New and in the midst of my first IVF cycle — The Bump

New and in the midst of my first IVF cycle

Hi I’m Gracie. DH and i have been trying for 21 months and after being diagnosed with PCOS, sperm issues, multiple timed intercourses and several IUI’s we have decided to go with IVF. Today is day 7 of injections. I’m freaking out right now because we went into this with insurance benefits and I thought that the mention of IVF was the whole process. I paid for the service and then found out that FET is a separate service. I saw the price tag of the IVF cycle and unless there are significant insurance discounts, we are in danger of maxing out our insurance. No one can give me a quote for the FET and I’m not sure we can afford the sticker price. Really upset that I started and was not informed that they were separate services. No matter how many ways I asked I kept getting the impression it was one service.

On a related note, I wasn’t responding strongly enough to the medication so they upped my dose. Meaning I don’t have enough medication for the whole cycle and had to buy more. Found out my pharmacy benefits were maxed and now everything is out of pocket.

Any advice whatsoever is greatly appreciated, but I would really love to know if you have any negotiation strategies that have worked to reduce the sticker or after insurance price of the FET; if you have pharmacy recommendations for cheaper meds; what medications are typically taken during FET and how much they cost you.

I had to buy more Menopur and found it cheapest at encompass pharmacy in GA. It was $74 a vial. They overnight. Would love to swap prices if anyone is willing.

I am very grateful for my insurance benefits, but I’m really freaking out if I can afford the next step.

Re: New and in the midst of my first IVF cycle

  • I'm sorry that you're going through this. I also was surprised to see that FET costs were also separate from the egg retrieval costs. I haven't been through FET yet (I'm due to start in a couple of weeks), but I'm pretty sure I'll be on estrogen pills for the first two weeks, and I'm just making a guess here, but I have a feeling those will be relatively low cost (compared to the injectables from the ER cycle). Also, and I know this is of little help now, but maybe might help a bit since you need to buy more medsL: We realized that meds are WAY more expensive (at least for us) when they're billed through insurance, and that's why we paid totally out of pocket for our meds. We knew we'd max out our insurance coverage with one cycle, and instead of having a huge portion of that OOP cost in medication, we opted to have more of our procedure covered by insurance. Check to see the OOP cost vs cost billed to insurance for meds. 
    [Deleted User]
  • Try Schrafts 2.0 pharmacy.  I agree if you request the cash / oop price, it should be vastly different than what they would be billing your insurance.  FET meds go something like something like bcps, (which are cheap, or not even), estrogen (usually pills, super duper cheap), you may or may not have a trigger shot, and then some kind of progesterone.  Progesterone in oil (PIO) I would think could be more than suppositories, and it depends on your protocol. And then any syringes / needles are actually pretty cheap, too. Talk with your doctor about your concerns and what your anticipated transfer protocol would be.  Then talk with the financial coordinator, who should be able to answer LOTS of questions for you, and start calling pharmacies.  A "natural" cycle transfer has less medications, so that would be a fair question for your doctor if s/he believes that may be a good option for you.

    That stinks that they didn't make that clear enough for you.  Remember, not to discourage you, but you may also realistically need multiple transfers to achieve success.

    Deep breaths.  It is a lot.  But you will find a way.  There are also IF treatment grants and such available if you wish to start looking into that.  GL!
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  • I'm sorry you're going through this. I had a similar surprise with my insurance when I realized buying medications through insurance ate into a huge portion of my fertility benefit. For our second cycle, we chose to buy our medications out of pocket.
    Have you asked your RE office if you can swap any of the medications? (IE, I think they are ganirelix for cetrotide, follistem for Gonal-F?) There is a big difference in cost.

    [Deleted User]

  • @BusinessWife
    I actually think my PIO was much much cheaper than the name-brand Crinone progesterone suppositories I got! Those were like 1k for 30 or something crazy like that. There are generic progesterone vaginal suppositories and the pricing I saw for that was about 200 a pack of 30, but those are not considered therapeutic equivalents in the US yet for progesterone suppositories, so not sure if you could even use them?   PIO, even the specialty compounded one I got in ethyl oleate, was about 74 dollars per vial and I think each vial had 5 doses of 2ml each. I would get 3 at a time and then reordered periodically. I did that until 12 weeks so it got pricey, but nowhere near the suppositories! 

    Personally, I would shop as many therapeutic equivalents for the brand-name meds as you can, and sometimes there will be multiple brands to choose from which will vary in price. Most fertility pharmacies also know about the rebates/etc and apply those automatically for cash patients. I remember there being a big rebate for the Gonal-F at least the first time I got it and for the suppositories. Some pharmacies will also have financing options available if that's something you're interested in. You may also want to explore getting a credit card with some benefits or interest free grace period for this process-- honestly, any time someone offers me 0% interest for 6 month or 1 year, I take it and then divide my payments over that time so I get the full advantage without being hit with interest charges 

    ~~ Our Story in Spoiler! TW loss/child~~
    Fall 2012 -- started TTC
    Summer 2015 - no BFP yet, labs normal, referred to RE
    Fall 2015 - Summer 2016 - Further testing all normal. 3 IUI's -- BFN. Recommended move to IVF. Planned cycle for fall 2016.
    September 2016 - Surprise natural BFP. MMC @ 8 weeks. RE expressed confidence that we just needed the 'right' embryo.
    Fall 2016 - Spring 2017 -- Break from TTC
    June 2017 - Started IVF; egg retrieval for freeze all cycle. 9 mature eggs retrieved, 5 fertilized. 2 4BB embies on ice.
    August 2017 - FET transfer both embies. BFP.  Twin pregnancy confirmed by ultrasound. EDD 4/28/18
    September 2017 - Twin B stopped developing; Twin A doing perfectly! Graduated from RE @ 10 weeks
    March 2018 - Baby Girl born via C/S due to pre-eclampsia -- strong and healthy!

    TTC #2
    January/Feb 2021 - Freeze-all IVF cycle 
    March 2021 - FET of 1 PGS normal female embryo. BFP! Beta #1 156,  #2 472, #3 1241, #4 5268 EDD 12/5/21 - Christmas baby!

    "When all is lost then all is found."

    [Deleted User]
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