[GoldenTickets]

Okay ladies -- question for you!

It's that time of year at work where we enroll/make changes to our medical plans. Let me say that I have nice insurance.. it's affordable. DH and I both have our separate health plans right now. (Both our works require that we enroll in our own health plans... we're young and healthy and we don't see the need to pay the extra cost to enroll on each other's plans also)

At my work, we have different plans to choose from. I'm in the "middle of the road" plan... Good for people who are fairly healthy and don't have a lot of issues. The "best" plan actually will cover more things, including infertility treatments at 80%. Of course, the other costs increase with this plan too. The fertility treatments have a lifetime max benefit of $7,500 for treatments and $7,500 for prescriptions.

I was considering going ahead and switching to the "best" medical plan this year, just in case. I mean, I know people have miscarriages all the time, and then go on to have a healthy pregnancy. But if something is wrong, and there is actually a reason for the miscarriage, I don't want to wait until January 2012 for treatments, you know?

I didn't notice that there was a lifetime maximum for fertility treatments until tonight. So I guess here's where my questions come in...
1) How expensive are fertility treatments/tests? Between the doctor visits themselves, treatments, meds, etc.
2) What type of tests would they do with someone in my situation, if any? (One miscarriage, young, normal thyroid levels, irregular cycles)

At my D&C follow-up appt I told my ob/gyn we stated NTNP in August 2009 (when I thought we had started in November.. just a little fib). I got pregnant in June, so it made it seem like it took almost a year to get pregnant. My cycles are long/irregular, and I showed her a list of my cycles for the past three years, and expressed my concern about my ability to get pregnant. I spoke about the possibility of switching to an insurance plan that covers infertility in 2011, and she said that they could try Clomid with the goal of only having to be on it for a year (so I can go back to my normal insurance plan after that). This made me happy, that she wasn't going to make me wait until a year of actual TTC before doing intervention........ Then I later realized that we actually started in January 2010, not November 2009, so I got pregnant on my 4th cycle. I feel really bad about my fib now...... And I actually have an idea now of when I may be fertile, and my emotions are less raw than they were after my D&C.

What I'm wrestling with is if intervention/testing would be pointless at this point because my case doesn't seem that bad? Maybe they wouldn't be able to tell me anything anyway? Any testing they do would be basic, and maybe it would be better to pay out of pocket for these..... and wait to switch to the expensive medical plan if I ever have to get intensive medical help? (The $7,500 lifetime max would be better spent on expensive treatment, if I ever need it?).... Regardless, if I do pursue some medical intervention to help me to get pregnant, I would probably wait until March or so....

In case you're curious, here is a description of what is covered for infertility:

The Plan will pay charges in connection with the diagnosis and treatment of infertility problems, up to a Lifetime maximum payment of $15,000 per Participant split equally between infertility drugs ($7,500) and medical services ($7,500). The Co-Insurance you make for treatment of infertility problems will not count toward your Out-of-Pocket Maximum and the Plan will not pay 100 percent even if your Out-of-Pocket Maximum has been reached. Covered charges include in-vitro fertilization, artificial insemination, GIFT or ZIFT, and prescription drugs related to treatment of infertility.

AND in case you were wondering, my thyroid level is 1.74. (just had annual bloodwork for my primary care physician). My cycle length, in days, from when I started tracking in summer 2007 to the cycle before my BFP... 130, 117, 39, 39, 78, 28, 66, 36, 39, 35, 34, 40, 33, 64, 41, 51, 50, 26, 46. (What's funny is that the 5 months in a row where my cycle was between 35-40 days I was STRESSED OUT due a special project I was on at work. More stressed that I had ever been in my life. Stress is supposed to make your periods irregular, but not for me obviously! My stress level was low during my LONG cycles too... weird!)

Okay, sorry for the novel ladies. But thanks for any help or advice you can provide!

[ohnicole]

It's totally a personal decision. If your main issue now is irregular cycles, then Clomid with monitoring sounds like the place to start. Clomid is pretty cheap, so it's really the u/s you are paying for... at my clinic, the first u/s in a cycle is $350 and any additional u/s in that cycle are $250. My RE is shooting for just one u/s before O to check follies, but a lot will also add in an early u/s to make sure there are no cysts.

I think it will really depend for you on how crazy you are waiting on your irregular cycles. For me, I just reached a point where I was done with that, and I was ready to O on time. And the Clomid plus u/s is worth it to me.

If you eventually need other treatments they can get more expensive, I think meds for an injectible cycle run around $900, IUI runs around $300 at my clinic, and IVF averages around $15,000, meds included. I think in your case, they may run some hormone bloodwork (glucose, insulin, prolactin, and CD3 estrogen/LH/FSH). Those can add up. A semen analysis is about $150, and an HSG runs somewhere in the $1000 range.

Sorry if this is rambly and out of order, but I hope you figure it out!