RPL with minor septate uterus / insurance that opted out of coverage for all fertility treatments
I am 37 and my husband and I have been TTC since July. Since then, we have been suffering from RPL.
7/25 - CP
9/25 - 12/25 BO / MMC at 11+5 weeks
1/26 - CP
3/26 - CP
4/26 - CP
5/26 - CP
After the third loss, we were referred to a RPE. We ran every test imaginable and everything came back normal, including good genetics, good sperm, and an AMH of 2.7. During this time they discovered that I have a mild Septate Uterus measuring at .9cm. If I measured at 1cm then it would be considered a potential cause of the recurrent loss, but the .9 reading puts it in a gray area. I was told that my insurance would cover this surgery but would not cover IVF. I live in CT and my husband’s union opted out of any fertility coverage :(
It has been a traumatic few days leading up to my pre opt appointment for the hysteroscopic metroplasty surgery today. I found out I was pregnant on Thursday, let the doctor know, and then lost it Sunday. I went in for my appointment today and found out that they had canceled it and let me know my insurance came back Friday and declined coverage because it is a reproductive surgery :(
Obviously this was EXTRA traumatic to hear while actively suffering my 6th loss in less than a year. My doctor then made an appointment with my insurance for later today to try and convince them to cover this as a procedure to help relieve period pain…I won’t know which way it will go until tomorrow.
I’m wondering if anyone here has had this experience - did your insurance company change their mind? If you had to pay out of pocket, what was the cost? My treatment center is associated with UCONN health. It is very minimally invasive and it only will take 15-30 minutes but I will have to go under general anesthesia.
I know that the cost of IVF can be upwards of 25k per cycle which is obviously a devastating number (we also just bought a house 2 months ago 😩) so terrible timing. I was willing to try this surgery first because I expected insurance to cover it…but when I looked up the cost online, it was between 3k and 14k. Knowing this isn’t even definitively the cause of our RPL and knowing that insurance now might not cover it, has made the decision so hard to make. I stopped working last year in hopes that the reduction in stress would help, so we are facing this journey on one income. Although I’m willing to go into debt, I also want to mentally prepare myself for the worst financial outcome.
I would love to hear anyone’s experience with an insurance company that refuses to pay or has changed their mind when the “reason for surgery” has changed. Also any experiences with out of pocket cost for IVF, especially in this very expensive state of CT.
Lastly, has anyone had any experience with nonprofits that help to pay for fertility treatments? I would love to have more info on that if you’re willing to share.
Thank you ❤️