SART Data -SG vs Columbia

[Anonymous]

When comparing SG to CFA, SG is the clear winner. But after multiple failed cycles and the same protocol, I really feel like I need a new clinic.

I met with Dr. Abassi and right off the bat she said she wouldn't be using the same protocol I was on at SG and would explore all my baseline immune numbers. I am nervous to leave SG given their success rates in general, but I don't know how many more cycles it would be worth doing there if nothing changes. It seems it is a numbers game there- keep doing IVF and eventually something will stick.

Our original diagnoses was MFI and so we lack high quality embryos, but in the last year I have had two miscarriages from cycles and two BFNs from cycles. I am 37 and have Hashi's. Where else should I be looking?

If you left SG, where did you go, why and did you have more success?

[Anonymous]

I left SG for GWU, but had less successful results. Considering returning to SG, as much as I dislike them.

[Anonymous]

I kind of left SG and got better results. What happened was that after 3 cycles in the shared risk program I moved out of DC. In my new city(overseas) i decided to try out a local clinic, and it worked! They changed the protocol and I was pregnant twice with them, but miscarried both times. I never dropped out of the shared risk program though, because like the PP said, as much as SG really frustrated and disappointed me, I'll go back to the shared risk program if I have to. Plus I'll be able to go back with a record of success so I think my doctor would be willing to tweak the protocol at SG based on that alone.

PS--I actually did my first cycle at CFA, but not with Abbasi. There are pros and cons to any place. One of the up sides to SG and downsides to CFA is that at CFA your nurse won't be as organized, won't share a lot of detail unless you ask, and the routine is not as well managed. So on the callbacks my nurse at CFA would often just say 'everything is fine' and hangup quickly rather than telling me my actual E2 lab results. Or, on my cycle at CFA, which was my first, I never received a calendar so I didn't have a great sense of what might happen when (now I"m an old pro). Ultimately those things won't get you pregnant, they just impact stress level. Anyways, pros and cons. Do whatever you have to do to make it work!

[Anonymous]

My opinion, so take this for what it is worth... I think SG has a fantastic lab - so if you have the right protocol, you can benefit from the high success rates. However, they tend to be very rigid in their protocols - so if you have complicated issues (immune issues, for example), you might be better served by a different protocol. It sounds like your issues might be worth considering going elsewhere.

[Anonymous]

Anonymous wrote:When comparing SG to CFA, SG is the clear winner. But after multiple failed cycles and the same protocol, I really feel like I need a new clinic.

I met with Dr. Abassi and right off the bat she said she wouldn't be using the same protocol I was on at SG and would explore all my baseline immune numbers. I am nervous to leave SG given their success rates in general, but I don't know how many more cycles it would be worth doing there if nothing changes. It seems it is a numbers game there- keep doing IVF and eventually something will stick.

Our original diagnoses was MFI and so we lack high quality embryos, but in the last year I have had two miscarriages from cycles and two BFNs from cycles. I am 37 and have Hashi's. Where else should I be looking?

If you left SG, where did you go, why and did you have more success?

I am wondering exact same thing but on the other end - I did once cycle with SG which was way too oversupressing and overstimming, and since then did 2 more at CFA. With CFA I felt that all the testing I wanted to do was considered and done, which was very comforting. We uncovered a couple of issues but in the end addressing them did not lead to success. I loved shorter wait times for monitoring and the flexibility of approach. In SG I've ran into a very rigid cookie cutter approach and cattle like scenes during monitoring.

My worry about CFA is their embryology, but I don't have anything specific on this, just a hunch. And of course SART numbers - for my age group they are very very bad. I thought about going back to SG, but while there are certain things I can tweak (meds) others like when they trigger and on what day to transfer are still rigid, so that's what's stopping me at the moment.

[Anonymous]

I am at SG. I'm not sure I'd recommend them to anyone, but they have been flexible about some things. I tried lots of different protocols and triggered early in my last cycle. I had to present journal articles to my doctor to ask for the tweaks, but she was willing to do most of them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:When comparing SG to CFA, SG is the clear winner. But after multiple failed cycles and the same protocol, I really feel like I need a new clinic.

I met with Dr. Abassi and right off the bat she said she wouldn't be using the same protocol I was on at SG and would explore all my baseline immune numbers. I am nervous to leave SG given their success rates in general, but I don't know how many more cycles it would be worth doing there if nothing changes. It seems it is a numbers game there- keep doing IVF and eventually something will stick.

Our original diagnoses was MFI and so we lack high quality embryos, but in the last year I have had two miscarriages from cycles and two BFNs from cycles. I am 37 and have Hashi's. Where else should I be looking?

If you left SG, where did you go, why and did you have more success?

I am wondering exact same thing but on the other end - I did once cycle with SG which was way too oversupressing and overstimming, and since then did 2 more at CFA. With CFA I felt that all the testing I wanted to do was considered and done, which was very comforting. We uncovered a couple of issues but in the end addressing them did not lead to success. I loved shorter wait times for monitoring and the flexibility of approach. In SG I've ran into a very rigid cookie cutter approach and cattle like scenes during monitoring.

My worry about CFA is their embryology, but I don't have anything specific on this, just a hunch. And of course SART numbers - for my age group they are very very bad. I thought about going back to SG, but while there are certain things I can tweak (meds) others like when they trigger and on what day to transfer are still rigid, so that's what's stopping me at the moment.

OP here- this is my concern. I feel like the lab is awesome, but my RE hasn't changed anything without me pushing the issue. And they certainly aren't willing to do any immune testing. So frustrating!!

[Anonymous]

Anonymous wrote:I kind of left SG and got better results. What happened was that after 3 cycles in the shared risk program I moved out of DC. In my new city(overseas) i decided to try out a local clinic, and it worked! They changed the protocol and I was pregnant twice with them, but miscarried both times. I never dropped out of the shared risk program though, because like the PP said, as much as SG really frustrated and disappointed me, I'll go back to the shared risk program if I have to. Plus I'll be able to go back with a record of success so I think my doctor would be willing to tweak the protocol at SG based on that alone.

PS--I actually did my first cycle at CFA, but not with Abbasi. There are pros and cons to any place. One of the up sides to SG and downsides to CFA is that at CFA your nurse won't be as organized, won't share a lot of detail unless you ask, and the routine is not as well managed. So on the callbacks my nurse at CFA would often just say 'everything is fine' and hangup quickly rather than telling me my actual E2 lab results. Or, on my cycle at CFA, which was my first, I never received a calendar so I didn't have a great sense of what might happen when (now I"m an old pro). Ultimately those things won't get you pregnant, they just impact stress level. Anyways, pros and cons. Do whatever you have to do to make it work!

A note on CFA--like SG the office where you cycle makes a difference. CFA downtown is a mess but if you cycle in Bethesda, the nurses are great and you will get a calendar and phone calls with details.

[Anonymous]

OP, I did move from SG to CFA. I also had success there. I also looked at Dr. Wang who is up in NJ now I believe. I know people who have done immune protocols with him and have had success. I hope you keep us updated on your decision and the results! Best wishes!

[Anonymous]

SART numbers don't tell the whole story, and they don't differentiate stim from natural cycle IVF/FET's. We switched from SG to Dominion and got better results, and 3 PGS normal embryos. We plan to transfer one next month in a natural FET.

[Anonymous]

I moved from Shady Grove to Columbia 4 years ago.
I just looked at this year's SART numbers. The SART numbers 4 years ago were more inline with each other. I wonder what caused Columbia's numbers to go down since. Perhaps their head embryologist quit?
BTW, I had success on the first cycle at Columbia.

[Anonymous]

I moved from CFA to SG when I did IVF for this exact reason. But I do have friends who had success at CFA. OP, would you consider finding a different RE at SG? I know people who have switched when they feel one RE won't change protocol and later found success.

Also, I wouldn't rely on REs to manage thyroid issues. I found an endo who I love, and he managed my thyroid separately. He made me come in for blood draws as I was doing my betas to ensure my TSH was optimal, and increased my dose immediately when my TSH began to creep up.

[Anonymous]

Anonymous wrote:SART numbers don't tell the whole story, and they don't differentiate stim from natural cycle IVF/FET's. We switched from SG to Dominion and got better results, and 3 PGS normal embryos. We plan to transfer one next month in a natural FET.

SG and CFA don't do natural cycle IVF and FETs, so it doesn't matter that the stats don't differentiate.

For Dominion, I also don't see how NCIVF stats separated out would help - if success rate is higher all it means that they don't correctly recommend stimulated IVF to others.

[Anonymous]

Anonymous wrote:When comparing SG to CFA, SG is the clear winner. But after multiple failed cycles and the same protocol, I really feel like I need a new clinic.

I met with Dr. Abassi and right off the bat she said she wouldn't be using the same protocol I was on at SG and would explore all my baseline immune numbers. I am nervous to leave SG given their success rates in general, but I don't know how many more cycles it would be worth doing there if nothing changes. It seems it is a numbers game there- keep doing IVF and eventually something will stick.

Our original diagnoses was MFI and so we lack high quality embryos, but in the last year I have had two miscarriages from cycles and two BFNs from cycles. I am 37 and have Hashi's. Where else should I be looking?

If you left SG, where did you go, why and did you have more success?

i left SG after an early miscarriage, did some testing at columbia, but the testing came back all negative for any immune issues. ended up going back to SG and did shared risk PGS IVF and had success (12 weeks now) on my first FET. in between i consulted with Braverman in NJ and Frankfurter at GW. The consults were very reassuring, and i highly recommend doing that. because i had a lot of knowledge at that point, when my TSH came back slightly high before the IVF cycle, and SG thought it wasn't a problem, i decided to go independently to an endocrinologist and get on levox. SG had no problem with this. i have no idea if it made a difference, but i felt like i was doing everything i could. it is empowering to hear from other dr's. keep in mind that GW docs do not generally believe the repro. immune issues are legitimate. i think it is good to hear from all both sides what they recommend in your case. part of the reason i stayed with SG was the lab, but if i had any indication of immune issues, i might have switched (probably to braverman.) also i switched SG docs to the sibley office, which i preferred.

[Anonymous]

Anonymous wrote:

Anonymous wrote:SART numbers don't tell the whole story, and they don't differentiate stim from natural cycle IVF/FET's. We switched from SG to Dominion and got better results, and 3 PGS normal embryos. We plan to transfer one next month in a natural FET.

SG and CFA don't do natural cycle IVF and FETs, so it doesn't matter that the stats don't differentiate.

For Dominion, I also don't see how NCIVF stats separated out would help - if success rate is higher all it means that they don't correctly recommend stimulated IVF to others.

Unless things have changed, this isn't true. I did 2 natural cycle FETs (embryos were from a fresh round with stims) with Sacks. They were both BFNs, but he did do them and didn't even suggest doing a medicated FET.

I have not been to SG, and I ended up finding success after switching from CFA to GW. But the lesson I learned was that a second opinion on your treatment is always worthwhile. And I don't put too much stock in SART numbers, since they don't reflect biases that can be introduced when comparing clinics that are more willing to take on difficult cases (e.g. GW) to those that won't. Given your Hashi's, I would think that varying the protocol could make a big differnce, so I wouldn't let SART numbers keep you from switching.