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    Old 03-11-2006, 01:02 AM   #1
    Joliving
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    Thinking about IUI due to Male Factor

    Hey there, I am new to this board, I have been trying to find others that can relate to me on this fertility stuff. My husband and I have been TTC for almost 11 months now, we found out my husband has a low count and low motility. That was 4 months ago and we just got another SA done today, we don't know the outcome yet. I have had him on a lot of vitamins that are supposed to help sperm so I am praying the outcome of this SA will be better. I would like some advice on assisted conception. I have not even visited an RE yet, only been to a urologist for dh's issues. I have no fertility problems that docs have detected and I ovulate fine every month, we're just dealing with dh.

    Financially, I don't think we'll be able to afford IVF, though I would like to skip right to that. As far as I know, our insurance won't be covering anything, but I really can't say for sure because I haven't looked into it yet, though I just hear most insurance plans do not cover any infertility unless your in one of those states that cover it.

    So we're considering IUI, I tried to schedule an appointment with a reproductive specialist today but I got an answer machine so I am hoping to receive a call back on Monday and get a consultation appointment set up. How low is usually too low of a count for them not to consider you for IUI? Our urologist seemed to think we would be able to try IUI but my husbands count was under 5 million 4 months ago. His motility was only 20% but I was told sperm washing before IUI can up that motility a lot.

    I have a good friend that had been TTC for 13 months, her dh's motility was in the normal range of 42% but they went for IUI due to her having severe ovulation problems that not even clomid was helping. They still did the sperm wash on her dh and his motility went from 42% to 92% with the washing, so I thought that was great. She was blessed in becoming pregnant on her first attempt at IUI and thats whats really got me thinking about it. She was on all kinds of injectables for herself and she did back to back IUI's, 1 one day and another the next day, I can only pray that I would have such a good outcome.

    Though her situation was different than mine since we're dealing with male factor. So if anyone can relate to me and give me some advice, info, etc, I would really appreciate it. I want to look at doing IUI in May if we go for it, so that gives me 2 more cycles of natural TTC...anything is possible through Christ so I know we can end up being blessed before the potential IUI. I was going to wait until July, after my vacation, but the emotional stress is becoming too much for me.

    Took a pregnancy test today, negative, I took it hard, probably the hardest I have in awhile, April will mark one year of TTC. Sorry I made this post so long, I have so much on my mind. Thanks for reading, God Bless!

     
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    Old 03-11-2006, 02:21 PM   #2
    dh22
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    Re: Thinking about IUI due to Male Factor

    from my expeience IUI won't be as successful if it is mostly male factor... but it depends on specfically what is going on with your DH.
    best bet is to talk to a specialist.
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    Old 03-11-2006, 07:34 PM   #3
    km7503
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    Re: Thinking about IUI due to Male Factor

    Joliving4Jesus, Welcome to the board!
    You and I sound really similar with our situations. My DH and I will be TTC for a year in May. My DH also has a low count, low motility, and low morphology. He has had 3 SAs done. There hasn't been much improvement and he has been on vitamins, but not long enough I think b/c it takes about 74 days. Anyway, I didn't think we'd be covered for IVF either until I checked it out and it turns out, we have unlimited tries! But, there are also issues with me, since AF is irregular and I'm not sure if I ovulate. We are in the beginning of our first cycle now. I just started the Lupron injections.
    Anyway, I wanted you to know that IUI wasn't even recommended for us. Our RE went straight for IVF with ICSI, she never even mentioned the stats for any other method, so I'm assuming they were too low or not worth trying. I don't know if that will be your outcome, but I have heard of other women who had similar situations, and had the same recommendation.
    I also wanted to say that I know that it can be very frustrating, but this is a great message board. The women here are very helpful. One thing is for sure, you are not alone, no matter what path you choose.
    Good luck!

     
    Old 03-12-2006, 06:28 PM   #4
    Joliving
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    Re: Thinking about IUI due to Male Factor

    Thanks so much for the replies, its really good to have some people to relate to me. KM75, which insurance company do you work with? I have Blue Cross Blue Shield but know very little of what they cover, I just assumed most insurance companies do not cover infertility, maybe thats starting to change, I hope so!

    Here is a paragraph about IUI from Georgia Reproductive Specialists that I will be visiting: Intrauterine insemination (IUI) is a procedure in which sperm are placed directly into the uterine cavity through a catheter near the time of ovulation. This procedure is most commonly performed when there are problems with the sperm, such as low count or low motility, or an incompatibility between the sperm and the cervical mucus. It can also be performed to overcome problems associated with a man's inability to ejaculate inside the woman's vagina due to impotence, premature ejaculation or other medical conditions. IUI increases the chances of pregnancy because the sperm are placed directly in the uterus, bypassing the cervix and improving the delivery of the sperm to the egg.

    So it seems as though IUI is most commonly done for sperm problems and I heard it was a higher success rate with male factor over female infertility, but who knows. The only reason I am thinking of IUI is for the price, if its out of pocket, I won't be able to do IVF, at least not at this moment, but maybe I will be pleasantly surprised to find out I have coverage for IVF, if so, I most definitely would skip straight to that, I am young, only 23, with no apparent ferility problems. My dh is 33, so I don't want him waiting too much longer to become a daddy and I do want to be a young mom. So if I called my insurance company, would they be able to tell me if I have any infertility treatment coverage? I know they covered nothing of my progesterone blood test because it was listed under infertility, so would this probably mean they do not cover anything to do with infertiliy?

    The Georgia Reproductive Specialists had a section on their page about insurance companies they were in contract with and my insurance company was listed, do you know what it means when they say their in contract with them? I haven't set an appointment with them yet but will be calling them back tomorrow if I don't hear from them, so I don't know how much info they will be telling me over the phone, their is so much I don't know about all this, but I do feel that I am so ready to become a mother, my dh feels the same way.

    Thanks again for the replies, look forward to meeting more of you ladies. God Bless!

    Last edited by Joliving; 03-12-2006 at 06:31 PM.

     
    Old 03-13-2006, 03:46 AM   #5
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    Re: Thinking about IUI due to Male Factor

    Well, I have Blue Cross Blue Shield of Illinois...My husband is with the National Elevator Division and has excellent coverage. We do have to pay some co-pays on the meds, (we are with MEDCO) and we have a small deductable of $300. Maybe, the blood work payment was part of a deductable? You should find out.
    You can just call your insurance, and they should be able to tell you. You could probably also check online. I'm not sure what "in contract" means with your RE but, it's probably a good sign that you have some coverage. Even if it's not all, some is better than nothing!
    Also, I think that info on the IUI is accurate. In fact that's what my OBGYN had suggested we could do after analyzing our first SA, before my DH went to a urologist, and way before we went to an RE. But I have been reading that the male needs a good enough sperm number for IUI to be considered successful. I think it's at least 5 million. Since my DH has less than that, they probably went right to IVF to increase our odds. At first I was worried about the #, but they said that what he had was plenty for IVF.
    Anyway, get online, or on the phone with both your insurance and your RE and get some info. The waiting and not knowing is worse than just finding out what your options are. (I was hesitant at first too, but the call was so worth it, I felt 100 times better knowing!) Keep in touch, and let us all know how it works out for you. Good luck!

     
    Old 03-13-2006, 06:49 AM   #6
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    Re: Thinking about IUI due to Male Factor

    Just wanted to pop in and give my 2 cents. Insurance coverage depends on the company that employs you rather than the insurance company itself. There are also states that are mandated by law to cover infertility. KM7503, Illinois in one that is mandated by law to cover infertility including IVF. I live in Texas and Texas is only mandated to OFFER the coverage to employers but the business doesn't have to purchase it. My husband's company was bought out a few years back and the insurance company didn't change, however benefits did. We went from only having diagonisis coverage from having $10 grand coverage including IVF. We have to pay our deductable of $350 and then we are responsible for 20% but it is 20% of negotiated costs verses the actual costs that a person pays cash. There are of course loop holes and exemptions. Illinois has a less than 25 employee exemption, where as Maryland has a less than 50 employee exemption. My advice is to call your insurance company several times and ask. Even after my husband's company was bought out I called and was told we had coverage, then I called the RE's office and when they called to check coverage they were told none existed. I left it at that and a YEAR later I ran across some informations stating coverage and began e-mailing my insurance company. They wrote back in black and white our coverage which INCLUDED IVF. I was soooo upset because a year had gone by. I contacted the RE office again and told them my news. They again came back telling me I had no coverage. I finally called the insurance company and asked to talk to a supervisor and it ended up being that they have a specific department for inferitility. She gave me the 800 # and told me to have the RE's office call them directly. They called and verified and we are on our way to IVF. Good luck, I now personally the strain financially this can have on a couple. There are also financing packets that are offered at most clinics. The one I go to has a 3 time guarantee. They finance 3 attempts for a certain price and if by the end (I think 18 months) if you do not have a live birth you are given a % of the $$ back. There are guidlines to that to though, like FSH levels, age, and SA counts.
    I know I wrote alot, hope some of this info helps.

     
    Old 03-13-2006, 07:43 AM   #7
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    Re: Thinking about IUI due to Male Factor

    IUI is better than natural TTC for male factor but it's not as good as IVF. We did a few to give it a chance, but if you aren't averaging 10M good swimmers they'll recommend getting more aggressive. (When a woman buys sperm from a sperm bank, they get their money back if it isn't 10M.)

    Obviously it varies from state to state, and even most "state mandates" don't mean that everyone with insurance in that state gets the coverage. For example I'm in Illinois and we have a state mandate that all group plans IN ILLINOIS must offer the coverage. But all an employer has to do is "sign the certificate" for the plan in another state to avoid the coverage. So check with the employer before you take that job.

    That said, many large companies offer it, especially if they have employees in different states. Not that we can list every good employer here, but Classified Ventures and Computer Associates are two examples for full-time. Another example is the temp/contractor agency Aquent, great if one spouse temps. You qualify for the coverage by averaging 20 hours per week over a rolling 4-week period, and when you become disqualified between assignments, you go into COBRA. While you are working, the coverage is very cheap, but COBRA is about $450 a month. It seems expensive, but the price reflects the fact that there's no deductible -- otherwise the accounting people would have a nightmare trying to carry over the deductibles as people move between the eligible and COBRA versions of the plan. Anyway, the COBRA coverage for a month costs about the same as an IUI and is WAY CHEAPER than IVF.

    (This is just to give a general idea of how the coverage can work. I was freelancing for awhile and worked out of Aquent partly to keep this coverage.)

    Clinics also understand the financing issue and some offer "shared risk pools." This means the quicker it works, the more you pay. If you do a certain number of tries and it fails, you end up paying nothing.

    So don't assume you can't afford it!

    You are luckily only 23 now. My advice is that if you have male factor you are wise to plan for IVF. Begin putting money away now in a mutual fund, separate from all you other investments you need to make as a couple. By the time you're 30, you'll have enough for a couple of IVFs if you need them. There are online calculators that will tell you how much to put away every month and choose a medium-term risk/reward ratio. with any luck, you won't need it and you'll be able to stop that investment and have a little nest egg.

     
    Old 03-13-2006, 07:48 PM   #8
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    Re: Thinking about IUI due to Male Factor

    Hello. My husband and I are dealing with low motility and poor morphology. We've been ttc since December 2004 with no luck. We've talked to our specialist about all of our options and she doesn't suggest IUI. She will try it for us if we want, but she said we'd have no more than a 10% chance over four tries. My husband had surgery for bilateral varicoceles in January, and we're going to have another SA in April (after the 78 day mark) and we'll check if there's any improvement. If we don't see the results we're hoping for, we'll likely go forward with IVF in May. IVF is really, really expensive, I know ($12000!!) but our chances are 70% with IVF, so I'm hoping we'll end up with a baby in our arms and the money will seem totally worth it.

     
    Old 03-14-2006, 12:50 AM   #9
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    Re: Thinking about IUI due to Male Factor

    Thank you all so much for the replies, its a lot to take in, I've had a really rough night, my dh and I got into it a bit. I was discussing the possibility of IVF with him and he said he would go for it if insurance covered it but if it does not that we just cannot afford it, I asked him what we were supposed to do then? That might be all the RE recommends for us and I just cannot give up my dream of having a biological child. Dh knows this but he is going to want to wait longer if insurance doesn't cover it and the waiting now is just killing me. I know that God can let it happen for us anytime but my patience is running so thin, I wish I was stronger!

    I just don't know what to do, the costs of IVF are through the roof, all I can do is hope and pray that our insurance will cover it, we have excellent medical and dental coverage and its one of the most popular insurance companies, so I am holding out hope that they will cover, but it worries me that I am not in one of the mandated states for coverage and my husband works for a very stingy company that probably would not go the extra mile for infertility coverage. I am actually scared to call my insurance company to find out because I am afraid I will be so disappointed and not know where to turn if they say their is no coverage . I know I have to find out sooner or later.

    Question, the hospital my dh did his SA at said they usually get results in the same day and then their faxed to our urologist, we have an appointment with our urologist this Monday but I am kinda anxious to find out the results now, do you think if I called the urologist they would be able to give me the results over the phone? I know with our first one, the results were sent to my obgyn and they gave me the results over the phone, but we've only been to this urologist once so I don't know much about them. I think I am going to be so nervous to walk in the urologist office Monday not knowing the outcome of the second SA yet .

    So many questions, so many wonders, I can't wait to get some answers, thanks again for all your help, God Bless.

     
    Old 03-14-2006, 07:57 AM   #10
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    Re: Thinking about IUI due to Male Factor

    I am actually scared to call my insurance company to find out because I am afraid I will be so disappointed and not know where to turn if they say their is no coverage . I know I have to find out sooner or later.

    This is not criticism, just advice. Get over this RIGHT NOW! It is a long road and even though you're very young, you'll lose that advantage if you let the grass grow under your feet. By waiting you are giving up your power to (for example) look for a job YOURSELF that has the coverage, or start the investment plan I suggested. In the meantime you can get some of the less expensive tests and procedures done.

    More importantly, you need to try to toughen up, because you as yet have NO IDEA of the emotional rollercoaster this will be, even if you end up getting it all for free (as I do). You may think it's tough now, but it only gets tougher when you're dealing with "this is my big chance" or worse, pregnancy following infertility. I hate to say that the emotional rollercoaster does not exactly end with that positive test -- it can get worse. My husband is talking about stopping NOW even with two free IVFs left because of the trauma of years of infertility, IUIs, IVFs and two miscarriages.

    Question, the hospital my dh did his SA at said they usually get results in the same day and then their faxed to our urologist, we have an appointment with our urologist this Monday but I am kinda anxious to find out the results now, do you think if I called the urologist they would be able to give me the results over the phone? I know with our first one, the results were sent to my obgyn and they gave me the results over the phone, but we've only been to this urologist once so I don't know much about them. I think I am going to be so nervous to walk in the urologist office Monday not knowing the outcome of the second SA yet .

    Call the urologist and ask for the results. Your right to this information is much more important than their convenience, or "how they prefer to do things."

     
    Old 03-14-2006, 01:03 PM   #11
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    Re: Thinking about IUI due to Male Factor

    I understand what your saying but I will admit, I am not a very strong person with certain things, not all things, this is me, and I have a good idea of the amount of stress this is all going to put on me, I know what I am experiencing now is nothing to what I have yet to come. But I have fears, concerns, what not, and it just isn't going to go away over night, its going to be a process.

    I am not looking for a job, my dh is looking for a new job and he isn't looking particularly for places that cover infertility...we're just wanting to hold on to his current job if our current insurance covers infertility so he doesn't end up in a new job that doesn't cover.

    The investment plan would be too much for dh or I to handle, I cannot wait until 30 to have a baby, dh will be 40 so that is out of the question, I am trusting the Lord knows what he is doing and he will not give me anything that I cannot handle and if at any point he gives me the feeling that I am not doing the right thing, I will stop.

    The thoughts of failure, miscarriage, etc, have all crossed my mind, but this is where the trusting in the Lord comes into part. Once again, he won't give me something that I cannot handle so I have to remember, whatever happens, its the Lords will and he will bring more opportunities my way.

    All in all, this is all new to me, and I am very aware of the emotionally roller coaster that is yet to come if I have to go through assisted conception, I am not blind in that area, I have done a lot of research and know many people who have been struggling with infertility far longer than I have and what they went through, so thanks for your advice anyway...God Bless.

     
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