How was your experience with Isiah Harris at Kaiser Permanente NorCal?
Dr. Harris is really incredible. He talks very fast, but he is so well versed in the research and gives rationale for why he wanted to do a protocol. He did every monitoring ultrasound during IVF, and would make adjustments as he saw you. He tried to set expectations about how many he expected to retrieve and why he was making adjustments to the protocol. He batches patients so that he can do every ultrasound-- so he'll go from retrieval to ultrasound to transfer to ultrasound all day long. I'm pretty sure he doesn't sleep for 3 weeks at a time. However, he always manages to light up the room with his infectious smile and laughter.
What's one piece of advice would you give a prospective patient of Isiah Harris at Kaiser Permanente NorCal?
He doesn't recommend lifestyle changes (ie supplements, diet, etc). However, he fully supports you if you want to do them. He knows how out of control this feels and will support you if want to try to find some control. So please be honest with your supplements; he'll give you an honest opinion about when to start/stop them during your cycle.
During treatment, were you treated like a number or a human with Isiah Harris at Kaiser Permanente NorCal?
Dr. Harris is warm, friendly, knowledgable, and really partners with you. He shares pieces of his life with you, knows who you are, and asks about partner/life/work.
Describe the protocols Isiah Harris used in your cycles at Kaiser Permanente NorCal and their degree of success.
I did a couple of injectable IUIs where the lead follicle stopped growing with a step-down approach (meaning I started at higher doses and then decreased the dose). Based on this data, he made some adjustments to my IVF protocol. We did the antagonist protocol. We started with 150 follistim/150 menopur and then added in the ganirelix after day 6 or 7 of stims. We increased the dose of one or the other med at each appointment, with my max being 375 for both meds by the end. We did ICSI just as a precaution and I'm glad we did; it just took the guesswork out of it.
We expected 12 mature eggs, but only ended up with 8 (this was a huge blow!). 7 fertilized and all 7 were growing well at day 3, so we opted for a day 5 transfer. When we got to transfer, we spoke with Dr. Harris and the embryologist who informed us that we had an early blast and a morula. Both of these were a little behind where they "should" have been. All the rest had already arrested or were so far behind they most likely wouldn't make it. They encouraged us to transfer both despite our terror of twins. He did the transfer and then he has a little dance/ritual he does over all his patients after transfer (waving his hands over your abdomen-- maybe a little prayer?) I loved it; as I really felt he was giving us extra love (even if medically it doesn't make a difference). Unfortunately we did not have anything to freeze and our transfer ended in a chemical pregnancy.
Describe your experience with the nursing staff.
Kaiser does not assign you a primary nurse for IUIs or IVF. The IUIs are all done by rotating NPs-- all of whom are competent, kind, and engaging. The IVF nurses reinforce what Dr.Harris just told you when he did your ultrasound.
I was surprised that it was the nurse who gave the results; not Dr. Harris. Unfortunately, they informed me I was not pregnant (beta 17) and to stop all meds. I now understand that while the chance of sustaining the pregnancy is almost nothing; I was technically pregnant. I wish they would have told me to continue meds and re-test in 2 days (rather than stop and re-test a week later) I'm 99% sure the outcome would have been the same, but I wish they would have given it a shot. And I didn't know enough to push for it.
Describe your experience with Kaiser Permanente NorCal.
Kaiser is a well oiled machine. For all fertility workup, it's pretty standardized, meaning they do initial blood work, semen analysis, saline sonogram, HSG, and hysteroscopy regardless of diagnosis (I think). I never felt like diagnostic testing was hard to get or was missed.
For IUIs, they don't perform them on Sundays, so they'll do it a little early or late if the ideal time was a Sunday. For IVF, it's a full 7 day/week system. They batch patients as the Dr does every ultrasound and you see him at every visit. Unfortunately, that meant a pretty long wait in between cycles. But, that does mean a ton of face time with your dr and consistent scans. They also made you pay to reserve your spot. This meant we paid almost 6 months before cycling (which was a nice break), but now I wish we had gone somewhere else or paid for IVF while still doing IUIs to not have that long break. We ended up switching clinics simply because we couldn't do another 6 month break before cycling again. If we could have cycled more quickly, we would have stayed with Dr. Harris and Kaiser.
Describe your experience with your monitoring appointments at Kaiser Permanente NorCal.
The monitoring could take 10 mins or 3 hours. Since Dr. Harris does all of his own monitoring, he would go from retrieval to ultrasound to transfer to ultrasound. It was great that you always saw your doctor, but it could lead to some very LONG waits. Additionally, you're given a specific time for monitoring, but it's actually first come/first serve. So ignore the time you're given and just show up as early as possible.
Describe the costs associated with your care under Isiah Harris at Kaiser Permanente NorCal.
Fertility workup, IUIs were all covered under insurance, so very minimal. IVF was completely out of pocket. I believe it was about 12k for IVF + ICSI. Meds were separate and ended up at about 6k.
Describe Isiah Harris's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Kaiser Permanente NorCal.
He favors eSET, but since both of our embryos were a little behind (early blast and morula) he felt that the morula would probably NOT make it, so it was less risky.
What specific things went wrong at Kaiser Permanente NorCal?
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at Kaiser Permanente NorCal.
When the nurse called me with my beta, she told me I wasn't pregnant. However, I did have a low positive pregnancy test (17). Granted, I don't think it would ended in a live birth, but there's a difference between less than 0 and 17. It proved I could GET pregnant (the first time I ever was) and that information changed the way I thought about the cycle and subsequent cycles. I wish they would have communicated that to me and allowed me to stay on meds and re-test 2 days later rather than stopping all meds and re-test a week later.