FAQ - Medications
Yes, each package can be financed for 6, 12, 18, or 24 months with CNY’s in-house payment plans.
The length of medication preparation will depend on your treatment type. For most Timed Intercourse or IUI cycles, oral stimulation medications are taken for approximately 5 days. For most IVF cycles, injectable stimulation medications are taken for approximately 8-12 days prior to retrieval. For FET cycles, most lining preparations will be 7-10 days. This will all be dependent on how your body responds to the medication. Once your procedure is complete, you will receive a new medication protocol to take you to pregnancy test, and if positive, some medications will continue until 8-12 weeks of pregnancy.
The bundles are refundable if the service has not been rendered, and the medications have not been dispersed. If you purchase a package and medications are dispensed but you do not proceed with egg retrieval, a partial refund may be available.
Because the use of many over the counter medications has not been studied with fertility treatments, we recommend you take Extra Strength Tylenol, per the package instructions, for pain. If you experience any pain that is not controlled, you will want to alert our office immediately and/or be seen locally in an urgent care or ER.
Possibly. The bundles are designed based on our most common base but comprehensive treatment protocols. For many, the bundles will include all the medications they need. Others, like those doing an FET, PGT (which requires FET), immune/enhancement protocols, or who do not respond as efficiently to the medications during stimulation, may need to purchase medications outside the bundle. Should you need to order additional medications, you will purchase these medications at CNY’s standard negotiated rates with our pharmacy partners.
Once you speak with your Nurse Navigator, as well as our Patient Accounting team, a message will be sent to our Prescription team to start ordering your medications. While some can be purchased locally (with or without insurance), many will receive their medications shipped to their house from a specialty fertility pharmacy. If you have insurance coverage, we will assist in processing your medication authorizations and forward your medications to your insurance’s preferred specialty pharmacy. If you are paying out of pocket or are interested in using one of our CNY Bundle Packages, we will send your scripts to one of our partnering pharmacies to obtain the best out-of-pocket pricing.
To continue to make fertility treatment accessible to everyone, we have created CNY Bundle Packages, which are inclusive of both the base medications you would need for IVF and transfer, as well as the procedure itself. The Bundle Package chosen for you will be based on your medication protocol. Aside from your medications, this package includes:
Retrieval and Anesthesia
Embryo Culture
ICSI Fertilization
Assisted Hatching
ONE FRESH transfer w/ Embryo Glue
Cryopreservation of Remaining Embryos
*Please note, if you are unable to have a fresh transfer due to lab/ultrasound results, there are no partial refunds for these packages.
In many cases, your provider at time of consultation will place a plan in your chart based on any previous testing, fertility history, GYN history, and goals for treatment. Approximately 7-10 days from your consultation, you will receive a call from our Consultation Nurse Navigators who will review your specific protocol, as well as provide any pre-treatment medication/testing recommendations.
For constipation, we recommend Citrucel, Colace, Peri-Colace, FiberCon or Milk of Magnesia. We also encourage increasing your water intake.
We have a dedicated team of nurses available via phone and able to assist you from 6am-8pm EST M-F, and 7am-2pm EST on Saturdays. Outside of these hours, we do have a nurse on call that can assist in urgent situations. We recommend reviewing your medications and protocol prior to our phone lines closing to avoid panic or confusion later.
For more information on medications, watch our YouTube video: How can I get my meds ordered? When will I get medication instructions from CNY Fertility?
After your initial consultation, medications will be prescribed for you typically within 7 to14 days to whichever the least expensive self-pay fertility pharmacy is at the time. These medications can be reviewed in your patient portal. Because New York State prohibits the release of paper prescriptions, should you elect to fill any of these medications elsewhere, we request that you call the pharmacy where they were initially ordered, and request they be forwarded electronically to the pharmacy of your choice. This helps to reduce duplicate medication orders which cause confusion for you, CNY, and the respective pharmacies. You will need to ensure you receive all your medications prior to calling to notify us you have started your period.
Inflammation and immune issues can be contributing factors in infertility. Dr. Kiltz always recommends adding certain immune medications pending each case which may include Low Dose Naltrexone (considered a “miracle drug” that simply reduces inflammation,) Lipid Infusions, Neupogen, Lovenox injections, oral prednisone, low-dose aspirin, Prograf, PRP (platelet-rich plasma), and HCG washes to your cycles. Additional potential immune treatments like Humira or IVIG may be recommended. See more information on our immune protocols here.
Medications used for IVF may include:
Gonal-F/Follistim (FSH), Menopur (HMG), HCG-LH Supplement, Cetrotide/Ganirelix, Letrozole, Low Dose Naltrexone (LDN), Z-Pak, Prednisone, Omnitrope (HGH), Lupron Acetate Trigger, HCG Trigger, and prenatal vitamins.
Medications used for embryo transfer may include:
Estrace, Z-Pak, LDN, Prednisone, low-dose aspirin, Prograf, Endometrin or Prometrium, Progesterone in Oil, and prenatal vitamins.
At CNY, we firmly believe in providing each client with a personalized plan based on their age, testing, fertility history, and goals of treatment. Each client protocol may vary, and what works for one person may not work for the next!
No, however, you can easily add an FET to any IVF bundles for $995/each if the FET is done within 12 months of the retrieval.
We understand that one of the scariest parts of this process for some may be the injections. While some people elect to give themselves the injections, others work together with their partner, a friend, or a family member to assist. Our nurses will provide instruction on how to self-administer injections, and there are many online resources as well.
The first step/action item for you depends on where in the treatment journey you are:
IF YOU HAVEN’T HAD YOUR CONSULTATION YET:
During your consultation, you will collaborate with our provider, who will formulate a treatment protocol matching your medical history and goals. If you know you would like one of our bundles, please tell your provider during the consultation so they can formulate your protocol with this in mind. The provider may recommend additional immune or enhancement medications not part of the bundle. These medications would need to be purchased in addition to the bundle. Even so, you will realize a significant savings when purchasing a bundle.
And if you haven’t scheduled your consultation yet, you can click here to schedule your consult.
IF YOU HAVE HAD YOUR CONSULTATION, WANT A BUNDLE, BUT DON’T KNOW WHAT BUNDLE YOU NEED BASED ON YOUR PROTOCOL:
Have no fear; most patients will not know what bundle package they need based on their pre-existing protocol. Please contact your nursing team through the patient portal, telling them that you would like a bundle but need help converting your existing protocol into the most appropriate bundle. If you are a travel patient, please message the Global Travel-IC/IUI/IVF group in eIVF. If you are local to one of our offices, please message the nursing team of that office (for example NursingTeam- SARASOTA).
The respective nursing team will convert your protocol into the closest matching bundle and inform our Financial Team, who will send you a contract to pay for the bundle. Once payment is made and the financial agreement has been signed/returned to our Patient Account Team, the Financial Team will send your order to our Prescription Team, who will forward your prescription to our preferred pharmacy to be fulfilled. You should receive a call from the pharmacy within the next few days.
IF YOU HAVE HAD YOUR CONSULTATION AND KNOW EXACTLY WHAT BUNDLE YOU NEED TO BUY:
If you’ve already had your consultation, want to purchase one of our bundles, AND KNOW EXACTLY which package you need, please contact your nursing team through your patient portal, telling them which bundle package you would like to purchase. If you are a travel patient, please message the “Global Travel- IC/IUI/IVF” group in eIVF. If you are local to one of our offices, please message the nursing team of that office (for example, “Nursing Team- SARASOTA”). The nursing team will send your bundle request to our financial team, who will send you a contract to pay for the treatment. Once payment is made and the financial agreement has been signed/returned to our Patient Account Team, the Financial Team will send your BUNDLE PACKAGE NUMBER to our Prescription Team, who will forward your prescription to the pharmacy to be fulfilled.
IF YOU HAVE HAD YOUR CONSULTATION, WANT A BUNDLE, BUT HAVE FINANCIAL QUESTIONS ABOUT THE PACKAGES
(FOR EXAMPLE: YOU PURCHASED AN IVF CYCLE ALREADY AND WANT TO CONVERT/UPGRADE INTO OUR BUNDLE):If you’ve already had your consultation and would like to purchase one of our bundles but have financial questions about the bundle, please message the “Patient Accounting” team through your patient portal, and they will reply as soon as possible.
Inflammation and immune issues can be contributing factors in infertility. Dr. Kiltz always recommends adding our full immune protocol which may include Low Dose Naltrexone (considered a “miracle drug” that simply reduces inflammation) Intralipid Infusions, Neupogen, Lovenox injections, oral prednisone, low-dose aspirin, Prograf, Plaquinil, PRP (platelet-rich plasma), and HCG washes to your cycles. Additional potential immune treatments like Humira, IVIG, and cannabinoid oil (CBD) may also be recommended.
Yes! You will simply need to pay the difference in the price. Please get in touch with the Patient Accounting team via web correspondence through your patient portal to start the process.
What is the purpose of LDN?
LDN is a therapy that has shown promise in a variety of health issues including infertility and other symptoms associated with PCOS. LDN boosts the immune system, the mechanism for which we do not entirely understand. LDN makes the immune system begin working at optimum levels again which includes the correction of the many imbalances which plague our body. Studies have also helped to uncover some relationships between the immune system, the hormonal imbalance of the body and the problems experienced by women with PCOS.
LDN therapy requires taking 4.5mg by mouth at bedtime. The medication will cause a blockage of endorphin receptors throughout the body, and decreases hyperfunction of microglial cells, which are supporting cells in the nervous system that regulate immune and inflammatory response. The brief blockage every night appears to be enough to effect a prolonged change in many aspects of the immune system and increases the body’s ability to heal itself.
Although LDN is noted for being side-effect free because it stimulates the body’s own mechanisms, there are clients for whom it is not well-suited, especially those being treated for addictions.
LDN is ONLY available at a specialty compounding pharmacy and will not be available at your local pharmacy.
Yes, the patient pays CNY Fertility directly for the entire package (including medications). A participating pharmacy will fulfill the prescription. Can I use my FSA/HSA plan to purchase this Bundle Package? Potentially, please contact your plan administrator to determine our treatment medication bundle’s eligibility for your plan.
Intralipids are a liquid emulsion of fat. It is mainly composed of soybean oil and egg fats. Intralipids can be used along with conventional fertility treatments. Researchers believe it acts to suppress the body’s Natural Killer Cells. These cells may attack the sperm or egg and possibly the cells of the developing fetus. This is an IV infusion that is performed in our office and generally takes approximately 20 to 30 minutes. The recommendation is to infuse Intralipids before IUI / Egg Retrieval / Embryo Transfer and weekly thereafter to 12 to 14 weeks gestation.
Intralipids need to be used with extreme caution in patients who have diseases that may affect the function of the liver or kidneys. These may include but are not limited to: diabetes, liver failure, hepatitis, cirrhosis, kidney disease, sepsis or metabolic disorders. People who have an allergy to soybeans or eggs are unable to receive Intralipid therapy.
As with any medication, there are side effects that may be experienced. The side effects are often related to the rate of infusion and will lessen if the infusion is stopped. The possible side effects may include; fever, chills, nausea, vomiting, headache, back pain, chest pain or difficulty breathing. If you experience any of these side effects during or after your infusion, please let the nurses know. There is also the potential of an allergic reaction. Should this occur, the infusion will be stopped immediately, and the necessary actions will be taken to treat the reaction.
