On Thursday, I have an appointment with my new OB-GYN. (Remember that insurance change I mentioned before?) The appointment will be a consultation to discuss renewing my referral to an infertility specialist. I've been doing a lot of research to prepare for this appointment, because we're thinking about making some changes before we pursue our last two insurance-covered IVF cycles. We're considering adding a little alternative medicine into the mix - maybe acupuncture, maybe chiropractic care, maybe professional massage, or maybe some combination. I've been educating myself on those options, and I plan to ask the new doctor what his opinion is of the effectiveness of those things in conjunction with ART (assisted reproductive technologies). We're also strongly considering asking for a referral to a different fertility center. Initially, I really wanted to stick with Dr. Peppy and the folks at her network of clinics; despite the insurance changes, I wanted the comfort of the familiar. But this post about the importance of comparing success rates at local clinics spurred me to do a little research. I had looked at the SART reports for Dr. Peppy et al before, and they seemed pretty decent. With my new-found motivation, I looked at the reports again and this time compared them with other nearby clinics. I found three other clinics here in the western suburbs of Chicago with better success rates! I called all three to ask two main questions: (1) do you take our insurance? (2) are you willing to work within our Christian ethical constraints (fertilizing only a few eggs, transferring all viable embryos, freezing/discarding none)? Only one did not work with our insurance, and the two remaining both said they'd accommodate our beliefs. At my consultation on Thursday, I plan to ask the new OB-GYN what he knows about these clinics and their doctors, to find out which is best in his opinion. We'll get a new referral from there. Here's the break-down of the options (using 2005 data, the most recent available):
Dr. Peppy et al
Total cycles: 2,270
Number of cycles* for patients <35: 802
Percentage of transfers resulting in live births (<35): 36%
Proven in the past to be willing to work with our ethical concerns, albeit somewhat grudgingly.
The Fertility Institute at Posh Hospital
Total cycles: 535
Number of cycles (<35): 160
Percentage of transfers resulting in live births (<35): 47.8%
Said they would definitely work with our ethical concerns
Oh Baby Fertility Center
Total cycles: 158
Number of cycles (<35): 58
Percentage of transfers resulting in live births (<35): 55.3%
When I explained that we were Christians and detailed our ethical concerns, the staff person enthusiastically said they would work with us and went on to say that they can, to avoid putting any "life" (her word!) in danger, freeze unfertilized eggs to be thawed and fertilized for later cycles.
What do you think? On one hand, it would be nice to stick with a clinic that already knows me; on the other hand, it might be beneficial to get fresh eyes on our treatment. Changing practices could cause some delays if we needed to redo diagnostic tests, but maybe we ought to have those tests redone anyway since it has been almost two years since we did them. I like how much experience Dr. Peppy's group have (they have done so many cycles!), but their success rates are lower. Posh Hospital seems like a good middle ground, with a significant number of total cycles and higher success rates. Oh Baby hasn't done that many cycles, comparatively, but they have a fabulous success rate and I really liked the response I got to my questions. Then there's the factor of location; it's not a big deal most of the time, but something conveniently nearby is significant during the spate of daily appointments. Dr. Peppy's office is a 20 minute drive, but retrieval and transfer must be done in downtown Chicago (one-and-a-half hour drive). Posh Hospital is so close I could bike there (though that's probably not advisable with loaded ovaries!), and all monitoring, retrieval, and transfer are done at the same site. Oh Baby is probably 20-25 minutes away. So, leave your thoughts in the comments, and then - are you ready for this interactivity?! - cast a vote on the poll in the sidebar to the right. We won't necessarily go with the poll winner, but I'm curious to get input from all of you.
*cycles = IVF done with fresh embryos (not frozen) using the patient's own eggs (not donor)