Second opinion at Cornell or CCRM?

[Anonymous]

Has anyone gotten a second opinion at Cornell or CCRM who could share how it worked? Could you do a virtual appointment initially, and could you send over your previous IVF records before hand and get their immediate thoughts on next steps (taking precious failures into account) during the first consultation meeting, or are my expectations too high? I have been a patient at SGF for awhile, but am very frustrated by their suggestion that we make no changes whatsoever to my protocol after my last failure, so am contemplating a second opinion. I am still on the fence about whether I am ready to leave SGF, due to their convenience and seemingly good lab, and am fully self paying so don’t want to have too many extra expensive appointments unless needed, but do think a second opinion may be warranted at this point. Any advice would be much appreciated, thanks!

[Anonymous]

I tried contacting CCRM for a second opinion appointment as a new patient and never heard back. This was about a month ago.

[Anonymous]

I did both, and was same boat as you (SGF patient). I have DOR though so challenging case and knew SGF wasn't right for me. Weighed Cornell vs CCRM, everyone in this area voted Cornell so iw ent there bc closer and easier. failed miserably so now i'm trying to get into CCRM lol (but lone tree, not NOVA).

For both, you can request a consultation and send your records in advance. Both Drs I met with (Davis at Cornell, and Surrey at CCRM) reviewed my records and discussed it with me during my consultation, as well as what their protocols would be. I had to pay for both consultations (cornell was $600 ish, CCRM 350?). Depending on your diagnosis, that could determine which one might be better suited for your needs but overall, usually CCRM Lone Tree is the mothership of all IVF in US. I wish I went to them first (bear in mind lots of people have failures there too, but for various reasons there's a resaon so many people travel there).

[Anonymous]

Thank you so much for this comprehensive and helpful reply - I really appreciate it!

[Anonymous]

I went to Cornell with Dr Davis after three miserable failures with SG. Cornell worked the first time for me so I recommend them but ymmv

[Anonymous]

I have experience with both places (assuming you are talking about CCRM Lone Tree, CO). At both, you will have a hard time switching once established with someone, so pick well.

I can guarantee you Schoolcraft at CCRM won’t look at your past records in detail.
It’s not worth his time. Then again, he universally counsels all women with two or more rounds of no PGT normals that they need donor eggs (as well as any woman 42 or older, regardless of treatment response). Place felt super corporate. He is known to be negative and his advice was not evidence-based (as a side, at 42+, I persisted w/ my own eggs). I succeeded at a smaller west coast academic setting without further testing embryos. This was after the second “opinion” at CCRM broke my spirit for no good reason.

Both CCRM in CO and Cornell are absolute factories. The ratio of embryologists to patients is really important to consider. Overall, I favor Cornell despite not succeeding there. If I could go back, I’d choose Dr Davis. I like “old school” RE’s who are evidence-based but also acknowledge the limitations of modern IVF “add-ons” …and who won’t use the same approach on straight forward patients for the sake of their own convenience.

[Anonymous]

I am the poster who did consults with both Cornell and CCRM LT. wanted to add, schoolcraft isn't accepting new patients. But there are lots of other great docs. CCRM is one of thr largest in the country so you will def not get a small clinic feel, I agree with the other poster. But, they were extremely buttoned up when I did my work up visit. I hear good things about NOVA too, but you're paying for Lone Trees lab, really.

Everyone here loves Dr Davis at Cornell and while he's a nice guy and wants success for everyone, I was actually disappointed with him. Not just because we didn't have success there, but because I felt their testing wasn't thorough (eg they never retested my AMH or FSH, I was recommended Dr Davis's go-to protocol... the one that even Dr Surrey at CCRM predicted Davis would do [they are friends]). It's the onLy place I've had a cancelled cycle, and the next cycle was a completely bust - in hindsight I should have advocated for myself and pushed for a different protocol other than his standard.

That said, a lot of people love Dr Davis - he just didn't work out for us. That's the challenge of this battle, finding the right doctor and clinic for YOU and your diagnosis - everyone is different and needs something suited for themselves. Good luck!

[Anonymous]

While my consultation with Schoolcraft left me really turned off (both as a patient and medical professional), I agree that their baseline work up ( they will make you repeat for $4K) was extraordinarily thorough and their lab extraordinary anal. I suspect this is rooted in their own risk aversion (they’ve been sued before for things like a donated egg carrying a cystic fibrosis gene), but it works out in patients’ favor.
Cornell (I was not with Davis at the time) assumed my miscarriages were all age-related without doing much of a workup and repeatedly used a protocol on the basis of, “We use this all the time.” CCRM uncovered a possible non age related factor.
However I liked that Davis doesn’t sound married to PGT testing and has a good track record with “older” AMA patients. You will find that there are generational differences in how reproductive endocrinology is practiced and that’s not a bad thing.

[Anonymous]

Just thought I’d chime in with Schoolcraft experience. He will not give you a protocol or anything like that, so it’s not worth it unless you are willing to go through with their extensive testing. He also started off suggesting donor eggs for me, which ehhh I was 33 with one early miscarriage from a fresh transfer and no other blasts from two IVF cycles. I pushed back though and pointed out my other results suggested something else was going on and he actually did agree and said I was like one of the few people he would actually not recommend donor for (even though he just did at the beginning of the call ….). So yeah he definitely just recommends donor to everyone. We ended up switching to SGF because it was March 2020 and we couldn’t travel. We ended up with 8 PGT A normal blast across 2 rounds with a different protocol. (Some miscarriages later, a live birth and some in the freezer). So yeah protocol and lab matter and honestly I don’t think you really know until you try. Good luck!

[Anonymous]

Anonymous wrote:Just thought I’d chime in with Schoolcraft experience. He will not give you a protocol or anything like that, so it’s not worth it unless you are willing to go through with their extensive testing. He also started off suggesting donor eggs for me, which ehhh I was 33 with one early miscarriage from a fresh transfer and no other blasts from two IVF cycles. I pushed back though and pointed out my other results suggested something else was going on and he actually did agree and said I was like one of the few people he would actually not recommend donor for (even though he just did at the beginning of the call ….). So yeah he definitely just recommends donor to everyone. We ended up switching to SGF because it was March 2020 and we couldn’t travel. We ended up with 8 PGT A normal blast across 2 rounds with a different protocol. (Some miscarriages later, a live birth and some in the freezer). So yeah protocol and lab matter and honestly I don’t think you really know until you try. Good luck!

Interesting. He also immediately knocked the Cornell lab as being inferior to his when we first spoke and suggested my outcome (with many blasts) was unusual, even for being 40+ at the time. He could be right that not all labs are equal in culturing blasts but I succeeded w/ fresh day 3’s after multiple rounds with tons of blasts. Some errors occur in vitro and culturing to blast hasn’t improved the live birth rate of IVF. CCRM subsists on PGT testing because it supports their stats when they find PGT normals via donated eggs or women who rapidly produce normals within the first 2 cycles. This is why, per their geneticist, they’ve adopted a stance of suggesting donor eggs to any and all women who can’t “find” normal embryos after two consecutive cycles. This is no way evidence based and I personally know women who cycled 5 times (3 with CCRM) to find a normal embryo or who like me just stopped testing.

PGT testing can require multiple needless cycles when potentially normal embryos are trashed based on sampling 5 cells from the future placenta alone. Schoolcraft has a huge chip on his shoulder and rivalry with RE’s who threaten his corporate model because they are outspoken about the limitations of PGT testing. For reference, Stanford has a trial called TAME determining the efficacy of non FDA approved testing modalities like PGT. When he learned that I’d completed a cycle with one of his arch nemeses after first consulting him about my early PGT results, he got butt-hurt and told me not to bother with my own eggs. I succeeded with an RE who encouraged me to keep cycling and who lectures prolifically about the limitations of testing.
There have been reviews by women in which they were told Schoolcraft would only take them on if they agreed to testing.
Just gross. I’m glad his panel is full and definitely recommend going with anyone else but him if still looking at CCRM.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Just thought I’d chime in with Schoolcraft experience. He will not give you a protocol or anything like that, so it’s not worth it unless you are willing to go through with their extensive testing. He also started off suggesting donor eggs for me, which ehhh I was 33 with one early miscarriage from a fresh transfer and no other blasts from two IVF cycles. I pushed back though and pointed out my other results suggested something else was going on and he actually did agree and said I was like one of the few people he would actually not recommend donor for (even though he just did at the beginning of the call ….). So yeah he definitely just recommends donor to everyone. We ended up switching to SGF because it was March 2020 and we couldn’t travel. We ended up with 8 PGT A normal blast across 2 rounds with a different protocol. (Some miscarriages later, a live birth and some in the freezer). So yeah protocol and lab matter and honestly I don’t think you really know until you try. Good luck!

Interesting. He also immediately knocked the Cornell lab as being inferior to his when we first spoke and suggested my outcome (with many blasts) was unusual, even for being 40+ at the time. He could be right that not all labs are equal in culturing blasts but I succeeded w/ fresh day 3’s after multiple rounds with tons of blasts. Some errors occur in vitro and culturing to blast hasn’t improved the live birth rate of IVF. CCRM subsists on PGT testing because it supports their stats when they find PGT normals via donated eggs or women who rapidly produce normals within the first 2 cycles. This is why, per their geneticist, they’ve adopted a stance of suggesting donor eggs to any and all women who can’t “find” normal embryos after two consecutive cycles. This is no way evidence based and I personally know women who cycled 5 times (3 with CCRM) to find a normal embryo or who like me just stopped testing.

PGT testing can require multiple needless cycles when potentially normal embryos are trashed based on sampling 5 cells from the future placenta alone. Schoolcraft has a huge chip on his shoulder and rivalry with RE’s who threaten his corporate model because they are outspoken about the limitations of PGT testing. For reference, Stanford has a trial called TAME determining the efficacy of non FDA approved testing modalities like PGT. When he learned that I’d completed a cycle with one of his arch nemeses after first consulting him about my early PGT results, he got butt-hurt and told me not to bother with my own eggs. I succeeded with an RE who encouraged me to keep cycling and who lectures prolifically about the limitations of testing.
There have been reviews by women in which they were told Schoolcraft would only take them on if they agreed to testing.
Just gross. I’m glad his panel is full and definitely recommend going with anyone else but him if still looking at CCRM.

Yes, this is a really good point about how much CCRM pushes their embryo testing (which is supposively so much better than PGT-A). I had forgotten about that. Also I totally agree about no testing if you aren’t getting blasts. I ended up getting a bunch so it made sense, but even so I wonder if it was worth the cost with everything that is coming out now.

[Anonymous]

CCRM is definitely all about their testing and have a reputation for that. I will say though, that at my workup they didn't push - they just said it's an option, and something a lot of patients opt out of for multiple reasons... so I never felt pressured to do it, which is what I expected. That said, some REs prob push it more than others!

And CCRM lone tree is the one with the fantastic lab, so I do agree that theirs is superior to pretty much anywhere else in the country. But this is prob most helpful for extreme cases who need every box checked and every last oomph to get them across the finish line; plenty of other clinics have amazing labs too, including SGF and Cornell.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just thought I’d chime in with Schoolcraft experience. He will not give you a protocol or anything like that, so it’s not worth it unless you are willing to go through with their extensive testing. He also started off suggesting donor eggs for me, which ehhh I was 33 with one early miscarriage from a fresh transfer and no other blasts from two IVF cycles. I pushed back though and pointed out my other results suggested something else was going on and he actually did agree and said I was like one of the few people he would actually not recommend donor for (even though he just did at the beginning of the call ….). So yeah he definitely just recommends donor to everyone. We ended up switching to SGF because it was March 2020 and we couldn’t travel. We ended up with 8 PGT A normal blast across 2 rounds with a different protocol. (Some miscarriages later, a live birth and some in the freezer). So yeah protocol and lab matter and honestly I don’t think you really know until you try. Good luck!

Interesting. He also immediately knocked the Cornell lab as being inferior to his when we first spoke and suggested my outcome (with many blasts) was unusual, even for being 40+ at the time. He could be right that not all labs are equal in culturing blasts but I succeeded w/ fresh day 3’s after multiple rounds with tons of blasts. Some errors occur in vitro and culturing to blast hasn’t improved the live birth rate of IVF. CCRM subsists on PGT testing because it supports their stats when they find PGT normals via donated eggs or women who rapidly produce normals within the first 2 cycles. This is why, per their geneticist, they’ve adopted a stance of suggesting donor eggs to any and all women who can’t “find” normal embryos after two consecutive cycles. This is no way evidence based and I personally know women who cycled 5 times (3 with CCRM) to find a normal embryo or who like me just stopped testing.

PGT testing can require multiple needless cycles when potentially normal embryos are trashed based on sampling 5 cells from the future placenta alone. Schoolcraft has a huge chip on his shoulder and rivalry with RE’s who threaten his corporate model because they are outspoken about the limitations of PGT testing. For reference, Stanford has a trial called TAME determining the efficacy of non FDA approved testing modalities like PGT. When he learned that I’d completed a cycle with one of his arch nemeses after first consulting him about my early PGT results, he got butt-hurt and told me not to bother with my own eggs. I succeeded with an RE who encouraged me to keep cycling and who lectures prolifically about the limitations of testing.
There have been reviews by women in which they were told Schoolcraft would only take them on if they agreed to testing.
Just gross. I’m glad his panel is full and definitely recommend going with anyone else but him if still looking at CCRM.

Yes, this is a really good point about how much CCRM pushes their embryo testing (which is supposively so much better than PGT-A). I had forgotten about that. Also I totally agree about no testing if you aren’t getting blasts. I ended up getting a bunch so it made sense, but even so I wonder if it was worth the cost with everything that is coming out now.

I was perhaps an oddball case of a woman over 40 who was able to produce tons of blasts but each batch of 6-10 per cycle kept resulting 100% “abnormal.”
Not just abnormal, but 3+ errors in each (complex). I had a hard time convincing most RE’s to transfer day 3 embryos because it’s virtually considered antiquated when you an produce blasts. I’m grateful to have found an “old school” RE who believes in trying different protocols, believes in transferring day 3’s even for older blast producers, and isn’t married to testing. I adore the old dudes of reproductive endocrinology.

Schoolcraft who is neither an old dude or youngster of the field, doesn’t believe protocol has any impact based I think on internal data. He also first shunned Cornell for his perception that they were doing tons of day 3 transfers “until recently” (untrue), while his lab is light years ahead. Again, his lab is probably awesome for some tough cases but the old way of doing things (in Schoolcraft’s words, “going back to the 1970s”) is what worked even for a prolific but older blast producer like me. I think this is in part because 80-90% of eggs are aneuploid in the early 40s and sometimes “high load” day 3 transfers are what works despite current blast inclined IVF culture. The data show that in older women, most untested day 3 embryos won’t even implant so it’s not a huge higher order multiples risk. My MD at Cornell cited a statistic that at 41, my odds of no-normals per batch with the number of blasts I had was like 1 in 5 (sadly not true). I think this is why Schoolcraft first suggested it could be Cornell’s lab, but later decided it was my crappy eggs. There is so much disagreement in the field and so much they still don’t know about the biology of human embryos.

Getting second and even third opinions in a field with an unchanged efficacy (live births) despite perceived advances and with so much yet to discovered is an absolute MUST.

[Anonymous]

I got a second opinion from (and switched to) CCRM after various failed cycles with SGF (and SGF's position that my protocol didn't need to be changed, despite numerous unsuccessful ERs). I had a consult with Dr. Payson (virtually) while I was getting ready to do another ER with SGF, and, when that failed to produce any PGT normal blasts, I switched to CCRM (and got pregnant with a PGT normal blast after my first ER at CCRM). I will never know it was just luck or something CCRM did differently (one additional drug; different lab; etc.) but I was glad I switched.

Good luck!

[Anonymous]

Dr Reichman at Cornell is wonderful.