The Other Approach: Natural-Cycle IVF
Natural-Cycle IVF involves the extraction of an individual egg without the usual medical stimulation to create multiple eggs as happens in standard IVF. Natural IVF costs less and is gaining popularity amongst those wishing to conceive.
Dreaming of Baby speaks with Michelle Katz, LPN MSN, a Healthcare Advocate here to help readers make an informed choice.
Daniela: Good morning, and welcome to Dreaming of Baby! We have with us today Michelle Katz, LPN MSN, with whom we shall be discussing natural IVF. It’s a pleasure to welcome you with us Michelle, and we’re looking forward to what you have to share with our readers. Before we start with our discussion, it would be great if you could introduce yourself and your story to our readers.
Michelle Katz, MSN, LPN: I have spent much of my career “forming the role” of what many know as the “healthcare advocate” today. Unfortunately, I have been in many healthcare situations which could have – and some have – put me in major medical debt. But, based on my background as a nurse administrator with an emphasis on coding and HIPAA and an understanding of healthcare in general, I was able to test many aspects of our healthcare system and come up with solutions that work in almost any situation. This is why Diane Sawyer named me ABC’s “Healthcare Consumer Advocate” at one point. Most of my tips can be found in my books “Healthcare Made Easy,” “Healthcare for Less” and “101 Health Insurance Tips” and now, I am on my next journey in healthcare after recovering from an accident where I was almost paralyzed.
Daniela: Thank you for this impressive overview, Michelle. As our discussion today is focused on IVF, what led you here and how does your experience as a healthcare advocate impact the care you are seeking now?
Michelle Katz, MSN, LPN: Everyone has a different story, mine might be similar to some of your readers… the timing was just not right for me to have kids and life always throws you curveballs. Unfortunately, I have come to a point where my biological clock was ticking. After assessing my situation from all aspects: career, financially, physically, I continued to do research since IVF was not a solution for me. Besides my age being a factor, I found out I had poor ovarian reserve and the pharmaceuticals used for IVF are extremely expensive and not covered by many insurance companies. After much research on methods I discovered all over the world, I found research that was performed on natural IVF and the doctor that was performing it in the US was Dr. Michael DiMattina located in the DC Area. After my initial consultation, I factored all of my concerns into the equation and realized that traveling to the east coast when my cycle was right, was the best solution for me.
Daniela: We’re aware that the financial side to IVF is a concern for many who wish to become parents. Based on your own experience, to what extent is natural IVF a more affordable option?
Michelle Katz, MSN, LPN: Much more (even with a cross-country flight). Due to the fact that it is “natural”, you are not using all the medications that you do in IVF. You have just one “trigger shot.” You also have time to price around for the medication like I do. Prices go up and down daily depending on the specialty pharmacy (which can be another article). You can also apply for patient assistance programs for the trigger shot in some cases. This depends on your income level; just be sure to ask the pharmacy you choose not only for the rate and discounts, but also if there is such a program that they participate in. In addition, you can try every cycle (month) because it is natural. The biggest expense, to be quite honest, is the egg retrieval since it requires anesthesia, as compared to stimulated IVF where the medication is a huge expense and women usually try a few times before they have a successful complete transfer, so that can add up. In addition, I have discovered that quite a few women have had a bad reaction to the IVF meds which require treatment. These costs can add up too. Remember, all you need is ONE good egg. There is usually one dominant follicle/egg that “takes over” the other follicles per cycle. There is more of a chance for multiple births with stimulated IVF as opposed to natural IVF, which is another expense.
Daniela: This is truly enlightening, and also gives hope to those worried about the financial impact of such treatments. I’m sure you’ve more than done your research on this subject, as well as your background as a nurse which must help in reaching such decisions – would natural IVF be a suitable option for most women or there are stringent medical requirements?
Michelle Katz, MSN, LPN: If a woman has normal to strong egg quantity (ovarian reserve), and the center she chooses can perform pre-implementation genetic screening on embryos to determine which embryos are genetically normal, and the woman has time (she is younger), stimulated IVF might be a better option, since it is about numbers. However, for women who are at an advanced age, have poor ovarian reserve or have even failed stimulated IVF, a natural cycle may be a better option. I was lucky enough to find Dr. Dimattina who explained all the options and made sure my expectations were realistic since even extracting a good quality egg can take a few attempts. This is because you may produce a bunch of follicles, but some may not have eggs. There are no “medical requirements” per se except for what I mentioned above as well as if you might have a reaction to the IVF medications. It is mostly a preference.
Daniela: Great, thanks for clarifying – and that is indeed positive! In our conversation prior to this interview, you made a note on pharmacies and ‘women’s emotions’ – can you elaborate on this a little? How is this connected to IVF?
Michelle Katz, MSN, LPN: Recently, when I called to ask for the cash price of HCG medication (what I call the trigger shot) from different pharmacies, I was quoted prices from $100 – $180. I even had one pharmacy say, “well if you pick it up today as opposed to tomorrow the price may go up or down by a couple of dollars.” One pharmacy even said they ran out of the drug and the next shipment they would be getting in might cost up to $500. Because I know the prices of many medications and have done extensive research, I know this drug costs around $30 – maybe even less – but due to “supply and demand”, the price may vary. So plan accordingly and know you can store the drug for a short period of time (and there are generic forms).
Daniela: This is insightful – so for the woman about to embark on the IVF journey, what kind of research should she be doing in sourcing her medication? Cannot she rely on her own fertility clinic?
Michelle Katz, MSN, LPN: A woman should interview a few clinics and see where she is comfortable; is the staff responsive and accommodating? Ask questions about the treatments they provide and if they are aware of other treatments and their thoughts. Are they pushing one treatment? etc. In addition, these clinics may not be aware of all the specialty pharmacies that carry the meds out there, so if you have a specialty pharmacy that you prefer that will give you a discount and work within your budget, let your clinic know. Some clinics are able to negotiate discounts with some specialty pharmacies, so be sure to ask. Also, don’t be afraid to ask the clinic about other treatments you heard about and their thoughts on what might be best for you after you get your preliminary tests (and yes, check with your insurance because you MIGHT be able to get some of the preliminary tests covered, like the HSG). Some pharmaceutical companies offer discounts or patient assistance programs for medications to those with proof that they cannot afford them, but this you might have to go directly to the pharma company for.
Daniela: So would you say that communication, and also being somewhat assertive about your wishes, help you be in control of your own journey?
Michelle Katz, MSN, LPN: As well as managing your expectations.
Daniela: Great, thank you. On a final note, what would be that one piece of advice that you’d always give someone about to embark or thinking of embarking on this unique journey?
Michelle Katz, MSN, LPN: Be prepared for the roller coaster and make sure you have a support system (including an awesome doctor and his/her team) who will be your biggest cheerleader….and plenty of tissues. Keep in mind that every woman’s journey is different.
Daniela: Thank you for your time today, Michelle; it’s been a different discussion from our norm, but totally enlightening. Thank you for sharing this insight with our readers.
