Clinic referrals

[Panama]

I just went through my second unsuccessful round of IVF/ICSI. I will be using a new doctor/clinic for my next attempt. Can anybody refer or share their experiences with the Institute for Reproductive Health in Cincinnati or Advanced Fertility Center of Chicago?? I am looking for a clinic with a high quality lab and a doctor exceptionally skilled in difficult transfers. Any feedback is appreciated.

[angelaezra]

I am located in Ohio, which is about 45 minutes north of Cincinnati. I do know that one of my recent March/April cycle buddies just got her BFP and I believe her IVF was in Cincinnati. Her sign-in name is: Heekinje . She probably can provide more insight into the docs in Cincy. My RE is in Kettering, Ohio and so far I have been happy w/ him but I will happier w/ him if I get another BFP w/ this cycle … lol. I wish you good luck!

Angela

[Ghost]

I just went through my second unsuccessful round of IVF/ICSI. I will be using a new doctor/clinic for my next attempt. Can anybody refer or share their experiences with the Institute for Reproductive Health in Cincinnati or Advanced Fertility Center of Chicago?? I am looking for a clinic with a high quality lab and a doctor exceptionally skilled in difficult transfers. Any feedback is appreciated.

I have the impression that Advanced Fertility is very good.

The University of Iowa is outstanding, perhaps the best in the world, according to their stats. Maybe a bit too far to go, though.

[heekinje]

HI, Panama -

I just finished up my 2nd cycle at Institute for Reproductive Health - both cycles were BFPs. My RE is Dr. Awadalla and I really like him a lot. There is one other RE at the practive, Dr. Schreiber. I really like him as well - you can't go wrong with either one. They each have different approaches in how they work with patients - Dr. Awadalla is less inclined to give up the gritty details and data to patients because he knows how much stress it can add. You'll get a lot of "Looks great!" and "You get an A!" from him while Dr. Schreiber will tell you your lining measurement and pattern before transfer The nurses are attentive, understanding and most of all easily accessible for even the smallest question. The nurses have a dedicated IVF line where you leave a message and the call is returned usually within the hour - always the same day. Their practice is located in a new office builiding and all procedures are performed there - no hospital time or fees!

Their fees are very competitive and the practice is smaller than some of the gigantic clinics you read about on this board. They don't use birth control pills to have patients cycling together in a group - your protocoal is designed for you and your DH. They also rarely if ever prescribe progesterone in oil injections for progesterone support - a nice advantage I have endometriosis though it has been managed well over the years with drugs and surgeries - so I'm not sure if it effects our fertility. My DH has male IF with low count and morphology. We did not even try IUI because of his sperm and went straight to IVF w/ICSI. For your first cycle with the clinic, you will need to have an IVF consult with the RE of your choice. I believe they only do these appointments once a week, so if you are interested, call soon. Once you decide to move forward, you will fill out pages and pages of paperwork and then attend an IVF Education Day for a few hours. For any cycles after the first, you can skip both of those and go straight into your cycle.

Our protocol for both cycles was as follows: (with your first cycle, there may be an initial appointment to do and antral follicle count with ultrasound and a mock transfer to measure your transfer catheter.)

Call with Day 1 of period - both me and DH begin 10 days of antibiotics; order meds
Day 3 - blood draw: FSH level
Day 22 - begin lupron injections
Call with period - if none in 2 weeks, call
Once period comes, ultrasound done to verify down regulation
Stop lupron, begin Gonal-F
4 days of Gonal-F, ultrasound to measure follicles
3-5 days later, ultrasound to measure follicles and lining
Trigger with Ovidrel when follicles are ready (for me, 10 days of gonal-f)
Egg Retrieval
Embryo Transfer - my transfers were both 3 day. I had roughly 9 embryos that were healthy and only 2 were the ideal 8 cell on day 3, so the transfer was not done on day 5. Some clinics will only do 5 day transfers, which many (including myself) believe is not ideal for all patients.

Anyway, I hope I did not overwhelm you with information. If you have other questions, feel free to PM me. Good luck!!

Oh, also, I'm not sure why their SART data is unavailable right now, but last year, their stats were excellent!!!

Heeks

[Ghost]

Oh, also, I'm not sure why their SART data is unavailable right now, but last year, their stats were excellent!!!

Heeks

Their stats are available on the CDC website.

They look very close to the national average, just a tad below.

[heekinje]

Ghost - I think I interpret the data differently than you do. The stats for my clinic on the CDC website show that they do an above average number of cycles - at least from the clinics I have looked at. I looked at the clinic in Iowa that you said was the best in the world and they do far fewer cycles with a very low percentage of woman with depleted ovarian reserve or dysfunction. I guess the fewer patients you take, especially those with the most complicated problems, the higher your reported success rate is going to be? That's how I look at it, but I am not a clinician or scientist....my gut tells me you are I'm expecting some big jumps in the success rates for my clinic for 2008 based on my conversations with my RE, especially for FET...but who knows, right? Thanks for being there for all of us.....

Heeks

[Ghost]

Ghost - I think I interpret the data differently than you do. The stats for my clinic on the CDC website show that they do an above average number of cycles - at least from the clinics I have looked at. I looked at the clinic in Iowa that you said was the best in the world and they do far fewer cycles with a very low percentage of woman with depleted ovarian reserve or dysfunction. I guess the fewer patients you take, especially those with the most complicated problems, the higher your reported success rate is going to be? That's how I look at it, but I am not a clinician or scientist....my gut tells me you are I'm expecting some big jumps in the success rates for my clinic for 2008 based on my conversations with my RE, especially for FET...but who knows, right? Thanks for being there for all of us.....

Heeks

Then you are correct, we do look at it differently.

I care little about the volume, much more about the success rate.

That clinic had 42% live birth per transfer in 2007, with an average of 2.1 embryos transferred in patients under 35 years old.

At Iowa, it was 59% per transfer, with an average of 1.6 embryos transferred in that year and age range.

Higher rate with fewer embryos wins.

But you bring up an excellent point. If we pick "Diminished Ovarian Reserve" from the list of diagnoses, they have almost no data! That just does not make any sense. My first thought was maybe they screen patients severely. But the donor cycles should be mostly in patients with diminished reserve (DOR is the most common reason to need an egg donor). And the patients over 40 years old would tend to have diminished reserve. I wonder if they are not entering the diagnosis data correctly? Either that, or they are not taking in many DOR patients, not even as donor recipients or older patients. Something makes no sense to me.

[Waiting4GodsMiracle]

can u share the full web address for the cdc website. Thx. I'd like to look up my fertility clinic here in Houston.

[Ghost]

can u share the full web address for the cdc website. Thx. I'd like to look up my fertility clinic here in Houston.

This is the 2007 report, the most recent on CDC has:

http://apps.nccd.cdc.gov/ART/FCT.aspx?SelectedYear=2007

CDC's interface is much more awkward than SART's.

[Panama]

Thank you all for the replies and information. This helps in my decision making process in selecting a new clinic. While my husband and I do want a child, we want to be sure we are putting our money with the right doctor, clinic, lab, etc. for the best return on our investment. A helpful hint if I may.........don't ever agree to pay the asking price for an IVF procedure. I don't think anybody here would pay the $15,000 to $30,000 + asking price for a new car or piece of real estate. EVERYTHING is negotiable. Don't be afraid to look your doctor right in the eye and ask, "Is this the best price you can give me?" I am finding there are way too many players in the IVF arena and you don't have to sacrifice quality to find a better price. We have saved a few thousand so far by just asking.

Thanks again....

Panama

[angelaezra]

Thank you all for the replies and information. This helps in my decision making process in selecting a new clinic. While my husband and I do want a child, we want to be sure we are putting our money with the right doctor, clinic, lab, etc. for the best return on our investment. A helpful hint if I may.........don't ever agree to pay the asking price for an IVF procedure. I don't think anybody here would pay the $15,000 to $30,000 + asking price for a new car or piece of real estate. EVERYTHING is negotiable. Don't be afraid to look your doctor right in the eye and ask, "Is this the best price you can give me?" I am finding there are way too many players in the IVF arena and you don't have to sacrifice quality to find a better price. We have saved a few thousand so far by just asking.

Thanks again....

Panama

Thank you so much for sharing that advice because this can be so very expensive!

Angela

[Ghost]

Thank you all for the replies and information. This helps in my decision making process in selecting a new clinic. While my husband and I do want a child, we want to be sure we are putting our money with the right doctor, clinic, lab, etc. for the best return on our investment. A helpful hint if I may.........don't ever agree to pay the asking price for an IVF procedure. I don't think anybody here would pay the $15,000 to $30,000 + asking price for a new car or piece of real estate. EVERYTHING is negotiable. Don't be afraid to look your doctor right in the eye and ask, "Is this the best price you can give me?" I am finding there are way too many players in the IVF arena and you don't have to sacrifice quality to find a better price. We have saved a few thousand so far by just asking.

Thanks again....

Panama

Correct. And you are correct to say "look the doctor in the eye" because the subordinates do not have price flexibility, not like the doctor does.

[jentruma]

You better try to find some clinic list and try to get some patient feedback of each one of them. It could give you a good idea on choosing one.

[rypell1985]

After reading this I went online to view my doctor's percentages, but was unable to find her...any idea why?

[angelaezra]

After reading this I went online to view my doctor's percentages, but was unable to find her...any idea why?

Maybe your doctor doesn't report and that is a good question to ask them. This is some information that I came accross in the past when looking for a good clinic.

"Other sources include the Society of Assisted Reproductive Technologies (SART) which lists practices and physician qualifications. Also, the Centers for Disease Control in Atlanta currently maintains the success rate statistics for reporting practices. If a site does not report to SART, it is important to learn why. Unfortunately, the SART data is dated by two years because of reporting requirements".

Angela