I had my IVF consult with Dr. Cohen yesterday (long and DD ment))

I had my IVF consult with Dr. Cohen yesterday (long and DD ment))

AJ
AJ

October 21st, 2011, 9:00 pm #1

and I really like her. She started off by asking me why I made the appt. I explained that I made my initial consult with Dr. Check with the intention of pursuing IVF but that based on my history he suggested doing monitored cycles first. I told her that over the course of the cycles they monitored that the cycles were inconsistent and that I was worried that my FSH was getting too high and that quite frankly, with the amount of money I was paying for these cycles I wanted to be more aggressive. She completely agreed and feels like it is time to move on. Things in my favor are: Even on my really high FSH cycles I still produced a follicle on my own and my age (I'm 38 and have never had a Dr. tell me time was on my side, LOL). I knew that Cooper does low-dose, but I was surprised at how low she suggested we go. They feel like with someone like me it's best to get as close to natural as possible with the drugs, with 1-2 mature eggs being the goal to protect egg quality. A couple of options, if they can get my FSH down to below 10, take Clomid every other day and maybe Menopur if a boost is needed, or take a low dose of Menopur. I guess in both options I would take cetrotide too.

I asked her about doing multiple cycles to stockpile embryos and she said that's an option, but a fresh transfer is better as some embryos don't survive the thaw. I'm not sure how I feel about transferring one embryo though. But at this point maybe I should feel lucky if I even have 1 to transfer??? So DH and I need to sit down and go over a few things, like, how many cycles are we willing to do, will we transfer just one or try to get more...

And then there's the monitoring and travel. I didn't realize until now how much cheaper it is to do monitoring in Cooper's office! I've paid about $600 per visit for full bloods and u/s locally. Those of you who live close enough to do it in the office are lucky:) So we need to think about if it would be better for me to go out and stay in like a Residence Inn with DD for a few days and do monitoring there. If we did that it would also be easier to buy a plane ticket rather than waiting until the last minute before ER. Honestly I have no idea how the whole travel thing works so if any of you have any tips or suggestions I'd love to hear them.

And finally she asked what CD I was on and I told her CD 4. She said that worked out great if I wanted to start BCP's on CD 5 to try to get my FSH down this cycle. She also suggested taking Estinyl after the last BCP until I get my CD 3 baseline. If the FSH is down we can get started or stay on it until it gets down. So I'm officially getting the ball rolling! Really scared though about investing all this $$ in a cycle with maybe 2 eggs. I think we'll just have to play it by ear. If I do make it to ER and the egg is total crap we might rethink doing multiple cycles. At this point I just need some closure one way or the other. And if doing IVF makes me realize that it's just not going to work then I'm ok with that.

Sorry that was so long! But I thought I'd go over everything since there are others considering Cooper for IVF, even though our cases might be different. Any input or thoughts are welcome too!
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MargieD
MargieD

October 21st, 2011, 10:38 pm #2

IVF at Coopers is definitely a lot cheaper than other places, but they only get 1-3 eggs and there's the travel issue, getting time off work, etc., and not to mention the stress level trying to get away for a week or two. Those are the very reasons why we plan on doing IVF locally. For us - the math would be about the same - give or take - and lot less stressful.

We learned a lot from Coopers and plan to use their methods with the local RE. He wasn't too thrilled about it, but was willing to give us a chance.

If I didn't have that option with the local RE, I would probably go straight to Coopers or maybe check out other places.





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Sara H
Sara H

October 22nd, 2011, 12:12 am #3

and I really like her. She started off by asking me why I made the appt. I explained that I made my initial consult with Dr. Check with the intention of pursuing IVF but that based on my history he suggested doing monitored cycles first. I told her that over the course of the cycles they monitored that the cycles were inconsistent and that I was worried that my FSH was getting too high and that quite frankly, with the amount of money I was paying for these cycles I wanted to be more aggressive. She completely agreed and feels like it is time to move on. Things in my favor are: Even on my really high FSH cycles I still produced a follicle on my own and my age (I'm 38 and have never had a Dr. tell me time was on my side, LOL). I knew that Cooper does low-dose, but I was surprised at how low she suggested we go. They feel like with someone like me it's best to get as close to natural as possible with the drugs, with 1-2 mature eggs being the goal to protect egg quality. A couple of options, if they can get my FSH down to below 10, take Clomid every other day and maybe Menopur if a boost is needed, or take a low dose of Menopur. I guess in both options I would take cetrotide too.

I asked her about doing multiple cycles to stockpile embryos and she said that's an option, but a fresh transfer is better as some embryos don't survive the thaw. I'm not sure how I feel about transferring one embryo though. But at this point maybe I should feel lucky if I even have 1 to transfer??? So DH and I need to sit down and go over a few things, like, how many cycles are we willing to do, will we transfer just one or try to get more...

And then there's the monitoring and travel. I didn't realize until now how much cheaper it is to do monitoring in Cooper's office! I've paid about $600 per visit for full bloods and u/s locally. Those of you who live close enough to do it in the office are lucky:) So we need to think about if it would be better for me to go out and stay in like a Residence Inn with DD for a few days and do monitoring there. If we did that it would also be easier to buy a plane ticket rather than waiting until the last minute before ER. Honestly I have no idea how the whole travel thing works so if any of you have any tips or suggestions I'd love to hear them.

And finally she asked what CD I was on and I told her CD 4. She said that worked out great if I wanted to start BCP's on CD 5 to try to get my FSH down this cycle. She also suggested taking Estinyl after the last BCP until I get my CD 3 baseline. If the FSH is down we can get started or stay on it until it gets down. So I'm officially getting the ball rolling! Really scared though about investing all this $$ in a cycle with maybe 2 eggs. I think we'll just have to play it by ear. If I do make it to ER and the egg is total crap we might rethink doing multiple cycles. At this point I just need some closure one way or the other. And if doing IVF makes me realize that it's just not going to work then I'm ok with that.

Sorry that was so long! But I thought I'd go over everything since there are others considering Cooper for IVF, even though our cases might be different. Any input or thoughts are welcome too!
I know in the past people have posted travel advice and all sorts of tips. Try using the 'search' and you'll get answers!

It sounds like a good plan to me! Also, do the "blood and ultrasound" package, much cheaper.

Good luck to you!
Hugs,
Sara H
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Joined: May 20th, 2011, 1:32 pm

October 22nd, 2011, 12:42 am #4

IVF at Coopers is definitely a lot cheaper than other places, but they only get 1-3 eggs and there's the travel issue, getting time off work, etc., and not to mention the stress level trying to get away for a week or two. Those are the very reasons why we plan on doing IVF locally. For us - the math would be about the same - give or take - and lot less stressful.

We learned a lot from Coopers and plan to use their methods with the local RE. He wasn't too thrilled about it, but was willing to give us a chance.

If I didn't have that option with the local RE, I would probably go straight to Coopers or maybe check out other places.




I am going to NY next week to see check. So is check willing to work with local RE? I mean dies he agree if I do retrival and transfer at local RE and he check manages the protocol?? Or do I still have to go to check for retrival?

Age=28
FSH=28, AOAB, endo stage 4, right overy very small, left overy covered with endo,AFC 2, cash pay

3/2011 IVF #1 : 2 follicle, failed abnormal egg didn't fertilize

From 3/2011-9/2011 went to Re every other week and had a cyst or low AFC and couldn't start IVF

9/2011 IVF #2: EPP, stim for 15 long days, 1 follicle only, sudden E2 drop @ stim day 14,converted to IUI, BFN
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AJ
AJ

October 22nd, 2011, 1:47 am #5

IVF at Coopers is definitely a lot cheaper than other places, but they only get 1-3 eggs and there's the travel issue, getting time off work, etc., and not to mention the stress level trying to get away for a week or two. Those are the very reasons why we plan on doing IVF locally. For us - the math would be about the same - give or take - and lot less stressful.

We learned a lot from Coopers and plan to use their methods with the local RE. He wasn't too thrilled about it, but was willing to give us a chance.

If I didn't have that option with the local RE, I would probably go straight to Coopers or maybe check out other places.




and I looked at other options, and there really aren't any:)! I live in CO so I have CCRM, and I had a consult with them a few years back and I think they'd cycle with me but that would be like $25,000 so I'd be one and done. I don't even know if I could do that once honestly. My old RE advertised themselves as the practice that took the hard cases to complete with CCRM and they told me they would only go to ER with 4+ mature eggs and this would be on the full court press of stims which in the past responded poorly to. It really only goes downhill from there as far as options go. The thing that draws me back to Check is that he's the only one that really addresses the high FSH before cycling and I think that's important.

Last night I woke up and lay in bed awake thinking "WTH am I thinking?? Am I crazy????" I think I am for doing this but I just feel like I have to, you know? Thanks for responding:)
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AJ
AJ

October 22nd, 2011, 1:48 am #6

I know in the past people have posted travel advice and all sorts of tips. Try using the 'search' and you'll get answers!

It sounds like a good plan to me! Also, do the "blood and ultrasound" package, much cheaper.

Good luck to you!
Hugs,
Sara H
But I think your idea is good. I'll do some searching and see what comes up. Thanks!
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MargieD
MargieD

October 22nd, 2011, 3:15 am #7

and I looked at other options, and there really aren't any:)! I live in CO so I have CCRM, and I had a consult with them a few years back and I think they'd cycle with me but that would be like $25,000 so I'd be one and done. I don't even know if I could do that once honestly. My old RE advertised themselves as the practice that took the hard cases to complete with CCRM and they told me they would only go to ER with 4+ mature eggs and this would be on the full court press of stims which in the past responded poorly to. It really only goes downhill from there as far as options go. The thing that draws me back to Check is that he's the only one that really addresses the high FSH before cycling and I think that's important.

Last night I woke up and lay in bed awake thinking "WTH am I thinking?? Am I crazy????" I think I am for doing this but I just feel like I have to, you know? Thanks for responding:)
I feel the same way. That's why I gotta do the IVF, too. It's not time to give up. When we get there - we'll know.

As for CCRM - that would have been out of my price range.(!!!) I totally agree about the whole bit addressing the FSH issue. That's the only reason why I'm ok with going to the local RE. Even though he might not get it, I know enough from working with Coopers to know that it's being addressed before starting a protocol.

It stinks that there aren't more options for women like us.
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MargieD
MargieD

October 22nd, 2011, 3:24 am #8

I am going to NY next week to see check. So is check willing to work with local RE? I mean dies he agree if I do retrival and transfer at local RE and he check manages the protocol?? Or do I still have to go to check for retrival?

Age=28
FSH=28, AOAB, endo stage 4, right overy very small, left overy covered with endo,AFC 2, cash pay

3/2011 IVF #1 : 2 follicle, failed abnormal egg didn't fertilize

From 3/2011-9/2011 went to Re every other week and had a cyst or low AFC and couldn't start IVF

9/2011 IVF #2: EPP, stim for 15 long days, 1 follicle only, sudden E2 drop @ stim day 14,converted to IUI, BFN
But my understanding is that he wants you to do retrieval with him... not with the local RE....

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Joined: September 29th, 2010, 9:51 pm

October 22nd, 2011, 3:28 am #9

and I really like her. She started off by asking me why I made the appt. I explained that I made my initial consult with Dr. Check with the intention of pursuing IVF but that based on my history he suggested doing monitored cycles first. I told her that over the course of the cycles they monitored that the cycles were inconsistent and that I was worried that my FSH was getting too high and that quite frankly, with the amount of money I was paying for these cycles I wanted to be more aggressive. She completely agreed and feels like it is time to move on. Things in my favor are: Even on my really high FSH cycles I still produced a follicle on my own and my age (I'm 38 and have never had a Dr. tell me time was on my side, LOL). I knew that Cooper does low-dose, but I was surprised at how low she suggested we go. They feel like with someone like me it's best to get as close to natural as possible with the drugs, with 1-2 mature eggs being the goal to protect egg quality. A couple of options, if they can get my FSH down to below 10, take Clomid every other day and maybe Menopur if a boost is needed, or take a low dose of Menopur. I guess in both options I would take cetrotide too.

I asked her about doing multiple cycles to stockpile embryos and she said that's an option, but a fresh transfer is better as some embryos don't survive the thaw. I'm not sure how I feel about transferring one embryo though. But at this point maybe I should feel lucky if I even have 1 to transfer??? So DH and I need to sit down and go over a few things, like, how many cycles are we willing to do, will we transfer just one or try to get more...

And then there's the monitoring and travel. I didn't realize until now how much cheaper it is to do monitoring in Cooper's office! I've paid about $600 per visit for full bloods and u/s locally. Those of you who live close enough to do it in the office are lucky:) So we need to think about if it would be better for me to go out and stay in like a Residence Inn with DD for a few days and do monitoring there. If we did that it would also be easier to buy a plane ticket rather than waiting until the last minute before ER. Honestly I have no idea how the whole travel thing works so if any of you have any tips or suggestions I'd love to hear them.

And finally she asked what CD I was on and I told her CD 4. She said that worked out great if I wanted to start BCP's on CD 5 to try to get my FSH down this cycle. She also suggested taking Estinyl after the last BCP until I get my CD 3 baseline. If the FSH is down we can get started or stay on it until it gets down. So I'm officially getting the ball rolling! Really scared though about investing all this $$ in a cycle with maybe 2 eggs. I think we'll just have to play it by ear. If I do make it to ER and the egg is total crap we might rethink doing multiple cycles. At this point I just need some closure one way or the other. And if doing IVF makes me realize that it's just not going to work then I'm ok with that.

Sorry that was so long! But I thought I'd go over everything since there are others considering Cooper for IVF, even though our cases might be different. Any input or thoughts are welcome too!
AJ - I was excited to read your post. We actually made a follow up with Dr. Check - one year after we started with natural cycles (Margie D's suggestion and the nurses also suggested. I thought about another doctor as well. But we already got on the donor embryo list and made our first round of selections so I feel emotionally I have nothing to lose with us asking if there is a chance to try IVF OE. I like you, couldn't get off the "natural cycle hamster wheel" I hear about from many Check Chicks. However I have some idea of how my body is going to react. 5 years ago with 450iu of gonal f I, at best, got 2 eggs per cycle. We never went farther than IUI. We fortunately have a DD from those rounds. FF and I only ever O'd once with Cooper - prior to that I had a year of very little cycles/AFs. So we are stuck with should we really do IVF if there is one egg at all or at least try an IUI again? Not sure. I really don't expect to get more than one or two eggs. And for me I think it is better for me to get a small amt of quality. When pg in 2007 I had twins up until 11 weeks. We carried a singleton but it was determined that the placenta did not develop and in fact the egg was most likely not great quality. So I fear getting a lot of not great quality eggs.

I live in the western suburbs of Philly so I drive to either Melrose park or Marlton. It probably does pay to stay local if you can do it from a cost analysis perspective. I've never had an issue with lab results. The only challenge for me was making the drive. Anywhere you drive in Philly is about an hour. Best of Luck to you. I'll keep you posted after my appt on Monday. Curious to see what Dr. Check will say with the information he's had over a year for me.
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jnoels
jnoels

October 22nd, 2011, 12:53 pm #10

and I really like her. She started off by asking me why I made the appt. I explained that I made my initial consult with Dr. Check with the intention of pursuing IVF but that based on my history he suggested doing monitored cycles first. I told her that over the course of the cycles they monitored that the cycles were inconsistent and that I was worried that my FSH was getting too high and that quite frankly, with the amount of money I was paying for these cycles I wanted to be more aggressive. She completely agreed and feels like it is time to move on. Things in my favor are: Even on my really high FSH cycles I still produced a follicle on my own and my age (I'm 38 and have never had a Dr. tell me time was on my side, LOL). I knew that Cooper does low-dose, but I was surprised at how low she suggested we go. They feel like with someone like me it's best to get as close to natural as possible with the drugs, with 1-2 mature eggs being the goal to protect egg quality. A couple of options, if they can get my FSH down to below 10, take Clomid every other day and maybe Menopur if a boost is needed, or take a low dose of Menopur. I guess in both options I would take cetrotide too.

I asked her about doing multiple cycles to stockpile embryos and she said that's an option, but a fresh transfer is better as some embryos don't survive the thaw. I'm not sure how I feel about transferring one embryo though. But at this point maybe I should feel lucky if I even have 1 to transfer??? So DH and I need to sit down and go over a few things, like, how many cycles are we willing to do, will we transfer just one or try to get more...

And then there's the monitoring and travel. I didn't realize until now how much cheaper it is to do monitoring in Cooper's office! I've paid about $600 per visit for full bloods and u/s locally. Those of you who live close enough to do it in the office are lucky:) So we need to think about if it would be better for me to go out and stay in like a Residence Inn with DD for a few days and do monitoring there. If we did that it would also be easier to buy a plane ticket rather than waiting until the last minute before ER. Honestly I have no idea how the whole travel thing works so if any of you have any tips or suggestions I'd love to hear them.

And finally she asked what CD I was on and I told her CD 4. She said that worked out great if I wanted to start BCP's on CD 5 to try to get my FSH down this cycle. She also suggested taking Estinyl after the last BCP until I get my CD 3 baseline. If the FSH is down we can get started or stay on it until it gets down. So I'm officially getting the ball rolling! Really scared though about investing all this $$ in a cycle with maybe 2 eggs. I think we'll just have to play it by ear. If I do make it to ER and the egg is total crap we might rethink doing multiple cycles. At this point I just need some closure one way or the other. And if doing IVF makes me realize that it's just not going to work then I'm ok with that.

Sorry that was so long! But I thought I'd go over everything since there are others considering Cooper for IVF, even though our cases might be different. Any input or thoughts are welcome too!
Hi AJ -
So glad you feel good after the phone consult w/Cohen - and thank you for the long post. This is really useful information for the other Cooper girls, and for anyone in a similar boat.

I don't have any IVF experience to draw advice from, but I absolutely can relate to the thought process you're going through. It's hard to decide when enough is enough, and it's really hard to decide how much money to spend in the process. And I think I feel the way you do - if I can try a less expensive IVF or two with a doctor who understands my particular case and has experience with and faith in high FSHers, then I will do it.

There have been women on the boards who only had 1-2 follicles and got PG, so it DOES happen. And I know you probably saw the same Check research that I did - that when ladies with low AFC make it to retrieval, the pregnancy rates are the same.

And last - 600$ for b/w and ultrasound????????????? Holy cow!

Good luck, and keep me posted on what you decide! I don't have travel info, but I can certainly fill you in on all the hot spots near Cooper!



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