Wednesday, March 30, 2016

FET Prep

So, I'm just a bit over a week into my Frozen Embryo Transfer (FET) prep.  What does that mean exactly? Shots, pills, patches, appointments...hoping...
Currently, I take Lupron every night to shut down my reproductive hormones.  I'm also still taking birth control for a few more days.  This is all in preparation of hopefully being able to craft the perfect uterine environment for it's potential incoming inhabitant.  Next week I will start taking estrogen while decreasing the Lupron so my lining can build back up over the next three to four weeks.
I have one procedure left, a saline ultrasound where they inject saline into the uterus to measure the space, and see the shape of the uterus.

Lupron
Lupron is a sub-cutaneous injection, which means it goes just below the surface of the skin into the fat.  The needles are small, not even an inch long and are relatively painless.  The medication itself sometimes stings or itches depending on the night.  I haven't found a common denominator as to what makes some injections hurt, or itch, or sting, and some nights they're even painless!  If pain is a concern, I've found ice to be very helpful in numbing the area.  Since I've been around this block a few times, I've definitely manned up to the task.  I remember during my first round of injections back in 2008 during our Intrauterine Insemination, it took many many attempts, and tons of convincing in order to safely receive my injections.  Thankfully, I have a very patient husband, otherwise I'm sure several of the injections would have ended up with me being pinned against the wall with a needle shoved into any readily location.  Side effects of the Lupron include constipation, nausea, dizziness or headache, hot flashes and trouble sleeping. Thankfully it seems that I'm taking to the medication like I have previously with very little side effects.  I have noticed that I sometimes get slightly over heated, which isn't necessarily anything new for me, and my breasts are ever so sore. Although that's not a listed side effect, it happened soon after beginning the Lurpon, so I'll blame it on that! Thankfully I haven't had any problems with my plumbing, but I guess it's a good thing I decided to buy a box of Fiber One Brownies at Costco a couple weeks ago.  Yumm...
Estrogen
Estrogen is the medication that helps build the uterine lining, which is hopefully where the embryo will implant after the transfer.  I was supposed to take estrogen in the form of patches that get switched every other day, however my insurance doesn't cover it, and the out of pocket cost was $700!!! The second option was an intramuscular injection of estrogen taken every third day.  Now, for those of you not aware of the intramuscular injections, I'll be frank-it's a huge ass needle, no pun intended.  It's a huge needle, meant for your ass.  But I've never been so excited for a needle in my ass until they called to tell me that my co-pay was only $10!!!! I'll take it...but to be honest, it's a huge blessing.  The raw costs for all the medications for the transfer are about $2,000.  With insurance coverage, I've paid $160.00.  

Ways to Get Covered Medication 
Should you be reading this and are embarking on this journey, there are some options for medication cost.  
1. First, always ask your doctor or clinic if they have samples of medications.  Many times they do.  2.Next, ask if they have any medication that can be donated.  Often times, people order all the drugs needed for a cycle at once.  Sometimes, the dosing changes, cycles get canceled, people back out, get pregnant, you name it-and they'll have medication they don't need! Most likely, patients donate unused and un-open medication to their doctor/clinic.  I have been on the receiving end of these drugs and it's always appreciated.  
3.Ask around!  There are several fertility related forums, blogs, Facebook groups, websites and even word of mouth! Post, talk, e-mail and try to find connections to those who might have left over medications that they would be willing to donate.  
4.  Talk to your insurance and/or doctor about medications that are alternatives to the ones not covered.  Often times it has to be the generic brand, or in a different form. My insurance denied the estrogen patches, but didn't offer an alternative. My doctor offered me a different option-not his first preference, but fine nonetheless, and it was covered!  I have prescription benefits through a separate program other than my general insurance.  They actually don't cover my fertility medication since it's not a regularly received medication, but with some help, you can possibly get coverage through an unsuspected avenue.  You can also pay out of pocket and file an appeal or submit for reimbursement.  This measure will require a willing physician, and sometimes it works, and sometimes it doesn't.
Unless you have deep pockets, it definitely is worthwhile to make a plan about how you'll tackle the unexpected expenses like non-covered medication, or surprise injections, or all the co-pays for the frequent monitoring appointments.  

And honestly, just remember...always 
Never. Give. Up.:

Life has ebbs and flows; fair weather and storms. Keep your ship well-maintained and upright, knowing it's always darkest before that glorious sunrise.:

"Do not give up! Never give up!"—James B. Martino:

It's hard to wait around for something you know might never happen, but it's harder to give up when you know it's everything you want.:

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