Need second opinion and don't know which clinic to turn to next....

[Anonymous]

OP I think you should at least talk to Dr gordon at DF, he'll give you some straight answers and tell you if you would be better off at Cornell or St Barnabas.

[Anonymous]

NP here - Yes, people really go to Colorado (and NYC and elsewhere) to cycle, including myself. There are some really good clinics in D.C., but none that are extremely cutting edge.

Given that you're fairly young, I'd recommend a number of consults before making any decisions. This is my list:

1) Dr. Gordon at Dominion - will handhold, their lab is the best in town, IMO, and he is local so an easy consult.
2) Dr. Tortoriello at SIRM in NYC. Cutting edge - will look at immune issues, which D.C. docs don't do, and they do the similar PGD (genetic testing) as CCRM. I believe he will do a phone consult.
3) Cornell - They don't deal with immune issues or do much genetic testing, but are the only clinic in the U.S. that does co-culturing (using your tissues to culture the embryos). Should be worth a consideration, even if you have to take the train up to NYC.
4) Possibly GW - If you want someone else local. They seem to do protocols a bit differently from the other clinics, so may be worth a listen.

I'm not sure SG would offer you anything new, and at this point if I were you I would not go to someone who isn't considered a big gun.

[Anonymous]

Considering that you can only transfer one embryo at a time, have you considered doing natural cycle IVF? Dominion does it, and it's a lot cheaper than a stimulated approach. $4400 ($4900 if you need artificial hatching). No drugs, and articles have shown that there is a greater likelihood that an embryo will implant in an environment that has not been affected by stims.

[Anonymous]

I'm the PP who had success at Cornell. One downside of Cornell (esp for you) is that they have very strict freezing criteria and a lot (I forget the stats) of their patients have nothing to freeze. So if you can only transfer one embryo, that is something to be aware of.

You could also try NYU (Dr Grifo) - I don't know much about them but he is very aggressive (for better or worse).

[Anonymous]

Another consideration if you are transfering one is whether the clinic uses vitrification for freezing. Thaw rates are supposed to be much better with it. SG and GIVF use it locally - not sure who else does. Cornell does not use it - surprisingly! SIRM does. CCRM does.

I would not discount doing a consult at SG despite what PP said. Cover your bases. They do have an excellent lab. Some docs are better than others. Dr. Greenhouse in VA is very good and very approachable. I would definitely consider out of town consults as well. As good as some of the clinics are locally, they are not one-size-fits all and some women succeed elsewhere.

[Anonymous]

For the previous poster: I thought Dr. Widra's protocols were similar to Cornell's. What changed after you switched to Cornell?

[Anonymous]

Dominion uses vitrification for freezing.

[Anonymous]

PP here who suggested St. B's. St. B's is St. Barnabus in Shorthills, NJ. It is close to NYC but you don't have to deal with all of the traffic getting in to the city like Cornell. I would schedule appointments for mid-day and could drive up and back the same day. There is a Hyatt (if I remember correctly) that is not too expensive if/when you need to spend the night as well as a fabulous mall to help pass the time. St. B's tries to make it as easy as possible for you - -like I said earlier, I did much of the local monitoring here in DC and only went up there for certain diagnostic tests (they wanted to do the HSG personally for example). Any ultrasounds close to retrieval they wanted to do as well as the actual retrieval itself -- so you would need to be there a few days for that. We ended up doing everything inside of one calendar year and kept track of all of our expenses and deducted them from our taxes -- hotel, food, gas, car depreciation as well as medical bills can be deducted if they exceed a certain percentage of your AGI (check with your accountant, I may have mangled that). We were lucky that blood draws, ultrasounds and medicines were covered by our insurance so our out-of-pocket was lower than it could have been.

As far as what they did differently that made them worth it, they tweaked our protocol in subtle ways and added a low dose of a steroid and an antibiotic to my meds. They did assisted hatching and co-culture as well. At the end of the day St. B's lab was only satisfied with two embies which sounded devastating at the time but it was because their standards are so high for what constitutes an embie that will implant. Those two embies they they approved for transfer for me are now thriving in elementary school.

If you even think it is possible that you would like to consult with them make an appointment now because it takes a while to get in for even a consult. You can always cancel.

Good luck and feel free to post more questions if you wish.

[Anonymous]

PP again. Here is the CDC's ART success rates report, you can look up and compare the labs of all the clinics we are all recommending to you based on your individual criteria (age, fresh or frozen, donor eggs, etc). HTH.

[Anonymous]

Forgot the link:

http://www.cdc.gov/art/ART2007/index.htm

[Anonymous]

Here is St. B's most recent stats (2007):

http://apps.nccd.cdc.gov/art/FertilityClinicReport.aspx

Half of its fresh transfers result in live births while 1/4 of its frozen transfers result in live births. And these are for a lot of women who use this clinic as a clinic of last resort, like me.

[Anonymous]

I failed 3 IVF cycles at local clinics (VCRM and DF) and went to Sher in NJ. Success on first try. Agree with previous posters, going out of state may be your best shot. Especially if money is running out. Then at least you know you went to the best.

[Anonymous]

SART is the official reporting organization for IVF stats. See attached link:

http://www.sart.org/find_frm.html#

It appears that St. B's stats are not as high as PP mentions. Definitely look at clinic stats for your age group and diagnosis, as those stats are the ones that are most relevant.

[Anonymous]

Sadly, I've been on fertility boards for many years, and did lots of research about the best clinics. I've heard of St B's, but it's certainly not one of the top 10 or so clinics in the country. I'd do some more research before taking PP's word on this one.

[Anonymous]

Anonymous wrote:Sadly, I've been on fertility boards for many years, and did lots of research about the best clinics. I've heard of St B's, but it's certainly not one of the top 10 or so clinics in the country. I'd do some more research before taking PP's word on this one.

What would you consider the top ten then?