Clinics, Costs & Consult

Updated: Feb 9

My virtual consult appointment was made (since it was still a pandemic, they were doing all initial consults via Zoom!). I was all excited, nervous and a little anxious. But then I remembered.... I live in the USA. Why the sudden downer?


One word..... INSURANCE!


To anyone that doesn't reside in the US, let me explain. Medical care here is one of the most confusing, expensive and mind boggling things I have ever experienced. If you don't have private health care (which costs an arm and a leg), you are basically left for dead or left with a lifetime of hefty expenses that send most people bankrupt.


When I made my initial appointment I made the rookie error of not even taking into consideration my insurance and in network doctors (luckily yes, I have private health). I called the clinic and asked a few questions, most definitely was NOT in network but they said come anyway (laughing out loud right now). Instead, I thanked them and cancelled my appointment promptly.


Then comes the fun part... calling my health insurance company (insert eyeroll here). After 6 wrong voice prompts (my Aussie accent and American voice recognition doesn't work so well), being transferred twice and put on hold for at least 45 minutes, I finally got a person on the other line.


I started to explain that I wanted to have a baby but I needed some help to get there due to infertility issues. I then got some news that I was very excited about. My insurance has a $25,000 lifetime infertility limit! WOOHOO! I was told I just needed to ring another department and register with an Optum Nurse before I could get any further information.


I was connected to a lovely nurse, Kristy. I actually was feeling pretty confident in my insurance company for once and was thrilled that I got my own dedicated nurse. She started our conversation explaining all of the benefits. Then she asked the question... "does your husband have any known sperm issues?" Ouch. When I responded that I was single and planned on using a donor, she advised me that things might be a bit more complicated, DUH. Then the funny part, in order to qualify as 'infertile', you have to prove that you have tried to become pregnant for 12 months if you are under 40 or 6 months over 40.


I went silent. I reminded her that I was SINGLE. She said she understood that, and it meant that I would possibly have to try ICI (intracervical insemination, ie. the turkey baster haha), but it really depended on my test results once. I advised her that I had been told I couldn't have kids, my medical history and that I had tried with my ex to no avail.


She provided me with a list of accepted fertility clinics in the area, they must be a Center of Excellence in order to be covered. She told me that once I choose a clinic, they would then assess my 'infertility status' after all the tests and I would then find out if I was a candidate for coverage.



Choosing a clinic for me was pretty easy. I don't have a car, so that got rid of 3/4 of them as they were just too far away and no public transport. I came across Columbia University Fertility Clinic in Manhattan, right near Central Park. So I made the call right away. I was sent a bunch of online forms to complete and told that I needed to chose the doctor I wanted to see. I didn't really look into it much, I didn't think I really needed to, so I chose one, completed the forms and my virtual zoom appointment was made 2 days later.

 

HOT TIP!! If you are just starting out, I strongly advise doing a lot of research on the doctor. Some doctors are cold and very blunt & all about the science. If you are not expecting that, do your research!


If you prefer to be nurtured and for them to have good 'bedside manner', you will find a lot of reviews on the FertilityIQ site below!

 

My consult came around, I was so ready for this. Armed with a pen and notepad, we went through my story, my history, the same as I had told the United Healthcare Nurse. The doctor said I sounded like a good candidate, music to my ears!!


So then the doc asked me the question, was I interested in IUI or IVF?


At this point, I knew very little about either, except what I'd seen in movies or on TV. I clearly had not done any research at all. Here is a quick breakdown.

  • Intrauterine Insemination (IUI) is the process of putting sperm directly inside your uterus with a catheter. It is a very quick and easy process and far less invasive, and only requires oral meds and 1 injectable trigger shot.

  • In vitro fertilization (IVF) requires injectable hormones for several weeks, so that several eggs mature at the same time. Then a doctor surgically retrieves the viable eggs. In a lab, the eggs are either mixed with sperm. The fertilized eggs are then monitored for their development in a lab. A few days after the eggs fertilize, and become embryos (hopefully).

The chances with IUI are far less than IVF for someone my age, the odds are about 5% vs 25% but the sound of IUI was so inviting. I was glad when the doc told me I didn't need to decide now, we would wait for all of the tests to be completed to see if I was even a candidate.


After that, she started telling me all of the tests I was going to need to get done. I stopped writing after filling 2 full A4 pages with a bunch of scribble I had no idea what any of it actually meant! Luckily, I'd just had my annual physical with a ton of blood work already done (not fertility stuff but everything else they required!) So I already ticked a lot of boxes on their checklist!


The other thing I had to do independently, because I am 40 now, was a mammogram! Didn't even cross my mind.


Oh boy... I'm old enough to require to get my boobs squished in an x-ray machine for free now.... should I really be thinking about having a baby???




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