Choosing an RE/fertility center

Kershnic · May 2011

What would you look for? What questions would you ask?

(Bonus points if anyone has any input on NYC doctors/clinics)

cookiemonster03 · June 2011

I asked the local board for recs. Worked out fab, I love our doc and two of my IRL friends are moving to his practice. Are you in NYC itself? There's a couple of folks on multiples and IF that are in NY and could probably give recs.ETA: I would ask about protocol for natual cycles to start, and try to get a feel for how they move forward with issues. I also want to be seen by a doc for most monitoring (I know sometimes scheduling issues come up), and you should ask how weekend monitoring works. And if they use triggers or OPK. I can't spend 500/mo on sperm without knowing exactly when ovulation is happening!

ctbride08 · June 2011

ditto cookie. ask for recs then check on their stats (live birth rate per transfer is the most reliable statistic to "grade" a clinic). You may also want to go to a couple info sessions at different places (if they are free) so you can get a feel for the differences and their importance to you. Some places will be small with just a few docs and you will see your doctor every time you have an appointment, others will be large and you see someone new each time you go in.

There are pros and cons to all the differences. For example, we ended up at a huge research hospital with 12 REs, a bunch of residents, and a gaggle of nurses. Not exactly intimate....but they are one of the highest ranked fertility centers in the country and had more reasonable prices than the smaller places.

Two*True · June 2011

Just my two cents but you might want to start with your insurance. Find out what they cover and where. They may have a specific doctor they want you to go to.

ctbride08 · June 2011

Two*True:

Just my two cents but you might want to start with your insurance. Find out what they cover and where. They may have a specific doctor they want you to go to.

oh right. i always forget that some people have insurace coverage for this stuff Stick out tongue

definitely do what two says!

Kershnic · June 2011

cookiemonster03:
I asked the local board for recs. Worked out fab, I love our doc and two of my IRL friends are moving to his practice. Are you in NYC itself? There's a couple of folks on multiples and IF that are in NY and could probably give recs.ETA: I would ask about protocol for natual cycles to start, and try to get a feel for how they move forward with issues. I also want to be seen by a doc for most monitoring (I know sometimes scheduling issues come up), and you should ask how weekend monitoring works. And if they use triggers or OPK. I can't spend 500/mo on sperm without knowing exactly when ovulation is happening!

I can't believe I didn't think of the local board, haha. We've been focused on moving (kind of in a holding pattern with that, but moving forward with research here) and NYC parents can be a little overwhelming... But I will definitely hop over there. We don't live in the city, but would like a clinic in the city (more convenient for work days). Thanks for the tips! We don't really want to do natural cycles due to some concern about anovulation, and $700/pop sperm. Sigh.

Kershnic · June 2011

ctbride08:
ditto cookie. ask for recs then check on their stats (live birth rate per transfer is the most reliable statistic to "grade" a clinic). You may also want to go to a couple info sessions at different places (if they are free) so you can get a feel for the differences and their importance to you. Some places will be small with just a few docs and you will see your doctor every time you have an appointment, others will be large and you see someone new each time you go in.
There are pros and cons to all the differences. For example, we ended up at a huge research hospital with 12 REs, a bunch of residents, and a gaggle of nurses. Not exactly intimate....but they are one of the highest ranked fertility centers in the country and had more reasonable prices than the smaller places.

Thanks. We're actually going to an info session at a "baby factory" type place tonight, which is why I asked. I am inclined to go with a big center (there seem to be several of them here) because this is all they do, so they must be good at it... But DW and I are both fearful of the baby factory/your body is not your own/mostly male staff atmosphere. We googled the heck out of several places and then I told DW we should just choose based on location because they're all the same. :P

Kershnic · June 2011

Two*True:
Just my two cents but you might want to start with your insurance. Find out what they cover and where. They may have a specific doctor they want you to go to.

Ah insurance. "12 months of unprotected heterosexual sex." But all of the major clinics I'm looking at right now list my insurance, so I harbor secret (desperate) hope that thhey will cover something.

2brides · June 2011

We also went with the convenience factor with a good reputation. It was a large practice, but given that I was going multiple times a month for several months it made it easier to be near work. I wasn't looking to be friends with any one doc, I just wanted someone to get me knocked up. :P The one person you should be friends with is the finance/insurance person. Even if your insurance doesn't cover infertility treatments (like mine) they are sometimes able to code blood work and ultrasounds so they are covered. Good luck!

Two*True · June 2011

Kershnic:
Two*True:
Just my two cents but you might want to start with your insurance. Find out what they cover and where. They may have a specific doctor they want you to go to.

Ah insurance. "12 months of unprotected heterosexual sex." But all of the major clinics I'm looking at right now list my insurance, so I harbor secret (desperate) hope that thhey will cover something.

The clinic/doc you choose should have his/her financial counselor sit down and talk with you and DW. At our clinic, while we were meeting with the doctor, the financial counselor was talking to our insurance. She then came in and explained in detail exactly what they would and would not cover. And like 2brides said, offices can often code things in ways that get the procedures covered.

c&m0726 · June 2011

I did mine in Long Island. My insurance actually covered everything but the sperm.... I did and IUI w/ clomid. My dr's were great it did take 2 cycles but paid off.

cookiemonster03 · June 2011

our clinic marked us as "infertility unspecified" immediately (they do a lot of same-sex couples and were AMAZING at handling the insurance. I'm nervous for future though b/c we're on a different plan now (new job) and I've heard this company is not so easy to get coverage through). anyway, a lot of clinics do early morning hours - we had 7 am appts pretty much every time for monitoring, and I know the RMA in NJ opens at 6 or 630. Just a thought, since you might end up popping over on the weekend too and who wants to go to NYC for no reason? (I guess with a train pass its not a big deal, but I went to 95% of C's appts, and if I were to get a doc in the city while we live in NJ (I work in NYC now) she wouldn't be coming, cost and travel time and all you know? not that this is really a deal breaker since monitoring appointments aren't terribly exciting.)

anyway, fwiw, I did do a natural cycle since I ovulate normally (had a nice big follie too) and we did have it monitored (I went in on CD 3 and I think 13) and triggered for the IUI. It didn't work and we switched sperm at that point, but unless you know you need meds, don't rule out trying a natural one first even with the RE and good monitoring! That said, if you are concerned about anovulation, most docs will let you do a small dose of Clomid to start. I'm so glad we did with C because it didn't work at all, and effectively saved us a month.

cookiemonster03 · June 2011

Kershnic:
Two*True:
Just my two cents but you might want to start with your insurance. Find out what they cover and where. They may have a specific doctor they want you to go to.

Ah insurance. "12 months of unprotected heterosexual sex." But all of the major clinics I'm looking at right now list my insurance, so I harbor secret (desperate) hope that thhey will cover something.

if you're with Aetna, ask them to submit claims anyway. One of my friends had this issue (this is the issue I'm afraid of as this is my new insurance, referenced just a min ago), and in her third month of trying, Aetna randomly decided she actually was infertile, and PAID THEM BACK for their OOP expenses they'd submitted!

Kershnic · June 2011

My insurance is Oxford. I guess we wait and see... We're checking out Columbia, RMA, NYU, and I believe Cornell has one...and a few others that I found randomly. I have read the most about RMA and Columbia, and have read/heard that both of their financial counselors are good. We buy unlimited bus passes, so coming to the city on the weekend is easier than driving somewhere before work. Thank you so much for your thoughts though! I wonder how close we live/work to each other! If you ever want to meet up...

c&m0726 · June 2011

Kershnic:
My insurance is Oxford. I guess we wait and see... We're checking out Columbia, RMA, NYU, and I believe Cornell has one...and a few others that I found randomly. I have read the most about RMA and Columbia, and have read/heard that both of their financial counselors are good. We buy unlimited bus passes, so coming to the city on the weekend is easier than driving somewhere before work. Thank you so much for your thoughts though! I wonder how close we live/work to each other! If you ever want to meet up...

OMG I have Oxford and they covered EVERYTHING

Kershnic · June 2011

c&m0726:
Kershnic:
My insurance is Oxford. I guess we wait and see... We're checking out Columbia, RMA, NYU, and I believe Cornell has one...and a few others that I found randomly. I have read the most about RMA and Columbia, and have read/heard that both of their financial counselors are good. We buy unlimited bus passes, so coming to the city on the weekend is easier than driving somewhere before work. Thank you so much for your thoughts though! I wonder how close we live/work to each other! If you ever want to meet up...

OMG I have Oxford and they covered EVERYTHING

I pray so hard this happens for us...but it doesn't jive with the whole "12 months unprotected heterosexual sex" thing....

cookiemonster03 · June 2011

Kershnic:
c&m0726:
Kershnic:
My insurance is Oxford. I guess we wait and see... We're checking out Columbia, RMA, NYU, and I believe Cornell has one...and a few others that I found randomly. I have read the most about RMA and Columbia, and have read/heard that both of their financial counselors are good. We buy unlimited bus passes, so coming to the city on the weekend is easier than driving somewhere before work. Thank you so much for your thoughts though! I wonder how close we live/work to each other! If you ever want to meet up...

OMG I have Oxford and they covered EVERYTHING

I pray so hard this happens for us...but it doesn't jive with the whole "12 months unprotected heterosexual sex" thing....

i always wonder how this is substantiated. i mean its not like you can PROVE it one way or another....

we're in the process of moving from PA and are staying near exit 153, if that means anything to you Stick out tongue

raven0855 · June 2011

I live up in Albany but was a part of a clinical trial at New Hope on Park Ave. It was a crazy and hectic place. Not sure how I would have felt about it if I were a paying patient. It wasnt a bad place just a busy one. I love the CNY but its up here in Albany. They are wonderful and very reasonable as far as paying out of pocket....our insurance only covered ultrasounds and blood work. Oh and they dx us with "male factor infertiity".

Kershnic · June 2011

raven0855:
Oh and they dx us with "male factor infertiity".

Haha, I find this really funny.

Choosing an RE/fertility center

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