IVF Options - SG or Columbia Fertility and should I switch insurance or go with Shared Risk at SG?

[Anonymous]

I turn 37 next month and just found out after a blood test with Dr. Sacks that I have low egg reserve (.36 AMH).

Several questions for those of you who have been there:

1. Stay with Dr. Sacks or go with SG?
2. If SG, should I switch my insurance at the end of the year to an HMO (I work for the Federal Government) to help pay for the procedure(s) or go with the Shared Risk program at SG? One issue with insurance is that it would require that I do several rounds of IUI prior to IVF. I had two failed rounds of IUI three years ago so I am not excited about waiting the extra couple months while doing IUI, but who knows, maybe it will work this time around and I certainly appreciate that this is a less invasive way of attempting to get pregnant.
3. What questions should I ask of either provider to figure some of this out?

Thanks for the advice in advance.

[Anonymous]

Are you sure that IUI would be required? MDIPA waived that requirement for us (with a doctor's statement). In our case the dx was MF, so IUI has very little chance. But with such a low AMH, I'm guessing your situation would be similar.

[Anonymous]

Author here.

I am reading the insurance requirements now and it says that IVF will only be covered if the following conditions are met:

1) You and your spouse have a history of infertility of at least 2 years duration; and
2) Your oocytes are fertilized with your spouse’ s sperm; and
3) Your infertility is associated with endometriosis, exposure in-utero to diethylstilbestrol (DES), blockage of, or surgical removal of, one or both fallopian tubes, or abnormal male factors, including oligospermia contributing to the infertility; and
4) You have been unable to attain a successful pregnancy through a less costly treatment that is covered by the Plan.

I meet all of the criteria except #3, I believe, so I am wondering whether I would even qualify.

[Anonymous]

That plan language infuriates me. That they would leave out single women, couples who need a sperm or egg donor, and gay couples. Horrible. And then to have such limited infertility reasons where there is coverage. Basically leaving out older mothers-to-be and many others.

[Anonymous]

Agree w/ 7:02
Signed: Single woman

[Anonymous]

Anonymous wrote:Agree w/ 7:02
Signed: Single woman

+1

So discriminatory. Single women make terrific mothers!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Agree w/ 7:02
Signed: Single woman

+1

So discriminatory. Single women make terrific mothers!

+2

[Anonymous]

I even have the exposure to DES prong and I have been denied because my fsh is 17.1. My dr said it's 17 so it should be covered but they are holding the .1 against me.

[Anonymous]

I would go with Shared Risk at SG if you can afford it. Do you think that your insurance would cover meds since you have some coverage? I am just speaking from my experience, my Dr told me he thought I wouldnt need IVF and IUI would work. 3 failed IUIs, 2 failed IVFS, on my 2ww of a FET from my third IVF (now at CCRM)
All from age 28-30

Just my personal opinion, do what you think is best.

[Anonymous]

You have to make sure that you will be accepted into SG shared risk program. I don't think they accept everyone.

[Anonymous]

Number 1 annoyed me. At first our insurance tried to say we had to be under a doctor's care for two years -- to establish a history. As if you don't try on your own before going to see an RE. Our RE, however, pencil whipped out the form that said we had two years under our belt.

If you use shared risk, you will not meet condition 2 either.

Here is my advice, even though it could cost you money, it might save you time. Ask Dr. Sachs very directly if there is any thing else they can test or examine to determine the cause of your infertility. Not what is prudent based on the information currently available, which is what they do. For us, it seemed like after every other failure they (not CFA but another RE) tested for and found some new issue. We could have saved years and money if they had not been trying to save us money at the front end.