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Doctor's Appointment Update
I had my doctor's appointment today. It was more or less "What's our next steps?" discussion.
She basically went over what she would do. She wanted me to call my insurance to see what coverage I had. I don't have any coverage for infertility :-(
She said she would want to do an evaluation for me, which included blood work and something else (can't remember right now). She said depending on the lab, that could cost anywhere from $300-500. She said she would want DH to do a SA as well. Again, depending on Insurance (which DH is supposed to be calling his insurance), that could cost anywhere from $300-$500. She said next would be an HSG. If all that came back good, she would move to Fermera (sp), instead of Clomid. She said she'll do that for 6 months. She said statistically speaking, if you're unable to get pregnant in 6 months on Fermera, you probably won't without the help of IUI or IVF.
She said she would recommend DH doing the SA first if insurance won't cover my evaluation. She said that would be the biggest bang for our buck.
So, that's where I'm at right now. She did ask me if DH smokes. I wish I could say he doesn't, but he does. I'm well aware that smoking could quite potentially be killing his sperm, I just wish he would realize that! I don't think he will do anything about it, until he gets the SA results and it shows if his sperm count his low. Ugh!!
Ky - I'm assuming you had that testing done? Did your OB/GYN do the testing, or did he/she automatically refer you to an RE? I know you saw an RE, but I wasn't sure at what stage you went and saw him. As I've been reading on TTGP, they are very opposed to OB/GYNs doing the testing, and think you should go to an RE. My doctor didn't mention anything at all about seeing an RE yet, so I'm just curious.
Obviously right now, we need to see about finances and such. I don't want to do an SA and spend the money until I hear DH say that he will in fact quite smoking if he has a low sperm count. Why waste the money? And then if he doesn't want to quite, well, then we have bigger issues at hand than infertility unfortunately. But he does want kids, so I do believe he will quit...he just needs to see that it's his low sperm count (if that's what is even the issue is).
TTC since June 2012
Re: Doctor's Appointment Update
These appointments are overwhelming, aren't they?
My obgyn ordered DH's SA, because at one of my appointments I mentioned we had been trying for a while and he chewed. She suggested getting one (showed low mot & morph), and then a second one just incase that one was a fluke, but those were still low.
Then I met with her at the 1 year mark. Since we knew we were at least MFI, she told me to go straight to the RE. She said she could do the testing there, but there was no point since we would most likely have to pursue treatment with him anyways.
It's totally up to you if you want to test with her or a RE. But personally, I would go with the RE. My doctor made the comment of, she's an expert with pregnancy, he's the expert at helping get pregnant. Also, regarding the HSG, does she actually do it? I've heard of the radiologists/techs/whatever-they-are doing the HSG, then give the pictures to your obgyn, which then call you with the results. With the RE he actually does the test, tells you what he's seeing as they do it, and can probably tell more seeing it live vs pictures. Plus, I would think the RE has more experience with them than an obgyn?
But, on the positive side.. at least she wants to do all those tests before treatment, so that's very good!
I'd also be curious if the pricing would be any different with the RE vs obgyn? Did she tell you how much that would be? I think mine was $800 with the RE. I checked what my blood work was, and it was $346 with the RE. DH can't remember how much his SAs were.
Curious.. why does she want to do femara instead of clomid? Because that may be our next step, and I was wondering the difference between the two. Will she do the drugs, or will that be with the RE?
Regarding your DH and smoking... I'm sure that's hard on both of you. I've been in that same situation. DH quit (for the most part), but it did not improve his tests at all. So.. I'm not sure the chewing had any effect. But, if there is any sort of abnormal/low result, they will require a second one (and you should too just incase it was a bad test/sample). At that point, maybe he will be able to quit or at least cut back, wait a few months and see if there's any improvement. (I think its like a 72 day period from when sperm are made until they are released.)
Okay, I'll stop my novel now. Good luck with all these decisions & steps!!
TTC since March 2012
BFP 3/14/13!!!
U/S 4/15: Identical twins!
Lost my angel boys at 10.5 weeks
My Chart***My TTC blog
Thanks for your info!
I'm not sure how much the HSG would be. If she told me, I forget. I do remember she made the comment about all the tests plus the HSG would come out to be around $2000. So, I'm thinking that the HSG would be close to 1000.
As for, who would do the actual HSG, I'm not sure. That would be a good question to ask! I believe she said something about radiology doing it, but I'm not 100% positive. Ahh! In the office, I go to, I think their may have been a room labeled radiology?! Also, I do know some o the Ob-Gyns at the office specialize in infertiity, so maybe they would do it?! Something to ask!
As for Femera, she said she feels it works better than Clomid. One of my friends that is pregnant right now, got pregnant while using Femera. She started out on Clomid and did that or a couple of cycles, and thn switched to Femera. I believe her first cycle on Femera, she got pregnant. She said she would do the drug. She said she will do 6 cycles of Femera and if that didn't work, then I would need to see someone else.
Confession time...Not only does DH smoke cigs, he also smokes weed. Double whammy, I know! Ugh! He has always smoked weed. Yeah, illegal, I know, but it's not a big deal to me. I've never done it...and I have no desire to do it, but it doesn't really bother me that much. I'd much rather anyone smoke weed than drink! But anyway, that is also killing his sperm, and he realizes it. Ugh! When I called him after my appointment, he was with one of his long-time friends. They were driving, so I was on speaker phone, so she heard everything. Lol. I didn't know she was with him at the time. But as soon as we hung up, she looked at him, and told him it's the weed. I know neither is helping, and he realizes it know too.
I stopped by his work this afternoon, and was talking to him. He asked me if I told the doctor about him smoking the weed, and I said no, just the cigs. He told me I should have told her. Hind sight? Probably...but I didn't want that talk. He needs it, not me. He said he wouldn't be able to quit both at the same time (which I understand, but maybe he can work on that!). He said he will quit smoking the weed and see where we're at. I think that's going to be our plan for the next couple of months. Better timing and him quit smoking so much. Yes, the problem could still be with me...but we both find it really hard to drop $400 or so dollars for him to do a SA just for them to tell us what we already know...that he needs to get smoking.
I'm not sure if this is good logic or not right now, but this it's what I'm thinking right now. We'll need to save up money for infertility if that is the case.
He is still supposed to call his insurance to see if a SA is covered...however, if it is covered, then I'll tell him he needs to go have one.
TTC since June 2012
Ali made some good points.
I read your reply when I was laying awake last night (which I will discuss why in my WTF Wednesday post, ha) and was thinking about it.
I know you don't want to spend the money on a SA, but I would strongly recommend whether he is quitting or not. You never know what you may find.. his count, motility, etc may be fine! Or, and I hate to say this, but there would be a problem with a extremely low count. And if you don't know that, you'd be wasting your money on drug treatments when you should be saving up for more aggressive treatments like iui, etc.
It would really help to know at least what you're dealing with. Also, it may help those questions in your head on whether or not smoking has an effect.
I know it's hard, and so expensive. DH gets really upset with how much money we've spent.. and have nothing to show for it. Well, he doesn't really understand that we have to get all the basic information figured out first. All my tests came back okay, which is good to know. But he just sees is as thousands of dollars gone.
I'm not sure what the difference would be between a RE and a obgyn that specializes in fertility. There's a website where you can look up doctors and their success rates.. let me see if I can find that and post it on here. I'm biased towards my doctor, haha.. and my personal opinion was if it was about the same amount of money between the RE and obgyn specialist, I would go wtih the RE. Just seems like they would have more experience.
Also, when I met with the RE for the consultation (which was $170), I also met with a financial person who went over each and every item and exact cost, which helps when planning.
TTC since March 2012
BFP 3/14/13!!!
U/S 4/15: Identical twins!
Lost my angel boys at 10.5 weeks
My Chart***My TTC blog
TTC since June 2012
I go to Midwest Fertility, the one in Carmel on 31. It looks like the main fertility clinics are all on the northside, other than ones that are in smaller practices/obgyns, like yours. There are 4 doctors, I think, at my practice. I see Dr Bopp.
I don't want to scare you or stress you out thinking you're not doing the right thing by not seeing a RE. Just looking back, and after hearing other peoples issues with infertility/obgyns, I'm glad I've been doing everything through the RE. He's done all my testing, I've developed a relationship him, and he just seems like he knows and understands what we are going through.
There's a RE in carmel, Dr Jarrett I think... My boss knows him, and he has great reviews & success rates. But, my obgyn has a close relationship with Dr Bopp, which is why I went with him.
TTC since March 2012
BFP 3/14/13!!!
U/S 4/15: Identical twins!
Lost my angel boys at 10.5 weeks
My Chart***My TTC blog
TTC since June 2012
I'm so sorry you are going through this and you ladies have gone through it. I'm right behind you. I'll be talking in the fall about all this with my obgyn if I'm not pregnant by then. I'm sorry y'all have/ are going through this but this information is so helpful.
I find it strange that everyone is billed after by their insurance. The only time that happens for me is when I go to the emergency room. I have to pay for everything upfront or arrange a payment plan ahead of time.
Athlete good luck.
KY, I want to thank you you for giving the info and recommendation on here. We hit the one year mark TTC in July. I didn't have an ovulatory cycle coming off BCP until November, so we plan to go have testing done in January (after all the holidays, basically). My cycles are ranging from 69-90 days right now, so I've mentally prepared myself that we will need to see an RE. I work near Midwest Fertility and have wondered about it. I know we're still several months from doing all this, but it seems so overwhelming just thinking about even where to start.