The $$$ lowdown

I have created a new page on my site that sums up all the costs of our infertility journey so far.  I will keep this up to date as much as possible…I have copied the text from it and pasted it below (or here is the link to the page)

We are very lucky that our medical insurance includes coverage for the treatment of infertility, including IUI and IVF.

We are being open and honest about these costs because it is important for people to understand the difference having insurance coverage can make.  Only 15 states in the US make it mandatory for insurance providers to cover infertility treatment, and even some of those are extremely limited.  There is much debate on whether infertility should be covered as an essential health benefit.  There are many campaigns ongoing to change state law in this regard (www.resolve.org)

There is definitely a lot to be said about the psychology and stress to infertile couples over spending this vast amount of money if they do not have insurance coverage for infertility.  Chris and I find this process stressful enough as it is without the added burden of the actual cost.  I cannot even begin to imagine what it would be like without coverage.  At each stage of our journey we have had to get approval from our insurance company and with having an ‘unexplained’ diagnosis we have always been nervous that they will not cover us.  However, we have been fortunate so far. Fingers crossed they will cover our IVF too.

Item Full cost Insurance covered? Final cost to us
Ovulation Kit (pack of 20) x3 $70.00 No $70.00
Pregnancy Tests (various types) x4 $85.00 No $85.00
Basal Thermometer x1 $13.00 No $13.00
Pre-seed Lubricant x1 $24.00 No $24.00
Chris blood tests $572.00 Yes $10.25
Dani blood tests $560.00 Yes $14.43
Reproductive Endocrinologist Consulting Fees (Doctor visits) x3 $340.00 Yes $5.85
Ultrasounds x4 $900.00 Yes $71.72
Anti-biotics for HSG $15.97 Yes $1.60
Sperm Analysis $110.00 Yes $1.53
HSG $835.00 Yes $29.18
Letrozole x3 $8.53 Yes $0.86
Ovidrel x3 $371.16 Yes $37.11
IUI x3 $765.00 Yes $36.81
Sperm Wash x3 $320.00 Yes $16.80
Progesterone suppositories x3 $147.00 No $147.00
Running Total* $5,136.66   $565.14

A note about our healthcare insurance.  We pay a 10% co-pay for each bill of the ‘in-network’ cost, not necessarily 10% of the whole cost.  Our current infertility clinic (or ‘provider’ as it is also called) is ‘in-network’ so we get extremely preferable rates; for example our new doctor visit it was $190.00, our insurance paid $0, so we paid $0.  This is because our insurance company has negotiated these types of ‘bulk’ discounts in advance with our provider.

Choosing an ‘out of network’ provider can increase overall costs.  There is one other fertility clinic in our area we could have chosen, but is out of network.  It was something we considered, but we went on recommendation and did not think too much about this at the beginning.

Currently my insurance premium is ~$500 a month, plus my employer contributes ~$1100 a month, this covers both Chris and I for all medical expenses including dental and optical.

*As of 10th May 2015

Don’t panic Mr Mainwaring!

You know how I said third time round means I must be expert on IUI and I felt at ease with this round of treatment?  Well today is Cycle Day 11, everything had been going to plan so far…..But this morning I had my CD11 Ultrasound to check how my follicles are doing.  (By the way, you know you are in serious business when they send my actual doctor to do the ultrasound – they were obviously sending in the big guns for round 3!  It was good to see her.)  Back to my follicles, they are looking good.  I have two maturing, one in the left ovary and other in the right.  Both are 22mm – perfectly sized!  My doctor commented on how good my uterine lining was – 7mm.  She pondered on why the eggs hadn’t wanted to make a home in this nice uterus already!  She knows all the right things to say 🙂 I told her that I thought I was about to ovulate in the next 24hrs because this morning I had a 0.53 degree drop in my body basal temperature and my Ovulation Predictor Kit came up with an almost positive line.  She thinks I will probably surge on my own, but I should take the Ovidrel shot, just in case.  But this would mean I would have to take the shot now for an IUI procedure tomorrow pm (Weds).  OK….sounded good! Just one problem – I’ve got to go home, get the shot out of the fridge to bring back to room temperature – and I’m going to have to do this thing alone! Oh and I’m supposed to be back at work too. Cue panic attack.

I furiously attempt to call Chris to see if he can come home to give the shot, because I really don’t want to have to give myself a shot for the first time under pressure.  Chris must be busy. So here I am, sat here with my Ovidrel shot warming up next to me, whilst I wait for Chris to call me back. I’m freaking now because it’s either do it myself or nothing. And nothing is not a valid option.  You’d have thought stabbing myself with a needle is a very small price to pay to have this chance of having a baby and my logic would take over my fear.  But no logic does not dictate in this case.  Come on Chris!  Call me back!!!!!

For those of you who have not heard of the ‘saying/quote’ “Don’t Panic Mr Mainwaring”, here is a little video excerpt….

The weird science of ovulation, the things I didn’t know

A few days ago when I was curled up in bed wishing my ovaries would stop hurting, I did a google search on ovulation.  I wasn’t looking for information on how women ovulate (I studied that at GCSE biology ), but more about what else happens to a woman’s body when she ovulates.  My google search terms were based on a question I had earlier on whether there is a correlation between the side of ovary a woman ovulates from and an increase in boob size.  So my search lead me to ‘ovulation symmetry‘.

There are two articles of interest I would like to share with you.  The first is an academic paper, the second is a blog post from a website called 1Flesh (advocates for natural family planning).  Both were interesting and got me thinking how much of a dark science ovulation is to the unsuspecting.

I’ll actually start with the 1Flesh blog post, called “9 reasons ovulation is pretty much like witch craft” by Marc (yup he’s a guy talking about ovulation, that’s pretty cool!).  He talks about 9 things that happen when a woman ovulate (links to supporting studies are provided in his blog post):

  1. Women become more beautiful when ovulating – lips, ears, fingers, breasts and other soft tissue parts of the body become more symmetrical, thus making us more beautiful.
  2. Gaydar initiated – the better women become at discriminating men who are a good match for them.
  3. Higher voice – again a more attractive thing to men…apparently!
  4. Smell better.
  5. Naturally want to look their best – in fact women’s self esteem lowers around ovulation, and to compensate for this tend to dress better, put make up on, even sway hips unconsciously.
  6. Spidey senses –  women have an increased ability to spot and avoid danger (I must chart this one in particular!!)
  7. Increased sex drive – unsurprising.
  8. General well being – women are less stressed and have fewer headaches.
  9. Get smart – why didn’t I know this sooner??! I could have made sure I took all my exams on these days!

So let’s go back to the 1st point – women become more beautiful when ovulating.  This is where the first hit on google provides a link to an academic paper, entitled: “Symmetry and ovulation in women”*.  It was the first line of the introduction paragraph

Many primates show visible signs they are ready to reproduce.

Many primates show visible signs they are ready to reproduce.

that got me interested:

“In primates most females show cues to ovulation.  However, among humans it is generally considered that ovulation is not perceived consciously by others nor is it usually perceived by self.”

This is very true of baboons and bonobos – they could not make it any more obvious to the male that they were ready to reproduce.  Why are humans more subtle?  Actually, I think after a year, I can now tell when I am ovulating, the signs are mostly there.  But I am not sure Chris can really tell, though perhaps he can unconsciously from the more subtle signs like the list above suggests.

The paper presents evidence that asymmetry in ears and fingers is lowest at time of ovulation.  The evidence is compelling (but I’d like to see a larger sample size).  Could measuring and tracking the length of your digits be a more effect way of determining ovulation?  Sounds easier than feeling your cervix, peeing on a stick and taking your temperature everyday!  Clearly as this paper was published in 1996 it hasn’t caught on as I assume the differences are very small and requires an accurate measuring device.  So we will just wait out on that one for now…

D.Scutt & J.T. Manning, Symmetry and Ovulation in Women, Human reproduction, vol 11 no 11, pp 2477-2480, 1996.

Letrozole all gone – waiting for the Ultrasound CD11

I took my last two Letrozole tablets today.  I haven’t had tiredness today like I had last week, but I do have some abdominal pains so I am sat here with a hot water bottle.  Maybe its a psychological thing, but I think the hot water bottle helps.  I don’t really know if it is my Irritable Bowel Syndrome or a side effect of the Letrozole that is causing it.  Either way, it sucks and wish it would go away.

The abdominal pains started today after lunch, just as I was about to lead a workshop for the afternoon.  I thought about all the possible excuses I could come up with as people arrived.  I looked around the room filled with men all over the age of forty five I decided that I would only end up embarrassing one of them with the truth.  So I stuck it out.  But as soon as I got into the workshop I forgot about the pain.  It was only when I stopped thinking and took a breather for a minute that I realised the pain was still there.

I’ll start my ovulation predictor tests tomorrow, a couple of days sooner than when the nurse suggested.  But I have paranoia that I will have a short cycle this month and miss out on IUI!  I’m not sure the nurse was aware that I sometimes have short cycles of 22 days.  It was only after I got home and read the information pack I thought perhaps I should start the tests a bit sooner.  Yey! Holding my pee in the mornings to pee in a cup time.  Trying to do it in the dark can be fun when I don’t want to wake Chris up too early.

Chris took this photo yesterday - It says so much more about him than a blog post possibly could

Chris took this photo yesterday – It says so much more about him than a blog post possibly could

I asked Chris to guest blog for me this week.  He wants to, he is just not sure what to write.  He is a good writer.  He has a published book already and has been writing a novel in his spare time over the last few years, so he knows how to write well.  Unlike me!  He has some ideas what to write about, but is nervous sharing his thoughts.  I said he should read some of the blogs from other men, perhaps it will help him see from a different perspective how blogging can be a bit of therapy for the mind.  I hope he does write something, but I am not going to pressure him or make him feel bad.  Blogging is not everyone’s cup of tea and I am certainly still learning – so far it tastes pretty good and I can see it fitting into my daily routine.  Let’s see how addictive it can get 🙂