Did any of you have to make a choice about which clinic to go to for IVF?
My husband and I live smack-dab between two of the major IVF clinics in our state — each is about a half-hour drive away. Our RE is affiliated with one, which is at the big-name teaching hospital (BNTH) in the area. But once I knew we’d be starting IVF, I took a look at the SART data for clinics in our state. The results surprised me.
Based on the SART data alone, there’s no contest — the other clinic (I’ll call it the IVF Factory) has live birth rates for both fresh and frozen cycles that are significantly above the national average, and does many more of both kinds of cycles than BNTH. The fresh cycle rates are different only at the margins of statistical significance, but the frozen rates are miles apart — with BNTH way below the national average, and they hardly do any to begin with (we’re talking single-digit numbers of FET cycles in the 2013 data). So, why the difference?
I could think of several possible explanations:
- Maybe the IVF Factory haphazardly transfers more embryos, resulting in more multiple births. Nope — both the average number of embryos transferred and the twin pregnancy rate are lower than BNTH.
- Maybe the IVF factory is more choosy about who they accept as patients. If BNTH helps anyone who walks through the door while the IVF Factory turns unlikely-to-succeed patients away, that could artificially lower their IVF success rates. This is harder to figure out, but I think there might be some truth here — proportionally, the IVF Factory only does half as many transfers for women over 42 as BNTH.
- Maybe BNTH is more open to using cutting-edge and experimental techniques. Sometimes these will work and sometimes they won’t, so their success rates might be more variable.
We’re also going by feel, to some extent. IVF factory seems to run like a well-oiled machine. Last night we went to their required 2.5-hour seminar, which was led jointly by one of the five doctors and their staff psychologist. I had… mixed feelings about this seminar. On the one hand, I felt like a cog in a wheel, not an individual. With well over 800 cycles per year, you know they’re cranking through patients every day. On the other hand, IVF is clearly their focus — they do it a lot, and they do it well. Their seminar was really well organized, and if that organization carries over into their desk staff… well, that would be an enormous relief.
At BNTH, the operation is a little smaller and a little more varied. The doctors are all professors and do research and training in addition to patient care. I like the idea of being part of a teaching hospital, as a teacher myself, and I like being advised by people who are actively working on research… but at the same time, I’m also feeling like I’ve had a lot of mistakes and crappy medical care throughout this process and I’m worried about some sleep-deprived medical resident making even more of a mess of my reproductive system (especially since we’d be starting in July!). It also might be a case of the devil you know vs. the devil you don’t. I am constantly frustrated by the inefficiency of the front desk staff at BNTH, and while I love their scheduler (seriously, she’s amazing), at our last appointment we had to wait an hour for a 10-minute conversation with the doctor, and it always takes at least 10 minutes just to check in. There’s a lot going on there, and they just feel sort of disorganized about it all. That said, maybe I’d get into the IVF Factory and would wind up feeling like there was a lack of flexibility and responsiveness.
This is probably also going to sound a little precious, but IVF Factory does seem to do a really good job (at least as far as we’ve seen so far) with streamlining the whole experience for you. Their seminar did a fabulous job of laying out important issues that we need to discuss as a couple — embryo freezing, banking semen, ICSI, etc. — and laid out some of the ethical and scientific pros and cons of the various options. At BNTH, by contrast, we were handed a thick paper packet of extremely technical medical information and were told to read it and bring any questions to our appointment with our doctor next time. The IVF Factory also hosts one of the few Resolve support groups in the state, and their staff psychologist both takes my insurance and explicitly offers to help identify good local therapists who specialize in infertility and pregnancy loss. BNTH’s social worker was useless when I tried to find a therapist who took my insurance, and after picking a name at random off my university’s mental health resources web page I wound up with a not-so-awesome therapist who I just sort of stopped seeing after two sessions.
If you can’t already tell, at the moment we’re leaning towards the IVF Factory, even though it makes me feel like a little bit of a sell-out. I think the frozen transfer rate difference is the biggest factor, along with the generally rosy SART numbers, but like I said, a lot of it is feel. And I’m irrationally worried about offending my doctor. It’s not as though I feel any great loyalty for her, as I’ve probably only had about six or seven total appointments with her over the last two years, but I really like that she’s listened to my concerns and that she found the problem with my tubes right away. A good relationship with a doctor is something that I’ve come to really value through this whole process.
So, we’ll see. We have an appointment set up for a consult with one of IVF Factory’s doctors in a couple of weeks (they wouldn’t let us do a consult before attending the 2.5-hour seminar, which was annoying). In the meantime, I need to go back to BNTH for an ultrasound at the start of my next period to see if I require surgery to remove my “partial hydrosalpinx” before starting IVF (my doctor says she doesn’t think so, but wants to check just in case). And then we’ll have to do some thinking and evaluating — but we can’t wait too long. I’d really love to get through one cycle before classes start again in the fall!
Anyway, that’s where we are. Any thoughts, insights, or stories of how you made your own choice of IVF clinic would be much appreciated!