When is it time to change clinics??

[Aleriya]

Hiya!

Upon browsing through the forum, I've noticed a lot of you guys obtain a lot of information from your clinics. Our clinic was not very forthcoming about....anything really. We had to constantly ask and re-ask questions, and never really got much in the way of answers.

Also, looking through the forums people undergoing IVF seemed to be closely monitored compared to what we got. Our "plan" had more scheduled visits than we got. They didn't monitor bloods just did like 2 ultrasounds then converted us to IUI because there weren't enough follies. We were given no real instruction from the clinic regarding the medication that we had. Honestly, some of the medication wasn't even opened or used.

If questions were asked, it was basically a typical "we'll let you know what you need to know when you need to know it", kind of deal. So, being it was our first experience with a clinic we just figured, well they are the professionals they will know what to do. We loved our Dr. She was kind and very warm. However, we went in for our BETA and this is where I decided that I'm not sure if a warm doctor is enough reason to stay. That is why I am reaching out to you ladies to see if this is normal.

We went in, and we had a rude nurse, but maybe she was just having a bad day. She asked if we took a HPT, we said we did the previous day and it was negative, and she was like right those are accurate so it's more than likely negative. She never even asked which kind we took, but whatever. I asked about the next cycle and how we should proceed if when we get called we were given a negative. She was like well, you'll stop taking the meds. (That was kind of like a no-duh since obviously the meds were to stop miscarriage, and in order for the cycle to start we'd need off the progesterone).

Skip forward like 3 or 4 hours later, we get a call. Not from the Dr, but from some random girl (I would assume is a nurse). She was all "your test came back negative". Pretty much as blunt as could be, I again asked how we should proceed for the next cycle, etc... Everything from then on felt so cold, like well just call when your period starts which will be 3-10 days. Is this normal??? Do you not get to speak to the Dr? Do we not get any information, like at all? I can deal with a lot, I'm very quiet and shy mostly. However, I just want to know what your experiences are like, and if you guys think it's time to change clinics? It seems you all know your blood levels, and everything else. So, I feel like there is a disconnect. Is it normal that when your ovaries aren't responding to the meds that they just keep going? Part of me felt like the IUI was rushed as well because a bank holiday weekend. Because we finally got to 4 mature follicles, but they were like no we'll just do IUI. I don't want to sound like I'm complaining because I'm grateful we can even afford to do this.

Also, on a side note, during the investigative procedures, a part of the catheter was left inside. It literally came out 2 or 3 days later on its own. Then we were told not to worry about it by the nurses. Then a day or two later the Dr called and had us go in for a pelvic exam just to be sure it was all out. There were some other minor annoyances/problems, but again we really liked our Dr.

What do you guys think? Advice is greatly appreciated.

 

[KatO79]

I live in Denmark so things might be different here compared to where you live but here are my thoughts and experiences.

A bit of backgroud: I had 6 IUIs at a private clinic and 2 IVFs at a hospital. His is because in DK if you're TTC'ing #1 and have tried naturally for 1 year without getting pregnant, th state pays for 6 IUIs and 3 IVFs. The medicine you pay for up to a certain amount, then the state starts to help you pay for them. Often the state wants you to do IUIs at a private clinic and then switch you to a hospital for IVF because it's cheaper for them.

Anyway when I did IVF, they didn't do blood tests either. I think it depends on which country you live in as I've also noticed that some members on here doing IVF get blood tests during. As for ultrasounds I think I only got about 2-3 each IVF round as well. As for converting to IUI, I think that may be normal procedure if there aren't very many follies. They wanted to do that to me for my 1st IVF cycle as I also only had 4 follies but I'd already been through 6 IUIs at the clinic and the hospital thought I'd only done 3 IUIs so when I told them I'd done 6 they quickly said they'd let me do IVF regardless of follie count in my case.

As for the meds that's just odd. A nurse showed me what to do each time I was given a new med and I even was given a pamphlet and/or told that on their website I could see a video of how to do it. I would definitely complain about that if no one showed you. But did you ask? I think sometimes the nurses are so busy that they sometimes get a bit forgetful so if no one was showing you then it can be good to say that you haven't tried that particular med before and if they can show you how to do it.

As for the nurse with the beta I do think the nurses can be busy so they can be a bit curt. Saying that if the HPT was negative it probably meant that a beta would also be negative doesn't sound strange to me given my experiences. I don't think they have the time or energy to be very supportive or give a "hold your hand" type of treatment. That the doctor didn't give you the beta result could also very well be normal. A nurse called me each time as well with beta results. Her saying that you should call once AF starts sounds normal as well. They don't have time or energy to be supportive and get to know every patient. Remember they may have 100s of patients at a time so they can't get to know you very well or use time to be very supportive. When you go in again to start the next round, the doctor should be there though to talk about things, answer questions and discuss what she/he wants to change this time to see if it e.g. gives you more follies. I would think your doctor will try upping the meds or change up the protocol e.g. from short to long or long to short depending on what you've tried last time. E.g. I first did a long protocol IVF that gave me 4 follies and my doctor decided for IVF #2 to up my dosage of Bemfola and do a short protocol to see if I'd get more follies that way.

Normally if your ovaries aren't responding they do try upping your dosage of the FSH med. That's what my doctor did during my 1st IVF round. Also bear in mind that the 1st IVF cycle is often unfortunately a test type of round as they are basing their treatment at that point according to what they have experienced works for women with a similar age, hormone level ect. So hopefully the next IVF round should go better. As for the IUI feeling rushed I'm not sure what you mean? For an IUI they want you to trigger when thy feel the largest follie/follies are reaching the right size so it can't be planned out beforehand which date you will trigger and come in for the actual IUI beforehand. They need to see how the ovaries and follies are responding to the meds which is different from person to person.

The catheter sounds like an unfortunate incident although I don't know if it's bad enough to actually warrant switching clinics I'd say if you're happy with your doctor and she/he makes time to answer your questions when you see them at appointments then I wouldn't personally switch just yet. Wait and see how your next IVF goes.

 

[Aleriya]

Hi KatO79,

Thank you for responding. Also, congratulations on your successful IVF and your little boy!

I understand that they get busy, it was just the way she said it, that rubbed me wrong. I do ask a lot of questions and generally just get a brush off. Regarding the meds, when I asked because we were told to bring all but the ones that have to stay in the fridge, she only showed briefly a couple of the meds. Then when I asked about the other meds...etc...it was like you'll know when you need to know kind of deal. I suppose I just see all these videos of people in America going to these private clinics from their vlogs and everything just appears so different. I live in the EU as well, and since we are a same-sex couple we weren't trying from home for a year. We did try about 4 cycles from home with buying sperm from DK cryos. However, according to our GP that was like a shot in the dark. So, we decided to start paying a private clinic. Our clinics are quite lack luster, a lot of people choose to go abroad to other countries. However, we thought we'd try closer to home first because of our 2 dogs, rather than leave them for weeks on end.

I will discuss everything you said with my partner, because you do bring up valid points. I don't want you to think we wanted someone to hold our hand, but I did feel that when you are paying them so much money, that at least that should warrant a future plan. Rather, when there was a negative it was like well that's that. Do you understand? I'm not really great with words, if you can't tell. I am terrible at explaining things. It was just a feeling I got inside, but I didn't say anything throughout the process because my partner was happy, and that is all that mattered to me was her happiness. However, when we got home she had a lot to say, which made me realize I wasn't the only one. That is why I reached out to see if this is all normal. Thank you again. I appreciate it very much!

 

[KatO79]

Thank you

I understand you felt she was rude. I've felt a few times myself that way but have tried to just not take it personally and just try and assume that she's maybe having a bad day or is busy or something. As for the meds they should be showing you how to use the ones you'll be using although I'd assume they've only gotten you to buy what you need? Was it a nurse? If so I'd maybe ask your doctor about it. Hopefully she doesn't brush you off? Mine was always really good about taking time to answer questions and always encouraged my DH and I to ask questions when we needed to.

I do think there are differences from how the Americans do things and how e.g. it's done in the EU. I also noticed that the Americans get blood tests during while here they don't do that and just do scans.

True although the hospital I went to never talked about future plans either when I would call about my beta. In my case the 1st IVF was a CP and since it was at the start of December, I couldn't reach to start another IVF cycle until the AF after New Years because the staff would be going on a Christmas vacation for about 1 week from around the 23rd until January 2nd. I don't think the nurse said anything about future plans simply because she probably had no idea. I think the nurses took care of taking calls and setting appointments and showing how to use meds and the like while the doctors concentrated on seeing patients and answering questions and planning what they wanted to do with those that got a BFN or CP. Anyway maybe try and see if your doctor would be open to you calling her about questions e.g. concerning future plans?

Yeah I think a lot of this is pretty normal for clinics in the EU.

I really hope your next IVF goes a lot better and that you get lots of follies with great eggs!

 

[scoobybeans]

Hi Aleriya

My very long post just got eaten by BnB lol. So I'll just say that I'm sorry you got a BFN and had a bad experience at your RE, and in my opinion you should absolutely change clinics.

At the very least they should be monitoring you more closely, ESPECIALLY doing bloodwork. Estrogen, LH level and progesterone should all be checked at various points in your cycle. They should have explained the different protocols out there and why they chose the protocol that they did for your specific situation. And they should have explained what all of the medications do.

I think with IVF there is a certain level of care that should be expected. With the amount of money that you have to pay & the emotional and physical toll it puts on your body, at the very least you should feel like you're in good hands and that you trust your doctors.

And after a BFN you should absolutely have a follow up appointment with your doctor to discuss what went wrong with the cycle and the possibility of changing protocols. My first IVF was also converted to an IUI (although I made that choice, not them), and when that failed I did tons of research and had a long meeting with my doctor requesting a specific protocol that I'd read about. Sometimes you need to be your own advocate!

Best of luck to you with whatever you decide

 

[Aleriya]

Hi Kat

I agree it seems eu does things a lot differently than in America. Based off your original post and af coming yesterday we decided to try one more time. We were given a lot more medication than we used. We still have a large bag of medication. Regardless we will try again they changed the protocol so here is hoping.

Hi scoobybeans

Thank you for the response. Due to how quickly af came we are giving another try. Then we will probably go abroad. Did your second cycle work? Best of luck!

SORRY FOR ANY TYPOS WAS DOING THIS ON MY PHONE.

 

[scoobybeans]

Aleriya- I'm glad you've decided to try again, and I hope you get better care & attention this time. My second cycle was successful & I'm cautiously expecting at just over 8 weeks now. Good luck to you!

 

[Aleriya]

Scooby! What great news! I hope everything goes great and you have a healthy pregnancy and delivery!

 

[KatO79]

At the very least they should be monitoring you more closely, ESPECIALLY doing bloodwork. Estrogen, LH level and progesterone should all be checked at various points in your cycle.

scooby in the EU it seems to be the norm that they don't do bloodwork during an IVF cycle. They don't do that here in Denmark either and Aleriya also lives in the EU.

Doesn't always seem to be a necessity either as I got pregnant on both my IVF cycles although #1 was a CP while the 2nd one resulted in my now 8 month old son.

 

[Regin7]

Well, we also changed the clinics because got no more hope with the previous one. Our journey started in 2012 with one round clomid which ended with BFN. Then biopsy results diagnosed severe endo later adding PCOS. And other 2 fresh rounds ivf with oe. Everything seemed ok, I mean service and docs. But we just felt we had to go further and stop with them. After a long break we found ourselves in Ukrainian clinic where were suggested to consider using de with the procedure. At first it was a heartbreak for us, for me particulary. I couldn't let this thought settle down for weeks, but dh supported me. He told we went through lots of things and that it wasn't the time to panic. Finally we signed the contract with them for 5 att. For the sum of money we got 2 pros using them. All the meds needed for the procedure were covered by the package, so we didn't have to worry about them that time. Another thing was 100% refund in case of failure. It made us feel more confident. All in all, not a single euro to be regreted for. Docs and nurses were super caring. We could talk to our manager day'n'night and get answers. Our donor turned to be a very young attractive lady of course with proven fertility. And I don't know why but I just felt confident with the place. Just believed that it would bring us success, long-awaited LO. And it happened - we became a happy family of 3 At the end I'd like to say that sometimes when you start feeling uncomfortable with the place you are in it's really better to think about other variants. Even though new clinic doesn't know you, and they see your medical history for the first time - it doesn't seem they can't cope. It is vital to choose the right place to be with where you're understood and supported. Wish you all the best with your further steps. Hugs x