Wednesday, February 4, 2009

Second opinion

We have a phone consult tonight with a clinic in Colorado to get a second look at our case.

Part of me wonders why we're going this route, because we're at an undisputably great clinic in NYC and I really don't have doubts about the care I've received here. I feel a little guilty getting another opinion, like it means we don't trust our RE or like we're cheating on him a little bit. But I'm hoping he would understand the desperation and anxiety we are beginning to feel. After all, we've been at IVF for over a year and a half with no baby to show for it. We also have only one more IVF left before we're out of insurance coverage (I do realize we've been very fortunate to have this much coverage in the first place).

When our NYC clinic couldn't fit me in last month for the endometrial co-culture, I started to panic. Within a few days, I'd requested my records and lined up this phone consult. This clinic in Colorado is supposed to be the best clinic in the country. We're currently receiving care at what is probably number 2. Is there a difference between the two clnics in outcome? Hard to say. But a fresh pair of eyes never hurts.

So the plan is to stay at our NYC clinic at least for IVF #4 and then see where to go from there. It feels a little weird to be going in to our next IVF cycle already preparing for #5, but that's where we're at. I am hopeful that #4 will result in a live baby but am also trying to be realistic and come up with a plan B (and also begin considering plan C - adoption/donor egg).

This is so different than where we were at emotionally when we started. We went into this IVF business excited and eager, disappointed that this was an expensive and stressful way to have a child, but really believing and expecting we would come out of this with a baby after 1 or 2 IVFs.

Those expectations have not proven to be true and we're left trying to come to terms with where things are at, to try to make sure we leave no stone unturned before we call it a day.

Tonight's talk is part of the process of looking under every stone, I suppose. Making sure we're not missing something that we should be considering while we still have the time and the financial and emotional resources to do something different. We'll see what they have to say.

Have any of you sought second opinions from another clinic? What questions should we be sure to ask?

Mo

16 comments:

  1. I hope everything goes well on the call tonight!

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  2. We switched clinics after IVF #1 and FET #1 failed. We went in for just a talk and had such a better feel for the new clinic. For what it is worth, the old clinic was Duke and the new was NCCRM. New doc talked about how to change the cycle, what the old clinic could have done better/more aggressively, etc. We just walked away convinced that a fresh set of eyes was the right move. Plus, new clinic picked up on (and treated) an autoimmune issue that old clinic glossed over - telling me it was no big deal. Given that you are comparing the top clinics in the country, I'm not offering much help, other than to say we just had a feeling, after the consult, that the new clinic would succeed. Plus, their stats were higher.

    Good luck tonight! I hope you come away with some good answers or next steps. And maybe a really good feeling one way or the other.

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  3. Good luck tonight! Don't feel bad about getting a second opinion.

    It's difficult to really think of IVF clinics as a service business because it's such a personal experience to patients, but ultimately, it is a business. If they can't provide for you, you shouldn't feel bad in looking to see if some other clinic can. In addition, your current RE may in fact know his/her own limitations and the limitations of the clinic, and might even (secretly, of course) think that you'd get better care elsewhere.

    Mo, as you've written, only you can decide if/when you and Will are ready to consider other options, but don't let the possibility of switching clinics get in your way!

    ~Jeremy

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  4. I believe very strongly in getting second opinions. A fresh pair of eyes could see what the others have been missing!

    My experience with the phone consult at CCRM (and also from what I read on IVFC), was that a) Dr Sch (if that's who your consult is with) MAY call a little earlier than your scheduled time. b) He may have all your records, but he may not know everything you've gone through on the top of his mind, so be prepared to tell him your experiences - cycle by cycle.

    We had asked him if we were missing anything in terms of diagnosis, or treatment. Were there any further tests that he felt we needed to get done? Was there anything he'd do differently? Did we stand a chance at all?

    It's our health, and it's in our best interest to get all the answers we need. I would be much happier going into IVF#4, knowing that I had a backup plan ready.

    Good luck! Can't wait to hear how your consult goes!

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  5. I did the same thing after my second IVF...requested my records (felt like a traitor).. and set up calls with CCRM and Cornell. I ended up staying with my existing clinic because I had "that" feeling, the one you can't put in words, but just guides you to the best decision for you. You're smart to do this though and I'm anxious to hear what's said.

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  6. I've worked with 2 clinics, but mainly b/c we got into a study last spring and had to switch. I can see positives and negatives for each. They are both highly respected. The one I use now is super huge, people come from all over. Great success rates.
    When there, it can feel a bit factory like. But, it really comes down to the nurse and RE, and I like them both a lot. I agree with Mermaid, it will probably be a feeling, one way or another.
    Good luck!

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  7. I know how hard this is - I did a phone consult with CCRM and it actually helped reaffirm staying with my local clinic since they would both try a similar protocol. I felt like I was betraying my clinic too, etc. etc. but I would get a second opinion if I had any other serious medical issue going on - why did I feel so weird about getting a second opinion for the most critical part of my life? New eyes, new opinions are critical and I think it can only help.

    I am looking forward to what CCRM has to say. I outlined my call with them on my blog if you are interested in comparing notes.

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  8. My husband and I just finished IVF #2 and it also resulted in a BFN!!!! Maybe we need to try more aggressively...I just don't know! Good luck!

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  9. I understand the traitor feeling. It is so hard to be objective. I have such a love/hate relationship with my clinic, if this cycle doesn't work I will definately seek a second opinion. I think a second opinion is better than second guessing later.

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  10. I'm glad you're getting a second opinion. You're entitled to hear another clinic's protocols and beliefs as to how best to get you what you want. Even if all the second opinion does is reaffirm that you're in the right place right now, it's worthwhile.

    Besides, a trip to Colorado is never a bad thing, eh?

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  11. Hello-
    This is the first time I have visited your blog. Getting a second opinion was the best thing me and my husband did. Even if it doesn't change anything, you can say you heard another perspective.

    I am reaching out to my fellow bloggers to talk about my new non profit Parenthood for Me.org. I am an adoptive mom who underwent IF for 4 years. Our mission is to provide financial and emotional support to those starting families through adoption or medical intervention. Please visit our website and blog http://parenthoodforme.blogspot.com. We are trying to raise awareness and build up the endowement so that we can begin to help people start their families.
    Thank you,
    Erica Schlaefer

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  12. I had consults at both your big NYC clinic and CCRM. The CCRM medical director pushed me toward DE because it was IVF 5 and I had a m/c and didn't care that my m/c was a normal karyotyped male. NYC clinic didn't even mention it. I waited the extra time for co-culture and was VERY frustrated. I also didn't think much of the coordinator for coculture. It was the only cycle I got an 8 cell embryo out of 6 IVFs. Unfortunately only a chem pg that time. I hope it goes well for you and is worth the wait. The NYC clinic is at least as good as CCRM. That survey with the ranking is from 2005 or something. My big beef with NYC clinic is that it feels like a factory. Best of luck to you.

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  13. I'm glad you are getting a second opinion. Every doctor will tell you something a little different. It's like taking your car to a mechanic - each one will tell you something different, but you learn something new along the way. I hope you got to ask all the questions you wanted to!

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  14. Absolutely don't feel guilty about a 2nd opinion. I'm at the best IF clinic in South Africa and my doctor told me to feel free to get a second opinion if I wanted to reassure myself (of course I didn't)

    At the very least you'll feel more confident in what they are doing for you.

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  15. hello Mo and Will:

    I've appreciated reading your blog-- hope your CCRM consultation went well. I'm feeling adrift, as well, and in need of some fertility-focused support, but not sure where to turn. Blogs seem to be the best source of inspiration/hope at this point! I'd be happy to tell you more about our situation-- which does not compare to the trials you have been through-- but would rather do it via email. If interested (and I understand if not), my email is flowermahon -AT- gmail. I've been through cancer, as well, but a mild variety-- and now in mid-30s, no kids, embarking on cycle 3 (fet#2).

    Anyway: looking forward to hearing about CCRM on your blog, at least. Hope it was promising!

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  16. I am also glad you are getting a second opinion. I find myself planning for the worst as well and CCRM is on my list for if/when this FET fails. Just like you said, no stone unturned!
    GL! I can't wait to hear his thoughts!

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