Shady Grove vs Weill Cornell (Dr. Davis)

[Anonymous]

Hi all,
Just wanted to share my experiences with IF treatment. I am DC based, in my early 40's, and have DOR. I have done 2 IUI, 2 IVF, and 2 FET cycles at Shady Grove off and on over the past five years. My second IVF was successful and I have a DD who is 3. Our FET's were more recent (2018), and after the second failed one and because of AMA and DOR, Widra said I wouldn't be a good candidate for IVF and that I should consider DE. I researched other clinics and Dr Davis at Weill Cornell has a higher success rate for my age/condition, so we decided to do an IVF cycle there. I'm in my 2ww for a 3day transfer. I wanted to share my reflections of the experience in case it's helpful to anyone.

-the doctor's at Cornell are far more hands on. There is always a doctor to do the ultrasounds for monitoring, and their ultrasound machines seem more advanced. At shady grove, the only time I saw a doctor was on egg retrieval or embryo transfer days. I assumed this was the norm, but I got so much more interaction with doctors at Cornell.
-Cornell adjusted my protocol several times during stimming. My two cycles at Shady Grove were different protocols, but they didn't make any adjustments during each cycle.
-Cornell checks your blood often, like almost every day before retrieval, including day after trigger day
-Cornell put me on prednisone and z pac after retrieval and before transfer and they do a test before transfer called a sounding where they measure your uterus for optimal placement of the embryo during transfer.
-doing an IVF cycle out of town was no fun. you basically need to be there every day during the latter part of stimming, and it is isolating to be stuck in a hotel room waiting for your nurses to call. Not a huge deal, but it takes over your life more than IVF normally would, and there is the added train and hotel costs.

Not making a judgment either way (and I don't know if Cornell was successful for me), but I wonder if all of these little tweaks are the reason that they have a higher success rate.
If both clinics were local for me, I would choose Cornell hands down.

[Anonymous]

What is the purpose of the z pack?

Can you share your stats? I'm 41, also DOR, and had a consultation with Dr. Davis and he told me that I'm not DOR and that I am unexplained, but SG thinks I'm DOR. I have not had a positive pregnancy test in 4 years after getting pregnant right away with my son, age 5.

[Anonymous]

Anonymous wrote:What is the purpose of the z pack?

Can you share your stats? I'm 41, also DOR, and had a consultation with Dr. Davis and he told me that I'm not DOR and that I am unexplained, but SG thinks I'm DOR. I have not had a positive pregnancy test in 4 years after getting pregnant right away with my son, age 5.

I'm not sure about the z pack. Maybe to clear up any underlying infections? I husband did a course of antibiotics too. I don't remember all my stats, but I'm 42, and FSH was 15 and AMH was .3, 7 follicles in baseline ultrasound.

[Anonymous]

OP - Did you do any local monitoring?

[Anonymous]

Can you share more about your IVF experience at SG? How old were you? What were your stats? Results with each cycle? And do you recall which protocols they used for you? Also, does Cornell always do day 3 transfers for DOR? Do they ever PGS for DOR? Thanks for all the info!

[Anonymous]

I think both are good, but if you're older and not having much success with typical protocols, I think Davis is a good option. He will do consults if you want to see what he thinks of your particular case before you commit to going there.

I did the consult, but didn't go b/c I did a round at SG and ended up with significantly more eggs than the 2 rounds I did at Dominion (which I also liked, so not a slam). The consult with Davis was centered around DOR and an assumption that I'd probably not be able to get all that many eggs, so it seemed like (and at the time was) a good choice to stick with SG. My #s were pretty good for 41 (FSH 6, AMH 0.9, AFC 9 or 10?), so not clear cut DOR. Well, I got up to 15 eggs, but they were all crap and didn't do much past day 3. So, I ended up going back to Dominion and doing a mini-stim protocol, like the protocol Davis had recommended. I got only slightly fewer eggs, but more blasts, although they ended in a chemical. I called it quits(ish) and did DE. I'm so very happy I did, now that I'm finally pregnant again (this was for #2 - first was without difficulty and forever top of my things to be thankful for list, with the ability to do DE being a close second). My conclusion after 8 rounds plus DE is that IVF over 40 is a different ball game and involves more luck than science. Hopefully, that changes even if it's too late for me!

I hope you are lucky earlier than I was!

[Anonymous]

Anonymous wrote:OP - Did you do any local monitoring?

OP here. Yes, I did most of monitoring at Shady Grove up until day 7/8 of stimming when Cornell insisted that I come to NY. I knew the ropes and it was comfortable, but you can do it anywhere. It was fairly seamless except for one time that Cornell didn't receive the results and we had a fire drill where Cornell doc had to call Shady Grove doc to give him results. Really kind of Shady Grove to do this. One caveat is that I pay for everything OOP, so that is an added cost to be aware of.

[Anonymous]

Anonymous wrote:Can you share more about your IVF experience at SG? How old were you? What were your stats? Results with each cycle? And do you recall which protocols they used for you? Also, does Cornell always do day 3 transfers for DOR? Do they ever PGS for DOR? Thanks for all the info!

OP here. I don't remember all of the details with my first round at Shady Grove. I was 38, and diagnosed unexplained (not DOR). Don't remember stats. First cycle did high doses of Gonal F and menopur. They retrieved 6 I think, but none fertilized and they didn't do ICSI (this wouldn't have happened at Cornell). I was crushed. Second round included lupron (Sorry I don't remember much else). Got 5 eggs, 3 5 day blasts (didn't PGS), one is DD, the other are the 2 FETs I did at 41 that didn't take, one was chemical.

Just being 42.5 is a totally different ballpark. My numbers are so different now and I am DOR. I agree with PP that doing IVF in your 40's is very slim returns. The SART numbers show that. But we had to try one last time, even though we're aware that it's a roughly 6% chance.

As for day 3 transfers, I don't know for sure, but I can tell you anecdotally that it seemed like 70% of the women who were with me on egg retrieval day were also there on embryo transfer day (day 3). I know that if you don't get a lot of eggs, Davis will strongly suggest no PGS.

I am done with IF treatments after this, and will forever regret not trying for #2 sooner. I was just so sure my frozen blasts would work. I am open to DE but hubby isn't (yet).

[Anonymous]

OP here, I also found the recent book Conceivability very helpful to understand the industry of IVF. I know SO much more now than I did when I first did IVF.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Just being 42.5 is a totally different ballpark. My numbers are so different now and I am DOR.

Can you share more about this?

I have similar numbers to you OP. I got pregnant with my son on the first try at 35, easy pregnancy and delivery. Started TTC #2 when my son was 10 months old. I went to an RE when he was 16 months old after 6 months with no luck. My numbers at that time were: AMH .30, AFC 10, FSH 5. I was told by 2 REs that I was unexplained and 2 REs that I was DOR. I then did some IUIs with Gonal-F, all negative. Then I had a laparoscopy. Uterus was clear and they removed a few polyps, tubes clear. Never any sperm issues. I then did 3 IVFs, all BFNs. I had a consult with Cornell when I was 39 and they said I was unexplained, but no DOR. I was then told I had less than a 1% chance of ever getting pregnant again due to zero BFPs in 5 years.

I am now 41 and have never had a second positive pregnancy test. My numbers are similar to yours but I'm not sure what to think of my infertility journey and I've given up on all infertility treatments.

[Anonymous]

OP any updates?

[Anonymous]

I was at Dominion and just switched to CCRM. While I wasn't thrilled with my experience in Dominion for a number of reasons, a Dr always did the ultrasound. I cannot believe that at SGF they did not.

[Anonymous]

OP, it not as much a SG problem, it's Dr. Widra problem. He is busy, overbooked and not very diligent (in my view).

That said, SG also does Zpack, and daily blood checks before retrievals, it's standard with all doctors, perhaps you just don't remember that?

Cornell is marginally better, but in the end, same type of conveyor belt as SG, only fancier.

[Anonymous]

Anonymous wrote:OP, it not as much a SG problem, it's Dr. Widra problem. He is busy, overbooked and not very diligent (in my view).

That said, SG also does Zpack, and daily blood checks before retrievals, it's standard with all doctors, perhaps you just don't remember that?

Cornell is marginally better, but in the end, same type of conveyor belt as SG, only fancier.

Can you share more about your experience at SG and Cornell?

[Anonymous]

Anonymous wrote:OP, it not as much a SG problem, it's Dr. Widra problem. He is busy, overbooked and not very diligent (in my view).

That said, SG also does Zpack, and daily blood checks before retrievals, it's standard with all doctors, perhaps you just don't remember that?

Cornell is marginally better, but in the end, same type of conveyor belt as SG, only fancier.

New poster here and i was going to say the same. I did antibiotics at shady grove. I also had my meds adjusted throughout the cycle. Both of my ivfs were with Dr. Osborn who I love. We did 50/50 split conventional icsi for my first Ivf. Second ivf we did all conventional based on my results. Second ivf I went in daily actually from day 3 onwards as I had a suspected cyst. Turned out it wasn't. Again all Osborn. All this to say it may really just be age at this point.