How was your experience with Frank Yelian at Life IVF Center?
Dr. Yelian is very excited about the science of IVF and ready to explain every detail. It really seems to be a passion. He's confident, but also practical. I wanted facts, I wanted to know what could be done, how and when. He could give all the answers and answers for what ifs. I like to read studies on Fertstert and I wanted someone who could discuss them with me. His scholarly background makes him a good fit for anyone approaching this as science and research.
He also framed the answers in a positive way and recognized the importance of this. Another doctor had said you only have a 5% chance of a live birth as a dismissal of trying. Dr. Yelian estimated a similar percent as a positive -- you still have a 5% chance of a live birth. It's subtle, but important. I liken it to finding out you are diagnosed with a terrible disease-- I want the doctor that says, I can help you fight this, it's hard but we have these options, you have a 5% chance. I don't want the doctor that says you only have a 5% chance of survival, why bother?
Dr. Yelian combines both science and compassion. I had hoped to have more appointments where I saw him. At this clinic, you will only see the doctor for your consultation, for your first appointment with the clinic, for retrievals and transfers. Theoretically, you can make additional appointments for a fee, but this is downplayed when you actually try to do it.
What's one piece of advice would you give a prospective patient of Frank Yelian at Life IVF Center?
You should be prepared to keep track of everything and ask a lot of questions. You won't get many opportunities to talk to the doctor, so you will want to be fully prepared for every chance you get.
During treatment, were you treated like a number or a human with Frank Yelian at Life IVF Center?
The clinic is very busy and I'm not able to see the doctors often, but when I have talked to them they seem to understand how this is important and emotional. I met with two previous doctors at other clinics who didn't seem to understand that not being able to have a child is upsetting. I don't feel like with Dr. Yelian that his success rates are more important than me.
Describe the protocols Frank Yelian used in your cycles at Life IVF Center and their degree of success.
I did three mini-IVF cycles in a row, but had started four cycles. I then have started two FET, only one of which progressed to a transfer, which was negative. My FSH is high, my AMH is low and I am old. I was 39 when I started, 40 now. The theory on mini-IVF is that I was not going to produce many eggs regardless of how much medication I used because my FSH was already high, further stimulation wasn't going to do much. However, by doing three cycles each with less eggs collected, I could end up with a similar number of eggs to a standard cycle.
My first attempt at a cycle was cancelled the first week as I already had a lead follicle. The thought was, this could be normal for me or it could be an off cycle. If we wait a month and it is the same, we're essentially in the same place, but maybe by waiting a month it would be better. Fortunately, it was a little better the next month. I was sad, but appreciated the practical approach.
My first cycle to progress used clomid daily, Menopur every other day and a trigger with Lupron. I did not prime before. I had two eggs from six follicles, which was disappointing that day, but both made it to 5 day and were frozen. At the end of the cycle, I realized two from two is amazing.
My second cycle used clomid daily and Follistim every other day with a double trigger. Because the first cycle had resulted in only two, the second was a change just to see if it worked better. I was to take 10 days of BCP, but started my period after 7 days, even on the BCP. I had four eggs from five follicles, but only two made it through the first day. Only one made it to 5 day and freeze.
I then skipped one month because my cycle put my retrieval right in the middle of their week closed for the holidays.
My third cycle was clomid daily, Gonal F every other day. I did not prime before. I triggered with just the Lupron. I had three eggs, two of which survived the first day and made it to day 5 to freeze.
My first FET cycle I used estradiol, lots of it, then threw in tamoxifen for 10 days. There was not priming before, it followed my natural cycle. My lining wouldn't get above 7.6 at cd20 and the doctor decided to transfer because it seemed to be as good as it would get. My pregnancy test was negative, not even a chemical.
My second FET cycle I used lots of estradiol, tamoxifen for 9 days and had an endometrial biopsy. I had more follicles growing, all of similar size than I had on any of my retrieval cycles, I regret not being able to switch it to a retrieval. My lining was 7.8 at cd14, and we tried going through the weekend to see if it would thicken. At some point over the weekend I ovulated and the cycle was cancelled.
The plan is my next FET cycle would follow the protocol of the second, but transfer at cd14 and not risk going longer.
Describe your experience with the nursing staff.
Almost all of the nursing staff and staff in general is exceptionally nice, kind and thorough. I think with any workplace there will be a couple that are less pleasant or that you encounter on an off day.
I had been warned by another patient that the staff wouldn't be friendly, but I found everyone friendly and warm, just also efficient. You won't be seeing the same people each time and they see a lot of patients, so while I felt I was familiar to everyone after my second cycle, I didn't expect them or need them to know much in the way of details about me. When some did I was pleasantly surprised.
Of all my visits, and I have been there a lot, I've only had three instances of a not completely pleasant interaction -- and none of them were problems that would affect the results of the cycle.
Describe your experience with Life IVF Center.
Life IVF's patients are almost all "hard" cases for other clinics. If you are of advanced age, have DOR and/or high FSH, they are ideal. It's what they are dealing with all day, everyday-- you won't be a problem patient. I sort of feel like no matter how awful my numbers are, I don't scare them. It makes treatment more promising and waiting in the waiting room more pleasant... at 40 I'm never the oldest there. Considering the patients, I think their success rates are amazing.
The clinic's emphasis is on the least amount of drugs/procedures/extras to make IVF as minimally invasive and as easy time management-wise as possible. If you are uncomfortable with the sheer amount of medication involved in a cycle elsewhere, Life would be ideal. They just don't do the everything and the kitchen sink style cycle. Retrievals can be done without anesthesia. I had read other patients posting that they did retrieval completely drug free, so I tried my first cycle and I highly recommend Norco and Valium. It wasn't the most awful experience of my life, but some pain killers made it so much more manageable the second time. Anesthesia is an option if you'd prefer. With the exception of one, all my cycles were based solely on my natural cycle and did not include taking injections or birth control to get on a schedule convenient to the clinic.
It was important to me to know that I would not be cancelled if I had even a little chance. Other clinics cancel if you don't have lots of follicles, Life advocates "it only takes one". If you only have one or two and want to proceed, they will and if you feel a moment of panic and consider canceling, they will reassure you without pressuring you, either.
Almost all information will come through emails with great brevity. I almost always would like more information and sooner... but the information that you need always arrives in time (just not as immediately as my anxiousness would occasionally like). I don't think this clinic would be a good option if you want to feel you are being guided and hand held.
In general, I feel that the pain involved in all aspects of a cycle is slightly underestimated by the nurses and doctors. I am tough, but, goodness. Last cycle I learned that an endometrial biopsy is much more painful than a pap smear (which it was presented as being just like). If I started over with them again, I'd very much like to feel confident asking for painkillers and valium before procedures. Once I said I was interested in them, they are happy to advise and proscribe without making you feel weak.
Describe the costs associated with your care under Frank Yelian at Life IVF Center.
I'm uncomfortable giving numbers, we're asked not to. My three mini cycle package was a similar price to one full cycle at another local clinic. Monitoring is in addition to the package price, as are medications. At this point, three retreival cycles and two transfer cycles, with medications and monitoring I am over 20,000 and under 30,000. I did not use PGS.
Describe Frank Yelian's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Life IVF Center.
Life IVF is very strongly pro eSET. Because I am older, I felt transferring at least two would be reasonable and they agreed to it while cautioning that it is not their recommendation. (I ended up doing eSET)
What specific things went wrong at Life IVF Center?
- Failed to call in prescriptions to pharmacy
- Provided conflicting information
Describe the specific things that went wrong at Life IVF Center.
My second cycle, the day before my retrieval I received a call informing me they had followed my directions and cancelled my retrieval. It was a message left on my cell phone, I was at work, working retail (no access to cell phone during work) and did not receive the message until late afternoon. I did not hold myself together well and was near hysterical (okay, hysterical). I had a hard time getting through to the desk which made it more upsetting. In the end, it was an error of confusing two patients, sort of. Another woman had called in and left a message that she would like to cancel her cycle, but we must have enough overlapping identifying characteristics (first name? date of birth? I don't know) that I was called instead. That was upsetting, but understandable. I was more upset about it in that they didn't try my work number or my partner's number both also listed on my records. I understand that the confusion could happen, but why not try to resolve it, rather than leaving a sad scary message. I was able to keep my retrieval appointment and everything went okay.
The clinic does not call in your prescriptions. They give you a written prescription or you purchase there. My pharmacy wanted to verify before filling my prescription, which was chaos. I suggest purchasing through the clinic. It's easier and it seemed to be reasonably priced.