The importance of a 2nd opinion

After it is all said and done, we will have ended up with 3.5 consults as 2nd opinions (CCRM counts as 1/2 of a consult;)). I cannot emphasize enough the importance of getting a 2nd opinion for failed IVF cycles! I don't know what the outcome will be for us in the future but it is so important that no stone is left unturned.

Our 1st cycle was local and had dreadful results. No blasts or even morulas resulted in that cycle. At the WTF meeting, our RE gave us a blank stare when we asked what went wrong.

So we switched to the Chicago clinic. That clinic is really great. Granted I have had problems with their billing department but their nurses are consistently on the ball and our RE is one of - if not, the best in the Midwest. However, we would probably not go back there even if our insurance would cover that clinic. We were gravely disappointed with our WTF meeting. The suggestion that we just reshuffle the deck and hope for better eggs is really not something that we have the luxury or emotional capacity to waste money on. It seems almost careless to suggest that. He could have easily thrown us a bone during our 5 minute conversation (that costed us $120 I might add) that involved a protocol tweak or he could have suggested that next time we do all the monitoring in his clinic to pinpoint the most effective trigger date. After we requested our records we learned that during our successful cycle in 2013, we did not have 8 mature out of 13 retrieved as originally communicated. Actually, all 13 of our eggs in that cycle were mature (same as this past cycle). Only 8 fertilized normally. Does this make a difference? Apparently to the RMA doc, it does. My E2 was 4800 on trigger day as well and I only produced 13 eggs. We only had 2 poorly graded blasts result from that batch - of COURSE, one of those blasts was Kellen so the cycle was not a failure. But as the doc at SIRM said, "we got lucky".

So there were things wrong with our successful cycle too that we really should have looked at before trying this past fall. Had we requested our records and talked to other docs before proceeding, maybe we would have had a different outcome...but maybe not. My point is that you are your best advocate. Success with IVF is highly dependent on 2 things - the right protocol and a high quality lab. If your doctor is not interested in your case enough to apply a tailored protocol to your individual situation, that is an obvious red-flag. Lab quality is harder to gauge. The people that patients talk to when choosing a clinic are the RE, nurses, and admin staff. We never have consults with the embryologists. We don't know what their lab protocols are and we have no idea what exactly it is that they do. So we must rely on the clinic's word and age-specific success rates from SART. In my case, my successes and failures have been no surprise based on these rates. My local clinic is below the national average for all age groups. The Chicago clinic is very high for those under 35. There is a large drop in success for women older than 35. With that said, there is an unfair disadvantage given to those clinics who have excellent labs but attract and accept difficult cases, many of whom go on to have low success rates. So lab quality can't be based entirely on the success rates. It's all basically a crap-shoot. A gamble. A gut-feeling. All you really can do is ask God if you are making the right choice and if you are doing everything within your control because in the end, God is giving the first spark of life in that incubator - not an embryologist or gifted RE or your beautiful eggs. God is the reason why some beautiful embryos fail to form babies and why some ugly embryos do. He is the reason behind all that is unexplained. We are still not doing this alone. However, when a possible answer has been found, that is something that should be explored and utilized for success. I've said it before, God gave us brains to use for a reason. It would be a waste of His creation to not use our knowledge.

I am babbling at this point, but my point has been made. Get a 2nd opinion!!