DRUGS & CONDITIONS

ABOUT INFERTILITY

Infertility means that a couple has been trying for at least a year to get pregnant without success even:

  • With frequent intercourse
  • And without the use of birth control.
     

Infertility can be caused by a variety of factors and may be hard to diagnose. Female factors, male factors or a combination of both can lead to infertility.

There are different types of doctors that can help diagnose and treat infertility.

  • Gynecologists are doctors trained to diagnose and treat women's reproductive problems. And they care for women during pregnancy and childbirth.
  • Board-certified reproductive endocrinologists are gynecologists who have additional training to diagnose and treat infertility in both men and women.
  • Andrologists are urology doctors who are certified to treat male infertility.
     

The first step in tackling infertility is choosing the right doctor. Important questions to ask when choosing a fertility doctor may include:

  • Where and when did you receive your medical training?
  • Are you a board-certified reproductive endocrinologist?
  • How long have you been treating infertility?
  • Do you or your nurse have a specific call-in time to ask questions?
  • Who can I call if I have a problem after office hours?
  • Can procedures be done on weekends?
  • Are you affiliated with a hospital?
  • What insurance plans do you accept?
  • Do you offer any financing options or long-term payment plans?
  • How much will treatment cost? Does that include lab work, procedures and medications?
  • Do you offer assisted reproductive technologies (ART), such as in vitro fertilization (IVF)?
  • Does your practice have a sperm or egg donor program?
  • Can you explain the success rates for your clinic?
  • Can you explain available treatment options, including which tests and treatments are necessary?


There are different treatment options available for infertility. These treatment options vary depending upon the cause of infertility. Treatment options may include:

  • Medications to stimulate ovulation
  • Insemination techniques
  • Assisted reproductive technology (for example, IVF)
     

Infertility can be a challenge—CVS Specialty™ is here to help. We are a leading fertility specialty pharmacy that offers more than medication. With decades of experience, we understand the support and personalized care patients need when undergoing fertility treatment.

You can count on CVS Specialty to take an active role in your care by working directly with you, your doctor and your insurance company. We’re here to serve and support you through every step of your fertility treatment; from insurance assistance to delivering medications to the location of your choice.*

*Where allowed by law.


This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

CAUSES AND RISK FACTORS

Infertility means that a couple has been trying to get pregnant with frequent intercourse without the use of birth control for at least a year without success. Infertility can be caused by a variety of factors and may be hard to diagnose. Female factors, male factors or a combination of both can lead to infertility.

Possible causes of female infertility:

  • Ovulation disorders and underlying causes. Examples may include: polycystic ovary syndrome, too much exercise, eating disorders, injury or tumors.
  • Problems with the uterus or cervix.
  • Fallopian tube damage or blockage. This is usually a result of inflammation caused by sexually transmitted diseases.
  • Endometriosis. A condition where the endometrial tissue grows outside the uterus. It can affect how the ovaries, uterus and fallopian tubes function.
  • Early menopause. When a woman’s ovaries stop working and her menstrual cycles end before age 40.
  • Thyroid problems. Having too much thyroid hormone or too little thyroid hormone.
  • Damage related to cancer and cancer treatments, including radiation.
     

Possible causes of male infertility:

  • Blockages in various parts of the sperm pathway. These blockages often occur as a result of infections, including sexually transmitted diseases such as chlamydia and gonorrhea. In many cases, surgery can remove the blockage and get the sperm back on their way.
  • Congenital absence of the vas deferens. This type of blockage is common in men who have cystic fibrosis.
  • Hormone imbalances, inflammation in the urinary system (including prostatitis and urethritis) and retrograde ejaculation (a condition in which semen flows into the bladder). These causes can usually be treated.
  • Varicose veins, or "varicoceles," in the testicles. These twisted, enlarged veins may hamper sperm production, and the effect tends to get worse over time. Surgical repair of the vessels can improve sperm counts and boost the odds of pregnancy.
  • Some prescription medication. In some cases, a change in a prescription can restore fertility.
  • Illicit drugs. Some include marijuana, cocaine and performance-enhancing drugs such as anabolic steroids.
  • Damage related to cancer and cancer treatments, including radiation.
  • Overexposure to heat, chemicals and poisons in the environment.
     

Some infertility risk factors that affect both men and women include:

  • Age. A woman’s fertility decreases with age, with a large decline beginning during her mid-30s. Men over 40 years of age may be less fertile than younger men.
  • Smoking. Tobacco use reduces a couple’s chance of conceiving.
  • Alcohol use. Large amounts of alcohol (usually defined as more than two drinks per day for men and more than one drink per day for women) may lower fertility. Women who are trying to conceive should stop drinking entirely.
  • Weight. Being underweight or being overweight can affect fertility. For example, an overweight man may have a decreased sperm count and testosterone level. In women, being overweight, as well as being underweight, may increase the risk of infertility.
  • Sexually transmitted infections. Chlamydia and gonorrhea are a leading cause of both male and female infertility.

 


This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

TESTING FOR WOMEN

After completing a complete physical exam, gynecologic exam and medical history, a doctor may recommend a woman may have the following tests to help diagnose infertility and possible cause(s):

  • Ovulation testing – this blood test determines whether or not ovulation occurs.
  • Ovarian reserve testing – this blood test helps determine the quality and quantity of eggs available for ovulation.
  • Thyroid-stimulating hormone and prolactin levels – these blood tests help determine if thyroid problems are a factor.
  • Genetic testing – these blood tests determine whether there is a genetic defect causing infertility.
  • Transvaginal ultrasonography – an ultrasound probe placed in the vagina checks for abnormalities of the uterus and ovaries.
  • Hysterosalpingogram – this is an x-ray procedure that uses iodine contrast to look at the condition of the uterus and fallopian tubes.
  • Sonohysterography – an ultrasound probe is placed in the vagina after the uterus is filled with saline. This can help identify problems inside the uterus such as polyps or fibroids.
  • Hysteroscopy – this is a surgical procedure in which a lighted telescope-like instrument is passed through the cervix to view the inside of the uterus. This can help identify and, at times, treat problems inside the uterus such as polyps, scar tissue or fibroids.
  • Laparoscopy – this is a surgical procedure in which a lighted telescope-like instrument is inserted through the abdominal wall using a small incision (cut) to view the fallopian tubes, ovaries and uterus. This can help identify endometriosis, blockages, scarring or other problems with the ovaries and uterus.
     

This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

TESTING FOR MEN

After completing a complete physical exam and medical history, the doctor may recommend that a man have the following test(s) to help diagnose infertility and the possible cause(s):

  • Semen analysis – a laboratory analyzes semen to measure the number, movement and shape of the sperm.
  • Hormone testing – this blood test measures the level of testosterone and other male hormones such as follicle-stimulating hormone, luteinizing hormone, estradiol and prolactin.
  • Genetic testing – these blood tests determine whether there is a genetic defect causing infertility.
  • Transrectal ultrasound – this imaging test uses high-frequency sound waves to produce images from the inside of the rectum (a wand is inserted into the rectum). This test checks the prostate and looks for any blockages of the tubes that carry semen.
  • Scrotal ultrasound – this imaging test uses high-frequency sound waves to produce images of the scrotum. This can help identify problems in the testicles such as varicoceles.
     

This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

INSEMINATION TECHNIQUES

Insemination is when sperm are inserted directly into a woman’s cervix or uterus to treat certain kinds of infertility. There are two methods of insemination:

  • Intracervical insemination
  • Intrauterine insemination (IUI)
     

Intracervical insemination is the simplest method. It involves placing semen in a long tube that looks like a syringe but with an opening instead of a needle. This is used to propel the sperm directly into the cervix (the opening of the womb). If a woman's partner has a low sperm count, intracervical insemination may be a solution.

The other method—IUI—is sometimes called artificial insemination. IUI is performed with sperm (fresh or frozen) that has been separated from the semen—making it highly concentrated. The process also removes any toxins. The concentrated sperm is placed in a long tube and injected directly into the uterus. This positions the sperm much closer to the fallopian tubes, where it can fertilize an egg. IUI is a common treatment for women who have ovulation problems or unexplained infertility or in women whose partners have low sperm counts, poorly shaped sperm or problems with sperm motility. Single women, couples where the man has no viable sperm and lesbian couples using donor sperm are also good IUI candidates.

Many fertility specialists feel women have a better chance of getting pregnant if they combine IUI with a medication that stimulates the ovaries to produce mature eggs (for example, clomiphene citrate or human menopausal gonadotropin). Women taking these medications are at risk of ovarian hyper-stimulation syndrome. This is a rare but potentially life-threatening condition. Combining IUI and fertility drug treatment increases the chance of having twins, triplets or more.


This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

ASSISTED REPRODUCTIVE TECHNOLOGY (ART)

Assisted reproductive technology (ART) includes all infertility treatments where both the eggs and sperm are handled outside of the body. ART steps include:

  • Removing the eggs from a woman’s ovaries
  • Combining the eggs and sperm in a laboratory
  • Returning the combined egg and sperm to the woman’s uterus or donating them to another woman
     

Available types of ART procedures are presented in the table below.
 

In Vitro Fertilization (IVF)

About 99% of all ART procedures done in the United States are IVF.

IVF is a multi-step process. The full IVF cycle takes about six weeks to complete—from the first day of treatment until embryo transfer.

First, the woman must take fertility medications (for example, clomiphene citrate or human menopausal gonadotropin) to stimulate her ovaries to produce multiple mature eggs. Once the egg(s) are mature, they can be removed (called egg retrieval) from the ovaries so fertilization can take place. Egg retrieval can be done in a doctor’s office.

Fertilization is next. A man provides a sperm sample. In the laboratory, the egg and sperm are combined in a dish and left in an incubator in the hopes that fertilization will occur. If fertilization occurs, the embryo that develops will be placed into the woman’s uterus.

Embryo transfer is then performed in a doctor’s office. During this procedure, the doctor inserts a long, thin tube into the vagina and injects the embryo into the uterus. The embryo should then implant itself into the lining of the uterus.

The main risk with IVF is multiple pregnancy (increased chance of twins, triplets or more). The process of IVF may involve ovarian stimulation, which can increase the risk of ovarian hyperstimulation syndrome (OHSS), a potentially dangerous complication in which the ovaries become enlarged and, in severe cases, may lead to problems such as respiratory problems, blood clots or kidney damage. Other possible complications may include: bleeding or infection, premature deliver, low birth weight and birth defects.

IVF success rates vary based on many factors such as: age, ovarian reserve, sperm count, reproductive history (for example, the number of pregnancies/miscarriages), reason for infertility, etc.

Gamete Intra-fallopian Transfer (GIFT)

GIFT is not a common ART procedure because it requires surgery. In this procedure, eggs and sperm are combined in a laboratory and immediately inserted into the fallopian tubes through a small incision (cut) in the abdomen. Fertilization can then happen in the body and the embryo implants naturally.

Zygote Intra-fallopian Transfer (ZIFT)

ZIFT is not a common ART procedure because it requires surgery. In this procedure, eggs and sperm are combined in a laboratory. Once fertilization occurs in the laboratory, the embryo(s) are inserted into the fallopian tubes through a small incision (cut) in the abdomen.

Intracytoplasmic sperm injection (ICSI)

ICSI is a treatment for male infertility. ICSI is often used when a man has a low sperm count or sperm with poor motility. Men who have an irreversible vasectomy, and even men who were considered sterile after cancer treatment, are candidates for ICSI.

The ICSI procedure involves taking single sperm and directly injecting it into the egg to initiate the fertilization process. This process takes place in a laboratory. ICSI requires the IVF process to directly manipulate sperm and eggs. As in a routine IVF procedure, the woman must take fertility medications (for example, clomiphene citrate or human menopausal gonadotropin) to stimulate her ovaries to produce multiple mature eggs. The full IVF cycle takes about six weeks to complete—from the first day of treatment until embryo transfer. More than one embryo can implant and lead to a multiple pregnancy.

The processes of IVF and ICSI and other fertility procedures involve ovarian stimulation, which can increase the risk of OHSS, a potentially dangerous complication in which the ovaries become enlarged and, in severe cases, may lead to problems such as respiratory problems, blood clots or kidney damage.

Babies conceived through ICSI may have slightly higher rates of certain birth defects and other problems. Some of the conditions associated with the use of ICSI are Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias or sex-chromosome abnormalities. These conditions occur in far less than one percent of children conceived using ICSI.

Donor Eggs

IVF treatment can also be done using eggs donated form another woman. While advanced maternal age is the most common reason for using donated eggs, other reasons for choosing to use donor eggs may include a history of genetic disease and premature ovarian failure. Premature ovarian failure occurs when a woman experiences menopause before age 40, often as a result of treatment for cancer or another disease.

Because there's a considerable amount of time, pain and inconvenience involved in donating eggs, most donors are paid. Although state laws differ slightly, donors usually sign away the rights to any children born as a result of the use of their eggs.

The success rate of IVF using donor eggs varies depending upon the donor's age, the sperm quality and the health of the women involved.

The main risk for the recipient of the egg donation is multiple pregnancy (increased chance of twins, triplets or more). The egg donor may be at risk for OHSS, which causes the ovaries to become swollen and painful and, in rare cases, can lead to more serious symptoms. Some women find the medications they are required to take have uncomfortable side effects, including hot flashes, depression, headaches and insomnia.

Donor Sperm

IVF treatment can also be done using sperm donated form another man. Couples can use donated sperm when a man does not produce viable sperm, or in cases of a genetic disease.

Surrogates/Gestational Carriers

If a woman cannot carry a pregnancy to term, a surrogate or gestational carrier may be an option.

A surrogate is a woman inseminated with sperm from the male partner of the couple. The resulting child will be biologically related to the surrogate and the male partner.

A gestational carrier is a woman who carries a pregnancy that consists of an egg and sperm from a couple. The resulting child will not be biologically related to the gestational carrier.

GIFT=gamete intra-fallopian transfer; ICSI==Intracytoplasmic sperm injection; IVF=in vitro fertilization;OHSS=ovarian hyper-stimulation syndrome; ZIFT=zygote intra-fallopian transfer


This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

MEDICATION

The main treatments for women who are infertile due to problems with ovulation are fertility medications. Doctors choose the most appropriate medication or combination based on many factors including:

  • Type of infertility
  • Choice of assisted reproductive technology (ART)
  • Possible side effects
  • Risks versus benefit of each therapy
     

Selected U.S. Food and Drug Administration (FDA)-approved fertility medications are listed in the table below.

Selected FDA-Approved Infertility Medications*

Name**

How Given

Selected, common side effects

Clomiphene citrate

Tablets taken orally (by mouth)

  • Enlargement of ovaries
  • Flushing
  • Abdominal or pelvic pain or bloating
  • Nausea and vomiting
  • Breast discomfort

Urofollitropin

Injection (SC or IM)

  • Headache
  • Hot flashes
  • Ovarian hyper-stimulation syndrome
  • Pain
  • Respiratory disorder
  • Abdominal cramps or fullness
  • Nausea
  • Pelvic and post-retrieval pain

Follitropin alpha

Injection (SC)

  • Headache
  • Ovarian cyst
  • Nausea, gas or diarrhea
  • Upper respiratory tract infection/sinus infection
  • Ovarian hyper-stimulation syndrome
  • Abdominal or pelvic pain
  • Back pain

Follitropin beta

Injection (SC)

 

  • Ovarian hyper-stimulation syndrome
  • Ovarian cyst
  • Abdominal or pelvic pain and discomfort
  • Headache
  • Nausea
  • Feeling tired/fatigued

Choriogonadotropin alpha

Injection (SC)

  • Injection site pain or bruising
  • Abdominal pain
  • Nausea or vomiting

Chorionic gonadotropin

Injection (IM)

 

  • Headache
  • Irritability
  • Restlessness
  • Depression
  • Feeling tired/fatigue
  • Swelling
  • Pain at injection site
  • Hypersensitivity reaction (such as itching, rash, shortness or breath)

Menotropins

Injection (SC or IM)

  • Pulmonary (lungs) and vascular (blood vessels) complications
  • Ovarian hyper-stimulation syndrome
  • Ovarian enlargement
  • Ovarian cysts
  • Abdominal pain, cramps or bloating
  • Nausea, vomiting or diarrhea
  • Headache
  • Injection site pain or inflammation

Bromocriptine mesylate

Tablets and capsules taken orally (by mouth)

 

  • Nausea
  • Headache
  • Dizziness
  • Feeling tired/fatigue
  • Feeling light-headed
  • Vomiting
  • Abdominal cramps
  • Nasal congestion
  • Constipation or diarrhea
  • Drowsiness

Ganirelix acetate

Injection (SC)

 

  • Abdominal pain
  • Fetal death
  • Headache
  • Ovarian hyper-stimulation syndrome
  • Vaginal bleeding
  • Injection site reaction
  • Nausea

Cetrorelix acetate

Injection (SC)

 

  • Ovarian hyper-stimulation syndrome
  • Nausea
  • Headache
  • Injection site reactions (redness, swelling, bruising, itching)

FDA= US Food and Drug Administration; IM=intramuscular/into muscle; SC=subcutaneous/under the skin
*Available options approved for infertility treatment as of October 2015 are listed.
**Generic or chemical name only.
Side effects listed can vary based on indication. Consult full prescribing information for complete details.


This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

LIVING WITH INFERTILITY

Living with infertility can be a challenge. Overall, the healthy habits for fertility are the same for good, overall health. Try to exercise, eat well, don’t smoke and drink alcohol in moderation. Follow these fertility-friendly tips:

Maintain a healthy weight

  • Male and female sex hormones are tied closely to weight. For example:
    • Heavier men and women face more fertility problems
    • Being underweight can also increase a woman’s risk of infertility

Get the right amound of exercise

  • Too much exercise can throw hormones out of balance
  • Some excessive exercise in men, like cycling, may lower sperm counts

Don't smoke

  • Stop smoking right away. Make it a top fertility priority
  • Smoking can slightly lower a man's sperm count
  • Smoking can interfere with a woman's fertility, from ovulation to early development of the embryo

Limit or avoid alcohol

  • Large amounts of alcohol (usually more than two drinks per day for men and more than one drink per day for women) may lower the odds for getting pregnant
  • Women who are trying to conceive should stop drinking entirely. Pregnancy may occur before the woman is aware of it, and alcohol can permanently harm a developing fetus

Limit caffeine intake

  • Women trying to get pregnant should limit caffeine intake to no more than 100 mg per day
  • For men, large amounts of caffeine may cause sperm to swim slower

Avoid illicit drugs

  • Marijuana, cocaine, and anabolic steroids can all contribute to infertility in men
  • Women trying to get pregnant should avoid illicit drugs because of the potential danger to the fetus

Check your medicine

  • Some medicines can impair fertility in both men and women
  • Ask the doctor if any of your medicines could be causing infertility

Extra tips for men

  • Spending long hours sitting can increase the temperature of the scrotum and testes a few degrees. Sperm production can decline as the temperature rises
  • Avoid saunas or long soaks in hot baths because this can lower sperm count
  • Avoid holding a laptop computer on the lap because it may impair fertility

Living with infertility can be stressful and can lead to depression. Some fertility clinics have services to help with depression. Many feelings associated with the stress of infertility can be similar to depression.

These include:

  • loss of interest in usual activities
  • sadness that won’t go away
  • trouble in relationships (with partner, family, friends and/or colleagues)
  • difficulty thinking of anything other than having a baby
  • high levels of anxiety
  • decrease in ability to accomplish tasks
  • difficulty with concentration
  • change in sleep patterns (difficulty falling asleep or staying asleep or sleeping more than usual)
  • change in appetite or weight
  • increase in use of drugs or alcohol
  • thoughts about death or suicide
  • social isolation (wanting to be alone)
  • constant feelings of anger or guilt


Many fertlity clinics offer counseling, yoga, stress management and other relaxation techniques. Patients can join a support group where they can share their feelings and find understanding among other men and women who also face infertility.


This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

STAYING ON TRACK

We understand staying on track can be difficult. Following these tips can help you stick to your treatment.

Take medicines as scheduled

  • It’s best to take your medicine exactly as prescribed. Some infertility medicines may take a while to work. And some have side effects. You should never change or stop medicines without talking to your doctor.
     

Use medicine reminders

  • Set a standing alarm on the cell phone. Use the CVS Specialty mobile app - anyone can download and use it free from Google Play or Apple® iTunes® stores
  • Post a sticky note where it can be seen easily. For example, on your bathroom mirror or refrigerator
  • Schedule tasks or appointments on the computer
  • Use a pill box or make a check-off chart
     

Make and keep doctor appointments

  • Write down and keep all doctor visits. Skipping them could affect your treatment goals.
     

Join a support group

  • Join an in-person or online support group. Talking to others living with infertility may help you cope with treatment and everyday challenges.
     

Work with the entire health care team

  • Work closely with doctors, pharmacists, nurses, laboratory and other providers. Stay in touch and don’t be afraid to ask questions.
  • CVS Specialty can help patients manage infertility and get the best outcomes from their treatment, including managing side effects and staying on track. Call us toll-free at 1-800-237-2767 to speak to a pharmacist or nurse specially-trained in caring for patients with infertility.
     

Go online

  • Refill medicines on time so there are no breaks in your treatment. Register at CVSspecialty.com or download our app. You can refill your infertility prescriptions, track orders, set reminders and more.
     

This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information.

©2016 CVS Specialty. All rights reserved. 75-37188A 021216

This document contains confidential and proprietary information of CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Specialty.

DRUGS & CONDITIONS

SUPPORT

CVS Specialty is a leading fertility specialty pharmacy that offers much more than medicine. With decades of experience, we understand the support and personalized care you need when undergoing fertility treatment.

You can count on us to take an active role in your care by working directly with you, your doctor and your insurance company. From reviewing insurance coverage to offering convenient pick up at CVS Pharmacy® locations** to delivering prescriptions to your door*, we are here to serve and support you through every step of your fertility treatment.

A Dedicated Fertility CareTeam

When you enroll in the CVS Specialty Fertility Care Program, a pharmacist-led CareTeam is assigned to you. This dedicated group of clinicians provides you with comprehensive support and education on appropriate use of the prescribed therapy, administration and storage, potential side effects and injection-related issues. You can call your CareTeam any time of the day and any day of the year.

Fertility Drug Coverage Pre-Verification Program

By participating in our complimentary Fertility Drug Coverage Pre-Verification Program, you will receive a comprehensive overview of your fertility drug coverage before the prescription is written. These results include fertility medication copayments for all major fertility agents. Understanding the fertility drug coverage in advance can help you and your doctor make important financial decisions about your fertility treatment.

Prompt delivery of your fertility medications

By having your doctor fax or call in your prescription to CVS Specialty, you can expect prompt intake and discreet, timely delivery of your medications and supplies. And your medication will arrive in a temperature-controlled, secure package. We ship anywhere in the United States and offer complimentary next-day delivery. In certain markets, we can provide same-day delivery. Or pick up your medication at your convenience at any CVS Pharmacy or Long’s Drugs location.*

Complete offering of medications and supplies

CVS Specialty has a broad product offering, including all medications and supplies required for a typical fertility treatment cycle.

Education based on your needs

We provide personalized education based on your condition and treatment. In addition to the materials you receive in your New Patient Guide, you also have access to our Fertility Resource Center. Here you will find a wealth of information on the diagnosis and treatment of infertility and links to helpful resources.

Competitive pricing

CVS Specialty is one of the largest purchasers of prescription medications in the nation and can offer competitive pricing. If you do not have fertility medication benefits, you may be eligible to receive immediate savings on certain medications for the treatment of infertility.

Reimbursement services

As part of our patient-centric approach to care, CVS Specialty has reimbursement specialists who will help you maximize your fertility coverage while minimizing out-of-pocket expenses by offering a comprehensive analysis of your benefits. This team will also help ensure that your claims are completed and filed in a timely manner.

Egg Donor Services

Our experienced staff in the field of reproductive pharmacy understands the customized needs of an egg donor and recipient patient. We work exclusively with the recipient, clinic and egg donor and coordinate every aspect of the donor and recipient medication therapy.

To learn more about the Fertility Care Program, please call toll-free 1-877-269-4831.

*Where allowed by law.

** Where allowed by law. In-store pickup is currently not available in Arkansas, Oklahoma and West Virginia. Some states require first-fill prescriptions to be transmitted directly to the dispensing specialty pharmacy. Products are dispensed by CVS Specialty and certain services are only accessed by calling CVS Specialty directly. Certain specialty medication may not qualify. Services are also available at Long’s Drugs locations.

Copay, copayments or coinsurance means the amount a plan member is required to pay for a prescription in accordance with a Plan, which may be a deductible, a percentage of the prescription price, a fixed amount or other charge, with the balance, if any, payable by a Plan.

Ready to Get Started With Us?

Please call CVS Specialty toll-free at 1-800-237-2767 to start filling your infertility prescriptions with us. We can help you get the best possible outcomes for a better quality of life. And help is always available, anytime.

Already Enjoying Our Services?

Contact your CVS Specialty Care Team toll-free at 1-800-237-2767, if you have questions or concerns about your health or treatment. A pharmacist, nurse or specialist is ready to help.

Resources

Visit these websites to learn more about infertility and available treatment options:

American Pregnancy Association
americanpregnancy.org/

American Society for Reproductive Medicine
www.asrm.org/

National Infertility Association
www.resolve.org/

Society for Reproductive Endocrinology and Infertility
www.socrei.org/

Society for the Study of Male Reproduction
www.ssmr.org/


This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about the information you find. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content.

CVS Specialty does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Specialty. This document contains references to entities not affiliated with CVS Specialty.

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