Update and More Waiting

As I mentioned in a previous post, I had been instructed to call the clinic with the first day of my period. So when I finally got my period I called the clinic to report this and assumed that I would soon be told to start taking birth control pills in preparation for the stimulation. (Birth control pills are often used prior to the stimulation phase in order to “rest” the ovaries and reduce the chance of ovarian cysts.) Imagine my surprise when I got the call back from the clinic that this time, I would be doing a “no pill” cycle and that I would need to start doing the stimulation injections on the second day of my period. Of course this involves now waiting for my NEXT period before starting because it was already Day 4 of my period by the time I got the call back with this information.

During my first egg retrieval cycle, I had a lot of trouble with the HCG trigger shot (see previous post) so I asked if I could have Ovidrel this time instead of generic HCG. I had trouble getting all of the HCG medication out of its vial and into the syringe. Ovidrel comes in a pre-filled syringe so it would eliminate that problem. (I learned about Ovidrel from reading other people’s egg freezing blogs.) The doctor agreed so I am relieved that it should be an easier trigger shot this time.

When I got the prescription list, I saw that my doctor is making some changes in addition to switching to the Ovidrel: Last time I was on 75 IU Follistim + 75 IU Menopur for the first 8 days of stimulation, before moving to 150 IU Follistim + 75 IU Menopur for a couple of days, and 75 IU Follistim + 150 IU Menopur on the last day of stimulation. This time, I will be on 150 IU Gonal-F and 150 IU Menopur from the start, so double the dose of what I was on for most of my first cycle. And it will be Gonal-F instead of Follistim.

I am very lucky to have insurance that covers the medications. However there is a lifetime limit on fertility coverage of $15,000 and the medications count against that limit. So I decided that it would be a good idea to find out which pharmacy had the cheapest medications so that I would not use up more of that lifetime limit than necessary. This turned out be an exercise in frustration. I called my insurance to confirm that its preferred pharmacies had not changed since last year. They are still the same--one mail-order pharmacy plus the Walgreens Specialty Pharmacy. I asked the insurance guy if I could compare the prices of the two pharmacies for certain medications, and he said I would need to call the pharmacies to do that. I called up the first pharmacy and they said that they could not tell me the prices that would be charged to my insurance plan and that I would need to call the insurance in order to get that information. Of course, when I had called the insurance, they said I would need to call the pharmacies to get pricing information. Frustrating! I did not bother calling the second pharmacy since I would be unable to do a price comparison without any information from the first pharmacy. So my attempt to be a good consumer and find out all the prices was a bust, and I ended up going with the mail-order pharmacy because that seemed more convenient. When my packages of medications arrived, I looked through all the paperwork to see if I could find out the cost of the medications, but all it told me was my copay amount, so I still have no idea how much is counted against my lifetime limit.

I have an ultrasound scheduled for around the time that my next period might start. I explained to the coordinator doing the scheduling that my periods are irregular and that I could not be certain that it would have started by the time of the appointment. She said that was ok and that basically they try to get the ultrasound within 5 days of my period, so even if it hasn’t started yet, I could still go in for the appointment. So my next step is that appointment, and to notify the clinic (again!) when I get my period. For now I’m waiting.