starting clomid vs hsg question

shootingstart · May 2011

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

Citygirl1015 · May 2011

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.

KaliChick · May 2011

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.

mandalinn25 · May 2011

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.

inlovewithB · May 2011

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!

CluckyEV · May 2011

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.

txhillcountrybaby · May 2011

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.

ChicagoWeded2007 · May 2011

$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

...

shootingstart · May 2011

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!

CluckyEV · May 2011

shootingstart:
.
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.

ChicagoWeded2007 · May 2011

shootingstart:

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?

KaliChick · May 2011

$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.

mandalinn25 · May 2011

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.

shootingstart · May 2011

ChicagoWeded2007:

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.

shootingstart · May 2011

ChicagoWeded2007:
shootingstart:

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..

shootingstart · May 2011

mandalinn25:
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.

ChicagoWeded2007 · May 2011

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

starting clomid vs hsg question

Re: starting clomid vs hsg question

Choose Another Board

Search Boards