It wasn't supposed to be like this. What next?

[Kelilah]

I always took it for granted that I'd be able to conceive when I wanted to. Since I first began menstruating at 11, I've had a super-reliable 28-day cycle, little to no cramping or pain, reasonably light flow, and no "female troubles" whatsoever. I eat all-natural, organic foods, most of which I cook myself; I eat clean grassfed beef and pastured chicken and homegrown eggs, raw milk and homemade whole-grain breads, garden-fresh local produce. I avoid high-fructose corn syrup, cigarettes, caffeine, etc. I don't take medications. I'm in excellent health.

My husband eats the same way I do, and while he's overweight (and losing his excess weight quickly now that he's working out every day) he too has been extremely healthy throughout his life.

We got married when I was 29 and he was 30. Now this year he'll be 32 and I'll be 31. We've been off birth control since just before our wedding and all we have to show for it is last November's miscarriage.

Every month I find myself sobbing, brokenhearted, crushed. I never even wanted pregnancy before, I always thought I'd adopt but I never reckoned the expense. I feel like it shouldn't matter this much to me, but it does, I can't help that. (He is honestly fine either way but his interest in pregnancy grows the more depressed I get about it; he wants this desperately now because I do.)

So we finally agreed today to give Western medicine a try. I did acupuncture a couple of times but I can't afford to go every week, and our insurance doesn't cover naturopathy.

I need to make a doctor's appointment, I guess. But with what kind of doctor? We don't have a general practitioner. Should we go with an OB-GYN? Or would a midwife help us? What will they do? Should we both go to the first appointment or just me? Will they write us a Clomid prescription at the outset, or analyze his semen, or do... something? ...to me?

How does this work? I'm so afraid, and so angry that this very basic and natural thing - creating a child with the man I love - is becoming a drudge and a science experiment. I don't know what to expect and it's freaking me out even more. But I guess we're at the point now where we have to do this.

I would really appreciate information and guidance. Thanks!

[ladylaura]

First of all, I'm so sorry that it hasn't been easy for you the past few years. It's hard to realize it's not going to be as easy as you think, especially when everything has seemed to be perfectly normal your whole life.

If I were you, the first thing I'd do is contact an RE (google fertility clinics in your area, for a start) and see if you can get a consultation. Usually they will want to ask you if you have charted (basal body temperatures) and confirmed that you ovulate (if you haven't, don't worry, you can still go in for the consultation), they might do a semen analysis, and they might want to do bloodwork.

It's really hard to take this first step... but getting answers is worth it.

[Tear78]

Originally Posted by ladylaura

First of all, I'm so sorry that it hasn't been easy for you the past few years. It's hard to realize it's not going to be as easy as you think, especially when everything has seemed to be perfectly normal your whole life.

If I were you, the first thing I'd do is contact an RE (google fertility clinics in your area, for a start) and see if you can get a consultation. Usually they will want to ask you if you have charted (basal body temperatures) and confirmed that you ovulate (if you haven't, don't worry, you can still go in for the consultation), they might do a semen analysis, and they might want to do bloodwork.

It's really hard to take this first step... but getting answers is worth it.

: I'm so sorry, hon. I feel like I could have written your post. You are not alone, even though society makes us feel that way. I agree with consulting a RE, since fertility treatment should be monitored. Your insurance may want a referral from your PCP or OB, which shouldn't be a problem. Good luck and keep us posted!

[goldfinches]

I wasted 2 years with an OB, who I feel only added to my medical issues. Definately go see a RE.

I'm so sorry you're here.

[Kelilah]

Thanks, y'all. It looks like the first step is going to be calling our insurance people to find out who we can see and how to go about it so that it will be covered. We'll get on that today!

[Kelilah]

Well, never mind. Our insurance doesn't cover any fertility treatment whatsoever, not even semen analysis. Nothing we can do at this point except keep on praying, I guess. Sigh.

[ladylaura]

Originally Posted by Kelilah

Well, never mind. Our insurance doesn't cover any fertility treatment whatsoever, not even semen analysis. Nothing we can do at this point except keep on praying, I guess. Sigh.

Only about 6 states mandate that insurance cover fertility-related things. It's horrible.

Still, it might be worth your time to save up for a semen analysis. And some procedures aren't too expensive. An IUI without using any drugs at all is only a few hundred dollars a shot. Your cycles are regular so that might actually be a possibility.

Think about it... pray about it... save some money... and hang in there.

[Tear78]

I'm so sorry! Darn our healthcare system!!! sigh....ladylaura had some good advice. And yes...hang in there!

[jeminijad]

Originally Posted by Kelilah

Well, never mind. Our insurance doesn't cover any fertility treatment whatsoever, not even semen analysis. Nothing we can do at this point except keep on praying, I guess. Sigh.

Clomid is cheap. Sure, it has downsides, but it is a start and pretty much any OB will prescribe it.

[goldfinches]

Be careful on the clomid, it can cause health problems after just a few cycles.

Does your insurance cover testing up until diagnosis? I used to live in an insurance mandated state, but it didn't do us any good because DH's company was self-insured and chose not to have infertility coverage. But, they would cover anything up until "diagnosis" or until "treatment", (which meant things like egg retrieval or embryo thaw).

[Kelilah]

Hm, I don't know what they cover and what they don't. We're constantly being surprised by misinformation. Our dental care was supposed to be free and then we got a bill for $200 because our dentist was "out of network" - and this is after I called them to find a dentist that would be covered within our plan and switched from an old dentist we liked! So honestly, I have no idea what they cover and what they don't. I don't have a PCP or a gynecologist because I don't know what I'll get a surprise bill for if I go for a physical. (And supposedly we have really terrific insurance.)

So argh. I guess I should find a gyno and get a PAP, at least, and see if I can bring it up in conversation. And I'm going to go back to charting again when my next cycle starts - I had begun charting last month, but the dog ate my thermometer and I got frustrated and never bought another one. Meanwhile we'll just keep trucking along and maybe, someday, when we're 75 years old and we win the lottery, we might have a baby.

[LROM]

Originally Posted by goldfinches

Be careful on the clomid, it can cause health problems after just a few cycles.

Does your insurance cover testing up until diagnosis? I used to live in an insurance mandated state, but it didn't do us any good because DH's company was self-insured and chose not to have infertility coverage. But, they would cover anything up until "diagnosis" or until "treatment", (which meant things like egg retrieval or embryo thaw).

This is what I was going to say - I thought most insurance covers diagnostic tests but not treatments. That's how mine was - I could get the RE workup (fertility workup) like the HSG test and some pelvic ultrasounds to look at my follicles, but any actual treatments I'd have needed to pay for on my own.

Also as sad as your miscarriage is, it helps a lot re: insurance that you've been trying for more than a year and already had a miscarriage. A couple that hasn't been trying and hasn't had a miscarriage is going to have a harder time justifying the fertility workup - in that case diagnosis might not even be covered.

My general policy in life when it comes to dealing with huge companies like health insurance is to keep calling and trying to get an operator who seems to have a full brain working and maybe even wants to be helpful. Then you milk them for info. Also, document who you talk to, dates times etc. Because if you end up making a choice based on what you're told and then they present you with a whopping bill, you need ot be able to explain who told you you'd be covered.

Last bit of advice - whenever you talk to an insurance person about what is and what's not covered, have the most recent manual/policy in front of you and ask them to direct you to where what they're telling you is in the policy. That also should protect you so you can understand what's in the policy and whatever they tell you you can make notes on the pages.

I went through all this for dental work I was having, and my dental office said they got it approved through my dental plan, then I had the work, paid my copayment, and thought everything was good. 6 weeks later I get this letter from my dentist "Your insurance didn't pay what we thought they would so you owe us $400+ dollars". I hit the roof, what do you mean they "didn't pay what you thought they would?" But instead of just generally complaining, I called and called and kept asking "Ok, what is your process for assessing what they would pay for? When I called and asked if you'd confirmed it, where is your evidence that they confirmed it?" Turned out they'd called but I'd changed plans and they called my old plan - which does cover it, but not my new plan, which doesn't - and really it was their error and I raised heck about it until they just agreed to suck up the cost and not bill me for it.

Keep track of who gives you what info. Yes it's a pain in the butt. But if it is part of your path to parenthood, trust me, if it works out (and it WILL work out, however you end up getting your little one I bet a child does come to you), you will not be sorry you worked this hard at seemingly trivial details.

Best of luck!

[Juvysen]

I've heard from someone who used to work in an insurance company that they were trained to misinform and misdirect people so the company could get away without paying.

[thtr4me]

My insurance covers nothing either, although I did get approvals for 50% coverage for an HSG, and 50% coverage for office visits and ultrasounds for ovulation induction and IUI. The only way I was able to get in to see an RE for a workup, was because I had an amazing OB who referred me due to multiple losses (2 consecutive). And my RE worked the approvals as best he could, so my fibroid surgery was 100% covered (coded it as irregular cycles/mid cycle spotting). Luckily the fibroid did not need to be removed, so all he ended up doing was go in and taking some pretty pictures.

Since you have had a loss, I would start with seeing an OB. Maybe you are having some issues with your cycles post loss that need to be looked into. I originally went in to see mine because we were not getting pregnant, and as soon as I mentioned my second loss, he jumped on that and used that to get testing done. Hoping you are able to find a way to get some testing covered.

And not sure if this is true for you, but I am in California, and my RE said that no semen analysis is covered. Only a few specialized labs do the analysis, and none take insurance. I am sending DH to our family doc to ask for testing. Hopefully he will either refer DH to one of the labs, or be able to collect the sample and send it to the lab himself. Still won't be covered, but much easier that way.

[cureinfertile]

thanks for sharing

[zensven42]

Have you tried charting your cycles to see if you are ovulating each month and WHEN you are ovulating? This can better help you know if you are having intercourse at the proper time of month, if your luteal cycle is long enough, if your body temp is high enough (low temps can suggest hormone imbalance) or other issues. It may be simpler than you think to get pregnant again if you chart and have a higher awareness of your fertility. I use Fertilityfriend.com. It has a good free charting system. I would try this before you go spending money on medical treatment, or before taking medications that may not be necessary. Good luck!

Kristin SS

[fierrbugg]

Originally Posted by goldfinches

Does your insurance cover testing up until diagnosis? I used to live in an insurance mandated state, but it didn't do us any good because DH's company was self-insured and chose not to have infertility coverage. But, they would cover anything up until "diagnosis" or until "treatment", (which meant things like egg retrieval or embryo thaw).

I also agree about the insane cost of adoption. In my corner of the world, there are 9k kids in foster care, waiting for families and the cost is so daunting.

Imho you also have to find those dr.'s who aren't afraid of the insurance companies and know how to deal w/ them. My issues are related to serious hormonal defects which I've been trying to figure out completely for years. Thankfully technology in Endocrinology is advancing, so procedures for treatment have changed in the 9 years I've been dealing with this. My RE and Endo have both written procedures up as something other than infertility workups to make sure we could get them done. Sadly it's sometimes a game w/ insurance companies. But doing some of these tests in the past have allowed us to discover body wide issues that I would never have known about. For instance I originally went to my Endo for more hormone testing and she ended up finding a large nodule on my thyroid, requiring a biopsy. Kind of important for full-system health, no? Anyway, don't give up and don't be afraid to shop around for the right Dr.

[Kelilah]

Thanks, y'all. I probably should go get checked out by an OB-GYN regardless, but I'm just so afraid of what it will cost us because money's so tight right now, and our insurance company will never tell us up front what's covered and what isn't. This whole thing is killing my sex life and killing my emotional health.

[bk_hope_2_b_mama]

I understand where you're coming from. I also have always had completely normal 28 day cycles, healthy eating and other habits, etc, etc. I also resisting seeing any kind of specialist because I feared the "science experiment" effect you described and also the possibility of being pressured to use meds or serious interventions right away.

I'm older than you are - 37 - and my husband and I have been trying for about a year and a half. In that time, I've had three very early miscarriages. The first thing I came to terms with is that miscarriages are very common, which helped me feel less like something was necessarily wrong with me. I will say that my regular gyn was no help at all with the situation and really didn't have any input until I was at least 8 weeks pregnant (to which point I never got). But, after the second miscarriage, we decided to see an RE.

I'm so glad we did. First of all, there has been no pressure at all to jump into anything. The clinic (CWRC in New York City) is amazing, research based, and has many years of experience. They provide support groups, counseling (emotional and financial), around the clock availability, and have financial support for people whose insurance doesn't cover the services. I'm saying that to just encourage you to look into it, even if you think you can't afford it. Fertility interventions are absurdly expensive, but I was surprised how much support our clinic offers, although our insurance covers it.

In terms of the information I've gotten, I've been surprised how low pressure it's been. The head of the clinic met with us at our first appointment and talked to us for about an hour. He actually told us that even if we did nothing at all (no drugs, no interventions, in fact never came to them at all), we'd still probably be pregnant within another year. His scientific perspective was actually really reassuring, because he addressed it from a serious evidence/research view and made it really clear what might be going on with my body. They ran a bunch of simple blood tests to rule out obvious things, and then did some exams to rule out anatomical problems. In my case, they found polyps and fibroids in my uterus, which may be preventing implantation. We can't be sure, but I did have them removed and now at least I know there's nothing identifiable that's preventing pregnancy. Without seeing an RE, I absolutely would have no idea that I had fibroids. I find the information very reassuring, and I definitely started out feeling like you're describing. This has not been an easy journey, and I'm skipping a lot of details, but my point is that something was going on with me that I could have never known without the help of a specialist.

It was also hard for me to admit to myself that I might have a problem, because I wanted pregnancy to just happen naturally. And seeing an RE seemed like we were officially entering the "infertility zone." Believe me, I am surrounded by friends who seem to be popping out babies at the drop of a hat, and I assumed I'd be the same way. It sucks! But, I feel so much better now that I have access to some experts who can at least help me see the possibilities. The mystery of "why me" and "what's going on" became way too much, emotionally.

I don't know if this helps, but what you said sounded really familiar to me. You will be okay! Best thoughts...

[Twylightdove]

Hi Kelilah,

I'm sorry about what you are going though. I know the feeling.

I don't have any advice on dealing with the insurance stuff except to say that my tests and such were never under infertility so my regular insurance covered it. It was only when I got in to meds and IUIs that it triggered my very limited infertility insurance.

However, I may be able to suggest a place for acupuncture and herbal consults that is reasonable. I don't buy into the thought that acupuncture will result in pregnancy (I've been going to acupuncture regularly since before I started ttc and I sure as hell don't have anything to show for it!) but I did find it really helps my stress level. I noticed you are local to me and I know of several Community Acupuncture Clinics in the Portland area. Look up Community Acupuncture Network online for a list of clinics. I go to Working Class Acupuncture and love it. It is sliding scale and, though each clinic has it's own scale, it usually starts at $15 per appointment. Working Class has an herbalist, Matt, who was a wonderful help during my miscarriage. Feel free to DM me if you want more info about this. I almost never visit the forums so I won't see a forum reply. (Too hard for me to see the success stories.)

Good luck and take care.
Yona