Talkin' Shop

So last night we went to an IVF seminar, put on monthly by the clinic. I kind of wanted to go, since it's been over 3 years since we last did IVF, and I remembered looking up a lot of the terms online in the middle of the night, so hoped that maybe they'd explain more.
I didn't view it as a waste of time, but my husband kind of did. He said he's glad he went, in case there had been anything new, but he didn't feel he heard anything new. I was glad I went, since they did go a little more in-depth, plus showed pictures of some of the procedures, like ICSI. They showed a picture of embryos at Day 1, Day 3 and Day 5. I hadn't realized how crappy our embryos were until I saw that beautiful Day 3 picture. Eight clear little cells, happy as could be. Mine were jumbled messes, with all the fragmentation. I was kind of surprised at some of the stuff they left out. Like one of the reasons to recommend ICSI is if enough of the sperm don't have the enzyme on their heads for getting into the egg, or if the caps don't come off to expose the enzyme (I forget which they're looking for.) That was one of the reasons they wanted to do ICSI with us the first time.
And it was kind of neat (and scary terrifying at the same time) to see the needle depositing a sperm into the egg too.
And the embryologist at the seminar mentioned fragmentation a few times, but never explained what it was, so I asked, even though my husband and I were probably the only ones in the room, other than the medical experts, who actually knew.
There were a lot of stupid questions. A LOT. And I didn't like how the doctors answered several of them, but I kept my trap shut. My husband doesn't like me butting in at stuff like this, plus I didn't want to wave it in everyone's faces that we'd done this before and had a child.
Stupid questions, like, should they do ICSI if it's not deemed necessary. Is there an advantage to using assisted hatching if they aren't over age 38 or have thick egg walls?
But I knew where those questions were coming from. From the fear that this wouldn't work. I remember being there. I remember being supremely pissed off and terrified that it had all been for nothing every time I realized they had let some detail slip through the cracks. I remember wanting every. single. advantage we could get. Will this procedure make it more likely? Less likely? If we do this, do our chances increase...?

Plus questions that were financially based. Do I have to do ICSI with frozen sperm? Can we 'collect the sample' at home and bring it in that day? This 'flat fee' for IVF, what if we've paid and you decide to stop that cycle, or do fewer checks along the way? Or more checks? What if we do ICSI and there are tons of eggs? Will it cost more?
Since we had the benefit of partial insurance help the last time around, and 80% coverage this time, it was hard to be patient with these questions, since really, 'saving' on these types of things are just nickel-and-diming it. The IVF retrieval, fertilization, and transfer are the big costs. Around $10,000. ICSI is only a few grand, varying by around $500 whether they are fertilizing more or less than 10 eggs. All the other stuff is peanuts. But it is daunting. Seeing this $15k price tag, plus $3-5k in medications. Each peanut becomes a bigger deal.

Money, Money, Money

Now that we got the ball rolling, it's rolling pretty fast. My insurance company finally called back and said that IVF is covered if IUI hadn't work. So we should be good, as long as the prior-auth process doesn't take too long. Luckily, the lady I talked to on the phone in the finance department understands the urgency and has seemed very understanding and supportive. She was off the day we went in for our initial consult, and I wasn't wowed by the financial counselor subbing for her. And I was almost feeling hatred for the person I was initially transfered to when I called to tell my financial counselor what the insurance company had said about the PA requirements. She was all "looks like she's working on it." "Next time you can just punch in her extension." Look lady. They transferred me to you. No need to get all snippy! And I don't exactly have confidence in their financial counseling team, who first told me that my insurance didn't cover IVF, then, when I said it did, she actually read the info in their computer and told me we wouldn't need a prior auth. I had urged them when I first made the consult appointment to be getting on my insurance. And again at the consult visit. But when I finally got to speak to the regular person at this office, on the phone, she told me she would start the PA process as soon as we did my Day 3 labs. She took me seriously, and seemed empathetic and supportive. Phew.
One of my issues with the previous clinic was the financial stuff. They were so used to IF not being covered, I had to nag them for each. visit. to bill my insurance before billing me. At the time, the IUIs were covered, as were the ultrasounds and bloodwork. When we finally went with IVF, the IVF procedures themselves weren't covered, but the ultrasounds during the ER and ET were covered, as was all the bloodwork and U/S during the medication cycle, and the anesthesia was covered for the ER. But it was like pulling teeth to get them to bill my insurance. And they wouldn't even bill for the labwork. They made me pay them and submit for reimbursement. And then, at some point, they were able to bill my insurance, so there was a bit where they were getting paid by me and the insurance, which they credited later. Supposedly. I'm still not 100% sure I didn't get screwed on the bloodwork somewhere. And then there was an issue at the end, where months later I get a notice from a collection agency that I owe the clinic money. Whuuuuck? They made us pay in full before they did the IVF procedure, and then I went in and paid more for the extra bloodwork and U/S that they added as we were nearing the retrieval date. But they said I was paid in full. Turns out they had double billed my insurance, since my insurance was slow to pay. So they had sent some claims twice, gotten PAID eventually for the first set they sent, then the second requests got declined for obvious reasons, so they then pooped all over my credit rating by sending those to collections. ARRRRRRGH!