February check ins

[turboteal]

I think there's some transfers happening this month? Good luck to those!

Had my retrieval Saturday morning. They got 9 eggs, 8 were mature. Today they let me know 6 fertilized. Day 3 update will be Tuesday I think. I am nervous because we had a lot more last time (like 19 retrieved, 12 fert, 7 blasts on day 5, 4 were pgs normal) and still only had 1 successful pregnancy.

[ilovecandy]

Turbo that is a great a fert rate. Had my transfer last Wednesday currently in hell. Thank goodness beta is Wednesday so the hell shouldn't last long. The progesterone side effects are awful and I while I was optimistic before transfer have been pretty pessimistic since thinking it likely failed

[doggielover]

I was going to do another hysteroscopy and biopsy prior to transfer however now I'm thinking maybe I should just see an RI instead before transfer. The RI will do all possible testing and do a specialized protocol based on blood numbers. I feel like my clinic did the minimum testing and generic protocol. The only issue is the RI is very expensive an the blood work alone is almost 5k plus (not to mention the cost of hysteroscopy/biopsy with them) and they want you to wait 3 months before doing a transfer so they can keep adjusting meds and doing monitoring before you get the green light to transfer.

I know it's still not a guarantee which is where I'm hesitant but maybe the generic blanket approach isn't ideal and after 4 failed transfers maybe I need more. Time also isn't on my side due to age. DH isn't really on board with me seeing an RI strictly due to price and needing to travel there because there's only a few RI's in the US. I'm kinda torn.

If I don't go the RI route I'll do my hysteroscopy/biopsy again with my current clinic and then transfer right after.

[ilovecandy]

Feb 8, 2021 11:23:17 GMT -5 doggielover said:

I was going to do another hysteroscopy and biopsy prior to transfer however now I'm thinking maybe I should just see an RI instead before transfer. The RI will do all possible testing and do a specialized protocol based on blood numbers. I feel like my clinic did the minimum testing and generic protocol. The only issue is the RI is very expensive an the blood work alone is almost 5k plus (not to mention the cost of hysteroscopy/biopsy with them) and they want you to wait 3 months before doing a transfer so they can keep adjusting meds and doing monitoring before you get the green light to transfer.

I know it's still not a guarantee which is where I'm hesitant but maybe the generic blanket approach isn't ideal and after 4 failed transfers maybe I need more. Time also isn't on my side due to age. DH isn't really on board with me seeing an RI strictly due to price and needing to travel there because there's only a few RI's in the US. I'm kinda torn.

If I don't go the RI route I'll do my hysteroscopy/biopsy again with my current clinic and then transfer right after.

Assuming my transfer didn't work we will be seeing and ri. Pretty sure we will be going to Vidali in New York. Not sure yet if we will do their fast track program which does all the testing upfront then the appointment to go over everything after ($3000) or a consult then testing. My insurance also won't pay for these tests but I need to look into it because they may pay the consult fees?

[pinkpeony08]

ilovecandy and doggielover - if you are looking at RI, I would look into Dr. Derbala in Detroit. He takes insurance and is newer to his own practice than some of the other clinics so his wait time is short. If he is like Dr. Kwak Kim's office, they don't bill as infertility code rather other codes if you don't have fertility coverage. He did a fellowship with Dr. Kwak Kim, who has a much longer wait but also takes insurance. Dr. Braverman was famous but is now deceased. His friend has taken over his practice, though I believe is a surgeon and doesn't have as full in depth understanding of the immunology aspect and doesn't take insurance so is very expensive.

I also just learned that Dr. Jubiz (who recently finished fellowship with Dr. Kwak Kim) just joined a practice in Florida.

[ilovecandy]

Feb 8, 2021 22:04:10 GMT -5 pinkpeony08 said:

ilovecandy and doggielover - if you are looking at RI, I would look into Dr. Derbala in Detroit. He takes insurance and is newer to his own practice than some of the other clinics so his wait time is short. If he is like Dr. Kwak Kim's office, they don't bill as infertility code rather other codes if you don't have fertility coverage. He did a fellowship with Dr. Kwak Kim, who has a much longer wait but also takes insurance. Dr. Braverman was famous but is now deceased. His friend has taken over his practice, though I believe is a surgeon and doesn't have as full in depth understanding of the immunology aspect and doesn't take insurance so is very expensive.

I also just learned that Dr. Jubiz (who recently finished fellowship with Dr. Kwak Kim) just joined a practice in Florida.

Thank you I have heard of him. Vidali is who took over for Braverman. I need to keep doing more research. Part of the reason I wanted vidali is because I have endomy and he is known for that

[ste]

I have a telehealth consult tomorrow night with the RE, and it’s also the DD from our loss. I’m feeling a whole assortment of mixed emotions. I have a therapy appointment today, thankfully (but also not really thankfully, because a big part of me just wants to pretend like tomorrow isn’t actually happening).

[pinkpeony08]

Feb 9, 2021 6:43:31 GMT -5 ilovecandy said:

Feb 8, 2021 22:04:10 GMT -5 pinkpeony08 said:

ilovecandy and doggielover - if you are looking at RI, I would look into Dr. Derbala in Detroit. He takes insurance and is newer to his own practice than some of the other clinics so his wait time is short. If he is like Dr. Kwak Kim's office, they don't bill as infertility code rather other codes if you don't have fertility coverage. He did a fellowship with Dr. Kwak Kim, who has a much longer wait but also takes insurance. Dr. Braverman was famous but is now deceased. His friend has taken over his practice, though I believe is a surgeon and doesn't have as full in depth understanding of the immunology aspect and doesn't take insurance so is very expensive.

I also just learned that Dr. Jubiz (who recently finished fellowship with Dr. Kwak Kim) just joined a practice in Florida.

Thank you I have heard of him. Vidali is who took over for Braverman. I need to keep doing more research. Part of the reason I wanted vidali is because I have endomy and he is known for that

Yes! Vidali is well known for endo, but there are a lot of qualified endo surgeons who take insurance too. Have you heard of Nancy’s Nook? They are an endo educational resource that also shares info about endo surgeons. I ended up having a lap last August with someone I found through Nancy’s Nook who was in my local hospital system. I had a great experience, though they only found a small amount of endo and no dramatic change in my labs. Just wanted to share bc you don’t have to pay out of pocket for all of this unless you really want to.

[ilovecandy]

Feb 9, 2021 8:05:34 GMT -5 pinkpeony08 said:

Feb 9, 2021 6:43:31 GMT -5 ilovecandy said:

Thank you I have heard of him. Vidali is who took over for Braverman. I need to keep doing more research. Part of the reason I wanted vidali is because I have endomy and he is known for that

Yes! Vidali is well known for endo, but there are a lot of qualified endo surgeons who take insurance too. Have you heard of Nancy’s Nook? They are an endo educational resource that also shares info about endo surgeons. I ended up having a lap last August with someone I found through Nancy’s Nook who was in my local hospital system. I had a great experience, though they only found a small amount of endo and no dramatic change in my labs. Just wanted to share bc you don’t have to pay out of pocket for all of this unless you really want to.

I have. I had a lap years ago. My Endo grew back within 3 years. I may try derbala just because he has free consults anyways.

[pinkpeony08]

Feb 9, 2021 8:09:49 GMT -5 ilovecandy said:

Feb 9, 2021 8:05:34 GMT -5 pinkpeony08 said:

Yes! Vidali is well known for endo, but there are a lot of qualified endo surgeons who take insurance too. Have you heard of Nancy’s Nook? They are an endo educational resource that also shares info about endo surgeons. I ended up having a lap last August with someone I found through Nancy’s Nook who was in my local hospital system. I had a great experience, though they only found a small amount of endo and no dramatic change in my labs. Just wanted to share bc you don’t have to pay out of pocket for all of this unless you really want to.

I have. I had a lap years ago. My Endo grew back within 3 years. I may try derbala just because he has free consults anyways.

Ugh, how frustrating that it returned. I hope you can get some answers.

[doggielover]

Feb 8, 2021 22:04:10 GMT -5 pinkpeony08 said:

ilovecandy and doggielover - if you are looking at RI, I would look into Dr. Derbala in Detroit. He takes insurance and is newer to his own practice than some of the other clinics so his wait time is short. If he is like Dr. Kwak Kim's office, they don't bill as infertility code rather other codes if you don't have fertility coverage. He did a fellowship with Dr. Kwak Kim, who has a much longer wait but also takes insurance. Dr. Braverman was famous but is now deceased. His friend has taken over his practice, though I believe is a surgeon and doesn't have as full in depth understanding of the immunology aspect and doesn't take insurance so is very expensive.

I also just learned that Dr. Jubiz (who recently finished fellowship with Dr. Kwak Kim) just joined a practice in Florida.

I'm actually looking into Dr. Derbala.  I know he takes insurance which is good however the lab he uses for me is out of network and some of the immune tests he does are not covered by insurance so it'll end up running me several grand.  The whole thing is overwhelming and trying to find a lab locally to me who will give me my blood is next to impossible.  They insist they can run the tests themselves but Dr. Derbala won't accept them then.  

[turboteal]

Today's update was good! 5 embryos are 8-12 cells, 1 is 4 cells (they should be 6 cells by day 3, so that 1 is a day behind). Hearing this was a big relief, I was feeling pretty anxious/doom spiral-y last night. Final update on Thursday before they go for pgs testing.

[pinkpeony08]

Feb 9, 2021 14:03:23 GMT -5 doggielover said:

Feb 8, 2021 22:04:10 GMT -5 pinkpeony08 said:

ilovecandy and doggielover - if you are looking at RI, I would look into Dr. Derbala in Detroit. He takes insurance and is newer to his own practice than some of the other clinics so his wait time is short. If he is like Dr. Kwak Kim's office, they don't bill as infertility code rather other codes if you don't have fertility coverage. He did a fellowship with Dr. Kwak Kim, who has a much longer wait but also takes insurance. Dr. Braverman was famous but is now deceased. His friend has taken over his practice, though I believe is a surgeon and doesn't have as full in depth understanding of the immunology aspect and doesn't take insurance so is very expensive.

I also just learned that Dr. Jubiz (who recently finished fellowship with Dr. Kwak Kim) just joined a practice in Florida.

I'm actually looking into Dr. Derbala.  I know he takes insurance which is good however the lab he uses for me is out of network and some of the immune tests he does are not covered by insurance so it'll end up running me several grand.  The whole thing is overwhelming and trying to find a lab locally to me who will give me my blood is next to impossible.  They insist they can run the tests themselves but Dr. Derbala won't accept them then.  

It’s frustrating, I was lucky to be an hour away from Dr Kwak Kim. For lab draws, My ob clinic was willing to schedule a tech appointment to draw my blood and take it with me. If you are having other blood drawn, I have had good luck about adding an extra 2-3 tubes to ship even when the policy is I’m not allowed to leave with the blood... the phlebotomist rarely cares. I know some of the tests they want to specific labs (the nk and inflammation labs go to Dr Kwak Kim’s lab in Chicago), but others can be drawn locally I presume or at a national lab chain like Quest.

[ilovecandy]

Feb 9, 2021 14:03:23 GMT -5 doggielover said:

Feb 8, 2021 22:04:10 GMT -5 pinkpeony08 said:

ilovecandy and doggielover - if you are looking at RI, I would look into Dr. Derbala in Detroit. He takes insurance and is newer to his own practice than some of the other clinics so his wait time is short. If he is like Dr. Kwak Kim's office, they don't bill as infertility code rather other codes if you don't have fertility coverage. He did a fellowship with Dr. Kwak Kim, who has a much longer wait but also takes insurance. Dr. Braverman was famous but is now deceased. His friend has taken over his practice, though I believe is a surgeon and doesn't have as full in depth understanding of the immunology aspect and doesn't take insurance so is very expensive.

I also just learned that Dr. Jubiz (who recently finished fellowship with Dr. Kwak Kim) just joined a practice in Florida.

I'm actually looking into Dr. Derbala.  I know he takes insurance which is good however the lab he uses for me is out of network and some of the immune tests he does are not covered by insurance so it'll end up running me several grand.  The whole thing is overwhelming and trying to find a lab locally to me who will give me my blood is next to impossible.  They insist they can run the tests themselves but Dr. Derbala won't accept them then.  

Well derbala is out. The require in person initial appointment because they want to do labs and a hysterscopy. Like I have all my basic labs done all I want is the immunology stuff. So we will likely head to Braverman with vidali later this year. My insurance also won't pay for most of it anyways. So we are just planning on paying for it all.

[Jalapeñomel]

My insurance will pay for one last FET. I do not know if I will do another one or not.

[doggielover]

Feb 10, 2021 11:54:34 GMT -5 ilovecandy said:

Feb 9, 2021 14:03:23 GMT -5 doggielover said:

I'm actually looking into Dr. Derbala.  I know he takes insurance which is good however the lab he uses for me is out of network and some of the immune tests he does are not covered by insurance so it'll end up running me several grand.  The whole thing is overwhelming and trying to find a lab locally to me who will give me my blood is next to impossible.  They insist they can run the tests themselves but Dr. Derbala won't accept them then.  

Well derbala is out. The require in person initial appointment because they want to do labs and a hysterscopy. Like I have all my basic labs done all I want is the immunology stuff. So we will likely head to Braverman with vidali later this year. My insurance also won't pay for most of it anyways. So we are just planning on paying for it all.

You only need to go in person 1 time, everything else is virtual.  The in office appt is for the hysteroscopy/labs/biopsy.  Derbala likes to do his own labs since the majority of the time something is missed from your RE.  Did you check with your insurance to see if they'll cover the labs?  There's a whole list of CPT codes for the labs they are going to run.  I'm just trying to find a lab that will give me my blood back so I can ship it (via fed ex) to the lab he uses.  From what Heather told me and several others on the FB group there's only a few dr's that use the lab for immune testing (Derbala, Kwak Kwan, all use the same).  Also, I'm sure you know that the office which used to be Braverman doesn't do immune testing, it's run by a surgeon who doesn't do immune testing (he's not an RI).  

[pinkpeony08]

I believe Braveman's clinic needs you to go once in person as well if you would like them to prescribe. Otherwise they can make med recommendations but you need to someone else to prescribe. You would need a very RI supportive OB and/or RE or MFM to prescribe. My OB was supportive of me seeking out RI after my history, but wasn't comfortable prescribing all of the medications recommended. He was ok with some, but not all.

[ilovecandy]

Feb 10, 2021 14:52:45 GMT -5 pinkpeony08 said:

I believe Braveman's clinic needs you to go once in person as well if you would like them to prescribe. Otherwise they can make med recommendations but you need to someone else to prescribe. You would need a very RI supportive OB and/or RE or MFM to prescribe. My OB was supportive of me seeking out RI after my history, but wasn't comfortable prescribing all of the medications recommended. He was ok with some, but not all.

From what I noticed they said it could all be done virtually. You can just have a lab draw the blood and send it in. But if pinkpoeny said is true then it is a moot point. I guess I have to contact them to find out. I have a re who is willing to work with their recommendations.

[pinkpeony08]

Feb 10, 2021 16:19:31 GMT -5 ilovecandy said:

Feb 10, 2021 14:52:45 GMT -5 pinkpeony08 said:

I believe Braveman's clinic needs you to go once in person as well if you would like them to prescribe. Otherwise they can make med recommendations but you need to someone else to prescribe. You would need a very RI supportive OB and/or RE or MFM to prescribe. My OB was supportive of me seeking out RI after my history, but wasn't comfortable prescribing all of the medications recommended. He was ok with some, but not all.

From what I noticed they said it could all be done virtually. You can just have a lab draw the blood and send it in. But if pinkpoeny said is true then it is a moot point. I guess I have to contact them to find out. I have a re who is willing to work with their recommendations.

Certainly worth investigating further. That’s great you have a supportive re. Do you have a supportive ob who could continue to prescribe after you graduate from the re? Or maybe the re would have a recommendation.

[ilovecandy]

Feb 10, 2021 16:22:16 GMT -5 pinkpeony08 said:

Feb 10, 2021 16:19:31 GMT -5 ilovecandy said:

From what I noticed they said it could all be done virtually. You can just have a lab draw the blood and send it in. But if pinkpoeny said is true then it is a moot point. I guess I have to contact them to find out. I have a re who is willing to work with their recommendations.

Certainly worth investigating further. That’s great you have a supportive re. Do you have a supportive ob who could continue to prescribe after you graduate from the re? Or maybe the re would have a recommendation.

The re we talked to recommended someone locally they work with (re we will switch to is 1.5 hrs away). But we also just decided to wait until we can switch our insurance plan when open season starts because tricare prime is annoying in dealing with referrals anyways and will be worse trying to figure this out vs going on the select plan hopefully some stuff may be able to get billed to them but who knows. I will be paying way more than the deuctibke on the plan either way likely. Might as well as deal with the plan that lets me self refer to specialist (I know several people here have tricare work have dealt with it).

[pinkpeony08]

ilovecandy ugh, insurance is the worst and so frustrating how much depends on it. I hope you you can figure all the details out.

[red]

Waiting for my transfer on Friday. Starting PIO on Vday, how romantic lol.

[turboteal]

Well fuck. I had no blasts by day 5, none by day 6, and 1 on day 7. I am concerned that it won't have good pgs result since it was so delayed, and I'm wondering if I should do another retrieval to try and get more to send at once (I think pgs costs the same if I send one or multiple embryos). I was not expecting such a dismal result this time.

[red]

turboteal- shit, I am so sorry. I hope that one tests normal and you find success with it. It’s so hard to know what’s right to do.

[Jalapeñomel]

Oh turboteal I’m so sorry. I know that feeling all too well, and it sucks so bad.

[pinkpeony08]

turboteal I’m so sorry