Post by wanderingback on Jul 7, 2021 17:20:08 GMT -5
Hi all! Was wondering for those that were able to choose, how you picked the REI doctor that you saw or are seeing? I'm over 35 and my partner is over 45 and I stopped taking my birth control method about 8 months ago and we've been trying for 6 months (assuming nothing happens this cycle). My cycles are regular and I seem to be ovulating from what I can tell. So it seems like next step is off to a specialist.
I live in a large city with endless choices and the privilege of decent health insurance. So not even sure where to begin. I have an appointment with my regular doctor in 2 weeks to get some recommendations, but otherwise, not sure if I should look for anything in particular or just go with who she recommends. I'd love to find a Black REI, but so far that seems pretty difficult. I work and live in 2 different parts of the city and taking off work isn't easy for me as I feel bad cancelling on patients, so I'm guessing maybe I should look closer to work so I can minimize travel if I have to leave early? Otherwise not sure if there's anything else in particular I should look for. I'm usually a pretty go with the flow type person, but thought I'd see if anyone had any suggestions.
Sorry to see you here, but hopefully you'll have a short stay. One thing I did was reach out to find out how long it takes for new patient appointments. Some places take forever. I suggest unless you have to pay up front just to schedule, that you schedule for any place that may work because you can always cancel. That first appointment will tell you a lot, including if you can deal with the doctor, staff, receptionist, etc. Also knowing how they structure their appointments should help you. As a doctor, I'm sure yu understand limitations but some places make more logical sense than others. Some require more testing to start than others and success varies, especially by age group. Don't let anyone talk you into a treatment you aren't comfortable with. Good luck!
Long version - I moved to this city in late 2018. This city is home to a medical school. My new neighbor was (since retired) the dean of the college of nursing associated with the school. She set me up with a primary, neurologist (hx of brain tumor), and ob/gyn.
On my first ob/Gyn visit, he asked if I wanted kids. He was waiting for his fellowship into RE. I was ~4 years post brain surgery at the time. I told him I wasn’t sure due to history. He referred me to his mentor who he would be training under fellowship. I had a genetic screening and other basic blood testing, including AMH, which was on the higher side for my age so we decided to wait. 3 years later, here we are. My OB/Gyn is currently in fellowship
As if this isn’t weird enough…we bought this house from an estate. Unknown to us at the time, the deceased was also an RE. She (the deceased) trained my current RE. And my RE is training my OB/Gyn
Post by thoseareradishes on Jul 7, 2021 20:27:49 GMT -5
I had a fibroid that needed to be removed, so my gynecologist had a recommendation for a local RE who I stuck with through the first few rounds of treatment. The office was close and convenient. Monitoring appointments (ultrasound and blood work), once you are doing treatments, are often very early in the morning. After no success there and more issues coming to light, we changed to a big clinic that had a state of the art lab and is on the forefront of research and development. It was much less convenient. Monitoring hours were 6-7:15am, so I was getting up at 5:30am. But ultimately it was worth it.
We did check out another clinic closer to home but their monitoring hours were annoying (scheduled rather than first come first served), always running behind, there for an hour plus sometimes), so that just wasn't going to work.
There is a website called FertilityIQ that might be helpful too. Good luck, and hope it ends up not needed!!
Post by jerseyjaybird on Jul 7, 2021 23:17:05 GMT -5
We are on our third clinic, so we seem to be choosing based on trial and error! In sum, we chose our first clinic because it was cheap, our second because it was convenient (which is not nothing when you're visiting frequently for monitoring), and our third, and current, clinic because we finally feel that we are in hands that are both capable and compassionate. I suspect that those of us who have lots of choices have to find some balance among these characteristics. Every time we've chosen a clinic, we've had consults with 2-4 doctors/clinics before committing.
If Hoboken would be at all convenient for you, our new clinic's office there is the home office for an RE who is a Black woman:
I got a referral from my ob, but once I met with a few people in the office, I definitely preferred one md over the others in the practice. I also have had the issue of recurrent loss rather than difficulty conceiving.
In general with finding good providers, I’ve had the best luck asking around friends and colleagues. Especially friends and colleagues who work in medicine. I am an NP myself. I’m not sure if you are comfortable asking around? You could always say it’s for a friend or cousin, etc if you aren’t comfortable asking for yourself.
As others have alluded to, monitoring appointments are usually early in the morning (and there will be a lot of them if you pursue treatments), so as far as location goes I'd choose one that would the most convenient to be at around 7-8am. I also live in a city with tons of great options (Boston) so I chose a clinic at a well-regarded hopsital near my work and stopped for my monitoring appointments on my way into the office. Had it been across town it would have been really stressful to manage.
Post by seeyalater52 on Jul 8, 2021 14:05:53 GMT -5
Hi Wandering - I was wondering how this was going for y'all. So sorry it hasn’t worked out yet.
Definitely echo the suggestion to work with a clinic convenient to your early morning location. And if you need particularly early options (for example 7am vs 8am) you might want to call some places and ask what their “monitoring hours” for people cycling are.
I also live in an area with a million clinics and chose based on the “feel” of the clinic for lack of better word. The clinic success rates and such (SART data etc) are all similar, so we went with the place with more personalized attention from the REs. I liked having access to my doctor when I needed her and not have to wait a month for a follow-up or regroup appointment once we’d completed a step of treatment. In fact, since we were in active treatment for more than 4 years straight our timeline to a live birth would have been MUCH longer had we been waiting around. She called me personally with results (embryo freezing report, beta hcg results) every time and we set up next steps then. I also preferred that they had only 3 REs on staff so even if I wasn't seeing my doctor I was seeing someone who knew me and was familiar with my case (ends up being extra helpful if you are a “difficult” case.) REs did all scans for cycles which was also nice. I’m the kind of person who would go nuts if a tech did the scan and wanted me to wait hours for a nurse or doctor to call with the information. Having it right there (how many follicles, how thick my lining was) was helpful.
If you think you might want to do treatment or choose options (for example PGS testing) that insurance doesn’t cover, finding out about process and pricing may also be useful. The cost of PGS varies substantially from clinic to clinic depending on how they charge the biopsy and what lab they’re using for testing.
We consulted at a million other clinics about halfway through wondering if we should switch and for all the above reasons we stayed and I’m glad we did.
Post by starburst604 on Jul 8, 2021 15:08:50 GMT -5
A family member recommended her RE and after doing some research on her and determining that location-wise they were a good fit, I booked with that doctor. Have you done any other testing yet? I found that it was helpful to have some basic testing ordered by my gyn for the RE to look at when we went for the first consult. I'd had an HSG and labs done, and my H had a sperm analysis done. Her office had already researched the particulars of our insurance, so with all that information on the first consult we were able to formulate our plan of action right there and forged ahead right away with IUI (which was the first step required by my insurance before they would consider IVF).
I was 38 when we got started, so I was pretty fastidious about the timing of everything. When I was coming up on 5 months of TTC I booked the gyn appointment for a month out. She ordered testing and recommended 3 months of Clomid. I booked right then with the RE and her next available was 3 months out, so I figured there was no harm in trying Clomid in the meantime. So I was in with the RE by my 9th month of TTC and we lucked out with a successful first injectables/medicated IUI with her.
Post by wanderingback on Jul 8, 2021 17:55:45 GMT -5
Wow thank you so much everyone for the advice! That's good to know about morning monitoring appointments. I actually think there are a lot of options between where I live and work, so that should work well if I have to go to my appointment on my way to work. I'll def check out fertility IQ for info, thanks for the rec thoseareradishes.
starburst604, nope I haven't done any testing. I made a televisit appt with my doctor. When I start the basic infertility work up for my patients I like to get FSH and E2 on days 2-5, so I didn't even think about if I should try to make my appointment around that time and do it in person. But I guess I'll just talk with her and see. I did have a TVUS last year for unrelated reasons and everything looked good and I had lots of follicles that I could even see on the huge screen the tech was using, haha. But great idea about the semen analysis, I'll talk to my partner.
I'll have to think if I know of any friends who have gone down this route that I can ask.
Appreciate everyone sharing their experiences as it's super helpful to know some things to think about. Will keep you all updated with what I find if that's ok
Post by tacoflavoredkisses on Jul 8, 2021 18:06:32 GMT -5
I didn’t need a referral so I called my insurance company to get a list of in network REs in my area. After doing a little research, I picked the largest clinic (it was also closer than others) and was assigned to an available doctor who ended up being perfect for the short time I saw him. I ended up finding out I was pregnant right before I planned to schedule an HSG.
Post by stellelinds25 on Jul 9, 2021 12:20:29 GMT -5
I have zero fertility coverage, so I chose an office based on recommendations. And I was happy there for awhile, but started getting pushed off after a failed retrieval cycle (I didn't respond to the meds) and later found out it was b/c my RE was leaving the practice and joining another. I left BEFORE I found that out, but everything made sense then. I switched to a large, well-known practice for the tri-state area (I live in PA) that happened to have an office where I live and have been beyond happy with them!
Long story short, like the others said, choose somewhere that is convenient to home/work, comes recommended or is well known and make sure you feel like you "mesh" with the dr. I never felt like I did with my first RE, but my cousin had success with him and I honestly didn't know any better to advocate for myself, so I stayed. Good luck to you, I hope that you have success quickly!
Post by wanderingback on Jul 9, 2021 14:34:57 GMT -5
Thanks again everyone - just a quick update. I went ahead and made 2 appointments and then will see if when I go see my doctor she has another recommendation and if she wants to do bloodwork. So I have options just in case! They're both on my way to work and seem like they have good hours.
One option I kinda made cause it was easy to make an appointment online, but the other had great reviews and making the appointment I already talked to the doctor's personal assistant and she seemed really nice and helpful, so I'm hoping it's a good fit.
I talked to my partner about doing a semen analysis and he said he'd figure that out. Hopefully I don't have to remind him :/ But at least we have until mid-August. So it seems like things are moving ahead!