Phone consult question — The Bump
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Phone consult question

So, I finally got all my IF records together and mailed to rba and shady grove. It was an embarrassingly large package! I have telephone consults with rba Monday and shady on Tuesday (for DE, fresh or frozen) I honestly have no idea what we are going to talk about. I think deep down I'm hoping someone will suggest more OE Ivfs and a guarantee program that guarantees us a biological child. Or I'll get PG in the meantime while I drag my feet about this. My heart is just not in this DE thing, but I have to keep moving forward. Anyway, my question is this: why can some clinics charge for an initial phone consult and some don't? I know c.crm said they can't legally charge because of tele-medicine laws, and shady can't charge either. Rba has a $250 charge. Does this vary by state? Does it depend on my states laws or the physicians state laws? Just curious really, I have no problem paying for a consult at all. Just seems odd. And if have any ideas wth I'm going to ask these docs, feel free to chime in. Seems pretty straight forward really!
Me: 37, DH: 38: ttc 7 years, dx: unknown
10/11: after 2 years, saw a RE, FSH 5.4
11/11: BFP! (surprise after thyroid & normal hsg),
12/11: missed m/c after 7 week u/s, 1/12: D&C
6/12 IUI#1-IUI #3: clomid = BFP!, C/P
IVF #1(10/12) FSH 5.4, AFC: 16 long Lupron, 5R/5M/4F, all 4 made it to 5dt, 1 blast/1-8 cell transferred=BFN
IVF #2(12/12)AFC 21, MD lupron, 4R/4M/3F, 5dt of 1 blast and 2-8cell. BFN.
IVF#3(4/13) Natural start antagon protocol, 12R,11F. one PGS normal at day 6 transfer. BFN.
IVF#4 (11/13) C.CRM (ODW.U normal 8/13 Still no Diagnosis) EPP/antagonist. ER 13R/7M/6F. Only 1 made it to freeze. Abnormal. Looking into options of DE, Fresh vs frozen.
10/14 new local RE to look into what's next. CD3 FSH 4.7, AMH 0.9. Met with DE agencies and exploring options for feb/march 2015.
Surprise natural bfp (4 days before donor is signed). Beta #1 at 9dpo: 51.8, 2nd beta: 195 (25 hours doubling) @11dpo. 3rd beta (12/15): 516 (35 hrs doubling) 4th beta(12/17): 895 (58 hours doubling) 5th beta(12/19): 2120. U/S at 5w0d(12/22): one gestational sac with yolk sac. U/S #2 (6w0d)12/29. One little bean measuring 6w0d with HR 124. 3rd u/s(1/4)7w0d: baby measuring 7w2d. HR 134. 3/30: A/S at MFM went great except for low lying placenta. Verifi results are normal! Team Blue! Please send any positive thoughts our way! EDD:8/24/2015
Baby Will born 8/18. He's perfect.

Re: Phone consult question

  • I think whether or not they can charge has to do with state laws based on the clinic's location. The only phone consult I've had was with a TX clinic and they charged $50. I can't help with questions to ask as I was dead set on a DEmbryo cycle and just asked about that, although the RE did review my records and wanted me to cycle with my OE again. I would definitely ask their opinion about cycling with your OE so they'll know it's still something you would consider. FX they'll be able to give you some answers that will help you move forward, one way or another!

    ***signature & ticker warning***


    Me: 30 ~ Stage IV Endo ~ AMH .38 ~ AFC 8
    AMH .97 as of 4/2012! ~ AMH 1.63 as of 4/2013!?!
    Him: 29 ~ perfect swimmers

    Laparotomy w/partial oophorectomy 8/2009 to remove cysts/endo.
    Stopped BCP 4/2010.
    Multiple clomid rounds from 11/2010 to 6/2011. ~ All BFN
    IUI w/clomid 7/2011. IUI w/clomid & injectables 11/2011 & 1/2012. ~ All BFN
    IVF:EPP 5/2012 ~ (4R, 3M, 2F w/ICSI). Both embryos txfrd. ~ BFN
    BCP to manage endo from 10/2012 to 12/2012.
    FET w/donor embryos #1: 10/2013 Cancelled
    FET w/donor embryos #1.2: 11/2013 ~ ET of 2 beautiful blasts on 11/27.
    Beta 1: 503(12dp5dt) Beta 2: 1035(14dpt) Beta 3: 3001(16dpt) Beta 4: 8503(19dpt)
    Twins with an EDD of 8/15/14! Team Purple
    G&B born 6/30/14 at 33w3d via emergency c/s.

    If you're wondering about my avatar...it's a fried pickle chip shaped like a fetus!

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  • hmz819hmz819
    Ninth Anniversary 250 Answers 1000 Comments 250 Love Its
    member
    Actually I think it's the state you live in laws. I was charged for my CC.RM phone consult.

    TTC#1 since April 2011
    IVF#1 July 2012 5R, 3 made it to blast, sET c/p
    FET#1 Aug 2012 2 blasts transferred BFN
    IVF#2 Oct 2012
    16R/6M/6F/2-8 cell grade 1 transfer
    Beta 1-237.9, Beta 2-566, Beta 3-8657
    US 6w3d shows one baby w/ HB 115
    US 7w1d no more heartbeat/ D&C 11/30/12 normal karyotype
    IVF#3 Mar 2013
    6R/4M/4F 1 compacting and 2-8 cell transfer
    ectopic pg MTX given 3 month break from TTC

    IVF#4 Sept 2013--BFN
    IVF#5-7 Apr 2014, Jun 2014 and Aug 2014 banking embryos for CCS testing. Praying for normals! Image and video hosting by TinyPic image image

    http://i61.tinypic.com/34zll06
    luvboston
  • No clue on the consult fee but I know my RE at RBA told a friend who was 30 that maybe she should keep trying with OEs until she explained she did 6 OE IVFs and wanted to move on.. Anyway, just look at like a fact gathering mission. You don't have to move forward if you aren't ready...

    TTC #1 since 8/1/10; Me:41 and BRCA1+, DH:46
    DOR (FSH 24.3)/ terrible egg quality ; homozygous MTHFR c677t
    5 IUI's: 2/11 to 6/11 and 1/12= BFN
    OE IVF#1-4 8/11-6/12= all BFN
    DE IVF#1 11/12 bad embryos= BFN
    DE IVF #2 2/13 BFP/Beta hell: m/c 5w6d
    CFNBC 7 months, not doing well; decided on guarantee program at RBA w/frozen DE
    DE IVF #3 1/14  ET 4BB; BFP;M/C 5w1d, incomplete m/c; MVA extraction in ER 7w1d

    DE FET#1 ET 3/1714; BFP, beta 1 3/27= 197, beta 2 3/31= 1586, beta 3 4/7= 13879!!
    First u/s= Twins with HBs at 6w2d! We are Team Pink x 2!!

    K & K born 11/21/14 at 38wks 4 days

    imageimage

    SAIF/PAIF Welcome


    http://waitingforraintostop.wordpress.com

  • I'm sorry I can't answer your clinic question. But I'm excited to see you moving forward. I thought your break might be longer. Is DH on the same page now? I plan to never move on to DE, so my conversations are always OE or bust. Since you are (hesitantly) open to it, I think it's the right move to start pursuing it, if only on an introductory level & to ready the ball to start rolling. I would also discuss another OE cycle with them. I don't think I would have been content without this current, just-one-more-time cycle. (And I think I can finally say that I am over it. WAY over it.) my only advice is to let the RE lead the conversation with their own recommendations. I've found that if I lead with MY preferences, then the doc follows my lead. I also ask what new or unusual tests, protocols, procedures they are open to trying. Most REs, I've found, tend to follow cookie cutter treatments when people like us are way past the norm and require more intensive treatment. Good luck next week. I can't wait to hear what they tell you.

    imageimageimageimageimageimageimageimage
    My BLOG: www.ivfbabyquest.wordpress.com -Update - old blog.

    PAIF/SAIF Welcome!
    Me: 42, Hubby: 35, TTC since Jan 2010. Dx: DOR due to advanced maternal age. Also: Hypothyroidism (100mcg Levothyroxin). Positive for MTHFR (hetero-C677T), Factor V Leiden, and Fragile X (on DH side). Taking pre-natal vitamins
    .
    First natural PG 9/27/11; mc: 1/20/12
    First RE visit: 8/8/12, Saline Sonogram: 8/28/12, IVF injection class: 10/11/12, add FaBB Tab for FVL, +Vitamin D.
    IVF #1
    : 10/17/12 Baseline: FSH- 9.4, E2- 24, LH- 3.7, Prog- 0.3 The u/s showed 6 follicles in my right  & 9 in my left. Rx: 150 Bravelle & 150 Menopur SQ nightly. 10/21/12: Add Ganirelix SQ every morning.
    ER 10/28/12: 13 Retreived. 7 Mature. 6 Fertilized. 5 Made it to PGS. ET 11/2/12: CANCELED. All 5 came back from PGS as having "severe abnormalities."
    IVF #2: 1/7/13 Baseline: FSH- 8.8, 4 follicles in my right & 6 in my left. Rx: 150 Bravelle & 150 Menopur SQ nightly. 1/11/13: Add Ganirelix SQ every morning. hCG Trigger 1/16/13
    ER 1/18/13: 9 Retrieved. 5 Mature. 5 Fertilized. 2 Made it to PGS. ET 1/23/13: CANCELED. All embryos (he even sent the ones not growing) came back from PGS as having "multiple severe abnormalities."
    IVF #3:
    NEW RE! 3/1/13 Baseline: FSH- 9.6, E2- 61, Prog- 0.94, 3 follicles in my right & 4 in my left. Rx: 150 Bravelle& 150 Menopur SQ in PM. 3/7/13: Add Ganirelix SQ in AM. hCG Trigger 3/9/13 SQ.
    ER 3/11/13: 6R, 2M, 2F. Day 3: one 8 cell, grade 0.  Five day ET 3/16/13: one early blast, grade Fair. 3/24/13 AF came a day before beta. BFN

    IVF #4: (Added acupuncture to this cycle.) 3/25/13 WTF & Baseline: FSH-11.8, E2- 56, Prog- 0.84 3/26/13 Start stims. 3/30/13 u/s: 5 follicles in my right & 4 in my left. Rx: 225 Bravelle& 225 Menopur SQ in PM. 3/31/13 Add Ganirelix SQ in AM.hCG Trigger 4/3/13 SQ.
    ER 4/5/13: 5R, 3M, 3F naturally. Day 3: two 8 cell, grade 0, one 8 cell, grade 2 (Scale 0-best to 3-worst). Five day ET 4/10/13: two blastocysts (the 3rd stopped growing.) Beta 4/18/13: 2.5 BFFN. RE recommends we stop trying and focus on living childless, due to the extremely poor quality of my eggs.
    ***
    Decided to stop trying and live CFNBC. I couldn't adjust. So, six months later...
    IVF #5: Changed RE. Going to one of the big name clinics now. OWDU: 10/29/13. Update: HORRIBLE experience. Disgusted and distraught at their complete unprofessionalism and how much money and precious time they cost us. Sickening. Have now changed RE again. New Patient appt. 1/30/14.
    BFP! Out of nowhere, I got KU the old fashioned way! POAS 1/26/14 - Positive! FDLM 12/30/13. Beta #1 16dpo= 373. Beta #2 18dpo= 801. EDD 10/6/14
    2/4/14 1st U/S revealed a 5wk2day sac but no fetal pole. Started 200mgs of progesterone suppositories daily
    2/11/14 2nd U/S revealed a perfect 6wk1day "diamond ring" embryo with a beating heart! 138bpm! Add 1mg folic acid and 40mg Lovenox
    2/25/14 3rd U/S: perfect 8w1d embryo, 178bpm. 3/6 start spotting. 3/11 10w1d U/S shows no heartbeat. Scheduling D&C. The Stork has forsaken me again.
    IVF #5.2: New in-state RE. Supplement priming for 1.5 cycles prior to start of cycle, including DHEA 50mg (stopped 5/15), CoQ10 200mg 2x/day, L-Arginine- 1000mg 2x/day (stopped 6/5 due to cold sore!), myo-inositol- 2g 2x/day, melatonin- 3mg, and Neevo (prenatal for MTHFR).
    5/16/14 Day 2 bw cycle prior: FSH- 12.22, E2- 38.37, Prog- 1.35, LH- 9.46. 6/2/14 Day 19 bw: Prog- 23
    6/12/14 Baseline: E2- 122.7, Prog- 0.4. 5 follicles in left, 4 follicles in right. Start stims: 375IU Follistim & 150IU Menopur. 6/19 Increase Follistim to 425IU, Menopur still 150IU. 6/18 add Ganirelix. 6/23 Ovidrel trigger SQ. 6/25 ER: 8R, 8M, 5F naturally. Start Medrol & Doxy. 6/26 Start Endometrin. 7/2 Start Lovenox.
    7/8/14 Beta= 137.4 BFP!!! (My first from IVF!) E2- 1109, Prog- >60. Stop CoQ10, myo-inositol, and melatonin. 7/9 2nd Beta= 281.4. TSH- 2.70. Increasing Synthroid to 100mcg daily. 7/24 6w3d u/s measured 6w3d, hb: 121bmp! 8/5 8w1d u/s measured 8w3d, hb: 164bpm! Graduated from RE to OB. Now I just need to find an OB!
    EDD 3/18/15!

  • I would ask about OE and DE and what they would do for both, as long as they would agree that OE had some chance.  We've been having this discussion for the past week or so almost every day and I think that what gets me is that I have to try once more.  I didn't feel like my last cycle was my last cycle with OE and I just want to make sure I don't regret my decision.  I hope you get some good information and they go well.  I don't know about the charging differences, but the state differences makes sense to me.  
    ****************SIGGY WARNING****************

    image
    TTC since 2011
    DH: 29, Severe MFI; grade III varicocele; surgery postponed till KU
    Me: 30, POF/DOR, factor II hetero, MTHFR homo
    5 IVF's, LLP, EEP, MDLF all BFN
    IVF 6 using DEB USA frozen eggs
    developed bilateral PE's from BCP, cancelled/delayed 6 mths, taking lovenox
    Feb'15 SURPRISE 1st BFP ever! EDD: 10/10/15, FX
    Still have frozen donor eggs on ice
    All are welcome!
  • GL I hope you find some answers you're looking for and get some clarity about the direction you want to pursue!

     


    imageimageimageimage

     
     

    *******siggy/ticker warning***** 

     Me(31). DH (31)

    DH SA normal count and motility, 1% morphology
    Me .72 AMH, Fragile X premutation carrier
    IVF #1 (6/12/13) BFN

    IVF #2 (8/16/13) BFN

    FET 10/4/13 Chemical

    IVF #3 MC 5 weeks 5 days

    IVF #4 DE 11/7 BFP, edd 7/28/15

    All Welcome

    BabyFruit Ticker

  • Thanks ladies for your input. @chucktgirl‌- I would love for the RE to go in open minded about OE or DE, but they already asked me beforehand if I was consulting on DE or OE so I think they will already be swayed. @LeggyJeggy‌ , I know that if I bring up OE with them they will tell me I have a chance with OE still, there really isn't any glaring reasons to discount my own eggs other than the failed ivf which we really don't know the cause of. Problem is, we can't spend any more money and of it's going to take 4 more ivf of OE we just can't do it without a guarantee of some sort. I cannot pay for 4 more Ivfs and end up with nothing. @mrsmcirish- unfortunately I will never be ready to move forward with DE, it's just something I'm going to have to suck uo and do. I feel I'll never be fully on board but it is a decision purely mad on logic and for financial reasons unfortunately...
    Me: 37, DH: 38: ttc 7 years, dx: unknown
    10/11: after 2 years, saw a RE, FSH 5.4
    11/11: BFP! (surprise after thyroid & normal hsg),
    12/11: missed m/c after 7 week u/s, 1/12: D&C
    6/12 IUI#1-IUI #3: clomid = BFP!, C/P
    IVF #1(10/12) FSH 5.4, AFC: 16 long Lupron, 5R/5M/4F, all 4 made it to 5dt, 1 blast/1-8 cell transferred=BFN
    IVF #2(12/12)AFC 21, MD lupron, 4R/4M/3F, 5dt of 1 blast and 2-8cell. BFN.
    IVF#3(4/13) Natural start antagon protocol, 12R,11F. one PGS normal at day 6 transfer. BFN.
    IVF#4 (11/13) C.CRM (ODW.U normal 8/13 Still no Diagnosis) EPP/antagonist. ER 13R/7M/6F. Only 1 made it to freeze. Abnormal. Looking into options of DE, Fresh vs frozen.
    10/14 new local RE to look into what's next. CD3 FSH 4.7, AMH 0.9. Met with DE agencies and exploring options for feb/march 2015.
    Surprise natural bfp (4 days before donor is signed). Beta #1 at 9dpo: 51.8, 2nd beta: 195 (25 hours doubling) @11dpo. 3rd beta (12/15): 516 (35 hrs doubling) 4th beta(12/17): 895 (58 hours doubling) 5th beta(12/19): 2120. U/S at 5w0d(12/22): one gestational sac with yolk sac. U/S #2 (6w0d)12/29. One little bean measuring 6w0d with HR 124. 3rd u/s(1/4)7w0d: baby measuring 7w2d. HR 134. 3/30: A/S at MFM went great except for low lying placenta. Verifi results are normal! Team Blue! Please send any positive thoughts our way! EDD:8/24/2015
    Baby Will born 8/18. He's perfect.
  • I guess knowing that DE is the best option is the best place to start.  I completely get where you're coming from.  I hope the consults go well!  Let us know what they say :)
    ****************SIGGY WARNING****************

    image
    TTC since 2011
    DH: 29, Severe MFI; grade III varicocele; surgery postponed till KU
    Me: 30, POF/DOR, factor II hetero, MTHFR homo
    5 IVF's, LLP, EEP, MDLF all BFN
    IVF 6 using DEB USA frozen eggs
    developed bilateral PE's from BCP, cancelled/delayed 6 mths, taking lovenox
    Feb'15 SURPRISE 1st BFP ever! EDD: 10/10/15, FX
    Still have frozen donor eggs on ice
    All are welcome!
  • I completely agree with @Mrs.McIrish, "just look at like a fact gathering mission"  There is no harm is doing research until you feel comfortable.  I know for me, the more research I do the more comfortable I feel.  I also understand how you feel completely.  I don't think I'll ever be ready to give up on a biological child, even when I am in menopause, I know that sounds crazy but I feel like that has been stolen from me and I'll always desire it.  For me, I was dead set on no DE/OS but apparently a switch was flipped because I've suddenly been okay with it.  I honestly can't explain it and DH was very confused and still is as to why the change of heart.  I think that everyone changes in this journey and you never know what a new day may bring.

    P.S.  Do you mind if I stalk you?  I'm interested in learning more about RBA and Shady Grove too :)
    TTC #1 Since May 2011 ~ Everyone Welcome
    Me (34): DOR d/t chemo/radiation, Immature Endometrial Lining, Hypothyroidism
    DH (35): MFI d/t testicular torsion and removal, Low T, Oligospermia, Anti-Sperm Antibodies, Currently on T supplements
    Sept '11-April '13 ~  Testing, failed multiple MFI treatments, saving & TONS of praying
    January 2014 ~ IVF/ICSI & PGS ~ no response to stims ~ converted to IUI ~ BFN
    February 2014 ~ On to donor embyros ~ 5 blasts!!! 
    March 2014 ~ FET #1 ~ Transferred 2 blasts ~ BFN
    July 2014 ~ Kliman's mock cycle with endometrial function test
    Sample too small for EFT, HE slide showed immature cells
    New protocol planned, saving for another biopsy for EFT
    January 2015 ~ Considering adoption options
    April 2015 ~ Privately arranged adoption of planned pregnancy
    DD#1 ~ Lillyana Violet Marie born 6/15/16, Finalized adoption 12/20/16
    July 13, 2018 ~ BFP....WTF?!?!
    7/16 Beta #1 ~ 466...7/18 Beta #2 ~ 1,077...7/23 Beta #3 ~ 5,291
    7/23 US #1 ~ 1 gestational sac seen and yolk sac
    7/30 US #2 and 1st OB appt ~ 1 perfectly round gestational sac, 1 perfect yolk sac and 1 teeny tiny heart beat seen!!!
    Lilypie Maternity tickers


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