Tuesday, January 10, 2012

New Year, New Doctor

It’s official, we made the leap to a new RE (fertility doctor). 
So scary to try this with a whole new office, new nurses, etc. 
After our last cycle, we started feeling like it might be time to move on to a different doctor. Not that our old RE had done anything wrong... we just felt like maybe we should look around for someone with better percentages. After spending almost 40k out of pocket (our insurance doesn’t cover IVF) for our first 2 cycles it was time to give someone else a shot. My husband likes to use a gambling analogy... There comes a point when you have been gambling and losing your ass (money) at one table... when you need to pick up what’s left and move it to another table (this is of course because we aren’t done gambling yet). So we are onto a new table. 
This decision wasn’t an easy one. After much research and discussion we decided to get second opinions from two other REs. 
Second Opinion #1 was with a doctor from CCRM (Colorado Center for Reproductive Medicine). We had scheduled this phone interview with them a while ago and had it at the beginning of December. The phone consultation was $250. They had all of our medical records submitted in advance so they knew what they were working with. The doctor himself was informative, educated, funny and nice... that said... I didn’t get an overwhelming sense of “I feel good about my ability to get you a baby”. I don’t know. Maybe I just wanted some kind of hope from him. He mentioned donor eggs and that that should be a possible next step for us. He said he was willing to try with my own eggs since donor eggs will work the same for me today as they will in 5 years. That was hard to hear. I wasn’t prepared for the words donor eggs or for the feeling that using my own eggs was some kind of consolation till the inevitable. Maybe that is a reality for us in the future and if so... it is something I will need to process... but for now... I want to keep trying with my own eggs. Other than that... we love CCRM. They are a well oiled machine and highly successful with difficult cases. That was definitely appealing. What wasn’t appealing was the price. The cost to cycle there is so expensive. We would have to do PDG (since my egg quality is so bad) on the  embryos which means we couldn’t do a fresh transfer. We would have to cycle, retrieve the eggs, pgd biopsy on day 5 and come back a couple months later for a FET. Just seemed like a long process and did I mention expensive? One cycle cost was almost as expensive as the 3 cycle package available with RE #2 below. 
Second Opinion #2 was with a doctor in my Southern California area. Their success percentages were higher than my last RE but not as high as CCRM. The doctor himself was a bit cold, clinical, informative and definitely made a few jabs at my old RE (which wasn’t attractive). The lab is pretty new and state of the art which is something my hubby and I really wanted this time around knowing one of our issues has been embryo quality/health. They also offered a 3 cycle package which we were interested in to help diffuse the cost of future cycles. We of course didn’t buy any kind of package originally because we were going to get pregnant on the first one. Right? Lolz. Anyway, I actually left the consultation and flat out said... we weren’t going to be cycling there. Again... I wasn’t getting any hope from this guy either! All I wanted was for someone to say... “oh yes... I see this all the time... I can make this happen for you two”. I suppose that is not reality. But still. He was pretty cold and not really very like-able. Then... I slept on it... and woke up feeling like I wasn’t paying this guy to be my friend. I wanted a baby, not a new RE friend. If this guy has a better chance of making that happen for me... then I needed to rethink about cycling with him. A bunch of things we wanted in terms of our next cycle this guy had (new lab, good percentages, 3 cycle package, advanced methods for sperm selection, PGD biopsy at day 5 vs. day 3 and he was local).
In the end... we went with the Second Opinion #2 (we are going to call him Dr. Cold). We choose him basically out of convenience (no traveling) and the fact that we could afford multiple cycle with him (if that’s what it took). 
Interesting enough, at the consult with Dr. Cold he had recommended I go through a RPL (recurrent pregnancy loss) panel of blood work. I had really wanted this completed after my recent miscarriage but my old RE hadn’t felt it was necessary. When Dr. Cold suggested it... I jumped at the chance. Guess what... we found something in it. OMG. Could you imagine if we had just kept cycling with the old RE and never knew about this? I was found to be positive for the MTHFR gene mutation. Compound heterozygous - one copy of the C677T mutation and one copy of the A1298C mutation. I am still in the process of learning what all of that means but it is tied to recurrent miscarriage. I understand it has to do with the bodies ability to clot and also process folic acid, B6 and B12. The office immediately called and put me on a prescription for MetanX, which should help my body get the folic acid, B6 and B12 it needs. I imagine we will need to discuss blood thinners, etc when we do get pregnant but for now I am just pleased we know about it... and are doing something for it.  
Needless to say... even if my new doc is Dr. Cold... I am happy he saw a need for additional testing and now we can deal with this next cycle with even more information. 
Still trying to figure out how to let my old RE know we won’t be cycling with them in Feb, Eeeeeep! I love this office and doctor. The whole team is awesome. They have been through so much with me. They hugged me when I got pregnant, hugged me when we lost him/her and were there for me for everything in between. 
As much as I loved the connection with my old RE and his office. I feel good about our choice. Looking forward to my next cycle as it rapidly approaches!

Ready for IVF #3! 


  1. Good luck with your new RE. I'm starting to feel like it might be time for second opinion for me, too, but I hate going to new doctors, so I've been putting it off.

    That's great that the RPL pannel actually gave you some useful information and that your doctor is doing something with it. I have MTHFR, too, and I've found that there is a lot of variation in how different doctors treat (or don't treat) it. I hope this turns out to be an important missing piece in your fertility puzzle and that your February cycle goes well!

  2. Wishing you the best of luck with this new RE. Changing doctors is never easy, but you need to do what's best for you. And it sounds like he's off to a good start!

  3. Hi,
    I just found your blog and want to wish you the best! Just have to tell you that I had tremendously better egg quality after taking large amounts of CoQ10. I did two IVFs and there was much better egg appearance according to the lab, plus on the first IVF I had a chemical pregnancy and on the second I had a live birth. I was also older than you: 38 for the first IVF and 39 for the second. I have told other women about this on a board I am on and about 5-6 have gotten pregnant and had babies too (all late 30s). I took 200mg of CoQ10 and 200mg of Ubiquinol twice a day with meals. Ideally you'd take it about 2 months before cycling. Just consider it and possibly google CoQ10 and egg quality. Good luck!

  4. P.S. CCRM recommends donor eggs WAY too early . . . at age 36 they told me that was the only way I'd get pregnant. Given that I had a healthy daughter at almost 40 with my own eggs through IVF at a different clinic, they were dead wrong. Just disregard.

  5. Thank you everyone for the comments!!!

    JNS - Thank you for finding me and commenting. I actually started taking CoQ10 (200mg twice a day) a few months ago in preparation for this coming cycle. I am also taking Inositol and L-Arginine too. Hoping all of those help with egg quality and am so happy to hear your success story. :)

  6. I'm really glad things are doing so well with your new doctor. Your easing my fears about changing doctors. We meet with our new RE in Feb. I really hope things go well for us both!

  7. Hi Denise-I didn't realize you were in SoCal too. I just switched-again-and it sounds like this was the right thing for you. I agree that in the end it's the ability and the numbers. My new guy is super sweet, but also very successful, and has recommendation from friends who were my age (40 plus) and achieved success.

    I've been on co-enzyme Q10 for about 6 months now. I don't know how much or little it contributed, but I went from 1 crappy egg retrieved to over 10 on following cycles.

    Best of luck to you!

  8. Good luck with the new RE Denise! Sometimes change is good if you've had no results. That is excellent he had you tested and you learned another piece to the puzzle. I have that too, but my RE was not concerned. I had just been tested for B12 and folic acid and everything looked okay.

    I love all the comments about COQ10 since I too have poor egg quality. I've been taking it since April, but not sure how it is translating to better egg quality.

    I have to do PGD next time too. So expensive for everything. All out of pocket like you. I was under the impression that they did a 6 day transfer after PGD.

    Anyway, it seems they are taking good care of you and you know so much of what is going on with your body so I think you're in a great place! :)

  9. Well, I am glad you guys made some changes and it sounds like Dr. Cold will be just what you need! Wishing the best for you both!

  10. Good luck with the new Dr. That is so great they found something that they can do something with the results they found!

  11. Oooh, I want to hear about what your IVF doc says about MTHFR. Please keep us in the loop! xoxo

  12. Hi, you visited me from my blog (ocw2010.blogspot) and I thought I'd visit and wish you luck on your upcoming cycle. Have faith in Dr. Cold, he was my RE too and he came HIGHLY recommended by friends of ours that are both doctors and did extensive research on REs in OC. Dr. Cold has the best lab in OC, the embryologists are excellent. You are in good hands. I felt the same way about Dr. Cold's attitude but honestly after a few weeks with his office, he REALLY grew on me. I always had faith that I had the best Dr in OC for this job, and I'd rather have that than a "really nice guy". You will love the staff and convenience of the 2 offices too. Email me with ANY questions at all, I'd be happy to chat with you. ocwife1977 AT gmail DOT com.

  13. I wish you the very best with your new RE! Maybe you can send me some info on Dr. Cold...I'm in the So Cal area as well. We've been starting our research on docs. Right now, just in the beginning stages of dealing with IF...best of luck again and keep positive!!! ;)

  14. your new doc sounds more responsible than the last guy, even if he's 'cold'. good luck!!