Dr Devore was extremely personable. She knew my history and wants/needs as a patient very well, and always communicated with me in a way that was precisely tuned to the kind of communication style I prefer - which I feel is a huge talent, to intuit what communication style a patient likes and be able to give that to them. I felt as if she grieved alongside us with every failed cycle and miscarriage, and like she was just as elated as we were when we finally had success...
It [NYU Langone Fertility Center] can feel a bit like cattle call at morning monitoring. Sometimes the wait can be very, very long during busy "seasons" (one time I was there for over two hours). Other times you are in and out and the only patient in the waiting room. It really depends. That said, by the end I definitely felt like all the nurses knew my name. I also felt that the billing office was easy to work with...
How was your experience with Shannon DeVore at NYU Langone Fertility Center?
Dr Devore and I had a relatively long journey before achieving success. After a monitored cycle, a canceled Clomid IUI (too many follicles), four failed IUIs, two miscarriages of euploid IVF embryo transfers, and a referral to reproductive immunology, we got pregnant on our third IVF transfer. I felt that Dr Devore was very much on our team throughout the entire process. It was always clear that she had a deep understanding of the science and was making evidence-based decisions in our care. After our second euploid loss, she referred us to a reproductive immunologist given my history of lupus and other autoimmune conditions. Whereas another RE might have kept transferring embryos in hopes one "stuck," Dr Devore was willing to explore a relatively-unknown field because she believed it might be uniquely helpful in my situation, with my medical history.
Throughout, I felt Dr Devore showed great compassion both for my anxiety throughout treatment, as well as for our grief at losing our embryos. I have a PhD in a science field and my husband is a medical doctor, so we were relatively well-informed and research-minded patients. I'm sure that can be annoying for some doctors to deal with, but Dr Devore didn't miss a beat. She was always prepared to answer our questions, did not hesitate to say "I don't know, but I'll look into it" when that was the case, and was extremely well-versed in all the statistics and risks vs benefits for various treatments.
Importantly, I also never felt like I was being taken advantage of financially. I am a member of an online support group for people dealing with infertility and have watched several of my friends undergo numerous expensive, invasive tests and treatments that did not have solid scientific backing. If I asked Dr Devore about pursuing a test or treatment that she did not feel was evidence-based or appropriate for my personal situation, she never hesitated to say so. I never felt pressured into doing something just for the sake of it - every step of my treatment felt personalized and well-considered.
What's one piece of advice would you give a prospective patient of Shannon DeVore at NYU Langone Fertility Center?
Trust is so important in a doctor-patient relationship. I felt I could trust Dr Devore implicitly because of her candor and honesty. I also felt like she had a really solid grasp on the science behind everything she recommended. I know trust can take time to build, but for what it's worth, my advice is to trust her. Ask questions as much as you need to, and trust she will be honest and has your best interest at heart (and not money or pride).
During treatment, were you treated like a number or a human with Shannon DeVore at NYU Langone Fertility Center?
Dr Devore was extremely personable. She knew my history and wants/needs as a patient very well, and always communicated with me in a way that was precisely tuned to the kind of communication style I prefer - which I feel is a huge talent, to intuit what communication style a patient likes and be able to give that to them. I felt as if she grieved alongside us with every failed cycle and miscarriage, and like she was just as elated as we were when we finally had success.
Describe the protocols Shannon DeVore used in your cycles at NYU Langone Fertility Center and their degree of success.
Our first cycle was monitored and unmedicated to confirm ovulation and a short (7-day) luteal phase. Next step was going to be a Clomid cycle, but I developed five follicles so the cycle was canceled. (I remember being very torn about this and wanting to try anyway, but Dr Devore did a great job explaining why the risks truly did outweigh the benefits here.) After that, we did four IUIs with Clomid, all of which resulted in negative pregnancy tests.
After the fourth IUI, Dr Devore felt it was in our best interest to move on to IVF. We did an egg retrieval and retrieved 26 eggs, 20 of which were mature, 16 fertilized, resulting in 10 embryos, 4 of which were euploid. Dr Devore advised PGS testing, which we ended up being glad that we did; even though I was just 32 at the time of egg retrieval, over half of our embryos were aneuploid or mosaic.
Our first transfer we did the basic protocol with four days of medrol (a steroid), estrogen to build uterine lining, and progesterone injections combined with progesterone suppositories. We ended up having a positive pregnancy test and a relatively high beta. Dr Devore was optimistic that this would be a successful pregnancy. Unfortunately I noticed my home pregnancy tests were lightening so I requested an early second beta, which confirmed a chemical pregnancy.
We proceeded with another transfer the very next month, hoping that this was just a fluke. This time we did add 10 mg of daily prednisone (because of my history with lupus), baby aspirin, claritin, and pepcid. Again we had a positive beta. This time Dr Devore scheduled an earlier second beta (because of the previous chemical), and unfortunately once again we learned I was having a chemical at the same gestational age as my last.
Rather than go into a third transfer, Dr Devore advised pursuing testing with a trusted local reproductive immunologist. Reproductive immunology is a relatively new field of fertility treatment and has been controversial as there is not much evidence around it. Dr Devore communicated to us that she would not make this recommendation to most patients, and that it was just because of my history of several autoimmune diseases and the fact that both my euploid losses were at the same gestational age that she suspected an immune issue might be the cause. I remember asking if we could look into endometriosis or do an ERA first, but she was very firm in her belief that immune issues were likely at the root of my miscarriages.
With that in mind, we did do the reproductive immunology testing, which ended up revealing several potential culprits for our losses. As part of that treatment I did an intralipids infusion four weeks before transfer, an IVIG infusion four days before transfer (and every 3 weeks thereafter until 16 weeks of pregnancy), 20 mg of prednisone daily (until 16 weeks), baby aspirin, 60 mg lovenox daily throughout entire pregnancy, metformin 1500 mg daily, magnesium citrate, calcium, vitamin D, probiotics, and prescription folate.
We transferred our third embryo, which was a 3CB. Again we got a positive beta, much higher even than the (high) beta from our first transfer. We did another beta two days later, and every two days thereafter until 21 days past transfer, and confirmed that hcg continued to double. We saw a strong heartbeat on ultrasound at 6w3d, and I am now 24 weeks pregnant on this protocol.
Describe your experience with your nurse at NYU Langone Fertility Center. (Assigned nurse: Omayra)
My primary coordinator, Omayra, was amazing.
I did have some issues with one of the nurses, who asked me about domestic violence when she saw my Lovenox bruises. Although asking was appropriate, the way she asked wasn't--she asked loudly, in front of several other people. Had I actually been in a dangerous situation, I would not have felt comfortable admitting it given the way I was asked.
I also had one time overhearing a nurse, when I was in for my third transfer baseline, murmuring "oh no, she's back?" Although the sympathy is nice, I just wish I hadn't overheard that, as I was already struggling emotionally a lot and didn't want to be reminded how bad my situation was.
Otherwise my experience was good. You see lots of different nurses when you go in for monitoring.
Describe your experience with NYU Langone Fertility Center.
It can feel a bit like cattle call at morning monitoring. Sometimes the wait can be very, very long during busy "seasons" (one time I was there for over two hours). Other times you are in and out and the only patient in the waiting room. It really depends. That said, by the end I definitely felt like all the nurses knew my name. I also felt that the billing office was easy to work with. The new west side location is gorgeous (although I mostly went to the east side).
Describe your experience with your monitoring appointments at NYU Langone Fertility Center.
There was a window for monitoring appointments. Although you scheduled for a specific time, I was told that as long as you showed up generally around that time, precise punctuality wasn't that important.
Describe the costs associated with your care under Shannon DeVore at NYU Langone Fertility Center.
It was around $4500 for PGS testing of embryos and around $5000 per transfer, if I recall correctly. We did have partial insurance coverage.
Describe Shannon DeVore's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at NYU Langone Fertility Center.
Dr Devore strongly recommended eSET for all my transfers.
What specific things went wrong at NYU Langone Fertility Center?
- Provided conflicting information