A portion of the medication I'll be taking this cycle.
Here's my list of medication for this round. Don't panic if your list is longer or shorter. Each clinic is different, just like each of us. The new protocol is a little different. This time I'm using Cetrotide instead of Lupron, and they added a follicle stimulating hormone (FSH).
So let's talk about ordering the medication, which is a little tricky because pharmacies in the United States won't take prescriptions from a Barbados doctor. The first step I always take is creating a spreadsheet to compare the prices of several online pharmacies. Overseas pharmacies are the only option, with the exception of one pharmacy in Florida. You can search online for pharmacies or ask your IVF clinic for a list of recommended pharmacies, but here are a few I used for my price comparison: IVFMEDS, Fertility2u and FastIVF. My favorite is IVFMEDS because they have a flat rate for shipping, the prices are quoted in U.S. dollars, and they had most of the medication I needed. Unfortunately I am never able to get all the medication I need at one pharmacy. I had trouble finding prednisone, progesterone and clexane (lovenox). I also needed to order the needles and syringes because overseas pharmacies won't ship those. I remembered having a hard time ordering the needles and syringes last time, and I ended up getting them from a pharmacy in Florida. I found an old email from the pharmacy and called them to ask about the additional meds, needles and syringes. They were so nice, but also so expensive. I bit the bullet because I was having trouble finding the medication anywhere else. They waived the shipping charge, so that was nice, and I got their package the next day! Double nice!
When shopping for medication, don't forget to take the following into consideration:
- Cost of the medication - This is obvious, but it is the number one on my list. Medication can vary in price greatly. Don't forget to check if the prices are in United States dollars before placing the order.
- Injection type - This is overlooked, but pretty important. Depending on what medication you purchase, you'll have subcutaneous injections (SQ) or intramuscular injections (lM). SQ injections are done with small needles, usually in the abdomen or thigh. IM injections are done with large needles (1.5"), usually in the butt. There is a significant cost savings with the IM medications, but you may need help with the injections. I personally opted for the IM medication because my husband wasn't worried about administering the injections. Side note: If you need assistance with IM injections, be sure that someone will always be around at the time of your injections. This could be anywhere from a week to three weeks, every night before bed. I know, it all seems scary, but I can honestly tell you with a straight face that all injections hurt equally. They all begin with anticipation, a small sting, a burn from the medication being injected, and then end with a sigh of relief. I wouldn't do them for fun, but they aren't that bad. Honestly. In short, if the thought of giant needles terrifies you, make sure you look for medication that is approved for SQ injections.
- Quantity of injections - This is another item often overlooked, until you get the packages and realize you have to do multiple injections in one day. Ugh! As an example, I have to take a blood thinner with each cycle, and this leaves bruises in your abdomen. Over time, you start running out of space because you can't administer the injection in an already bruised area. You can purchase Heparin, which is cheaper, but requires two injections a day. Or you can purchase Clexane/Lovenox, which is more expensive, but only requires one injection a day. You just have to decide if you want to save money or save yourself an injection.
- Price of shipping - Each pharmacy has different shipping options. Some waive the shipping fee if the order is over a certain dollar amount. Some pharmacies charge a percentage of the total price for shipping, which adds up fast. Some pharmacies charge a flat fee. You'll want to order at one pharmacy, if possible.
- Timeframe for delivery - Each pharmacy will quote a different delivery timeframe, but remember that the medication has to go through customs. There have been several instances of IVF medication being held up in customs, so the sooner you order the better! I would not pay for rush shipping, if you don't have to, because it will be a waste of money if the package gets held up in customs. What a waste of money. Also, I saw some pharmacies that quoted 21 day delivery timeframes. No thanks!
- Availability of medication - Just because you see the medication listed on the website, does not mean the medication is available. Before you commit to an order, I would talk to someone from the pharmacy to ensure all the medication is available for immediate shipping. I made this mistake last time. I placed an order for all of my medication and then received an email that said one of my medications wouldn't be available again for a month. Uh oh! Thankfully the pharmacy was willing to cancel my order and refund the entire amount. I needed the medication in three weeks, otherwise it may not have been a deal breaker.
- Available for U.S. shipping - Here is another lesson learned from experience. The pharmacy has all of your needed medication. You place it in your shopping cart and go check out. The next day you receive an email stating one or more of your medication cannot be shipped to the United States. Ugh! Just when you thought you were done. In my case, the medication (progesterone) has to be refrigerated, so it can't be shipped overseas.
Using online pharmacies will save you money, but if you put a little extra time into researching you can save big time! Ask you fertility coordinator or nurse about your medication before you place the order. They can break down the injection type and amount. Just remember that you will probably need to order needles and syringes separate, and you may need refrigerated medication, so order what you can and then ask your clinic for their recommendation. I was never able to find the trigger shot (hCG/Ovidrell), so both times I had to purchase it from BFC once I got to Barbados. Good luck and happy shopping!
Feel free to leave a comment or ask a question. I'd be happy to help because I know the medication search can be overwhelming.