My Medical Insurance Sucks

My medical benefits coverage sucks for my needs.  Now if I were a drug addict or wanted to have an abortion, that would be just dandy.  But alas, I “only” keep losing babies.  The insurance solution for that is – stop procreating cuz that’d be best for us.  We certainly don’t need to help you with your fertility issues just because you want to have more children.

I’m not infertile.  I’m just a habitual loser in the whole pregnancy maintenance arena.  Who can help me there?  My path has taken many turns, most leading to dead ends with providers who can’t acknowledge their limits.  Most recently, I was diagnosed via an uterine xray with a double uterus and told to “keep trying.”  I would need a referral to see an endocrinologist, even though I doubt that a general endocrinologist in this town would have a whole lot of experience in reproductive endocrinology.  In fact, the endo that my insurance service agent recommended seems to do more with diabetes.  But I’m expected to exhaust in state possibilities before I pursue specialists out of state.  I have yet to find an obstetrics group in town that believes that imbalanced hormones contribute to pregnancy loss.

I’ll be in Denver this summer, and even though there are reproductive endocrinologists (RE) there that are considered “in network,” I’m not allowed to see them?  I can waltz into any urgent care clinic in Denver with a common cold and get treatment, no questions asked, but I’m not allowed to see a RE?

My employer has no maternity policy and no infertility benefits.  Great place for a woman in the childbearing years, eh?

Anomaly

Anomoly.  Congenital.  Rare – in my case occurring in 0.1-0.5% of women or possibly as high as 10% in women with recurrent pregnancy loss[1].

On Monday I had a hysterosalpinogram (HSG) done to check the lining of my uterus for abnormalities potentially caused by a cesarean section in 2004.  My doctors and I are not finding good reasons for repeat pregnancy loss.  My lupus anticoagulant panel came back clean, and the only test left to do in my current OB’s mind is an ANA.

As a result of the HSG, I was diagnosed with uterus didelphys, one of several Mullerian Anomalies.  The OB is certain that this is the cause of my recurrent losses though still recommends the ANA blood draw.  He doesn’t think I need to proceed with a thrombophilia panel.  He didn’t offer any course of action for this issue, suggesting that we should just “keep trying.”  He was surprised that this hadn’t been diagnosed sooner.

Of course, being the curious person that I am, I performed internet searches for “double uterus,” “didelphic uterus,” and “uterus didelphys.”  I also chatted with an internet friend who put me in touch with a couple of other people who have been diagnosed with anomalies.  I have joined a yahoo group that deals specifically with these anomalies.  Even a couple of hours after the procedure, having looked at many pictures on the internet, I began to have doubts about my diagnosis.

I will obtain a copy of my HSG “picture” hopefully today from the radiology lab.  When I compare what I remember seeing on the screen at the hospital with what I see on the internet, I think it’s more likely that my uterus is bicornuate (heart shaped) and/or possibly contains an uterine septum.  A septum would be most problematic for maintaining a pregnancy because if the baby implants on the septum, it will not have enough vascular support to grow.  (This just breaks my heart.)

What next?  I am going to be in Denver for a couple of months studying vocology (vocal science).  (I need a calculator and to remember my college physics class from 1990, eek.) I am looking for a reproductive specialist there who will do a thorough investigation of immunological, endocrine, and structural causes for my losses.  It is possible that the immunological path has been exhausted, but with my mother’s history of autoimmune disease, I’m not so sure.  Endocrine/hormone issues haven’t been addressed to my satisfaction.  Neither OB group I have worked with in town believe in progesterone deficiency.

So, that’s my story in a nutshell for now.

[1] Müllerian duct anomalies are estimated to occur in 0.1-0.5% of women. The true prevalence is unknown because the anomalies usually are discovered in patients presenting with infertility. Some women carry babies to term with anomalies, so it could be more common, possibly as high as 3% of all women.  Sources: http://www.emedicine.com/Radio/topic738.htm; http://www.seattlefertility.com/treatmentOps_UterineAnomalies.htm