Endometrial biopsy after IUI

[renavoo]

Hi! I was hoping someone could help me with a question I have; I'm new to forums so forgive me if I don't give enough info! My DH and I have been TTC for about 1 year. We just had our first Clomid/HCG trigger/IUI plus progesterone, which turned out negative. This is so depressing. Anyway, my doctor wants to do an endometrial biopsy. I'm not sure why this wasn't done before. I was supposed to do this today but I had a work engagement I couldn't get out of...I will be getting AF tomorrow so I won't be able to get the biopsy. So the question is...do I continue and do the Clomid/IUI cycle again without the biopsy? Or do I wait until I can have the biopsy and then do another round? The issue is that we have to pay out of pocket for the IUI. With the meds plus the ultrasounds, etc, we're paying about 1500 per round!

Thanks for any help!

[goldfinches]

I know it seems so hard to wait the extra time while fitting it in, but I would go ahead and do it.  Usually they don't find anything wrong, but if they do, they can alter your treatment accordingly and get better results.

[GaleTX]

 Our OB wanted to do an endometrial biopsy pretty early into the infertility workup, but we decided against it because it was something we'd have to pay out-of-pocket for and, when we spoke to him, our RE said it wasn't something that definitely needed to be done. Both told us the results could show a lpd, which would be treated with Clomid.  Since I was already on Clomid, it seemed almost like a waste of our money. We reasoned the money we didn't spend on that can be used for other procedures if we need them. Instead, we opted to do 2-3 rounds of IUI and then move on to an exploratory lap and hysteroscopy.  We have done two rounds of IUI without success, so the next step is the surgery in April.  I've never had an issue with my luteal phase or ovulation and didn't feel like the biopsy was a good way to spend our money when the cost was as much as a round of IUI. If your insurance covers it, it wouldn't hurt to do.  If it's out-of-pocket, you'd just have to decide if that's where you want to allocate your money or if you'd rather use it for something else not covered.

[renavoo]

Thank you so much, ladies!! I spoke with my nurse at the office and she said that the biopsy is part of the normal work-up. She suggested I go ahead with the cycle and see how it works so I guess I'll do that. I hope I'm doing the right thing! if I don't get pregnant the next month, then I will do the biopsy. I agree with you, goldfinches, it'll be good to get it done just to confirm that nothing is wrong.

As for coverage...all of this is just so confusing and frankly, a little annoying. How is it that this stuff isn't covered by insurance? I definitely think it all should be. I don't know if a biopsy is covered. i have coverage of "diagnostic tests" which this does seem to be. However, any type of treatment is not covered. I better call my insurance company just to see. However, I have a little while before I have to do this, I guess! Gale, i certainly hope that your exploratory lap and hysteroscopy is covered!!

Have a great day today!!

[goldfinches]

ah, insurance.  i could wax eloquent on that for quite a while.

i had no idea that a biopsy was that expensive, it's really just a super big pap.  wow!

Mine diagnosed a lot more than a LPD.  It revealed atypical hyperplaysia.

My insurance only covered test until diagnosis/treatment, and it covered the biopsy.

It also covers my yearly ones, yes, I get one every year. yay.

[renavoo]

Wow, a yearly endometrial biopsy, goldfinches? Does it hurt? And are you able to go back to work after one? I hope so, since you said that you think of it as just a super big pap!

[blueyezz4]

Originally Posted by renavoo 

Hi! I was hoping someone could help me with a question I have; I'm new to forums so forgive me if I don't give enough info! My DH and I have been TTC for about 1 year. We just had our first Clomid/HCG trigger/IUI plus progesterone, which turned out negative. This is so depressing. Anyway, my doctor wants to do an endometrial biopsy. I'm not sure why this wasn't done before. I was supposed to do this today but I had a work engagement I couldn't get out of...I will be getting AF tomorrow so I won't be able to get the biopsy. So the question is...do I continue and do the Clomid/IUI cycle again without the biopsy? Or do I wait until I can have the biopsy and then do another round? The issue is that we have to pay out of pocket for the IUI. With the meds plus the ultrasounds, etc, we're paying about 1500 per round!

Thanks for any help!

I don't really know anything about this, but what made him want to do one in the first place???  Did he see something on an U/S?  Just wondering b/c we have done many clomid/injectable IUI's and now have moved on to IVF and no one has ever mentioned this to me.  Hope it all goes well for you!  Good luck!  Ps. if he thinks that this is the true reason why you are not getting pregnant then I'd wait and not spend the money.  I know with us insurance doesn't pay unless coded testing for infertility so we pay out of pocket pretty much for everything, but I kick myself now for all the $ we spent on IUI's when we should have just gone to IVF earlier, but you don't know that until you go through it all.  If only I had a crystal ball I could have saved so much money!!

[tea_time]

I had a biopsy as part of my IF workup.  It was actually done by my Gyno before I even went to the RE.  It was the most painful test I'd had (worse than the HSG, sonohystograms, etc).  What made it worse was that it took 2 tries to get a good sample.  I was able to go to work after, it only hurt in the moment of the biopsy.  You have to plan ahead b/c you need to abstain the cycle that they take the sample.  

Good luck!

[renavoo]

Thanks ladies! Blueyezz4, the nurse said that it is just part of their "usual" work up so I don't think they suspect anything is wrong...I think they just want to be sure. The nurse told me to just go ahead with my clomid cycle and if I don't get pregnant this month, they will do a biopsy next month. Oh tea_time, I'm so worried about the pain. I'm already a wuss when it comes to pain so I'm not looking forward to getting a biopsy. We'll see. Maybe I will get pregnant this month. Is it sad, though, that I'm getting more and more pessimistic as the months go by? My DH is trying to keep my spirits up but I'm just feeling a little down about it.

I'm also worried because my period was basically non existent this month. I'm waiting to speak with my nurse because seriously, I know I'm not pregnant (I took a blood test on day 13) so I'm worried that the clomid did a number on my endometrial lining. All of this is just so much to deal with!

Thanks for listening to me rant!