WWYD -lying to medical insurance.

[Sleepswithbutterflies]

Well. Not exactly lying, more exaggerating. Please stick with me, it's quite involved.

So we have ds conceived easily and naturally but have been TTC dc2 for 2 years, our issue is extreme male factor (hardly any sperm usual shape).

We've had two failed rounds of icsi Ivf where we got to transfer but have never had any embryos survive to blastocyst. However both times they gave us about a 35% chance of success.

Both failed and at my follow up appointment the consultant advised me to have a laparoscopy to see if the c section I had with ds has caused endometriosis. I did have some problems following my c section (retained product, sorry tmi) and the consultant said that scar tissue may be stopping embryos from implanting. I personally think that the embryos have just stopped developing since none of the ones we didn't transfer did brilliantly but he's the expert I guess.

Anyway a laparoscopy costs £4k privately. The only symptom I have of endo is extremely painful ovulation which I have been to the gp for previously even when we weren't TTC. It is much much worse since having ds and sometimes makes me cry with pain and lasts for several days. Other months not so bad but definitely painful every month. The gp basically said that the nhs would just give me progesterone treatment to stop me ovulating and hence stop the pain but that is no good when TTC. The nhs won't help me with anything fertility wise because we already have one child. Fair enough.

We have private medical insurance which we've paid for a long time but they won't pay out understandably for fertility issues or I think for problems caused by childbirth, which possibly mine is. I have to be honest and say I probably wouldn't go for a laparoscopy if we weren't TTC and I wasn't worried about scar tissue affecting implantation, we will never get pregnant naturally because dh's sperm is so poor.

The private consultant has advised me to tell the gp that Im suffering painful periods, bleeding between periods, painful sex and pain on ovulation. It just doesn't sit well with me and I'm a crap liar. The only bit that's true is the painfuld ovulation. He said to ask the gp to refer back to him and as long as the insurance don't get wind of fertility issues it'll be ok. I've spoken to the insurance and told them that we've had fertility treatment for male factor infertility and they said that was ok, it wouldn't affect this claim. But it still feels wrong.

Otoh god I want a baby and we've already spent £10k on treatment and don't really want to spend another £4k on something that may or may not help. The sensible thing would just be to except I've got one child and live with it but it's so hard. I'm only 31. I don't want to feel sad about this for the rest of my life.

WWYD?

I think you have too high a risk of getting caught - the insurance are highly likely to 'get wind' that you've had fertility treatment. You could then be landed with a court case AND a bill.

I'm a bit confused as you are saying that you won't get pregnant naturally as your husband's sperm is poor - but a) you already have one child and b)how would treatment for you help this?

easy for me to glibly suggest from here; but get treated for the pain and consider adoption?

Its fraud and you know it

It's fraud, they will also try A LOT of other things before lap, like put a Mirena in.

It's fraud. You're only 31, so save up for a while then get it done.

I don't want to adopt. And I find a lot of people say it to those who are infertile.

I don't know how we had ds. Some sort of miracle? Or maybe dh's sperm weren't as useless then?

The insurance know we've had fertility treatment. The treatment was for male factor infertility.

They can't put a coil in if we are ttc though surely?

I wouldn't even be considering it had it not been advised by my consultant at the fertility clinic. They will refer back through gynaecology rather than fertility.

They will not go straight for the lap, especially because those symptoms can also be indicative of conditions like cervical cancer, STI and cysts.

I suppose I could go and just say about the painful ovulation and see what happens. That bit is true anyway. Ovulation shouldn't be that painful should it?

It's easy to say save up but when you've spent £10k already on something that most of the population does at the drop of a hat it starts to smart a little.

It takes a lot for them to refer for lap, that's why so many women suffer horribly with endo before finally be diagnosed. That's right, you are pretending to be one of these women whose lives are agonising during their cycle because of endo. Nice.

My smear tests are up to date so should be ok where that concerned. Happy to rule out other things though.

Tbh I'm still slightly annoyed about what happened regarding my c section. Went back several times in agony, told it was normal, finally collapsed, turned out was retained product and had to have a d and c. I know this has no particular bearing on anything except it annoys me that I was told repeatedly everything was normal and I knew it wasn't. And now it may have left me with additional complications on top of the fact that dh has problems.

Sometimes OP, we do bad things for good reasons. We manage to overcome our moral objections somehow and do it. This doesn't sound like you. You're in so much doubt that you'd just crumble in front of your GP and all of the other medical staff you'd go through and feel rubbish.

Although, if I've read your post right, you've already asked the insurance for their opinion and they've said as it is male factor infertitlity it is ok. So is it just you feel it's wrong? Because ifg that's the case I'm administering a dose of "don't be daft and get on with it" medicine.

I have painful ovulation. It's fairly common.

If you have already saved and spent £10k, why can you not save another £4?

Or, go ahead, defraud your insurance company so others can pay higher premiums or you get caught and wind up paying them back and more.

My understanding is that actually amount of pain has nothing to do with how bad the endo is. It can be bad and cause not too much pain or it can be not as bad and cause a lot of pain, but yes I appreciate not fun.

However I'm not pretending to be anything. I think you will see I'm asking for opinions on what my consultant - someone we should be able to trust - has advised me to do. So please don't be snippy with me. I'm not having a barrel of laughs either.

Doesn't matter if your smear test is up to date, if you go in and say you are bleeding between periods it's one of the first things they will check again because it is a symptom of cervical cancer.

they wont do a lappy straight away for endo anyway - they will do a hystoscopy first

I have similar symptoms to you - extremely painful second half of my cycle, sometimes I can't sit down for the abdo pain, also had 2 sections - I now have a date for a lap but it's taken 4 months of other investigations

if you have symptoms of endo go to your GP and get the ball rolling - I'm not sure you have to lie?

I rang the medical company just to see where we stood.
It wasn't what I expected my consultant to tell me to do. It threw me. I did not lie to the medical insurers. I told them yes we were ttc, yes we had had fertility treatment for male factor and that I suffered painful ovulation. I did not lie to them.

Snippy? You are the one with a consultant who is advising you to commit insurance fraud, and you are contemplating it.

I'd like a new car. A mechanic mate advised faking that it's been stolen, get someone to make it go away and not come home. How about it?

That is what my pain is like - it goes up my back and sitting down is painful! It isn't normal ovulation pain which I used to have before ds.
It's like appendicitis.

I don't know - I guess because he advised us to do it I thought maybe that's just what happened?

I didn't think it was hugely professional of him to say it tbh but then I thought maybe it is just what happens.

Yes we could save £4k and our lives will be on standby a while longer, than we could spend that then another £10k on some more treatment and what do you know - still no baby.

That's what fertility treatment is though OP. And that's from someone who had seven years of fertility treatments to have a child. You don't get to commit fraud just because you don't think it's fair.

For those saying the OP would have to do other things before the lap - no, the consultant is saying if she asks to be referred back to him for any problems, then he will request the lap for her.

OP, I would first go to the GP and say you have been reading up on Endo, explain the symptoms you do have, mention anything else that could be relevant but still true (it doesn't sound as if you'll be able to lie well?), and ask him specifically to refer you to that consultant again.

I guess I will just have to go along to the gp, tell them about the ovulation and see what happens.
If they will legitimatly cover the treatment then that's great.
If not then I think it will be the end of line and I will just have to accept that my family will never be complete or a proper family. Just a couple with a kid.

Thanks hopeful - that's the conclusion I've reached. The insurers said once they had a letter of referral they'd be able to say if they would pay an initial consultation. The excess is £300 anyway so probably the consultation wouldn't be anymore than that.

I will be truthful with the gp that we are still TTC and that I experience very painful ovulation (which should be on my records from prior visits) and take it from there. I'm not making up symptoms though.

((hugs OP))

you ARE a family.

I had suspected scarring after an op for a miscarriage a couple of years ago. The HSG wasn't definite but doc said it was a possibility especially after having a c-section with my son.

He also said a lap would cost us £4k which we didn't have, though we did have enough to try an FET cycle.

I was convinced this meant we wouldn't conceive, however somehow the FET did. So it wasn't an implantation issue after all (probably).

Yes, it could be in your case, but if you mention embryos not doing so well it could also be other factors. The sperm, the actual treatment, your hormone levels. Would you consider trying iui with a sperm donor?

*somehow the FET did work

We would and in fact are considering using a donor but after the consultant said that it could be implantation I thought what if we try that and it still doesn't work? I will always think it was an implantation problem. I think if I didn't have the very painful ovulation then I might think otherwise. My uterus tilts back (again tmi sorry) and I wonder if after having the c section it feel back into place and everything kind of got, well, stuck together. I do think there's something for the ovulation to be so bad.

I'm glad things worked out for you in the end. I just feel like all the doors of possibility are being shut at the moment.