Can I get some input/advice? IF consult and plans

nittanyllama · September 2014

[XP on TTGP IF check in]

I'm lost and I need help.

We had our "IF consult" on Friday. I have low progesterone and was really hoping OB would just put me on progesterone. He said he "doesn't believe in that" and wants to start clomid. I asked about monitoring and he seemed confused, and gave some bullshit answer about watching my bbt chart to see if it works. Um, no thanks. When he realized I was concerned about monitoring and multiples he just started giving me names of REs in the area.

Except my insurance told me today once an IF diagnosis is made they will not cover anything else. So it will all be OOP (they told me last month testing was covered) and we really can't afford much of anything without going into debt. So...

1. Would you go into debt to see an RE? Especially with already having one LO?

2. An RE would want to do more testing before starting meds, right? I've only had P4 blood work at 7dpo which was 3.3 and MH's SA came back fine. How much could appointments and additional tests (ultrasound? HSG? other?) cost OOP?

3. What about clomid and monitoring - how much could that cost OOP each month?

4. Is there a realistic chance that losing weight or increasing metformin could help with weak ovulation?

I just feel really stuck with finances. I don't want to take on debt but I feel devastated at the thought of giving up.

lilmac2929 · September 2014

I am sorry for your struggle! I noticed your adorable son is about the age of my kiddo (born 11/2/11).

Now my thoughts on your questions!

1. Would you go into debt to see an RE? Especially with already having one LO? – This is such a personal question but yes. As an FYI, my RE did some help consulting with what my insurance would cover and what it wouldn’t. This may be unethical, but when we did the HSG test, she wrote that it was for PCOS because it wouldn’t be for fertility. Again, maybe it is questionable but maybe there are options for you. I would definitely go for the testing (especially since you said some was covered?) to see what you can learn about your situation. Then, you can decide if you want to pursue a natural path or what avenues make sense.

2. An RE would want to do more testing before starting meds, right? I've only had P4 blood work at 7dpo which was 3.3 and MH's SA came back fine. How much could appointments and additional tests (ultrasound? HSG? other?) cost OOP? – Mine just did HSG and bloodwork and SA.

3. What about clomid and monitoring - how much could that cost OOP each month? – I am not sure sorry!

4. Is there a realistic chance that losing weight or increasing metformin could help with weak ovulation? – I have heard great things about people doing supplements, going whole 30, doing acupuncture, etc. Would it be possible to do some testing, pursue some of those avenues and try to save up for other treatments?

ellebelle2384 · September 2014

I like what the other ladies have said. I would see if maybe you could find an OB who would be willing to do increased monitoring and try to go around the IF diagnosis that way to cut down on OOP expenses.

sailorgal · September 2014

My naturopath was able to prescribe me progesterone as I waited for our RE consultation so perhaps try a route like that for a few months.

I would strongly advise against doing clomid without monitoring so I could go with another OB or RE.

bearfootz · September 2014

1. Would you go into debt to see an RE? Especially with already having one LO?

That's a tough call but I've always felt like the desire to have a child is the same whether it's the first or fifth - but I also understand not wanting to go too far into debt when you have a family to take care of already. I think it would be worth contacting an RE and getting an estimate of costs. My RE office has always been very upfront about checking with the insurance as to what will and will not be covered and estimating costs beforehand.

2. An RE would want to do more testing before starting meds, right? I've only had P4 blood work at 7dpo which was 3.3 and MH's SA came back fine. How much could appointments and additional tests (ultrasound? HSG? other?) cost OOP?

Check with the RE to see what medical history they could carry over and what they think would need to be done.

3. What about clomid and monitoring - how much could that cost OOP each month?

I would ask about letrozole/femara. It is techincally a breast cancer drug and therefore not given that scarlet letter of being fertility related by the insurance company. You can confirm this with your insurance company, but when I used it, it was only $2/month. I think the u/s monitoring was $600 but I'm sure that varies by region.

4. Is there a realistic chance that losing weight or increasing metformin could help with weak ovulation?

It could, but I've been told there are no guarantees. I've read more about the metformin/letrozole combo being successful.

good luck!

nittanyllama · September 2014

Bearfootz said:

1. Would you go into debt to see an RE? Especially with already having one LO?
That's a tough call but I've always felt like the desire to have a child is the same whether it's the first or fifth - but I also understand not wanting to go too far into debt when you have a family to take care of already. I think it would be worth contacting an RE and getting an estimate of costs. My RE office has always been very upfront about checking with the insurance as to what will and will not be covered and estimating costs beforehand.
2. An RE would want to do more testing before starting meds, right? I've only had P4 blood work at 7dpo which was 3.3 and MH's SA came back fine. How much could appointments and additional tests (ultrasound? HSG? other?) cost OOP?
Check with the RE to see what medical history they could carry over and what they think would need to be done.
3. What about clomid and monitoring - how much could that cost OOP each month?
I would ask about letrozole/femara. It is techincally a breast cancer drug and therefore not given that scarlet letter of being fertility related by the insurance company. You can confirm this with your insurance company, but when I used it, it was only $2/month. I think the u/s monitoring was $600 but I'm sure that varies by region.
4. Is there a realistic chance that losing weight or increasing metformin could help with weak ovulation?
It could, but I've been told there are no guarantees. I've read more about the metformin/letrozole combo being successful.
good luck!

Thank you for thoughtful response! I think we have decided to at least do the initial consult with the RE to see if that helps us get answers / make decisions. I do plan to ask about femara. Thanks again!

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