Making the switch from your OB/Gyn to a Reproductive Endocrinologist is a huge step. Many couples are very nervous about making the switch because of the fear of the unknown. What kinds of test will we have to endure? How much will all of this cost? Will our health insurance cover any of it? Every couple's appointment will vary to some degree depending on what tests their OB/Gyn has already performed.
On your first visit with the Reproductive Endocrinologist you can expect to answer questions about your health history, family medical history of both partners, have a physical examination possibly including a pelvic ultrasound and often have some blood drawn to test FSH, LH, testosterone, estradol, progesterone and prolactin. You can also expect to discuss your monthly cycles and it would be helpful if you had 3-6 months worth of basal body temperature charts for the Reproductive Endocrinologist to look at.
Some common tests ordered by a Reproductive Endocrinologist are:
- Post-Coital test, this is very much like a pap smear, it is performed after intercourse to determine whether the sperm survive well in the cervical mucous. It needs to be timed around the day of ovulation.
- Saline Sonohystogram an ultrasound is preformed while the uterus is filled with saline (salt water) to determine if there are any abnormalities of the uterine cavity that could interfere with pregnancy.
- Hysterosalpingogram (HSG) is a series of x-rays taken while dye is injected into the uterus to determine if there are any abnormalities of the uterine cavity or fallopian tubes.
- Endometrial Biopsy, a small piece of tissue is removed to evaluate the uterine lining as relates to embryo implantation.
- Semen Analysis this is a test done to determine sperm count, shape and motility or the ability of the sperm to move in a forward trajectory.
The cost of these services varies greatly from state to state and often it varies from clinic to clinic. Many Reproductive Endocrinologist's have financial counselors on staff that will work with you from the time of your referral through your treatment process, they will give you information and offer you advice but most of all they will help you choose payment options that best meet your needs.
Health insurance policies are tough to read and seem to be open to interpretation. If you are lucky enough to live in a state that mandates infertility coverage such as Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New York, Ohio, Rhode Island, Texas and West Virginia, don't be fooled, the insurance company is bound by the laws of where the insurance company is located not by the state where the insured lives. The customer service office of your insurance carrier should be able to help you determine what is covered and what isn't.