Yes. That’s right. ME.
And also?
Antral follicles: YOU CAN SUCK IT.
So this will come as no surprise to you, but I am a total idiot.
Like the time in college I walked straight into the men’s room in the packed student union and when I suddenly realized my mistake (BOYS! STANDING UP! HOLDING THEIR PEE PEES! IN THEIR HANDS!!) I turned around, rushed back out the door and then looked at my watch. And tried to appear impatient and totally in control of all my faculties.
As if to say to anyone who had witnessed my grave error: Oh! I meant to do that. I am waiting for someone and he is very late and so I thought I’d take a peek into the men’s bathroom and see if he was in there.
I am that kind of an idiot.
Because I thought once you said, okay doc, I’m ready, let’s get this IVF train out of the IF station and straight downtown to babyville it would just happen quickly.
But no.
I have to do not one — but TWO — cycles of birth control pills. I guess because of the antral follicle count they want me to start the Pill at the beginning of my next cycle, take it for the 21 days, have a period, and then start another pack of pills and then the Lupron.
Is this normal?
And by ‘normal’ I mean ‘within reason’ because, really, my definition of normal is skewed now that I will willingly be putting my feet into stirrups and asking a doctor to pluck my eggs from me, mix them with BeBop’s sperm in some kind of a petri dish contraption thing and then (if all goes well!) stick them back in me.
So it looks like I’ll start Lupron the first week or so of March and then the whole retrieval/transfer business won’t happen until the end of March.
Which brings me perilously close to my younger sister’s baby shower planned for April, but that’s a whole other whiny, poor me post. (Which I’ll treat you to another day because I’m a sharer like that!)
In addition to the whole timing issue, I also have a question for you lovely ladies about the meds. There is a local pharmacy that carries the Lupron, Gonal F/Bravelle, Repronex, Medrol (which? What is this? There’s a great middle eastern restaurant in San Francisco called Med.jool but I’m thinking this is not a gift certificate courtesy of my doctor for some Cosmos and pita with hummus…) and the PIO (Oleate or Oil? Wha???).
And the needles. Sweet mother of God, the needles!
And I know: totally preaching to the choir here.
Here’s my question: should I just get the meds through the local pharmacy or order them from some other place that ships? Is there a cheaper way or am I just dreaming that I don’t have to spend the future kid’s college fund just getting knocked up with him/ her??
Any other helpful hints in terms of the meds?
Ask your clinic for a price rundown of exactly what amounts of the drugs you’ll need (the stims, for example, come in different sizes, so you can figure out the most cost-effective way to order them based on what your doses will be), and if you’re paying out of pocket for them, ask them which discount pharmacy they refer to. This should not be an unknown question. At the same time, the birth control pills are likely covered on your regular insurance, right? And for what it’s worth, I paid about two grand for one cycle of IVF drugs, and ended up not even needing a $600 vial of Gonal F. So it’s sitting in my fridge, an expensive vial of chilled drug.
Don’t know anything about the two sets of BCP, but from what I remember, the Lupron shots were OK, but the Gonal-F pen I took for the stims had a needle that was whisper-thin. And again, I say this as a longtime diabetic who knows from needles. It was nothing to take the stim shot, I tell you.
Good luck!
Two cycles! That sucks big, sweaty donkey nads. I’m sorry Sweetie.
Good luck!
Interesting. I wonder why he thought you needed TWO cycles of the pill? One should do it just fine, particularly if you’re adding Lupron at the END OF THE CYCLE like you should. The Lupron should suppress you enough that your antral follicle count would be null and void.
At least, that’s what WHY I though people used Lupron in IVF cycles to begin with.
But hey. Don’t listen to me, I’m no doctor.
If it helps (and I’m SURE it doesn’t), if I don’t need more surgery there’s a good chance we’ll be cyclesistas.
And every time I’ve cycled with someone, that particular someone has gotten pregnant. Every time.
To your question – there are discount pharmacies that will ship to your door. I was lucky that mine were covered by insurance, so I can’t help you with which one though.
WAAAH! Two packs? What’s up with that? (Not that I know squat about IVF protocols or anything, but it just sounds like making a long-ass process longer and…assier.) And, pardon me for being a dumbass (most people do!) but is the two-pack thing because you have too MANY antral follicles or too FEW?
Finally, BLAAH to the baby shower right around retrieval/transfer. But I guess the bright side is–if you’re in the mood for grasping at straws–that if the shower takes place during the 2ww, you’ll be so distracted by wondering “Was that an implantation twinge?” and “Are my boobs getting sore?” that you won’t be able to get into full woe-is-me mode. (And, there’s always that bizarre outside chance that you’ll…you know…get pregnant. Which would make a lovely story to bore the cousins with years from now.)
Sorry… I don’t have any info about the meds, or why you are doing 2 cycles of BCP. But mother fuck… I feel for you. It’s the kind of thing that other (umm, you know, those fertiles) don’t understand- what’s another couple of days, they say. Every day counts, we get that.
But, sounds like you’ve got your schedule set up well, and I’m excited for you for this cycle.
Much empathy for the shower…
My only bit of assvice – the PIO in the oleate for apparently is easier to inject. I *think* Faith at Keeping the Faith posted that. If that is the case, go oleate!
How many antral follies did you have?
Hey, I’m just through OCP’s, Lupron and Follistim, and am ‘triggering’ tonight. I did a ton of research on meds, and was worried about the same thing – is it smart to get them somewhere other than my clinic or a local pharmacy, blah blah blah. I found
http://www.fertilityplus.org and they have a link to “discount fertility medication” I called about 20 of them across the US. Alexander’s pharmacy in NJ was by far the cheapest ($365 for 600IU Follistim, vs $564 local). Anyway, they fedEx’ed it out next day delivery free, included needles, a sharps box and all of the crap that goes along with the injections. I was pissed enough that insurance didn’t cover shit, even my preIVF STD tests, that I didn’t want to spend even MORE $$ on the god-damn meds.
Ah, yes, the drugs. Sadly, I have enough experience to have lots of advice:
1) Check with Freedom Drug and the Apothecary Shop (Arizona-based, but they ship). Both tend to have good prices.
2) Find out if your insurance will cover the Lupron and whether you need a pre-authorization for them to do so. It’s a drug that’s used for other things than infertility, so a lot of times it is covered. However, my insurance co. required a pre-auth, so others might too.
3) I think the Medrol is the trigger shot.
4) Once you find out how much stims your RE is going to recommend you take, you can determine how to order them. The Gonal-F and Follistim come in 300 (equivalent to 4 vials), 600 and 900 unit cartridges; ask the pharmacy what their refund policy is for an unopened cartridge and how quickly they can get more to you if you wind up needing more.
5) Whatever pharmacy you get your PIO through, ask them if they can put it in cottonseed oil. It’s thinner than sesame oil, so it’s easier to use a 25-gauge needle if it’s in cottonseed. I know Apothecary puts it in cottonseed; I don’t know about the others.
6) You may have a few different sizes of needles and/or syringes. If so, get a gallon-size plastic bag for each set, and group things together in those bags and label them. For example, one bag would have the syringes and needles you need for the PIO, along with the PIO vials; another bag would have the Lupron needles. (The Lupron itself is stored in the fridge.) Depending on what meds you’re taking, which needles go with which meds may be pretty obvious anyway, but in my case there are so many different meds that this helps.
7) Speaking of the needles, they’re really not that bad. Ice the area for 20-30 seconds first, then use the alcohol swab, then wave your hand or a fan or something over the area to dry it before injecting. (The alcohol can pinch a little bit if it’s not evaporated when you stick the needle in.) For the PIO, alternate sides and in addition to the ice, lay on a warm (not hot, you don’t want to cook the embryos) heating pad for 5-10 minutes afterward.
8) Make Mr. Watson help you. My husband preps all the IM shots (draws up the meds, gets out the band-aids, etc.), then he holds the mirror while I lay on the bed and inject the needle. Once I have the needle in, he takes over from there and pushes in the plunger, because it’s kind of hard for me to twist around for that long.
Sorry about the BCP’s issue — those always suck!
RE: the Medrol, in particular: It is NOT the trigger shot. 🙂 Usually hCG is the trigger shot!
Medrol is a form prednisone — a type of mild steroid type of medication used to “calm” the immune system, so that when the embryos are transferred, your body doesn’t freak out and kill them. 😉 It is actually a VERY commonly prescribed med. I’ve had four days of Medrol for all of my cycles. It’s not really a big deal. Kind of falls into the category of “Can’t Hurt, Might Help”. 🙂
I don’t know if you guys have any prescription drug coverage at all — while we have NO fertility treatment coverage at all in Canada, our prescription drug coverages through my husband’s company are excellent, and all our meds have been covered.
Lupron is also used as a cancer treatment, so it SHOULD be covered by all plans.
There are tons of pharmacies you can get your standard fertility meds from….others above made some good suggestions. The best thing to do is get your EXACT prescriptions and dosage instructions, and then just check between every pharmacy to see who has the best prices, etc. There is also Shraft’s Pharmacy, which ships anywhere in the world. I think everyone mentioned the other ones. 🙂
That’s all I can think of for now — if you don’t want to do PIO injections, what about Pr0metrium intravaginally? I’ve done it for a mock cycle in the past, and it worked well. Also using it againg for this FET cycle, since we switched our protocol from Delestr0gen IM injections, to Estr0gen patches, and along with that switch, comes the change from Pr0gesterone injections to Pr0metrium. Trust me, it is a LOT easier! 😉 Just something to think about. 😉
Good luck with all of this! You know where to find me if you have more questions or whatever! 🙂
xx
Nilla
I have no idea of how you guys do your cycles over there- but I had to tell you that I did the changeroom thing too- AT THE GYM!! About 10 years ago I joined a new gym, didn’t realise that on weekends the womens changeroom became the mens! Ack- pee pees galore!!
Interesting about the two cycles of birth control pills. Did they explain why you are doing this? Is this to quiet down your ovaries and lessen the chance that cysts will form? I’m assuming you have PCOS. Dr. Z must think you have a pretty severe case to put you on Metformin for 3 months and then bcp’s for 2 months. To bad they couldn’t overlap the last two months of Met with the bcp’s to save some time. In theory the Met should make the quality of your eggs better. If you have questions or don’t understand why your on this protocol then I’d e-mail one of the nurses or your nurse coordinator. You could even e-mail Dr. Z. I always get a response right away. They are wonderful like that.
About the medications… Dr. Z recommends the Progesterone in Ethyl Oleate b/c it’s a much thinner substance than sesame or peanut oil. This makes it easier for the medication to distribute once injected and you’re less likely to have welts and you can use a smaller gauge of needle so the actual injection won’t hurt as much either. You can use a 25 gauge needle with the progesterone in Ethyl Oleate. Dr. Z is great about that. He allows a smaller gauge for several of the meds. For the Lupron you can use a 29 gauge instead of the 27 and it makes it basically painless.
Maybe we should exchange phone numbers via e-mail so we can dish on our protocols and compare notes…. I’m also in a waiting pattern due to my damn cyst. Drop me a line if you’re interesting in chatting sometime.
-Faith
I did 2 rounds of BCPs before my FET, but not IVFs. . . .
As for the meds, Rebecca always gives the best advice. She was a lifesaver for me. I was soooo intimidated by the needles for the PIO shots. Then Rebecca explained the deal to me and so did many other bloggers — thankfully!! For me, though, PIO shots are better if you warm them (I stuff the vial in my bra) and my husband is now a pro at administering them. One night, though, we got into an argument and I did it myself ‘cuz I was so pissed off. It didn’t even hurt, seriously.
So, the long and short of it is, YOU WILL DO JUST FINE!
My memory of US bloggers is that ordering the drugs online from a store which is based in gibraltar was by far the cheapest option. I thought it was called Freedom drug but it sounds like they are someone else.
Re the 2 months of bcps I would push back hard on this. Given you didn’t have a good response on at least one IUI, I’d be worried abuot over suppression. What was your antral folicle count? I can’t find it in your archives. In the UK they usually don’t use bcps at all as they worry about over suppression. It’s simply not needed as the lupron will suppress you anyway. The US clinics seem mostly to use bcps for scheduling, so I’m very confused as to why you’d do 2 cycles of this.
I can offer no help, other than to validate your assessment that, yes, it all SUCKS.
I know nothing about meds (yet) but I have a feeling that my body is going to Reject this IUI and insist that I pay through the noise or (Va-J-J ) and so I am sure we can empathize with each other…but it still sucks the BIG one.
However, I think your posts could make me giggle no matter what. I have to thank you for keeping my “funny bone” in working order.
I’m thinking of you sweetie pie, hang in there.
*hugs*