Thursday, March 11, 2010


It's necessary to take risks, and to follow certain paths whilst abandoning others. 
No one is able to choose without fear. 
Paulo Coelho 

After a lot of wrestling with a lot of things, Joe and I have decided that we're ready to cycle again. Of course we have to wait for my body to cooperate. As of last week I was still pushing positive betas and AF is no where in sight.

During our last IVF cycle at our current clinic a lot of things went right (namely I got knocked up), however there were a lot of things that were just…off. For the sake of cluing you in, here are some of the issues we had:

1. I wasn't always called with information regarding tests and such that were run that day. This was especially true after we found out I was pregnant but the betas weren't going well.

2. When we were told about our miscarriage we were brought into an office covered in pictures drawn by the NP's chidren which read "I love you Mommy", her screen saver on her laptop was a slideshow of her children. All of this was, to me, highly inappropriate for a fertility clinic. But I could have lived with that, what I wasn't okay with was being told that my pregnancy did not count, and that on paper I could never say that I had gotten pregnant. Something I later found out from the RE was not true.

3. I was never given the option of a D&C. A week after my ultrasound which confirmed my miscarriage I got an email with my chart notes from that appointment; in the notes the nurse told our RE that she had advised us of all of our options including a D&C. It was only after I told them at my WTF that I had called my OB/GYN about proceeding with the D&C that it became an option through the RE.

4. I was never given instructions for after my D&C, I didn't know when I could take a bath again, or make love to my husband again. To this day no one from my RE's office has called to follow up with me regarding this procedure.

5. My nurse, who has been my point of contact for nearly a year, never called me or contacted me after my miscarriage. The first time I spoke to her was when I literally ran into her at the office during my preop for my D&C. For what it's worth, she is also the IVF Coordinator.

That's a lot of negative, right? It's all in their approach to both patients and cycling. My current clinic runs like the Land of Oz and the RE operates from behind a sheet. No one has access to the great and powerful Oz. They are very clinical, straightforward and the less you know the faster they can work. This is what I've come to expect anyway.

The new clinic is a million times different. Even the way they look is different.

Current clinic - white walls, open seating area, broken coffee machine, two couches, if you meet with a doctor or clinical person for a face to face it is in an office with a desk that is a quasi cubicle.

New clinic - decorated with pottery barn furniture, holistic books all over the place, gorgeous facility (I thought I walked into a spa), Enya playing in the background, relaxation fountains, our meeting was held in a cozy little room with a deep sofa and leather chair.

It was like NIGHT AND DAY.

The new doctor and nurses took time to answer all.of.our.questions. We never felt rushed or unimportant and everyone reiterated over and over again how whatever we wanted they would do and how they are here for us. The new clinic has a support group that meets once a week (for free) that is open to all patients. They have a wellness facility on the second floor that offers acupuncture, massage, yoga and regular spa treatments. They gave us a book (free) to read so we can learn how to deal with infertility in our marriage. This in addition to a free spa treatment at their wellness center. And all of that was lovely.

But what blew my mind was that the person who handles billing there is a nurse. She discussed our insurance with us and realized that we are running out of money so she put a special billing code on today's appointment so it wouldn't count against our IF coverage. They want to do a repeat SHG to make sure my uterus is clear after my D&C and they will bill it as cystic ovaries so it too does not count against my policy (I spent over 40 hours in the last three weeks on the phone with the insurance company fighting incorrect billing codes submitted by the current RE's office).

After our meeting a nurse said she'd call me in a week to follow up and make sure we didn't have (or think up) any more questions. They listened to us and sympathized with us and let us have emotions but encouraged us to stay positive. I walked out of the building convinced I had started to shit puppies and rainbows.

If I had gone to this clinic before mine (or compared the two a year ago) I would have definitely gone here. So (and if you are still with me, thank you SO much for caring enough to keep reading) why wouldn't I switch then?

1.) my current clinic KNOWS me, they know my body, how I respond to meds. And they got me knocked up the first time. Maybe it was a fluke, but it's the only time I've EVER been pregnant before so that means something.

2.) the new clinic wants to change my protocol to antagonist (from long lupron) based on my response to meds in previous cycles. I'm afraid to shake things up even though this could be a better fit for me.

3.) This is the last cycle that will be covered under insurance and I don't know if I would feel less regretful if we stuck with our current clinic and didn't get pregnant or if we switched clinics and didn't pregnant (like will I always wonder what if I didn't switch?)

4.) and lastly, my current clinic is wiling to be aggressive in terms of the number of embryos that are put back at transfer. The current clinic seems much more conservative and even mentioned the idea of a single embryo transfer (something I am NOT okay with).

Yes, my current clinic is not very kind and gentle, they are not very human sometimes, but I know what I'm dealing with and I'm not afraid to be pushy this time. Then again this other clinic is everything that my clinic isn't, except they don't know me and I don't know if they can "help" me.

We want to cycle again in either March or April - depends on which clinic we go with. So I have somewhere between a week and a month to decide. And I have no idea what to do.

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