Friday, August 9, 2013

The Pokey Little Follicle

We're having trouble getting the dosing right with the gonal-f.  For about 3 hours on Tuesday, I was convinced that they were going to cancel my cycle.  My estradiol dropped from 130 back to 100 -- decidedly heading in the wrong direction.  I guess this is typical with PCOS -- the numbers can be a little weird until you hit the dose sweet spot.  I'm hoping that is where we are now.  At the last check, my estradiol had climbed back up to 137.  My dose is currently holding at 187.5 and then I head back for more blood work and an ultrasound on Sunday morning.

I have blown through 1800IU of Gonal-F and have been stimulating (getting stabbed!) for 14 days and it's looking like probably another week's worth of meds.

THANK GOD I qualified for the compassionate care plan through the manufacturer. 75% off the out-of- pocket/cash price!!!  So, from Freedom Fertility I was able to get 300IU gonal-f pen for $74.00  each!!!  EACH!!!   And my ovidrel trigger shot?  19.70!!!  ( The last 5 triggers that I bought cost me between 97.00 and 112.00!!!)  Freedom has great customer service and they work directly with the compassionate care people to give you those great rates on meds. I highly encourage you to see if you qualify.  You CANNOT have insurance that covers fertility meds for this program. You must be an out of pocket/cash buyer only.

Here's a little trick: the manufacturer overfills each pen a little bit.  From Freedom Fertility Pharmacy, the price of the medicine is standard per IU, no matter the size of the pen.  So, you should ask your doctor to RX qty3 300 pens instead of qty 1 900pen, so you get three pens worth of overfill instead of only overfill from one pen -- all for the same price!  Then, you get yourself a 1ML syringe and you can draw the leftover meds out of each pen and save yourself some money. Out of my three "empty" pens, I was able to get a combined dose of 150IU or .25ml.  That's a lot of medicine!  So, then I just topped off with one 37.5 (.06ml) click from a new pen to reach my total dose of .31ML or 187.5IU.  Hooray!

Gonal-F conversion from IU to ML (I had my pharmacist double check my conversion below):

900= 1.5ml

450 = .75ml

300 = .5ml

225IU = .375 ml

150= .25ml

112.5 = .1875ml

75 = .125ml

37.5 = .0625ml

Thanks to Andy for the following info based on my dose of 187.5: "I converted IU to ml. Remember that ml is a measure of volume, IU is a measure of effect. There cannot be an IU syringe or scale. There is no standard conversion from iu to ml or mg. It varies from substance to substance. Be very sure here that your conversion is right!

Get a 1 ml syringe, it should be numbered to the 0.1 with marks in between to the 0.01 - draw up 0.3 then one more mark is 0.31 of a ml and go quarter of the way past that to the next mark, and you're good. "

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