RBA ladies- Question about Dr.'s and Process

RBA ladies- Question about Dr.'s and Process

DeeinNYC
DeeinNYC

March 31st, 2012, 3:49 pm #1

Hi ladies,

I have decided to go with RBA for DE's. Unfortunately, I was not able to get an appt with Dr. Toledo until mid-May. I am hoping to cycle by the 1st week in August at the latest for many reasons. Do you think that with an mid-May consult date that I could reasonably cycle by early August? I have most of my preliminary tests done but have no idea if RBA will require that if get an endometrial biopsy or have a mock transfer. Are both mandatory? If so, do they make you come to Atlanta for a mock transfer? I guess Im trying to get a sense of what their calendar might look like from the start of treatment to transfer. I will be an out of town patient. My next question...I think that Dr. Shapiro has a shorter wait list and that I can get a consult with him quicker. Do you think I should transfer to Shapiro to get the ball rolling sooner? Would RBA even let me? I understand that they are both outstanding Dr.'s but I went with Toledo because I will be doing an immune protocol and have also had repeated (age-related) losses and someone told me that he specializes in both areas. Thanks for any help that you can give.
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Joined: December 4th, 2011, 1:32 am

March 31st, 2012, 5:27 pm #2

Good choice, I have to say I love RBA. I am cycling from out of town too and consulted over the phone with Dr Shapiro end of Jan, picked out a donor three days after getting access to the database and am cycling right now. It moved pretty quick. When you consult with them they will go over the timeline. The biopsy was not pleasant but nothing to worry about - I was told it was optional but I got it anyway - I had my local RE do it and it took 15 minutes. They do not send the tissue out to the lab, they just want it done (something about stimulating blood flow to the area or something.) I have Dr Shapiro who I love but I have not been dealing with immune issues, so I can't advise on that. I only flew down once - for six days. On the day of the thaw your husband has his appt and I did the mock transfer that day. I stuck around down there until the 5 day transfer.

Good luck!!
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Joined: June 28th, 2008, 7:01 pm

April 1st, 2012, 3:48 am #3

Hi ladies,

I have decided to go with RBA for DE's. Unfortunately, I was not able to get an appt with Dr. Toledo until mid-May. I am hoping to cycle by the 1st week in August at the latest for many reasons. Do you think that with an mid-May consult date that I could reasonably cycle by early August? I have most of my preliminary tests done but have no idea if RBA will require that if get an endometrial biopsy or have a mock transfer. Are both mandatory? If so, do they make you come to Atlanta for a mock transfer? I guess Im trying to get a sense of what their calendar might look like from the start of treatment to transfer. I will be an out of town patient. My next question...I think that Dr. Shapiro has a shorter wait list and that I can get a consult with him quicker. Do you think I should transfer to Shapiro to get the ball rolling sooner? Would RBA even let me? I understand that they are both outstanding Dr.'s but I went with Toledo because I will be doing an immune protocol and have also had repeated (age-related) losses and someone told me that he specializes in both areas. Thanks for any help that you can give.
He is/was my RE and I think he is fantastic. I LOVE, LOVE, LOVE him. I have been through a lot and a tragic loss and he has really been there for me. He truly cares about his patients. I say he is worth the wait and there is a reason why he has the longest wait list in this city. I think you will still have time to cycle, esp. if you already have had all of the testing done. Maybe can you call and ask to talk to one of his nurses to ask specifcally about this? That being said, Dr. Shapiro is also supposed to be a very good doctor. I never worked with anyone but Dr. Toledo. And thank goodness, only because Dr.Shapiro is friends with a lot of friends of mine, and I would be too embarrassed to run into my RE at a friends house/party, etc.,after he has "been in the neighborhood". As much as I love Dr. T, it is an "in office" relationship! I'm shy that way.

While I was cycling, I was not aware that they were requiring an endo biopsy, although I had a few because I had major lining issues. The first one was done for testing. Then, and this was later, we did an endo biopsy, which they called a "scratch test" to just disrupt the endometrium a bit to help stimulate blood flow. This was done just before you started your cycle. I don't think the scratch test is any different than the endo biopsy other than they are not sending it to the lab to be tested, they are just doing it to improve the lining and possibly chances of implantation, based on a study that originated out of Tel Aviv. That is how I understood it, anyone who knows better, please feel free to correct me. And that was the long winded way of saying that since this biopsy is done just a handful of days before your cycle starts, that won't slow anything down.

Not sure about the mock transfer thing, as I just did it while I had my SHG done, and I was in town. But I think the pp covered that. However, I needed to use a GC this time around and she did not have to come in town prior to the transfer for that. No problems with the transfer. Did an eSET and I am now almost 35w pg (via the GC).

Last edited by margolis on April 1st, 2012, 4:24 am, edited 1 time in total.
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DeeinNYC
DeeinNYC

April 1st, 2012, 1:53 pm #4

Good choice, I have to say I love RBA. I am cycling from out of town too and consulted over the phone with Dr Shapiro end of Jan, picked out a donor three days after getting access to the database and am cycling right now. It moved pretty quick. When you consult with them they will go over the timeline. The biopsy was not pleasant but nothing to worry about - I was told it was optional but I got it anyway - I had my local RE do it and it took 15 minutes. They do not send the tissue out to the lab, they just want it done (something about stimulating blood flow to the area or something.) I have Dr Shapiro who I love but I have not been dealing with immune issues, so I can't advise on that. I only flew down once - for six days. On the day of the thaw your husband has his appt and I did the mock transfer that day. I stuck around down there until the 5 day transfer.

Good luck!!
Thanks for helping to answer some of my questions. Good to know that the mock transfer could be done while down there for the transfer. You seem to have moved pretty quickly. Did you have most of your pre-requisites done? Were you able to do your psych consult in advance of your consult? Do you think that I can get this out of the way? Do you know if they have a specific form that must be filled out by the therapist or can the therapist write their own letter to RBA regarding the consult?
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DeeinNYC
DeeinNYC

April 1st, 2012, 1:58 pm #5

He is/was my RE and I think he is fantastic. I LOVE, LOVE, LOVE him. I have been through a lot and a tragic loss and he has really been there for me. He truly cares about his patients. I say he is worth the wait and there is a reason why he has the longest wait list in this city. I think you will still have time to cycle, esp. if you already have had all of the testing done. Maybe can you call and ask to talk to one of his nurses to ask specifcally about this? That being said, Dr. Shapiro is also supposed to be a very good doctor. I never worked with anyone but Dr. Toledo. And thank goodness, only because Dr.Shapiro is friends with a lot of friends of mine, and I would be too embarrassed to run into my RE at a friends house/party, etc.,after he has "been in the neighborhood". As much as I love Dr. T, it is an "in office" relationship! I'm shy that way.

While I was cycling, I was not aware that they were requiring an endo biopsy, although I had a few because I had major lining issues. The first one was done for testing. Then, and this was later, we did an endo biopsy, which they called a "scratch test" to just disrupt the endometrium a bit to help stimulate blood flow. This was done just before you started your cycle. I don't think the scratch test is any different than the endo biopsy other than they are not sending it to the lab to be tested, they are just doing it to improve the lining and possibly chances of implantation, based on a study that originated out of Tel Aviv. That is how I understood it, anyone who knows better, please feel free to correct me. And that was the long winded way of saying that since this biopsy is done just a handful of days before your cycle starts, that won't slow anything down.

Not sure about the mock transfer thing, as I just did it while I had my SHG done, and I was in town. But I think the pp covered that. However, I needed to use a GC this time around and she did not have to come in town prior to the transfer for that. No problems with the transfer. Did an eSET and I am now almost 35w pg (via the GC).
First of all..Congrats!!! So exciting...you are due any day now!! Your post really made me feel good. I think I will stick with Dr. Toledo. Thank you so much for answering my questions. When you say that the scratch biopsy was done just before the start of your cycle, do you mean that they do it in the cycle where you for instance start Lupron which I think they start on CD 21 or in other words..the cycle immediately before the transfer cycle? Does that makes sense? I'm going to ask my current RE f he would monitor me and give me the scratch biopsy. Thanks again.
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Maggie
Maggie

April 1st, 2012, 2:18 pm #6

They do the scratch biopsy after you start the Lupron but they want it done before you start to bleed. They started me on the Lupron, and then scheduled me for the biopsy within the next week. I'm not sure if some of the Doctors there do it differently or not. I saw Dr. Slayden and he does send the biopsy off for results. I don't know if it's to get it covered by insurance or what but the main reason he does the procedure is to help implantation.
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Joined: June 28th, 2008, 7:01 pm

April 1st, 2012, 3:25 pm #7

First of all..Congrats!!! So exciting...you are due any day now!! Your post really made me feel good. I think I will stick with Dr. Toledo. Thank you so much for answering my questions. When you say that the scratch biopsy was done just before the start of your cycle, do you mean that they do it in the cycle where you for instance start Lupron which I think they start on CD 21 or in other words..the cycle immediately before the transfer cycle? Does that makes sense? I'm going to ask my current RE f he would monitor me and give me the scratch biopsy. Thanks again.
Yes, you understand it correctly. Exactly as Maggie stated. It is done shortly after you start the Lupron.

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Joined: December 4th, 2011, 1:32 am

April 1st, 2012, 4:26 pm #8

Thanks for helping to answer some of my questions. Good to know that the mock transfer could be done while down there for the transfer. You seem to have moved pretty quickly. Did you have most of your pre-requisites done? Were you able to do your psych consult in advance of your consult? Do you think that I can get this out of the way? Do you know if they have a specific form that must be filled out by the therapist or can the therapist write their own letter to RBA regarding the consult?
I had almost everything done already because of 4 failed regular ivf cycles & all the testing that came with that. I actually got the psych eval done before I consulted with RBA because i was going to start with another RE clinic and they had someone they worked with. But then i decided on RBA and just contacted that counselor and asked if she could send both me and RBA a copy of her recommendation, and she did. it looked like it was just letter that summed up what we discussed.
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DeeinNYC
DeeinNYC

April 2nd, 2012, 2:26 am #9

First of all..Congrats!!! So exciting...you are due any day now!! Your post really made me feel good. I think I will stick with Dr. Toledo. Thank you so much for answering my questions. When you say that the scratch biopsy was done just before the start of your cycle, do you mean that they do it in the cycle where you for instance start Lupron which I think they start on CD 21 or in other words..the cycle immediately before the transfer cycle? Does that makes sense? I'm going to ask my current RE f he would monitor me and give me the scratch biopsy. Thanks again.
Thank you both n/t
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DeeinNYC
DeeinNYC

April 2nd, 2012, 2:29 am #10

I had almost everything done already because of 4 failed regular ivf cycles & all the testing that came with that. I actually got the psych eval done before I consulted with RBA because i was going to start with another RE clinic and they had someone they worked with. But then i decided on RBA and just contacted that counselor and asked if she could send both me and RBA a copy of her recommendation, and she did. it looked like it was just letter that summed up what we discussed.
Okay..great. I'm already seeing someone that specializes in DE's so that part should be easy...I'll just set up an appt with DH too. Thanks for your help and good luck!!
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