Does my clinic suck and I just don't know it? Advice about SF Bay area & CCRM

amyalbert

Hi all, 

I usually post on IF but wanted to get some advice from you ladies who have had success with IVF. I'm sorry that I can't seem to write anything shorter than an essay, but I'll do my best to keep it concise.

In a nutshell... I cycled at Stanford and just got a BFN on my first IVF cycle. I know that's not unusual, so I was planning on biting the bullet and jumping into another cycle October/November at Stanford with a slightly different protocol. But I have some concerns below (and curious about experiences at other Bay area clinics). I'm also convinced that I am not an easy case due to surgery on both ovaries, so I am seriously thinking about pulling out the big guns and cycling at CCRM. Anyone have thoughts? More gritty details below...

Stanford: https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=2344

First question is, what do you think of these stats? To me, this seems somewhere between average & fairly good -- at least when I compared it to other Bay area clinics. I'm not sure if I'm interpreting this right. Thoughts?

Second question is about something I read on Yelp (don't judge!) Someone wrote that the lab basically sucked and they have a "thaw survival rate of 50%, low cleavage and blast formation due to poor culture medium and outdated equipment". Where does someone get that info? Is it hidden in the SART data or are they pulling it out of their ass?

I wasn't too worried before I read that, although I did notice a few things. I'm not sure if they're a big deal or not. The lab is in the basement, whereas the very-basic exam/transfer rooms are on the 3rd floor. So the embryologist literally has to walk down the hallway and stairs/elevator. Is that a red flag when it comes to this ultra-sensitive stuff? Also, they don't monitor with blood tests throughout the stimming, only before trigger. I asked my RE (specifically about E2 monitoring) and he said that was more of an issue for women who might overstimulate, whereas for me the concern was not responding enough. 

Other Bay area clinics:

There are clinics with better stats, but one of them has the most hideous reviews online (Reproductive Science Center), while one of them has glowing reviews (Nova). Anyone used either and want to chime in? I'm on Nova's waiting list, but I think I've got 5 months left to wait. Was imagining I could use them for hypothetical Cycle 3.

Nova: https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=2045

But maybe I just break out the big guns and go to CCRM -- either now for Cycle 2 or for Cycle 3. Anyone has tips/thoughts about that? Their stats are amazing. Are they actually as good as they seem on paper?

You can see more info about my background in my siggy. But here's info about my IVF #1:

I was on Follistim 300, Menopur 150, stimmed for 10 days. I was hoping to get 8 mature eggs (based on ultrasound follicles) but they only retrieved 7 eggs, 5 of which were mature. 4 fertilized but only 2 fertilized normally. This isn't totally surprising since I had surgery on both ovaries last year to remove endometriomas, plus a crapload of endo.  After the BFN, my RE suggested we keep the same meds but do an Estrogen Priming Protocol rather than birth control pills (which he suspects my have over-suppressed my sad little ovaries). We are also likely adding ICSI to help rule out a sperm issue with my low fert rates. I'm quite sure that was due to my eggs since my DH gets glowing results, but still. 

You all are delightful humans for reading all this. Wish I had the skills to give you an awesome pic or gif. Will work on that!

kmc84

I'm sorry about your bfn

The no blood work stimming is a HUGE red flag to me! How in the world are they accurately dosing your stims without knowing what's going on in your body!? If that happened to me during my first IVF attempt I would have ended up in the hospital with severe OHSS.... It would have been really ugly... I do not respond as expected to stims and that makes me very nervous that aren't monitoring.

The lab being 3 floors away is strange, but I don't know how unusual it might be. My clinic has a super duper nifty shnazzy air purification system for the lab. They also make a big deal about no scents, lotions, deodorants, makeup or things of that nature on patients undergoing ER or ET and with staff working in the IVF area. So air quality is a big deal to them.

I'm sure someone else will chime in to, but I have to think with your history, it may be in your favor to try and get in at CCRM. I don't know if you are OOP, but if so, I would put my money with the best now rather then later.

amyalbert

Thanks for the quick reply @kmc84. 

Just to clarify about the bloodwork monitoring...  I asked my RE about monitoring E2 (only because I was reading on the IF forum that a lot of women seemed to know these values throughout). He said it was important for women who might overstimulate. But in my case, he knew I wasn't going to respond that strongly based on my AMH, my lap report, etc. I did go in every 2-3 days for ultrasound monitoring with him, so he could see the number of follicles. And I really didn't have very many. At the very end of monitoring, I had 8 decent sized (over 12mm) and 5 much smaller ones. 

Yes, I'm paying OOP for everything no matter where I go. I think there's a decent cost difference between CCRM and Stanford, though it's more about the convenience. DH & I can literally bike there without breaking a sweat, whereas I'm not sure how DH will be able to make it work with CCRM (so would love to hear from ppl how it works there for non-locals). I don't view Cycle 2 as the last chance for us, but of course I don't want to be wasting my time, energy, and money on a place if it's crappy. 

Thank you ladies for any advice!

BabyKsMommy

I think you need to get a different clinic. I don't feel like the one you are using has very good sart data. I also looked at all the Bay Area clinics before. I considered NOVA because their data seems to be promising. We didn't end up doing IVF but I would switch from where you are now.

I would look at cost for CC.RM compared to NO.VA and see which would be the best to move forward with.

I actually have Ka.iser and their sart data isn't bad. I don't know how far Fremont is to you or if you've looked into it but you might want to.

amyalbert

Thanks for the advice @BabyKsMommy. Kaiser does have good sart data -- not sure how I didn't see that before! It actually is higher than even Nova or RSC (which I thought were supposed to be the best locally). I'll definitely reach out to them. 

itsmevkb

I'm pretty far away from my IVF, however, I will say that my RE really stresses that a good lab is a huge component to success.  It's too bad all you have is the info from Yelp, but it sounds pretty specific to just be a random comment from someone who didn't have success.

As an aside, I've read a bunch lately about how clinics are having more success by doing the egg retrieval and then not doing the transfer right away but instead freezing the embryos and doing a FET either the next cycle or whenever the couple wants. 

Whatever you decide, I wish you the best of luck.

summererobinson

Is there any way you would be able to travel ? Shady grove is the best in the country. They will let you do lab test and stuff at your normal lab and onyl come in for the big stuff