Pull the Trigger

Final stim shot last night. Last Lupron this morning. My u/s revealed no newcomers to the follie party so we're going to retrieval with 3 follies. I'm disappointed, but you know... 3 will do. It's better than none.

Trigger is Ovidrel and I take it at 8pm. Tomorrow is a "free" day according to my calendar... Though I dunno how you can call taking the pre-retrieval enema downtime. Lol (P.S. Why has no one else mentioned a pre-retrieval enema on other blogs?)

I don't feel like this is going to be it. I am already planning IVF #2. But if nothing else, this will be a great learning experience for when we get to an out of pocket paid cycle where we can deviate from the plan determined by trial sponsors.


We're also wondering... Since this trial allows a max transfer of 2 3d embryos, what we should do if we have a third... IF we have a third. Do we freeze at 3days or push and see if it makes it to blast before freezing? Anyone have suggestions?

Discount IVF Meds

Woohoo!  A little good news today from EMD Serono (remember the Compassionate Care application I submitted for up to 75% discount on my Gonal F and Cetrotide).  I faxed the application paperwork to them on Tuesday evening, and received my card and number, etc today by email.  What a relief! (and such amazingly fast turnaround time.) 

I realize that's just a discount on 2 of the 6 meds I will be needing, but as has been my motto through most of this planning stage, every little bit helps. 

I have discovered that there are two other programs that may offer reduced rates on meds that I need.  Heart + and Design Rx.  However, these two programs are pharmacy specific I am told by my finance rep at the RE.  In other words, only certain pharmacies will accept the discounts, and the pharmacy that my RE prefers (read: is pushing me) to use is not one of them. 

Heart +
This program is, again, not going to save thousands of dollars.  The website states, up to $500 though only one of the meds on my list - Novarel - is covered by this plan, and I have no idea what that costs, so I am quite sure that the full $500 savings won't apply here. Heart + offers eligible patients savings on prescriptions for Bravelle, Menopur, Endometrin and Novarel.

DesignRX
From their website:  DesignRx partners with pharmaceutical manufacturers through its elite network of specialty pharmacies to offer unique programs to help patients with little or no drug coverage. The DesignRx pharmacies are carefully chosen to participate in the network based on their distribution volumes, geographical locations, experience within a given disease state, and overall patient customer service.
I seem to have registered for this one, but really it's all not very clear.  I need to do a bit more digging to try and figure out what it is that I signed up for, as there seems to be some type of membership forum attached to the site as well.  At any rate, they discount Crinone 4 which is on my meds list.

Here's where I could use some help/advice/opinions...

1) Have you ever used either of these programs (Heart + or Design Rx)?  Were they worthwhile?

2)  What pharmacies do you recommend?  My RE likes Freedom Pharmacy but they really push them a lot and I get the feeling that theirs is a mutually beneficial relationship - which usually does not bode well for patient prices.  I don't mind going through multiple pharmacies, I just need to keep the costs as low as possible and I would at least like to have something to compare Freedom to, to make sure that I am getting the best deal.

Any advice from those of you who have walked this road before me would be GREATLY appreciated!!

Goals: # 4 Research Different Protocols for DOR

If you're just joining us now, this is the list of my personal goals as I work towards raising enough money and preparing my body for IVF treatment in Sep, 2013.  Here is a list of the previous posts in this series if you would like to look back.

GOALS:

1)  Financing.
2)  Improve AMH
3)  Egg Quality
4)  Research protocols for DOR IVF

IVF PROTOCOLS FOR PATIENTS WITH DIMINISHED OVARIAN RESERVE

Okay, I won't lie.  I am WAY over my head on this one.  I've read... maybe 50 articles on PubMed discussing various protocols for DOR patients.  Some say Add GnRH AND Micro HCG.  Others say adding HCG can lower the clinical pregnancy rates.  I know for a fact that my protocol, chosen by Dr. C will include Micro-HCG so I am specifically looking into studies that include it.  *Sigh*  I am WAY over my head. 

All the information I have on my protocol is a list of the drugs I will be needing.  Part of me wants to know exactly what he's planning so I can get opinions and reviews from those who have gone before me.  Another part of me wants to just let the man do his job and not stress over the intricacies of the protocol he has come up with. I am torn between the two.

So if you want to drive yourself batty I recommend that you mosey on over to PubMed and go hog-wild.  As for me... I think I am going to sit on this one a little longer.

Goals: #1 Financing

What does any self-professed perfectionist do when they get results like these?  They research like crazy to figure out the BEST way to achieve their goal.  Well, no, that's not quite true... FIRST they make a list (in order of importance).  ;)

GOALS:

1)  Financing.  Need MONEY!
2)  Improve AMH. NEED MORE EGGS
3)  Egg Quality.
4)  Research protocols for DOR 

Let's delve deeper shall we?

FINANCING

Our procedure from start to finish going to cost is $18,945 which breaks down as follows:

- RE: $10,695
- Egg Guy/Lab: $2,750
- Meds:  $4,500-5,500
- Urologist: $1,000

We already have (HAD... more on this in a later post) $3,000 so we needed to come up with an additional $15,945. *GULP!*

Now, my RE will allow me to pay 75% down on the first two items.  $10,083.75 and will allow us to pay the balance of $3,366.25 off over 6 months post test/end of cycle with first payment due in 30 days post test.

*My mouth gets dry just reading those numbers.  How about you?*

There is another beacon of hope here.  There is a program called Compassionate Care which may assist us with the medication costs.  Not all, but some of the meds in my protocol are covered.  (Gonal-F and Cetrotide.  They also cover Ovidrel, but Dr. C prefers to use Novarel and the good doctor will get what he wishes if I have to pay for it myself... somehow).  The Compassionate Care program is income based.  I am told that they will first examine my insurance coverage to ensure that there is no overlap, then enroll me into the program based on my income.  They offer a percentage based discount up to 75% off the total cost of these medications.  Looking at the bill of around $5,000 you betcha I'd like to see that discount! So that's (hopefully) 2 of the 5 drugs.   

Do you have any recommendations for pharmacies online or otherwise?  I see so many on the forums buying their meds online, but I am terrified of some fly by night scoundrel running off with my hard earned money.  I'm specifically looking for Micro HcG, Novarel, Estrace and Crinone 4 -- though some of these I am sure will have to be dispensed by the doctor, I am keen to have alternative suppliers lined up, just in case I have that option.

So let's assume the financial aid with Compassionate Care, and the dodgy internet purveyor of fine hormones can help me cut the pharmacy bill down to around $4,000, that, plus $1,000 for Urologist, plus the $10,083.75 down-payment with Dr. C brings us to $15,083.75 to get started, and then we sell the babe to the pixies for a pot of gold to pay the rest off within 6 months.

ERMAGHERD!!!!