Dr. Greenhouse and high FSH

[Anonymous]

Has anyone with a high FSH level been treated by Dr. Greenhouse? I've heard that some S. Grove doctors don't like to deal with this type of patient and am wondering if he's one of them. But he sounds great from the comments I've seen on this board. Thanks.

[Anonymous]

It depends on your age w/SH. If you're early 30's w/high FSH they are okay with it. Late 30's or 40's you may have problems.

I was an early 30's, high FSH patient of Dr. Levy's at SH. He put me on an EXTREMELY high dose of stims. I got pregant on the first try both times and now have 2 sweet boys.

[Anonymous]

I have elevated FSH, am of AMA (advanced maternal age) and am a patient of Dr. Stillman's. He has been great and has never raised my FSH as an issue, though I am assuming that is based on the fact that I respond well to the stim drugs and get a decent number of follicles. Might be different if I didn't.

That said, I know a number of people with high FSH who have cycled at SG or tried to cycle there. It definitely seems that some SG docs are more willing to give high FSH patients a try than others and Dr. Greenhouse IS one of those docs. A friend with FSH in the mid teens and in her mid-to-late 30s just had a baby via Dr. G and IVF. He is also treating another friend in her mid-30s with FSH in the high teens. Both have given rave reviews about him. It is definitely worth having a consult with him. If you are looking for a doc in VA, then I know Dr. Saffan is also friendly to high FSH.

[Anonymous]

Great, good to know. Thanks for the info!

[Anonymous]

Wow are you kidding me?? SG is not high FSH friendly and I'd advise anyone looking for serious help to go to Cornell or dominion Fertility.

[Anonymous]

Anonymous wrote:Wow are you kidding me?? SG is not high FSH friendly and I'd advise anyone looking for serious help to go to Cornell or dominion Fertility.

sight your source please.

[Anonymous]

I am PP from 17:16. Want to comment on Dominion and the patients of Dr. Greenhouse's that I mentioned, as they both cycled or consulted at DF. The one who recently had a baby via Dr. Greenhouse cycled at Dominion with terrible results (the one egg retrieved disintegrated when fert was attempted) and was told she needed DE. She had a much better response in terms of follicles and eggs at SG - had a chemical on her first cycle and had success on her second. The other woman went for a consult at DF and was told they could not treat her with FSH that high and she needed DE. Both were at DF prior to their natural cycle IVF offering, which DF specifically markets as THE treatment option for high FSH patients. If the OP is looking to do a stimulated IVF cycle with high FSH, then be prepared for DF to offer up natural cycle only or DE.

As I mentioned in my original post, some docs at SG are not high FSH friendly, but not all. I know women who have been turned away by specific docs in the practice because of FSH levels and others who have been given a chance. Cornell does treat many high FSH cases that other clinics won't touch and has success, but funnily enough only two docs in that practice treat those cases - Davis and Spandorfer.

[Anonymous]

Awesome post 19:43! Finally, a solid rebuttle on this board. Your information have been very helpful. And I'm not the OP!

[Anonymous]

OP, all that any poster can provide is anecdotal feedback. To the 18:26 poster, I disagree with your comments with the exception that Cornell is highly regarded for treating high FSH patients and also has some of the best success rates of any center in the U.S. However, it's a much larger commitment to travel to NYC to cycle vs. staying in one's hometown, especially when it's already very stressful to undergo IVF. In the D.C. area, SG has the best success rates. (Check out SART for rates -- http://sart.org/index.html).

That said, I cannot comment on Dr. Greenhouse. I would highly recommend Frank Chang at SG. I was of advanced maternal age (39 YO) when he treated me, and I also had very high FSH levels when tested multiple times (all higher than 40 - ouch! - which are menopausal levels). Moreover, I did not respond well to the stims -- I had 4-5 follicles at most, with only 2-3 mature follicles. I underwent one IUI (to see how I would respond to the meds), no success. Went on to IVF two months later, and was cancelled due to low response. Went on to do a second IVF right away, and we decided to go for it even though I, again, had a poor response; Dr. Chang retrieved 3 eggs, 2 made it to day 3 and those 2 were transferred, and I got pregnant with a singleton and now have a beautiful child. And, 6 months after my DC's birth, I got pregnant on my own -- a huge surprise! -- considering that I was given a 15% chance of ever delivering a healthy child. So, there are folks like me who beat the odds.

My husband and I met with Dr. Chang frequently so we could discuss our options, including the protocols. I am so glad we did this for peace of mind, as all we had to pay was a co-pay (and these consults typically don't cut into the "IVF/IUI insurance bucket" if you do have insurance). For my second IVF, I pushed Dr. Chang to consider using Dr. Owen Davis' protocol (Cornell), and he agreed. I'm not convinced that it was the protocol alone that resulted in my pregnancy -- I think it's also a bit of luck, and I also gave myself extra TLC during this time (cutting down work hours, accupuncture, workouts, extra rest, and anything else to reduce my stress level). Dr. Chang was open, honest, gave us sound medical advice, and I would recommend him over and over again. There are women who find him not so touchy-feely, but I personally liked his bedside manner.

I am so sorry you're having to go through this. Good luck deciding which doc to use! I hope you end up with a healthy, wonderful pregnancy, and wish you the best!

[Anonymous]

I was Dr. Greenhouse's patient several years ago. He's a really good guy, and we credit him with the birth of our son. I consulted with him recently -- I'm now high FSH. He suggested donor eggs, but when we said that we weren't interested, he was more than willing to let us proceed with my own eggs. He just wanted to make sure that I had a realistic view of the success rates.

[Anonymous]

Avoid Dr. Widra. He will just push donor eggs.

[Anonymous]

I am a patient of Dr Davis's at Cornell so I thought I would chime in. OP -- depnding on your financial/emotional situation, it might be worth considering going up to Cornell. For example, if you don't have insurance and can only afford one cycle -- Cornell will likely maximize your chances. If you can cycle multiple times, you could always start in DC (I'd recommend SG) and then switch to Cornell if it doesn't work and you want to keep trying. If you decide to cycle with Davis at Cornell, you can start monitoring with a local clinic and then spend the last week in NYC. I did 3 cycles at SG, then dropped out of the shared risk program, got my money back and went to Cornell. My cycle there went much, much better -- I was amazed at the difference (still waiting for the beta after transfering two 8 celled embryoes with <10% fragmentation, but Cornell gave me the same odds with my own eggs that SG did with donor eggs).

[Anonymous]

To the 21:12 poster - when is your beta? I am curious to hear if your Cornell cycled worked!!!!

[Anonymous]

"Avoid Dr. Widra. He will just push donor eggs."

I disagree with this. I have pretty high FSH (19) and was AMA and he had no problem cycling me a number of times with my own eggs. I don't think SG has the best protocols for high FSH patients, however. For some, a high stim approach might work, but for others (like myself) it won't and mini-stim or natural cycle are the ways to go. SG doesn't do either - well, I've heard a few stories of them moving to mini-stim after a good number of failed IVFs, but who wants to go through that (especially if you don't have insurance). I really think SG should offer a mini-stim approach for high FSHers, but they (at least Widra) doesn't believe in it.

One option is Dr. Check in NJ - he deals almost exclusively with high FSHers and does mostly mini-stim.

[Anonymous]

OP here. Thanks so much for all the feedback! It's so interesting (and confusing) how different the opinions are on this topic. I'm 38 with day 3 FSH test results of 14, 26 and 52 (this last one when I did the Clomid challenge.) Sonogram with Dr. Asmar showed 7 follicles.

To 19:59, it's so great to hear that someone w/ a similar age and FSH level has had success!! I believe you're the same person who responded to my other post with "extremely high FSH" in the title. Sorry I never responded to you on that one (I've been away from this board for a while for various reasons) but am again in hot pursuit of a doctor, and it was great hearing your story in both the posts. I called to make an appointment with Dr. Chang and realized that Dr. Greenhouse was in a closer office to me (I'm in Alexandria) and could see me a little sooner. Since I'd heard that he's also FSH-friendly like Chang, I made the appt. with him, figuring if they're both working for the same clinic then their views can't be that different. And I thought if I'm going to be going a lot, the closer locale made sense. Please let me know if you disagree.

So I have an appt. in a couple weeks with Greenhouse to no doubt get some revised FSH level and other testing (I'll ask him about AMH test that I've read about here) and hear what he recommends. I think this is the step that makes the most sense right now, before going all the way to NJ or NY, but I'll definitely keep those options in mind once I hear what Dr. G suggests.

I'm trying to decide if I should also make an appt. with Gordon or DiMattina at Dominion for ASAP too, just to not waste time and see what both places have to say, but not sure if that's overdoing it... and I'm not sure if insurance would cover 2 consultations so close together, but maybe...

Hopefully I will beat the odds too and not have to deal with too many steps to make it happen! Thanks again.