This question may seems similar to what I posted a month ago but, it's not. I'm not looking to compare clinics now, I'm sure I've settled on the one I want.
And, now that I've settled on a clinic (and assuming they accept me as a patient), I'm compiling a list of questions to ask the doctor at my first appointment.
I have a few already but, I'd really appreciate some input from those of you who've been down this path already.
Is there anything you wish you had asked up front or something you didn't know until later that you wish you had known from the start?
Now matter how small or obvious, please let me know. I want to cover all my bases this time.
It's not that I didn't feel that way last time but it was a different situation in a different time and place and James and I had a different mindset.
And, we were only considering IUI at that time because we had no IVF insurance.
Now that the insurance situation has changed and we're covered, I want to be thorough.
And one last question for those still trying: what vitamins/supplements are you taking? I'd also like to know how much, how many times a day and if your doctor suggested it or did independent research lead you to taking it.
I need you guys and since we're in the middle of ICLW, this is a great time to ask!
Lay it on me, guys!
Ask what tests are required. I think the HSG is standard, but you probably already had one of those for IUI. There's also a hysteroscopy, which my old RE didn't even offer. There's also some kind of embryo test implantation that my new RE recommended for my friend, but not for me. My clinic requires mandatory ISCI, even with no male factor, which they claim is important to their WAY above average stats. My new clinic also requires three weeks of birth control, and the old one was only two weeks.
ReplyDeleteI guess I'm saying the protocols can vary a whole lot, and you have to be able to trust the judgment of your doctor and the clinic.
I'm curious, what do you do if your insurance won't pay for ICSI? My insurance will only cover it if there is MFI. Would you have to pay OOP? That's pretty expensive! (I'm writing that question down on my list)
DeleteI know I've done one of those, I think the HSG. I'm not sure of the difference so I'll write that down, too.
Whoops, hit publish before I finished writing.
DeleteThanks for the tips - these were very useful!
We aren't sure if the ICSI will be covered, and it's about $1,500. DH does have a lousy sperm sample on record from a couple years ago, so maybe it will be covered. The IUI samples actually don't count for the IVF, they have to be standalone, no wash.
DeleteHaving made it this far, we plan to just pay it. ICSI requires a process to remove some other cells from eggs, and some clinics use it on everyone because of its higher rates. I trust my new clinic on this one because of their really high numbers.
I would love the opportunity to do ICSI but my insurance stated emphatically that it's only covered if there are two or more abnormal SA's. We did have one abnormal 18 months ago but all since then have been above average.
DeleteI'm going to see how much this new place charges for ICSI but my guess is it will be cost prohibitive for us.
IUI samples with washing don't count, so all those awesome samples don't count for this purpose. Each ins company will have different standards. We're not sure if we qualify or not with current numbers. The problem is actually way too much concentration and not enough volume, but with adequate total count, so we might.
DeleteI'll keep my fingers crossed that your insurance will cover it.
DeleteWe had one poor SA about 18 months ago when my husband was sick and four days of abstaining. One more SA since then came back great in every category and even pre-wash for IUI's his numbers were pretty high (I had them give me a copy of every single report after the IUI.
Aetna (my insurance company) told me that in order to pay for ICSI, two new SA's would have to be done and they'd both have to be abnormal.
I just don't see that happening. Don't get me wrong, I'm glad we don't have a problem in that department but it would be nice to have them pay for ICSI.
I agree with the commenter above. Before I could do IVF the first time, I had to undergo loads of tests before I could start. Every time I thought we were ready to go, there was another holdup. First it was the baseline thyroid, anemia, etc. tests. I got flagged for one of those, so I spent several months trying to regulate it. Then exercise was assumed to be a problem, so I stopped that. Then AMH, a hycosy (can't remember what it's called in the US, but the dye test to see if your tubes are clear), my husband's sperm analysis, genetic screening (all at different times) and now probably antibody tests. I was fine doing all of them, but I would have preferred to have done them all sooner since we were already making the commitment to IVF. So, I'd ask, "Is this everything you need before starting?"
ReplyDeleteI've actually had all those tests done already with the exception of hysteroscopy. I gave 15 vials of blood less than 3 months ago in fact.
DeleteI've done the HSG twice in 18 months but will be happy to do it again if they decide it's necessary.
I have Thyroid Disease but it's been under control for ten years and I'm tested by my endocrinologist every six month. My last RE tested it again anyway as part of that 15 vials of blood I gave.
If they want to run all the tests again, I'm happy to do it. But, they will have my records from my last RE so they might decide to go with that and skip all the testing again.
BTW - welcome! I'm going to add your blog to my list on the right side here in jut a few minutes.
Thank you, that's awesome! Good luck too. I feel like just getting there seems to feel the longest!
ReplyDeleteThe only thing I didn't know before I started was how much I'd end up paying OOP, because it just kept growing. It started small. Just a clinic "orientation fee". Then it turned out my drug cap was a mere drop in the bucket (covered about 2/3 of the first cycle and that's it). Then we were advised to do ICSI after all - another $1500. I spent roughly $3500 on the first cycle and roughly $7000 on the second (no drug coverage, ICSI, and cryo fees for one lonely embryo). I guarantee you we would not have pursued this had we known how much money we would spend on it.
ReplyDeleteAs for the vitamins, after my first cycle was such a crap-fest of bad eggs, my RE recommended CoQ10 600mg/day for 3 months, and I think it made a big difference, but we changed up so much that second time it's hard to say.
Good luck. I also felt like waiting for an appointment or a cycle to start was the longest wait. It always gave me way too much time to google and compile questions. I was always way more prepared than my partner.
You've added 3 more questions to my list, thank you! I know my insurance won't pay for ICSI for me unless the sperm is an issue so I am concerned they'll suggest we pay for it anyway. That will be tough.
DeleteI don't think I have a cap on drugs but I'm going to look into that now.
I've been taking 200mg CoQ10/day but I'm going to increase it to 600 now. You're the third person who told me their RE recommended that so thank you!
I have three months before I even want to get IVF started which means over 3 months before the first egg retrieval.
That gives me time to lose weight and get started on the new CoQ10 regime.