Had my CCRM consult

lynniecat · Post by **lynniecat** » Mon Sep 22, 2008 11:37 pm

Talked to Dr. Surrey. He was very easy to talk to and I felt comfortable right away. We went over my stats and he said, yes there maybe be a chance using my own eggs and wanted me to come out and do the initial lab tests. Once they evaluate me, I will hear from them what they are thinking. He said that my FSH of 11 was only mildly elevated, but that they would want to test it again with a clomid challenge test. Never had one of those and also have not had FSH done in a year. He wants to do an AMH test (I think that is what it is called) and check my uterus.

So I will at least go and see where I am at, then decide my next step. The bummer is that it takes 2 months of downtime before I could get started with a round of IVF and at 42 that is precious time.

I brought up donor eggs and he asked if I wanted to meet with the donor egg team, he said it was up to me if I wanted to talk about it or wait and see how my IVF round goes. Told me to think about it.

Anyway, so I am getting some stuff in the mail and planning to set up my appt to go for a day of testing.

Ghost · Post by **Ghost** » Tue Sep 23, 2008 2:48 am

Sounds like he handled it perfectly, but too bad about the 2 months delay.

AMH stands for anti-mullerian hormone and gives information used in the same way as your FSH. Two differences are that they don't need to wait til day 3, as AMH is pretty stable throughout the cycle, and AMH has a positive correlation with fertility, instead of the negative correlation that FSH has.

A clomid challenge test is yet another way to learn the same thing. Another is to get an antral follicle count on ultrasound.

lynniecat · Post by **lynniecat** » Tue Sep 23, 2008 3:13 pm

My work up is scheduled for next Friday. Now the real question is what they will say when the get back the results.

Having had a genetically normal pregnancy (that ended due to sickness on my part) in February showed Dr. Surrey that I at least then has some good eggs available.

kerpupples · Post by **kerpupples** » Tue Sep 23, 2008 8:38 pm

Bummer about the wait but great that they could get you in so quickly for your workup. I had both the clomid challenge test and my AMH checked at my clinic so hopefully it will give some good insight!

RSC · Post by **RSC** » Wed Sep 24, 2008 2:43 am

I go to CCRM, and Dr Surrey just did both my retrieval and transfer last week. It all went very well, and they really seem to know what they are doing! I was worried about the 2month wait, too, but it went by surprisingly fast.

lynniecat · Post by **lynniecat** » Wed Sep 24, 2008 3:39 pm

RSC --

Good luck in your 2WW. Oh btw--did you get your results from that 1st work up on the day you were there, or later?

lkmisc · Post by **lkmisc** » Thu Sep 25, 2008 4:48 pm

Dr. Surrey just did my transfer too last Thursday and I go in this weekend for the Preg test. Fingers crossed.

They were great to work with, albeit expensive. In the end though, I figure we can make more money and I couldn't justify going through a clinic with a lower success rate. The one I had checked out first in my local town had a success rate of 3.9% for my age group compared to 29.3% CCRM! It was a no brainer. Their stats are #1 in the U.S. for my age group.

I am turning 43 in Dec and this would be my first baby. My husband is 60 with no kids either.

My insurance only covered the pre-IVF stuff, but their lab does not work with insurance companies and I have a $1,000 deductible for "out-of-network" which I didn't even come close to reaching because what my insurance considered "allowable" to apply to the deductible was shockinglly low.

All in all it was a good experience and I'm trying not to think of the expense. Of course, I will be thinking of it if this doesn't pan out positively. I hope they take! We transferred two perfect 4AA embies on Day 5. Hope they were good eggs! We froze 3. We would be willing to do an FET, but would need to consult on that as they were lower quality than the perfect ones transferred. I would be concerned about them implanting if the perfects ones don't.

I saw the Dr. exactly 4 times during the whole process: consult, hysterscopy, something that had to be inserted as a result of the hysterscopy findings, and the actual transfer.

I kept my nurse busy.

If you need to know about RX sources, let me know. I created a spreadsheet and called 25 pharmacies nationwide, so I know which ones have the lowest prices. It turned out that my insurance ended up covering them, but with hefty co-pays, since CCRM will not prescribe generics due to inconsistency in results. Why mess with their stats?

Linda

lynniecat · Post by **lynniecat** » Thu Sep 25, 2008 5:46 pm

Hi Linda,

Being 42 I have the same thinking as you. Sounds like you have good numbers of eggs! Wow, even had some to freeze! I only had 2 embryos to work with on my 3rd IVF. They were 8 cells and looked perfect, but just did not take. The clinic I used was very good, but not as good as CCRM. I am now paying out of pocket and I wanted to give myself the best chance just like you. Time is tick tick ticking for us older ladies.

I am really hoping this worked for you...and with 2 blasts you have excellent odds! I am not sure I can even make blasts! I hope so..

On drugs, I have left over gonal f and menopur but not sure they will use those, so I may need to buy fresh. If so I would love to find out where you got your meds!

Fingers crossed!

Mellie_1233 · Post by **Mellie_1233** » Thu Sep 25, 2008 7:33 pm

Just wanted to add that I cycled w/CCRM in January and the lab did accept a "PPO waiver" so some of the cost was covered. What we didn't realize was that the surgical center was separate, so we neglected to get a separate waiver for that.

So, anyone planning to use insurance w/them should be aware that the dr's office, lab, and surgical center are 3 separate entities.

Good luck!

lynniecat · Post by **lynniecat** » Thu Sep 25, 2008 7:39 pm

Mellie,

What do you mean by waiver? I don't think my insurance will cover any of it, but maybe. I will submit everything.

lkmisc · Post by **lkmisc** » Thu Sep 25, 2008 8:50 pm

The meds I priced out were for Menopur, Follistim, Gonal-F, Endometrin, Vivelle patch, Novarel trigger shot and the brand name Lupron two week kit, which was the most expensive. There were wide variations in price on that, but all were above $300! It had to be brand name for that one.

I was also put on dexamethasone (steroid), and two different antibiotics. Those could be generic, and I just went to Target/Walmart since they have the $4 generic program.

Once you know what you will be on, let me know and I can tell you which pharmacies are cheapest, and they all ship overnight. I also compared shipping costs. Some actually charged for that. I crossed them off my list. Also, tell them that you are not covered by insurance for your meds and they will give you a price that falls under a program called Design RX, which is a free membership (at most pharmacies I called, but not all) program for those paying cash. It only applied to two of the meds I needed though.

So, I was going to use three pharmacies. However, in the end, the first one called me after doing my insurance verification and told me that my insurance indicated I had to go through my plan's speciality pharmacy, which turned out well, since I only had to pay co-pays. I had thought that the drugs would not be covered based on an initial conversation I had with an insurance rept. Luckily, there are other uses for the drugs outside of IVF, so that is why they qualified. I thought I would end up having to pay at least $3K for meds. So far, I am up to about $500, but that includes an error on my part where I ended up having to pay an additional $100 co-pay. If you only have co-pays, have the scripts written out so that your entire cycle is covered, otherwise you will have to pay a co-pay each time you order. That is why I had the extra $100 co-pay. I am still battling with my insurance over Vivelle patches. They cover a box of 8 per MONTH. I am required to use a box of 8 per WEEK. So, they have to get the dr to justify the dosage. I am hoping it pans out. Otherwise, I am looking at another $350!

RSC · Post by **RSC** » Fri Sep 26, 2008 2:21 am

Lynniecat, I don't remember when I got my work-up results!
You are in good hands; I am wishing for the best for you. I think the time will fly! I'm already going in for my beta on Monday!

lynniecat · Post by **lynniecat** » Fri Sep 26, 2008 2:58 am

Wow Linda,

Thanks for all the information! What is the vivelle patch for...is that used after the transfer? Also why gonal-f and follistim (I thought they were the same thing).

I am not sure whether I will have insurance cover any. I will definitely try. I am going to hopefully change plans to one they may cover part of this!

I hope you get that BFP!

lkmisc · Post by **lkmisc** » Fri Sep 26, 2008 2:56 pm

Oops. I didn't think to clarify. I didn't know if I would be on Gonal F or follistim, so priced them both out. I ended up on Follistim.

Also, would like to know the answer about the "PPO Waiver" from the previous poster too!

Linda

kerpupples · Post by **kerpupples** » Fri Sep 26, 2008 3:21 pm

I can partially answer Mellie's question as I have the same insurance company as she does and was looking into CCRM if this cycle didn't work. If your health insurance doesn't cover IVF either in or out of network, it's not relevant to you.

CCRM's doctors are considered in network for my insurance (Blue Cross of MA). Their lab and surgical center do not participate with insurance and thus are considered out of network. Apparently you can be granted a waiver so that they are considered in network which saves tons of money. Not sure if you get the waiver from Blue Cross or from CCRM though.

Had my CCRM consult

Had my CCRM consult

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