FINALLY the day had arrived!!! I was giddy-excited every day for about a week before our appointment at a reputable fertility clinic nearby. I had all my paperwork filled out for well over a month, and I had it all in a folder to bring with me Friday morning. Nicole had begun to get quite anxious and couldn't talk about it at all. For instance, I just mentioned to her one day that I had looked up the doctor and she was Finnish, and she said, "Can we not talk about this right now, please?" She took the day off work and was a rock for me throughout the appointment, but she could not handle the anticipation of it and had to try to keep it off her mind til the last possible second. We are learning a lot about how to respond to each other's needs throughout this process!
We met with the doctor first so she could go through my medical background. She asked many questions that I had already painstakingly answered on the huge stack of paperwork that she was clearly not reading. She asked me to tell her more about my concerns regarding possible hormonal imbalances, which I had mentioned where it asked if I had any additional comments or concerns. (I guess she read the "comments" section, at least.) I told her that many of the women in my family have hormonal issues and that I just wanted them to know that since I have never been tested for anything like that and it could affect my fertility. She said my thyroid levels are normal and that my menstrual symptoms (such as breast tenderness) and regular cycles lead her to suspect that I ovulate regularly and don't have any hormonal issues. Great news! This had actually been my primary concern, so once she said that, I relaxed a lot. Not so fast there, Rach.
She did a basic transvaginal sonogram to get a sense of whether there were any major fertility issues to start with, and saw a huuuuge cyst on my left ovary. There are several there, but one of them was pretty massive and of concern to her. She also said my left fallopian tube looks dilated, but that it was hard to tell because of the cyst and it could just be related to that. She gave me a referral for a radiologist to get more information and said we will go from there. She said the cyst will likely need to be surgically removed, and that it has to be taken care of before we can do anything else.
As I struggled to keep my tears under control, I let the assistant usher me to the person who would counsel me on cost and insurance coverage. I was told that my insurance will not cover any treatment unless there are diagnosed fertility barriers - not necessarily total infertility, but anything that could make it more difficult, such as PCOS. If there are no diagnosed barriers from the start, then I would have to have 12 failed inseminations before my insurance would cover treatment, and by that point we would already be moving on to other alternatives anyway because it shouldn't take anywhere near 12 in a healthy, fertile woman of my age. This is consistent with the information I'd gotten in advance directly from my insurance company, but I had hoped that the clinic would know some way to get around it.
If the next ultrasound shows that my left tube is in fact blocked, they can probably get it covered by my insurance as "pathology" even though my perfectly healthy and functioning right ovary should make it pretty easy for me to get pregnant. However, if my tube is NOT blocked, then once the cyst is removed, I will be considered fertile and healthy and will need to pay $1900 per insemination, on top of the $500-$1000 for each vial of sperm.
My heart sank. At that price, we would only be able to try maybe three times in a year! It's ironic for us that, after our initial relief that the fertile one of us would be the one trying to get pregnant, Nicole would automatically be covered by insurance if she were the one trying. It's also ironic that I am hoping and praying for a dilated, blocked fallopian tube. (I think it's unlikely, though, considering that I tested positive for ovulation every month back when I was checking. Shouldn't it only be about every other month if one side was out of commission?)
This certainly wasn't what I expected going into this appointment. Aside from the pregnancy issue, it shook me up to know there is this huge cyst on my ovary that might have to be surgically removed. I didn't expect to leave there possibly needing surgery before I even try to get pregnant. I'm still trying to wrap my mind around that. But it is what it is, and I'm glad to know now and to move forward. I have to get the ultrasound as soon as my next period starts, and then I should be contacted within a week of that by the doctor to discuss next steps.
Let the journey begin...
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