Cost for immune-related infertility/miscarriage

[cczbunnie83]

Hi ladies,

I have my first appointment with Dr. Abbasi at Columbia tomorrow afternoon. I've been told that while my insurance (CareFirst) will cover 80% of blood tests and ultrasounds it will not cover any fertility treatments.

Of course I've been thinking about all the things, drugs, procedures that I might have to go through. I even wonder if I will have to go through IUI or IVF since I have no problem getting pregnant but a lot of problems to keep it after implantation.

For you ladies that have gone through immune-related infertility, how much did you spend trying to have a baby?

[Anonymous]

For my first successful pregnancy we spent around 15K, none of which included ART at all since we could get pregnant on our own. That included IVIG, Humira, intralipids, lovenox, Neupogen, testing costs, repeat labs, phone consultant fees and anything not covered by my insurance.

For my second it's been less, around 10K because I didn't waste any money on stuff that didn't work. 80% of the cost this time has been lab fees using the safeguard program with Reprosource, consult fees (Dr. Braverman is not cheap) and Neupogen, which I paid out of pocket for both times. The Neupogen alone was about 5K.

How much you spend on treatment will depend on what (if any) issues you have. I did not have success with AEB but they are a good place to start for testing. There are some things they won't test though that Dr. Braverman will. Goodluck!

We were able to write off some of the medically related expenses so keep your receipts.

[cczbunnie83]

Anonymous wrote:For my first successful pregnancy we spent around 15K, none of which included ART at all since we could get pregnant on our own. That included IVIG, Humira, intralipids, lovenox, Neupogen, testing costs, repeat labs, phone consultant fees and anything not covered by my insurance.

For my second it's been less, around 10K because I didn't waste any money on stuff that didn't work. 80% of the cost this time has been lab fees using the safeguard program with Reprosource, consult fees (Dr. Braverman is not cheap) and Neupogen, which I paid out of pocket for both times. The Neupogen alone was about 5K.

How much you spend on treatment will depend on what (if any) issues you have. I did not have success with AEB but they are a good place to start for testing. There are some things they won't test though that Dr. Braverman will. Goodluck!

We were able to write off some of the medically related expenses so keep your receipts.

Wow, I guess i'm so new at this I had no idea what the cost would be. If you dont mind me asking why did you have to take Humira? And also, what is the Safeguard program? I looked through Reprosource and didn't find anything.

Thanks for the info!

[Anonymous]

I agree with PP--it really varies. We had a lot of our testing done at the Rosalind Franklin lab because they're a participating provider for BCBS PPO. A few other tests were done through Quest/LabCorp (all covered) and a few had to be done at other labs and were out of pocket. All told, I'd say we spent $1,000 or so on tests.

On our first cycle, we did LIT in Nogales, Mexico, which was not that expensive for the actual treatment (maybe $400?) but the travel costs are also a consideration. We were lucky that IVIG, Lovenox and steroids were all covered by my insurance with co-pays. Intralipids are significantly cheaper than IVIG if you end up going self-pay (although it's somewhat unclear if they are equally effective). I'm not sure about the cost of Neupogen. I think Dr. Braverman is currently the only doctor going this route.

If you conceive easily on your own, you may not need to do IVF, but it will depend to some extent on the cost of your medications. If you are prescribed something very expensive and not covered by insurance (like IVIG) it may make more sense to do IVF so you have better odds of conceiving immediately and not having to repeat your dosage over multiple months.

[Anonymous]

6:31 here we also had coverage for IVIG but my co-pay was $500 and I had 4 infusions. So, right there is $2,000. I was on Humira (~$1300) for high TNF but really my TNF was borderine (33 and normal is <30). That is primarily AEB protocol, but when it didn't come down on Humira I went ahead on IVIG and it came down a lot.

Neupogen (depending on the size of the vial) will range from $350 - $550 per vial (1.0ml or 1.6ml) That was my biggest cost both times because it's weight based and I needed 9 vials to get through 9w starting at ovulation. I paid OOP for the Neupogen and it was definitely what did the trick. Also factor in natural cycles and it took a couple months to get pregnant the second time.

The safeguard program is something that Reprosource participates in depending on your insurance. If your insurance participates then the monitoring panels will cost $487 each time (as of Oct.) and you are guaranteed not to pay any more than that. Of course if your insurance covers everything 100% (some do with specialty labs like this) then you will be reimbursed for whatever your insurance covers. I think out of network labs for me were covered 85% so it ended up working out to be about the same. For people with NO out of network coverage for labs it's a great deal. You can definitely call them or email and see if your insurance participates.

Also for initial testing with Dr. Braverman it will be more (safeguard=~$600) than the monitoring panel because it includes genetic testing like HLA and KIR, but those only need to be run once.

Good luck with your decision FWIW I wish I had started out with Dr. Braverman but I went to him after having two additional losses on IVIG so really the only treatment left for me was Neupogen before moving on to a gestational carrier. Given that, all the expenses I've incurred are nothing compared to what that would cost. I guess that's kind of how I look at it.

[cczbunnie83]

Thank you so much for all the info!