Signed up for June IVF cycle at MCRH! Very nervous!

Discussion forum for those particularly interested in IVF and embryo transfer including frozen embryo transfer.
Nifferela
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Post by Nifferela »

Hello Ladies!

Well, it's been rainy in Brainerd for the last 2 days. It's given me some time to do some research and watch my IVF video. I got my medication outline today! I am so overwhelmed I can't even make heads or tails out of it. I want to start researching where the least expensive meds. are, but I don't even know where to begin. Should I take this list to my local clinic pharmacy (where I have most rx's filled) and ask them to see if I only have a co-pay or if I have to pay full price? If they determine that they aren't covered, then do I start researching other pharmacies? Perhaps the online one that Brenda suggested...Freedom Pharmacy? And how do I get a price estimate for each med? Sorry, it sounds like I'm freaking out, I just like to try and be organized and I want to have an idea of this cost before it hits us!

Any advice or even a step by step outline of how to find out the costs of these would be greatly appreciated!

Thank you so much!
Niffie
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EYCI
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Post by EYCI »

I think starting with your local pharmacy would be a good place to begin. They can check with your insurance and also give you a price quote. I had mine do that.

Once I had the prices, I called other pharmacies that MCRH had provided information for. Hopefully somewhere in that packet of stuff you have there is a list of pharmacies. If not, call MCRH and they can send you one. Both Brenda and I had the best luck at Freedom Drug. They specialize in IVF drugs... so their prices were (as we found) the cheapest and also had great service. You will just need to fax them your prescription. Then, give them a few hours to get it into the computer. Then you can call them. Since you probably have several choices of meds (like Follistim vs Gonal - F) you can ask for prices on all. I really just went with the one that was the cheapest per dose. Which, for me, was the Gonal - F pen. They are extremely helpful and patient! You can do the same thing with other pharmacies.

Wasn't the weather just beautiful this weekend? Ha ha ha. Well, I guess April showers bring May flowers so we should be greatful for all the rain. Don't worry too much about the whole process. It seems complicated and overwhelming at first but will start to make sense. Just stay positive and try not to worry too much :)

--Julie
Me 36, DH 34 - Creating our family since 2002
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brenjamie
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Post by brenjamie »

I couldn't agree with you more Julie. I also checked with my local pharmacy but they told me they wouldn't be able to compete with the prices I got from Freedom Drug. They are great to work with. Very friendly. Just call them and ask for prices and they will give them to you. They also deliver next day and the shipping is free!!
Yes, it does seem like a very complicated process but you will do fine. Just read over the materials and ask questions. Before you know it, you'll have it down.
Yes, our weather in WI was rainy all weekend too. And it rained all day today also. I had my 2nd blood test today and HCG rose to 1868. It was 439 on Friday. They told me that is great and things look very good. I haven't gotten my official due date yet but they are sending me prenatal stuff in the mail and should get it in a few days. I'm sure it will be in there. I'm thinking around the 1st of the year. Do you remember what your numbers of HCG were Julie? And were they 14 days after transfer? Just curious. I know they sometimes say you can determine twins if the levels are higher. Since we already have our daugher Molly, we are a bit scared of having twins. But we are just happy to be pregnant again and will take what we get. Have a good week girls.

Brenda
Brenda age 33 (Male Factor
daugher Molly age 2 (FET)
3/2002 failed IUI
6/2002 failed IVF/ICSI
9/2002 failed IVF/ICSI
4/2003 positive FET
April 2006 IVF/ICSI ++tive BFP!!!
EYCI
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Post by EYCI »

Hi Brenda,
Glad to see your numbers are still looking awesome.

My first blood test came back at 900 something. We had our transfer on a Wednesday and my first blood draw was 2 weeks later on a Wednesday. When I went back for the 2nd draw on Friday, it was 2700 something. I was pretty sure by the numbers that it was twins, but they say you can't read into that too much. Of course, it did turn out to be twins :D Even though we lost one of them, we still feel extremely blessed and lucky to be where we are right now.

I hope that you have a happy, healthy, "uneventful" pregnancy! I look forward to hearing how things are going for you!

--Julie
Me 36, DH 34 - Creating our family since 2002
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Nifferela
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Post by Nifferela »

Thank you both for responding regarding my med questions. I'll be anxious to start calling around once I get MY detailed med outline. My list allows me to choose from the following meds. I don't know why they let you choose, and I don't know the diff. I'm sure they'll go over that with me, but here is what I have to choose from:

Gonal-f RFF 74iu
Gonal-f RFF Pen 900iu
RFF Pen 450iu
RFF Pen 300 iu
Gonal-f multi-dose 450iu
Bravelle 75iu

Then I need to choose either Repronex 75iu or Menopur 75iu.

At this time, I don't know what the difference is in these, or which one to choose. I'm certain the med outline person will help me understand. From your experience, are certain ones better for administering and for side effects?

Thanks!
EYCI
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Post by EYCI »

Hi Nifferella,

I asked the nurses those same questions. They said that as far as effectiveness is concerned, all are the same. Otherwise they said they wouldn't give a choice. As for side-effects, I'm not sure if any are better or worse than the others. I chose the Gonal - F multi-dose pen and Repronex. I picked Gonal - F because it was the cheapest (that I found) and Repronex because I still had some left over from a cancelled cycle.

For Gonal - F multidose pen, the medicine comes pre-mixed in a syringe. All you do is change the needle for each injection. At the end of the syringe is a little dial that you turn to the dose amount that the doc tells you. Very simple :) I had no injection site reactions to this medicine.

For Repronex, you will need to mix a liquid with a powder. It is a little more work, but still quite simple once you are taught how to do it. With the Repronex, some people end up reacting to the injection when you use a short, sub-cutaneous needle. I was one of those. I got big, 3-4" welts at each injection site. It took about 3 days for the welts to start showing up. They hurt like bruises. So, I had to switch to a long, intra-muscular needle which DH had to give me. He did an awesome job!

As for side-effects, I felt the worst during the down regulation on lupron. Hot flashes and never ending headaches. But once I started the stim meds, I felt much better.

Once you take your injection class at MCRH this will all make more sense. It will also help when you have the medication outline with one of the nurses. Try not to feel too overwhelmed. I'm sure you will do very well!

--Julie
Me 36, DH 34 - Creating our family since 2002
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Nifferela
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Sonohysterogram! What a nightmare!

Post by Nifferela »

Hello ladies!

Today was quite a nightmare! I went in for a sonohysterogram to make sure I don't have any fibroids, etc. in my uterus before we start the IVF treatment. I didn't anticipat it being nearly as bad as the HSG (with the dye) that I had in December. Boy was I wrong! First of all, the poor radiologist could not get the speculum in and ligned up with my uterus...he had to try 6 times. Once he finally got my cervix open, he tried feeding the catheter in. That was so awful I thought the pain couldn't get much worse! Finally, he had to page my OB/GYN dr. who just happened to be there today. She came to my room, started all over, and shoved the catheter right in. Then the pain really started! The saline they inserted caused such terrible cramping I actually started crying. My OB/GYN was holding my hand, telling me to breathe. It was by far the most painful thing I've had thus far. Usually when we have our IUI's, they can get the spec. and the cath. in with no problems, just a little discomfort! The radiologist was very apologetic and nice, and I appreciated that. I don't believe I will be having any more procedures that will be that painful (that I'm awake for at least) unless I've missed something in my IVF reading. Can you ease my nerves by sharing what I have to look forward to once we retrieve our eggs?

I read that the transfer back to the uterus is like IUI they just put embryos in you instead of sperm. Any thoughts?

Sorry for too much info, just wanted to share with you my nightmare day, hoping you can share some good news. How are you both feeling? Brenda...are you having twins?

Talk to you later,
Niffie
EYCI
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Post by EYCI »

Hi Niffie,
Sounds like you had quite the ordeal! My HSG was pretty painful as the dye caused lots of cramping, but the sono went well. Dr. C did both of them. Be glad they didn't find anything. I did and had to have surgery to remove them, which wasn't so bad, just a delay.

As for the procedures, during the retrieval the only painful part was when they had to clean the vaginal walls. It was some vigorous scrubbing to say the least. I asked them to crank up the drugs (via the I.V.) and that was about the last I remember from the retrieval. I vaguely remember moving to the recovery room.

For the transfer, it should just be like the IUI you've had done. They will do everything they can so that you don't have any cramping, which could push the embies into the wrong place. Mine was very painless except for some small discomfort with the speculum.

I've been feeling really good with the pregnancy. I was extremely tired during the first trimester, probably due to it being twins. I was lucky to only have a few days of nausea. I'm just starting to bust out of my regular clothes, but maternity stuff is still too big.

Don't worry about the procedures... the pain far outweighs the peacefulness you feel in your head, knowing that the outcome of the pain could be the answer to your prayers. It's ok if you feel wimpy about it. I had to get an I.V. the other day for dehydration and the nurse had a terrible time getting it to go. She missed 3 times and didn't give me any of the skin numbing stuff. Anyway, I new I was being a baby about it but I didn't care. If it hurts, it hurts. You don't always have to be brave. I just laughed and said "how am I ever going to get through labor if I can't even handle the I.V." I think it helps to have a sense of humor.

Keep us up to date :)

--Julie
Me 36, DH 34 - Creating our family since 2002
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Nifferela
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Thanks!

Post by Nifferela »

Thanks Julie for the words of encouragement. I didn't have this procedure done at MCRH, just my local hospital. I feel they know what they are doing when they are basic tests such as these, and since insurance doesn't cover any of this, why drive to Maple Grove when I can drive to Brainerd and have it done. Do you recall, did you have the "uterine catheter fitting" that MCRH lists as a pre-requisite before transfer back to the uterus? This is something Dr. C likes to do so he knows the "design" of your cervix and uterus? I'm beginning to think I really need to have him do that so I don't go through this again when they try to transfer my embies :)

I hope to be back to myself tomorrow. I feel traumatized from my experience today, and generally speaking I have a very high threshold for pain. So...with that said, labor (if we're lucky enough to conceive) is going to be very interesting :lol:

Again, thank goodness for this board. Julie, after I have my med outline on Monday, May 8th I'll know what I need for meds. Does your offer still stand about your unused meds? And if so, have any of them expired? I read that some expire 28days after, and some are 3 months.

Thanks!
Niffie
EYCI
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Post by EYCI »

Hi again,
I think they did the catheter fitting during the 2nd sono, since I had to have a repeat after the surgery to make sure all was clear. They might be able to do it for you during the egg retrieval procedure. But, to be honest, I'd ask the nurse that question during the med outline on Monday. I think they just take some sort of internal measurement that allows them to make sure that the embies get put in exactly the right spot.

You are still welcome to have my meds. I checked a few days ago and I don't think any are expired. The gonal-f needs to be refrigerated until you are ready to use it. I also kept the repronex in the fridge since it is not supposed to get above 77 degrees (or something like that). They have all been in the fridge since the day I got them. Once you are ready to use the gonal-f pen, it does not need to stay refrigerated. I think once you take it out of the fridge, it is good for 28 days (or something like that.) Freedom Drug shipped everything refrigerated so you don't have to worry about that. I think they also go over the storage requirements at the injection class.

Oh, one thing about the medication shipment. It comes FedEx and a signature will be required. They won't just leave it on your doorstep. So, I had mine shipped to my work address so that I didn't have to go pick it up. It is shipped confidentially, so the box doesn't give it away. But, it will probably say to refrigerate upon receipt so I had to give the shipping guys a heads up to bring it to me directly without opening it first.

--Julie
Me 36, DH 34 - Creating our family since 2002
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brenjamie
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Post by brenjamie »

Hi girls--
Sorry I haven't been around for a few days. I was out of town at a conference Thursday - Saturday. So yesterday was catch up time around the house and back to work today. So I tried to catch up on your posts from then.
Wow, your med outline was today already. Well, I guess it is now May and you are doing the June cycle. Time sure does fly. I hope it went well today. You will probably think of more questions, just don't be afraid to call and ask. Julie, that is great of you to offer your meds. Niffie- I would definitely take her up on it. They are very expensive and can not be returned so at least they can help you. I was very luck this time and calculated correctly and had none left over. I guess some of that came from experience after doing this for the 3rd time. I'm sure your head may be spinning tonight, but it will all start making sense soon.
I am so sorry to hear that you had such a painful experience with the sono. I had Dr. Corfman do mine. I didn't feel a thing. He always told me that if my other Dr. couldn't guarantee that it wouldn't hurt that wasn't a good sign. He really tries everything to make things as comfortable as possible. At least it is over and you don't have to do it again. Don't worry about retrieval. This last time I was pretty much out of it the whole time. I, like Julie, hardly remember them taking me to the recovery room. They will take very good care of you.
I do not know how many I am having yet. I have set up my ultrasound for Monday May 22 at MCRH. I could go to my OB since it is closer, but really want to return there and share our wonderful news with everyone there. This will be it for us, granted that everything goes well with this pregnancy, so we want to go and share one more moment with them and thank them once again for helping make our dreams come true. I am feeling fine so far. A bit yucky from time to time but nothing consistent yet.
As far as the meds go, I used Freedom Drug and they are excellent to work with. I used the Gonal F pen, it's great. I used Menopur as my FSH, LH med and used Ovidrel as my HCG. Ovidrel is nice as it comes prepackaged and premixed, all you do is open it and shoot. I did react to the Repronex as you mentioned, Julie. I got big red welts and had to switch to IM shots. Then it was fine. That was a with one of my failed cycles. That is why this time I just chose Menopur. But it doesn't really matter.
Julie - how are you feeling? I'm sure you are still very excited.
You girls will both do fine with labor when the time comes. I feel like a wimp sometimes with all this stuff too and then when I had my daughter you just get this overwhelming feeling of this is what I have to do and you do it. I went through labor with her and then her heart rate started to drop. I was then ready to push so I did that for a little while and it still started to drop so then I had to have an emergency C-section. Talk about going through it all. And you know what I can honestly say none of it was all that bad. We are strong. Look at all we are going through just to get the chance to have labor.
Well I've got to get to bed. Best of luck on your journey Niffie!! Keep us posted and we'll be happy to help you with any questions along the way. Julie - hope you are feeling well. And remember to enjoy every minute you are pregnant. I remember friends saying how they couldn't wait for it to be done. I enjoyed mine, but when it was over I worried I may never get to experience it again. So just enjoy it everyday. Talk to you both soon.

Brenda
Brenda age 33 (Male Factor
daugher Molly age 2 (FET)
3/2002 failed IUI
6/2002 failed IVF/ICSI
9/2002 failed IVF/ICSI
4/2003 positive FET
April 2006 IVF/ICSI ++tive BFP!!!
Nifferela
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Joined: Mon Apr 24, 2006 2:21 am

Post by Nifferela »

Hi ladies!

Glad to hear from you Brenda, and I'm glad things are going well. I bet you were tired after your conference and long weekend. Hopefully you are getting rested up now, in time for another weekend:)

I am going to order shortly from Freedom drug, and I'm thinking I should just order everything I need for the first round. Is there any disadvantage to ordering it in pieces or segment through the down reg, then stim. process?

I'll have to do some calculating to know just how much I need to order for the Gonal-F pen. Julie, is that what you have left over? I suppose I should really get the details from you now that it all makes more sense.

I have selected to use the following:

Gonal-f RFF Pen: If I take 150iu twice a day, that will be 300iu per day times at least 10 days...that's how I need to figure it right? So I need a total of 10,000 iu's over the course of the 10 days, so I need AT LEAST 4 of the 900iu pens. Correct?

I have also selected to take the Menopur. I can't remember if the clinic said this was one I had to mix. On my prescription chart is say under quanity 14 with 2 refills. If I only take that once a day, why would I need 14?

I don't want to over order, and I just don't know how to decipher this too well. Although MCRH is very helpful, they try to stay out of the details of ordering the amount you need for JUST one cycle. Can either of you help?

I also have to use the progesterone vag. suppositories for the first 12 weeks! That is going to be scary. Did either of you have to take them?

Thanks again...this has been great for my mental health.

Niffie
brenjamie
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Location: Wisconsin

Post by brenjamie »

Hi Niffie

It is a little confusing when it comes to ordering. I looked back on what I had done in past cycles to guide me a bit, but being your first time you'll have to make some good guesses. I would look at your med outline sheet and make sure you order enough to get you through to your first ultrasound( I think that is day 6?) and then order enough for maybe 2 more days. This will get you through a couple days after you find out results from your ultrasound and then you would be able to order more. Freedom Drug will get you meds next day if you order by 2 or 3pm. So that allows you to get closer with your amounts. But when in doubt I would make sure you order enough so you do not run out when you may need it.
I think this time I ordered
1-900 Gonal FPen
2-450's
10 Menopur
Ovidrel

It was close to this. Just sit down with it and try to come close. You dont want to get stuck with too much extra as it is wasted money, but you also don't want to run out when you still need it.

Yes, I did use the suppositories. In fact, I still am now and have to continue through 12 weeks. They are a bit messy, but they're OK. When I was pregnant with my daughter, I had to do those plus progesterone in oil injections. Those were 2 times a day and were IM shots. NOT FUN!! They have changed their protocol on that now. Thank goodness. Here too, only order enough for 3 weeks or so and then hopefully when you test positive you can order more.

Hope this info helps.

Brenda
Brenda age 33 (Male Factor
daugher Molly age 2 (FET)
3/2002 failed IUI
6/2002 failed IVF/ICSI
9/2002 failed IVF/ICSI
4/2003 positive FET
April 2006 IVF/ICSI ++tive BFP!!!
EYCI
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Location: Minnesota

Post by EYCI »

Niffie,
Trying to figure out all of this med stuff sure can be confusing, that’s for sure. I agree with Brenda that you may not want to order everything all at once because you may end up with a lot left over. I would do exactly what she suggested and make sure that you have enough stim meds to get your through past your first scan, plus 2 more days. The reason to make sure that you have at least 2 more days is that after your first scan, you may have your dosage changed and have to take more medication so you want to make sure that you have some extra. That’s what happened with me. I ended up with sooo much extra because of how my 2nd scan worked out with the weekend and so I ordered enough to get me through the weekend, but then didn’t need any of it because the scan showed the follies were ready.

For your initial order, I would get all of your down reg meds, the doxycycline for you and DH, the stim meds for the first few days, your hcg medication, and suppositories for 20 days (which for me was 40 pessies (suppositories)). You’ll end up placing another order for more stim meds as you go on, but at least you’ll have everything else to start with. HOPEFULLY, you will also end up needing more of the pessies because you will be pregnant J :D

I think the nurses are reluctant to tell you how much to order, because they don’t want to get blamed if you end up with extra. But, if you are truly overwhelmed with it, don’t be afraid to call them and push them for a little more help. I have one Gonal F multi dose 450 iu pen that you can have. Are you going back to MCRH for any of your scans? Perhaps I can leave it with MCRH and they can give it to you when you have an appointment. If you are monitoring up in your area, we will have to figure out something else.

When do you start your down regulation? I bet you are getting anxious! Hopefully you can keep yourself busy and not worry about things too much.

Brenda -- how are you feeling? When is your scan? Does your daughter know what is going on or will you wait to tell her until you know for sure that things are going well? I suppose 2 is a little young to understand what it means for Mommy to be pregnant, but I’m sure by the time this baby (or babies!) is born she’ll treat it like it is her own little doll. How fun.

Take care,
--Julie
Me 36, DH 34 - Creating our family since 2002
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jackoa21
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Post by jackoa21 »

what is down regulating? Sorry I am confused and keep reading this
me 34 DH 34 1st ivf 06/06 + lost at 5 weeks
Natural BFP 09/06 by the grace of GOD
Kennedy arrived 05/2007 and we are loving every moment...
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