Guide to clinics - Page 3 - Ask the Embryologist - IVF.ca Forums

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Guide to clinics


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#51

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Posted 12 February 2008 - 10:48 AM

Just to review my last post.

I have just been in to the clinic today to discuss our next treatment etc renew consent forms. Alot has changed. The service was 5 star from reception to talking with doctor, nurses and embryologist.

Everything has just changed from the last 2 treatments. Do not feel like I am on a conveyer belt anymore which is great. Note Last treatment for FET was the same, everything had changed, very good service. There is a new sign with a motto saying that they basically are there to listen to you, so maybe that is it? Dont know?? Maybe they feel a bit sorry as it is going onto our 5th fresh.

Do not know why but it has made a huge difference to us and we feel very good about our treatment and have decided if all stays the way it is we are actually going to stay at the NHS clinic because we feel it just would not make a difference if we went to another, besides the facilities are excellent at the womens hospital if anything goes wrong. We are so pleased we are going to celebrate with a glass of wine tonight. (just the one). Can not believe the difference, from 2 years ago with our first private IVF with the clinic.

Hope this helps Nickate.

#52

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Posted 14 February 2008 - 05:41 AM

Hi, What a great idea. I am currently in the 2ww. My ER was last Monday 4th Feb, my transfer Wednesday 6th. We did ivf with iccsi and ah. The clinic was Mitera in Athens Greece. We live in Crete and my gyno, here in Hania recommended Mitera. I love my gyno. here very caring and approachable. He suggested Mitera as a) he said the embryologist is highly trained (Giles Palmer) and B) b)the Dr. Antonis Mannikis and my doctor are friends.My doctor is Yiannis Marinakis and he also trained at University College Hospital, London. It was our 2nd ivf, both at this clinic. This was the first time with ah.

The clinic itself is clean,welcoming and busy; surely all good first impressions.
Although I know that my doctor phones Dr. Antonis prior to the ivf, it's still a little bewildering, not to consult with a doctor, immediately prior to ivf. It was my suggestion for ah, and I would have liked to have discussed this and other items first.The nurses were exceptional, very, very caring. Even though it was my second time, I did feel a bit 'out of the loop' as regards the sytem of things. Also could have done without the anaesthetist singing the line 'another one bites the dust' as I'm waiting in the recovery area to go in and he is wheeling one patient out!

I wasn't told to start the progesterone or estriadol right away after ER. The nurse rang me the next morning, to tell me when the transfer would be and mentioned to keep taking it and estriadol. So I missed out on the first dose. Also she made an error on her written note as to what time of day and how many pills. I pointed out that this was different from what she'd told me verbally and she altered it. It was still different from the first ivf notes.
I know that my age is a factor, just turned 46 last month, which is one of the reasons I suggested ah. I am am also curious as to why the day of transfer was 2dp er. (The first ivf was the very next day) I had read that to transfer on day 5 was better, and would like to have discussed this.

So, all in all very caring staff, but, would have liked contact with a doctor or embryologist first. Felt a little that it was a production line event,but, maybe if I'd spoken to somebody first I would have known more of what to expect.

regards Janie

Edited by JMac, 14 February 2008 - 05:43 AM.


#53

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Posted 12 May 2008 - 12:29 PM

Dear Peter,

Thank you for asking your questions! It's so refreshing to be asked when we as patients become so accustomed to just riding along, taking what we can get, being grateful for the services we do have access to. I have to say, first off, that when I was going through everything treatment-wise up to and including IVF 3 years ago, you were a wonderful resource to me. It's fanstastic that you are still here, providing this service.

I was very fortunate to have succeeded with our IVF cycle and gave birth to b/g twins. They turn three this week. Thank you for your own part in making that happen.

So, that's one bit of clinic feedback...your service is amazing and fulfills an incredibly important need. Please keep it up at all costs.

Regarding my own clinic, doctors, etc. Here is my think-out-loud:

Location: pain in the backside. I understand that another clinic has opened closer to me now, which is great. But overall, fertility clinics are so few and far between, and they are therefore extremely overbooked. It's impossible to not feel like a number, and wonder whether they've actually got the right embryos to go with the right couple, LOL! Not really a criticism, more of an observation.

My doctor is in the Rouge Valley Fertility Centre. She's wonderful. Her main lab tech, Liza, is also wonderful. In fact, she was probably my favourite part of the whole journey, and that's saying a lot for someone whose sole job it is to stick needles in your bruised arms (and sometimes feet!). The ultrasound people were another story...ugh. I don't know why they were all so miserable and cold. I really think they need to stop and think about their role and what they do to us...can they imagine what it's like for us to leave all pride at the door and spread our legs and endure the agony of full-bladder-wait over and over again, on top of our already stressed out feelings that we're never going to have babies. I remember one of them yelling at me for going out to the bathroom to pee a little bit, because I had been waiting over an hour and my bladder was overextended, and then when I finally went in for my u/s, she yelled at me for not having peed out enough...my bladder was so stretched out that she couldn't see anything.

Oh, that brings me to a "solid" suggestion for all clinics...put a freakin' bathroom for us inside your clinic!!!! It's cruel to make us walk out down the hall when we're literally in tears from holding it so long.

A suggestion I made to my clinic was that they start requesting Success Stories from their own patients for the the hopefuls to read. This was met with a cool "Hmm, well if you can figure out a way to get people to write them, great." Anyway, I'm going to do just that. I'm going next week for a consult about a FET with our one frozen embryo.

Some kind of web forum like this is an amazing tool. Perhaps if clinics had a page that they kept up to date of reference sites, forums, materials, etc it would be appreciated. We ladies of the infertility circle are extremely well-informed and we educate ourselves as much as we can. This is necessary because the clinics are so completely overbooked. Unless you take your journey into your own hands, you must feel very lost in the sea of terminology, patients, procedures, stats, etc.

Perhaps clinics could offer a cycle buddy system. We all already find cycle buddies online but perhaps pairing ladies up so that they could compare notes on the phone, etc would be well received.

The biggest thing of all, to me, is compassion. That, and showing by your actions that you are taking me seriously, and that you understand that there may never be a next time...and that money is a huge obstacle.

I feel I was very fortunate in receiving pretty awesome care. But those are my suggestions.

Again, thank you so much for providing this opportunity to us.

Sarah

#54 dove

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  • My Clinic:Mt. Sinai: Now Hannam

Posted 19 June 2008 - 08:36 PM

What I dislike about my clinic:
Always running really late with all monitoring appointments
(bloodwork, ultrasound)
Always running late with follow-up appointments
Nurses do not provide enough information to patients or allow patients to see their charts. You almost feel uncomfortable asking to see your own chart.
Do not explain treatments in enough detail. They kind of gloss over things assuming you won't want to know or would not understand.
Very impersonal
Not in tune to the emotional ups and downs of treatment
It's part of a hospital where they have a pregnancy clinic so there tons of pregnant women walking around. It's not what you want to see when you're doing fertility treatment
Do not refer you to any counselling until you've had a miscarriage or after 7 failed treatments
Give you a picture of your embryo after it is transferred--I don't think most people want this given most treatments do fail. I think they should put it in your folder and give it to you later if you have had a successful treatment.
They never tell you after you have had your yearly blood work if everything is okay. you some times wonder if they have even looked at it
What I like:
Good follow-up care
Call back the same day when you leave a message
Some of the nurses are very nice
Doctor's know their stuff which is the most important

















Dear All,

I want to write a review on what is important/essential/desirable/undesirable/unacceptable in an IVF clinic from the point of view of the patients.

I don't think that many clinics actually hear praise, complaints, ideas and feedback from patients. If they do they might not listen........

Some things will be very clinic specific, others might be more generic.

The review will not mention or criticise/praise specific clinics but is intended to be read by clinic staff in general so that it might ring some bells about their policies and procedures and ensure the highest quality of care for patients.

I need comments about every aspect of clinic activity from the receptionist to the lab to the operating theatre and back again.......even such things as clinic literature, communication, accesibility, empathy, counselling, friendliness, atmosphere.....anything you feel is important......

I can't do this without your input so I look forward to hearing from everyone.....

Best wishes,

Peter


me: 42
DH 47
DX: unexplained
TTC: 6 years
5 iui, natural and clomid 2007 - all negative
ivf #1 January 08 2 blasts - negative
(Fet #1): May/08 1 blast- early miscarriage
ivf #2 Aug/08 2 blasts - negative again
(Fet #2) 2 blasts - negative
(Fet #3) Jan 26 2009--3 blasts -postive, over the moon
Feb 4 1st beta 203, Feb 6 -502
7, 12, 20 and 26 wk ultrasounds: everything on target, one baby, we're thrilled.
EDD: Oct. 14\Baby boy born October 16, 2009!
Trying for a sibling with our frozen blasts:
Fet 1: 2 blasts--negative
Fet2: 3 blasts --negative
ivf 3: 3 blasts - negative
Fet 1-3 blasts - negative
Fet 2-3 blasts negative
Fet 3- 3 blasts-negative
Ivf 4 - new clinic, Hannam :positive beta fingers crossed
Saw hearbeat, due January 1, beautiful boy born January 6

#55 Ope

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Posted 20 June 2008 - 12:33 AM

Dove: I would have love to get a picture of my embies! We actually asked for it, at the ET, but unfortunatley my clinics doesn't do that. They showed it to us on the screen before transfer, but they do not make pictures of them. Becaused we asked for it they printed out an u/s picture of my uterus after the transfer, and you can see a tiny liqued pool in it , where they put the little ones. I kept that picture and that will be the first piece of my baby scrap book. If I hadn't been pg I think I still would have kept it because no matter it is a memory of an important journey of my life.

For me the one and most important factor of a clinics is their success rate for my situation! As my city doesn't have IVF clinics we knew we have to travel somewhere anyway. So I took quite a bit of time and checked out every canadian clinics website and check they stats. If a clinic wasn't in the top 10% it was out of my selection. Of course 1 or 2% difference is not end of the world, but if it is 10% lower then the top clinics then it was out. When i narrowed down my list for ~6 potential clinics, the time of waiting come to be a deciding factor.
As I am hitting 35 very soon, i can not afford to wait 1 year to get a treatment, because maybe it woill cost me my success at the end, so we decided to go with fastest clinic of themy selection.
The third most important is to have organized staff, be on time with appointment and give me clear instruction what should I do and when should I do it and how shopuld I do it. For example when the nurse showed us how to do progresteron shots , she had a foam cube, and my dh could practive on it with the real medication, and then he made my dh give me the first shot at front of her. When you getting the shots at home, this kind of practice really makes you content that you getting your shots the proper way.
I also loved that my clinics give me a one page instruction on day of ER and also on ET which told me what can and what shouldn't I do including sex, excersize,hot tub , food, travel medications etc. That page also had info on potential side effect, what is not normal and I when should seek help when not etc. It is not a big effort from a clinic, but it makes the patients, especially first timers, content about little thing such as little spotting or cramps. Also I think it frees staff time, as patients do not call every minute about the same tiny things.
Also email is a great invention of the 21st century, all clinics should use it for patient- nurse communication. It makes communication so much easier and smoother for both parties. Most women working at least part of their treatment, so talking on the phone is a bit problematic. Also the nurse doesn't have to be available at the moment, she may answer it any time during the day, when she has free time.
Additional plus that my clinic support accupuncture. They do not actaully have an accupuncturist on staff, but they let your TCM practitioner come to the clinc right before ET and they provide you with a room, so you can have a session right before the transfer.
I also liked that my RE do not try to show off and gave me false promises and he didn't try to push us any direction or decide to us. He gave us the facts what is our chances with different procedures or treatments, and we chose.
right now me : 37 Dh:40

TTC #1: natural TTC 1.5 yrs
Dh: 35, Severe Male factor infertility, morphology is 1-2%
Me: 32 , tubes open, no endo, regular ovulation, all hormones are good, 3rd day FSH 5.3 , antral follicle count is 12, only problem is my weight BMI: 30

IVF/ ICSI #1: 2008 February -McGill, Montreal
Long protocol: BCP for 1 month, burselin from CD21, 300 Gonal F and 150 Luveris for 10 days
ER: 11 egg , 6 mature , 5 fertilized, 3rd day transfer:a 7 cell & an 8 cell embyos, no frosties.
1st beta : 13dp3dt: 77, BFP
2008,November 19th: Adam has arrived 7 lb 4 oz, 21"

TTC #2: natural TTC 1.5 yr
Dh :39 morphology went up to 4%, we meet the IUI cutoff! count are fluctuating from 30 to 105 million, motility is great. Caryotyping is normal
Me: 36 FSH is slightly elevated and keep rising 8.5, 8.8, 8.9, 9.8 , AFC is still 12, everything else looks good.

IUI #1: Edmonton, 2011 January ,Clomid 50mg (x5), 106 mil ,68% motile, grade 4 :BFN
IUI #2: Edmonton, 2011 February, Clomid 50mg (x5), 30 mil, 57% motile, grade 3: BFN
IUI #3: Edmonton, 2011 March, Clomid 50mg (x5), 88 mil , 49% motile, grade 4: BFN
IVF#2: 2011 May, Edmonton: long protocol , nasal suprefact : CANCELLED due to high progresteron & cyst
IVF#3: 2011 August, Edmonton: short protocol/natural start: CANCELLED due to high progesterone
IVF#4: 2001 September, Edmonton: short protocol with BCP: CANCELLED due to high progresteron & cyst
Change clinic

IVF #5: 2012 March-April Hungary: stimulation starts march 28, 300 Menopur
mixed protocol: BCP for months, CD3: Menopur 300& lupron for 8 days
ER : April 8th , 4 eggs retrieved, all were mature and fertilized with ICSI and AH
ET : April 11th, 1 A quality 8 cell, and 1 A quality 4 cell embryo transferred, no frosties.
BFP on the HPT at 7dp3dt: happy 37th birthday to me :D
Beta: , 12dp3dt: 150, 2nd Beta, 15dp3dt: 550
Anna has arrived on 21st December after being induced at 39 week. She is 6 lb 9 oz, 20" , and has blue eyes, and long dark brown hair and just perfect !