Going to Cornell (Dr. Davis) for 1st round of IVF, any general advice?

[Anonymous]

Hi Friends,

Last year, I had a few unsuccessful rounds of IVF under Dr. Chang @ Shady Grove and I am now going to Cornell to start my first IVF protocol with them. I live in DC and I am going up there by Day 7 per Dr. Davis' request. He said there was no need to come before then and I will just do the 1 round of remote monitoring here.

Does anyone have some general advice about what helped them at Cornell? Or things I should know before I go?

It does make me nervous that there is no protocol sheet, I am used to that from SG! Also, if anyone has experience with Dr. Davis, what do you think of his nurse Katie?

Thanks everyone --I really appreciate it!

[Anonymous]

Good luck. I hear he's one of the best.

[Anonymous]

I did IVF with Jamie Grifo at NYU, but considered Dr. Davis as well. He's the best at Cornell, esp. for older women, from what I heard. Spandorfer also gets rave reviews.

[Anonymous]

He is very smart. His nurses, however, are not stellar. DW is a patient of his and Katie is our nurse too, and the one before her was equally sub par. Kind of crazy considering how much you pay them. We will do one more round with him before our insurance attempts are out- first two rounds resulted in BFP but ended in miscarriage. Third round was BFN. If this doesn't work we will either stop or switch to Abassi. Good luck OP. For what it's worth I think you are in great hands.

[Anonymous]

I went to Cornell about 6 years ago so some of this may be out of date. But I felt that (compared to SG) it was more impersonal and you had to be much more on top of things as a patient. One thing to think about is the logistics of getting your meds. Will you be able to have meds delivered to you in NYC once you arrive there? If not, be sure you have a second set of scripts that you can use at a local NYC pharmacy that covers fertility drugs.

Also, here is one protip that worked when I was there. Cornell makes everyone arrive for egg retrieval at the same time early in the morning and so you just sit there in the waiting room (hungry and thirsty) until it is your time for surgery. If you ask to have a Cornell nurse administer your trigger, you will get an early egg retrieval time because they aren't going to want to make a nurse come to your hotel at 1am to administer the trigger.

Also, you won't necessarily have time to discuss how many embryos to transfer with an RE the day of your retrieval unless you request that. We requested it and my husband had to change into scrubs so that he could meet with the RE. But it was a good thing we did -- going into my IVF cycle we had been [planning to transfer 3 embryos (in the past I never even had more than 1 embryo make it to day 3 so the threat of triplets seemed very theoretical when I had my initial consult with Davis). But it turned out that I had at least 3 8-cell embryos available for transfer on day 3. After DH and I talked to the doctor, we decided to just transfer two of them. I ended up having fraternal twins and feel very lucky we didn't stick with our original game plan of transferring 3!!!

On the plus side, Cornell does not make you drink a ton of water before transfer since they don't use an ultrasound.

[Anonymous]

Thank you for the tips! this is very very helpful.

If you have any other tips that cross your mind, please let me know!

Thanks again.

[Anonymous]

I went to Dr. Davis last year after several rounds of BFNs in DC, and finally got a positive on the first try there. So glad I went.
I also was monitored locally, but I think they told me to come up there before day 7 - so I did a bit of back and forth, because of work. Some people had cards that you would just scan when you arrive, I did not (which I never figured out why) so I had to sign up at the reception every time. Anyway, the wait for the morning monitoring was not long at all despite being such a huge machine. And I don't think it made a huge difference whether I went earlier around 7:30 or later at 8:20ish.
As one of the previous posters mentioned, if you are not so used to doing intramuscular injections on your rear side (for the trigger shot), it would be good to ask for a Cornell nurse to do it for you (you pay like $100 cash to the nurse - it's unofficial so they won't tell you unless you ask). I was not particularly impressed with Katie (but she was new then...), but when I had issues with the trigger shot (and that is why I am saying it may be better to ask a Cornell nurse), Jackie was super nice and went out of her way to find a solution for me.
I didn't like the receptionists in general, as they would be quite cold and unhelpful, but everyone else was nice. Although Dr. Davis was my doctor, I happened to be with Dr. Spandorfer for co-culture stuff and transfer. I really liked him, as he was funny and that made me relax (and maybe the opera that was playing in the transfer room )!
Good luck OP!!!

[Anonymous]

Anonymous wrote:I went to Cornell about 6 years ago so some of this may be out of date. But I felt that (compared to SG) it was more impersonal and you had to be much more on top of things as a patient. One thing to think about is the logistics of getting your meds. Will you be able to have meds delivered to you in NYC once you arrive there? If not, be sure you have a second set of scripts that you can use at a local NYC pharmacy that covers fertility drugs.

Also, here is one protip that worked when I was there. Cornell makes everyone arrive for egg retrieval at the same time early in the morning and so you just sit there in the waiting room (hungry and thirsty) until it is your time for surgery. If you ask to have a Cornell nurse administer your trigger, you will get an early egg retrieval time because they aren't going to want to make a nurse come to your hotel at 1am to administer the trigger.

Also, you won't necessarily have time to discuss how many embryos to transfer with an RE the day of your retrieval unless you request that. We requested it and my husband had to change into scrubs so that he could meet with the RE. But it was a good thing we did -- going into my IVF cycle we had been [planning to transfer 3 embryos (in the past I never even had more than 1 embryo make it to day 3 so the threat of triplets seemed very theoretical when I had my initial consult with Davis). But it turned out that I had at least 3 8-cell embryos available for transfer on day 3. After DH and I talked to the doctor, we decided to just transfer two of them. I ended up having fraternal twins and feel very lucky we didn't stick with our original game plan of transferring 3!!!

On the plus side, Cornell does not make you drink a ton of water before transfer since they don't use an ultrasound.

PP, congrats! What do you think made a difference in getting embryos to Day 3 where you hadn't before--and two 'normal' ones at that (I'm assuming you are AMA, but maybe not)?

[Anonymous]

I went to Dr. Davis two years ago. He is great and very wonderful on the first visit. He will know your entire folder. You will leave feeling fabulous, but to have a fabulous journey you really have to stay on top of everything because you really are just a number there. I never met my nurse- Elizabeth, only spoke through texts and emails. I rented an apartment for 3 weeks and stayed for my entire cycle. I mostly saw the fellows for monitoring and we had to call Dr. Davis once, because fellow suggested we cancel cycle. Sort of an awful experience, but at 41 I got a BFP with only one embryo to transfer. Can't beat that! Good luck!!!!!

[Anonymous]

I am one of the PPs. I was able to get Dr Davis on the phone when I asked his office to have him call me to get his take on how the cycle was gong. he also came to my u/s when it was his morning to do monitoring so I got to ask him questions then. So it wasn't totally impersonal - but you do have to be on top of things!!

[Anonymous]

All of this advice was very helpful and I am back from Cornell now with a transfer of 2 embryos. Just out of curiosity, did anyone take a pregnancy test before the official hcg bloodwork? The nurses theres seemed pretty adamant that I should not test before my blood test. My blood test is tomorrow and I have held out pretty good but waiting until tomorrow seems like forever. Since we do remote blood work, the fertility place we use just faxes everything to Cornell and we have to wait for Cornell to get back to us.

[Anonymous]

yes, i always test before beta. by 13DPO, a home test is pretty definitive. if it's a faint line, it may be a chemical, but if no line, then most definitely a BFN.

[Anonymous]

I like testing the night before beta.

[Anonymous]

Anonymous wrote:I like testing the night before beta.

(I'm also a Cornell patient btw) - good luck

[Anonymous]

The monitoring mornings and procedures might all feel a little bit factory, but I thought the REs were incredibly available and responsive to questions (at least via email). And they super fine-tune the protocol each day. So it felt very personalized in some aspects.

My first day of monitoring in NYC was CD5.

And I always start testing at the equivalent of 11dpo.