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[New To Forum] When should we switch our doctor?


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#1 tsm37

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Posted 20 January 2020 - 02:36 PM

Hi there, I'm new to this forum. It seems quite difficult to find a forum on the web about IVF with a number of active members and discussions. I find it a bit weird to seek help on an IVF forum as a male from NYC. It has been one full year of my wife trying IUI and IVF with no success. I'm getting frustrated and impatient, so I wanted to step up and see what I can do to help my wife and myself. 

 

My main question is that I want to get your thoughts as to when my wife and I should decide to switch doctor? 

 

Here is my story.

  • I'm 39 and my wife just turned 35. We do not have children yet. Both healthy. No issues with my sperm and no issues with her eggs. 

 

  • A good friend of mine recommended me this doctor in NYC. She and a few of her friends had success with this doctor through IVF. 

 

  • My wife started IUI in January 2019. We had tried IUI three times and no success, so we decided to switch to IVF.

 

  • First IVF in mid-2019 failed, and we didn't do PGD/PGS. Fresh transfer. Two embryos. One not sure what happened and disappeared. The other one remained but after six weeks, wife had a miscarriage and did a D&C. She was devastated. We later discovered that the embryo had a missing chromosome, and it was never developed into a fetus. 

 

  • Second IVF in late 2019 also failed. This time, we did two egg retrievals with 13 embryos. We paid out of pocket to do PGD/PGS (in addition to many other out-of-pocket expenses) and thought we could maximize our chances. We ended up having five normal embryos and we were happy initially. Wife did a frozen transfer and we had two normal embryos injected . After a few weeks. My wife bled and subsequently, the pregnancy signs were all gone. We knew things weren't good. About a week or two later, a tissue (the size is about 2x of an adult's thumb fingernail.) passed out of my wife's vagina. We were both devastated but luckily, my wife didn't have to do D&C this time.  Lab test said the tissue wasn't a fetus. Doctor never responded to our call. The nurse sent us a report and just said the issue wasn't a fetus. That was it.

 

  • We still have three normal embryos frozen. It has been about four weeks since the tissue passed out, and my wife's period hasn't made a come back yet. 

 

  • I'm not so happy about this doctor. It's not about the money that we spent, but it's more about his attitude toward things. I met with the doctor in person many times, and he spoke like everything was positive, but at the end, everything failed. The fact that a good friend of mine and her friends had success with this doctor, I'm just not sure how I should proceed. The doctor didn't even bother to call us back and explain to us what the tissue was and what it contained. 
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  • I'm now sucking this up because my wife and I still had three frozen normal embryos at this place. Our plan is once my wife's period is back and after 2-3 months of rest (letting her body to heal up, etc.), we will try another frozen transfer. At that time, I will see that doctor in person and I will sure asked what that tissue was. If the 3rd IVF fails, we plan to switch doctor. 

Wanted to get your thoughts on all these. I have learned a lot about IVF over the past 13+ months, and my wife and I we did whatever we could. All I'm asking for is what I can do to maximize my chances. We followed procedures but still failed. 

 

After the 2nd failed IVF, my friend (who did the IVF) said that my wife didn't do a full rest for two full weeks (i.e. just laying in bed and doing nothing) so that could be an issue. On the other hand, the doctor said a two-week full rest wasn't necessarily. My wife did do a one week rest at home after the frozen transfer. My wife reported allergic reaction on the patches, and the doctor/nurse didn't do anything once we reported the issue. After the second miscarriage, doctor said probably because the allergic reaction of the patches, and the absorbing was not good. I don't really believe him. 



#2 Cotton

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Posted 20 January 2020 - 09:34 PM

Random thoughts in no particular order

 

After 4 embryos transferred, two known to be PGS normal, I think its time to start working up other causes of your infertility, namely immune issues and delayed implantation window. Although it is in the realm of possibility that you could just have bad luck. And it's not necessarily the doctor's "fault".

 

I would be concerned that if weeks keep passing and if your wife's period doesn't come that she had an incomplete abortion.

 

I don't know how progesterone allergies work. If she is allergic to patches can she do injections? If they are off the table, can you clinic do natural cycle FETs?

 

I would go with a list of questions and if the doctor doesn't give you some kind of logical sounding plan of action it may be time to change doctors. BTW the remaining embryos are your's, you can have the moved to a different clinic

 

The bed rest thing is a total myth. Women get pregnant and stay pregnant naturally and with IVF working physical jobs and chasing after toddlers. The preop waiting area in my clinic has an article taped up to the wall showing bedrest actually reduces IVF success.

 

IMO, I would never transfer two PGS normal embryos. The risk of twin pregnancies is just too high. I've heard of women losing both babies in the second trimester. Very high risk of some time in the NICU. If you have some other issue going on you can be wasting precious embryos finding that out by transferring two. It is risky to the mother too. If your end goal is a healthy take home baby transferring two does not work on your side because you are more likely to lose embryos and more likely to take home a sick baby.



#3 tsm37

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Posted 20 January 2020 - 10:21 PM

Hi Cotton, thanks for your reply. A couple things:

  • We had a phone call with our doctor before Christmas. He said that the plan next time is possibly not to use the patches for the frozen transfer. Instead, he is thinking about doing the frozen transfer as if it's a fresh transfer. My wife understands that what he means. I need to ask the doctor about this as time gets closer. During that call, the doctor did say something about injections and let the body to naturally produce progesterone.

 

  • About the two PGS normal embryos. I spoke with a close friend of mine and the doctor. My friend and her friends who all did IVF went with two PGS normal embryos and they succeeded. The doctor suggested two as well. I have been thinking about 1 vs 2 because I know two is riskier. On the flip side, I learned those emotional and physical pains my wife went through over the last 12 months with all those failed attempts. They were really emotional hits. Seeing her doing the needles herself into her butt/thigh is really really tough. If we could just get one success attempt, that will be it and my wife does not have to go through this again. Also, I learned that as women age, the success gets less and less. I need to chat with my wife again about this.

 

  • Yeah, if my wife's period doesn't come in a week or two, I will definitely have her to go see the doctor. I too worry about that the tissue pass wasn't complete. 

 

  • I went with this doctor based on my friend and her friend's success stories because we got some comfort. What about the women here on this forum? How did you pick your doctor? 

 

This journey has been very tough for me and my wife. =( 



#4 annatarz79

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Posted 21 January 2020 - 12:12 AM

I m sorry you have to go through this. my first thought is that you need to do a few more things in testing like immune disorders, laparoscopy etc. Also I want to point out that your IVF was successful but the pregnancy did not last for other reasons. Bed rest is not only a myth but I personally found it more stressful. Progesterone pills etc come with warnings of side effects so she better get tested for allergies before transferring again. After many miscarriages I can tell you that the tissue was nothing of interest so don't waste your energy there. We pass on tissues on our periods too but never pay any attention to them then. If you are not happy with your doctor ask around for referrals. I believe NYC will have plenty more. Most doctors have seen worse cases than yours and I believe that is why he was optimistic. Can you imagine your devastation and state of mind if you actually went to a doctor that was all about the negatives??? I wish you both the best of luck and hope you find some satisfing answers in this forum. Personal it was one of my best decisions joining this group

#5 tsm37

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Posted 21 January 2020 - 09:19 PM

Thank you for your responses. I will discuss with my wife. 

 

I did ask the doctor about what my wife and I could do next time to further enhance our success rate, and he basically said "no, you guys are doing great already."  We had the chat over the phone, and my eyes were rolling after he said that. This is another reason why I start losing trust in this doctor. Either he has too many patients to deal with or just simply doesn't care. 

 

I have to do my own research outside (which is fine) and talk to ladies who are now doing or did IVF to acquire new information and see what my wife and I could do. Certainly understand that every woman is different in many ways and what works for one might not work for another. I just feel that I have to take control of this whole process and do whatever I can to prepare for the next frozen transfer. 

 

Sorry about the ranting, but things have been extremely tough for us. I lost three boys. 



#6 Cotton

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Posted 22 January 2020 - 09:02 AM

Unfortunately some doctors lose their ability to empathize with patients after a while and can say some really callous things and can't see things from the perspective of their patient.

 

It sounds like you are on the verge of firing this doctor. In this case I think it would really be worth your time to get a consult appointment for a second opinion with another doctor. Try to find somebody who specializes in failed transfers and is willing to do the immune work up. I would warn you your current clinic will probably give you a hard time getting your records so I would be prepared to show up in person multiple times.

 

Good luck!



#7 tsm37

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Posted 25 January 2020 - 10:11 PM

Thanks Cotton. A friend suggested another doctor specialized in this area in NYC. My wife and I plan to get a second opinion. I'm still on the fence about firing the current doctor, given that my friend and a few of her friends had success with him.