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Some Pharmacies are "Preferred Pharmacies" for certain drugs-- meaning they will offer better pricing and/or only sell certain manufactured drugs. Thus, you will find that some pharmacies only sell Gonal F and Cetrotide versus Follistim and Ganirelix. Mandell's, Kings, Alto, Freedom, Encompass, and Village Pharmacy are all preferred pharmacies for Gonal F/Cetrotide. MDR and Apthorp are preferred pharmacies for Follistim/Ganirelix.
Ovarian Stimulating Drugs
In a regular ovulation cycle, a hormone signal (called Follicle Stimulating Hormone (FSH)) from the pituitary is sent out at the beginning of the cycle (during menstruation) and it leads to the random selection of a follicle, which enlarges over the course of 1-2 weeks and eventually releases as a mature egg. When stimulating the ovaries in advance of egg retrieval, you are injecting these hormone signals (that naturally come from the brain to stimulate ovulation of a single egg) – but you are injecting these hormones at a higher level in an effort to select multiple follicles to grow and mature – not just the single one that would normally mature and ovulate naturally. Gonal-F and Follistim Aq are both medications that stimulate the ovaries to produce follicles and release mature eggs and are therapeutic equivalents with MD approval.
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Shop around! There is a huge difference in prices across the US, one pharmacy being a few thousand dollars less than the next one across the street. You can shop around for fertility medication at any pharmacy of your choosing, including international pharmacies. You are entitled to ask your doctor for a copy of your prescription and fill it wherever you want. Also, any person can buy drugs for personal import or personal use. Be mindful that your insurance may usher you to a certain pharmacy; the cost-sharing prices they offer may be 2x, 3x, or even 4x what you would pay self-pay.
Don’t order too much medicine at first! You can save hundreds to thousands of dollars by tapering your medication purchases. Patients often overbuy based on provider recommendation and may only use 60% of their order. Consider buying 70% of your medication up front and purchasing locally on an as-needed basis.
Drugs to Prevent Ovulation
We also need a strategy to prevent ovulation – because when follicles are mature they will eventually signal the brain to release LH and cause eggs to be ovulated. We want to collect the eggs with an egg retrieval procedure before they are released into the Fallopian tubes. Ovulation preventing drugs (Ganirelix Acetate and Cetrotide) are used to prevent eggs from being released too early and can help your provider be more successful during your egg retrieval procedure. Cetrotide, Ganirelix, and Fyremadel are therapeutic equivalents with MD approval. Lupron, when given over an extended period of time, can also be used to prevent ovulation and suppress the ovaries.
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MDR offers a "best price guarantee" where they match your cycle's quoted price and beat it by $100 for the entire order. This does not apply to quotes you have of Gonal-f and Cetrotide. Follistim AQ and Ganirelix Acetate will be quoted in place of Gonal-f and Cetrotide, respectively
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PRO TIP: The Leuprolide Acetate 2 Week Kit & the Leuprolide Acetate Trigger from Freedom Pharmacy have the same concentration (1 mg/0.2 mL) and dosage (2.8 mL vial). The 2 Week Kit comes in a kit with incremented dosages and syringes. You can save almost 80% by asking your provider to prescribe you the Leuprolide trigger instead. Freedom Pharmacy will send you additional needles, syringes, and alcohol free of charge.
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When shopping around and drawing up your Lupron dosage, note that 2mg = 40 units = 0.4ml, 4mg = 80 units = 0.8ml, and so on.
Also, a Lupron trigger is not an option for people using Lupron as an agonist to prevent ovulation during their treatment cycle. Those patients can only use an hCG trigger. Lupron triggers are great for patients who are at high risk of OHSS because they don’t have the same side effects that come along with the hCG trigger.