When to seek a 2nd opinion...(long)

MrsRedVelvet · November 2012

I'm contemplating seeking a second opinion but DH thinks we should try one more cycle at my current REs.

Some background, first IVF was an IUI to IVF conversion (antagonist protocol) and of the 7 embryos we had, only 1 made it it transfer and it was a BFN.

The second IVF we tried antagonist again and though I had 23 follicles, my E2 level after 10 days of stims was only ~800 so I voluntarily cancelled that cycle rather than have a disappointing ER and ET.

We just tested my AMH and my level was 1.2 however at 31 years old this is quite low considering my age.

RE wants to proceed with a long-lupron protocol for the next IVF; he thinks due to my past 2 performances that I may have an egg quality issue and we should change up the protocol. Even though my practice has about 10 docs and they all reviewed my case at their weekly meeting, I can't help but think maybe I should seek a fresh pair of eyes. Cornell has a satellite office by my work so I'm thinking of pursuing them for a consult.

Would love to hear others opinions and experiences on this, especially those that have not been successful with IVF#1. Just kinda feeeling bummed recently...thanks for reading, enjoy the cupcake

firesiren · November 2012

A second opinion can never hurt. Maybe there's something your RE is missing. I did a second opinion and was so glad I did. Good Luck to you!

kflynn81 · November 2012

Like your RE, after my first cancelled IVF, mine met with the other 7 doctors about my case as well and decided to put me on the MDL for my next attempt.(microdose Lupron). That worked so much better and I was able to get to ER and ET....BFN but I made it that far. I'm currently going in for ET #2, with an even better % of fertilization this round so FX.

As for getting a second opinion, it could never hurt, however if I were in your shoes I'd probably hold off another cycle since they're changing your protocol and just see what happens. Plus, although the AMH is low, I've seen stories around here of women getting pregnant with much lower AMH.

GL!

MandaS08 · November 2012

I think if you're questioning it, I would get a second opinion. It doesn't mean you have to move for your next IVF cycle, but it can't hurt to have another opinion, and should at least give you some peace of mind moving forward.

BzeetyD · November 2012

MandaS08:
I think if you're questioning it, I would get a second opinion. It doesn't mean you have to move for your next IVF cycle, but it can't hurt to have another opinion, and should at least give you some peace of mind moving forward.

I agree with this.

Also I would say you've done about 1.5 IVFs and that makes a big difference than just 1. Going through stims twice can be useful information moving forward.

I've got egg quality issues too and it's a very tough nut to crack but Corn.ell is a very good clinic from what I've heard and is highly respected. A 2nd opinion from them should be weighed heavily.

Most guys are 1 or more steps behind in this process, so it's not surprising that your DH is still very hopeful with your current clinic. Mister D keeps saying he's going to "knock me up naturally in December" - gotta love his optimism!

MrsRedVelvet · November 2012

BzeetyD:

MandaS08:
I think if you're questioning it, I would get a second opinion. It doesn't mean you have to move for your next IVF cycle, but it can't hurt to have another opinion, and should at least give you some peace of mind moving forward.

I agree with this.

Also I would say you've done about 1.5 IVFs and that makes a big difference than just 1. Going through stims twice can be useful information moving forward.

I've got egg quality issues too and it's a very tough nut to crack but Corn.ell is a very good clinic from what I've heard and is highly respected. A 2nd opinion from them should be weighed heavily.

Most guys are 1 or more steps behind in this process, so it's not surprising that your DH is still very hopeful with your current clinic. Mister D keeps saying he's going to "knock me up naturally in December" - gotta love his optimism!

One can hope, right?? I'm thinking that a second opinion may be helpful while I'm waiting to start IVF 2.1. Since I won't start stimming until at least the end of Dec, I may as well use this time to see what else can be offered. Just the fact that they are Cornell is mighty tempting.

Now comes the awkward process of requesting medical records...geez, this is almost as bad as breaking up with your hairdresser if it gets to that point.

arbutusbride · November 2012

When I requested my records, I just told them it was for my regular OB/GYN who wanted to be kept in the loop. (Which is true. I made a second copy myself.) Can you pick them up instead of having them mailed? That may make it a little less awkward.

MsGMChick · November 2012

Second opinions are always a good idea, especially if you're feeling like you need one. Either you find someone new you love! Or you find out you really did like your current RE's plan.

Also, (I'm not an RE so take this with a gain of salt)... An AMH of 1.2 is still good! Even at 31. Anything over 1 is considered good. There's a chart here from Advanced Fertility and a lot of great info. https://www.advancedfertility.com/amh-fertility-test.htm

Good luck!

baker916 · November 2012

MsGMChick:
Second opinions are always a good idea, especially if you're feeling like you need one. Either you find someone new you love! Or you find out you really did like your current RE's plan.
Also, (I'm not an RE so take this with a gain of salt)... An AMH of 1.2 is still good! Even at 31. Anything over 1 is considered good. There's a chart here from Advanced Fertility and a lot of great info. https://www.advancedfertility.com/amh-fertility-test.htm
Good luck!

I agree with all of the above. My Re also told me an AMH above 1 is considered "normal." Good luck!

ksfrye · November 2012

I would highly suggest getting a 2nd opinion. Many RE office will do a free 2nd opinion consult. I'm currently on my 4th RE and finally feel like I've found "the one". Another RE might have a fresh idea of what protocol to take. GL!

MrsRedVelvet · November 2012

baker916:
MsGMChick:

Second opinions are always a good idea, especially if you're feeling like you need one. Either you find someone new you love! Or you find out you really did like your current RE's plan.

Also, (I'm not an RE so take this with a gain of salt)... An AMH of 1.2 is still good! Even at 31. Anything over 1 is considered good. There's a chart here from Advanced Fertility and a lot of great info. https://www.advancedfertility.com/amh-fertility-test.htm

Good luck!

Thanks for the reply My RE did relay that although the value "1.2" is within the normal reference ranges, for someone at 31 my value is typically seen at about a 3. So compared to other healthy normals in my age group, I'm low

I agree with all of the above. My Re also told me an AMH above 1 is considered "normal." Good luck!

cupcake201 · November 2012

I am in a similar situation and just recently had a second opinion appt and switched REs.

For IVF #1 we did a long lupron protocol and it seems I was over suppressed. My E2 rose very slowly and they ended up getting 7 eggs, although only 3 were mature. All 3 fertilized, and 2 made it to freeze although they were not great quality. We did not do an ET because we have to do PGD and wanted to do another cycle and get more embryos to test since the cost of PGD is high and they will test up to 8 embryos for that cost.

I am 30 and my AMH is 1.17- I had asked my RE about it and he said it was fine. I felt given my age it was low, but went with what he said. For our next cycle I felt he wasn't being aggressive enough and sought a second opinion. The new RE is more aggressive and said that while my AMH is considered normal (above 1 is normal), that it is right on the edge and that for my age, it is low. I felt 100% more comfortable with this RE than I do with my previous one, and I am so happy I got a second opinion. (He is doing an antagonist protocol with estrogen priming for IVF #2).

IVF is so hard because you really have no control over the situation, so I think it is really important that you completely trust the RE you are working with. Initially I was kind of feeling "should I get a second opinion? And am I just doing this because our cycle failed?" I think that it is normal to kind of feel that way. I also know that if we did stick with our RE for IVF#2 and had similar issues, I would be kicking myself for not getting a second opinion. I sort of already feel like we "wasted time" with our first RE, and do not want to feel that way again.

I totally agree with PPs about getting a second opinion. I felt so much better after ours and feel excited about moving forward with a doctor I am comfortable with and confident in.

As far as requesting records or letting them know you are switching - they see it all the time. I was open with my RE and told him I was going to be seeking a second opinion because I just was not 100% comfortable moving forward at this time.

Phew, this was long! Good luck with whatever you decide, and keep us posted!

MrsRedVelvet · November 2012

cupcake201:
I am in a similar situation and just recently had a second opinion appt and switched REs.
For IVF #1 we did a long lupron protocol and it seems I was over suppressed. My E2 rose very slowly and they ended up getting 7 eggs, although only 3 were mature. All 3 fertilized, and 2 made it to freeze although they were not great quality. We did not do an ET because we have to do PGD and wanted to do another cycle and get more embryos to test since the cost of PGD is high and they will test up to 8 embryos for that cost.
I am 30 and my AMH is 1.17- I had asked my RE about it and he said it was fine. I felt given my age it was low, but went with what he said. For our next cycle I felt he wasn't being aggressive enough and sought a second opinion. The new RE is more aggressive and said that while my AMH is considered normal (above 1 is normal), that it is right on the edge and that for my age, it is low. I felt 100% more comfortable with this RE than I do with my previous one, and I am so happy I got a second opinion. (He is doing an antagonist protocol with estrogen priming for IVF #2).
IVF is so hard because you really have no control over the situation, so I think it is really important that you completely trust the RE you are working with. Initially I was kind of feeling "should I get a second opinion? And am I just doing this because our cycle failed?" I think that it is normal to kind of feel that way. I also know that if we did stick with our RE for IVF#2 and had similar issues, I would be kicking myself for not getting a second opinion. I sort of already feel like we "wasted time" with our first RE, and do not want to feel that way again.
I totally agree with PPs about getting a second opinion. I felt so much better after ours and feel excited about moving forward with a doctor I am comfortable with and confident in.
As far as requesting records or letting them know you are switching - they see it all the time. I was open with my RE and told him I was going to be seeking a second opinion because I just was not 100% comfortable moving forward at this time.
Phew, this was long! Good luck with whatever you decide, and keep us posted!

Thanks so much for your input; I did the opposite of you where I did antagonist first and am now doing long lupron (but I fear I may be oversuppressed). I asked my current RE about this and because of my response to antagonist he felt we had to change protocols; I'm just not 100% confident it's the right protocol.

I will likely go through IVF#2(2.5?) with my current RE but will get my second opinion in parallel.

Good luck with your next round moving forward

When to seek a 2nd opinion...(long)

Re: When to seek a 2nd opinion...(long)

NTNP 2009-2012 TTC since 2012:

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