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IVF Diary Part 5: The Pre-treatment ultrasound

This is Part 5 of the IVF Diary series. I’ll be keeping a diary of all important IVF days, starting from when we first chose to undergo infertility treatment in Prague. Click here to read all other IVF diary posts.

 

The… what cam?

Before flying over to Europe and start treatment, the doctors at my fertility center in Prague need to know if there are any cysts, polyps, or fibroids in my ovaries or uterus. A pelvic ultrasound is the method of choice. Doesn’t ring a bell? It’s also called a transvaginal ultrasound. Still nothing? Hmm, I guess most people describe it with a less medical-but-more-colorful-name… the dildo cam? Yes, now you remember.

Let me assure you there is absolutely nothing erotic about it. Or maybe my doctor just wasn’t very good at it…

I knew how much my regular OBGYN would charge as I’d just seen her a couple of months ago for exactly this. It was part of our “infertility workup” to check if the reason we failed to conceive so far was due to me somehow missing all my reproductive organs. Spoiler alert, they were all there.

Anyway, my doctor charged me $590. That’s almost 25% of what my IVF clinic in Prague charges for a full IVF cycle! Luckily, my insurance was kind enough to negotiate a $187.72 discount, how generous!

 

Cost of a pelvic ultrasound at the doctor's office.

I was still on the hook for $402.28 though, so forgive me for not sending them a Thank You card.

 

Never pay full price

So I called around and asked for alternatives. I immediately struck gold with the first office I called. They only charged $150 dollars for the ultrasound. Oh wow, I exclaimed, that’s so cheap! The lady on the other end didn’t care that much though. She just wanted to know what time to pencil me in for an appointment. 

Her lack of enthusiasm for me saving a boatload of money wasn’t what made me decide not to book an appointment though. It was the fact that they charged an additional $400 for the radiologist to read the scan. Ugh, of course.

Yes, always remember to ask about the all-in price. It reminds me of the time when Mr. Frugalcrib brought home a gigantic watermelon. Really. It was the biggest I’ve ever seen. But he carried it inside all grumpy and sour looking and proclaimed we’d be eating watermelon for breakfast, lunch, and dinner for the next couple of weeks! Apparently, he saw a huge SALE sign at the grocery store. 99 cent’s, get it before it’s gone. He looked for the biggest watermelon he could find. And big she was! He learned an important lesson that day though… watermelons are often priced per pound. 

Anyway, after doing some research, it seems that independent imaging centers are usually the cheapest option. A medical imaging technician performs the scan and a radiologist reviews the images and prepares the report. I called a couple and they were all $150 or less (yes, total price). The one closest to us charged $120. That’s more like it!

 

The Day 21 myth

Apparently, you need a referral from a doctor if you want to get probed by the d-cam. So I called my OBGYN and gave them the option to either match the price of the imaging center or write me a referral… They gladly wrote me a referral 😉

The clinic in Prague wanted the scan to be carried out around Day 21. Now, most of us who have been trying to conceive know that Day 21 doesn’t necessarily refer to the 21st day of your cycle. Day 21 is approximately a week after ovulation for the “average” cycle where ovulation would be around Day 14. It’s also very important to realize that almost no one is average, and the majority of women don’t ovulate exactly on the 14th day of their cycle. Just because your cycle is 28 days doesn’t mean that you ovulate halfway either.

Same thing with getting your progesterone levels checked on Day 21. This is usually part of your (in)fertility workup where the doctors try to establish if you ovulated. The level of progesterone increases after ovulation and usually reaches its peak 7 days after. There are a couple of very reliable ways to keep track of your ovulation so that you can time your bloodwork accordingly.

I personally use ovulation prediction kits (OPK) to know when I’m about to ovulate (24-48 hours after getting a positive OPK) and take my basal body temperature to confirm ovulation has occurred (clear upward shift in temperature seen after ovulation). So after I got my positive OPK, I immediately called to make an appointment with the imaging center.

 

The scan

The medical imaging center was next to the hospital in a fancy office building with lots of other medical services. The receptionist offered to run it through my insurance to see if they’d be willing to discount the $120 to $105, which was fine by me. They probably don’t want to as anything labeled “infertility” usually isn’t covered and therefore isn’t subject to discounts either. So I paid $105 and signed a consent form so they can charge me the additional $15 in case the insurance kicks it back.

After I filled out my medical history and stared at the other patrons for close to 15 minutes, the imaging technician called my name. A pelvic ultrasound (in contrast with an abdominal ultrasound) is best performed when you have an empty bladder. So the imaging technician first guided me to the bathroom to do just that.

The scan itself took about 10 minutes and the lady performing the scan wasn’t all that chatty. No foreplay whatsoever. She just asked me to undress from the waist down and cover myself with the provided paper sheet. I was able to see the screen but I’m no expert in ultrasonography.

Is that my uterus? Yes. Oh nice, how does it look? Like a uterus. Every open-ended question was met with a sentence containing no more than the absolute minimum number of words while every close-ended question resulted in a simple Yes or No. She was friendly and all, but yeah, not that talkative.

Afterwards, she told me (well, after I asked of course) that all seemed well. The radiologist would look at all the images and would send an official report to my OBGYN that same day. In less than 24-hours, the report was uploaded to my patient portal and I was able to download the results and email them to my IVF doctor in Prague who confirmed I was all set to start treatment.

 

That means that we’re still right on track with the protocol, and leaves us right here:

 

Click here to read how my first few days of injections went. It’s about to get real!!

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