Frustrated with no BFP, and AF has come! Here I go again...

emgem819

Hi ladies,

Just got AF today after a fairly rigorous cycle of femara, combined with 6 shots of bravelle on cycle days 3, 5, 7, 8, 9, and 10. Took my trigger after getting one good follicle at 19mm, then my DH and I BD'ed using TI.  It didn't work obviously as AF came today, and I just talked with my RE who has recommended I repeat the same medicated cycle this time around.  I'm a little concerned as I'm paying for these meds OOP and spent over $500 last month, and will spend $500 this month as well, and thinking maybe I should request a change of medication or push to do IUI?  We'd pay $400 for IUI OOP so trying to decide if we can really afford that right now even.  I asked my RE if they would recommend I have my DH take a sperm test before jumping into this next cycle or if I should take a pre-coitial test to make sure all is good before we go again, but she seemed to think it was best to just go right into it again.

Does anyone have advice they can lend?  Know of anyone who has had success after trying the same medicated cycle again?  I"m just feeling frustrated and starting to question if the prescribed process is the best option for me to TTC.

Thanks for any support or advice you can lend!

-Emily

HBamama2B

@emgem819 it makes zero sense to do that heavily medicated of a cycle without a) first doing a SA and an HSG AND b) doing an IUI. I'm pretty surprised your RE would recommend doing that once let alone twice. I think you were right to push back, especially if the oop costs are high. Why does she view the likelihood of a repeat cycle higher than the last? What's state has she given you or odds that it would work? Yeah... IMO your instincts are spot on. I'm really sorry you cycle didn't end with a BFP.

Piperella

I, too, think you need at a minimum to do a SA so you can eliminate that as an issue/variable in getting pregnant.  Also push for an HSG, which would need to happen before an IUI (or at least it should).    Keeping pushing for more clarity.. your instincts are correct!

riveridgional

See, I would say do the post-coital as a minimum. If your results are fantastic, it's likely not your DH (at least according to my RE). If it's not so great then you know an IUI should be done and your DH should definitely get an SA done ASAP. It could be your DH, your cervical "environment", or both. I also agree you should have an HSG done. If your tubes are blocked, no amount of TI or IUI will help.

riveridgional

To add to the above, an SA alone won't really give you guidance on whether to do TI or IUI unless the SA comes back with poor results. If you can afford SA and PCT, do both. They are both relatively inexpensive.

emgem819

Thanks ladies, it's good to know I am not the only one who thinks repeating the same medicated cycle is odd! I think I did have an hsg done earlier before I started my first cycle of femara. Is that where they push water through your tubes to make sure they are open? That was successful and both are open but I've never had the PCT and my DH has never had a SA. I'll try pushing for the PCT if you think that's the way to go...just hard because I'm at cycle day 1 now and the longer I wait to test...the faster I need to decide if I'm moving forward with her suggestion and forking out another $500 (bravelle shots would start Saturday). Ugh. It's all so different for every person I guess but it's hard to trust my RE if I'm doubtful it will work doing it the exact same way. I just wish meds were cheaper and I could afford to try all my options! (Oh and I was 21 again so I had time on my side lol!)

riveridgional

The PCT would need to be performed around CD 13 when you would be producing fertile CM, so you have some time.

Caroline351

I'm surprised they didn't do the SA first. It seems like they might want to look at that.

I understand the financial burden. I cry a little every time I write a check and nothing happens. My question is, does anyone know of prescription assistance for fertility? I know when I didn't have insurance I used the prescription club at Walgreens to get HUGE discounts, but I haven't a clue if it would work on fertility stuffs. 

riveridgional

@Caroline351 When it comes to injectables, there are a few programs that offer rebates or discounts. The ones coming to mind are GO Savings Direct and IVF Greenlight. I believe I've heard of a few others too. Typically, the injectable medications are not obtainable in your ordinary neighborhood pharmacy. My RE uses Freedom Pharmacy but I'm sure your doc can just call in a script to any pharmacy you may find online. Freedom Pharmacy automatically worked with me for discounts through GO Savings Direct and put everything together I would need for the rebate. My rebate check came in pretty quickly too. Maybe 8 or 9 days? Regarding, Clomid, Femera, prometrium, etc... I'm not sure. I never really thought about using the Walgreens pharmacy savings program. I switched from them to CVS bc the one in my neighborhood was downright terrible in refilling and picking up prescriptions. I'm past the point of it likely helping now, but good idea to at least call them and ask!

agriffin92013

On the Clomid if you have a Wal-Mart it is part of there generic discount program.  Femara I use to get a huge discount with a coupon from https://www.goodrx.com/femara  I found out through my Dr office that you could get prescriptions filled at Costco without a membership and it is less than $10.00 for 15 pills.

KidShrink

I'm quite surprised they would put you on injectibles without having done a minimum of an SA at first. What if DH's counts are low and you're doing all that for nothing?! If you can emotionally afford a month without treatment, I'd start there, and then make a decision. We had a PCT done and everything looked good, but despite that we wanted to be more aggressive with treatments, and there was no way I was going to make the jump to IVF without having tried IUI first.

emgem819

Thanks @riveridgional I appreciate the program list too.  It's bad because now they want me do gonal-f but I've been doing bravelle the last round and if I did bravelle this round I could have made the 10 vial limit for the IVF Greenlight Pharmacy rebate, which would have saved us some money.  Apparently bravelle is now nationwide recalled and the pharmacies can't offer it for the time being so doctors have to prescribe an alternative?  So gonal-f it is, but this means I'm not able to qualify for any discount until 10 vials, and I'm only prescribed 6 at a time.  I can get a $60 rebate through GO Savings Direct though, which every bit counts! 

@agriffin92013 thankfully I do have coverage for fertility meds like femara, just pay a copay for those, it's just the injectibles that my insurance doesn't cover. 

I talked to my RE and they're going to do an SA on Monday (even though I'm still set to start injectibles/femara starting tomorrow) but it'll be $175 OOP which really seems pricey to me, but best to know for sure if he's low or not. Thanks to everyone for your comments and advice!