I wish I could move forward with confidence. I wish I could say this is the clinic for me, commit, and be done with it. We will never know how much money we need until we commit to a clinic. We will never have a plan for achieving/earning/raising/borrowing this giant sum of money until we know how much we need. This is the pivotal decision that everything hinges on, and I can't seem to make the decision. The decision to eliminate. The decision to explore. The decision to commit. I can't make any of them.
I thought making a wish list might help… a "these are the five things I want out of my IVF clinic/doctor/experience" type list. So I did it; I made a list:
- high success rates- if we're only doing one fresh cycle, I want to know we're giving it our very best shot
- reasonable cost- I started to say low cost, but decided I really meant reasonable. I've decided reasonable means this: clinics with national average success rates get to charge national average fees, below has to charge below, above can charge above. Therefore, CCRM gets to charge an arm and a leg, but The Center for Reproductive Health in Nashville does not (15%! really?)
- patient-doctor contact- I know this about myself: I will be a FREAKING basket case if I never talk to my doctor. The more opportunity to see my doctor leading up to the biggest, most expensive moment ever, the better, in my opinion.
- location- obviously convenience of clinic lowers stress and seriously helps out the husband as he cannot get off of work very easily
- embryo success- everyone has assured me that I'll have gobs of embryos. If by some miracle this is true, I want to know that I'm giving these precious babies the best possible chance at life... the more I think on it, I'm wondering if this isn't THE most important criteria of all
I thought this list would help me decide, help me eliminate, help me make the best decision, help me do SOMETHING. Unfortunately, I'm simply more confused now than ever. So I decided to do what I always do... more research. I started reading articles about how to pick the right clinic, about the top clinics and what they have in common, about choosing doctors, etc. The theme seemed to be that while statistics often don't tell the whole story, we should take statistics seriously. In Georgia, the data available from SART places all of the clinics pretty close together... approximately a 10% spread just at or below the national average. Thus, I always assumed that this was true of the ENTIRE country. I started hearing crazy talk about CCRM and their wild rates as I had more and more friends go there, but I assumed they were the exception; everywhere else must be like Georgia. So I literally looked up EVERY. SINGLE. CLINIC listed on SART. You guys, not all IVF clinics were created equal! If you life in or west of Colorado, omg, the success is overwhelming. And the northeast... Rocking! However, if you live in the southeast, well bad news for you, but you'll be lucky if you have ONE clinic that beats the national average in your state. And poor mid-westerners. I'm so sorry, but your chances are slim. Like crazy slim. I found SO MANY clinics with less than 20% chances of success... that's like paying for IVF with the same chances most places give for IUI... huh?!? But on the flip side, there were TONS of clinics with great success rates... pages in fact... I filled SIX pages with clinics that met my criteria (above national average success and more than 100 total cycles in a year).
All of this research really made me mad. As if infertility isn't unfair enough. As if needing IVF to solve infertility isn't unfair enough. As if having no insurance coverage for infertility treatments isn't unfair enough, I basically live in the armpit of infertility treatment centers. I already unloaded on Suzanne (she gets it, if I'm in one armpit, she's in the other), so thank her for taking the brunt of my angst, but you guys, this is just frustrating. Georgia only has two clinics (based on the most current data) that fits my criteria, California has twenty-one, Colorado has three (of the best), Texas has eleven. I think I'm starting to understand Resolve's infertility scorecard a bit more... but I don't think 44 out of 51 really captures the difference between Georgia and Massachusetts (number 1). That's just ranking the states, but really if Massachusetts gets a 100, Georgia gets a 12 (in my opinion). So frustrating.
I just don't know where to go from here. IVF is already THE MOST EXPENSIVE THING EVER, so we really don't have the money to look at traveling to Pennsylvania, or California for treatment. But I feel like I'm settling by staying in Georgia, I feel like I'm saying my future maybe baby isn't worth it. And the Lord knows I would go to the moon and back for my child, no distance, no cost would be too high, but this doesn't feel the same... should it?
I'm just feeling really discouraged. I can't comprehend how everyone else chooses a clinic so easily. This feels MONUMENTAL. I suddenly feel the weight of IVF, the pure gravity of such a decision, the immense responsibility I have for these lives that we will attempt to create. I feel the pressure to get this decision right, not simply because we want to be successful, or because it's a lot of money, but because these doctors, these clinics will literally hold our children in their hands. And so I'm stuck, unable to decide, to choose, to move, to veto. In a word, I'm overwhelmed.
Anybody want to choose for me?
 |
| Six pages of clinics that do more than 100 cycles a year and have at or better than 42% odds of success |
All of this research really made me mad. As if infertility isn't unfair enough. As if needing IVF to solve infertility isn't unfair enough. As if having no insurance coverage for infertility treatments isn't unfair enough, I basically live in the armpit of infertility treatment centers. I already unloaded on Suzanne (she gets it, if I'm in one armpit, she's in the other), so thank her for taking the brunt of my angst, but you guys, this is just frustrating. Georgia only has two clinics (based on the most current data) that fits my criteria, California has twenty-one, Colorado has three (of the best), Texas has eleven. I think I'm starting to understand Resolve's infertility scorecard a bit more... but I don't think 44 out of 51 really captures the difference between Georgia and Massachusetts (number 1). That's just ranking the states, but really if Massachusetts gets a 100, Georgia gets a 12 (in my opinion). So frustrating.
I just don't know where to go from here. IVF is already THE MOST EXPENSIVE THING EVER, so we really don't have the money to look at traveling to Pennsylvania, or California for treatment. But I feel like I'm settling by staying in Georgia, I feel like I'm saying my future maybe baby isn't worth it. And the Lord knows I would go to the moon and back for my child, no distance, no cost would be too high, but this doesn't feel the same... should it?
I'm just feeling really discouraged. I can't comprehend how everyone else chooses a clinic so easily. This feels MONUMENTAL. I suddenly feel the weight of IVF, the pure gravity of such a decision, the immense responsibility I have for these lives that we will attempt to create. I feel the pressure to get this decision right, not simply because we want to be successful, or because it's a lot of money, but because these doctors, these clinics will literally hold our children in their hands. And so I'm stuck, unable to decide, to choose, to move, to veto. In a word, I'm overwhelmed.
Anybody want to choose for me?
The biggest reason it feels so monumental is tied to the financials for most people I think. If we all had IF coverage or had oodles of extra cash laying around, well the choice would be soooo much easier wouldn't it? I feel your pain. Every question you have, I share. We have zero infertility coverage too, and it really does compound the situation when $ is a factor and especially the added expense of travel.
ReplyDeleteAnd yes, it would also be easier if you lived around the corner from the top contenders. I think you are taking a very smart approach though. I love that you are analyzing it from all angles and doing all the research....smart girl! It might feel like paralysis by analysis right now, but you will get to a place where you can make the right choice because of all the legwork you're doing now. You are doing all the right things to get there!
Oh girl, I hear you on the indecisiveness. While it was easy for us to choose our clinic in Cancun, I've had a really hard time deciding what to do now that IVF is behind us.
ReplyDeleteNot knowing what to do is really difficult. I truly wish you all the best in deciding how to move forward, and most of all feeling confident in your decision.
Amanda, this sounds like such an agonizing decision. You've pointed out yet another thing I've never thought about regarding infertility, and that is the extent to which not only biology and finances but geographical location can affect your chances of success. One obvious good thing here, at least from my point of view, is how thorough you are being. You are arming yourself with information, and that's important. I know whatever you decide, the coming months are going to be an exciting time. I will be praying that you can find peace about this choice, and that joyful news won't be far away!
ReplyDeleteOk! I've got it! If MA is really THAT good... Come here!! You'll have a place to stay, my friend :). Anytime!!
ReplyDeleteI totally understand your frustration. I honestly think, though, that you absolutely don't want to go to a bad clinic (obviously), but I'm really at the point where I think it's (success, that is) so much more about the patient. I mean- I (my eggs) must be in really bad shape if four IVF's and one FET in MA didn't work. Not even a little bit. Anyway- this is all to say that YOU might have better chances than someone else (like me) at a clinic with success rates lower than CCRM's or than a clinic in MA.
XOXO
It's a tough decision, and it seems really unfair that you don't have any clinics with amazing success rates near you (on top of all the other unfairness of infertility).
ReplyDeleteYou probably don't want another item on your list, but does your gut feeling push you one way or the other? We looked at clinics where we lived previously (some insurance coverage but considerable language barrier) but didn't feel comfortable, and as we knew we'd move we waited. Here, no coverage but we felt our doctor knew what she was doing. I didn't actually see her during the entire cycle, but I knew that that was possible, and all her colleagues were great, too. All important decisions were always cross-checked with her (or so I was told).
I think the hardest part is that the stakes are so high and there are no guarantees. We got lucky. I hope you will, too.
I completely understand! I am so indecisive as well. I hope you find comfort soon!
ReplyDeleteOh girl, you are being too hard on yourself. It IS a difficult decision and you should spend hours pouring over what to do, but you shouldn't beat yourself up for not choosing so quickly. Everyone has different requirements from their clinic.
ReplyDeleteAnd you have to remember that MA has mandatory IVF coverage, so there's a lot more people who have it available to them. The more people who go, the better their potential outcomes could be. And don't forget that some clinics are more strict with who'll they'll treat so that their statistics look better.
We went to Boston IVF before we moved down south and they were okay. But the financial department was ruthless and you're really just a number there.
I would email a few clinics and ask what percentage of success they'd give you based on your personal information. Yes, they divide it by age group, but you still have a specific statistic unlike anyone else. I'd just throw out a few emails and see what you get back.
I'm sorry this is so stressful for you. I hope you start to feel less anxious soon. *hugs*
I so wish that I could choose for you - that I had that knowledge and confidence to just say, "Amanda, this is the IDEAL clinic for you. This is the clinic that will bring you a baby." Huge bummer that I can't do that. I would definitely encourage you to not go overboard with analyzing all of this stuff. I know that it's so expensive, that you may only get one shot, etc, etc. But chances are, you won't pick the absolute best clinic and you won't pick the worst. Chances are that you'll pick a really good clinic that will give you a great shot at a baby...an excellent shot. You can do it. I know you can.
ReplyDelete