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10.09.2007

Doctor, Doctor! Doctor, Doctor?

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)

11 comments:

In Search of Morning Sickness said...

Obviously this is you & your husband's decision, but I actually think switching is a REALLY good idea. From my experience and talking to other women, sometimes it REALLY helps to get a fresh set of ideas/doctors to look at your case. Esepcially since you spotted on the 1st cycle while on progesterone, I think that merits some looking into. Oh Baby just looks like a good clinic.

I've seen women do 2 IVFs at military clinics and not get pregnant and get a speech about needing "donor eggs." They then went civilian and got pregnant (this has happened to more than 1 on my message board). The military docs are great and have greta success rates, but they have a one-track way of approaching IVF meds/treatments/etc.

I think this is exciting and I pray for wisdom! And yes, you should get re-tested. The miltiary has ALL your & husband's tests expire in 6 to 12 months.

JJ said...

Best of luck making a decision--I am pondering some of the same things, so I will be interested to see what you decide!

Amy said...

Yay! An interactive vote!

I'm really digging this third column.

I don't have personal experience, but I'm glad to see you guys are looking into some alternative treatments to go along with the "traditional" ones. I really feel like there could be something there. I also think a fresh set of eyes could be beneficial. I am also praying for wisdom and discernment for you guys in this decision.

The Town Criers said...

Going to vote over on the side bar but wanted to add a "why": I think you should go with the third option because (1) they have the best live birth rate, (2) they are taking your ethical concerns seriously and (3) fresh eyes can sometimes mean solutions. So...

Tina said...

Hummm... I think the idea of switching to a new clinic could be a good decision - fresh/newer perspective on your issues could bring about better protocols.

However, it does seem like the two clinics you are looking at are rather newer (number of total cycles are MUCH lower than the original clinic). So, I would suggest researching the two newer clinics first (doctor backgounds to see what clinics they came from and their success rates, patient satisfaction, etc). You don't want to switch, only to find the statistics end up skewed because of the lower number of cycles right now.

You obviously are doing your homework - and, I think you will come to the best decision you can.

decemberbaby said...

Well... I always loved that my clinic was close enough to walk to, because that made showing up for monitoring just a little more palatable. But I like the way the staff at Oh Baby answered your ethical concerns. And their success rate looks good, too.

orodemniades said...

I had a 6 hour round trip drive to my clinic and had excellent treatment. I voted for Oh Baby because I suspect you'll have much better care there - as well as better chances!

e.d. said...

Hi, thank you so much for welcoming me to the world of blogging. I have been really encouraged by reading your posts! I am so thankful I have found some people who can relate to what I am going through. Thanks again!

BethH6703 said...

I personally like the stats about Oh Baby, so I'll be voting for them in the poll. But I do agree with Tina's comment about doing further research into the doctors at the 2 new clinics.

Whatever you decide, I'd recommend 2 things:
1) Get the full panel of testing done again. 2 years is a long time, and things can change.
2) If you're considering some alternative medicine thrown into the mix, then do some research on your ideas and make your own decision, rather than relying on your new doc's take on it. I know especially for chiropractic, there is still a huge gap between what "conventional medicine" feels and what chiropractors say.

Good luck in your decision, and with your future treatment!

GLouise said...

How long has "oh baby" been in business? It doesn't seem like they've done many cycles there, compared to Dr. Peppy. Perhaps their success rate could be scewed a bit due to the low # of cycles?

Definitely do a bio search through google on all the drs. at the new clinics to see what comes up.

That said, it is sometimes nice to get a fresh approach, and to feel confident that your wishes/ethical concerns will be respected.

T said...

I would typically go with the best stats, but I would try to find out more about the clinic (ivfc - chicago maybe?)- the best clinic in MA cherrypicks - which is why their stats are the best.

Oh and I hope you like your ob, mine knows nothing about reproductive endo - she gave me referrals to a couple of clinics, but has/had no hard knowledge.

Also - if you have a certain dx - high fsh, etc., find out which (if) doctor/clinic specializes in that specific diagnosis. That might help you make a decision as they'll have more insight into protocols that might better fit your profile.

I always think switching clinics is good - there's nothing like a fresh set of eyes (I've switched twice). A friend switched to my clinic and had her diabetes diagnosed within minutes of sitting across from her new RE.

Oh and finally - if you're going to do acupuncture (I'm high fsh and wouldn't do ivf without it, I probably wouldn't respond at all)make sure that your practioner specializes in IF - it really makes a difference (you could probably get a suggestion for an accu on ivfc too).

Let me know if I can help with anything. Good luck!