which Pre-IVF testing is mandatory?


#1

Just when I thought we would be able to afford all of the IVF I keep learning of more and more expenses. Now I am being told by the clinic I would need pre-IVF diagnosis testing. Ok I understand the purpose of them testing my hormones and doing an ultrasound. But why do I need all of these other expensive tests when there is absolutely nothing wrong with me! I have been tracking 37 cycles now with Basal temp and ovulation tests and I have ovulated every single cycle. I have 2 children conceived first attempt, no complications in pregnancy, and absolutely no signs of any fertility problems once so ever.

My main concern is HSG. Do I have to have this before starting IVF? If I have to spend thousands more on Pre-IVF testing than I won’t be able to afford the actual IVF! I am starting to loose hope about being able to do this at all. every day I am learning of a new expense and all I do is cry everyday now.

Which tests did you HAVE to get before IVF and which are optional/depending on circumstances?


#2

It is RIDICULOUS the number of tests and meds that an IVF cycle requires!

Can you chat with your RE and explain that you are paying all of this out of pocket? If you haven’t had any issues with ovulation/tubes in the past, maybe they will let you skip the HSG? YOU are the one coming to them for a baby, so if YOU say no, that should be something they consider.

I know clinics have to be careful, but I felt a lot of the testing I did was both harmful and non-essential. I did my HSG years ago, so I didn’t have to repeat that…but I did have to do the saline sonogram, which lead to a terrible infection and I found extremely uncomfortable. Only to tell us “everything looked great.” I think the infectious diseases bloodwork is non-negoatiable, but unsure about that. A mock transfer is a good idea because it really does help with knowing where to plant the embryos.

Again, ask your clinic and explain your situation, and see what they have to say. And check around and see if other clinics are more flexible…you’re right, why go through testing and not be able to afford the IVF? The whole cost of IVF just makes my blood boil. It is absolutely NOT OKAY.


#3

an HSG is an essential test - they are looking to see if your tubes are open. If they are open, it can rule out tubal infertility as a factor and help them figure out what might be the root of the problem. The issue here is that IF is a very complex diagnosis. If you have blocked tubes, it could indicate a larger issue like a hydrosalpinx (an infected tube which could prevent an embryo from implanting) or endometriosis - which could likewise have a toxic affect on your eggs and embryos.

The reason they do all of these tests beforehand is to minimize the risks of the IVF not working for some reason. Would you rather pay a couple of hundred dollars for an HSG to find a problem, or waste $10,000 on an IVF that was destined to fail and then find out that your RE could have saved you a lot of heartache?


#4

The only tests I had done before this IVF were blood work and a saline sonogram. I had just given birth to my DS less than 8 months before (so I knew I could get pregnant via IUI) and I thought the saline sonogram was going to be an easy test to pass. Turns out they found a polyp. I was like, WTF! I’ve never had one before and just been pregnant w/ tons of u/s and no one ever saw it before. So it must have been new. Goes to show you never know what’s going on in there, even if you’ve been pregnant before w/ no problems. I had the polyp removed via hysteroscopy prior to this IVF and at least I know it won’t interfere w/ this pregnancy.

I did not have a mock transfer, and IMO those seem like a waste unless you have an oddly shaped or tilted uterus. My transfer took all of 1 minute w/ the RE never having done a mock transfer. I did have an HSG a few years ago before I conceived my DS, so I don’t know if they considered that sufficiently recent to not repeat.

I agree w/ the previous posters that insurance might cover some of it. I do not have any infertility coverage but my current insurance does cover blood work and diagnostic tests. Although the insurance I had when I conceived my DS did not cover anything if it was related to infertilty, even testing, so it could go either way. Doesn’t hurt to have the RE’s office call your insurance to check.


#5

If i had to do all over again, I would have everything tested before starting IVF. I had all the pre-IVF testing done but skipped genetic testing ( didnt know you can test for all genetic disorders at the time), waited til i had chemical pregnancies to get recurrence pregnancy loss panel testing and some other immune testing. You will be more devastated if let’s say the IVF works but because you didnt get tested to see if you’re immune to chicken pox and varicella you put your pregnancy at risk.


#6

Insurance paid for my HSG after a little bit of a fight, and covered my infectious disease testing, too. I got a bunch of my hormone testing covered by insurance but some of it had to be re-done since my OB ordered the tests and didn’t do them according to what an RE would need. HIV/Hep testing is mandatory per FDA. I absolutely agree with everyone else that skipping testing could cost you more in the long run.


#7

The pre-IVF testing usually includes but is not limited to:

  • Blood work and LOTS of it - tests AMH, FSH, LH, etc
  • Screening for STDs for you and your partner
  • Semen analysis
  • Clean PAP and possibly breast exam
  • Ultrasound - to check your ovaries/uterus
  • Mock transfer - lets them know how the catheter needs to go into your uterus during the transfer - how deep, how your uterus curves, etc
  • Saline sonohysterogram/HSG or other procedure to check your uterus - makes sure you have no polyps or other uterine anomalies
  • Doppler ultrasound - checks bloodflow to the uterus
  • Genetic testing if you’re interested (optional)

That’s what I remember…there may be more.

Most clinics want you to do a CCT - or Clomid Challenge Test…

Don’t get discouraged! You can do it! It may just take a little more time!

A LOT of the tests can be done at an OB’s office and covered by insurance that way too if your RE is willing to work with you that way.


#8

We didn’t need to do a mock transfer or the Clomid test but did most of the others. Our insurance doesn’t cover IF but DID cover the testing (mandated in NY). I did have to fight about the HSG but in the end they paid. I agree with trying to get your OB to do some of these, I had them all done by an OB instead of the RE.


#9

As others have said, it’s well worth the expense to do thorough testing BEFORE you spend lots of $$ on the IVF cycle in order to maximize your chances of success. This is true even if you currently believe that male factor is your only diagnosis and you’ve successfully had children in the past.

Your body is always changing, your fertility decreases as you age, and common growths such as uterine polyps and fibroids can and do prevent implantation and increase the chances for miscarriage. An HSG or operative hysteroscopy are critical in order to get your uterus in top condition. Depending on your insurance, there’s a good chance it will at least partially cover these procedures as they are diagnostic.

Good luck!


#10

I still disagree that an HSG is always necessary. Perhaps if the diagnosis is “unexplained fertility,” it’s a good step to take. But for me, we KNOW why we aren’t getting pregnant…I have no sense of smell and don’t ovulate. Ever.

It’s nice to rule things out, but when you KNOW why you can’t get pregnant, spending extra money (and a LOT of money, at that) on tests like an HSG is very frustrating. I see why they do it, but it sure is a hard pill to swallow.

Hugs to the OP!


#11

So I was able to talk to their advisor and they told me since I have never had any fertility issues and if my ultrasound and blood tests come back with no further concerns than I should be able to skip the HSG. Thank you Lord! We are trying to get past a vasectomy that is all. I understand most women get the HSG but I will take my chances. Not only do I not like how invasive it is but it would run me another $1700! We are going to barely scrape by being able to pay all cash for the first fresh cycle and I hope to be able to pay some cash on 2nd cycle if needed. So I definitely can not afford spending money on tests that I don’t need.


#12

[QUOTE=NicoleJean]So I was able to talk to their advisor and they told me since I have never had any fertility issues and if my ultrasound and blood tests come back with no further concerns than I should be able to skip the HSG. Thank you Lord! We are trying to get past a vasectomy that is all. I understand most women get the HSG but I will take my chances. Not only do I not like how invasive it is but it would run me another $1700! We are going to barely scrape by being able to pay all cash for the first fresh cycle and I hope to be able to pay some cash on 2nd cycle if needed. So I definitely can not afford spending money on tests that I don’t need.[/QUOTE]

NicoleJean - I know you probably don’t want to hear this but, at the very least, I’d do a saline sonohysterogram…it’s less invasive, easier, and that way they can check for polyps/fibroids and stuff. My clinic only charged around $500 if I remember right…I’d have to look it up though to be 100% sure.

I did PM you too in case you didn’t realize.

The thing is - with the fibroids or polyps - if you don’t spend that little bit of money - and I know it seems like a lot now but in the scheme of “IVF” it’s not a lot (I know…it’s hard to stomach it all sometimes) but…if you spent $12k or so on a cycle (or more) and then had a miscarriage or problem with the embryo implanting…ask yourself if you’ll be able to deal with that emotionally? The thing with IVF is…we’re constantly questioning ourselves and everything we do it seems…maybe it’s me but I am totally OOP too…I just would hate for something to happen that could be prevented…your OB can do a saline sonohysterogram or even HSG and it should at least partially be covered by insurance…if your OB isn’t willing to help you with it - I say find a new OB. There are a lot of fish in the sea that are willing to help you.


#13

$1700 for an HSG!! Holy cow! I paid out of pocket for mine a few years ago and it was less than $400…it was at an outside radiology center, not at my REs office. And its not any more invasive than anything else for IVF. Took all of about 10 minutes…

I would also agree at least do a saline sonogram (basically an ultrasound where they put saline inside during the u/s). That would at least spot a polyp. I think mine took 5 minutes at my RE office and wasn’t any worse than having an ultrasound.

Good luck whatever you decide! I feel your pain on paying out of pocket…no insurance coverage sucks!