a rundown of the meds

Maybe the title should be more like '[...] the MEDS!' because there is nothing small or even average about infertility medication, especially IF medication for IVF patients.  If you're a veteran IVF patient, this will be old news to you.  But what IF blog is complete without an inventory of the pills, shots, patches, shots, and more shots?

So this is my 'medroll' in a nutshell:

June 16 - July 4:  As is standard before an IVF cycle, I was put on a round of BCPs.  I had no idea it was common practice to go through a month of BCPs before moving onto IVF; I was crushed when I learned we couldn't jump right into our first IVF cycle.  To make matters worse, I absolutely hate BCPs.  In any form.  I've tried just about all of them except the shots (too long term and not ideal for short notice potential baby making) and the IUD (also too long term and it just sounds awful).  My doctor's office instructed me to take the BCPs all the way through July 4, even though it was not a full month's worth (which was perfectly fine with me).

BCPs are not my favorite because they make me vomit (even the low estrogen pills), and when I'm feeling under control enough not to vomit, I am incredibly nauseous.  BCPs also give me headaches, decrease my libido (who wants that, seriously), and I experience photosensitivity (as in, when I'm in the sun and I'm on BCPs, I get little red dots all over my skin - like thousands of tiny capillaries coming to the surface of my skin - not attractive).  The only positive for me is that the pills help control the side effects of my endometriosis.

July 1 - July 4:  I was to give myself a daily morning injection of 20 units of Lupron, overlapping for four days with my BCPs.  The Lupron shots were to be taken at the same time every day, which sounds easy enough, but I was on vacation visiting my dad during this time.  I accidentally slept in too late on day one of Lupron, plus I was in a different time zone from where I live, so I had to gradually move my shot time back about 15 minutes per day for four days.  I needed to be able to take my shot before work when I returned home from vacation, and my doctor's office said I could change the shot time by up to one hour if necessary.

Let me tell you how great it was to have to store my fertility medication in my dad's refrigerator...while he had other friends visiting from out of state, plus my sisters and my grandma.  I was afraid my grandma would find my box of meds and throw it out or leave it on the counter when it should be refrigerated.  Not to mention my fears of my dad's friends finding it and asking what it was for.

Starting Lupron while on vacation was also not ideal for the road trip home with DH, my sister, and my nephew.  Because of our early departure time, I was forced to give myself my shot in the vehicle.  While on the road.  Travelling 70 mph.  I was in the backseat and tried to angle my body away from my three-year old nephew so he wouldn't see what I was doing.  As luck would have it, we went over a bump at just the wrong time and the needle bent as I was sticking it into the vial of medication (thankfully, it didn't bend as I was injecting myself).  And fortunately, I had a backup needle with me.

July 5 - July 10:  I continued taking the 20 units of Lupron at the same time every day, once per day for six more days (sans the BCPs and sans any road trips).

July 11 - 13:  On the 11th day of Lupron, I was instructed to reduce the dosage to 5 units and continue the injection at the same time every day for three days.

July 14 - July 21:  My doctor advised me to continue with the 5 units of Lupron per day and also add in 75 units of Menopure (taken at the same time every morning) and 225 units of Follistim (taken at the same time every evening).  As you can see, I was up to three, sometimes four, shots a day depending on how much medication was left in the Follistim vial.  My stomach was bruised, swollen, sore, bloated and even bore a few band-aids from a couple bleeders.  The Lupron shots didn't hurt at all but the Menopure and Follistim were not fun.  They both stung.  A lot.  And that's where most of the bruising came from.

July 22:  I was to give myself the same 5 units of Lupron and the same 75 units of Menopure in the morning, but my doctor's office called to tell me to only do 100 units of Follistim in the evening.  I was excited for a reduction in the medication and the potential for less pain caused by the Follistim.

July 23:  I answered a call from my doctor's office to schedule my egg retrieval for July 25 (yay!  I felt like we were finally getting somewhere!).  So this meant the plan for July 23rd was to take the usual 5 units of Lupron in the morning and skip the morning dose of Menopure.  Also, I was to skip the evening dose of Follistim, and instead it was time for DH to administer the dreaded hCG shot (my plan was changed from taking 10,000 units to taking only 5,000 units) at precisely 9:30 pm (exactly 36 hours before my egg retrieval).

DH mixing the powder with the solution.

DH using his finger to show the scale of how ginormous the needle was.

 Believe me, this photo does not do it justice.

As it came time for DH to give me the hCG trigger shot in the muscle of my tushie, which had to be administered at a specific time, with the biggest needle on the face of the planet, he chickened out!  Or so he said.  He claimed he was playing a trick on me but I didn't buy it (I still don't buy it).  Later he confessed he was afraid he would hurt me, which was a much nicer way and a less panic-inducing way of telling me how he was feeling.  So yeah.  I had a fleeting moment of panic because there was NO WAY I could reach around to my butt with a needle that size and give myself the shot.  So eventually, DH just did it, with a quick, dart-like motion as instructed in the training video.  Lucky for us we prepared for the shot a few minutes in advance so his 'joke' didn't throw off the timeline.  And I barely felt a thing!  All that worry for nothing (seriously, my heart was racing, I was sweating, and I was afraid I might pass out).  Boy, was I glad to have that done!

July 24:  The coveted day of NO MEDS!  Hooray!  :D

July 25:  Egg retrieval day!  Nothing to eat or drink after midnight last night to prep for the anesthesia.  I was a little thirsty but not too bad since my appointment was scheduled for 9:30 am.  Afterwards, I was given two extra strength Tylenol for the pain and that was all I needed.  Oh, btw, I'm not allowed to take anything for pain besides Tylenol during my IVF cycle.  Apparently, other pain meds interfere with embryo implantation.

July 25 - July 28:  Per my instructions, I took 100 mg of Doxycycline two times per day to prevent infection after my egg retrieval.  I am not a fan of Doxycycline; it made me feel very nauseated.  But it was only for four days and I guess it's better than getting an infection in my lady parts.

July 27 - (undetermined stop date):  I started the most favorite medication of all among IVF patients - Endometrin.  (I had two days of overlap of the Endometrin with the Doxycycline.)  For those of you not in the know, it is a vaginal progesterone suppository.  And you secrete fun, pasty, left over medication from your lady parts.  Some of it is not so pasty and more liquid-y.  I am lucky enough to get to take it twice a day.

July 30:  Embryo transfer day!  My doctor's office instructed me to hold my morning dose of Endometrin.  Apparently, they don't want to deal with the paste during the transfer.  And ooh!  I was also able to take a Valium!  I like Valium; it's so relaxing and calming, which was precisely the desired effect - to relax my uterus.  Hee hee, I tried to get another tablet from the nurse by saying I thought my original dose was wearing off but she didn't fall for it.  (I was actually serious though, I thought it was wearing off.)

August 3 - August 11 (or possibly longer, if I get a positive beta test) or August 3 - August 8 (if I get a negative beta test or if AF shows up):  Per my RE, I started the Vivelle patches today.  I am to use two patches at a time and change them every three days.  Since it's only been a few hours, I'll keep you posted on any major side effects.

Grand total for medication to date (none of which is covered by insurance, except maybe the one Valium pill with a whopping 31 cent co-pay):  $2,876.33  (plus whatever the co-pay was for the BCPs...something like $10)

I found out it pays to shop around.  I ordered from two different pharmacies after calling about 4 or 5 for pricing information.  I saved thousands, literally, over the most expensive pharmacy and about $400 by ordering from the two cheapest pharmacies.