Ah, Drama!

About two weeks ago, one week into birth control pills, I started spotting.  At first, I tried to ignore it.  Maybe it was just that clot in my uterus breaking loose.  The problem was, it kept getting heavier and more period-like until I finally called the RE’s office at day 12 of birth control.  After some back and forth, the plan was made that I would take days 13 and 14 of the birth control pills, then go off and let my period happen.  Because my body, apparently, just does not do schedules.

This all duly decided and executed, my period started according to the new plan and I called the office as directed about the FET cycle we had planned.  I asked if there was any chance I could use something other than PIO as my progesterone support.  Dr. E was fine with ordering Crinone, the nurse called my meds to the pharmacy, and I went on about my day.

Until there was this little random, unexpected moment that triggered all sorts of uncomfortable feelings and sadness.  This, in turn, caused some ripple effects into other areas of life that will remain unspecified but were unpleasant.  By night, I found myself laying in bed, not sleeping, watching the hours tick off on the clock on the bedside table, counting the various nasty creatures that emerged out of the dark cracks of my brain to have their turn sitting next to me, telling me all the horrible things they planned to do with the space I’d now given them in my mind.

I woke up Saturday morning exhausted and more pissed off than I had been going to bed.  I spent the morning crying to my mother and getting Arthur’s Valentine gift to me, a massage.  Feeling fortified for the afternoon, I got ready to tackle various responsibilities, including finalizing purchase and shipment of my medications for the FET.

In my infinite wisdom, figuring that this would be a quick phone call, I decided to order the FET meds before grocery shopping or doing any other major tasks.  This turned out to be a bad decision.

“Now,” the representative said, once I’d given her my name and birthday, “I see that your doctor ordered Crinone for you.”

“Yes, that was the plan.”

“The script is for 60 inserts, or a 30 day supply.  With the $50 off coupon we’ll apply, that comes to $965.”

Here’s where I make an embarrassing admission: in my search to ward off further nerve damage to my rear end, I hadn’t bothered to ask about the price of Crinone.  This was stupid, because I know my insurance doesn’t cover any of my infertility medications, but in my defense, I’d never thought progesterone could possibly be so expensive.  In  my previous IVF cycle, I’d used Prometrium, which had come to a grand total of around $5 for a 30 day supply.  I knew Crinone was more pricey, but I had figured a couple hundred dollars more pricey – not nearly a thousand.

After telling the pharmacy rep that I’d need to consider some things and call back to place my order, I did a quick, cursory internet search that revealed that the going price for Crinone was indeed around $15-16 for a single applicator.  I needed two per day.

“I’m done,” I announced to Arthur.

“But hon, we can afford it.  I know it sucks, but we can manage it.”

“I know that.  I don’t care.  I’m sick of making bullshit decisions where none of the options are ones I want.  Ones where I can have PIO, which will only cost us around $75 but potentially causing more damage and for sure a lot more pain or I can have Crinone which will be much less problematic to my nerves but will cost us so much more!  I budgeted $750 for drugs this cycle, which was the upper end of what I had heard the drugs would run.  At some level, I know we can afford it, but I don’t want to.  This is ridiculous.”

“Are you saying you’re done for right now?  Or done with treatments?”

“I’m done with all of this shit.  DONE.”

Arthur retreated to the computer to do his own research on Crinone prices, then retreated to the living room.  I tried to cool off for a few minutes, then followed.

I will spare you what followed over both Saturday evening and Sunday, which was not pretty but involved alternately fighting with Arthur and curling up next to him sobbing, needing to be comforted.

By Monday morning, when I finally called the RE’s office to see if there were any solutions to the dilemma there, I was a thorough disaster.  And of course, there were no solutions.  I could take the PIO.  I could pay for the Crinone.  I could pay for something called Endometrin, which was less expensive than the Crinone, but still expensive and less proven.  Many phone calls and frustrations later, a solution was finally reached: I would take the PIO prior to transfer, and if we actually had something to transfer, then we’d consider the Crinone.

Then, in the final phone conversation of the day, the nurse mentioned what I’ve been told all along: that it would be four days of progesterone support prior to the transfer of my cleaved embryos.  I caught the ‘cleaved embryos’ bit and stated that Dr. E had told me that we’d culture them to blast stage.  The nurse informed me that she hadn’t realized this, and that in that case, I’d need six days of progesterone support prior to transfer.  And that she’d need to confirm with Dr. E that this was indeed the plan.

“Uh, it’s not in the plan already?”

Nope.  Apparently the plan is still being finalized since we’re still a ways out from the actual transfer, and that while yes, this is the general plan for me, it’s not the usual one with the embryo stage I’ve got.  So it needs a few final bits and pieces confirmed.

*Facepalm*

Damn it all.

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15 thoughts on “Ah, Drama!

  1. Ugh, I feel your pain about the price of Crinone. My RE gave us the Crinone for free for our first IUI, as an apology for canceling it the month before because he went on vacation!! (that’s another story!) So for my second IUI, I had no idea how much it was going to cost until I was standing in line at the Costco pharmacy staring in shock at the lady at the register. I had a mini breakdown. I burst into tears and asked if there is any possible discount since my insurance didn’t cover it at all. When they said no I started crying even more and said “Do you know what this is for? I’m trying to have a baby and I can’t!” Not one of my finest moments. So sorry it came as a shock to you, too. Hopefully it will all be worth it in the end.

  2. Ugh. Totally sucks. Maybe you could compromise and just ask the pharmacy to give you half your prescription, or whatever is enough crinone to get you to your first beta? Then if it comes back positive (fingers crossed!) you can buy the rest. I know that’s not ideal because you’re still picking between 2 crappy choices, but hopefully the excitement of a BFP will get you past it.

    Good luck!!!

    • Thanks for the suggestion!

      I think we’re going to do PIO until we know whether or not the embryos survived/can be transferred, that way we’re not out much if we have nothing left. If we do have something to transfer, I think at that point we may bite the bullet and just order enough Crinone to get us to beta, and then if it’s positive we’ll go from there.

  3. Ugh GOD! Seriously sorry you had to go through that because I’ve been there. I hate insurance and I hate that fertility is barely covered or not at all. Seriously.

  4. As I read your post I sympathized so much, especially your comment about how your weekend “involved alternately fighting with Arthur and curling up next to him sobbing, needing to be comforted.” I spent this weekend doing practically the same thing with my husband. It’s hard not to get burned out when you repeatedly psyche yourself up only to get deflated in new ways. Hang in there.

  5. Ugh, seriously – I wish I could give you a hug and then just let you scream for a while. I could SO relate to the feelings you described, even though we’re not at the same stage at all. “the various nasty creatures that emerged out of the dark cracks of my brain to have their turn sitting next to me, telling me all the horrible things they planned to do with the space I’d now given them in my mind” – that’s pretty much how I spend most of every single night, most of the day, to the point where I feel like I’m developing a form of IF-related dementia. It’s so disheartening when an already difficult, emotionally charged and physically demanding process is complicated and made even more stressful by the inevitable financial considerations for most of us without IVF coverage. Do I really need to ask, again, wth they’re all thinking about covering Viagra but not IVF?? Sending you much love, hugs and courage!!

    • I love what you say about “IF-related dementia”. That is SUCH a fantastic descriptor of it! It becomes so hard to know which way to turn, where to go…it’s like living in a horrible, confusing house of mirrors that messes with all of the senses.

      Thinking of you as well. It is so, so hard.

      • Hah, that’s so true – like one of those horrible amusement park thingies where you just end up freaked out and crying! LOL In all seriousness, though – I agree, it’s so hard. It doesn’t help that it gets zero REAL national attention, and that the media treats infertility the way it once treated, oh I don’t know, adult acne: a minor inconvenience that can be easily overcome. 😦

  6. I know you feel sheepish about not checking, but I have an admission to make myself about Crinone. I started out on PIO last time, but I simply could not handle the soreness (couldn’t sleep at all on my bum) and so switched to Crinone. I was given Crinone samples by RBA for a short period, but when it came time to resupply, I did it in such a rush (work was madness at the time) that I just paid for it out of pocket, assuming that it wasn’t covered. I found out later (too much later) that it would have been covered. I paid $1400 for medications (Crinone and Vivelle) that would have cost $50 if I’d simply run them through my insurance—that just goes to show how busy and anxious and sort of out of mind I was at the time (because the baby had a low heart rate—and eventually the heart stopped). So don’t beat yourself up for not looking into this. Who should be beat up is your insurance co. for not covering something so basic. I understand why you said “This is it, done.” But I’m glad you are hanging in there. You can do it!

    • Oh, heavens – I totally hear you about doing things in a rush. I’m sorry you had to go through that!

      Thanks for the positive words. They are much appreciated. I’m going to check back with my insurance if we are lucky enough to transfer and then to get a positive beta and see if I can push them to cover it as a pregnancy medication. We’ll see.

      • Just as an FYI, my insurance did, indeed, cover Crinone (and PIO & endometrium) once the IVF was deemed successful and it became a “pregnancy” med instead of an “infertility” med. I also used that info to leverage a much earlier beta from my RE since the second I was pregnant it’d be covered.

        And, not to be dark and morbid, but I always made sure to fill a full 30-day prescription (60 applicators) the second I had a positive beta, even if it looked doomed to be a chemical. That way, I had tons of “extras” to carry us through to the next cycle. I think I only had to pay OOP once at full price for Crinone – I squirreled a sizable stash away through 2 of my three miscarriages. Even with insurance coverage it was still pricey, but a lot better than paying OOP. It was like a dagger to me, too, since I hated Crinone and always tried to convince my RE not to put me on it. I much preferred PIO or the compounded P4 my first RE sold for $1/pop…

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