More Tests

I went to the RE yesterday for a WTF after miscarriage appointment, and it went surprisingly well. I was truly expecting that given I’ve had 2 IUIs with injections, and both of them worked, but one ended in an ectopic, and one ended in a miscarriage, that he was going to say to just try IUIs again. And he did. BUT he said that we should do a miscarriage panel, to rule anything out before I get pregnant again. I was so happy to have him take my one miscarriage seriously. He said most doctors will wait until people have at least 2 miscarriages before they will do all this testing, but he said he didn’t want us to go through that grief if we didn’t have to – thanks doc! So here’s the list of tests that I’m going to have – all blood tests:

ANA w/Reflex if Positive
Anticardiolip Ab, IgA/G/M, Qn
Chromosome, Blood, Routine
Factor V Leiden Mutation
Fibrinogen Antigen
Homocyst(e)ine, Plasma
Lupus Anticoagulant Comprehens
MTHFR
Protein C-Functional
Protein S-Functional
Prothrombin Time (PT)

And a chromosome, blood, routine for the hubs. I think there are other tests that are part of the “miscarriage panel” but I had them done as part of the “treatment panel” so I don’t need to repeat them. I’ve spent the last hour on the phone with the insurance company and the lab company, getting procedure codes, and confirming that these are all covered by insurance, and it is, or at least 90% of it is. So I expect to pay $450 for these tests, which will max my deduction of $1,000 per year. Plus $80 for the hubs’ test, which is 10% of the total price. Not too bad when you consider what else we’ve paid!

Then I also talked with the RE about genetic testing after a miscarriage. As a reminder, the doctor and nurse at the RE office said there was no heartbeat, and then told me my options. I was such a wreck, and was not thinking clearly. I didn’t ask them about genetic testing. And then, a friend of mine suggested I go to my regular OB to confirm there was no heartbeat and talk through options. I did, and my OB was great, but when I asked about genetic testing, he said it was usually inconclusive and he didn’t do them, and didn’t recommend it and therefore doesn’t do it. He did the D&C, and we didn’t have genetic testing. I asked my RE about that yesterday, and he said that if they would have done the D&C, they definitely would have done genetic testing, and he wished we would have had that done. He said that it is inconclusive about 1/3 of the time, because it gets the tissue of the mother instead of the baby, but if they can get some answers about 2/3 of the time, then it’s worth it. He said most regular doctors don’t do it because it’s not usually covered by insurance, and it costs about $1K, but with us fertility patients, we’re used to paying out of pocket, and what’s another $1K if it gives you answers? Seriously, after what we’ve spent (see earlier post), and what we’re going to spend I’m sure, I’d love to have some answers. So I regret not having the testing done, and not pushing it with my doctor more. There’s nothing I can do about it now, but I told the hubs that if we’re ever in that situation again, that he needs to force the issue, and make it happen! He said ok. Plus now that I have the information, I think I’ll be able to be stronger about it. I see my regular OB next week for my post-op appointment (huh, just realized that will be 6 weeks post-D&C - I wonder when I’ll get my period) and I’m not sure if I’ll mention it to him or not. I really like him, and he normally deals with regular old fertile patients, I’m sure, but he should at least allow the option to do testing, particularly if the patient requests it! Sure, tell me the risks of inconclusive testing, and tell me the cost, but allow me the choice, right?

I can’t dwell on the genetic testing thing – I’m just happy to be trying something new. We’re at least seeing if there’s anything wrong, and then treat for it. It takes about 4-6 weeks to get the results of the tests, but that’s ok. We’re not going to do treatments again until October anyway, so that will be fine. Is it strange that I’m hoping that I have something wrong with me???