Insurance: Covered or... Not

It's How Much for IVF?! O_o

When it comes to IVF (in vitro fertilization), there doesn't appear to be any cheap routes whatsoever.  Some find themselves against a brick wall much like we felt when wanting to use an agency to adopt.  Some $20,000 price tag attached and that was one of the smaller fees.  I don't know how I managed but two years ago I was able to get our health insurance to cover my $50,000 Duodenal Switch weight loss surgery and we thought I would get pregnant after getting that weight off.  It didn't happen and now we know whatever I do it won't get me pregnant, as I was not the one with the complications.

So, here we are with Aetna health insurance through Nate's employer, Kraft Foods Global.  We have always had great insurance with them.  I have been calling into Aetna a lot, asking around and asking my fertility clinic about the financial burden that IVF can be.  We were provided with good news in two instances:

• Aetna covers $30,000 lifetime maximum medical coverage for fertility with the plan we have
• Ironically, effective January 1 2012, if the fertility drugs are billed through a pharmacy instead of with an office visit (medical claim) then the fertility drugs will be covered up to a lifetime maximum of $15,000 (if billed with an office visit they count towards the $30,000 medical)

Now, let me tell you how amazing this is.  My fertility drugs they are putting me on for the February procedure are going to be $5,000 and I thought for sure they were going to be out of pocket.  God just blessed us again.  We are so blessed that they are covered.  We were smart though to make sure to take flexible spending money on both our employers to cover any medical costs outside the realm of insurance like the sounding I am doing in February which is $350 out of pocket.  That, my friend, is so being paid with my Flexible Spending Account card. And this is just the beginning.  I am about ready!

Our shot education class is January 10th and I go on my first trip the 11th.  The IVF will be in mid-February and we are so excited.  This is a rare instance where an insurance company is truly doing what they should- cover fertility treatments.

Beautiful Uterus

*Warning: Some content is inappropriate so...

if you are gonna tell me so...

or complain or tease me-...

save yourself and...

x out of the window.

  Thanks!!

this blog and all contents within the blog are for both humor and education from what we are learning- have fun, lifes too short to be so serious

So, time for some more tests.  I have been found to NOT carry the CF gene (Cystic Fibrosis gene) we previous discussed.  We now are able to proceed.  We go in on a Sunday morning to the hospital, why a Sunday you wonder? Well, it was day 3 since starting menses and I had to have the hormones checked in my blood that particular day so 7:30am, Nate in slippers, we arrive.  There is a room full of young couples.  Few women alone. We wait for a short time before being called in to have blood drawn.  Nate was being tested for HIV, as was I plus my hormone levels.  Checking for things like FSH and I did ask what we were looking for there.  I was told my the amazing nurse that if the number comes back in the teens it means the brain is working harder for creating hormones to have an easy pregnancy/conception and also means a nearing of menopause which I want nothing to do with at this time.  No way.  I am 33.

*For those of you wanting more information on testing with a HIGH FSH see this: FSH stands for follicle-stimulating hormone. It is a hormone that is produced by the pituitary gland that, in the female, stimulates the ovaries to develop a follicle (the housing that accompanies the egg prior to ovulation) – each month. It can be thought of metaphorically as the gas pedal which causes the ovaries to ovulate each month. As women age, it becomes more difficult for the ovaries to ovulate as the supply of eggs gets reduced and so the level of FSH rises (in order to push down the gas pedal further) over time. When a woman enters menopause, her ovaries are depleted and the gas pedal stays depressed permanently; that is to say the FSH level remains high. It is also possible for young women to have prematurely high FSH. source: http://en.wikipedia.org/wiki/Follicle-stimulating_hormone*

It was only three hours before I received a call from the reproductive office mentioning that my level for FSH was 6.something which is great and the other levels were normal, as well.  Again, we proceed.  We haven't received our HIV tests back but that is the last of our concerns at this point.  Test for Sono is scheduled for the 22nd of December and the sounding will wait until the day of either egg retrieval or implantation.  I do not recall.  The sounding normally takes place the same day as the Sono but due to being on the cusp of a new year I had to split them as one is covered by insurance (sono) but not the sounding prior to IVF- it's out of pocked either $350 or $375 SO... I am using my Flex Spending Account after January 1st to cover it.  I made sure to load up on my employers and Nate's for flex spending to help compensate anything that may be needed out of pocket this year going through IVF, pregnancy, childbirth and normal health.  (I am going to create a new blog about insurance coverage, etc so I can elaborate on the flex spending, as well)

I went into my sono appointment early in the morning.  No big deal, only a tad nervous that something could go wrong like with Nate and his condition.  Total shocker for us.  So, in the dimly lit, very modern and comfy clinic room I undress from the waist down (yep) and cover myself with what any man would believe to be a table cloth.  I sat for about fifteen minutes waiting, looking around and thinking.  Waiting.  Anything fertility related makes me instantly anxious and impatient. :) Human. hehe

Tap, Tap! It was Dr. Doherty and a helper (I am terrible with names, sorry!).  They were giggling and Dr. Doherty was looking so... non-sterile. I mean that as a total compliment.  She was in dressy clothes, her normal cute heels and great hair- big smile.  This woman radiates whenever I see her.  I feel such a positive energy with her presence.  This is the woman that is going to make our dreams come true.  The woman that is going act as our stork in the life of reproduction.  She is my savior on earth, a true angel and it makes me choke up on how much she means to so many people.  Making huge dreams come true.

They start prepping and I get that hand motion to lay back and get in the stirrups. Previously I had observed a fancy odd computer for ultrasounds or so I believed, I saw a catheter- why was there a catheter? I don't like those.  Eek.  There is a small cup of a brown liquid and the usual long swabs.  So here I am, feet up, legs spread with two women with front row seats. Now, if you know me, this is prim-o, grade-A, , awkward and awesome material. Now they're poking around, business as usual, when the assistant says 'you sure do have the eggs'.  LOL.  How do I respond to that? LOL  I want to crack up. O-M-G. I must be a freak of nature. She starts pointing out how the gaining of 15 pounds (which I have almost done) and stopping exercising for now will be the perfect combination for IVF.  When the examine is over, my doctor sincerely looked me dead in the eyes and told me I have a 'beautiful uterus and things couldn't look better'. That's right people, be jealous. I have a beautiful uterus. I have to laugh about this.  I had no idea how to respond to that so I simply replied, "Thanks?" She gave me a big smile and said there shouldn't be any problems with the IVF.  We are all ready to go whenever we say - GO!  After talking with one of the girls there we realized we really have to wait till mid February to do the IVF due to my extensive travel schedule.

*a brown watery soap was used to 'wash' the lining of my uterus by injecting it with the catheter and then the sono was done to view the uterus and these are the pics I took. Now if you have medical knowledge and 'see something', I did overhear a conversation not to worry about it and that it appears to be in the abdominal wall. I didn't ask but I only assume weight loss surgery related- probably scar tissue being seen but that is pure assumption.

Next Appointment: January 10th, 2012: Shots Education

Next Blog: Insurance Related, coming soon

Born WITH a vasectomy? Huh?!

Today, I want to explain exactly what we are going through with Nathan's medical condition that we were not aware of until the fertility testing began last month (November 2011).

It was a bright weekday and I was on my way to pick up some lunch.  My cell phone rang and that isn't that common.  I usually just get text messages anymore.  It was the RN calling with the results from Nathan's semen/sperm analysis.  She said we found the problem, Nathan has zero sperm.  None.  She was stern.  She said something about urology, infertility, a specialist.  I instantly started to think of so many different things, my eyes welled up and I pulled into the Home Depot parking lot.  I was so shocked and confused.  I knew nothing about the possibility of zero sperm.  What did this mean?  The information we were given was interpreted as quite negative.  I was devastated.  I asked a few questions and it did not sound promising.  Did I just hear that I would need a sperm donor?  Was this really happening?  The next few days were horrible.  We did get an appointment set up with two doctors: a Urologist and a fertility doctor whose name I kept hearing.  Nathan either has obstructive or non-obstructive azoospermia.  Azoospermia is the complete absence of sperm in the semen.  The volume was also lower than the norm.  Obstructive means he is producing sperm but it is being blocked somewhere.  Non-obstructive could mean something as serious as testicular failure where no sperm is even being produced.  Now, there are other medical conditions where there is little sperm or low mobility- we had none of this.  There was no sperm whatsoever in the first analysis.

After having our first visit with Dr. Maud Doherty at 192 & Dodge Street in Omaha, we felt so much better.  Whether we needed a donor or could 'find' sperm, there were choices.  She did explain what was needed to be done and in what order.  We needed to start with blood work.  Then possibly a biopsy of testes.  What?! Nate's mouth drops to the floor, he starts talking a lot- obvious sign of his anxiety.

Next, testing for retroactive ejaculation where sperm escapes into the bladder instead of with the semen and out of the body.  Nate went in and still- no sperm in his semen, low volume even after extended days and no sperm in his urine which was also analyzed.  We had completed the hormone tests for Nathan and his fructose levels were low, his testosterone was normal.  He appeared to be a healthy man at 34 years old.  This made Dr. Doherty believe that Nate had obstructive azoospermia.  So, it was time to find the exact cause.  This would be slightly scary for Nate at this point.

I brought Nate to the Methodist Women's Hospital that also helps men by having the wonderful urologist and booked up Dr. Morton.  Talk about the nicest and most helpful person in an uncomfortable situation.  Nathan was given a local anesthetic in an in office procedure to biopsy his right testes.  His left would remain untouched in the case of later sperm retrieval for IVF.  Nathan was given a 'block' so he wouldn't feel the biopsies.  (nathan gives me full permission for OUR fertility journey, he's so damn cute!) we hope this helps another couple out there.

Dr. Morton was able to tell by a physical evaluation that Nathan was born with Congenital bilateral absence of the vas deferens (CBAVD). There was a needle like gun that made one click noise each draw, filling a very large test tube with pink like fluid.  Poor Nate.  He looked ok.  Eee.  I allowed him to decide if he wanted to attempt this and I am so thankful that he did because 15 minutes later we were told there was SPERM! Yay!  This would be IVF depending on my CF screening.  And again, we wait.   It was a rough few days for him as he healed and he was prescribed percocet / Oxycontin.

Nate recovering from testes biopsy

See the image below re: Vas Deferens

Nathan was basically born with a vasectomy.  In the case of a vasectomy the vas deferens are snipped and thus the sperm can not travel to the semen and out of the body.  Nathan was born completely without those vessels that transport the sperm out of the testicles where it is produced and to the semen.

Now, why was Nathan born this way?  We were about to find out but had more tests and more waiting to do.  Next, the CF gene test.  We were gonna screen him for the Cystic Fibrosis gene in many of its mutations.  He was positive.  This is why we were having this problem of infertility, obstructive azoospermia.  The CF gene that Nate carries isn't even the most common mutation per Dr. Doherty but that is what has caused this/ medical condition demanding medical intervention and assistance in having a child.  If I have the CF gene and Nathan has it we know, then we are at a 1 in 4 chance of having a child with the Cystic Fibrosis disease.  This is a tragic disease.  Dr. Doherty fully recommended we not use Nathan's sperm if the case is we both have the gene.

I called a couple times to see if my results were back on the CF screening.  It had been exactly a week.  I can't wait.  I need to know.  But, during a conference call- I got the call I was waiting for.  I tested negative for the CF gene.  We would proceed with the IVF (in vitro fertilization).  We have Aetna insurance and are allowed up to $30,000 in fertility treatments.  So... here we go.

That brings us to today's date:  12/19/2011