We had a second meeting with our IVF doctor to go over some blood work that I had done and we needed to have our educational session with the nurses as well to go over the entire process in detail. This took place in the first week of October on a Wednesday.
The doctor said that everything was as expected with my bloodwork and the only major red flag was that I am very insulin resistant, but I knew that already - that is a very common trait of patients with PCOS. He put me on Metformin, a diabetes drug, to help counteract that and that will help increase my uterine lining.
Then we had our appointment with the nurses and went over lots of information and forms and at the end of it, they gave me my calendar, on it was laid out the timing for all of the medications I will need to take and when, if everything goes according to plan, my procedure will happen.
The first shot that I was to take to kick off the process was scheduled for that Monday - 5 days away. Now this seemed kind of fast to me, but what was there to wait for? Well, I had planned to go up north that weekend, but I would be back Monday night, in time for Jeremy to give me the shot. The nurse said that the pharmacy would contact me to set up delivery.
I didn't hear anything Thursday and didn't even think about it, and we headed up north Friday morning. By the time we got to the cottage I realized I still had not heard from the pharmacy and that Monday was actually a holiday so I was starting to get concerned about even having a shot to take. I called my doctors office who then called the pharmacy (again) who then finally called me.
The mail order pharmacy that my doctor office had recommended we use went over the order for the entire process-long medications. They said I needed to be pre approved by insurance and that hadn't happened yet, as of that moment the approximate cost for the drugs was just under $5000. yikes. I knew it would be expensive, but yikes.
So I said, right now I really only need this one shot, nothing else needs to be taken for a few weeks, I will have time to figure things out with insurance, how much is just the one shot? Answer, $800. wow. So I said I would call them back, and I called my doctor to see if they knew of some way to get it covered by insurance. They then tried to call my local Meijer pharmacy, the Meijer pharmacist called to let me know that drug is not covered by insurance at retail pharmacies. ugh.
At this point, it was Sunday so nothing could be done. Monday we were heading home and I was pre-occupied with that and not really able to make calls, all my paperwork was at home. So Tuesday came and I had missed the calendar date. Now I figured the entire calendar would just adjust based on when I took that first shot - an assumption I quickly learned to never make again in this process. I talked with Jeremy that night and told him it looked like the first shot would be $800. I had talked again with the mail order pharmacy, they said my pre-approval had come through for the drugs and all the rest of the medication was down to under $300 co-pay, but that initial shot of Depot Lupron was not covered and would be full price.
Obviously there really isn't too much to discuss, it is what it is and Jeremy said go ahead and order it. I wanted to just double check before I did so Wednesday morning I called the insurance company, who turned me to the pharmacy insurance and it turns out, our pharmacy insurance is a mail order pharmacy itself (insurance is so confusing to me) and I quickly found out, if I order through them, the shot is covered and could be as low as a $60 co-pay. Big difference from $800! So I had the doctor call in the shot there and just as I was hanging up with the nurse I said "so how does this affect my calendar?" Well, I'm glad I brought it up because the answer is pretty dramatically!
It turns out every step of this process is very carefully timed and the Lupron shot needs to be taken on the 18th day of my cycle and Monday was already the 19th day so the fact that it was Wednesday and it would still be a day or two or more before I got the shot meant it was far too late and we would have to wait until my cycle started over.
This was pretty disappointing to me, but in a strange way it made me feel a little better. I plan to address this in another post shortly, but I had been feeling pretty uncomfortable with the whole IVF process and I felt like we were totally taking God out of the conception process - I took these delays as kind of a sign from God that he really is always in control, something that would be reinforced in the near future as well. There were just too many things that didn't go the right way, this was never meant to work out for this month.
My big concern now was timing, would we still be able to fit in a try at the procedure before the end of the year? I assume that the doctor is not preforming procedures during the holidays and who knows how much time he actually takes off in the month of December, that could really affect things and we are getting into December now. But, it will work out as it is meant to be, while we really want to have the procedure before the end of the year in case it doesn't work the first time - our insurance benefits will re-set in 2012 and we will have a new pool of money to help off set procedure costs. If that doesn't end up happening, well, we will just deal with it. I'm not sure we could really afford to try it twice in 2012 without any insurance coverage on the second try. Hopefully we won't even need a second try and what's done is done, now we just wait for the cycle to start again.