Trying to Get Pregnant

IF/Testing Check In - Week of 3/27

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Re: IF/Testing Check In - Week of 3/27

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  • madspunkmadspunk member
    edited March 2017
    @loveindc I typed my response before I saw your update. I'm sorry to hear your insurance won't cover an RE. How incredibly frustrating! As others have said, I would still consider additional testing. You might also ask her why clomid instead of femara. I dont know if an RE is the only one who can prescribe femara. 
  • madspunk said:
    @loveindc I typed my response before I saw your update. I'm sorry to hear your insurance won't cover an RE. How incredibly frustrating! As others have said, I would still consider additional testing. You might also ask her why clomid instead of femara. I dont know if an RE is the only one who can prescribe femara. 
    Just a couple points about this - my insurance doesn't cover anything at all to do with infertility so I get that.  But I DO want to just put this out there (With every single ounce of respect and love!) that when you get into fertility drugs that have a large impact on your body's chemistry sometimes cost needs to not be the top priority.  Also any doctor can prescribe Femara.  They just typically don't because Clomid has been around longer and it's just their go to.
  • Thanks @wabash15 and @madspunk for your opinions and input! Today's conversation was definitely not the end of it. When I go on 4/17 to discuss my BW, I will be asking many many questions before moving forward. I will bringing up why we aren't starting with an HSG or SA (my assumption is that it is an extra, uncovered cost that may ultimately be unnecessary). I think she's hopeful for Clomid because I'm young and because my chart shows repeated spikes in temp and fertile CM. Don't get me wrong, if I react poorly to Clomid or I'm not responding at all, I will take my troubles to the RE. I'm not interested in wasting my time or making decisions that may ultimately harm my body. At the same time, if there is an easy, cheap solution with someone I trust, I would rather try the easy solution before taking on the emotional and financial burden of seeing an RE right away.
  • Adding @eggplantface to the list of amazing helpful ladies here <3

    I talked to my OBGYN about IF not being covered by my insurance. She assured me that they code everything as "irregular cycles" and other helpful codes as much as possible to get around insurance. Luckily, my company provides a debit card that covers my deductible. So as long as I stay in network, everything is "free" on my end. It's just impossible to do that once I step foot in an RE office. Thanks for the tip of testing at the OBGYN and go to the RE for analysis! Definitely something to keep in mind moving forward.
  • @loveindc I wasn't trying to say you had to see an RE as long as your OB monitors you closely but more so the risks of a medicated cycle without having all the testing. Hugs, we all know how much this process can suck 
    *TW*
    TTC 1/2012
    Diagnosed : unexplained infertility
    6 rounds of IUI and a MC 2/2014, rainbow twins 4/2015
    TTC #3 5/2016
    Restarted Fertility tx
    IUI 2 rounds, baby girl 12/17

  • @LoveInDC random insurance suggestion - my insurance does not cover any infertility treatment at all, but they do cover all diagnostic work regardless of what office does it.  As long as it is coded as "diagnostic" it will be at least partially covered.  Yours might be the same?
  • @wabash15 With the flood of all the love, I started combining acknowledgements and responses :) So everyone please excuse me if I tagged you and then responded to a comment from someone else! I definitely agree, with you @wabash15 that a wasted medicated cycle is not something I want in my future. Anything I can do to avoid that, I will definitely push for! Thanks for the hugs and love <3 While it sucks to be here, I am so thankful to have so many amazing women with so many wonderful answers to help guide me to the best solution. FX we are all out of here soon.
  • *lurking* 
    I just wanted to say that I saw your update @LoveInDC and am happy that you like the new OB so much as well as the fact that she has started the steps to figure out exactly what is causing your crazy cycles.  I have been lurking this thread for some time both in anticipation for when I need to join in as well as to love-tit and cheer on my friends and these ladies truly are the best and really do know what they're talking about.  As far as insurance goes, I know that mine does not cover IF treatments but it covered the testing done (HSG, bloodwork and SA to some extent with H's ins).  Have you spoken with your insurance to confirm that they do not cover the testing?


    "It's time to try defying gravity."

    Me: 38  DH: 38
    Married 6/11/16
    TTC Since 6/2016
    12/2016 RE appt; 1/2017 SA & HSG results - all normal
    3/2017 Dx Hyperprolactinemia; 5/2017 Prolactin levels normal; 8/2017 Low Ovarian Reserve
    8/2017 TTA for personal reasons; 10/2017 NTNP; 12/2017 Re-start TTC
    7/2018 Clomid+IUI
    11/2018 Letrozole+TI
    12/2018 Letrozole+IUI
    2/2019 NTNP
    5/2019 Stopping all TTC efforts; living Childfree
  • LoveInDCLoveInDC member
    edited March 2017
    antoto said:
    @LoveInDC random insurance suggestion - my insurance does not cover any infertility treatment at all, but they do cover all diagnostic work regardless of what office does it.  As long as it is coded as "diagnostic" it will be at least partially covered.  Yours might be the same?
    @antoto I am going off my insurance portal. They have this section which all say that nothing is covered. I can get u/s for $50 and meds for a decent price through my OB. But they don't approve anything coming out of an RE office is my understanding.


    ETA: As we get closer to make this decision, I will be making calls to the insurance and confirm their policies. For example, I just learned that while Clomid is cheap, Femara is free under my insurance. Go figure.
  • @LoveInDC that's what I thought too!  But when my RE did my HSG they ended up covering a huge amount of it and they cover my ultrasounds at my RE as well (as long as it's diagnostic, that is). From that list it looks like yours might cover diagnostic work as well.
  • @antoto Thanks for sharing! I will definitely make sure that I don't make any decision "for the cost" until I'm 1000% sure what that cost will be.

    PS: As I was typing that, I remembered a recent OU/FFFC about judging people who use percentages over 100 to exaggerate and I chuckled :#
  • @wabash15 FX!  4 is great!  I can't remember - is this your 2nd or 3rd IUI?
  • vflux33vflux33 member
    edited March 2017
    Awesome news @wabash15

    @LoveInDC Sounds like your insurance plan is similar to mine. I called and confirmed with my insurance company like 4 times and as soon as the word IF or RE is thrown out even if the test is also related to your general health, nope, nothing (with the exception of a few things covered through my OB coded as being for the purpose of severe cramps and not IF). I *thought* I was in one of the lucky states where IF coverage is required at least for testing if not treatment, but it turns out in my state (CA) the insurance companies are required to offer a plan with it to employers but the employers can choose not to pay extra to include it, which means that most of them don't include it. In any case, I totally get that it's a concern for you (and, well, all of us). I don't know if other REs offer this but mine has a special program if you can show serious economic hardship they do a lot of stuff cheaper (they take off 500-7000 for an IVF cycle if you qualify). Also on my RE's website there is some info about a program where you might be able to get the meds cheaper (not sure if it's available outside CA): https://www.mdrusa.com/firststeps/

    eta grammar fail
  • @LoveInDC Judging by your insurance portal thingy it looks like testing is covered but not treatment. My insurance is the same, so none of the treatment was covered BUT when I was doing medicated cycles with just TI, my ultrasounds were covered because technically its a test. Once they added in the IUI though the ultrasounds were not covered. I was also initially told that nothing coming out of my RE office would be covered, but the finance girl at the office was really cool and coded it under obgyn somehow. She basically had me seeing my RE as an obgyn until I started IUIs. 
    Me: 31 Husby: 36
    Married May 2014
    TTC # 2  Since December 2021
    Baby girl W born 2/2021
    Our journey so far...
    (tw loss & infertility)
    Diagnosis: Poor Egg Quality 
    Working with an RE since March 2016
    2 failed TI cycles
    3 failed IUI cycles

    IVF Feb - April 2017
    23 eggs collected, 20 mature, 14 fertilized with ICSI, 4 day 3 blasts, 3 day 5 blasts, 1 PGS normal
    Transferred 1 PGS normal embryo 4.12.17
    BFP 4.21.17
    MMC due to small gestational sac 6.8.17

    Our adoption journey:
    12.25.18 Agency picked and apps submitted!
    5.1.19 Adoption on hold so we can buy a house! 
    1.1.20 Homestudy process started
    3.14.20 First social worker visit
    5.25.20 Homestudy Approved & Submitted to Agency

    6.1.20 Surprise! Positive pregnancy test!
    Healthy baby girl born 2/10/2021


  • @antoto thanks girl. I truly appreciate it
  • @LoveInDC Judging by your insurance portal thingy it looks like testing is covered but not treatment. My insurance is the same, so none of the treatment was covered BUT when I was doing medicated cycles with just TI, my ultrasounds were covered because technically its a test. Once they added in the IUI though the ultrasounds were not covered. I was also initially told that nothing coming out of my RE office would be covered, but the finance girl at the office was really cool and coded it under obgyn somehow. She basically had me seeing my RE as an obgyn until I started IUIs. 
    It's true that RE office people are usually really awesome and clever about coding things.  So many of my ultrasounds were covered only because of how they were coded.
  • @heatherdubrow I am so, so, so sorry that you are back 
    Me: 31 Husby: 36
    Married May 2014
    TTC # 2  Since December 2021
    Baby girl W born 2/2021
    Our journey so far...
    (tw loss & infertility)
    Diagnosis: Poor Egg Quality 
    Working with an RE since March 2016
    2 failed TI cycles
    3 failed IUI cycles

    IVF Feb - April 2017
    23 eggs collected, 20 mature, 14 fertilized with ICSI, 4 day 3 blasts, 3 day 5 blasts, 1 PGS normal
    Transferred 1 PGS normal embryo 4.12.17
    BFP 4.21.17
    MMC due to small gestational sac 6.8.17

    Our adoption journey:
    12.25.18 Agency picked and apps submitted!
    5.1.19 Adoption on hold so we can buy a house! 
    1.1.20 Homestudy process started
    3.14.20 First social worker visit
    5.25.20 Homestudy Approved & Submitted to Agency

    6.1.20 Surprise! Positive pregnancy test!
    Healthy baby girl born 2/10/2021


  • @heatherdubrow I'm so sorry to see you back here.  Hugs to you!

    @wabash15 YAAAAAAY follies!
  • @heatherdubrow Nooooo, so sorry to see you back here.  All of the hugs. 
  • @hartmich I did!! It was so what I needed  <3
  • @heatherdubrow I am so sorry you're back here!! Many hugs to you. 
    TTC History
    Me: 35 DH: 34
    Married 07/2012
    DD born 07/2014
    DD2 born 10/2018
    DS born 10/2022

    IF history:
    TTC #2 since January 2016
    June-Aug 2017: 3 IUIs w/Clomid = BFN
    Sept 2017: Dx w/Endometriosis
    Oct 2017: IUI w/Letrozole = BFN
    Nov 2017: IUI w/Letrozole = BFN
    Dec 2017: pre-IVF testing
    Jan-Feb 2018: IVF--17 eggs retrieved, 13 fertilized, 9 frozen and 1 transferred on 2/10 = BFP on 2/19!!! EDD 10/29/2018
    FET Oct 2021: BFP on 10/31! MC at 5 weeks
    FET Feb 2022: BFP on 2/15! EDD 10/29/22


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