Money talk, and why I’m not in a procedure-oriented specialty

For those interested, I started a page tabulating the costs of IVF so far. I wanted to keep track somewhere, so figured why not here. I’ve found it very interesting to hear the wide range in costs. The lowest I’ve heard is $9K (from the NP who did my last IUI’s – she also used my RE), and the highest I’ve heard is $25K – for one round! My acupuncturist says it can be a total racket with some doctors, who may not be upfront about a certain woman’s chances and will just tack on every possible test and procedure to rake in the money. Scary… I feel confident that my RE won’t rip me off, and though he is a man of few words, he hasn’t made me feel dumb for asking all the crazy questions rolling around in my head. Even so, I’m pretty certain I would not be doing this if I didn’t have insurance covering most of it!

Wheeeee!! Now the real fun begins!

I’m actually pretty competent at the few procedures I have to perform in my specialty, but there is a reason I could never be a surgeon – I can be a real klutz sometimes, and I stress myself out way more than I like with procedures. I decided to make up the Gonal-f solution last night, so it would be one less thing/needle to worry about this morning – see the contents of one full package in the top left photo. The 2 morning injections of Lupron and Gonal-f went very smoothly as a result (top right photo).

The evening Menopur injection was a hot mess – see bottom left photo. 3 bottles of powder, 1 bottle of diluent… thank goodness for the Q-Cap (bottom right photo), without which I would’ve unintentionally stabbed myself a few times. Of course, I still managed to screw it on the wrong end the first time. Yikes… It also took me a few tries to determine how much force I needed to insert then remove from each bottle. After almost 10 minutes of messing around, I finally had a syringe filled with 225 IU of Menopur in 1 mL of diluent. Popped on the injection needle, carefully pushed out the air bubble, jabbed it in, and HOLY-MOTHER-OF-ALL-THAT-IS-EVIL-THAT-SHIT-STINGS!! I mean, I’d read that it stings, but I still wasn’t expecting THAT much of a burn. I had to bite my lip to keep from screaming/crying out since I was at work. There is no way I’d be able to give myself Menopur at a concert tomorrow, so I’m glad I chose to give it in the early evening to avoid that trauma outside of home and work.

My belly now has quite a collection of tiny red blood spots and small bruises. Only 10 more days of injections to go!

Ouchie!

I complained way too early about not being asked to pay anything yet. Today the compounding pharmacy called me to confirm all the medications and supplies ordered by my RE. All of the following except the Progesterone suppositories (good for only a month so will be sent separately closer to egg retrieval time in a few weeks) will be sent by FedEx Overnight to arrive on Saturday, since I don’t want to deal with curious looks from the receptionist at work. And yes, I did confirm that he wants me to take both Progesterone injections and suppositories 😦 Here’s the itemized cost breakdown:

So there goes almost $4000 onto the emergency credit card. I plugged everything into the Freedom Fertility Pharmacy medication quote calculator, and they ran $400 higher than this, without the Diazepam and supplies. I’m confident this is the best deal I can get, short of buying from Canada and dealing with slow shipping and customs. I’m assuming this pharmacy has an agreement with my RE, because the pricing for Gonal-F, Novarel, Progesterone (both forms), and Menopur is definitely better than I’ve seen comparing on GoodRx. Still, I’m hoping that 80% reimbursement from insurance happens quickly, because with estimated taxes due September 15, it’s going to be a dicey month otherwise!

First hitch, no biggie

Decided I would drive the 30 minutes out to the pharmacy today to pick up one of my prescriptions (RE ordered the Menopur here because it’s cheaper). I had called yesterday to confirm they had it in stock, and the tech said they had “plenty”. Well, plenty is not enough for what he ordered for me I guess, because they told me they only had half of the prescription amount, and would let me just pay for half today and pick up the second half another time. Um, I don’t have time to drive out there again, so NO thank you! I emailed the RE, and he readily agreed to add it onto the big order with the compounding pharmacy. So I’m expecting a phone call from them tomorrow to confirm everything, get payment info (*gulp*), and arrange for delivery. Somebody will need to be home since some of the stuff needs to be refrigerated.

So far, I’m pretty happy with the RE. As I’d been warned, he is a man of few words, so not knowing what to ask can be a problem. However, he’s answered all my emails very quickly, since I often forget questions while I’m there. His office staff has also been very sweet and helpful. The weird part is, other than paying for the semen analysis before we were technically his patients, they have not asked us to pay anything yet. I know my insurance will cover most of the cost, but I still expected to pay something to him by now. I’ll probably ask at the next visit how they anticipate handling this – maybe they’re waiting to confirm what insurance pays, then will bill us for the rest. I did hear that I should be prepared to pay the anesthesiologist cash for the egg retrieval, which I found odd, but whatever. So long as I get some sort of receipt to turn into insurance.