59 replies to this topic

[Dalia]

Hi everyone,

 

Trying to find out  which clinics are really good in Canada.  To my expectations, good clinics are the ones where;

• only one doctor looks after you versus many
• nurses do not apply insemination
• nurses do not give opinion about drug reaction
• when your body reacts to a drug, you can see your dr.
• close monitoring during the treatment cycles
• they don't treat you as a statistical data
• you can get an appointment without waiting for months

Please share your expectations as well so maybe the clinics, which are trying to get competitive in baby making business will see the requirements.

 

I am from a city where there is only one fertility clinic. I had very bad experience with the system they are using. I stopped the whole fertility treatment once my body reacted to one of the drugs they used after insemination and a nurse advised me to go to my family MD or emergency as it had nothing to do with the treatment. That was it..!

It was 2.5 years ago and now I am trying to find a clinic for IVF. I know the Victoria Fertility is really good but if there is other clinics as good, it would give people like me more options.

 

Fertility treatment is such an emotional and private matter and one needs to trust the Dr. the clinic and their system... Thanks....

[GraceM]

Create fertility is very good.  You can see a dr. every time you visit, usually your own dr.

[SunshineTTC]

Although you mentioned it so you might already know details, a vote for Victoria from me.  I started at OFC (when I was living in Montreal, but under OHIP), so I know EXACTLY what you're talking about!  Feels like an assembly line... when I moved, well I guess they assumed I didn't get pregnant?   I had 3 IUIs there, the 3rd one a nightmare nurse spent 25 min trying to get the catheter through including transferring the sperm to a new catheter, finally calling in a resident... 45 min later... ugh!  And the last time I spoke to "my own" Dr was after the 1st IUI.  I felt like I was just a number.  I've also experienced another clinic in between. 

 

If you want personalized service, VFC delivers.  There are 2 Drs (both are great), but Dr Hudson runs the show -- you may have the other Dr for ultrasounds or egg retrieval etc, but the communication between them is great, no worries about 8 different Drs having no idea who you are or what your progression has been and unable to answer questions.  Also very individualized protocols, if you are someone who needs that.  You have Dr Hudson's email (and he does respond to patients quickly), emails for the 2 nurses (who are fantastic, and get to know you well... they're not just faces who work there), emails for embryologists, financial person, etc.  The Drs do all the ultrasounds, you even have his home number "for emergencies".  They are compassionate and seem to truly care about doing everything they can to get you pregnant, vs. just being a baby-making business.  If they were worried about their stats they would have never taken someone like me -- instead they were willing to "try", clearly telling me my chances were low, but having seen success with a few others like me they agreed it was worth a shot to find that golden egg.   Dr Hudson does phone/Skype consults, there may be a couple months wait for that, but then you can usually start almost immediately.

[Dalia]

Oh wow, you have much more patience than I do...  In my case; the nurse couldn't even place the speculam right, and after 5 min trying to place the catheter, I asked for a gynecologist and the whole process took 30 seconds with him.  But hey, she has 16 years of experience.!

 

Anyways, it is what it is. I really wish I wasn't that naive at the beginning and did my research right.

 

Luckily, I've met someone who had a great experience with Victoria FC, and that is how I know. I am also hoping to find out more about the other clinics, and give the heads up to other ladies who will go through it. I am about to set up a consultation with Dr. Hudson; a little bit worried as I will go through the first 10 days of IVF treatment alone and my husband will join me later

[Makana]

Yup....what sunshine said!! Good luck with your consult!

[gibasgirl]

I have heard good things about VFC (Victoria Fertility Centre). Same with Olive Fertility Centre. These are in British Columbia.

Create fits your criteria of seeing your doctor at each visit, but it is not uncommon to spend hours there for an appointment, just waiting around. Some doctors are more punctual than others, but they will spend time with you.

Markham Fertility Centre is very good. They monitor their patients closely. There is a 9-month wait to see Dr. Virro, though. There is a much shorter wait to see Dr. Garcia.

The last two are in Ontario.

All the best to you.

[Dalia]

Does anybody knows if any of these clinics have a anaesthetist for egg retrieval?

[Lola1973]

Markham does (I am a patient).

[BOOM]

Ya I heard VFC is pretty awesome! I'm shocked they would have an anesthesiologist at any clinics, does ur clinic put u under??? Our clinic just uses sedatives, to help relax and for pain etc:) Good luck in ur hunt!!!!

[SunshineTTC]

I was not aware that any clinics in Canada put you under for egg retrieval?  I think it's normally just IV sedation, which is plenty... I wouldn't want to be put under, definitely unnecessary and I'd rather be somewhat conscious (though dopey!) to what is going on.  At VFC usually the Dr hooks up the IV.  I usually feel some minor pain/discomfort when the aspiration needle first goes through, but others have said they've felt nothing.  You also get an Ativan before hand to begin to relax you, as well as Tylenol and gravol to ward off any pain or nausea after the procedure.

 

re: 1st 10 days, if VFC then you should be able to do your baseline blood testing and ultrasound in Ottawa (they will arrange), and then the first days of meds at home, only flying to Victoria when they need to start monitoring you.  I've done my baselines either in Regina or once in Ontario when I was visiting.  I fly to Victoria on cd 8 (might be earlier for someone on higher doses of meds).

 

Let us know what the wait time is for a phone consult with Dr H, there are others who have asked on these boards as well.

 

re: "patience" for that last IUI at OFC... I actually started asking if we should get a Dr about 10 min in, and the nurse kept insisting no, no, I'll get it and refusing... I should have insisted, but I was more naïve back then (and with your feet in stirrups, not a lot of power, lol)

[Dalia]

Why she had to call the dr after 5 min. opens another can of worms, beause I started having cramps and told her that my hysterosonogram experienc was a very painful one:(  That's why I'd rather have an anesthesiologist instead feeling the pain..

 

This is not the first complaint they received; and  probably the reason why Sunshine's nurse didn't want to call for the DR. right away. They use nurses in any of these grey areas in CMA to save money....

I personally do not recommend anyone to have IUI done by a nurse, simply ask for one of the specialist. This is what gynecologist are trained for; and the amount of money we pay, we should be treated by one...

[gibasgirl]

Does anybody knows if any of these clinics have a anaesthetist for egg retrieval?

They all do. Some do "twilight sedation" and others fully sedate you. But there is some level of sedation during retrieval.

[BOOM]

Wow I really am shocked that these clinics have them, bc it's just sedation. AB & NS does not have them. Very interesting...😊

[Red Wine]

 

Does anybody knows if any of these clinics have a anaesthetist for egg retrieval?

They all do. Some do "twilight sedation" and others fully sedate you. But there is some level of sedation during retrieval.

 

I think the doctors prefer "twilight sedation" as opposed to fully sedating patients as there are more risks associated with full sedation. There are risks with any medications that one takes, but full sedation can result in death and that is the most severe side effect. The IVF clinics are not using "twilight sedation" as a form of punishment, but an ER is a relatively quick procedure to perform (10 to 20 minutes) and with the "twilight sedation" it is quite effective. I felt some pain, but nothing too overwhelming. 

[Merry33]

I wouldn't want to risk general anesthesia but if you have an anesthesiologist at hand they can give you much more effective drugs for conscious sedation. I had two very awful retrievals (at two different clinics, so it definitely wasn't the doc's fault; guessing it's an issue with how my ovaries are positioned) and then I had a procedure in the hospital, also under twilight sedation (but that time I really fell asleep and had zero pain). If I ever had to do it again I would be willing to pay to get that same type of hospital sedation for retrieval. For me it was a day vs night difference. I was so horrified before the procedure because of my bad previous experience that the anesthesiologist thought I was crazy (I told him 10 times that he really needs to use different meds and a higher dose than at my retrievals). Afterwards I thanked him 1000 times and told him that he's my favorite doctor in the world, lol.

In summary, I can definitely see the benefits of having an anesthesiologist. They're awesome people Unfortunately I'm not aware of a clinic in AB or BC that has one.

[Merry33]

PS - anesthesiologists are also awesome at starting IVs, unlike most nurses at fertility clinics who couldn't ever even find a vein in my hand. Took the anesthesiologist about 5 seconds. Did I say they're awesome?

[SunshineTTC]

I don't believe it's the norm anywhere in Canada - relatively speaking, there wouldn't be enough work for an anaesthesiologist at most fertility clinics.  In the US where they do put you under, you usually pay $5-700 more directly to the anaesthesiologist just for that.  Pretty sure "any" nurse is not allowed to insert an IV tough?  You need specific training for that.  Took Dr at VFC about 5 sec, after first injecting a bit of freezing.  They also adjust the drip if they see that you are feeling too much discomfort.  I'd rather be conscious to what's going on, including knowing first hand how hard the Dr worked during the retrieval to try to get those eggs when we ended up with fewer than expected.

[Dalia]

Is the "twilight sedation" just an IV in the arm? I am pretty sure at the time there was local freezing involved with an injection to "down there"....

 

 I think ER pain is various on each person; I personally prefer to have an anesthesiologist to make me a more  effective cocktail,and  no injections to my precious

 

No need to be a hero for each of these fertility procedures, it can wait for child birth

[BOOM]

This is a very interesting topic. My title in the hospital was anesthesiology respiratory. So I'm unsure as to how the any fertility clinic in Canada could afford one.
I personally had no trouble with ER, I was lucky. I truly would never want to be put under, I'm not sure how they are even able to do so without being in a hospital, especially if there is a reaction to the anesthetic given. I'm going to look into this a little more... Only bc it both intrigues me and scares me all at the same time lol

[gibasgirl]

I've cycled at several clinics in Canada and the United States. There was always an anaethesiologist.

Twilight sedation essentially means you are not completely unconscious. You can talk, but it's kind of like being tipsy and you have very little recollection of what actually took place during the retrieval.

The meds are typically administered by IV. When I was completely sedated, there was an IV and one of those masks (don't know the actual name) put over my mouth.

A few times during twilight sedation I ended up completely out. Maybe it depends on the medication used, too.

Some clinics had us pay the anaethesiologist separately, while others rolled that fee into the cycle and retrieval costs.

Every clinic has their own way of doing things. Some prefer to break out the costs, others roll everything onto one bill for the patients. Some prefer full sedation, and others prefer "twilight sedation."

The pain of retrieval, in my experience, came down to the doctor; some had a gentler touch than others. For me, my most painful retrieval was when I was fully sedated. I think, in part, because I could not physically respond to pain and that particular doctor had a rough hand. Having said that, a friend of mine had the same doctor and did not have that experience. So it may have been my bad luck.

At the end of the day, you will be medically supervised during the retrieval procedure which is in many ways like surgery. The procedure (retrieval) is performed by a doctor.

There are a lot of good clinics here; it is a matter of finding one that meshes well with your needs.

All the best to you.

[gibasgirl]

Also note the retrieval lasts about 15-20 minutes.

[Makana]

Dalia - I would definitely recommend that you talk to Dr H from the VFC about the anesthesiologist and their ER procedure when you have your consult. I have not had an ER there, but have heard nothing but praises from those who have.

[BOOM]

Gibasgirl- Several clinics in Canada? I've only come across two, the one anesthetist in Montreal is also a professor. Can u let me know what the names of the clinics are. You also mentioned that u had more pain when u were fully sedated, by fully sedated do you mean that u were unaware of ur surroundings? Again, that should never happen, the point of general anesthesia is to relieve patient pain. That must have been awful, did they tell you what meds/cocktails that they were using prior?

[Dalia]

Dalia - I would definitely recommend that you talk to Dr H from the VFC about the anesthesiologist and their ER procedure when you have your consult. I have not had an ER there, but have heard nothing but praises from those who have.

 

Oh, so good to hear.... Thanks  

[Merry33]

Twilight sedation essentially means you are not completely unconscious. You can talk, but it's kind of like being tipsy and you have very little recollection of what actually took place during the retrieval.
 

 

I would revise that to - it SHOULD mean that you have very little recollection of what took place, and you SHOULD be tipsy.

Maybe my problem is that I don't react to the fentanyl, but I always had complete recollection of everything that happened during retrieval, I was entirely aware of everything happening at every second of it,  and I did not feel tipsy whatsoever.

When I had the hospital procedure under conscious sedation it actually WAS sedation, as opposed to the retrievals. I was out of it, then fell asleep and at the end couldn't remember much. For this they used propofol; hence the difference (and the need for an anesthesiologist and close monitoring).

 

What I also wanted to say is that I don't actually think that it depends on a person's pain threshold. What I forgot to mention is that I also had one retrieval that was like the "uncomfortable, slight pain, but not too bad" experience most people seem to have. So I know what people are talking about when they say that. My other two unfortunately were not like that. And I had the same doctor for the easy retrieval and one of the awful ones.

 

Dalia - the local freezing is actually not bad at all, and I think it's actually better to have that.

 

I honestly do think that it does come down to cost in many fertility clinics, and I think there could me much better pain management at some places. I don't think it's their perogative to try to make procedures "as painless as possible". I actually also read some interesting articles about colonoscopies when I did my research on fentanyl vs propofol, and the colonoscopy centers pretty much admitted that they use the cheaper drug (fentanyl) although they know that it causes significantly more pain in patients. Purely due to a cost issue.