IVF med question

slouise12 · July 2012

I hope this isn't a stupid question, is there an average number of days your are on each med when doing IVF? We haven't had our official IVF consult yet but I've been researching pharmacies since we will be OOP but I have no idea how much of each med I will need.

My nurse said since I respond well to oral meds my protocol will most likely be Lupron, Follitism, and Menopur. I tried to google but it kept redirecting me to other message boards so I figured I might as well ask here

Edwina.McDunnough · July 2012

10-12 is the target, but less or more is very common. Some protocols are notoriously slower than others. Your dose depends on your diagnosis, but the upper end is usually 600iu FSH/day, which could be a combo of Follistiim or Gonal-f and Menopur, so 300/300 or 450/150, etc. but that's max stims for many clinics and yours will probably be less than that. Note that that Rx could change every few days depending on how you respond. Unfortunately there is no reliable "average" dose. Good luck.

slouise12 · July 2012

Edwina.McDunnough:
10-12 is the target, but less or more is very common. Some protocols are notoriously slower than others. Good luck.

10-12 from beginning to end, or 10-12 days of stims? Sorry, I really am not very familiar with this at all yet.

slouise12 · July 2012

vinceandang:
It totally depends on your protocol. I was on 3 vials of bravelle and 1 vial of menopur per day for 7 days. Then he upped it to 3 vials of bravelle plus 2 vials of menopur for 3 days. And, I added cetrotide for the last 4 days. The total cost of all the meds, plus additional stuff (like antibiotics, vicodin, valium, etc) was $2900. Hope this helps.

That does help, thank you I have read the cost usually averages between $3k-$4k but I wanted to hear from people that have been through it.

Edwina.McDunnough · July 2012

10-12 days of stims. Advanced Fertility has a few sample calendars and common protocols. It'll become your go-to IVF buddy website, though your clinic may have differing practices.

BTW the upper end of stims can cost upwards of 8-10k and more, just for perspective.

slouise12 · July 2012

Edwina.McDunnough:
10-12 days of stims. Advanced Fertility has a few sample calendars and common protocols. It'll become your go-to IVF buddy website, though your clinic may have differing practices.
BTW the upper end of stims can cost upwards of 8-10k and more, just for perspective.

Thank you so much! I have a feeling I will be spending a lot of time on that site.

maggie2324 · July 2012

If you're a good responder, my RE generally starts with 225iu Follistim and 75iu Menopur and then adjusts up or down if necessary. I think 10 days of stims is usually the starting estimate too.

Good luck!

slouise12 · July 2012

maggie2324:
If you're a good responder, my RE generally starts with 225iu Follistim and 75iu Menopur and then adjusts up or down if necessary. I think 10 days of stims is usually the starting estimate too.
Good luck!

Thank you! I was looking at the Freedom Fertility site but I have no idea what dosages I will need. I can't wait for our IVF consult so I can get the details of my RE's plan. Patience is obviouslynot my strong suit

Deardra77 · July 2012

That was the protocol I was on. I was 300 ui of Follitism & 1 vial of menopur per day. They had ordered enough drugs for me to do 11 days of Follistim & 12 of Menopur. Ended up only stimming for 10 days so ended up with about $700 worth of left over drugs. As we are completly out of pocket thats kind of a bummer but may use it in a future cycle.

One thing on the Follistim, the 600 viles have almost 150 ui at the bottom in overfill so under order. You can get the last parts out of the viles with a lupron needle but you'll need help figuring out the dose so the RNs can help you with that.

We went through the Walgreens specilaity pharmacy & they were pretty good, gave us free lupron, wipes, needles & all that. Not sure if all pharmacys do, our clinic was super unorganised and only told us what protocol/meds we would be on the day they needed to be ordered so the cycle could go ahead as scheduled. That meant we didn't ahve any time to shop aropund which was unfortunate.

Here's a list of what I can remember we got & out cost was $3,300

Follistrim

Menopur

Lupron

Medrol

Vallium (for egg transfer, you will see ER for short)

Progesterone in oil

Estradiol

Our clinic told us the lower limit was about $3.5k and the highest amount $5.5K usually. That been said if someone is a very poor responder I'm guessing it could go up to a lot more but don't know enough to really comment on that

slouise12 · July 2012

Deardra77:
That was the protocol I was on. I was 300 ui of Follitism & 1 vial of menopur per day. They had ordered enough drugs for me to do 11 days of Follistim & 12 of Menopur. Ended up only stimming for 10 days so ended up with about $700 worth of left over drugs. As we are completly out of pocket thats kind of a bummer but may use it in a future cycle.

One thing on the Follistim, the 600 viles have almost 150 ui at the bottom in overfill so under order. You can get the last parts out of the viles with a lupron needle but you'll need help figuring out the dose so the RNs can help you with that.

We went through the Walgreens specilaity pharmacy & they were pretty good, gave us free lupron, wipes, needles & all that. Not sure if all pharmacys do, our clinic was super unorganised and only told us what protocol/meds we would be on the day they needed to be ordered so the cycle could go ahead as scheduled. That meant we didn't ahve any time to shop aropund which was unfortunate.

Here's a list of what I can remember we got & out cost was $3,300

Follistrim

Menopur

Lupron

Medrol

Vallium (for egg transfer, you will see ER for short)

Progesterone in oil

Estradiol

Our clinic told us the lower limit was about $3.5k and the highest amount $5.5K usually. That been said if someone is a very poor responder I'm guessing it could go up to a lot more but don't know enough to really comment on that

Good to know about the Follitism, thanks for the heads up. I'm hoping our clinic will recommend a pharmacy but I want to put in my research just incase.

Maybe Joleisa · July 2012

It is looking like I am on track to stim 10 days--today was day 6 of stims. Being OOP and ordering meds adds another layer of stressors, but with how the monitoring falls and free overnight shipping everything has been okay so far.

I ordered enough meds for 7 days of stims to start.

I went in for monitoring on the morning of day 4 of stims--resulted in no med changes.

I went in again for monitoring on the morning of day 6 of stims (today)--resulted in no med changes tonight, but I will start Cetrotide tomorrow morning and add an extra vial of Menopur in the PM. I ordered meds after my appointment to get me to day 10.

I will go in again for monitoring on the morning of day 8 of stims and I imagine everyday after that until they tell me to trigger.

Good for you for getting organized before your consult!

Aimothy · July 2012

My tentative schedule is Lupron (20 units) for 10 days, then I'll drop down to 5 units for the reminder of the cycle. I'll do 150 iu of Repronex and 150 iu of Follistim for 10 days (obviously to be adjusted based on how I respond).

We ordered 1500 iu of Follistim, 20 vials of 75 iu Repronex, one 2 week kit of Lupron (1mg/.2mL) and a 10,000 iu HcG trigger.

MBfromBMC · July 2012

It sounds like we were in a similar situation and I also responded well to oral meds, so here's a bunch of info:

1. First of all, we did a min-stim IVF because we are also OOP. At our RE, the min-stim costs less for ER and ET and is supposed to cost less for the meds. That said, we were on one vial of Menopur each evening and two vials of Bravelle each morning for 11 days.

2. They had originally kicked around the idea of Follistim for me, but when they heard I was OOP, they switched it to Bravelle. Ferring has a H.E.A.R.T. program for OOP patients that limits the cost to something like $55 a vial or something close to that. I'm not sure if your RE offers that, but it might be worth asking.

3. Finally, the not-so-great news... At our RE's office, they ordered a "set" of meds for us from a local specialty pharmacy and we had no say in the quantity. Obviously, they don't know how long you will be stimming until you're already doing it, so we ended up with tons of unused meds. For six boxes of Bravelle (with the H.E.A.R.T. price), five boxes of Menopur, six syringes of Ganirelix, the oral meds for post-ER and the associated syringes, we paid $4k. I know. It doesn't sound like much of a savings...

mama_cito95 · August 2012

First IVF (only counting injections not oral meds):

Lupron 20 days (10 days of 10 and 10 days of 2.5)= one bottle

Repronex: 10 days (2 days of 3 vials and the rest 2 vials)

Bravelle: 10 days (2 days of 3 vials and the rest 2 vials)

PIO: 9 days

HCG trigger (1 day)

That was just pre ER. Post ER

I did Delestrogen injections 2 times a week plus PIO once a day in addition to some other oral meds until I graduated from RE to OB (about 5 weeks post ET). This was 2 years ago so I don't remember the exact cost, but I would estimate about $4K

IVF 2 (again only counting injections not orals):

Lupron 20 days: (10 days of 10 and 10 days of 2.5)= one bottle

Menopur 9 days (originally but then extended to 15 days): 4 vials a day for first 3 days, 3 vials 2 days, and back up to 4 vials remainder of days.

Bravelle 9 days (originally but after day 8 was switched to Follistim): 3 vials a day

But because I responded much slower this time around my RE tweaked my dosage as we went along, and eventually prolonged the stims and switched me from Bravelle to Follistim.

Follistim 7 days: 300 iui a day

Total days of stims: 15!

Again, this was just pre ER and ET. Same protocol post ER and ET as first IVF but stopped once I got the BFP. Total cost for meds was close to $5K this time around with the extended stims. As pp states, you do get a bit extra with the Follistims. Even though they say the cartridge is "300 iui", 3 "300 iui" cartridges lasted me 4 days at 300 iui a day. But my RE's office told me this ahead of time and told me after the first 300 iui dose, to leave the cartridge in the pen, dial the 300 dose and use up what was left in the previous cartridge, insert new cartridge and finish the dialed dose with the new cartridge. I didn't have to use another needle to draw the rest out.

I am completely OOP. The first IVF I used Kaiser which was the best price for me at the time locally. This time around I used one of RE's specialty pharmacies. But ivfmeds.com and freedom meds seem to have much better prices than what I paid. If that is an option for you I would try one of those sites to save money.

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