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Tuesday, March 22, 2011

Webchat

The other clinic (with the doc that's not board certified) has a monthly webchat. I thought I'd hop on and check it out. It was SO interesting!!! However, it was like 20 women bomboarding the poor guy with all our questions so it was a bit slow. Anyways, here are some of the questions and answers I asked.

What do you do after a failed IVF? (Failed meaning no pregnancy)
After a failed cycle, I review the circumstances, the stimulation, length of the stimulation, egg quality, embryo quality, ease or difficulty in transfer & any other circumstances that might have impacted the result. I also consider running this battery of tests which I call both the "recurrent pregnancy loss panel" or "implantation failure panel"

Remember my ET story about my SUPER full bladder? Well I asked if he thought that had any effect on the result of our IVF?
At the end of the day, we will never know. We can only guess. I think it's very important for you to be comfortable during the transfer. In fact, most of the data about acupuncture revolves around transfer day. Generally speaking, the more difficult the transfer, the less likely success.

Are you board certified? (What can I say-I just straight up asked!)
I am board certified in OB/GYN, I have been practicing IVF since 1993, was first involved with IVF in 1985, and apprenticed with one of the world's leading fertility specialists for 10 years.

Fee for storage included in price or not? 2nd opinion included in $175 consult?
Freezing & storage is an additional fee of $500-$600 and it includes one year of storage. Then we transfer to a company called Reprotech whom we have found to be most reliable and reasonably priced. And as far as the consult, if you have insurance and a diagnosis that I can code without going to jail (heh), I'll bill it to your insurance.

One per month?
We currently only have one batched cycle per month.

What is batching?
Batching of cycles is a technique that has developed in the fertility world that seems to bring a lot of benefits. Patients prior to cycle are put on birth control pills when they start their period. Some remain on it for just 3 weeks, some up to 5 weeks. Everyone stops on the same day, so they are "batched" together. This has benefits for the patients and is helpful for the work in the clinic, the quality control in the lab.

Success rates?
Not everyone gets pregnant, unfortunately. Our success rates will be published in Jan of 2012 by the CDC - that is my understanding. Having said that, I would say we are doing above the national average, especially with poor responders, where our results are astonishing.

IVF success with male factor?
Male factor represents over 30% of our patients and I would have to say that it is probably in line with the rest of our success - that is, above the national average. We routinely perform ICSI. We have made beautiful embryos and pregnancies from TESE sperm. I feel that we can offer the best possible care for just about any male diagnosis.

Random comment: I have hundreds and hundreds of PCOS patients. I also have been using Metformin in this part of the world longer than anybody because I fought with WU's department chief in the 1990s over its use! I have the first Metformin babies in this area. I am a big believer in its liberal use - of course, as long as there's no history of kidney disease.

Egg donor?
General rules for egg donors are under age 32, BMI under 35 because "obesity" is often associated with PCOS, which is associated in turn with poorer egg quality.

See interesting, isn't it? Some things I liked, some things I didn't and some things I was indifferent on.

Liked:
*Follow-up after failed IVF.
*Egg donor.

Disliked:
*Frozen storage-don't like moving the tots around but that's just me.

Indifferent:
*Batching-not sure I'd want to be on BCP for 5 weeks.
*Board certified answer.

The random comment has nothing to do with me but the doctor he fought is at my current clinic. I know longer really look at success rates, as you know Dr. Val's figures are always 50-50 and we always seem to be on the bad side of the 50. And, of course, not everyone gets prego but the "poster kids" are the ones that do. I thought his answer about my full bladder was an interesting one...

It was eye-opening, gave me info to think about and some questions that my current clinic hasn't been able to give. I did follow up with the egg donation thing and I'll do a seperate post about that later.

Side note: Three periods post IVF and I'm still irritated. First cycle was 31 days, second cycle was 26 days and the cycle that FINALLY started today, 30 days!!!

8 comments:

COME ON BABY said...

This doc seems awesome!! How wonderful that he takes time out of his day for a webchat. LOVE it!! xoxoxo

Andrea said...

Thanks for sharing that info. It's definitely interesting stuff and good to hear what other Dr's have to say. :)

Kelly said...

That is very cool that he does that, and a great way to get information!

Just thought I would share this little tidbit. When I did my transfer this time I had to wait on the doctor a little bit so my bladder was SUPER full. When my doctor put the ultrasound down he decided to let me go pee a little because it was so full. I don't know if this was for my comfort or some other reason...but I was happy to pee!!

I do ultrasound and if someone has a uterus that tilts forward and their bladder is super full then this can push their uterus all the way back. I have always wondered if this has any bearing on a "good" transfer or not....We may never know!

You have so many doctors to choose from!

JC said...

Wow, that's very cool! Thanks for sharing! I hope you don't need another Dr but if you have to I like this guy! =)

Josey said...

Wow - that's really cool he does a monthly Q&A like that. Lots of great info for you to ponder!

Bobbi said...

That is sooooooooo informative and super awesome for the doctor to do that! After reading the info. about the importance of the transfer being easy and comfortable in the success, it makes me even more certain that had an effect on my unsuccessful IVF. I remember both you and I had super full bladders, and my doctor even told me that he doesn't want my bladder full at all this time around. Interesting! Thanks for posting all that info. If I were you, I'd go with this guy! :)

Christa said...

I just wanted to pop in and say that regarding the frozen embryos, they will typically send them to the company after a year, so you could do your FET(s) at that clinic if it's within a year of freezing, or we were also given the option of moving the embryos to a different location if we wanted to. It was up to us and yeah the $500 freezing fee is on top of their IVF cycle cost but if someone doesn't have any embryos to freeze (like us) they get a 100% refund on the freezing fee, which was really nice.

I also think the batching was a good idea because it seemed to streamline the cycle as the staff has a great "routine", if you will, with the group of patients. I was on bcps for about 5 weeks but it wasn't a big deal.

I hope so much that you make whatever decision is best for you and your DH and I'll cheer you on no matter what!

Kim said...

You asked some great questions, I like the doctor...still not sure how I feel about hatching, I'm with you on that one.