Need Advice--Lap vs. more medicated cycles

ElleBeeKay · June 2012

I had a consult this morning with my RE for a Laproscopy at my request. Just a brief background: My RE couldn't complete the HSG b/c my cervix was not cooperating. I've done two rounds of Clomid and responded perfectly both times. Once was TI and the other was IUI#1. Both BFNs.

I can't help but worry about Endo since my mom had it and I have symptoms. It's always been in the back of my mind. I don't want to keep wasting medicated cycles without knowing what's going on, but I also don't want to have surgery if I don't really need it. Also, we're 100% OOP and it is not covered by insurance.

The RE gave us three options today: 1) Have the Lap (where he would also check my tubes to see if they're open). 2) Try the HSG again by using an ultrasound to guide the catheter into my cervix or 3) Trying Clomid with a FSH inject to "bump up" my eggs a bit more to increase our chances.

What would you do? Thanks for any advice.

ukcats27 · June 2012

***Ticker Warning***

Please have the lap! If you think you may have Endometriosis then you need to have the lap done. It will not be worth putting off.

The lap is not covered by insurance? It has nothing to do with IF and it is diagnostic so any insurance should cover it. I was completely OOP but I only had to pay for 20% of my lap.

hmz819 · June 2012

I would have the lap especially if you are OOP. Why continue to waste money on meds/IUI if you don't even know if your tubes are open?

sarah_e87 · June 2012

I'd be going for the lap since you have Endo symptoms and you don't know what's going with tubes since your HSG wasn't completed. What good is doing more medicated cycles when you don't know what's going on in there?

ETA: It your RE codes it as diagnostic is should be covered. I know my insurance is very picky about what is/isn't covered and my RE was able to code mine in a way that it was considered medically necessary.

ElleBeeKay · June 2012

Thanks again for the advice...I am leaning the way of the Lap too and just want to know once and for all what we're working with. How were your experiences with the Lap?

MJ14323 · June 2012

I would also think your lap would be covered by insurance since it's not IF specific and they can say its a diagnostic procedure. We have decided to do a lap at the end of July to check for endo in hopes that they find some and burn it off. I just want anytype of answer at this point. Since I've met my deductible for the year, we will just be paying co-insurance. Good Luck!

tmsetzer83 · June 2012

Are you sure your lap wouldn't be covered? My insurance requires me to be on the plan for a year before doing infertility treatments, but the lap is covered now because it's considered testing. I called my RE office to get the CPT code they would be using and double checked with my insurance.

I plan to have it soon, even though I have no symptoms. Especially since I have to wait until January for treatments anyway. I just want to make sure all is clear before pursuing the more expensive stuff. I don't think it could hurt just for piece of mind!

cdale86 · June 2012

I agree with everyone else about doing the lap rather than possibly wasting lots of time and money. Surgery is never fun (not that I really know from experience) but worth it to r/o or possibly treat endo. Insurance should cover it. Talk to your dr's office and insurance to make sure there are no surprises.

ElleBeeKay · June 2012

Thanks again for all of the advice, ladies...definitely going to have the Lap scheduled.

ShelleyBQ · June 2012

I think you're making the right choice. My lap was better than I expected it to be. I googled laproscopy tips and got a lot of helpful advice, which let me prepare really well for the lap. I took a week off work, which I was grateful for. I might have been able to go back before then, but I am a teacher, so even then I was exhausted those first couple days back.

Everything I went through was so worth it to know exactly what we are dealing with, and to have been able to have the endo removed and the problems inside fixed (my right ovary and tube were completely adhered to my pelvic wall, making them nonfunction- even though HSG was clear- so YES the lap is way better). I haven't had any success yet- but at least I knew that my IUIs weren't for nothing. Good luck!

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