Introducing Myself and a Question re: IUI steps

rooonilwaazlib

Good Afternoon All.  I have been lurking here for a while and decided to introduce myself with a question.  

My wife (DW...still learning the lingo!) and I (a same-sex couple in case you were confused) will be starting our journey to conception this year; I intend to carry.   I have my first appointment with a RE next week and we will be starting with IUI, as most lesbian couples do.  (PS - I've looked into posting on the LGBT Parenting forums but they are disappointingly inactive.  I hope it's okay I ask my questions and join in on here)

I got a call from their billing office telling me that, because of my high insurance deductible, I will have to pay the costs associated with intro visit and the initial sonogram.  This is fine...I mean I wish I didn't have to pay it but it's either now or later on, so it might as well be now.  I'll be checking with my insurance company to see if there's some wiggle room there.  But really, I expect to just pay the full cost until we reach our deductible.

My question for all of you experienced with IUI is: What are the regular procedures and steps associated with IUI (that will cost us money) that will come before the actual process of sperm and fertilization, provided everything goes essentially according to plan?  I'm trying to assess what costs I will have, so we can decide whether to do this quickly over the next few months, or whether it'll be spaced out a bit more to ease the financial burden.   I know the RE will also be able to answer this question for me, but that's a whole week away and I want to know now so I can measure my expectations going into the appointment.

TYIA for sharing your wealth of knowledge.  I look forward to sharing this journey with you in the future.   

thothscribe81

@LeaveMyLoveBetweenTheStars welcome to the forum!  Its exciting to be starting on your journey isn't it? I'm not sure I can answer your question fully but I can try to the best of my ability.

I believe most clinics and offices are drastically different as to how they work so I can only give you the experience myself and and my fiance have had at our clinic.  Our fertility stuff isn't covered at all under my insurance - though we were able to use money from my HRA to cover some of the costs.  My clinic has packages available for IUI patients who are paying out of pocket.  So they basically had two levels - oral medication and injectables.  The oral was cheaper by a few hundred dollars.  Since you are not technically having fertility issues (just need a way for the sperm to meet the egg!) you will probably be on the lower side of cost unless  you need some help with ovulation timing/growing follicles.  We paid the package price usually when I went in for my baseline ultrasound at the start of my cycle.  That price covered everything but medication - so it covered all my ultrasounds and blood draws (did not cover the blood tests themselves, that was billed separately).  So in general we paid once at the beginning of the cycle and were good to go until the next period started.  That package also included the IUI, blood draw for progesterone check, and blood draw for pregnancy test.  The meds were all over the place as far as cost goes - the oral weren't to bad, the injections were expensive.  And the blood work was covered partially by my insurance in some cases, but the tests weren't to bad price wise.  

The initial testing/ultrasound I had done was luckily covered under my insurance plan so I'm not sure how much that would be.  

I hope that helps and hope you have great success!! :-) 

rooonilwaazlib

@thothscribe81 Thank you.  I am excited and a little nervous! DW is more than a little nervous...but she's the planner and I'm the dreamer of the two! 

Thank you for that breakdown, it is EXTREMELY helpful in that I will be asking my clinic if they have payment plans/packages for families paying IUI out of pocket. 

funkykey

Welcome @LeaveMyLoveBetweenTheStars! 

We're OOP for everything, so I can't speak to any of the insurance concerns, but I can speak to some of the steps we took before IUI.  We know a lesbian couple who are doing treatments here, too, so I can share some of the things they went through.

For our friends, our clinic wanted the woman who was going to carry to do an HSG before starting treatment, as well as all of the other introductory blood work - testing progesterone, for STIs, etc. Most IF women with a male partner will have this done before starting any treatment, but only after they've not managed to conceive for several months. For our lesbian friends, the idea was that they should do the HSG and blood work before treatment just because why bother with the IUI if there were an issue that needed to be addressed? Especially when considering the cost of sperm...

From what I've heard, sperm is pretty expensive! I've heard good things about this bank: https://cryobank.com/ and they're open with their price list: https://cryobank.com/Services/Pricing/

My IUI was about $600 - a little more when I count the OPKs and my drugs, but I didn't have to pay for sperm - I was shocked that it's almost $900 for the amount you need to do an IUI! I'm sure you can get it cheaper, but seems like something you wouldn't want to, um, skimp on - you'd want a reputable bank, if you're buying. $1500/cycle is a lot!- and that's the low-end. I mean, it's not IVF money, but it doesn't have the IVF success rates, either...

My IUIs were medicated - I was put on clomid - but our lesbian friend was not put on clomid for hers. I guess because they knew she was ovulating herself, and didn't want to overstimulate. Because of the clomid, I needed 2 ultrasounds per cycle - one baseline at the beginning to make sure no cysts before the medication, and one before ovulation to check for follicles. I imagine if you are not medicated, you will only need the one prior to ovulation - just to make sure there's something there before pulling the IUI trigger. Not sure how much your ultrasounds will cost.

For many women the OPKs work fine, but for us, I've done bloodwork to monitor my estrogen and for an LH surge during my IUI cycles - this can be a little bit more expensive, too. At our clinic, it's about $100 more - but really depends on the clinic/your insurance. It was important for us because of the clomid - we wanted to monitor my estrogen levels closely. The estrogen and follicle u/s together can give a good sense of the quality of your egg prior to the IUI.

Good luck!

rooonilwaazlib

Thank you so much for the response, @funkykey !

Yes sperm is expensive.  Especially considering some men just give it away to anyone!  Going through the decision on if we want to ask a friend/use a known donor or anonymous though, we felt we wanted to go the anonymous route.  So now we pay the price...literally!  And you're right.  This is not something on which I'd be skimping to save $. 

A question for my insurance company will be...would fertility meds be covered if I needed them?  

Will keep you all posted!  It's comforting to know these forums exist as a support system for this nerve-wracking and exciting time in our life.

funkykey

@LeaveMyLoveBetweenTheStars - Yes sperm is expensive.  Especially considering some men just give it away to anyone! 
Um, exactly. Hahaha. Insert college memory here.  

J1006

@LeaveMyLoveBetweenTheStars My DH and I are using a donor due to severe MFI. My doctor usually refers to the bank @funkykey mentioned as well as Midwest Sperm Bank. Midwest is a little cheaper, but depending on where you are in the country you could spend a lot on shipping. 
 When discussing treatments early on my doc mentioned IUI costing between 1-2 thousand. We will be paying OOP for everything (maybe). Our insurance stated they wouldn't cover my DH's SA but ended up covering almost full cost. I guess you never really know what they will cover. 

Irisheyes81

Welcome @LeaveMyLoveBetweenTheStars  of course you can post here! Good luck on your journey  

i am also out of pocket but found that my insurance pays for the most random things. For instance, all my blood work. They did genetic testing for the most common genetic abnormalities for my race. You won't need to do that because these are genetic conditions that are carried by sperm and egg. I'm sure they test sperm for those at the bank. I have blood draws all the time to test for E2 and progesterone among other things. The insurance covers so yours might too. 

My HCG trigger (ovadril) costs $150. My doctor allows people to trigger on their own but I've heard others always pay for it once the follicles are ready. I also take half a shot per month. Those meds aren't covered. 

Im on famera and it's cheap. It's letrozole generic. I take pills but there are injections that are a little more. 

Ultrasounds are covered (another weird thing) and those can be expensive. I pay $80 per ultrasound in copay and have 1 or 2 per month. You might be able to get ultrasounds covered under a disease but likely, since you are not suffering infertility, that might not be an option. 

Hope me that helps. 

funkykey

@Irisheyes81 - my trigger was only $75! I was given pregnyl, from Merck. 

Irisheyes81

@funkykey really?! Is Merck mail order? My friend that has her FET this month said that she gets all her meds online. The thing is, the doctor calls and is like "go right now" and so I can't really wait... $150 every time is killing me 

funkykey

@Irisheyes81 - call your pharmacy- definitely worth looking into! 

Irisheyes81

@funkykey Thanks! I totally will. 

prudence9-2

@LeaveMyLoveBetweenTheStars my first 2 IUIs were not covered at all. Back then the clinic did two IUIs per cycle. (Which I've later learned was b.s. you should just time one IUI correctly after the trigger instead of doing 2 IUIs day after day. 

So for me the the cost per cycle was about $600 for the IUI (twice 2 as I had them day after day). Also the trigger med was not covered. Don't remember how much it was. (It was back in 2013) but I think it was around $100-200. 

The dr was good at charging the ultrasounds and blood test in such a way that the insurance paid. 

Hope this helps.