Little Victories

In April we got a referral for FISH testing for Steve. This is the test that will tell us what percentage of Steve's sperm are antisocial killers, the remainder of which we can then safely assume will be baby-making snuggle-sperm. As interesting as this information will be for dazzling small talk at cocktail parties, it will also give us a great deal of clarity as we decide our future course, since this article indicates that when abnormalities account for more than 65% IVF with PGD will not work.

So, as I said, in April we got a referral for the test and then nothing happened for five months because my reproductive endocrinologist office was renegotiating their lab contracts. In August, during that blissful week when I thought I was pregnant with twins (sigh- that was so cool; I loved that week) the office called to say they finally had their contracts in place so feel free to swing by with the spunk. I declined, as the prospect of spending $1600 just for the hell of it was not so appealing.

However, when the ultrasound two weeks ago showed that we had lost this pregnancy, one of my first thoughts was that we should see about having the testing done. It was part of the whole Kick Ass Agenda that is going to be big, and I mean big, this Fall. In the interim, of course, the referral had expired, but I thought it would be no big deal to call and have it rewritten. A minor inconvenience arose from the fact that Steve had switched health care systems this summer, but I hastily switched him back and made him call his old/new managed care coordinated to get her started on the referral. This is when we learned that the primary physician who had provided the referral was not authorized, had never been authorized, to write orders for reproductive testing. We were told we would have to go see their own Dr. Authority and the decision to order testing would be his. I told them I already had an RE and I was damned if I was going to go to anyone else and besides I am not part of their health care system so my Dr. Authority and my husband's would, by necessity, always be two different people.

So I squawked and the managed care person twittered and we went 'round and 'round until she finally suggested that I call Dr. Authority and see if I could work something out. This actually sounded very sensible, so I agreed.

My irritation was all money-based, of course. We buy our own health insurance and although infertility testing is covered, we had been told by various sources that it was unlikely that they would agree to responsibility for the FISH testing. Too arty, I suppose. When we got an order written last Spring I was all giddy because I felt like we had snuck something past The Man and then I was snarked to learn we had done no such thing.

Anyway, I did not have great hopes for getting the FISH testing approved again but I duly called my RE's office and the MOST delightful receptionist promised to fax over the original letter my RE had sent to Steve's primary (and did!) She even re-addressed the letter to Dr. Authority. What a little jewel. I then wrote a letter from Steve to Dr. Authority (it's easier that way, he just signed it) briefly explaining our history and asking that the good doctor please rubber-stamp the referral like the noble spirit he no doubt is. I faxed that letter off and then I faxed a copy of the original useless order. Then I faxed a copy of the article which explains that some men are more lethal than others. Then I faxed over a basket of cookies and called it a day.

Imagine my surprise when a nurse called from Dr. Authority's office not three days later, just to tell me the order had been written and to ask if I would like her to send me a copy. I told her to fax it.

So with a sheaf of paperwork and growing confidence that my insurance company will eat 80% of this cost- heh heh- I duly presented Steve's specimen at the Andrology Lab this afternoon. They graciously let me read the paperwork which will accompany it and I verified that it did indeed specify that they are looking for (1:4) translocations at the correct breakpoints. I had nightmares of going through all this only to be told "Yep, it's SPERM!" or something equally useless.

FedEx is lovingly bringing the product to Rockville, Maryland as I type this and, in a few short weeks, we should know just how freaked Steve is down in Lower Darby.

Comments

[Julia]

Ah, the thrill of a successful insurance negotiation - rare, but all the more gratifying for it's trouble.

I'll be hoping some useful nugget of wisdom comes from this much postponed analysis.

Can they put those fellas in a centrofuge (surely I spelled that wrong) and siphon off the nasties? Sure would make things handy.

[JK]

This is great news! I wanna be a fly on the wall at a cocktail party where you discuss said results. :-)

J

[Laura K.]

Way to stick it to the man, Julia! :)

Thinking about you...

Laura

[cursingmama]

Have you thought about calling the clinic to get the FedEx tracking number for your, ummm shipment? That way you could track its progress online, and maybe even see who signs for it!
Okay, maybe not exactly a fun family project, but when its something truely this important I guess I'd be almost driving and delivering myself.
Hope nothing but good news comes your way - you're due a whole bunch!

[Summer]

The FedEx envelopes I have say very, very clearly that you are not to ship body fluids in them, or biohazards, and I'm sure that Steve's spunk qualifies as one of the two. Do they make special FedEx sperm envelopes? Do they have big pink stickers that say "body fluids" to put on the package? You should get a whole bunch, if they do, and use them to ship your Christmas packages.

Hoping for good news from this.

[Krista]

I am IMPRESSED with your persistance and glad your efforts "paid off". We were also faced with the choice of IVF-PDG and never went forward because of the cost. I'll be hoping you have positive results--at least it won't hurt so bad (financially) if it doesn't work out. I could never ever get that far because of my money issues. I love it when people get around the insurance system! Feel free to browse my blog too for my fertility story.

[bec 34]

I guess by Rockville you mean Shady Grove? Is that where they are doing the testing? I feel so privileged to be just a few short miles from this important scientific study. I should pop by and say "no, not quite ready for more IUIs or anything, but I was just wondering how Steve's sperm was looking...you are of course prioritizing it above all of your other testing, correct?" Just let me know if you want me to go over there and hover.

bec :D

[Anna H.]

You are KICKING ASS, lady!

xxoo

[Marla]

This is a rare sucess story. It should be put in the infertility insurance hall of fame. Or something like that.
We paid out of pocket for our FISH testing and now are trying to get them to pay because it was medically necessary. I hope ours has a happy ending, too.

[Kristine]

If you can beat the insurance game, you can do ANYTHING! I'm sure both you and Steve are anxious to get to know his sperm on a more personal level- good luck!

[B]

Okay, I admit it. I only read the summary of the article and not the entire article. Would you mind enlightening me on something? I didn't think that they could test sperm because they are 1 cell - I thought it had to be embies? Maybe I've got that all wrong since I'm a woman with bt so it's my eggs that are f'd up.

As mentioned before, we did PGD (all embies were abnormal so we had none to transfer). We did this at St. B's (across the country from us) and paid out the wazzoo. Since they said they expected roughly the same results on subsequent attempts, we decided not to throw good money after bad and moved on to DE.

I'm jealous of men and their never ending supply of sperm. And I can't believe I squandered my eggs for so many years - period after period. Years of BCPs. Ah, the regrets of an infertile woman.

Crossing my fingers for you (only 1 hand).

B

[Mollie]

Take no prisoners, J.

Want to start a business as an official claims-wrangler? We're trying to get BC/BS of MN to pay our Canadian bills right now. Seems the baby has fallen right through the cracks. She wasn't added to the policy before she was born! Imagine that! And the Canadians don't want to pay because her parents aren't permanent residents yet.

Good thing she wasn't the one who had the c-section. We paid out-of-pocket for it and are still waiting for our check. Egads.

[Julianna]

Congratulations on getting the response you wanted while raising hell. It gets so exhausting fighting the battle. The costs add up tremendously and every little bit helps.

I guess I am the only one who can't open the article? I have tried several times and it interests me greatly as I am about to undergo IVF#2 and feel strongly about PGD. I'll keep trying to open it but may request an email link if possible.

Good luck.