Since 2016, Alto has supported over 100,000 patients through their fertility journey. In this post we’ll provide guidance on how to select the right fertility pharmacy. In addition, we’ll share the benefits of selecting Alto as your fertility pharmacy.

What to Consider When Selecting a Fertility Pharmacy | Alto Pharmacy

The reliability of a pharmacy is especially important during fertility treatment, which involves an intensive and often changing medication protocol. Late deliveries of your fertility medications are more than an inconvenience — they can impact the effectiveness of treatment. And medication delivery is only part of fertility pharmacy care: your pharmacy partner can also affect the emotional and financial aspects of your fertility journey depending on their resources and accessibility.

Just as it’s important to do your research on fertility clinics and make sure you’ve found the right fit, give yourself time to make an informed decision about which pharmacy you use. Here are the key factors to consider as you explore your fertility pharmacy options.

How do I know if I’m administering an injection correctly? My clinic just changed my medications, what do I do? These are just a few of the medication-related questions that may arise during fertility treatments like in vitro fertilization (IVF) or egg freezing. There’s no substitute for expert answers. A credible fertility pharmacy will have a team of pharmacists who are experienced in the nuances of fertility treatment, including medications, dosing, and side effects.

At Alto, not only do we provide personalized support from expert pharmacists, we also offer additional resources to help you deepen your understanding of treatment and fully benefit from our team’s expertise. In injection guide videos, fertility-trained pharmacists share all the information you need to feel confident about administering your injections. Some medications have different administration methods, including subcutaneous and intramuscular injections. We’ve developed guides for each method.

We also have an extensive library of fertility-focused content, offering a deeper dive into various aspects of treatment from navigating IVF side effects to managing finances and more.

A pharmacy’s fertility expertise and resources are only as valuable as they are accessible. In addition to making sure that your pharmacy partner has experience with fertility treatment, consider how easy it is to get in touch with their team, the communication channels they offer, and their hours. Pharmacies with weekend and evening availability will be best equipped to provide support when you actually need it.

As an Alto customer, you’ll have a direct line to a fertility-trained pharmacist via in-app messaging seven days a week. Since our pharmacists are available until 9 pm PST (12 midnight EST) on weeknights, you can get the answers you need as you take your injections.

Additionally, we created all of our fertility resources with accessibility in mind. For example, you won’t have to sift through dozens of injection guide videos to find the ones that are relevant to you. Each Alto customer has their own unique playlist with videos for their specific medications in the app.

During fertility treatment, fast and reliable delivery isn’t an additional convenience that a pharmacy offers — it’s a must-have.

Since your medications and doses are based on your hormone levels, your protocol can change even after you start your injections. You can avoid a lot of stress during these instances — and reduce wasted medication — by choosing a pharmacy that can guarantee fast same-day delivery.

Alto offers same-day delivery seven days a week to customers within our courier zones, and you can choose the delivery window that’s most convenient for your schedule. Once your delivery is scheduled, you’ll be able to see where your courier is and get text updates on their ETA, so there’s no worrying about when your medications will arrive.

Your fertility medications need to arrive on time and in the right condition. Proper temperature-controlled packaging is another non-negotiable requirement during fertility treatment: medications can lose their efficacy if they aren’t shipped or stored at the proper temperature.

Alto ensures that refrigerated medications are held at the right temperature while in transit with temperature-controlled packaging. Clear labeling and stickers indicate which medications require refrigeration to ensure proper storage at home, too. Our packaging was also designed with discretion in mind to ensure privacy.

It can be difficult to understand just how much you’ll need to spend on fertility medications given the complexities of fertility benefits. A good fertility pharmacy will work with leading fertility lenders and can apply manufacturer discount programs if asked. A great fertility pharmacy will proactively connect you with financial assistance programs for qualifying prescriptions. Alto makes your medications as affordable as possible by proactively searching for savings and connecting you with outside programs that may require an application.

Since 2016, Alto has supported more than 120,000 fertility journeys. We understand that treatment is a significant investment — physically, emotionally, and financially — and we’re with you every step of the way.

We offer a convenient and supported pharmacy experience, with fast, reliable delivery of your medications and fertility resources like personalized injection guide videos and access to fertility-trained pharmacists.

In addition to local service offerings at our brick-and-mortar locations, we’re now serving more patients throughout the United States through our mail order service. We offer free FedEx next-day delivery of all fertility medications and supplies to patients served via mail order.

Interested in learning more about how Alto can support your treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

Editor’s Note: This post was originally published in September 2020 and has been updated for accuracy and completeness.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. 

What to Consider When Selecting a Fertility Pharmacy 

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options.

IVF Medications: Schedule and Side Effects Explained | Alto Pharmacy

IVF, or in vitro fertilization, is one form of treatment that may help those experiencing infertility to conceive. In fact, at least 8 million babies born today are a result of this procedure. That’s remarkable when you consider the first successful IVF procedure was only conducted in 1978.  

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options. Let’s take a closer look at how one might arrive at each step. 

What Medications Should I Expect with IVF? 

The IVF process itself requires considerable IVF medication use on a precisely timed schedule. For these reasons, it’s important to understand what you might be prescribed as well as any potential IVF medication side effects. 

On the first day of a patient’s menstrual cycle they will typically call to schedule a “baseline” visit for Day 3 of their cycle. This appointment includes an ultrasound and bloodwork. After this visit, if approved, patients will start hormone injections (commonly referred to as “stimulation meds” or “stims”). 

These injections stimulate egg production so a woman’s body produces many follicles in a cycle, not just one (follicles house eggs that contain all the hormones and fluids needed to make an egg mature). Patients with one or more follicles already grown may need to wait until their next period cycle or use a different protocol. 

Stims are typically injected between 6-9PM daily at a consistent time. 

Supportive/adjunctive medications include: 

Omnitrope® -  A growth hormone whose main purpose is to help improve the quality of eggs. Not every patient will see this on their protocol. Typical use cases include poor responders to stimulation medications and women who have a decreased ovarian reserve.

As a result of injections it is normal for patients to experience soreness or mild bruising at the site of injection. Bloating, cramping, headaches, breast tenderness and in some cases, temporary allergic reactions are also common side effects. 

During this period patients will continue stims and may start what is known as “antagonists” to prevent premature ovulation (i.e. once eggs are released into the pelvic cavity they cannot be retrieved). These types of medications block the hormone (gonadotropin-releasing hormone-GnRH) that causes eggs to be released from the ovaries. 

Regular monitoring visits will likely include additional ultrasounds and bloodwork and occur around days four and six and every other day after. Visit results will then determine if nightly doses need to be changed or if an antagonist is necessary. In these cases, patients will often have leftover medications or need refills. 

Side effects are similar to those experienced during days one to four. Some patients also experience what is known as ovarian hyperstimulation syndrome (OHS). In this instance there is an overproduction of follicles that can cause extreme swelling or pain in the ovaries. Depending upon the severity, treatment may be cancelled until a future cycle. 

Patients will receive a final ultrasound and bloodwork to confirm if the follicle pack has reached maturity. If so, a “trigger shot” is assigned approximately 35-36 hours before retrieval to stimulate final growth spurt and ovulation. 

Trigger shots are hormones that support the normal development of an egg in a woman's ovary, essentially triggering the egg to go through a final growth spurt, and stimulate the release of the egg during ovulation from the follicles within 36 hours. 

In most cases, patients will discontinue all other medications and are given a deep sedation for the 15-45 minute retrieval process. Following the procedure it’s normal to feel mild cramping or experience some vaginal spotting. 

Keep in mind that follicles may be empty at the time of retrieval or contain an immature egg. This means the number of eggs retrieved after egg retrieval may be lower than the number of follicles seen on the ultrasound or based on bloodwork.

Sperm is collected according to clinic protocol or donor sperm is thawed at the time of egg retrieval.

The retrieved eggs and sperm are combined and monitored for signs of fertilization as the embryo(s) divides into a small cluster of cells.

The quality of embryos are given a grade, often using a common A-D rubric with A = excellent quality, D = poor quality to determine the likelihood of a successful implantation.

“Fresh” transfer: For patients who are seeking to transfer their eggs immediately after retrieval, the embryo can be transferred in 2 different stages of its lifecycle:

1) They can be transferred on approximately day 2 or 3 after fertilization when it is in its cleavage stage.

2) They can be transferred between days 5-7 after fertilization when it is in its blastocyst stage.

The best appearing embryos are then deposited into the uterine cavity using a catheter. Patients may experience cramping, bloating and spotting following this procedure. 

“Frozen” transfer:  In some scenarios for egg freezing, i.e. planning for the future, the embryos are not transferred immediately. In this instance, because the technology does not currently exist to keep an embryo viable outside of the womb for an extended amount of time, embryos are frozen through a process called vitrification. 

After transfer (0-1 days post retrieval), progesterone supplements provide hormonal support for successful attachment of the embryo to the uterine lining using vaginal, oral, or injectable progesterone and in some cases, a combination of methods. Common medications include: 

Progesterone capsules, suppositories, lozenges

And finally - within 12 days to two weeks a blood sample is taken to determine if the transfer resulted in a successful pregnancy. This test measures the hCG (human chorionic gonadotropin) levels, often referred to as the “pregnancy hormone,” which indicates cells are forming in the placenta to nourish the fertilized egg.

Despite how involved IVF medications might be, know that you are not alone in this journey. Alto’s dedicated fertility pharmacists are here to help answer your questions and work with your physician to ensure your IVF treatment plan is followed properly. 

We offer a convenient and supported pharmacy experience, with fast and reliable delivery of your medications and fertility resources like personalized injection guide videos and access to fertility-trained pharmacists. In addition to local service offerings at our brick-and-mortar locations, we’re now serving more patients throughout the United States through our mail order service. We offer free FedEx next-day delivery of all fertility medications and supplies to patients served via mail order.

To learn more visit us at alto.com/fertility or reach out any time through in-app secure messaging or by phone at 1-800-874-5881. We’re here for you from your first cycle to your last and everything in between. 

Editor’s Note: This post was originally published in October 2022 and has been updated for accuracy and completeness.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

IVF Medications: Schedule and Side Effects Explained

Beginning your fertility journey can feel like arriving in a strange new world. Your conversations are suddenly full of unfamiliar terms and mysteriously strung together letters. The good news: these terms represent the wide range of procedures available to help hopeful parents conceive.

Fertility Acronyms, Explained

Beginning your fertility journey can feel like arriving in a strange new world. Your conversations are suddenly full of unfamiliar terms and mysteriously strung together letters. The good news: these terms represent the wide range of procedures available to help hopeful parents conceive. Some of them can be a mouthful, so a convenient shorthand has evolved. 

No need to worry about achieving full fluency—the hope is that your stop in the world of fertility will be brief. But if you don’t yet know your TTC from your ART, this fertility acronym decoder can be your guide. 

A Quick Guide to Common Fertility Acronyms

An individual or couple is said to be “trying to conceive” (TTC)  during the period of time in which they are intentionally trying to become pregnant.  

Assisted Reproductive Technology (ART) is an umbrella term used for infertility treatments that handle the egg or embryo in a laboratory. An example of non-ART fertility treatment would be using fertility medications to stimulate ovulation without having the eggs retrieved from the ovaries.

In vitro fertilization (IVF) is a fertility treatment that involves combining an egg and sperm in a laboratory dish, and then transferring the resulting embryo into the uterus. 

“In vitro” is Latin for “within the glass,” meaning fertilization, or the process of combining an egg with a sperm, occurs outside of the body. In vitro fertilization is the most frequently used ART technique. 

Intrauterine Insemination (IUI) is a medical procedure in which sperm that has been washed and concentrated is placed directly into the uterus to facilitate fertilization. This non-ART fertility treatment is done around the time of ovulation to maximize the chances for conception.

A Frozen Embryo Transfer (FET) occurs when a cryopreserved embryo that was created during an IVF cycle is thawed and transferred to a uterus. 

Male Factor Infertility (MF) is the term used when the cause of infertility stems from a male partner.

Polycystic ovary syndrome (PCOS) is a commonly diagnosed condition caused by an imbalance of reproductive hormones. This hormonal imbalance can cause a woman to have irregular menstrual periods, excess male hormone levels, or small fluid-filled sacs in the ovaries, all of which can lead to abnormal ovulation. PCOS is one of the most common causes of female infertility. 

Controlled ovarian hyperstimulation (COH) occurs when the ovaries are stimulated by fertility medication to produce multiple eggs. 

Luteinizing hormone (LH) is produced within the pituitary gland and stimulates follicular growth and ovulation. In the female body, a sudden spike in LH production induces ovulation. 

Human Chorionic Gonadotropin (hCG) is a hormone produced during pregnancy. When used as an injectable, hCG facilitates the final maturation phase of the eggs and triggers ovulation of the mature eggs from the ovaries approximately thirty-six hours after it has been injected. This is commonly referred to as the "trigger shot."

Follicle-stimulating hormone (FSH) is produced by the pituitary gland and stimulates the growth of eggs in the ovaries. FSH levels are tested to evaluate a woman’s ovarian function and egg quality. Also, FSH injections may be used during fertility treatment to promote the growth of multiple follicles in the ovaries. 

Remember—you don’t need to be an expert to be successful on your TTC journey. Your doctor will walk you through the treatment options that are right for you, one step at a time. With each stop along your path, you’ll naturally find that your fertility fluency improves. Before you know it, you’ll be discussing FSH levels and IVF cycles with ease.

The world of fertility medications can seem complicated, but Alto’s dedicated fertility pharmacists are here to answer your questions. Our team of specialists will ensure that you receive the right medications at the right time—delivered by hand to your door. To learn more visit us at alto.com/fertility. 

Our pharmacists are available to answer your questions from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends; reach out by in-app secure messaging or phone.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Lesbian, gay, bisexual, transgender, and queer parents-to-be have many options to become parents today. In this blog post we'll share an overview of the options as well as how Alto can help you in the path to parenting.

A Guide to LGBTQ+ Family Building

As advances in assisted reproductive technology (ART) and fertility preservation treatment open up new pathways to parenthood, more members of the LGBTQ+ community are choosing to have children than ever before, both as couples and individuals. A 2019 survey from Family Equality found that 63% of LGBTQ+ millennials were considering becoming first-time parents or adding to their growing families.

With many possibilities to consider — including different reproductive procedures and donor options — as well as additional legal complexities to account for, thoughtful research is part of the process. The guide below offers a starting point as you explore your options.

Many LGBTQ+ parents have children by using a donor egg or embryo and/or donor sperm.

Donor sperm allows same-sex female couples and individuals with female anatomy to have biological children through intrauterine insemination (IUI) or in vitro fertilization (IVF), reproductive procedures described in more detail below. The donor can be someone you know (known) or found through an agency (anonymous).

Donor eggs allow same-sex male couples and individuals with male anatomy to have biological children through IVF. Like sperm donors, an egg donor can be known or anonymous. 

It is also an option to use a donor embryo, which is an egg that has already been fertilized by sperm, as some individuals choose to donate unused embryos from an egg freezing or IVF cycle.

Your family building journey may also include a surrogate or gestational carrier, who carries the pregnancy to term and gives birth. Though these terms are sometimes used interchangeably, there is an important distinction: a surrogate offers both eggs and uterus and often plays a role in IUI whereas a gestational carrier has the embryo implanted into her uterus but is not genetically related to the child.

If you are using a surrogate or gestational carrier, think about the type of relationship you’d like to have with them. Some couples become very close with their surrogates while others value more distance. The most important thing is to honor your needs.

Additionally, as part of your planning, determine which aspects of your surrogate or gestational carrier’s medical care you’ll be financially responsible for.

There are two main reproductive procedures to consider: intrauterine insemination (IUI) and in vitro fertilization (IVF).

Intrauterine insemination (IUI) is a simple medical procedure in which sperm is placed directly into the uterus by using a small tube that passes through the cervix. It may be part of the family building journey for both male and female same-sex couples, as well as individuals with female anatomy having a baby on their own. Male same-sex couples pursuing IUI must use a surrogate who will be genetically related to the child.

In the process of in vitro fertilization (IVF), eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. It may include donor sperm, donor eggs, or donor embryos.

When pursuing IUI or IVF as an LGBTQ+ couple, you’ll have to decide which parent will be genetically related to the child. If you intend to have multiple children so that you and your partner can each have a biological connection to them, you’ll want to account for multiple courses of IUI or IVF during your financial planning.

Some LGBTQ+ couples explore reciprocal IVF, or co-maternity, an option for female same-sex couples as well as transgender men with female reproductive organs. In this process, one partner’s egg is implanted into the other partner’s uterus. While only one partner will be genetically related to their child, reciprocal IVF allows both individuals to actively participate in the pregnancy.

Gender affirmation treatment may affect a person’s ability to conceive in the future. Egg and sperm freezing allow transgender and nonbinary individuals to preserve their fertility options and have biological children after treatment or surgery, if they choose to.

Sperm freezing is a relatively simple process in which a sperm sample is collected or surgically retrieved by a doctor. It may be used before estrogen therapy or gender confirmation surgery.

In egg freezing, fertility medications are taken to stimulate egg production. Once the eggs are developed, your doctor will retrieve them from you in a minimally invasive procedure. Your eggs can then be frozen and stored for later use. Depending on how many eggs are yielded, you may have to undergo more than one cycle of egg freezing. This process may be used before testosterone therapy or gender confirmation surgery.

Note that while gender confirmation surgery can permanently affect reproductive function, researchers are still learning about the long-term impact of testosterone and estrogen therapy on fertility. Prolonged testosterone and estrogen use often stop sperm production and ovulation, respectively, but some evidence suggests that these effects may be reversible upon discontinuation of treatment. We encourage you to discuss your reproductive goals and options with your healthcare provider before pursuing gender confirmation treatment, so that you can have as much flexibility in your family building journey as possible.

Take a closer look at fertility options for transgender and nonbinary individuals.

ART and fertility preservation are often significant financial investments, and determining how to pay for treatment is an important part of planning.

Family Equality Council shares this list of family-building grants that can help make ART more affordable. Your clinic may also offer financial assistance programs and payment plans. At Alto, we have resources to help you understand your fertility benefits, compare the costs of cash pricing, learn about financing, or apply for assistance programs.

Read A Financial Planning Guide for Egg Freezing.

If you are exploring the use of a donor or surrogate, it’s critical to research your state’s laws about legal parentage procedures once your baby is born. In some states, a surrogate may automatically receive parental rights after your child’s birth since they are the biological mother, which will have to be legally terminated.

There are more legal complexities to navigate when using a known donor rather than an anonymous one, as an anonymous donor has already surrendered their parental rights.

Explore Movement Advancement Project’s interactive map on parental recognition laws as a starting point. You should also speak with an experienced LGBTQ+ family lawyer in your state before starting the process.

Choose the right fertility pharmacy partner

Alto is here to support your family building journey. We know that there are many paths to parenthood and that each individual or family’s needs are different. Our team of fertility-trained pharmacists has experience working with the LGBTQ+ community, and we’ll be here at every step of the way if you choose to pursue any of the above fertility treatments. We also offer discrete, private packaging and same-day delivery to keep stress at minimum during this special time in your life.

To learn more, request a price quote online or reach out through secure in-app messaging.

A Guide to LGBTQ+ Family Building Options

If you’re considering IVF or freezing your eggs and unsure of what to expect, this article will break down the basics and offer suggestions for how to prepare. 

IVF and Egg Freezing: What to Expect and How to Prepare

These days, egg freezing and IVF, or in vitro fertilization, are fairly common routes on the journey to parenthood. Yet, that doesn’t mean these fertility treatments are always an easy road. While both treatments helped millions of women conceive, they can require a significant investment of emotion, resources, and time. 

In vitro fertilization is a type of fertility treatment where:

The retrieved eggs are combined with sperm outside of the body in a laboratory 

The embryos (fertilized eggs) are then placed into the uterus with the potential outcome of a pregnancy. 

The main difference between egg freezing and IVF is the timing. Rather than attempting to get pregnant right away, egg freezing gives you the option to store your unfertilized eggs for a later time. When and if you decide you are ready to have a baby, your eggs will be thawed in the lab and the rest of the IVF process will be completed. Freezing healthy eggs at a younger age allows women more flexibility in their family-planning timelines.  

The initial screening and prescribed medications are very similar for IVF and egg freezing. After completing an initial ultrasound and bloodwork, your doctor will prescribe fertility medications to stimulate follicle growth. Follicles are fluid-filled sacs in your ovaries that potentially contain an egg. Your prescription will involve self-injecting hormones on a precisely timed schedule and regular check-ins for additional ultrasounds and bloodwork. For a more detailed understanding of the timeline and medications used during an IVF cycle, see our article,  IVF Medications: Schedule and Side Effects Explained. 

Once your follicles have reached maturity, your doctor will gently guide a thin needle through your vaginal wall and use suction to draw the eggs from the follicles. The 15-45 minute procedure is minimally invasive, and you’ll be sedated to ensure there’s no pain. The retrieved eggs are either frozen and stored for later use or placed in a petri dish with sperm cells so fertilization can take place. The fertilized eggs, or embryos, are then transferred to your uterus through a quick, non-surgical procedure using an ultrasound-guided catheter.  

IVF may include a variety of other parties at each stage. In some cases, an egg donor undergoes the egg retrieval process. The resulting embryos are then transferred to the intended parent’s uterus. Sometimes a gestational carrier carries and delivers a child for another couple or person. The embryo is created via IVF using the eggs and sperm of the intended parents or donors and then transferred into the gestational carrier’s uterus. In all of these cases, the sperm used to fertilize the eggs may come from either a male partner or donor. Your unique fertility journey may or may not include one or more of these variations.

From a biological standpoint, the American Society for Assisted Reproductive Technology recommends being at a healthy weight and avoiding smoking or alcohol use. It’s also important to mentally prepare, as this journey may take more than one cycle and be physically demanding on your body. Here are a few tips to keep in mind when it comes to your emotional well-being: 

Don’t let staying “stress-free” stress you out 

During any type of fertility treatment, it’s natural to feel anxious or apprehensive. You are emotionally invested in the outcome, after all. So the standard advice to avoid stress during IVF may only serve to catch you in a cycle of worrying about your worries. It’s true that stress isn’t good for your health and it negatively impacts your quality of life; however, recent studies have offered reassurance that your stress level is unlikely to affect your chances of IVF success. 

We recommend that you include stress-relieving techniques in your fertility self-care plan, but it’s important to know that some stress is expected and perfectly okay. Rather than trying to avoid anxious thoughts altogether, try to acknowledge whatever hopes and fears arise, then work to let them go through practices that help you feel calm. The key here is to be gentle with yourself. Try light, low-impact movement practices like yoga, walking, or tai chi, or lay in bed and listen to a guided audio meditation. There are meditation programs that focus specifically on supporting the fertility journey, like Expectful and Circle + Bloom, as well as free fertility meditations on Insight Timer. 

If possible, we suggest surrounding yourself with caring individuals who can provide emotional support or assist with injections when needed. Talk about your feelings with your loved ones. And If you know someone else who has gone through egg freezing or IVF, perhaps you can schedule a weekly phone chat or walk through your neighborhood. 

Finding this type of support isn’t always easy, however. If you’re feeling isolated or struggling to find someone to confide in, know that you are part of a community of women who share similar challenges. Your fertility clinic may offer counseling or support groups, or you can find one through Resolve, the National Fertility Association. No matter your circumstances, you don’t have to navigate fertility and family planning alone. 

Many people also find support through blogs and online communities centered around fertility and IVF, like IVF Babble and Pregnantish. While these can be excellent resources, be mindful that not everything you read online will be completely factual or apply to your unique circumstances. Your doctor or pharmacist should be your source for any medical advice. The stories others share will range from joyful to heartbreaking, so check in with where you’re at emotionally before you start browsing. Remember: whether good or bad, these are the experiences of others. Your journey will unfold in its own way. 

Because treatment can change from one day to the next, it’s helpful to have a pharmacy partner that can be just as flexible and deliver medications as needed. For that reason, we recommend selecting a pharmacy that offers reliable delivery and expert guidance on fertility medications. 

Alto’s fertility pharmacists are accessible by phone or messaging in our mobile app. We understand that protocols can change with little notice, which is why you will always receive a confirmation and updates from us after we receive your prescription. You can also view your delivery status in our mobile app and designate a safe place for us to place your medications for contactless delivery (we can facilitate contact-free signatures as well). 

For more tips on how to select your pharmacy, read “What to Consider When Selecting a Fertility Pharmacy.” 

The IVF journey can be challenging, but we’ll be with you every step of the way. Alto’s dedicated fertility specialists are here to answer your questions, guide you through your first injections, and work with your physician to ensure your egg freezing or IVF treatment plan is followed correctly. Visit us at alto.com/fertility or reach out via phone or the app to learn more. 

Editor’s Note: This post was originally published in April 2022 and has been updated for accuracy and completeness.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. In this article, we’ll explore some of the financial options available and how we at Alto can help. 

Managing the Costs of Fertility Treatment | Alto Pharmacy

For hopeful parents who are struggling to conceive, the costs of pursuing fertility treatment can often seem insurmountable. Though assisted reproductive technology (ART) makes it possible for many people experiencing infertility to become parents, the emotional and financial stakes are high. 

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. However, there are ways to manage or lower the costs so you can move forward on your path to becoming a parent. In this article, we’ll explore some of the financial options available to intended parents pursuing ART and how we at Alto can help. 

If You Have Health Insurance, Start There

Unfortunately, not all insurance plans cover fertility treatments. As you dig into your plan’s details, you may find that some options are covered with contingencies, while others are not covered at all. It’s best to contact your insurance provider for an in-depth explanation of your fertility coverage. 

Be prepared to ask questions about whether your plan covers diagnostic testing, medications, treatments, and consultations. Ask if there is a cap on coverage or a waiting period required to try certain treatments. You want to walk away with a comprehensive understanding of what your out-of-pocket costs might be.

Several states have enacted legislation that requires insurance providers to cover infertility treatments. The American Society of Reproductive Medicine maintains this online database with information by state.

Many fertility clinics now offer no- or low-interest financing. As you seek out the clinic that’s right for you, inquire about what cost-assistance services are available. It’s perfectly reasonable to seek out a clinic that makes you feel confident and fits your budget.

There are also companies that provide personal loans specifically for fertility treatments, with flexible monthly payment options. At Alto, we’ve worked with companies like Lending Club, CapExMD and Origin Finance to help our customers get the fertility medications they need. (Great news: the Origin application fee is waived for Alto customers!)

Most companies allow you to apply online and some even provide budgeting tools on their websites so you can get an idea of what your monthly payments might be. 

There are grants available through government programs, nonprofits, and private companies that can help cover fertility treatment costs. Many are designed to benefit intended parents who demonstrate financial need while others were created to support specific groups, such as veterans or the LGBTQ+ community. There are even some that will award money to those willing to share their infertility story. 

These grants won’t usually cover all of your costs, but they can provide a significant boost. CoFertility keeps a database of fertility grants and other funding opportunities, as does RESOLVE: The National Infertility Association. 

Fertility medications can represent a significant portion of your total treatment costs. At Alto, we’ll always advocate for you to ensure you get the lowest possible prices on your medications. We’ll run a thorough insurance benefits investigation and if your insurer requests a prior authorization, we can work with your doctor’s office to submit it on your behalf. Plus, we’ll remind you to collect any available manufacturer rebates with a monthly email.

If you’re uninsured, we can help you apply for income-based assistance programs like the Compassionate Care Program offered by EMD Serono. Even if you are still in the planning stages of your fertility journey, the earlier you can apply to the program, the better. Ideally, you will want to have approval before your fertility prescriptions are sent to your pharmacy. 

We accept ACH (direct) payments and offer a one percent discount for anyone who prefers this option over using their credit card. And don’t forget—with Alto, delivery of your medications is always completely free.

With mail-order pharmacies, you usually have to order your fertility medications all at once to ensure your precisely timed doses don’t get hung up in the mail. Because it’s difficult to predict exactly how much medication you will need, you often end up ordering excess. Not only will these leftovers add to your out-of-pockets costs, but you’ll also end up with wasted medication that you'll have to dispose of when you're done with treatment.

When you fill your prescriptions with Alto, we’ll hand-deliver your medications from our local fulfillment centers. That means we can deliver your medications every few days, avoiding overorders and minimizing how much you spend. 

Finally, we know that your time is the most valuable resource you have, so we’re focused on giving as much back to you as we can. Send us a simple message through the Alto app when you have a question, and keep all your medication information—plus expert advice—at your fingertips using our mobile app. You can also schedule refills and track your shipments from our pharmacy to your doorstep in real time. If you suddenly need to add a day of injections, there’s no need to stress or go running to the pharmacy. We’ll handle the details and coordinate delivery to your doorstep. 

If you’re interested in learning more, you can request a price quote online. Our care team and fertility specialists would be happy to answer your questions about navigating fertility medications. We know that the start of your ART journey can feel full of uncertainty, but we’re here to do whatever we can to make the process easier and more affordable. 

For more on choosing the right fertility pharmacy for your journey, read, “What to Consider When Selecting a Fertility Pharmacy.”

While it’s not always possible to predict the course of your fertility treatment, it can be helpful to set goals and parameters. Is there a maximum number of in vitro fertilization (IVF) cycles you’re willing or able to try? Are there other options you’d like to pursue first, such as intrauterine insemination (IUI)? What are the scenarios where you might try using donors or a gestational carrier, or consider fostering or adoption?

Once you have an idea of your budget, coverage options, and potential out-of-pocket costs, create a roadmap that outlines your treatment goals in relation to your financial, physical, and emotional well-being. 

Remember—dealing with infertility issues can take an emotional toll, especially if some options feel out of reach financially. Know that you are not alone, and there is a community of other hopeful parents you can lean on. Support groups like RESOLVE and The Fertility Tribe offer virtual meetups and online community groups. It’s also essential to lean on loved ones for emotional support during this time. The journey you’re taking isn’t easy, but you certainly won’t be walking it alone. 

Would you like to learn more about how Alto can help you manage your fertility treatment costs? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. We’re ready to be your partner through it all, from your first cycle to your last. 

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Managing the Costs of Fertility Treatment

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Join Alto Pharmacy® pharmacists as we walk you through how to prepare for various injections as part of a self-administered fertility medication protocol. From unboxing your medications and preparing the syringe, to correctly injecting the medication and safe disposal and storage options, Jane outlines everything you'll need to know to feel confident and prepared for your fertility injections.

To watch these videos with closed captions — offered in English, Spanish, Mandarin and Russian — click on the Gear icon in the lower right corner of each YouTube video and select your preferred language.

Fertility Medication Injection Guides

Cetrotide® + Subcutaneous (SQ) Injection

Fyremadel™ (ganirelix acetate) + Subcutaneous (SQ) Injection

Gonal-f® RFF Redi-ject® Pen + Subcutaneous (SQ) Injection

Leuprolide Acetate 14 Day Kit + Subcutaneous (SQ) Injection

Leuprolide Trigger + Subcutaneous (SQ) Injection

Menopur® with Mixing Needle + Intramuscular (IM) Injection

Menopur® with Mixing Needle + Subcutaneous (SQ) Injection

Menopur® with Q-Cap + Intramuscular (IM) Injection

Menopur® with Q-Cap + Subcutaneous (SQ) Injection

Omnitrope® + Subcutaneous (SQ) Injection

Join Alto Pharmacy®  pharmacists as we walk you through how to prepare for various injections as part of a self-administered fertility medication protocol. From unboxing your medications and preparing the syringe, to correctly injecting the medication and safe disposal and storage options, Jane walks you through everything you'll need to know to feel confident and prepared for your fertility injections.

Fertility Medication Injection Guides

Cetrotide® + Subcutaneous (SQ) Injection

Fyremadel™ (ganirelix acetate) + Subcutaneous (SQ) Injection

Gonal-f® RFF Redi-ject® Pen + Subcutaneous (SQ) Injection

Leuprolide Acetate 14 Day Kit + Subcutaneous (SQ) Injection

Leuprolide Trigger + Subcutaneous (SQ) Injection

Menopur® with Mixing Needle + Intramuscular (IM) Injection

Menopur® with Mixing Needle + Subcutaneous (SQ) Injection

Menopur® with Q-Cap + Intramuscular (IM) Injection

Menopur® with Q-Cap + Subcutaneous (SQ) Injection

Novarel® + Intramuscular (IM) Injection

Novarel® + Subcutaneous (SQ) Injection

Omnitrope® + Subcutaneous (SQ) Injection

Ovidrel® + Subcutaneous (SQ) Injection

Pregnyl® + Intramuscular (IM) Injection

Pregnyl® + Subcutaneous (SQ) Injection

Fertility Medication Injection Guides

Cetrotide® + Subcutaneous (SQ) Injection

Fyremadel™ (ganirelix acetate) + Subcutaneous (SQ) Injection

Gonal-f® RFF Redi-ject® Pen + Subcutaneous (SQ) Injection

Leuprolide Acetate 14 Day Kit + Subcutaneous (SQ) Injection

Leuprolide Trigger + Subcutaneous (SQ) Injection

Menopur® with Mixing Needle + Intramuscular (IM) Injection

Menopur® with Mixing Needle + Subcutaneous (SQ) Injection

Menopur® with Q-Cap + Intramuscular (IM) Injection

Menopur® with Q-Cap + Subcutaneous (SQ) Injection

Novarel® + Intramuscular (IM) Injection

Novarel® + Subcutaneous (SQ) Injection

Omnitrope® + Subcutaneous (SQ) Injection

Ovidrel® + Subcutaneous (SQ) Injection

Pregnyl® + Intramuscular (IM) Injection

Pregnyl® + Subcutaneous (SQ) Injection

From Our Blog

Managing the Costs of Fertility Treatment

IVF and Egg Freezing: What to Expect and How to Prepare

A Guide to LGBTQ+ Family Building Options

Fertility Acronyms, Explained

What to Consider When Selecting a Fertility Pharmacy

IVF Medications: Schedule and Side Effects Explained