Hysteroscopy Needed

One more hurdle to overcome.

I totally thought that once we decided on egg donation, all we had to do was to choose an egg donor.  Other things would fall into places.  This is so not the case.

Dr. No Nonsense didn’t call me until Thursday.  The saline sonogram was on Monday.  So it took a whole three days for that phone call.  The “no-news-is-good-news” theory didn’t really work here.  Fortunately I actually was available to answer his phone call on the day when I had back-to-back clients.  As usual, he put me on speaker phone, which I really dislike because I feel like I can never have a decent conversation with him.  He asked if the saline sonogram was painful.  Actually it wasn’t.  I have pretty high pain tolerance for these things.  My previous saline sonogram or diagnostic hysteroscopy all did not hurt at all.  Even the hysterosalpingogram (HSG) didn’t hurt either.  Anyways, Dr. NN said that it looked like there is scar tissue.  No one knows how much there is.  So he said that he would need to go in and clean out any scar tissue that I may have.  He would prefer to do it when I am awake vs. me being totally sedated so that I can look at the procedure being done.   He hoped that we could clear all of it out using this procedure.

I just remember my heart racing fast and my mind going wild.  I just don’t want any sort of surgery if I don’t need it.  I was really hoping that we didn’t have to go down this route.  I just wanted Dr. Director to be wrong and for Dr. NN to say that the images from the saline sonogram were fine.  I always pride myself for having a good lining because it has never been a problem.  The fact that there is scar tissue that needs to be cleaned out is enough to make me want to puke.  But I held myself together and started asking questions about logistics.  I have Kai.ser insurance, which means that whatever procedure I do at UC.SF will not be covered by my insurance.  I reminded Dr. NN that fact.  I could hear him go Ugh.  He didn’t know the cost of the surgery.  So I asked him, “Is it a hysteroscopy that you wanted?” since he never told me what the procedure was called.  He said Yes.  And he said that I could get it done at Kai.ser, but that means that it will most likely be done under general anesthesia in the operating room.  If that’s the route I want to take, he would want to talk to my doctor at Kai.ser.  He told me to give my nurse’s email to my Kai.ser doctor to contact him.  And if I prefer to have the procedure done at UC.SF, the financial coordinator can contact me.

We hung up.  I really was not feeling good that a procedure has become a reality for me.  I could have felt sad, or mad.  However, I didn’t have time to analyze my feelings because my problem solving mode was turned on.  In the short 10 minutes that I had left before I saw my next client, I emailed my Kai.ser doctor, updated Bob about the situation, and emailed my own nurse to get some questions answered, including my bleeding problem that I was too flustered to remember to ask Dr. NN.  Bob was sad and frustrated.  He was mainly mad at himself for quitting his big corporation job and losing the fantastic health insurance that came with it.  He was mad that this could all have been covered at UC.SF had I continued to use his big corporation insurance rather than having to sign up with Kai.ser through my own work.  Nobody could have predicted what might happen in the future.   So it’s really not helpful to blame oneself.  I told him that we can’t worry about what has been done already.  We have to look ahead.  He said that he wanted to scream out of frustration, but he would try to persevere, like I was doing at that point.  He felt so sorry that it has been so tough on me.

I went on to see my next three kids.  It was really tough to get myself together.  But I did it anyways.  I really had no choice.  I tried as best as I could be to focus on the kids, but at times, my mind drifted back to the reality of having to do a hysteroscopy and possibly delaying our egg donation process.  My mind again went to a dark place: the fear of not being able to carry a child to term because of whatever problem I have in my uterus.  Again, I know this is not logical.  But that’s what fear is.  Not logical.  My mind went far.  The possibility of losing the egg donor. The possibility of scar tissue that is too serious and needing a gestational carrier.  It was scary to let my mind go so far.

One great thing about Kai.ser doctors is the accessibility to the doctors themselves.  My OB/GYN, whom I have never met in person before, returned my email right away.  She said that this kind of procedure is usually done in the operating room by the Kai.ser surgical team. She could make a referral for me if I would like.  I wrote her back asking for a referral. I also wrote again, gave her my background of my IVF cycle, and asked her if my 15 days of bleeding was a concern.  She said that it is most likely the extra hormones in my system that cause the vaginal bleeding, because scar tissue doesn’t usually cause that.  She also said that the surgical team will call me in a week to schedule an appointment, and at that time my questions regarding diagnostic code and procedure code will be answered.

The whole night on Thursday, while I was still waiting for the quote from UC.SF on the procedure, I became more and more calm about this new development.  Like I said, I have turned to problem solving mode.  Things may get delayed for a little.  But I would rather get this done first than to risk having implantation problems because of scar tissue.  At the same time, I feel like one day I may just explode.  There just has been one twist after another in our quest of a baby.  It has been really tough.

God really spoke to me that night.  The several daily reading plans that I read all helped me refocus my eye gaze back on Jesus.  One says, “But there is one thing that will never change, even through the ups and the downs of infertility.  Jesus Christ is the same yesterday and today and forever.” (from Infertility Encouragement from Sarah’s Laughter)

Another passage says, “When it comes to hardships in life, it is common to feel as though you are stuck…… When bad things happen, it’s understandable to feel continually defeated in your heart and spirit.  We can be tempted to think that we will always stay stuck….. One of the best gifts God has given to use is free will……. We have free of choice… we can CHOOSE joy.  We can CHOOSE to run to God. We can CHOOSE to do something about life from this day forward.  We can CHOOSE to pick up the pieces and create the best life possible with God’s direction.” (from Grief Bites: Finding Treasure in Hardships)

With these reminders to put my focus back on God, I fell asleep.  I woke up feeling mostly at peace.

My nurse returned my email saying that 1) the financial coordinator will contact me, 2) the bleeding could be a sign of perimenopause and I could be put on birth control pills to stop the bleeding.  I was taken aback a little by the word “perimenopause”.  But I guess, we have already chosen this route of egg donation.  So whether on perimenopause or not, I should be okay.

About an hour later, a surgical coordinator from UC.SF contacted me informing of the cost of a hysteroscopy in the office with sedation.  The total of facility fees and professional fees for scar tissue removal is about $2600.  If Dr. NN finds more than just scar tissue to remove, the professional fee may increase with the maximum of $500.  I was to contact her when I would like to proceed.  Dr. NN would most likely start me on birth control pills or Aygestin on cycle day two and schedule the procedure 15 days or more after I have been on the medications.  I asked if I could chat with the doctor one more time to learn about why I should get it done at UC.SF instead of Kai.ser.  The coordinator said that since Dr. NN has been following me, he knows how much to remove.  I asked about the cost of the procedure done at an operation room with general anesthesia because that will most likely be the procedure done at Kai.ser.  I was shocked to learn that it would cost $18,000 at UC.SF.  Uh no thank you.

So currently this is what we are facing.  A choice between paying out of pocket at my own clinic with my own reproductive endocrinologist or possible insurance coverage for the procedure at Kai.ser.  I haven’t called Kai.ser to learn about the cost.  I have a high deductive insurance plan so I will need to pay out of pocket up to a certain amount before insurance starts to cover for health-related cost.  The cost of the hysteroscopy at UC.SF is actually well within my expectation.  I will contact Kai.ser this weekend or on Monday to get a quote.  Another thing is that, I don’t know what code will be used at Kai.ser.  If an infertility diagnostic code is used, then the procedure will definitely not be covered.  So that’s something I have to look into.  Plus if it’s not covered, the cost of doing the procedure with general anesthesia in an operating room at Kai.ser is going to be really high.  I may as well just get it done at a clinic with which I am familiar.  Then I’ll just have to put on my big girl panties and do it with sedation in an office.  Hopefully it won’t hurt too badly.

Yes.  One more hurdle.  But I think we are in good hands: both God’s and the doctor’s.  I just pray that Bob and I will continue to remain calm and get over this hurdle with the peace and strength that only come from God.


12 thoughts on “Hysteroscopy Needed

  1. Oh, Isabelle, I am sorry that nothing is simple or without a substantial price tag for you and Bob. I am glad your readings and presence of mind have given you some respite from the emotional toll and I hope you and Bob can share some tender moments together this weekend.


  2. All I can think to offer as comfort is that it’s better to bear this expense and delay than to go forward without having discovered this and to fail. It’s not fair, Isabelle, and I hope the path to parenthood clears for you ASAP!


  3. I had a hysterscopy, laparoscopy and chromotubation all at the same time. I can say from experience that recovery isn’t easy, but it may be a bit better if you only have the 1 thing done. The clinical cost seems pretty decent to me. I wonder if that is their cash price or with insurance, as even if you are going to the fertility clinic he may be able to swing it as non fertility related to the insurance company. With my own surgery, we scheduled it for a week after my period had ended as the lining was at its thinnest.


  4. I’ve had a couple hysteroscopies…if you have scar tissue or anything like that it definitely needs to be removed before proceeding…I think this is definitely one more step forward…you are on your way…keep going…lots of love sent to you Isabelle!!


  5. I discovered your blog a few days ago and can relate to many of your struggles with ivf. Have you looked at Ca Fertility Experts for donors? They are new, I’m currently cycling with them and I know they specialize in Asian donors.


  6. I’m entirely optimistic that everything is going to be fine, nothing will be delayed and your uterus will be in tip top shape when the time comes. I’m sorry you have to go through this though. You and Bob have gone through so much already, this just doesn’t seem fair. xox


  7. I’m so sorry to read about all you are going through. And having to deal with all the expenses and not being sure what will be covered or not makes it even more difficult! Sending you best wishes and hoping that everything goes well!


  8. I’m sorry that you are going to need a hysteroscopy. My RE thought that I might need to have one up until last Friday. I can tell you that my clinic said that I would only be sidelined for 3 weeks if I did have the procedure so it’s not a long wait.


  9. Pingback: “You Are Cleared To Proceed” | In Quest of a Binky Moongee

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