($1-3) each. (be aware that there are “quick pass” lanes on the far right, avoid them since you’re paying cash.)

Petty theft is HUGE in Costa Rica – watch your wallets, cameras, anything left on your table as you eat, and turn your head away… but we felt very safe. But we are “seasoned” travelers. Most neighborhoods, resorts, and even the stores, have lots of security guards. When in doubt, just ask the front desk or a local. Lock your doors when driving, and know where you’re going.



Doctor:

Dr. Perez was very pleasant. According to a local (who moved from Chicago 5 years ago with her husband) Dr. Perez is “thee” doc to see in CR for IVF. His walls are filled with tons of piks of the babies, and his schedule is booked SOLID 8am to 7pm six days a week. He is VERY busy. He is very straight to the point, and does not use extra words in any way. You may feel rushed in your appt, although we often waited 60-90 minutes past our appt. time to see him. Ask your questions in a simple way, straight to the point. NO EXTRA WORDS. There was a language barrier to some extent. Make sure he understands what you are asking. (I have found working thru Mark Semple, Passport Medical, MUCH easier, in a huge way, but keep in mind, he won’t butt in your personal doc-patient relationship. That’s not his role.) Dr. P is a perfectionist, and his office, the way he does things… it’s all done with precision and attention to detail. Not my style in a buddy, but for a doctor, I’ll take it! A sense of humor gets lost in translation. Don’t even try. Het het.

All said and done… this way is great if you’re looking to do a standard antagonist protocol IVF, and don’t have anything too far outside the box. It’s a bit of a “one size fits all” approach to doing it, which he seems to pull off amazingly well. I personally think he overshoots the moon to get you pregnant, and didn’t seem worried for one second about putting in too many. He even made the comment – “do not worry, many die early anyways.” Um, not what this momma wants to hear. I got the feeling he cares very little about your history, diagnosis, etc. Just do A, B, C and he’ll get you D. I can’t really say this is “bad”… but it’s different. There will be no coddling. Sorry. None.

The ER & ET office is tiny. You literally get knocked out while laying on a small table under a shelf. It was kinda funny. You do not get a fert report, he does not see what you have until you are standing there on day 3 outside the glass. We insisted on a few minutes to discuss (alone) which he willingly gave us. I’m actually questioning the “extras” like embryo glue, assisted hatching, etc. but can’t make claims. I just suspect those are fluff words. He says he’ll go to day 5, but we didn’t have that luxury. (nor did anyone we knew) I wore a tank top under my paper robe. They are very small. I am not. Ha. I was in a LOT more pain than I planned on. Ouch. He says you can swim after ER, but not after ET. It was so hot, I did swim in pools, not oceans, post-ER. I stay dry post-ET. DO NOT GET SUNBURN. You’ll be miserable.

We paid the $2450 in cash to him (or you can wire the money) and the clinic the (3) u/s appts by credit card. ($75 each?) Other costs unexpected were: estrogen patches to help my lining $90, E2 bloodtest $40, and the progesterone he offers, $100. (be aware it’s 17P, and once I did my homework, I found that to be a dangerous form of p4 to take in my case. It’s been taken off the market in the US, and only used to prevent PTL, later in pregnancy, and there are many issues I take with it. But do your own homework, or just bring a couple bottles of PIO with you from home. )

All in all, I am happy I did it this way. Like I’ve said all along… a $20K failed IVF would have been too much to swallow. I think this trip cost us under $7K. (we had hotel perks, however).

If you have any additional questions, I am more than willing to help.

-Tracie

Babies on board!

Well - we have a really nice outcome! (stats at a later date) We're happy!
Now we just sit and WAIT!




I am uber bummed we literally have all our eggs in one basket, and have nothing to freeze. ;-( I was not prepared for this, too optimistic about 10 taken out....



but I am THRILLED that the ones we had to transfer are that great of quality, and are quite comfortable with our decisions.



A million thanks again for all your support, thoughts, advice and love. I appreciate you all. Now we sit low for a couple days, in the shade on the beach... and fly home Wed am.



Stick. Stick. Stick. Something please stick.

3 Day Transfer Yesterday!!

Hey it's Tico (Christa).  I had my ET yesterday!  I had 5 eggs retrieved, 3 eggs fertililized (one blast and 2 grade 1's) which is GREAT!!!  Adam and I made the decision to transfer all of them. We thought long and hard about how many to transfer and were only going to do 2 the whole time saying we didn't want any more than twins.  After hearing the doctors statistics, we decided to transfer them all.

I'm feeling very positive about this cycle for the first time since my CD 7 check when they only found 5 follices (4 of which they thought were going to make it.  But, I guess most of me knew that they were FULL of goodness:)

Now, we wait. I'm not good at waiting.  But only time will tell at this point.  I've done my part, Adam has done his, so we wait.

Thank you for all the thoughts and prayers coming our way, every one is certainly appreciated!!