How was your experience with Robert Gustofson at CCRM Colorado?
We can't argue with Dr. G's results: the protocol he designed resulted in 4 viable embryos (3 after CCS) on the first IVF attempt, and caused me minimal discomfort while on retrieval and transfer medications. While his bedside/consultation manner could seem a bit fake-jolly, he always made time to answer as many questions as we had in each session, responded promptly to questions we submitted through the online portal, and provided thoughtful responses when we asked about the evidence behind various recommendations/requirements in our treatment. (For example, we wondered why the clinic still required getting Vitamin D levels up, when it isn't clear that it makes a difference for IVF outcomes. Dr. G. sighed and explained that Vitamin D had shown early promise as making a big difference, but now the pendulum was swinging back toward skepticism. In the meantime there was no evidence that boosting Vitamin D hurt IVF outcomes, so they continued to require >30 while the research dust settled.) He also looked more thoroughly into Zika travel recommendations to help make some important international work trips possible before our IVF/retrieval and FET procedures.
What's one piece of advice would you give a prospective patient of Robert Gustofson at CCRM Colorado?
Don't be afraid to ask lots of questions, especially if you've done your homework via sites like FertilityIQ and have your checklist of things you want to know. Dr. G may sometimes seem like he's trying to move things along quickly, but he means it when he says "do you have any other questions for me?" and will answer thoughtfully - or he'll check and get back to you within a day or so if he doesn't know the answer right away.
During treatment, were you treated like a number or a human with Robert Gustofson at CCRM Colorado?
While his bedside/consultation manner could feel a bit fake-jolly, he always made time to answer as many questions as we had in each session, responded promptly to questions we submitted through the online portal, and provided thoughtful responses when we asked about the evidence behind various parts of our protocol (e.g., why the clinic still required getting Vitamin D levels up when it isn't clear that it makes a difference for IVF outcomes).
Describe the protocols Robert Gustofson used in your cycles at CCRM Colorado and their degree of success.
Male factor infertility (10+ year old vasectomy)
Advanced age (male age 48, female age 40)
Female history of large fibroid and asymptomatic endometriosis (removed by laparoscopic myomectomy & lasering 3 years before)
This was our first time attempting to get pregnant. At Dr. G's recommendation, we decided to skip the low-probability steps of reversing a vasectomy, waiting for sperm counts to normalize, and trying naturally or with lighter assistance before advancing to IVF. (We also figured keeping the vasectomy in place was useful, as we only intend to have 1 child.)
Cetrotide (GnRH blocker)
Gonal-F (Injectable FSH)
Trigger with Lupralide (GnRH agonist)
Supported with doxycycline (antibiotic) and dexamethosone (corticosteroid) as well as daily prenatal vitamin + 5,000 IU Vitamin D
15 eggs retrieved
13 fertilized via ICSI
8 survived to Day 3
4 survived to Day 5
3 tested as euploid (CCS)
Lupron Depot (endometriosis & fibroid suppression, 2x monthly injection prior to Cycle Day 1)
Birth control pill (cycle timing control)
Progesterone in Oil (progesterone)
Supported by Medrol (steroid to prevent embryo rejection), doxycycline (antibiotic), and aspirin as well as daily prenatal vitamin + 5,000 IU Vitamin D
Uterine lining and hormone levels (P4, E2, TSH, LH) all at desired levels at transfer
Pregnancy and live birth TBD
Describe your experience with your nurse at CCRM Colorado. (Assigned nurse: Chris)
The nurses and clinic staff were generally great to work with - but were also the source of our biggest frustrations in the process, as multiple times we received contradictory, incomplete, or simply incorrect information, which we only caught because we had our own detailed spreadsheet and calendar. A few examples:
1. I had to travel for work to Zika countries between retrieval and FET, and was instructed just to call on Cycle Day 1 after I was back in the country. However, as we found out later, the 2 months of Lupron Depot I had complete first could have been done while I was abroad, as the Zika waiting period is 8 weeks. When I did call on Cycle Day 1 upon my return, the nurses were about to start me on a standard pre-FET protocol (birth control, etc.) until I reminded them that Lupron Depot was part of my treatment. At that point it was already too late to order and administer the Lupron Depot during that cycle, so we were delayed by yet another month.
2. We were told at the outset to get male communicable disease testing "close to retrieval date" and had planned accordingly, only to be told 2 weeks prior to retrieval that his communicables were late and had to be done within 24 hours - a significant disruption to both our busy work schedules.
3. After one set of labs I was told that I would need to extend one medication that I'd already finished by an extra 1-2 days; my fertility pharmacy was not local and had already closed for the day. I ended up having to take half a day off work to get a refill from a local (but faraway) fertility pharmacy.
4. I received contradictory information from different sources in the clinic whenever my treatment deviated from the norm - such as the 2 months of Lupron Depot mentioned above, the dosage schedule for Crinone (what my insurance allowed) instead of Endometrin, and the date of my pregnancy test (calculated for July 4, but split into two tests on July 3 and 5 to accommodate the holiday). Overall, I got in the regular habit of asking "Could you please double-check that that's what Dr. G specified in my file? Because I heard something different the last time I called."
All that being said, all the nurses and staff were friendly, efficient and responsive, and I did receive prompt calls with my lab results and regular nurse consultations to go over my treatment plan (where we caught a number of these ambiguities/errors).
Describe your experience with CCRM Colorado.
Results and communication. We were really impressed by how I responded to the protocol pretty much exactly as predicted, as did our eggs and embryos - it built a lot of trust in Dr. G, as well as the embryologists and other technicians. And we appreciated how every care provider proactively communicated with us (e.g., after every lab and before every procedure) and was willing to spend time to answer any and all questions.
Administrative departments were also great, from scheduling to billing to sending paperwork. The finance department was also very helpful in answering questions we had about the costs and options for payment/reimbursement.
Imperfect coordination across care providers. Contradictory information was our main frustration in this process, and it usually stemmed from the Lone Tree staff having different information/assumptions than the Louisville staff, or whoever answered the phone assuming standard operating procedure with our treatment when there were important changes/adjustments made by Dr. G in our file.
What you should know:
As with any clinic and fertility treatment, be prepared to be more organized than anyone else involved in your care, and to press for clarification/correction whenever something doesn't match your understanding or simply doesn't feel right to you. These are caring professionals who share your goal of a successful pregnancy, and they have an impressive track record of making that happen. But they are still an imperfect operation, especially when it comes to coordinating the little details, so make sure to stay on top of those yourself.
Describe the costs associated with your care under Robert Gustofson at CCRM Colorado.
$30,495 (before insurance reimbursement): covers one cycle of IVF including PESA, ICSI and FET. Does not include pharmacy (medications) and some labs
Describe Robert Gustofson's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at CCRM Colorado.
Dr. G strongly recommended eSET based on our profile (no history of miscarriage) and preference to have one child. During our first consultation he did write out the statistical rates of success and complication risk for single vs. multiple, and let us make the choice.
What specific things went wrong at CCRM Colorado?
- Failed to inform you of changes in protocol
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at CCRM Colorado.
Specified in another free-response section