Lawyer Guy and I are facing one of the no doubt many practical conundrums we'll encounter as we move forward with ART. I could use some advice from those of you with more experience in these sorts of things.
So, to set the stage first for where we are right now, LG and I are doing a natural (i.e. break) cycle for the month of December. I'm on CD5 and unmedicated will ovulate anywhere between days 18 and 27, though it's usually more in the range of CD 21-24. I will most likely, then ovulate the week before Christmas (though earlier or later are always possible) and won't get my period until the first week of the new year.
In January, we begin our last Clomid+IUI. If that fails, we'll be meeting with Dr. W. in early February to discuss next steps.
Our options, as she laid them out to me briefly, are either to move to injections+IUI (which has an increased risk of triplets that worries her) or straight to IVF.
All of this is very hypothetical at the moment, and there's no reason to spend tons of time stressing or evaluating or deciding what we'll decide to do in Feb/March, when there are cycles to get through right now and conversations waiting to be had (and test results--from the RPL panel--that still haven't come in).
But there is a complicating factor at play. While our current course of treatment is covered by our insurance, we have zero coverage for IVF or injectible meds (the IUI procedure and all monitoring/testing/doctors' visits would still be covered). We have enough saved to handle the both routes for at least a few months and parents who we could turn to for help in a pinch (though that's a last resort scenario) but would obviously like to do whatever we can to keep costs down (and I don't believe our clinic offers any shared risk or other incentive programs).
LG does have a flex spending account for medical expenses. And his benefits coordinator just let everyone know that they need to specify the amount they want to put in it by December 20th. And, of course, whatever is unused in the flex account at the end of the year is lost.
So, how do you think we should handle this? As of now, there's still a chance that Clomid+IUI could work and we wouldn't need to go out of pocket for fertility expenses at all. But it's highly likely that we will be paying for medications at the very least in 2011. We don't know anything about the pricing of IVF at Cor.nell, since we haven't officially had a chat with Dr. W about that yet, but I'm thinking $12,000-$15,000 is pretty standard. And maybe $2,000-$4,000 for the meds, a little less if we're just doing an IUI? (Hard data on these figures would be appreciated.) If we knew for a fact we would be going the IVF route, I'd want to put in enough to cover one whole cycle, but since we don't know anything yet, it may be too big a risk to lose that money at the end of 2011.
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