Monthly Archives: November 2013

Specialty Pharmacies – The 411

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Specialty Pharmacies - The 411

The Specialty Pharmacy

A specialty pharmacy is a pharmacy exclusively dedicated to providing medications that require special storage, handling, or specialized knowledge of the condition being treated. These medications are usually high-cost, complex, and are not immediately available at regular retail pharmacies.

Because infertility treatment typically involves a complicated therapy regime, requires the use of medications that must be injected and/or refrigerated, and often necessitates close monitoring by a pharmacist or nurse, certain specialty pharmacies focus solely on patients with infertility. Of the more than 57,000 pharmacies in the United States, only about 125 specialize in infertility.

** Apply for the EMD Serono Compassionate Care Grant and get up to 75% off on your infertility treatment meds !

A Woman’s Place DC at Grubb’s NW Specialty Pharmacy

A Woman’s Place DC at Grubb’s NW Specialty Pharmacy is a warm and inviting place focused on serving the women’s health needs in our community. We are a team of caring and compassionate professionals focused on providing the highest level of service to our patients and providers. We are not a nationwide pharmacy, but rather a community pharmacy with the intent of providing unmatched fertility & pharmacy services to the communities we serve throughout DC, Maryland and Virginia. We are the ONLY fertility pharmacy located inside the District of Columbia. If you live near DC, MD or VA let us show you what service is all about. Start by visiting our website at http://www.grubbsnw.com. You’ll be happy that you did.

Ambulatory Care Pharmacy II

Ambulatory Care Pharmacy is the largest infertility pharmacy in the entire Washington-Baltimore corridor. Our pharmacy specialty has been infertility for the past 15 years and enjoys a close relationship with many local fertility specialists. Some of us have gone through the heartache of trying to become parents, so we understand your emotional needs and support you during your journey. We supply all patients with the following educational materials: internet resources, information about the medications, their uses, and relevant tax information for those paying out of pocket. We have the largest inventory of fertility medications in the area and do not have to special order any of your prescriptions. For more information please check our website at http://www.fertilerus.com.

Apothecary by Design

Apothecary by Design is a pharmacy that’s uniquely focused on the practice of, well, pharmacy. We’re built around the forgotten notion that you don’t just need your prescription filled, but you need attention, advice and individualized care. And with competitive prices and free shipping nationwide, you’ll experience more without paying more. Our unique Clinical Support Team is eager to help you through your treatment and available to you anytime you need them to answer questions. Our entire team has extensive experience in all aspects of pharmacy services, healthcare solutions, and patient management. Tom Madden RPh, our women’s health specialty team leader—is one of only 50 pharmacists nationwide and only three in New England certified by the American College of Apothecaries in infertility treatment. For more information, please go to our website at http://www.apothecarybydesign.com/Infertility.htm

Apthorp Pharmacy

Apthorp pharmacy has been serving the upper west side of Manhattan since 1910. We have been working with and serving fertility centers, their doctors, nurses, patients and support groups for over 20 years.
We understand the needs of patients being treated for infertility. We are open 365 days a year, offer free delivery via same day messenger service in Manhattan and free FedEx overnight priority to other locations. Medications are always in stock and we take most insurance plans. We offer very competitive prices for those patients who do not have coverage for fertility medications. Our pharmacists and support staff are ready to assist you any way they can with your fertility medications. If you have any questions or need price quotes please call us toll free 1.800.775.3582. For more information, please contact: http://www.apthorprx.com

Avella Specialty Pharmacy

Avella Specialty Pharmacy is committed to helping our patients lower their out-of-pocket costs by uncovering and securing financial assistance. To learn more visit http://www.avella.com

BesScription

BesScription is a licensed specialty pharmacy dedicated to providing fertility medications, responsive customer service, and compassionate personalized support to women and men diagnosed with infertility. We are one of a kind because we treat each individual as a whole person (body, mind and spirit), instead of simply dispensing medications. We offer compounding capabilities for unique products and specialized dosages, and a wide selection of homeopathic, holistic and natural products is in stock to complement your fertility medications. From working with your physician and insurance company to delivering medications to your door, BesScription will be with you every step of the way, providing support and helping you on your journey 24 hours a day 365 days a year. BesScription is more than a pharmacy. BesScription is a comprehensive solution to your reproductive health needs. Contact us at http://www.BesScription.com or call us toll-free at 1-866-237-9419.

Freedom Fertility Pharmacy

At Freedom Fertility Pharmacy, we recognize the struggle that fertility treatment can present. It is with this in mind that Freedom has, for the last 20 years, committed ourselves to the advancement of patient services, education and support for each of our patients on their journey. Our team’s fertility-only focus gives you access to highly trained and focused professionals throughout your treatment. Additionally, our extensive educational and mobile resources ensure that you are always connected to programs designed to support and complement your treatment from start to finish. As a leader in fertility pharmacy, we recognize the importance of advocating and supporting not only current patients but also those who may be taking their first steps towards treatment.

We are proud to partner with RESOLVE in their unwavering commitment to increasing access to quality fertility care for all patients, leading the way for patient rights advocacy and their dedication to spreading awareness of infertility.

For more information on how we can support you, please visit http://www.freedomfertility.com or call us at 1-800-660-4283.

Mandell’s Pharmacy

The experts at Mandell’s Clinical Pharmacy specialize only in infertility care and take price in providing superior pharmaceutical service nationally to all of our Fertility Patients. Our staff is expertly trained to handle all of the needs of the Fertility Patient and we continually exceed our customer’s expectations. A pharmacists is available 24/7/365 to answer questions and address any concerns the patient or the physician may have. We are proud to partner with Resolve in order to achieve a common goal; Helping couples build families! For information on our services, please visit us at MandellsClinicalPharmacy.com.

MDR Pharmaceutical Care

MDR is YOUR Specialty Pharmacy for Fertility Medication. Patient care is at the center of everything we do. We are a nationwide provider and also experts in international shipments. MDR pharmacists, specialized in all aspects of infertility, are on call around the clock for emergency medication related questions. We offer competitive pricing and a comprehensive package of value added services. There is always a live voice on the phone and our staff speaks many different languages. We deeply care and strive to always provide patients with the highest quality of products and services.

Family is our inspiration. Fertility Pharmacists since 1989.
Call 1-800-515-DRUG (3784) – http://www.mdrusa.com

Metro Drugs

Metro Drugs is a full-service pharmacy offering specialized fertility care and support to our patients. Metro is a partner of choice for doctors and patients by providing expert skill with exceptional, compassionate care. We offer compounding and micro-dosing, competitive pricing, nationwide deliveries and pharmacy hours 7 days a week. Metro’s comprehensive care also includes field support for providers, customized egg donor/surrogacy services, insurance screening and advocacy, 24/7 nursing support and a multi-lingual staff. Our Metro family enjoys a genuine sense of pride and reward in helping our patients create their own families! Please visit our website at http://www.metrodrugs.com and get started!

Roxsan Pharmacy

Roxsan Pharmacy has over 40 years of compounding and 20 years of infertility experience with a highly-qualified staff to answer all your questions and take care of all your needs.

Our goal is to make sure all our patients receive high-quality service. Our team of experts provide one-on-one care and 24-hour live access to specialists trained in infertility care. Roxsan Pharmacy is committed to helping women and men build their families.

For more information, check our website or call our toll free number 1-888-371-9919.

Village Fertility Pharmacy

Village Fertility Pharmacy is a leading pharmacist-owned and operated specialty fertility pharmacy dedicated to providing unmatched service to medical professionals and their patients nationwide. With 25 years of experience, Village understands the unique nature of fertility treatments and is devoted to building committed relationships by providing compassionate support, competitive cash pricing, unmatched educational resources, and 24-hour customer care. For more information, please contact http://www.villagefertilitypharmacy.com/.

Walgreens Specialty Pharmacy

Walgreens Specialty Pharmacy’s comprehensive fertility services help patients fulfill their dream of having a baby. An experienced care team of fertility nurses and pharmacists understand the fertility process, the importance of timing, and the need for personalized fertility therapy. We are committed to compassionate care and support throughout your journey to conception. Walgreens Specialty Pharmacy offers:

Support from pharmacists and nurses 24/7, including holidays
Same-day emergency service
Insurance verification
Overnight shipping
Interactive educational tools
Complimentary medication materials

To learn more visit http://www.walgreens.com/pharmacy/specialtypharmacy.jsp or call 800-424-9002

Just Have Faith !

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Just Have Faith !

“In their hearts humans plan their course, but the Lord establishes their steps.” Proverbs 16:9

I saw this scripture today and it resonated in my spirit. Holidays can be a bit daunting when you wish you had a partner and children to share it with. Christmas and Easter are especially hard. Santa… Easter Bunny and baskets…

As difficult as infertility is and as heavy as it weighs on the human spirit, we must remember that FAITH is believing God WILL do what He has promised us and that although we make plans, His plan is perfect and He orders our steps.

I have a renewed faith that God will allow my child to be born according to His time table and not mine. God operates in Kyros and Chronos ! I feel in my soul that the time is now for me to bear fruit and these babies will be everything God has shown me they will be.

#patientlywaitingtobeamommy #prayingmyfirstivftakes !

Acupuncture for Infertility- The 411

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Acupuncture for Infertility- The 411

For those considering IVF, acupuncture increases your chances of conception by 65% !

A surprising new study has demonstrated that women undergoing in vitro fertilization have a higher rate of pregnancy and live birth if they receive acupuncture at the time of their embryo transfer. The study, which looked at 1,366 women in seven different studies undergoing IVF along with acupuncture, a sham treatment or no additional treatment, found that the odds of achieving pregnancy were increased by 65% if a patient underwent acupuncture within 1 day of embryo transfer. One of the strengths of this study, is that it included women of different ages, types and durations of infertility.

These results probably don’t come as a surprise to the Chinese, who have been using acupuncture for centuries to regulate the female reproductive system. While modern scientists don’t know why acupuncture impacts fertility, they hypothesize that it could be related to neurotransmitter release, increased blood flow to the uterus, or a decreased stress response from the release of naturally produced opioids.

The 65% increase shown in this study means that for every ten women undergoing IVF, one additional woman would successfully become pregnant. Considering the cost of in vitro fertilization, which averages at over $12,000 per cycle in the US, any safe and effective means for increasing the success rate would be well received by the 10-15% of couples who seek fertility treatment at some point while trying to conceive.

Reasons to NOT use Assisted Hatching – the 411!

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Reasons to NOT use Assisted Hatching - the 411!

I was researching today about assisted hatching- the procedure in which the doctor pierces the embryo to “help” it attach to the uterine wall. Well guess what…. it can cause DEFORMITY, DEATH, or CONJOINED TWINS ! I do not think so ! I have not waited ALL this time to have a baby and then get pregnant and have to deal with this. Not only can the increased risk of conjoined twins, deformity, or death be possible, but this procedure can cause other problems. (see below)

“Risks Associated with Assisted Hatching”

Unfortunately, there are some risks associated with assisted hatching procedures. In particular, assisted hatching procedures do seem to increase the likelihood that you will have identical twins (also known as monozygotic twins). This is because the micromanipulation technique used to break through the zona pellicuda can sometimes cause the embryo to split into two identical halves.

There is also an increased risk of:
damage to the embryo, potentially causing death
fetal complications
physical deformity
conjoined twins

The procedure can sometimes also cause complications for the mother, including:
high blood pressure
infection
nausea
mood swings

I will take REGULAR OLE IVF with NO TINKERING for 1000 Alex ! 🙂

Sperm Donor & Cryobank 101

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Sperm Donor & Cryobank 101

After researching all of the top rated cyobanks aka sperm banks, I ultimately decided on using Fairfax Cryobank.

FC, of all cryobanks, does the most comprehensive testing of all of them. FC is the ONLY cryobank which tests for HPV and Herpes via DNA. It is important that a woman TTC (trying to conceive) not walk away from the experience with more than what she came in with and only walk away with a baby or two… or three :-).

No one wants a sexually transmitted disease !

FC has extremely strict donor guidelines and they also limit the number of births that can come from one donor.

The last thing I want is to end up on the new reality show, “Generation Cryo!”

ps: good thing I have a sense of humor, as all of this is a tad bit overwhelming !

I have made a list of the most important factors that I would want in the father of my child. I will begin my seach using that criteria.

I have opted to use a “Donor ID” as opposed to an Anonymous Donor. At the age of 18, I am allowing my child/ren the option of seeking out their “father” and developing a relationship with him, should they so choose.

My mom, sisters, godmother and my closest friends and I are going to have a “DONOR SELECTION PARTY” ! Open up a few bottles of wine, lay out a spread of cheese, appetizers and a Bible (just kidding) and narrow down my “baby daddy #49877ab2”

Plan B In Action

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Plan B In Action

I spoke with my coordinator today at CNY Fertility Center and Spa and have decided on a tentative date for my IVF transfer. To plan for a Christmas birth, I am looking at having my egg retrieval done around March 28th and having the fertilized embryos implanted on April 2, 2014 !!! I made my hotel reservation to be in the city for a total of 8 days. I am going to stay two days past the procedure so that I can rest. I am praying that the little ones “stick” and 40 weeks later I will have two bundles of pink and blue 🙂

Questions To Ask About Infertility (source – NY Times)

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What to Ask About Infertility

 

Confronting a new diagnosis can be frightening — and because research changes so often, confusing. Here are some questions you may not think to ask your doctor, along with notes on why they’re important.

 

What is your success rate in achieving pregnancies in women of my age and with my diagnosis?

 

Fertility diminishes with age, and so do I.V.F. success rates. Make sure the statistics cited by your prospective fertility doctor apply in your circumstances, not those of a woman 10 years younger.

 

Do you have a treatment specialty?

 

Working with a medical team experienced in your type of infertility can enhance your chances of getting pregnant.

 

How long do you believe your patients should try less advanced methods before moving to assisted reproductive technologies?

 

Depending on your age and diagnosis, oral medications such as clomiphene (Clomid) and artificial insemination can increase your chances of conception without the cost or emotional commitment of I.V.F. But patients over 35 years old should not spend too much time on such low-tech methods if they’re not successful within a few ovulatory cycles, many experts say.

 

How do you treat repeated miscarriage? What are your views on the use of intravenous immune globulins (IVIg)?

 

Recurrent miscarriage often is treated with hormonal supplements along with pre-implantation screening of defective embryos. Some centers may also offer IVIg, a highly controversial procedure that involves an intravenous cocktail of antibodies from many blood donors. Most well regarded fertility practices don’t administer IVIg because of its risks and as yet unproven benefits.

 

Do you perform preimplantation testing of embryos? If so, do you do it for anything other than genetic disorders?

 

Preimplantation genetic diagnosis, or P.G.D., is a procedure in which cells removed from an embryo are tested for genetic abnormalities before it is transferred into the uterus. P.G.D. can help doctors identify devastating genetic diseases, like Tay-Sachs or cystic fibrosis. Yet recent studies suggest P.G.D. is not as reliable as originally believed.

 

What’s your position on pregnancy reduction?

 

The more embryos transferred into a woman’s uterus, the greater her chances of carrying one to full term — and of having multiple births, with such complications as premature birth and underweight babies. Many doctors have begun transferring fewer embryos in order to lower these risks.

 

At what age, or after how many failed cycles, do you recommend the use of donor eggs?

 

Fertility centers and specialists vary in their approach; the answer also will depend on your age, diagnosis and history of live births. It can be useful to know your prospective doctor’s views and whether a prospective fertility practice would be able to locate an egg donor should you need one.

 

Can acupuncture aid fertility?

 

Some evidence suggests acupuncture may have beneficial effects on stress and reproduction, though studies have been mixed. Whatever treatment approach you choose, stress management is an important component of infertility treatment.

 

What happens to my unused embryos?

 

A reputable fertility center will have you sign an informed consent form expressing your wishes. The usual choices include donating unused embryos to another infertile couple, offering them to a research institution or having them destroyed.

 

Do you freeze eggs? Do you use the slow-freezing method or vitrification? What is your success rate with frozen eggs, compared to frozen embryos?

 

Egg-freezing is an area of growing research and promise, but the American Society for Reproductive Medicine, the main professional body for fertility specialists, regards it as an experimental procedure that should only be provided to younger cancer patients facing sterilizing treatments. I.V.F. with slow-frozen eggs leads to pregnancy less often than procedures relying on fresh eggs or slow-frozen embryos. . Vitrification, a new process by which eggs are flash-frozen, may rival that of fresh eggs, though the procedure is new.

 

What about ovarian tissue freezing?

 

The safety and effectiveness of this experimental technique, which involves making a small incision under the navel and removing thin strips of ovarian tissue for later transplant, remains unproven. The American Society for Reproductive Medicine currently states the procedure should be considered only for women who must undergo medical treatments that may leave them sterile, not as a lifestyle option for women who want to advance their careers or find a partner.

The American Fertility Association, a nonprofit advocacy and education group based in Baltimore, also has a list of recommended questions on its Web site, www.theafa.org.

How To Select An IVF Doctor – The 411

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When looking for a IVF doctor, a good place to start is to ask your OB/GYN for his/her opinion of doctors in your area. Because fertility treatment usually requires several office visits, you will probably not want to travel too far for testing and treatment. Other sources are friends or relatives you know who have had an experience with a fertility doctor. Because there is a wide range of IVF clinics, it is helpful to know the ins and outs of how to select an IVF clinic.

Though some OB/GYNs do provide limited infertility treatment, they are not trained in the more advanced reproductive technologies like IVF. You will want to find a doctor who has been trained to do IVF.

Reproductive Endocrinologists (RE) represent a subspecialty of obstetrics/gynecology devoted specifically to treating infertility.  RE’s are required to have specialized training that is above and beyond their 4-year OB/GYN residency training and board certification.

Once you have narrowed down your options, you should make an appointment to meet with, and interview, the doctors on your list. Your partner should attend the appointments with you.

Some questions to ask:

  • Where did you receive your medical training? When?
  • Are you a board-certified reproductive endocrinologist?
  • For how long have you been treating infertility?
  • Do you have a treatment specialty?
  • How long have you been in this practice?
  • Are you affiliated with a hospital?
  • How many patients have you treated with IVF, and how many IVF cycles have you performed?
  • What are steps in the procedure?
  • If the reason for my infertility is unclear, what diagnostic tests do you recommend?
  • Do you have a call-in time so that I can ask questions?

As with selecting an IVF clinic, you will want to listen to your gut when choosing your doctor. Your comfort level with the doctor is a very important aspect that should not be ignored.

How to Select a Fertility Clinic- the 411

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So, it’s been recommended that you find a fertility clinic. With over 400 IVF clinics in the United States, there is no shortage. But how do you choose among them?

Often women or couples are referred to a particular clinic in their area by word-of-mouth. Recommendations may come from your gynecologist or from friends and relatives. Sometimes clinics are known by ads and news articles or found through Internet searches. Even if you are given a recommendation, it is wise that you do your own research in advance of visiting a clinic. Doctors report that IVF patients these days are typically well-informed and knowledgeable when visiting a clinic for the first time. It is to your benefit to be an educated consumer and to know what to look for.

First, you should check this list and rule out centers you SHOULD NOT use ! :  http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/default.htm

Types of clinics

There is a range when it comes to types of fertility clinics and no two clinics are alike. There are pros and cons with each type, with no type being better generally better than another.

  • Sole practitioners
  • Small practices with 2 – 8 member physicians
  • Large, full-service practices
  • Fertility networks
  • University-based clinics
  • Hospital-based clinics

Sole practitioners may offer a more personable experience than a larger practice, and you may have more direct access to the doctor when you have questions.  Larger practices typically have the benefit of an in-house lab, equipment and more resources available, but it is more likely you will be communicating with nurses and staff, rather that directly with the doctor when you have questions. With a larger practice you may not always see the same doctor from visit to visit.

Fertility networks are groups of clinics that have come together under an umbrella organization. They offer different forms of financing.

Clinics at university hospitals are involved in research which could be advantageous in that they could be using the latest techniques, and offer discounts.  Medical students are sometimes present during exams at university-based clinics.

With both university-based and hospital-based clinics, there are usually lots of resources, but typically bureaucracy as well. People often wrongly assume that a clinic’s reputation is the same as that of the university or hospital within which it resides, but that is not the case. it is important to assess a clinic in the same way you would any clinic.

Success rates

It is important to know the the success rates of clinics that you are considering. The Centers for Disease Control (CDC) mandates that all IVF clinics report their statistics annually. Note that it takes two years for the CDC rates to become available and, therefore, it is possible that the published data may not be representative of an IVF center’s current performance. Many factors that contribute to a clinic’s success rate may have changed. For example, physicians and staff may be different, equipment and training may, or may not, have been updated, and so on.

You can see individual clinic’s statistics by referring to the Annual ART Success Rate Reports. It provides an in-depth picture of the type, number, and outcome of ART cycles performed in U.S. fertility clinics. To help you interpret the CDC’s individual fertility clinic statistics, be sure to read How to Read a Fertility Clinic Table and Introduction to Fertility Clinic Tables.

Understanding IVF clinic success rates

While a majority of clinics publish their success rates on their websites, some do not. When investigating a clinic, you should ask a for a report of a clinic’s success rates, and it is always wise to compare their reported statistics to the CDC report. Some clinics may choose to show only a subset of their statistics.

When selecting a clinic, be sure to look for one that has a success rate that’s at least above the national average.

Financial aspects

Cost

Of course you will want to know costs ahead of time. When looking into the cost of IVF you will find that costs depend on your individual circumstance.  Also, you will find that costs vary from clinic to clinic.  It is important to ask exactly what is included when you are given a quote for the cost of an IVF cycle.

While cost is an important consideration, it should not be the determining factor when selecting an IVF clinic.

Health insurance

Find out if your health insurance policy covers fertility procedures such as IVF. Even if it a procedure like IVF isn’t covered, your insurance may cover fertility diagnostic procedures.

In either case, if you want to take advantage of your coverage, you must choose a doctor that is in your insurance plan.

You can read about state infertility insurance laws to see how they pertain to you.

Interview

Once you’ve narrowed down your options, you should contact the fertility clinic(s) to set up an interview.

In conclusion

As you can see, there are a variety of factors to weigh when selecting a fertility clinic that is right for you.  After doing your research, in the end, it is very important to listen to your gut. Remember that fertility treatments can be an emotional and stressful experience, and you will want to feel comfortable and supported with the medical provider you choose.