I agree that the large "factory" style places like Shady Grove are ideal if your case is relatively straightforward, which most cases are!! We had PCOS + male factor (varicoceles). Standard SG antagonist protocol, got a baby first IVF try.

If you're dealing with immune issues or other special circumstances I would definitely seek out an expert in that field and not go to SG.

Shady Grove is not perfect but they have a terrific lab due in part to the sheer volume of cases (and presumably their ability to attract and train top notch embryologists)
The lab is where the magic happens.....
So yes, the cons are that you won't see your doctor much (although she/he will be available) and that when you're in the waiting room, it feels like you're part of a cattle call.
I had success with them at 41 with PGS normals on ice so perhaps my good experience makes me more tolerant of some of the negatives
And they completely adjusted the protocol for a 42 (almost 43) year old friend after a dismal first cycle and she too now has a healthy baby

I agree it really depends on your needs. We have a pretty cut and dry case- no known fertility issues with me, my husband was just born with a vas deferens. So for us, finding a good urologist to get sperm was our #1 priority, #2 priority was the quality of the lab. Shady Grove fit the bill here in MD and I was happy with the convinience of having a monitoring office nearby. We also saw a "larger" (not SG large though) clinic in Texas and also had a good experience there. One thing that might be better at a larger, reputable clinic is the quality of the lab. If I needed a special protocol, however, I would definitely go to whatever clinic has a doctor that is known to specialize in your diagnosis. I've seen too many stories of people at Shady Grove having failed cycles without any major changes or further testing being done.

Shady Grove is a factory, they do generic treatments (so might not work for every single issue that causes infertility, though I’ve found if you are knowledgeable and advocate for yourself, you can get a lot accomplished), their admin is a cluster and you rarely if ever see “your” doctor. But if you get any embryos from a cycle, SG is the best lab in DC to have taking care of them and getting them to blastocyst and on to successful implantation. To me, that’s what’s most important, not whether or not it feels like a factory.

Also, for those saying they only do generic treatments, keep in mind they want you to get pregnant. Not because they’re emotionally invested in you having a baby, but because they want good success rates for them, to attract more customers, to make more money. They want success, too.

Shady grove is the Walmart of clinics

It is not the bigger the better, a clinic need a certain number of cycles to get good in-house experience, in the number of hundreds per year, IMHO. but beyond that there is a diminished return in the number of cycles creating not only experience but also bureaucracy and inhuman process. You need to find the sweet spot.

Clinics are very important for healthcare these days. In my opinion, you can visit site to be a bigger clinic for good services it is all about the well medical and paramedical staff. If a clinic has trained and well educated staff then it is good enough.

Factory or not, SGF gave us our first baby and I’m due next month for my second. I have 3 BFPs out of 3 attempts (one resulted in miscarriage).

Agree that it depends. I started small for 2 cycles and had ho-hum results and didn't agree with the way the RE wanted to go at that point, although I liked her a lot. Switched to SG for 3 cycles. Immediately had a significantly better response, but still no success (41/21 with MF, so not an easy case). SG was pretty flexible on some things, and I did like it (it was easier to go there after getting my feet wet at the smaller clinic). I went back to the small clinic and requested a new protocol (mini-IVF) and had the best results in terms of #s of blasts yet. I'm now waiting for transfer. If you're at a reputable place that does a significant # of cycles and stays up on the newest technologies, I doubt it's a huge factor.

It’s all about diagnosis. I was dx’d w DOR at 34. The mega places treated me like a number and would not do anything different or new protocol wise. I then went to SIRM (Sher) in NYC.

Big Clinic at 34/35 (.4 AMH, 7 FSH)
Cycle one : cancelled poor response
Cycle two: three retrieved, all fertilized nothing to blast (or transfer)

SIRM at 36/37 (.2 AMH, 8 FSH)

Cycle one : 14 Retrieved! 12 mature, 11 fertilized - DD is now 18 months old.

Cycle two (freeze all) : 12 Retrieved, 10 Mature, 10 Fertilized w ICSI - 8 day three embryos frozen.

The difference is always seeing your doc for monitoring, being able to actually talk about different protocols and actually having a say in your treatment.

I think it depends on the cause of your IF, if you have this information
I was younger when I went to SG with PCOS, and SG worked well for me (we were paying OOP for IVF and qualified for shared risk). If I were older or had more complicated problems, I would find an RE who was an expert in my issue.

I got pregnant with SG for my first but after two years doing IVF and nothing happening I switched to GW, where I am now newly pregnant. SG is like a factory and isn't one to think outside their normal protocol, which didn't bother me at first. It was only after spending a lot of time with them, feeling like they were just guessing on what to do next that I had a consult with GW and felt immediately at ease. It's been such a pleasure working with them. I'd recommend talking to doctors at the clinics you're interested in, taking into acct the location that's convenient for you since you'll have to go in for bloodwork and monitoring. Good luck!

Blessed to get a baby from both SG and Dominion. But Dominion was such a better experience and a more productive cycle (maybe because they had info from my first one), but for us the smaller lab did just fine.

i've been listening to a lot of beat infertility podcasts and all the doctors and embryologists on there talk about how you need a big clinic with a big lab. the more ivf cycles they do, the better they're going to be at it.

for here, that clinic would obviously be shady grove. they do over 7,000 cycles annually, compared to about 700 for columbia, and about 300 for gw.

but then i read on here about how shady grove is like a factory and people with complicated cases get pushed out so ad not to mess up their stats.

what do you think?