Things the USA has got wrong

April 19, 20189 Comments

OK, so aside from Trump (just lost a few of my readers there!!) the USA has got a few things wrong. As I sit here in the UK on a short work trip back to my home country I realised the USA got a few things wrong, very wrong particularly when it comes to infertility. Let me explain.

But before I do, have you ever heard of a ‘shit sandwich’ as a method for giving feedback to someone? Briefly, a shit sandwich is where you tell someone something positive, then something negative, then something positive again. It helps make the negative more palatable. So here is my shit sandwich.

Things the USA has got right!

Parking for FREEEEEEE! (or very cheap and you never need change if you do need to pay). It’s very easy where I live in Virginia to drive somewhere, anywhere random, and not have to worry about whether or not I have change for parking, or limit my time somewhere because I only had 2 quid on me at the time. True fact.

Portion sizes in restaurants. I can buy one meal and have a second meal for free because the portions are soooo big…it’s expected that all leftovers are taken in a ‘doggy bag’. It is deemed rude not to take a doggy bag! So I always order something that will taste good the next day.

Friendly customer service. Any American reading this disagreeing with me on this point, just come on over to the UK and return a shirt you recently purchased because you changed your mind. Good luck with that one!

Things the USA has got wrong.

Poor healthcare coverage for infertility. In 2012 a survey showed that 46% of people with infertility did not have ANY form of healthcare insurance coverage. And I am willing to bet that of that 46% that do, the majority of insurances will only cover testing and minimal treatment options. Infertility IS a DISEASE. Why is still perceived as ‘optional’?

IVF for wounded Veterans. The coverage runs out in September 2018. WHAT??? WHY??? In 2016 congress passed a bill that allowed the veterans agency to provide cover for IVF for wounded….for TWO YEARS ONLY. WTAF. I mean what monster could have not passed this indefinitely – these people have literally gone to war for their country and can’t now build their family because their deployment caused made them infertile. What is your beef?????

Introduction of Personhood Bills to declare when a person becomes a person without understanding the implications. Wait. A personhood sounds pretty reasonable? Well on the face of it, agreeing when a person becomes a person sounds like a good thing. I am NOT going to debate here about personhood bills, but I will say that there are huge implications on infertility treatment if any of these bills pass. Most people would believe that these bills aim to create a constitutional framework that would make abortion and embryonic stem cell research illegal. I am not debating these issues here, they are separate. But such legislation endangers IVF with many uncertainties over what the implications are for embryos that are created from the IVF process. severla questions that have unclear answers if personhood bills were passed include:

Would women who have ectopic (tubal) pregnancies after IVF be able to receive life-saving treatment, or would the embryo’s legal rights have to balanced against hers? ITS A HARD DECISION TO MAKE WITHOUT THE LEGAL ISSUES AS IT IS…if you have been following me for a while you will know that I went through this and had to terminate my pregnancy of unknown location, suspected ectopic.
If one or more microscopic embryos from an IVF cycle do not develop normally in the lab or fail to result in live births after transfer (all natural events), could the physician, lab, and/or patient be criminally liable? Except for the embryos transferred in all my three IVFs – ALL BUT ONE of my embryos arrested. That’s a whole lot of potential legal implications under personhood bills.
Not all frozen embryos thaw successfully. Could embryo freezing be prohibited as too risky? I’m relying on my little one frostie, but there is a 50-50 chance it won’t survive the thaw.
Will patients be prevented from donating their frozen embryos to research after they complete infertility treatments? If we decide not to use our embryo or I died we agreed to donate our frozen embryo to research.
There are many more questions, you can read about them here on Resolve’s website here.

Things the USA has got right Pt II

Okay, so I will end this shit sandwich with something positive.

Open and progressive Ameicans. I have found an amazing online community who are largely Americans who are willing to be open and share their story to break down the stigma and barriers about infertility. The charity Resolve is also prevalent in the community, bringing people together to fight infertility related issues and provide support to sufferers. When I come back to the UK I sense a lot of reservedness when it comes to infertility ,whereas I don’t find it quite that way in the US. For that I am grateful that America is breaking down boundaries with their openness around the subject of infertility and that it is a disease that affects 1 in 8 couples.

The cost of a suspected ectopic pregnancy

November 21, 2015November 21, 201511 Comments

You can’t put a price or a value on having both your fallopian tubes intact. In fact I imagine that anyone who has lost one or two of their fallopian tubes wouldn’t be able to put a price on how much they are willing to pay to have them whole and functioning again. Without a doubt. And so when the doctor told me that there is a risk that I had an ectopic pregnancy and a fallopian tube could rupture at any point, you simply don’t think about the $$$ money.;

After I found out that my pregnancy was non-viable, the whole process of determining whether or not I had an ectopic pregnancy was absolutely soul destroying and mentally exhausting. I tried to research what the likelihood was of having an ectopic pregnancy was with IVF. I tracked my hCG levels to try and determine what my odds were. I even joined several online groups to talk to other women who had experienced what I was going through. (I have probably mentioned this before, I dislike online forums because you get exposed to some real stupid, dumb, insensitive and simply irritating people. And you just can’t get rid of them.) All of this led me to some tiny hope that I was going to be one of those women who was going to beat the odds and carry a pregnancy despite the slow doubling hCG levels.

The doctors cared a lot about my wellbeing and were concerned of an ectopic. I mostly followed their recommendations: We both dropped everything to come in to the clinic for blood tests, consults and ultrasounds. What they didn’t tell us was how much it is all going to cost. Like I said, when there is a risk of losing a body part or even worse, your life, the money doesn’t matter. And now I can finally say how much it all cost.

I am not complaining about the cost because we are lucky, we have amazing insurance and we can afford to pay the bills. What I would like to know is what about those people whose insurance wouldn’t cover the costs? It’s just another slap in the face if you have saved up or taken on debt to pay for IVF. Of course, most insurance companies cover the cost for maternity healthcare, but the treatment of an ectopic or any other type of pregnancy loss doesn’t come for free. Remember I told you about the woman who couldn’t afford to have an ‘abortion’ to end her life threatening pregnancy at her hospital because of a CRAPPY law? (You can read about it here).

When you save up and take on debt for IVF, no one tells you to save a little bit extra in case things go slightly wrong. I have discovered, however, that most hospitals and healthcare providers will negotiate the costs if you can’t afford this type of care. There are also some charities out there that can help. I also believe that friends and family will be there too to help out. We have helped out some friends in the past when they got caught out with unexpected medical bills. It’s not only a difficult emotionally, it can quite quickly become difficult financially.

So how much did it cost? Luckily for us, not much. The total cost was $3,107 of which our insurance covered most of it, and so cost us $140. I have updated my ‘Cost Lowdown’ page with the breakdown of where the biggest costs lie here. But this has made me think about putting aside more savings specifically for unexpected healthcare costs.

My appreciation for the UK National Health Service has simply sky rocketed.

Mild Insurance Panic!

February 5, 2015February 5, 20153 Comments

This evening I was helping Chris with filing his taxes and was searching through our medical paperwork. I pulled out our insurance policy booklet and flicked through it to read about infertility treatment coverage. I already knew we were 100% covered, but what I caught sight of was that we needed prior approval for certain procedures – such as IUI! Whoops…!!

We are learning a lot about medical insurance, policies, bills, coverage, approval, pharmacies – the lot! But there is so much to keep tabs of that I am not used to. This was one of them.

After mildly panicking that I had screwed up, I called up my insurance company, and phew, I discovered that I did not need prior approval for this. Panic over. These insurance booklets can be very confusing. Especially when our insurance is worldwide cover, so depending on which country you are in, depends on the process. Grrrrrrr. However, I am entirely grateful that I do have amazing insurance.

I appreciate the NHS – I really do, particularly when it comes to the complicated billing system we have here. However, if we were in the UK right now things would be different. NHS guidelines used to be that IUI treatment was offered on the NHS if:

a man has mild fertility problems
a woman has mild endometriosis
a couple has unexplained infertility

However, new guidelines released in 2013 state that IUI is no longer offered in these circumstances. Instead, we would probably have been advised to keep trying to conceive through regular unprotected sexual intercourse for a total of two years. Only after this time we may be offered in vitro fertilisation (IVF). So if we were in the UK right now we would be 10 months and counting, then going straight to IVF. That would be pretty scary. I’m kind of glad we are where we are right now in the US!!