How was your experience with Carrie Wambach at Reproductive Partners Medical Group?
Positives: Dr. Wambach was warm, friendly, and empathetic, with a caring bedside manner. She is very emotionally invested in her patients having success, and cried when my egg retrieval failed. I appreciate that she genuinely cares so much about her patients. I also appreciate that she does the ultrasounds herself (instead of having ultrasound techs do the ultrasounds) whenever she is working in the office, and that she has a gentle ultrasound technique and never caused me pain during ultrasounds like some of the other doctors did. And it's nice not having to have ultrasounds with a dozen different people and knowing that as long as your doctor is in the office, they will do the ultrasound themselves.
Cons: Before the cycle started I expressed concern that my stress levels were extremely high, since I was not only dealing with infertility, but also chronic pain and severely limited mobility due to my pain, plus a number of other very stressful life events. I told her I was breaking down crying almost every day, was severely depressed, and concerned that going through an egg retrieval cycle would cause me even more pain which would be very difficult to get through since you can't take pain medication during IVF, plus cause even higher stress levels, which might negatively affect my egg quality. I also expressed concern that I was on high doses of NSAIDs at the time, and asked whether that could negatively affect my egg quality too.
I wanted to wait until I had time to have my back pain treated, and wasn't on the NSAIDs but Dr. Wambach said we really needed to get my eggs out as soon as we can due to my diminished ovarian reserve, and that the NSAIDs don't affect egg quality very much as long as they are stopped by day 7 of ovarian stimulation, and that everyone who goes through IVF has extremely high stress levels. So I went forward with the cycle, which was very painful for me due to having to get to the clinic every other day for 15 days. I had 8 appointments which was much more than I had anticipated, I felt absolutely horrible (physically and emotionally) the entire time, and my stress levels were absolutely through the roof, depsite therapy, meditation, etc.
During the cycle I also expressed concern that my follicles didn't seem to be growing well, but she reassured me that it's ok or even good for them to grow more slowly, so there were only tiny adjustments made to my protocol (raised Gonal by 75 IU 2x only) and she didn't add in Menopur until day 13 of injections. Then my follicles jumped in size from only 2 days of Menopur, I lost the synchronization of my follicles and only ended up with 2 eggs at retrieval, and they were both such terrible quality that they died the first day. I was absolutely devastated, and went into a really serious, deep depression for several months afterwards.
Afterwards I learned from other fertility doctors that NSAIDs can lower egg quality, and so can extremely high stress levels, and so can having such slow growth of follicles, since then the eggs are exposed to the medication for longer which can damage the quality. So now looking back, as much as I liked Dr. Wambach's personality, bedside manner and ultrasound technique, I feel really upset that I wasn't warned that my high stress levels from my pain and the NSAIDs I was on could damage my eggs, and that more adjustments weren't made to my protocol so that I'd only need to stim for 8-10 days, which studies show is the ideal time period for the best egg quality. I was so upset with how the cycle went (as well as many frustrations we had with the clinic and other doctors in the practice) that we switched clinics and doctors.
What's one piece of advice would you give a prospective patient of Carrie Wambach at Reproductive Partners Medical Group?
Firstly, I do not recommend being a passive participant in your fertility care, no matter which clinic you go to or doctor you see. Fertility treatments are extremely physically and emotionally difficult to go through, as well as extremely expensive, and when a cycle fails, it is absolutely devastating. So you really want to maximize your chances of success and minimize how many cycles you have to go through, and that requires being an informed patient. You wouldn't go buy a $25,000 car without thouroughly researching it first, so (even if you have fertility insurance coverage) don't blindly follow whatever protocol your doctor suggests without researching it yourself first. You won't get an in depth, lengthy explanation from any doctor or clinic you see - that's just not how it works.
So I strongly recommend getting multiple opinions from different doctors whenever possible, following other doctors on Instagram to see their tips and joining support groups so you can ask patients with your same age and diagnosis, who have been through many cycles what worked for them and what didn't. And look up studies yourself if you have the time and you're able to understand them - you can use pubmed to do this, that's how I found out that NSAIDs and long exposure to IVF meds can lower egg quality, and a lot of other information. The more you educate yourself the more you will be prepared for your appointments with Dr. Wambach, or ANY other fertility doctor. I also recommend scheduling several 15-30 min telehealth appointments per week for while you're in a treatment cycle.
If you schedule these appointment in advance, as soon as you decide that you're going to do a treatment cycle, it will give you the opportunity to ask Dr. Wambach (or any other fertility dr you decide to go with) questions as the cycle progresses. Dr. Wambach and pretty much every other fertility dr are extremely busy, so if you wait until something happens or goes wrong during your cycle, and then try to schedule an appointment with your dr to talk about it or to ask questions, you probably won't get an appointment for weeks, and by then the entire cycle will be over.
The ultrasounds & bloodwork appointments can't be scheduled until 1-3 days beforehand, but you can set up the telehealth appointments to ask questions weeks in advance, so take advantage of that and have at least 2 appointments per week set up during your treatment cycles, in order to have access to your Dr to express concerns and ask questions. Also, if you aren't happy with how the cycle is going (follicle growth seems too fast, or too slow, not staying synchronized, bad feeling about the outcome, whatever else) express it to Dr. Wambach, and be firm about wanting to adjust your protocol. Don't be afraid to take charge (I would have done so, if I had known that my follicles should really be growing faster - so that circles back to educating yourself before starting).
During treatment, were you treated like a number or a human with Carrie Wambach at Reproductive Partners Medical Group?
Dr. Wambach is very empathetic. She shared that she went through IVF in order to have her child, so she understands how hard it is. She always asked how I was doing, and she called me several times when I was upset, worried or had doubts. I never felt that she was just in it for the money, I feel that she she cares about her patients.
Describe the protocols Carrie Wambach used in your cycles at Reproductive Partners Medical Group and their degree of success.
For my egg retrieval Dr. Wambach had me do estrogen priming for about 12 days before my period started, which was to sychronize my follicles, since I normally have a big lead follicle very early in my cycle. The estrogen prevents the lead follicle from getting too big compared to the other follicles, so they can hopefully all make it to the retrieval in synch. That part of the protocol worked fine, I had 8 follicles and 6 of them were synchronized by the time I got my period.
Then for the actual stimulation protocol Dr. Wambach had me try what many clinics call "Mini IVF". This is a very low dose of fertility medication which some clinics believe is better for people with diminished ovarian reserve, like myself. It does work better for some patients, but unfortunately it didn't seem to work well for me.
My mini IVF protocol was Letrozole 2x daily for about 1 week, plus 150 IU Gonal F. But after a whole week my follicles had barely grown at all, so we stopped the Letrozole and increased Gonal to 225 IU on day 5 of stimulation. But they were still barely growing after a week of stims (and I should have been basically almost done at this point) so then Dr. Wambach increased the Gonal to 300 IU, but still very slow growth.
Finally, on day 13 she finally added in Menopur, which it seemed I really needed to have since then my follicles finally grew, but I feel it was added in at too high of a dose (150 IU) since then my follicles shot up in size from 14 mm to 22mm in only two days.
After the cycle failed, I found out that the Gonal F only protocol I was on is not consistent with protocols based on the POSEIDON group classification system for patients with diminished ovarian reserve. There are specific recommended protocols for different subgroups of DOR, which Dr. Wambach didn't mention and I unfortunately only found out about after my cycle failed. If I had been on the protocol recommended for my POSEIDON group, then I would have been on Menopur from the start, and probably would have responded much better. Also, my LH levels really should have been checked every few days, since I wasn't on Menopur (Gonal F is FSH only, Menopur is FSH + LH). Even if Dr. Wambach doesn't believe in doing a POSEIDON specific protocols, my LH levels definitely should have been monitored, and if they had been, then Menopur probably would have been added in much sooner, which could have prevented stims from dragging on for 15 days and possibly resulted in better egg quality.
Dr. Wambach also had me take 1/2 vial (8.7 IU) of Omnitrope (human growth hormone) during the cycle, mainly because I wanted to try human growth hormone to see if it would improve my egg quality. But after my cycle failed, I found multiple studies on human growth hormone for diminished ovarian reserve, and all of the protocols with succesful outcomes had patients take it for 4-6 weeks before egg retrieval. None of them showed a benefit of taking it only during stimulation. So that was upsetting and I feel the timing was not consistent with what studies show for my diagnosis.
Describe your experience with the nursing staff at Reproductive Partners Medical Group.
The nurses and clinic as a whole were extremely disorganized. They all share a workload, so messages through the portal and voicemail are responded to by whoever gets to it first, and you're communicating with what seems like a dozen different people. And since you don't have an assigned nurse, and your doctor doesn't have a specific clinical group or group of nurses, the result is that no one is ultimately responsible for getting things done and no one is held accountable when mistakes are made.
And there were constant mistakes made, throughout the 4 months we went to this clinic. First, the nurses didn't run blood tests that were ordered, lost my partner's blood samples and shipped an empty bloodwork kit to the lab. The lab apparently called them and spoke to multiple different people, plus left voicemails several times, over a two week period, informing them that the bloodwork order and kit had been sent without a blood sample and that they needed to redo it.
So they were fully aware that they had made a mistake and that the test needed to be redone, and yet the nurses never called or messaged us. We even messaged them several times asking if it was done and yet they never told us of the issue. We didn't find out that the blood hadn't been shipped to the lab until a month afterwards, so then the results took an entire month longer than they should have which was extremely aggravating.
Dr. Wambach reassured us that the mistake happened because this particular blood test was one they don't normally do and that the egg retrieval/ICSI cycle would go much more smoothly, but that was definitely not the case. The nurses continued to make mistakes left and right, were extremly difficult to reach (no one answers the phone when you call, they work off of their voicemail system and most times your call isn't returned until the next day, but oftentimes it's a crucial question or issue that needs to be addressed right away).
They also gave me incorrect information about my insurance coverage and ordering medications. They said that my insurance wouldn't cover ordering a larger quantity of meds, so I had to refill my injectable meds every 2 days which turned out to be a giant, extremely time consuming, stressful process, especially since the only pharmacy my insurance covers is closed on weekends, and doesn't do same day delivery.
So then I had to get Menopur on short notice during a weekend from a local pharmacy which my insurance doesn't cover, which turned into a 4 month long battle with my insurance company that took an appeal and multiple hour long phone calls to resolve. Then come to find out from my insurance that they actually don't have any limits on the quantity of meds that can be ordered and that the nurses could have ordered ALL of the meds that I would need for an entire cycle (or even multiple cycles) upfront, before I even started, so then I wouldn't have had to deal with ordering medications during my IVF cycle, on top of all the other stress and hormone side effects that I was dealing with.
My stress levels during that cycle were through the roof, and at least 50% of that was because of having to hassle with my dang pharmacy and insurance company every 2 days, plus dealing with medication being delivered to the wrong place, etc. and turns out it was all totally unecessary.
I complained about the difficulties I was having with the nurses and was given an apology for what the clinical director called "a series of unfortunate events" and was told that the clinic director would reach out to me within one day to address my concerns, but no one ever reached out. And we are STILL dealing with errors made by reproductive partners 4 months after switching clinics, because they apparently also didn't refrigerate one of my partners STD panel blood tests, so the test was invalid. That means that reproductive partners actually went forward with handling his sperm, without a valid STD panel test at the time of our cycle. And now my partner has to redo the test in order to do another cycle with our new clinic. Unbelievable.
Describe your experience with Reproductive Partners Medical Group.
Although my experience with my primary doctor was mixed, my experience with the two male doctors was terrible. I saw each of them once, during a week when Dr. Wambach was working from home. The first time, a female tech did my ultrasound but had trouble getting a good visual of my ovary. She was digging around in there for 20 min which was already uncomfortable enough, but then just when I finally thought I was done, and had gotten dressed, Dr. Hyuang came over and abruptly told me he was going to do an ultrasound on me himself because he wasn't happy with the images that the tech had gotten.
This caused me a lot of anxiety, and I had asked for a note to be put in my file that I'm an abuse survivor and have extreme anxiety during ultrasounds with male doctors, and that I only wanted to have ultrasounds with females. Either the note was never put in, or Dr. Hyuang completely ignored it, either way he insisted on doing the ultrasound on me himself, and I felt like I had no other choice, since if the images were really bad, then they wouldn't get the info they needed and I was in the middle of an IVF cycle.
So I went through with it but told him I have anxiety and pelvic pain from endometriosis, he absentmindedly said he understood, but then he still pressed the ultrasound wand into my cervix really hard, which hurt me and was extremely upsetting, considering my history of abuse. I was SO upset and angry,
Then, two days later I needed another ultrasound, and again my Dr was gone so I saw Dr. Rosen, and this time I insisted on only having a tech do the ultrasound, but then he told me that I only had 3 follicles left (2 days beforehand I had 5) and that by the time we did the retrieval I would probably only have 1-2. That was a shock and caused me to break down crying on the ultrasound table, and it was terrible having to give my partner such awful news, we were both extremely upset afterwards and he had to call out of work, but then after I messaged Dr. Wambach about how upset I was, she called and said that she saw 5 follicles on my ultrasound, and asked why Dr. Rosen said I only had 3 follicles! Ummm I'd like to know the answer to that question myself!
Dr. Rosen literally gave me terrible news, that turned out to be incorrect. Both of the male doctors put me through unnecessary emotional distress and I would never recommend anyone to them. And as mentioned in other sections of my review, RPMG made many mistakes, it was consistently difficult to reach them since they never answer the phone, the clinical director never followed through with my complaint, as far as I'm aware no one ever addressed the issues we brought up with the nurses... it was just a terrible experience all around.
The clinic is also extremely busy almost all of the time and wait is usually very long. We waited for 45 min to an hour each time, our appointments were almost never on time, and now after switching clinics, we realize that not all clinics have such long wait times. Or disorganized staff. Or difficulty reaching someone and getting responses on time... or tons of mistakes made.
I really advise anyone who is choosing a clinic (or anyone who is having a hard time with their current clinic) to get feedback in multiple IVF support groups and recommendations on where to go, and seriously consider switching if too many mistakes are made. It isn't worth the added stress to stay with clinics that make mistakes or are difficult to deal with, you have to do what is best for you and the success of your treatment.
Describe the costs associated with your care under Carrie Wambach at Reproductive Partners Medical Group.
We have Progyny coverage, so we didn't find out what the cost of our cycle was.
Describe Carrie Wambach's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Reproductive Partners Medical Group.
Dr. Wambach prefers single embryo transfers due to the risks during pregnancy associated with twins.
What specific things went wrong at Reproductive Partners Medical Group?
- Failed to call in prescriptions to pharmacy
- Failed to call with results
- Failed to order appropriate test
- Lost results
- Provided conflicting information
- Failed to convey critical information
- Lost or damaged samples
Describe the specific things that went wrong at Reproductive Partners Medical Group.
As mentioned in the rest of the review, RPMG:
1. Lost one of our blood samples
2. Shipped a lab order to the lab without the blood sample
3. Didn't refrigerate another blood sample
4. Didn't respond to multiple phone calls from the lab informing them of their mistakes
5. Didn't inform us that there was a mistake, which delayed our test result by over a month
6. Didn't order a test that our genetic counselor requested, and didn't respond to our genetic counselors multiple phone calls and voicemails and my multiple messages explaining the test
7. Gave me incorrect info related to my insurance and pharmacy practices and made me reorder medications much more often than was necessary
8. Didn't respect my wish to only have vaginal ultrasounds with females due to my history of abuse and anxiety, and I had a male doctor redo an ultrasound and cause me pain during it
9. A doctor gave me incorrect info about my follicle count which was extremely distressing
10. The clinical director said they would contact me to discuss the mistakes, but then they never contacted me
11. My protocol wasn't adjusted soon enough, dragged on for a long time, and then failed
0
Clinic
Reproductive Partners Medical Group
Los Angeles