Yesterday's appointment went well. Nothing astounding, nothing terrifying, just a good solid appointment. He did commend me for exploring my options and stated that more people should do that. And he also scored some points by commenting on how knowledgeable I was and how well prepared I was (at which point I smile and think, I wish you could meet my friend Emily over at Eat Love Procreate. She'd knock your socks off!). I didn't love his rationale behind which embryos to freeze and which to discard, but he was open to my interpretation and willing to do as I asked. He recommended a different protocol than the other doctors, but was honest with me that his reasoning has less to do with me and more to do with what he is confident he does well. I can respect that. Like I said, overall, a good consult. I feel confident that he is an intelligent doctor who knows what he's doing.
So here's the thing: within about two hours of being in Jacksonville, I started to get a really good feeling. I can't really explain it, but for the first time I felt like I could breathe and talk about IVF at the same time. It felt doable. I immediately shrugged these feelings off as euphoria over a mini vacation... who wouldn't feel great at the prospect of beach, pool, and shopping. I told myself to focus on the facts. But the feeling just stayed. I felt good. I went to the consultation yesterday, and was unconsciously thinking "you've got to beat FIRM". I literally had to make myself stop half way through the appointment to refocus because I was comparing everything he said to the Jacksonville clinic.
On my way home (two hour drive) I spent some time thinking through what it is specifically that I like about FIRM. I came up with three things: doctor-patient interaction, cost, stress level. Almost all clinics I've been to utilize the doctors rather than nurses or ultrasound technicians for monitoring appointments, but FIRM seemed the closest to my experience with ACRM. I would see MY doctor at every appointment, I'd have a few minutes to voice my concerns directly to HIM not a doctor or a nurse, but to MY person. This is huge to me. I have never been so frantic as when I couldn't get in touch with my doctor at RBA... seeing my doctor every few days eliminates a lot of this worry. The cost is huge for us! We currently have $4,400 in the savings account. That's not too far away from $7,300 but it's a drop in the bucket to $14,700. We could potentially pay for IVF and meds in January 100% out of pocket and I love that. And lastly, I never would have dreamed that traveling away for IVF would make things less stressful, but the more I think about it, the more I'm confident that being away from work, away from Atlanta traffic, away from regular responsibilities would alleviate a lot of stress. IVF will be stressful enough, why make it more so, right?
It may seem like I've talked myself straight into a decision, but I just can't seem to pull the trigger. Sam is fully on board (hallelujah). He loves the price. There is no real reason why I can't commit to FIRM except this nagging voice in my head, "but what if?". I had almost gotten there last night... Sam and I were both good with it, and then I stopped to look at the numbers. I wrote it all out on a napkin... I'll spare you all the napkin.
The Great Clinic Debate of 2013 (ordered by fresh cycle success)
[IVF pregnancy rate-frozen rate-cost]
- Emory- 65.7% 30% $12,800
- PREG- 56.4% 39% $9,500
- FIRM- 54.2% 28% $7,300
- ACRM- 49.6% 42% $13,200
- SMFI*- 47.8% 50% $6,975
- RBA- 40.7% 50% $14,700
After looking at the numbers, I was worried again. The fresh rate seems solid to me... it's not the best in the country, but it is better than average. It's the frozen success rate that gives me the willies. It is the LOWEST of all the clinics we're considering. If I'm being 100% honest with you guys, it makes me feel like a bad parent to subject my (yet uncreated) embryos to such conditions. I tried to explain it to Sam last night, these protective feelings, this sense of burden I have for these lives and I obviously did a great job because he looked at me like I had a third eye. I'm trying to comfort myself with the fact that lesser quality embryos are less likely to succeed, but that Dr. Duffy regularly freezes grade C (which I like)... but maybe this explains the less than stellar success rates?!?!? Maybe it's not something FIRM is doing wrong, but just a different view on what is freeze worthy?!?!
I could talk about this for days and still be in the same place. I still have an appointment scheduled with Emory, but we're thinking about cancelling. Emory is pretty close to the other Atlanta prices... now granted they have success rates to back it up, but Sam's not loving the cost. I'm 80% in agreement, and I desperately need the hours of paid leave, but I haven't dialed because "what if?".
I am a self-professed Commitment-Phobe and I don't know what to do about it. Anybody have any insight? Which clinic would you choose?
J-ville's looking good to me. Maybe you convinced ME to go there...although 80% of my reasoning would be that my BFF lives in J-ville and then I could live with her for 2-3 weeks and that would be so awesome. So actually, ignore that. But seriously...why not go with the one that your heart feels good about, where you feel a peace? And then the numbers also back it up, ESPECIALLY the pricetag? And is there are reason you couldn't move the embryos to another clinic in a few years and do your FET w/ someone else (RBA)? I'm sure there'd be an additional cost with that, but it could be possible, right?
ReplyDeleteI am a big believer in going with your gut. If the clinic in Jacksonville felt right, I think that's your biggest sign to go that direction. Also, looking at the chart you made, FRIM does seem to be the best option overall. It's by far the most affordable (other than SMFI which as you noted is a new clinic without much experience). It's ranked number three on your list according to fresh cycle success, but its 52.4% is pretty darn close to the 56.4% of PREG. I can see what you mean about being nervous about the frozen success rate, but FIRM's 28% there is not far from top-ranked Emory's 30%. And I think your point about FIRM agreeing to freeze lower grade embryos is really important. That is definitely going to affect their overall frozen success rate. It seems to me that Dr. Duffy is willing to sacrifice the overall frozen success rate in order to give those lower grade embryos a chance. I like that logic.
ReplyDeleteThis may sound like a horrible analogy, but you might think of the different clinics here as little league coaches. The strict coaches who pick only the best and fastest kids are going to have more wins. The gentler coach who chooses to see potential in the slower, less confident kids is going to lose more games. But I know which coach I would want my kid to have.
Annie's analogy is awesome. Love it.
DeleteBest Analogy Ever Award goes to: Annie B
DeleteAw, thanks :) Amanda, I know whatever decision you make will be the right one for you, your husband, and your future children. Thinking of you and praying you will feel at peace with whichever clinic you choose!
DeleteYES! I agree 100% with Annie. Go with your gut. Not the numbers. Numbers can lie and be manipulated to look they way someone wants them to. Do what feels right. Do what you can live with. No matter what clinic you choose, if it doesn't happen for you with them then you will second guess your decision. There's always a coulda', shoulda', woulda' but you can't live life that way. XOXOXO praying for peace.
DeleteI love how you're approaching all of this. So many people dive right into a clinic for reasons sometimes as simple as it's the "closest to my home". I love that you're thinking through every single angle and what makes the most sense for you (& Sam).
ReplyDeleteThat said, I have no idea who I'd choose. I like you, would have a hard time canceling an appointment and not forever have it on my brain of what if it was "the one". However, if you know that the finances of that clinic simply won't work, then why tease yourself in case you really, really like them?
I think of you often and I wish you lots of peace as you make this decision. I have no doubt that whatever you decide...will lead to your baby(ies). xoxox
Major props to you for doing all of this research! It is such a very important decision and I know when you do make your choice it will be the right one :) (Also in ref to yesterdays post I see you had dealings with those pesky, stinky love bugs. I HATE them! I thought they were everywhere and everyone had to deal with them but I guess that's not the case. Here in southeast Texas we deal with them twice a year for about 3 weeks at a time...worst ever!)
ReplyDeleteI think FIRM has good numbers,good price and good success rates. I also like that they are willing to give lower grade embryos a "chance."
ReplyDeleteGut feelings are good, Amanda. How did you know Sam was your guy? I mean, is he 100% perfect or something? ;) Haha, you know where I'm going with this. I think you've got a good feeling about FIRM, and I think there's a reason why. I'm no expert but have gone through this a few times times: Pregnancy success has a lot to do with embryo quality. I was and am very protective of my frozen babies, but they are humans on a cellular level and biology takes over. When you freeze your beautiful, healthy embryos, they will thaw magnificently and implant in your comfy uterus. I don't know why FIRM has lower FET success rates. Maybe it's based off the fact they freeze grade c embryos, like you said. I would be interested to know their thaw success rate. And, pardon me, but it looks like someone hasn't been updating their IVF fund tracker!!! $4,400! You are doing awesome! What a blessing it would be to pay for IVF out of pocket. That is great. :)
ReplyDeleteI really like the fact that you were getting such a good feeling at this clinic. Listen to that gut instinct! Our intuition is a powerful thing that we often minimize when we focus on numbers and the like. The numbers are SO important, especially when it comes to IVF...but it sounds like your intuition wants a say as well. Thinking of you as you venture into decision-making territory!
ReplyDeleteWell, I am so honored at the mention, coming from the spreadsheet analytical queen that is you. haha!
ReplyDeleteI do not know which one to pick, but I will say this...your gut feeling is a very big deal and you should listen to it. In looking at other clinics, I've thought the same thing about how important it is to be comfortable doing IVF in a place that won't give you a bunch of anxiety. Honestly, that is why I barely even researched NYC, because the thought of running around like a rat on the subway or hailing cabs or walking in that dirty city just doesn't sound very Zen to me. No offense to any NYC peeps....it's fun to visit, but not my cup of tea for IVF if I can help it. I totally get where you're coming from. Obviously, the numbers matter, but it's got to feel right too. Sleep on it some more sister!
I love that the Lord gave you a peace while you were there - How exciting :)
ReplyDeleteI had to laugh at your post because I wrote exactly this post about 5 months ago before deciding on CCRM. There are no easy answers and the increased cost at CCRM was hard for me to swallow. We had to borrow money to afford it even. But in the end, I asked myself what decision will I regret the least no matter the outcome. It's all about regret-management for me. Good luck finding peace in your decision.
ReplyDeleteI think that since you felt so good at the Jacksonville clinic, that might be the way to go. As long as the travel won't be too stressful for you. Does the Jacksonville clinic have any sort of program for multiple rounds of IVF?
ReplyDeleteI love Annie's analogy and to second so many others... I agree... GO WITH YOUR GUT. Trust yourself and you can't go wrong. xoxo
ReplyDeleteThinking of you as you take this last step in choosing a clinic. Praying for you to come to a decision that gives you both peace!
ReplyDelete