starting clomid vs hsg question — The Bump
Trouble TTC

starting clomid vs hsg question

I met with my OB/GYN last week. He mentioned that I could have an HSG done. While he does not think that I am at great risk of having blocked tubes, he says that it would not hurt to check it out. We are 100% OOP, and the total cost for this will cost about $3,000.

A few ladies that I know have gone through the whole gambit of testing. They mentioned that the places they doctor at typically start people on a clomid before resorting to an HSG. They said that even though you are ovulating (according to temp/OPK), your egg might not actually be releasing. Does this sound right to you? I understand that everyone is different, but think it is worth mentioning to him.

A little background - DH's SA checked out fine. My bloodwork checked out fine. I have fairly regular cycles (30-35 days, OB/GYN says this is normal). My temps and OPK's confirm ovulation.

I am wondering what option you would choose if given one? Have the HSG done, or try clomid. Thanks, as always, for your guidance and support :)

Re: starting clomid vs hsg question

  • I would definately get an HSG before starting clomid. It is only recommended to use Clomid 6x in your lifetime, so why put your body through Clomid, if you're not even sure it has any chance of working. Hopefully your HSG will come back all clear, but atleast then you'll know what you're working with.

    FWIW, I have one blocked tube, and my doctor didn't have any reason to think it was blocked prior to my HSG.

    TTC #1 since Oct 2009, Dx: Unexplained Infertility
    HSG: Right tube all clear, left tube inconclusive
    3 failed Clomid Cylces
    4/5 lap revealed blocked left tube, but right tube is open
    April/May- 50 mg Clomid + Ovidrel + IUI #1= CANCELLED left ovary ovulating
    June 1- 100 mg Clomid + Ovidrel + IUI #1 = BFN
    June 28- 100 mg Clomid + Ovidrel + IUI #2 =BFP!
    7/12 Beta #1= 14 Beta #2= >5 Chemical Pregnancy :(
    July-Nov long break to recover emotionally and financially
    Nov 24- 100 mg Clomid + Ovidrel + IUI #3= BFN
    Jan 22- Gonal-F + Ovidrel + IUI# 4 = CANCELLED no response on right
    IVF #1- Start stims 4/7, ER 4/20, 21R, 14F, 6 frosties, ET 4/25, 2 embryos transferred= BFN :(
    FET #1- June 2012, Lurpon starts 5/27- CANCELLED
    FET #1 take 2- August 2012, delayed until Sept-CANCELLED
    FET #1 take 3- ET 10/11, 2 embryos transferred,= BFFN
    FET #2- Transfer 12/4--Cancelled, no embies survived thaw :(
    Next steps-- IVF #2 with new RE in March
    HOLY SURPRISE BFP 2/15/13!!!! Beta 1- 286, Beta 2- 782, First Ultrasound 2/25- baby in uterus & all looks good!


    BabyFruit Ticker

  • My doctors won't even start you on clomid without having a HSG first.  If your tubes are blocked all the clomid in the world isn't going to help.

    That being said, I've not had a HSG ... we went straight to IVF and the tubes are bypassed so there was no need.

    Our Journey to Brenden

    IVF #1: 4/11(Follistim/Menopur/Ganirelix) 10 retrieved/8 mature and all 8 fertilized / 2 embies transferred ... nothing to freeze Beta 5/10 = BFN

    IVF Take 2 Long Lupron July 2011

    ER 7/3/11 (our 6th anniversary) - 8 retrieved/7 mature/fert ....ET 7/6/11 - 2 beautiful grade A 8 cell embryos

    Beta 7/18/11 - 149!!! Beta 7/21/11 - 311 Beta 7/28/11 - 2,000 8/5/11 - Empty Sac 8/8/11 - There's a yolk sac and maybe a heartbeat 8/12/11 - Fetal pole, yolk sac, heartbeat 8/18/11 - Baby looks GREAT!
    3 babies waiting on ice


    Lilypie Second Birthday tickers


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  • First of all that sounds really high for an OOP HSG...I just had mine done and we are also 100% OOP and it was $600 for mine. So I might see if you can get it done somewhere else or at least check on the price. For me it was peace of mind knowing that my tubes were clear.
    TTC since 2006
    Me: 36 DH: 40
    DH dx azoospermia My dx: RA & AMA
    d-IUI's--6/10, 7/13 & 8/4: all BFN
    d-IVF#1--Lupron/Menopur/Bravelle/Novarel; mini-dose protocol
    ER: 10/25--18R; 14F; ET: 10/28--3dt of 2 embies; 3 blasts frozen
    + HPT 11/4; Beta #1--14dp3dt: 441; Beta #2--21dp3dt: 9298
    One beautiful jelly bean growing! Saw h/b on 11/28 and 12/5!!!
    P/SAIF welcome
    <a href="http://s22.photobucket.com/albums/b315/mandalinn/?action=view
  • Are you sure insurance won't cover the HSG? My health insurance doesn't cover anything related to IF, but my RE's office had my ob/gyn request the procedure and it did "get covered" by my health insurance. We have a $3,000 deductible, but since it was "covered" we only had to pay the "negotiated rate" which was 50% less than what was actually billed. GL!
    June 2010-Lap
    b2b Injectable IUI #1 7/25/10 & 7/26/10 = BFP beta 14dpIUI = 133 MC 9/14 at 9 weeks
    b2b Injectable IUI #2 12/5/10 & 12/6/10 = BFN
    IVF #1 ER 3/28/11 ET 3 embryos 3/31/11= BFN
    b2b Injectable IUI#3 6/28/11 & 6/29/11 = BFN
    PAIF/SAIF Welcome :)

    Submitted Adoption Application on 6/1/2011
    Homestudy 7/19/2011
    IVF#2 CX due to Adoption Match
    We were blessed with our daughter through the gift of adoption
    IVF #2.1 ET 2 embryos 2/14/13 7 frostiesLilypie First Birthday tickers

  • An HSG can tell more than if your tubes are blocked.  Clomid is not candy.  If you are going to move along to fertility medications, please make sure you are properly monitored.  When we refer to monitoring this means cd3 (before 1st pill) & cd8 or cd10 (day after last pill).  Cd 3 will make sure you don't have cysts.  Cd8/10 will make sure you are actually responding to the medication.  Please check out the 2 links for the "importance of clomid monitoring." 

    Short answer I would go for the HSG before you waste your money on meds.

    "When the world says, 'Give up,' Hope whispers, 'Try one more time.'" -Anonymous

  • I just started all of this myself and just had an HSG today and the cost for just that was $625 they billed to my insurance. They would have been cheaper if I was paying cash without insurance.

     

    The same as my husband had a SA a couple years ago and it was great they have to rule certain things out before going forward. I was started on Clomid before my HSG only because I was there on day 5 for my initial visit last week. This cycle is they only one on Clomid before they want to move on to IUI.

    Baby Birthday Ticker Ticker Began TTC July 09 Began Charting August 2010 BFP 10.28.10 Natural M/C 11.12.10 DX PCOS May 2011 DH SA= perfect First round Clomid/Ovidrel/IUI/Prog. July 2011 BFP 7/19/11 Grow Baby Grow!! Due Date 3/27/2012 first beta 7/22 542 second beta 7/25 958 She is here!! Sarah Bethany born 3/20/12 @ 4:13am 6lbs. 15oz. 19inches long
  • $3,000?! No way.  Mine was like 800.  And I would definitely do it before clomid, especially considering you seem to already be ovulating on your own.

    I would get a second opinion from a Reproductive Endocrinologist.

    Here is a boilerplate warning for anyone taking clomid:

    If you are taking clomid, you need to be monitored with bloodwork and vaginal ultrasounds at the beginning and middle of the cycle.  The cycle-day 3 u/s is to make sure you have no cysts on your ovaries before beginning clomid.  If you do have a cyst, taking clomid could create a dangerous situation where the cyst enlarges and/or bursts.  The day 3 bloodwork is to make sure you are not pregnant (very bad! on clomid) and to check your FSH and LH levels. The mid-cycle monitoring is to make sure you have not under responded or over responded. If you have not responded, you need to know to change your protocol.  If you over-respond (have too many big follicles), then you are at risk for multiples.  The mid-cycle blood work is to check your estrogen levels, which can determine how many eggs are hiding in your follicles. I wouldn?t want to have to go through a reduction.  I cancelled my first IUI cycle because I had 4 follies, and estrogen showed 4-5 eggs and we were not ready for that risk of multiples at that time. There is a low probability of these risks, but they are bad risks and detecting them with ultrasounds is easy and absolutely necessary.

    Also, some doctors say you should not take clomid for more than 6 cycles in your life ? that is because of the risk of ovarian cancer.  Therefore, you should get your husband a semen analysis and you should get an HSG to make sure your tubes are clear, before you start clomid.  You do not want to waste cycles of clomid if you have no chance of getting pregnant anyways.

    Also, here are some stories from other ladies who were not monitored.

     https://community.thebump.com/cs/ks/forums/thread/52199545.aspx

    https://community.thebump.com/cs/ks/forums/thread/37113868.aspx

    ...

     

     


    Be kind, for everyone you meet is fighting a hard battle. -Philo
    image


    Baby N conceived after 1 miscarriage and more than 2 years of TTC. Diagnosis was low sperm count. We found success after 3 months of anastrozole to increase DH's testosterone and one IUI.
    Some charts AlternaTickers - Cool, free Web tickers
    image

    I'm stupid. You're smart. I was wrong. You were right. You're the best. I'm the worst. You're very good-looking. I'm not attractive. - Happy Gilmore
  • I have called around, the facilities are all pretty much in the range of $3000. I know that my insurance will not cover this. I have checked into it (I am a health insurance agent..not that that matters.. but, I know how to "navigate the system"). I also do not get a "cash" discount, because I HAVE insurance, it just will not pay for this service. My insurance company gets me a little bit of a discount, but it really doesn't amount to much.

    I didn't think that the taking Clomid option would be the way to go, but I have talked to multiple women that said their doctors now say that they generally try clomid before an HSG. That was the first time I had ever heard something like that..but I was talking to three different women today, and they all said the same thing.

    I am wondering why there seems to be such inconsistency in the way things are done.. FRUSTRATING! :(

  • imageshootingstart:
    .

    I am wondering why there seems to be such inconsistency in the way things are done.. FRUSTRATING! :(

    B/c OBs want to try to prove they can do what an RE does.  REs are pretty consistant in what they do, since that is what they specialized in.

    "When the world says, 'Give up,' Hope whispers, 'Try one more time.'" -Anonymous

  • imageshootingstart:

    I have called around, the facilities are all pretty much in the range of $3000.

    May I ask where you live?  Are you sure you are talking about an HSG and not some other thing, like a Lap?  I have never heard of it costing so much.

    What would be the advantage of trying clomid before an HSG?


    Be kind, for everyone you meet is fighting a hard battle. -Philo
    image


    Baby N conceived after 1 miscarriage and more than 2 years of TTC. Diagnosis was low sperm count. We found success after 3 months of anastrozole to increase DH's testosterone and one IUI.
    Some charts AlternaTickers - Cool, free Web tickers
    image

    I'm stupid. You're smart. I was wrong. You were right. You're the best. I'm the worst. You're very good-looking. I'm not attractive. - Happy Gilmore
  • $3000 for a straight HSG?  Seems high!  I know I was quoted somewhere around $1500 (and I live in Southern Cal where everything is more expensive). 

    If you have insurance but they aren't paying you are a cash patient.  That's how all my doctors, labs, surgery center, etc look at me.  I have insurance that doesn't cover IVF so I pay out of pocket (OOP) and they discount me as a cash patient.  Why wouldn't they?  They aren't billing my insurance.

    I also had my OB GYN order some of my tests (STD panel, CD3 bloodwork, etc).  The insurance covered it.  Had my RE ordered it or had I been labeled "fertility patient" in the system they wouldn't have covered it.  They won't pay for anything related to IVF but they did cover some of the blood work, etc.

     

    Our Journey to Brenden

    IVF #1: 4/11(Follistim/Menopur/Ganirelix) 10 retrieved/8 mature and all 8 fertilized / 2 embies transferred ... nothing to freeze Beta 5/10 = BFN

    IVF Take 2 Long Lupron July 2011

    ER 7/3/11 (our 6th anniversary) - 8 retrieved/7 mature/fert ....ET 7/6/11 - 2 beautiful grade A 8 cell embryos

    Beta 7/18/11 - 149!!! Beta 7/21/11 - 311 Beta 7/28/11 - 2,000 8/5/11 - Empty Sac 8/8/11 - There's a yolk sac and maybe a heartbeat 8/12/11 - Fetal pole, yolk sac, heartbeat 8/18/11 - Baby looks GREAT!
    3 babies waiting on ice


    Lilypie Second Birthday tickers


  • We have insurance as well (just not IF coverage) but are still able to get cash discounts on things not covered. I really don't know why the HSG is so much more for you though I mean that is a huge price difference from what I have ever seen posted. Good luck.
    TTC since 2006
    Me: 36 DH: 40
    DH dx azoospermia My dx: RA & AMA
    d-IUI's--6/10, 7/13 & 8/4: all BFN
    d-IVF#1--Lupron/Menopur/Bravelle/Novarel; mini-dose protocol
    ER: 10/25--18R; 14F; ET: 10/28--3dt of 2 embies; 3 blasts frozen
    + HPT 11/4; Beta #1--14dp3dt: 441; Beta #2--21dp3dt: 9298
    One beautiful jelly bean growing! Saw h/b on 11/28 and 12/5!!!
    P/SAIF welcome
    <a href="http://s22.photobucket.com/albums/b315/mandalinn/?action=view
  • imageChicagoWeded2007:

    Also, here are some stories from other ladies who were not monitored.

     https://community.thebump.com/cs/ks/forums/thread/52199545.aspx

    https://community.thebump.com/cs/ks/forums/thread/37113868.aspx

    ...

     

     

    Thank you for posting this info! How scary.

  • imageChicagoWeded2007:
    imageshootingstart:

    I have called around, the facilities are all pretty much in the range of $3000.

    May I ask where you live?  Are you sure you are talking about an HSG and not some other thing, like a Lap?  I have never heard of it costing so much.

    What would be the advantage of trying clomid before an HSG?

    I live in WI. No, the pricing they gave and my appointment I scheduled are definitely for an HSG. They are checking for blockages in my tubes.

    I had not heard of trying clomid before an HSG until today - I didn't think it was a great idea. I wanted to ask here to get more opinions. The women I spoke with basically all said, in their own words, that the doctors in the area generally start with clomid first now vs ordering an HSG. The ladies didn't know why (I asked them). This is the exact opposite of what I had thought, which is why I wanted opinions from here..

  • imagemandalinn25:
    We have insurance as well (just not IF coverage) but are still able to get cash discounts on things not covered. I really don't know why the HSG is so much more for you though I mean that is a huge price difference from what I have ever seen posted. Good luck.

    I thought it seemed high too - my OB/GYN thought it would be about $1000, but scheduled the procedure and had me talk with the billing dept to confirm the cost. I called around to other facilities too, and the prices were similar.

  • Well, if you are in Wisconsin, maybe you can come down to Northwestern Memorial Hospital in Chicago and do it for $600-800.

    Be kind, for everyone you meet is fighting a hard battle. -Philo
    image


    Baby N conceived after 1 miscarriage and more than 2 years of TTC. Diagnosis was low sperm count. We found success after 3 months of anastrozole to increase DH's testosterone and one IUI.
    Some charts AlternaTickers - Cool, free Web tickers
    image

    I'm stupid. You're smart. I was wrong. You were right. You're the best. I'm the worst. You're very good-looking. I'm not attractive. - Happy Gilmore
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