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Fertility Drugs

Pharmacies specializing in infertility drugs typically provide a better understanding of the requirements to serve the patients.  Additionally, they are often in a better position to secure better pricing directly from the manufacturers.  If you complete this form, we will make an attempt to forward your information to a specialty pharmacy.  The Fertility Network will make reasonable efforts to keep your information amongst professionals that can help you.

General Information

Common infertility drugs:
Bravelle, Repronex, Menopur, Luveris, Follistim and Gonal f.

Menopur & Repronex:
human-derived hMG products
contain LH and FSH hormones

Bravelle, Follistim & Gonal-f
:
FSH products

Luveris:
LH product

Although most medications for fertility treatment can be acquired through any pharmacy in the USA, the distribution for fertility drugs in the USA is predominantly served by pharmacies specializing in infertility.  We are currently contacting these pharmacies to participate in our network.

These pharmacies, normally called "depot pharmacies" or "mail-order pharmacies", have a unique understanding of the fertility treatment process.  Many get volume discounts from the manufacturers which help them reduce their prices, especially compared to the "everyday" pharmacy that you most likely have used for all your other pharmaceutical needs.

Many of these pharmacies participate in insurance drug benefit plans, in the event you have insurance coverage for fertility drugs.

If you complete the form to the right, we will make an attempt to forward your information to a local depot or mail-order pharmacy.  It will be up to them to get back to you.  We will do this as we make our routine calls to invite them into our network.

Due to the volume of requests, we are not able to get to every request, but typically forward your information within 24-48 hours.

We understand this is a trying time for you.  We sincerely wish you the best and will try to help where we can.

 

 
REQUIRED:  I accept.

I am requesting The Fertility Network to contact pharmacies on my behalf to help secure pharmaceutical products for my fertility treatment.  I understand this is a courtesy service and that The Fertility Network is not a pharmacy, does not control prices, and is under no obligation to complete this request.  I also understand that this form is not a secure means of transmitting personal information.  The Fertility Network will respect my privacy by making reasonable efforts to keep information shared between medical professionals.

Name:
Address:
City:
State:
Zip Code:
Phone:
Email:
Insurance:
Prescribing Doctor:
Practice Name:
Description: Quantity/Product
GnRH Agonists: Ganireilix (Antagon)
  Cetrotide
GnRH Agonists: Lupron
hMG Products: Menopur 75IU Vials
  Repronex 75IU Vials
LH Products: Luveris 75IU Vials
FSH Products: Bravelle 75IU Vials
  Follistim AQ 75IU Vials
  Follistim AQ 75IU Pens
  Follistim AQ 150IU Pens
  Follistim AQ 300IU Pens
  Follistim AQ 600IU Pens
  Follistim AQ 900IU Pens
  Gonal-f RFF 75IU Vials
  Gonal-f 450IU Multi-Dose Vials
  Gonal-f RFF 300IU Pens
  Gonal-f RFF 450IU Pens
  Gonal-f RFF 900IU Pens
hCG Products: 10,000IU Vials
Progesterone/Oil:
Other Medications::
Comments:::
 

 




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