Anonymous wrote:And one of my nurses ordered thousands of dollars in extra meds that we never needed, which totally sucked.

This happened to me as well (at CFA DC office). I read other threads on this board from patients who had the same nurse do the same thing to them. Despite the insane billing issues, I originally was reasonably happy with my RE at CFA. But I had issues with my nurse contact during my first cycle, which should have been a sign. Instead I continued (doing three more IVF cycles) there thinking that the RE was the most important thing. But I should have realized that the state of the practice tells you something about the doctor as well. In my case, not only was the staff disorganized, the RE missed a very common and easy to diagnose condition that resulted from the miscarriage I had after my first cycle...which made it nearly impossible to get pregnant again. My RE dismissed my complaints about my symptoms...which I think was also somewhat of a result of the office's disorganization. When I finally switched clinics (to GW), it was diagnosed and corrected right away. I'm now almost 15 weeks.

All I can say is you have to trust the RE, and you have to trust the staff. Your IVF cycle depends as much on the staff as it does on your RE...if you are not comfortable with both it will add unneeded stress and possibly impact the outcome.

In addition to the other suggestions, I would strongly encourage you to interview the doctor's primary nurse along with the doctor. You are going to be doing most of your communicating with the nurse and there are some bad ones out there. Some nurses are really bad about communicating regularly for example, especially when you are out of cycle. I've also had nurses go on maternity leave while I was between cycles and not even tell me they were out! Other nurses seemed like they were just too busy to answer questions. And one of my nurses ordered thousands of dollars in extra meds that we never needed, which totally sucked. OTOH - I've had some great nurses who were responsive and kind and helpful.

Just as with the doctors, do not be afraid to ask to switch nurses if you don't really like and trust the one you have.

I looked at SART stats and at the time (2008) it looked like SG and Dominion were the best in the area. I had initial meetings at both places and decided I felt more comfortable with Dr G at Dominion, so I went with them.

I've been to three REs in the area (Dr. Dimattina at Dominion, Dr. Nair at SG and Dr. Abbasi at CFA). I would recommend getting all the testing done somewhere before committing to do IVF anywhere. There is a TON of testing to do before you even get started with actual IVF. This is testing beyond what your OB-GYN does. SG is a good place to do that because they're pretty organized and comprehensive, although Abbasi at CFA will do more of the unconventional testing (e.g., for immune issues). Once you figure out what your specific issues are, you may be better able to assess which clinic is best for you by showing them your results and asking them to tell you what protocol they would recommend for you.

We have DOR and MFI so had more difficulty than we imagined we would. We are about to start a cycle with CRMI up in NYC because of their experience and success with both of these issues.

I agree that you should check the SART stats but make sure to check with respect to your age and issues. Also, if you have enough money only for a few cycles, it is worth looking into the shared risk thing at SG. CFA gives you a cycle on the house if you fail two cycles so that's a nice backup to have. Each clinic has different doctors so don't be afraid to meet different ones until you find one you feel comfortable with.

Good luck OP!

Run from Dr. Durso, that's all I can say

www.sart.org

Check out the statistics for the local clinics--that should help guide your decision.

If you are just getting started, I think the place to start is the one where you are in network for your health insurance. You do not necessarily need IVF and all clinics are going to want you to try IUI first unless there is a reason to go straight to IVF. I have United Healthcare and everything until I started Clomid for my first IUI was "diagnostic" and not considered fertility treatment.

I am at Shady Grove and I'm not sure why they made the other poster cry. My experience has been very positive so far - except for the no baby part of course.

Also Shady Grove's locations are convenient for me - K St is on my way to work and Rockville for weekend appts is not too far from NW DC.

Gindoff does not have a good reputation- according to many.

i recommend washington fertility center for various reasons:
1. they have clinics at 4 locations in DC metro area
2. they are very organized. they have a plan for each patient after initial consulting. you dont have to keep wondering what to expect. in my case they emailed me my calendar, so i could adjust all my personal programs well in advance
3. they are prompt at answering questions and returning phone calls
4. their waiting times are short. in my case i scheduled all appts at 8 am in the morning. my doctor and the nurses there were never late. if going for usual sonograms i was out by 8:20 am and could make it to work on time
5. dr.gindoff is very good. he is new there. he has a terrific experience and expertise. i dont know about the other doctors there
6. lan and marcella, the nurses are good too
7. costs are more or less the same everywhere (expensive!!). my cycle came to about 13-14K including meds. that included ICSI

good luck!!

Who was your RE @ CFA?

I think there are four things:

1) As another poster said, location and convenience really do matter. You will have many early morning appointments and don't want to stress each one.

2) Read these boards to see the pros and cons of different clinics. E.g., Shady Grove seems like the most organized but also the most rigid and factory like. GW seems to have a well love doctor but some uncertainty in terms of having enough other staff right now. Many people seem to have billing issues at CFA but love their doctor their and can get immune issues checked out and find more flexibility there in general. What matters to you most.

3) Think about what issues you might have. If you are worried about immune issues CFA would be a good bet. If other issues, maybe other places.

4) Fit with the doctor. I met with a doctor at CFA and Shady Grove. I could tell SG was more organized but (a) it freaked me out on my first visit to be told how much my insurance would cover for IVF (I hadn't even tried Clomid yet) and (b) I had a really bad consult there and found the doctor patronizing and rigid. I ended up very happy at CFA mostly because my doctor there was a good fit for me.

Anonymous wrote:We only have the funds for 1-2 IVF cycles so I want to be confident we maximizing our options. !

If this is the case, and you think you may qualify, then I would check out Shady Grove's shared risk program.

My recommendation is to do at least a couple consults with different doctors at different practices and see which doctor, nurse, and practice fits your style. Also, if you aren't happy, don't be afraid to switch. You will spend a lot of time at the office, talk to the nurses almost daily, and have a ton of emotional energy invested. It's paramount that you feel comfortable and trust your medical team.

In hindsight the location was very important. I didn't realize how many appointments were involved with the whole process. Being close to my dr decreased the stress I had in balancing work, home, and all the apps.

Next was my comfort with the practice. I went to shady grove for an initial consult and the first dr appt. first appt was upsetting, second one I left in tears. I would up a Mausher and Dr Durso. Loved the whole practice. Small practice, same people every time, and they really really cared. (I did 5 full ivfs and had two successful pregnancies).

While I did look to the success stats, I think success data can be impacted by many things.

Good luck!!!

CFA (Columbia Fertility) has 2 cycles and the 3rd one (if needed) is free. I recommend Dr. Abbasi. Locations in Bethesda and DC and Arlington. CFA is also "high FSH friendly."

After TTC for over a year we are starting this journey. Reading these boards it sounds like there are different skill levels with drs.
Can you tell me how you vetted and picked which clinic or dr to work with? We only have the funds for 1-2 IVF cycles so I want to be confident we maximizing our options.

Thanks for helping a nervous newbie!