Monday, August 1, 2011

IVF meds... Meno-wha?!

A couple of weeks ago, we got a printout of the medication order for our latest round of IVF fun. I forgot how freaking long the med list is for a fresh cycle. We have two new additions to our list since last time: Birth control pills to be started on CD4, and Me.nopur to be used along with the Fol.listim. I’m not exactly sure why the Me.nopur was added when I did fine with the protocol I had last time (Fol.listim alone) and I plan to ask the nurse about that. It makes me nervous to rock a boat that sailed so well the first time out. I am supposed to call the clinic on CD1 which should be at the end of this week. Getting through their phone system is a nightmare so I figured I’d consolidate my calls and ask about the med change during the same conversation. In the meantime, I turn to you, oh knowledgeable Internets!

Why add Me.nopur to Fol.listim when there is no history of poor response? Is this just the med cocktail du jour? Have new findings come out about the efficacy of a Me.nopur-boosted cycle? I let my virtual RE degree lapse about three years ago, so I am not up on the latest in our field. Give me the scoop, friends.

I’d rather not add in the Me.nopur for several reasons:
  1. As I mentioned before, why fix something that ain’t broke?
  2. I’ve heard it burns going in. What’s not to love about that?
  3. Another needle per day? I do okay with the shots, but come on!
  4. We’re pretty well stocked up with Fol.listim at the moment, and I’d really like to use that before paying out of pocket for other meds we may not even need.
About that last point above… We were the lucky recipients of a large amount of unused Foll.istim, passed along to us by another blogger after her family found her through a different avenue. Based upon our dosing/response from our last IVF, it should be enough to get us through a full cycle without having to purchase anymore on our own. Have you ever received a gift that was so generous, so life-changing, so… huge… you didn’t even know how to respond? That is what happened to me when these meds showed up on our doorstep. Their generous gift saved us thousands of dollars in OOP medication costs. Thousands. That is hard to wrap your head around. I sent a thank you card, but really, what do you say to someone who does that for you? I guess you let the gushing overflow into your blog and hope they read it and can somehow feel how much you appreciate what they have done.

So on that note, it seems ungrateful and silly to raise an eyebrow at $750 worth of Me.nopur, and of course we will gladly pay it if the RE thinks it will make a difference, but… will it? What do you all think? What has your experience been like on Me.nopur, with or without Foll.istim? (And yes, I promise that I will ask my nurse about it and get Actual Medical Advice before leaping to any conclusions. I just trust you guys, and I’m curious to hear your thoughts.)


Anonymous said...

Not a whole lot of help from me except to say that I'm on Menopur with my Clomid(Devil)/Injectable hybrid IUI cycles. I'm on cycle 2. It does burn going in, but it's sub q so it's not a big deal. When I told my dr. (new RE) that I was on follistim for my fresh IVF cycle, he said menopur and follistim are basically the same thing. I'm interested in hearing your RE's response.

anofferingoflove said...

we did menopur + gonal-f for both of our fresh IVF cycles. i *think* menopur has been shown to steady the speed of egg development/assist with quality, but im not sure. you had such a good response with just the follistim though, im with you on the "if it ain't broke..." logic.

that's really amazing about the follistim gift. really, really amazing.

Anonymous said...

I can understand your questioning the Menopur, and I'm curious to hear your RE's reasoning for it as well. Hope you get some good insight!

Having said that, I was on Lupron, Gonal-F, and Menopur for my protocol, and I didn't find the Menopur any worse than the other two, in terms of burning. I just turned up some loud rock and roll and pushed them in slowly after a little bit of icing.

I did indeed receive the gift of black market (hehe) fertility drugs from a handful of other bloggers--Gonal-F, Menopur and Endometrin. I had no RX coverage at all, and this saved me well over $1K OOP. All of those bloggers had conceived from their IVF cycles, and passed their leftovers on to me, and it felt like the most amazing kind of pay-it-forward ever. Those ladies will always have a special place in my heart, and that gratitude swells when I look at Arlo.

Good luck, K! :)

Anonymous said...

That is an AMAZING gift. (now in a hushed voice "is it legal?") I'm certainly not going to turn anyone in.... just wondering. I had a LOT of psych meds (try this one--nope that didn't work. Try this one....) and wanted to give/donate/something but couldn't find anywhere to go with it. I hated throwing them away.

tbean said...

We had different kinds of cycles that we did. With straight stim cycles (no antagonist) they used both lupron before the follistim and then follistim plus menopur. Our last cycle for S's eggs she was on the antagonist protocol which was no lupron, straight up follistim, then the ant. added later, ganerelix. But I don't know more about menopur beyond that. Good luck--I'm thinking about you as you gear up for this cycle!

Anonymous said...

I've actully never heard of an ivf without menopur...

Pomegranate said...

It was part of my protocol along with bravelle. Menopur is FSH plus LH while bravelle/follistim/etc are just FSH. Don't really know the difference but it seems like most people have menopur as part of their protocol.

Also, i don't remember it stinging. Not like lupron!

Inlocoparentis said...

At the time we did our IVF, I remember asking why the Menopur/Bravelle combo as opposed to the drugs everyone else seemed to be using. I vaguely remember the RE saying the outcomes were better and the risk of OHSS was lower. This was the same RE who did my retrieval without any anesthesia, however - she probably had some kind of pharma endorsement going on!

Anonymous said...

Don't doubt the heartfelt thank you - that's often the best gratitude one can give. And besides, if that blogger's family has found her, I bet she fully understands what it means to have recieved such a gift for which there just aren't words ;)

Rooting for you!!