ROLLING THE DICE: The Stats

My husband and I met with our RE to discuss the results of our testing, our options and our chance of becoming pregnant.

After reviewing our results, Dr. H informed us that “the issue with your egg quality is concerning…that combined with your age”.  I wasn’t too thrown off by this because I had heard it before when I received the results of my clomid challenge test.

Here are our options and their respective stats:

1)     Clomid + IUI =   8-10% chance of conception

2)     Injectables + IUI =   10-15% chance of conception

3)     IVF = 30-40% chance of conception

*Dr. H said that those with ‘normal’ egg quality have a 50-60% chance of

conception with IVF

4)     Natural conception = very low…

I have to admit, I was a little shocked by the odds.

To add fuel to the fire, next we were presented with the cost of our options.  Keep in mind, we have NO INSURANCE COVERAGE!!! for treatment.

1)     Clomid + IUI =   $1,553/cycle

2)     Injectables + IUI =    $3,618/cycle  plus

$1,500 for medication

3)     IVF =   $14,088/cycle   plus

$2,500-5,000 for medication

$682.00 for cryopreservation of embryos

*** Estimated Total for 1 cycle of IVF = $19,770!!!

Naturally, the best odds of achieving a pregnancy is IVF, which is also the most stressful on the mind, body, and pocketbook.  Overall, none of the odds are great.  I’m not sure many would bet on those odds in Vegas.  That’s a lot of money to spend on just the “chance” of becoming pregnant.  Don’t get us wrong, we would consider taking out a 2nd mortgage and spend the money if we could be certain the end result would be a success story.  My husband equated those odds to “it’s like putting $5000 on the Colts and hoping they cover” [we got the stats news the week before the Super Bowl game, if you hadn’t guessed].

Clomid + IUI, and injectables + IUI hadn’t worked for us in the past [when we were in our 20’s and didn’t have issues with egg count/quality or hormone imbalances], so this choice doesn’t seem the most promising for us either.  Considering a ‘normal fertile couple’ has only a 20% chance of conceiving in a given month, our 8-10% and 10-15% odds respectively [with meds and IUI] don’t give us the most hope either.

We haven’t yet decided what to do…I thought by the time I posted the stats, we would have made a decision on the direction we are going.  Of course, affordability is a huge issue that needs to be factored in to our decision.  We struggle with knowing that we will literally be putting all of our eggs in one basket.  We will have one shot at this, if we decide to go the IVF route.  How does one control their stress when so much is at stake?  I don’t know that I could handle the let-down if it didn’t work.

I feel and sound like a pessimist as I write this post.  Like all infertile people, I have my ups and downs.  Perhaps I should have posted on a different day…either way, the statistics don’t change.  Soon we will have to make a decision and roll the dice.

We live in southeastern Wisconsin – has anyone had a positive experience with a doctor/clinic in the area that they would like to share?  Are the prices for this clinic out of the spectrum, or are they considered the norm for these services?

I’ve been going to acupuncture off and on, which I really enjoy.  I need to do a little more research into protocols for acupuncture related to infertility.  Does anyone have any experience with acupuncture?  Dr. H said they often use acupuncture in conjunction with fertility treatments.  I asked her if acupuncture and herbs could change/alter my FSH levels and she said no.  This is a question I plan to pose to my acupuncturist at my next visit.

Insurance Coverage Sucks!

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I spent a lot of time on the phone today with both my insurance carrier and the staff at the clinic trying to get an estimate of how much this one test will cost us, and if we can afford it.  It was a very frustrating experience let me tell you.  First of all, since it is a new year, I will be paying my $300 deductible with this procedure for sure.   I was also informed that if the facility charges the cpt code for HSG [same code Dr. H will use], I will owe an extra $250 as a copay, as the HSG is considered an “outpatient surgery” if billed by the facility.  No one could tell me what cpt codes would be used by the facility, so it was very difficult to find out what my insurance would cover of the facilities fees.  If the facility only charges for the equipment used, xray, and radiologist, then I won’t be billed the extra 250 bones.  It didn’t matter how many times I explained that this isn’t a surgery, but the insurance company said that they interpret “anything invasive to the body” as a surgery in that setting.  So basically, if Dr. H. had an xray machine in her office, then it wouldn’t be interpreted as a surgical procedure and I wouldn’t owe another $250.  But since this procedure is taking place in the hospital xray dept, and I am an outpatient…surgery it must be.  This is absolutely ridiculous to me!  How many women have vaginal US and it’s not billed as a surgery [this procedure was no more invasive than that!].

So basically, after calling multiple depts. [billing, radiology, the estimator, Dr. H. office, the insurance company], I didn’t get anywhere.  Apparently no one knows or can find out how this procedure [that gets performed daily] is coded/billed.  So I have to wait and see.

Likely, this is what I’ll owe:

HSG [billed by Dr. H.]

Radiologist fees

Facility fees

$300 deductible, $250 copay, then 10% of all of the above.  Pocket change.  Sucks.