Wednesday, May 14, 2014

Catching Up...

It has been a while and a LOT has happened in the last few months... I'll write a better catch up soon, but today I made the call to get the ball rolling again because guess what??? We discovered that Mr. R has IVF coverage through his employer subsidized insurance!!!! We nearly fainted when we found out!

As our previous cycle was part of a study there was no WTF appointment.  It was just over.  I didn't get the minimum 5 eggs necessary for a second trial subsidized attempt, and our beautiful 3 day 8A embryo didn't implant in my "perfect" lining so we were done.  I decided to schedule an appointment myself... The trial was managed by nurses, and we didn't consult with doctors on the process at all, outside of the test transfer, retrieval and transfer.  I decided not to go with Dr. C who was my previous RE, not because I don't like him, but because one of his partners (Dr. S) had done the test transfer and the retrieval and I had really liked working with him.  I felt like he was more invested in the trial cycle and I wanted his take on things.

My gut was right.  I LOVED him.  He's blunt, no-nonsense and to the point and he looked over the charts from the trial and made the same observations I had had.  Namely... The BCP suppression didn't work... (I bled the whole way through). They started me on WAY too low a dose of Lupron and then waited too long for me to reach the magical E2 level before stimming... which was almost impossible for me and many others in this study! And he laughed out loud at the dose of stims they had me on... He says any woman over 35 who walks into his office DOR or no DOR he wouldn't start them on stim dose lower than 450 and there I was for almost 2 weeks on 225!  He isn't shocked that we had such a low number of eggs.  He WAS surprised that our one awesome egg didn't take given the excellent odds, but these things happen.

He has put together a plan for me, a CUSTOM plan.  YAY!! And he is hopeful that we will have a much higher number of eggs given that I started with 15 follies before stimming last time -- he feels that they waited too long to stim and that's why we ended up with just the 3 at retrieval.

I called in today to get my drug list so I can start calling around for prices.

If you have an awesome pharmacy to recommend PLEASE let me know!

Here's what I know about so far...

Microdose Lupron Flare Protocol, 5 Day Transfer with ICSI and Assisted Hatching


1) BCP - NOT Desogen.  We're going to try something else.
2) Doxycycline
3) Microdose Lupron
4)  Follistim
5) Menopur
6) Pregnyl (Trigger)
7) Prednisone
8) Crinone 8% (Bleurgh!)
9) Estrace Oral
10) Pregnyl (HCG Boosters)
11) Valium for retrieval

(Updated list)

If everything goes to schedule (HAH!)  I start BCPs on June 2nd, and projected ER for July 7 with ET on July 11th... my birthday... 

I know NOTHING about Microdose Lupron and it seems counter-intuitive to me to say "I wouldn't start any woman over 35 on Lupron less than 450" but then prescribe me something with the words "micro dose" in the title.  I have to do more reading on this... But I am confused. [Strikethrough because DUH!  I clearly did a total brain shutdown in the post-failed-cycle-IF-avoidance months. Thank you to WhenHowWhy for refreshing my memory/knowledge.]

But first things first... let's shop these prescriptions around and see what the insurance is willing to cover.

 

2 comments:

  1. I respond the best (not great, but I don't respond at all on any other protocol) on microdose lupron. I think the lupron suppresses ovulation. The 450 mg of drugs is for the stimulating medication, so for the follistim/bravelle/gonal-f. So my protocol is microdose lupron twice/day + 300 follistim/gonal-f/bravelle in the AM + 150 menopur and 150 follistim,etc. in the evening.

    I hope that your insurance covers a lot of these costs--that would be so awesome!

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  2. I am an eejit! haha Of course, you're right. Lupron = suppress, Stims = well, stim! haha

    Thank you so much for pointing that out. Excuse me while I walk of hanging my head in embarrassment.

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