what to test first after waitng 2 years

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what to test first after waitng 2 years

Postby JB7764 » Tue Nov 22, 2011 3:21 am

After 2 years TTC with no pregnacies we finally decided that we want to do some testing. The problem is that it all has to come out of pocket. We know that we first need to get a SA done for DH. But I'm not sure where to start with testing for me. I have normal cycles of about 27-30 days with clear O temps every cycle. I've wondered if endo might be an issue for somtime, but realize that it is best diagnoised with a LAP (I think that's the right one) which will definitely not be my first test because of cost.

So my question is what test is the most important at this point and should I ask to do first? And since it all has to be out of pocket, about what should i expect cost wise for it, and what about the cost of a SA?
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

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My Ovulation Chart

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Postby socialite_baby » Sat Nov 26, 2011 3:19 pm

My doctor and I also suspected endo so a laparoscopy and an HSG were the very first things we did. Sure enough endo was found/removed and my tubes were clear. HSG cost (for a repeat with my current RE) we've been quoted at around $400, out of pocket I had to pay for my lap (insurance covered it because it was for diagnostic purposes) was around $800 because we hadn't hit our deductible yet. SA cost us $75, but I've been quoted as high as $300. Blood tests for me are cheaper because I also pay cash and get a discount for it. They range from about $25-$80 each. My consult with our RE was $150 at the visit and then they billed me I think $200 or so. They bill most things so it can be put on a payment plan as needed which can be helpful so maybe ask about that? Also, if you don't have insurance check and see if your county/hospital offers indigent funds or some sort of discount program based on your income, that might be a way to get a lap you can afford. Good luck! :D
Lindsay (Mild Endo, thin PCOS, Hypothyroid, implantation failure)
TTC #1 for 7.5 years...

April - November 2011 - 7 Rounds of 50 mg Clomid, 3 IUIs. All BFN.
February - March, June 2012 - 3 Rounds 5 mg Femara. BFN.
April 2012 - "Immune Protocol" Follistim IUI. BFN.
May 2012 - Diagnosed activated natural killer cells and told we'll NEVER conceive naturally... *treatment break*
October 2015 - IVF #1. OHSS. Freeze all. 9 blasts on ice.
November 2015 - FET #1. BFN.
January 2016 - Holy *NATURAL* BFP!!! WTF?! First ultrasound 2/1/2016. Praying for a healthy sticky baby. <3
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Postby JB7764 » Sat Nov 26, 2011 7:49 pm

Thank you so much for responding! I feel much better about the costs of things (hopefully around here will be about the same) although it sounds like the LAP will still be out of reach for a while. But I can probably get the rest going. I'm not sure about if my regular doctor's office does cash discounts. But I probably will be trying to shoot for an RE and they might. RE's are better to do this kind of stuff anyway.

I just want to make sure that I'm clear, but all of those totals aside from the LAP were NOT covered by insurance and you had to pay out of pocket, correct?
As of right now, I don't have any insurance coverage. But I'm hoping to soon.
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

Image

My Ovulation Chart

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Postby socialite_baby » Sat Nov 26, 2011 8:12 pm

Yep. Those were all out of pocket. Most hospitals and doctors offices are somewhat obligated to offer patient financial services, at least to a certain extent, so you might be able to put it on a payment plan or spread it out enough that the cost won't be as noticeable... I assume my prices are relatively cheap. I live in New Mexico where about 25% of everyone here is without insurance so they make it easy to afford/pay off.

Just be aware that if you see a doctor while not insured once you get insurance it'll likely be "pre existing" and you won't have coverage for it. Most of the time that doesn't matter with infertility since it's generally not covered anyway. I'm having that issue trying to get insurance now, my endo is considered pre existing and I've been denied by insurance.
Lindsay (Mild Endo, thin PCOS, Hypothyroid, implantation failure)
TTC #1 for 7.5 years...

April - November 2011 - 7 Rounds of 50 mg Clomid, 3 IUIs. All BFN.
February - March, June 2012 - 3 Rounds 5 mg Femara. BFN.
April 2012 - "Immune Protocol" Follistim IUI. BFN.
May 2012 - Diagnosed activated natural killer cells and told we'll NEVER conceive naturally... *treatment break*
October 2015 - IVF #1. OHSS. Freeze all. 9 blasts on ice.
November 2015 - FET #1. BFN.
January 2016 - Holy *NATURAL* BFP!!! WTF?! First ultrasound 2/1/2016. Praying for a healthy sticky baby. <3
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Postby JB7764 » Sat Nov 26, 2011 11:39 pm

Thanks for mentioning the pre existing thing. I'll probably give it a few weeks before trying to get me tested for endo just in case. But we'll move ahead with dh's testing. That most likely won't be covered when I get insurance. Its probably a good idea to do te testing in pieces to keep from getting overwhelmed.
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

Image

My Ovulation Chart

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JB7764
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Postby ptcruzer80 » Fri Dec 02, 2011 12:36 pm

I also waited a good 2 years before seeking medical help. Basically, your doctor will want to do cycle day 3 hormone testing: estradiol, FSH, LH and probably TSH (thyroid stimulating hormone). Including a semen analysis is a good idea. Then they'll probably want to do a HSG test where they fill your uterine cavity with dye that flows through your Fallopian tubes to check the shape of your uterus and if your tubes are open.

I went through all the above tests. I paid about $300 for the semen analysis and about $400 for my hormone testing. My insurance wont pay for anything with the diagnosis of infertility; however, they will pay for routine screening diagnosis. So maybe you can see what works for you. Also, I knew that my insurance wouldn't pay so I was able to get a cash discount from the lab. I also got a cash discount for my HSG though my insurance picked up some of the cost. The HSG was about $1200 out of pocket (hospital costs, doctor costs, radiologist costs).

After going through 3 failed IUI cycles ($700 each with monitoring and meds) and not being pregnant despite good response, we're moving onto IVF with a new RE. My new RE said that we could do a laparoscoppy if I wanted to but it may or may not increase my odds of a natural pregnancy. So I'm opting out of that procedure as the odds are that I'd still need to do IVF. Check out his website as it has a lot of information about infertility and what tests are recommended and why. http://www.advancedfertility.com/

Good Luck!
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Postby JB7764 » Fri Dec 02, 2011 6:50 pm

Thanks for the info ptcruzer! I called my doctor's office and found out that the lab that they use for testing offers something called an Easy Access Plan for those without insurance. You still have to pay for tests upfront, but the upfront cost is amazingly cheap. For a SA it's less than $18! We will have to pay way more then that because my DH isn't a patient at my office and doesn't have his own primary doctor so we will have to pay $160 for a new patient fee. They said something about needed to see if the test is necessary, but I was talking to the billing department who I believe I never told that we have already been TTC for 2 years. I don't think a visit to see if the test is needed is necessary, but I guess I will have to call again and try to talk to my doctor to see if she will just take him on and order the test without having to have an office visit. But if we have to do the office visit and pay the fee, we will still have to find a way to get the sample to the lab within an hour when the lab is over an hour away. So one option is a hotel room which will add even more to the cost. My DH says all he needs is a few minutes in a private bathroom and he's good lol. All I can think of is a bathroom at a gas station or the lab itself lol. Though it would seem awkward to have him do that in a bathroom if that wasn't one of the intended uses for that particular bathroom. And for me to get a FSH+LH test and a prolactin test it's going to be $80. But I'm not sure that the Prolactin test is necessary, but at $80 for the two, why not?
The FSH+LH is a CD 3 test, but does it matter what day the other one is done? Doing them all in one shot would probably be best if I could.

I'm already convinced that I'm the issue and will have to jump into a HSG or a LAP, but hopefully testing will reveal an easy, cheap, fix.
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

Image

My Ovulation Chart

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Postby indygirl297 » Fri Dec 02, 2011 9:50 pm

Another thing I would talk to your doctor about is finding out if you might have insulin resistance. I have family genetics against me and was severly IR which can cause you not to get pregnant or can cause early miscarriages. I had to pay out of pocket for that test because we didn't have insurance at the time and it was about $110.
Me (Tiffany):28 DH(Jon): 32 TTC #1 going on 11 years. DH has SevereMF. I have severe Insulin Resistance, metformin 2000mg/day to keep that in check. Also have ovulation issues
Aug 07: Lap, hysteroscopy, cystoscopy, and HSG
IUI#1 BFN
IUI #2 BFN
IUI#3 clomid/donor sperm BFN
IUI #4 Oct 2011 BFN
IUI #5 Nov 24,2011 BFN
IUI #6 50mg clomid, IUI 12/26/2011 BFN
IUI #7 50mg clomid, 10K pregnyl trigger, IUI 5/26/12 BFN
IUI#8 6/29, clomid, trigger, progesterone BFN
Currently Taking a break, persuing other options.

http://firstbabyorbust.blogspot.com
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Postby JB7764 » Fri Dec 02, 2011 11:37 pm

I'll look into that! Thanks indygirl! How did they treat the IR?
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

Image

My Ovulation Chart

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JB7764
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Postby indygirl297 » Sat Dec 03, 2011 12:44 pm

Just with metformin. Which is becoming a standard treatment it seems in infertility stuff anyways.
Me (Tiffany):28 DH(Jon): 32 TTC #1 going on 11 years. DH has SevereMF. I have severe Insulin Resistance, metformin 2000mg/day to keep that in check. Also have ovulation issues
Aug 07: Lap, hysteroscopy, cystoscopy, and HSG
IUI#1 BFN
IUI #2 BFN
IUI#3 clomid/donor sperm BFN
IUI #4 Oct 2011 BFN
IUI #5 Nov 24,2011 BFN
IUI #6 50mg clomid, IUI 12/26/2011 BFN
IUI #7 50mg clomid, 10K pregnyl trigger, IUI 5/26/12 BFN
IUI#8 6/29, clomid, trigger, progesterone BFN
Currently Taking a break, persuing other options.

http://firstbabyorbust.blogspot.com
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Postby JB7764 » Sat Dec 03, 2011 1:11 pm

You know I just read this REALLY informative post that someone made on another board about IR and PCOS and the link and how diet can have a huge impact on it. It was just this one person's experience, but she had so much info and I learned a lot from it and it makes sense. She chose a natural or holistic, I'm not really sure what you would call her method of treatment, but she found a nutritionist and an acupuncturist I think (it was the same person in this case). And she pretty much cut out all food that turns into sugar or is sugar and her cycles became normal. She was able to conceive naturally 2x after being told she would never be able to and already TTC for 2+ years. Her babies were even surprises. I'll have to see if I can find it since my internet history cleared already so I can't find it the easy way.
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

Image

My Ovulation Chart

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Postby JB7764 » Sat Dec 03, 2011 1:49 pm

So while I was trying to find this article I was seeing more and more articles and what not that relate PCOS to IR. It seems that IR is the major contributing factor to it. Were you diagnosed with PCOS too, or just IR? I didn't see anything that said you have to have one with the other, so I'm curious if you have both or just the IR.

But in this article she kind of does push not using traditional medicine, but I think she does somewhat recognize that it's not always an option for everyone since all situations are different. I just thought that she had a lot of info on the two. And I thought it was all interesting to read.

So here is the link:
http://www.mothering.com/community/t/24 ... story-info
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

Image

My Ovulation Chart

Image
JB7764
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Postby indygirl297 » Sun Dec 04, 2011 6:21 pm

Sorry the email update got lost in my email for this thread. Yes the link between IR and PCOS is huge. I have only been diagnosed with IR, mine is genetics. I was not overweight, eat healthy, etc. Not a big sugar eater. But before it was diagnosed I was getting sick all the time, it was nothing to get 2 rounds of pneumonia back to back. I was always tired with no reason why. I remember sitting in the doctors office crying thinking I was crazy. THen I got diagnosed with IR (this was after living in Montana for 4 years, and moving back to Idaho, and going back to my original OB/GYN) and she felt these little hard spots along my neck and telling me that she thought I was IR. I researched IR and found that I fit into almost every category except being overweight or unhealthy eating. But I do not have PCOS. Once I started the metformin my cycles regulated them selves and now when I get a cold its just that, a cold. Anyways sorry for rambling.
Me (Tiffany):28 DH(Jon): 32 TTC #1 going on 11 years. DH has SevereMF. I have severe Insulin Resistance, metformin 2000mg/day to keep that in check. Also have ovulation issues
Aug 07: Lap, hysteroscopy, cystoscopy, and HSG
IUI#1 BFN
IUI #2 BFN
IUI#3 clomid/donor sperm BFN
IUI #4 Oct 2011 BFN
IUI #5 Nov 24,2011 BFN
IUI #6 50mg clomid, IUI 12/26/2011 BFN
IUI #7 50mg clomid, 10K pregnyl trigger, IUI 5/26/12 BFN
IUI#8 6/29, clomid, trigger, progesterone BFN
Currently Taking a break, persuing other options.

http://firstbabyorbust.blogspot.com
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Postby JB7764 » Sun Dec 04, 2011 7:15 pm

Oh no that wasn't rambling lol. It was very helpful! I didn't see much on the net about the genetic side of the IR, only the link to PCOS, so it was good to hear a little more about that side of it.

I'm glad to hear that the Metformin is helping you. I hope you get your BFP very soon!
:babydustb: :babydustg:
Me 29
DH 33
TTC since November 09'

DH's SA results (abstention- 5 days):
Liquefied in 20min
Viscosity- high
pH-8
Motility-56%
Activity- moderate
Directional- 15%
Volume- 2 ml
Count- 143 mill/mL
Total count- 286 million
Normal morphology- 23%

My test results:
TSH: 1.320 uIU/ml
FSH: 6.34 miU/ml
Prolactin: 8.3 ng/ml
Progesterone: 4.41 ng/ml
1st Clomid cycle: March 2013

HSG 10/2/13 showed everything clear and looking good

1/1/2016 BFP: 1/4/016 MC @ 5 weeks :angel:

Image

My Ovulation Chart

Image
JB7764
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Postby kez71 » Sun Dec 04, 2011 7:54 pm

JB7764, your DH will most likely be able to produce his sample at the lab..give them a phonecall and just check, but I would think theyd have a room even a bathroom as Im sure theres a few tests that need to be done and to the lap within a certain time frame.
http://www.fertilityfriend.com/home/10d294

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M/C Dec 08 7 weeks
Lap/hyst/dye work Aug11th 2010- Blocked tubes
First IVF Oct-Dec 2010 BFN- chemical :(
IVF#2 April/May 2011 BFN :(
FET #1 July 2011BFP!!! MC 10w3d
FET#2 Feb 2012 BFP!!! MC 8 weeks
IVF#3 July 2012 BFP Baby Girl born April 2013
FET #3 Feb 2015 Beta due 12th March. stick baby!

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