How was your experience with Melanie Landay at Valley Center?
Dr. Landay is super relatable. She's gone through procedures herself so she knows exactly how to describe it to a patient. She's funny and witty and helps take some of the stress out of tense situations while always remaining professional. While I didn't get the outcome I hoped for, I know that Dr Landay did everything im her power to make us parents. We're trying donor eggs soon (my egg quality is beyond poor), and I will continue my care under Dr Landay. She's amazing at what she does, and I have zero doubts about my quality of care, even though we weren't successful.
What's one piece of advice would you give a prospective patient of Melanie Landay at Valley Center?
Do it. Go see her. Even if you're just thinking about egg preservation or if you're a same sex couple wanting a baby. She can help. My only regret was I waited a very long time before I sought help. Dr Landay is among the best there is. She can help.
During treatment, were you treated like a number or a human with Melanie Landay at Valley Center?
She took time during our appointments, even if it put her behind in her day. She was available by phone and text, even on weekends. She cried with me when we didn't get the results we had expected. She was available for consult - free of charge - to discuss next steps when things went awry. She answered all my questions, even when I asked them multiple times. She sacrifices part of her personal life to keep appointments for IUI/egg retrievals even if they fall on weekends/holidays.
Describe the protocols Melanie Landay used in your cycles at Valley Center and their degree of success.
When we started, I was a 33yo with a history of two early miscarriages (5-6 weeks), after trying for over 7 years. We did an HSG and hydro to make sure everything was working, no blockages or fibroids, and she checked all my hormone levels, my thyroid, even auto immune markers. She was thorough. When everything looked great, we prepped for IUI using Clomid and progesterone suppositories. I was initially diagnosed with "unexplained fertility", but once she saw I was only getting 2-3 follicles on Clomid, she changed the "diagnosis" to low ovarian reserve, even though my hormone levels were great. We switched protocol to Letrozole and a half cycle of injectable hormones (Gonal F, HCG) which was supposed to help out. I got a few more follicles, so next try we did a full round of injectables. I responded better, but was still only getting 4-5 big follies (over 14mm), but didn't get pregnant. I instead had 2 biochemicals. Since more than 3 IUIs had failed, she was very candid and explained that if we hadn't gotten pregnant yet with IUIs, it most likely wouldn't happen, and there must have been something else going on that she couldn't diagnose without moving forward. She suggested stopping the IUIs and saving up for a different course of action. She recommended acupuncture in conjunction with ubiquinol, DHEA, and a slurry of other vitamins and herbals, to help with my ovarian response and what she was now assuming was an egg quality issue (my husband's sperm analysis came back perfect). She even suggested an in depth genetic study of my husband's sperm as well as a genetic screening for him, and the only hiccup was that he had an inverted Chromosome 9. She met with a genetic counselor to determine it's significance and they declared it medically insignificant. So we moved on. I was responding very well to the injectables and would be a great candidate for IVF, so we tried that after a few months of acupuncture and supplements. I don't remember the exact dosage, but I was injecting Gonal F and Menopur, then Certitide with a 10,000 IU dose of HCG for the trigger. We retrieved 12 eggs, but only 5 were mature. All 5 fertilized with ICSI, but they all arrested by day 4.
After this failure, she discussed with us how to move forward. She was sure now I had a bad egg quality issue, since less than half of my eggs were mature and 4 of the 5 embryos arrested by day 3, before the sperm really had a chance to be a contributing factor in cell division. She explained all of this, in a free consult, at my convenience. There were tears on both sides, and even though I was hurting, seeing her upset right with me made me feel better - she was just as invested in this as my husband and I were.
We discussed trying again with a different protocol. She upped my dosages of both Gonal F and Menopur, and added Omnitrope (human growth hormone), Dex, and pushed my retrieval an extra day to get my levels up. Everything went well - but even though we retrieved 17 eggs this time... only 5 were mature. She was able to get 2 more to mature in the lab with assisted hatching, but only the initial 5 fertilized. All arrested/disintegrated by day 3.
We knew then it wasn't going to happen with my eggs, and we discussed an egg donor...which is where we're at now.
Describe your experience with your nurse at Valley Center. (Assigned nurse: Jessica Pena)
I know I'm sounding like a broken record, but this staff is wonderful. There is one older nurse at the clinic that assists in ultrasounds that I'm not 100% fond of - she couldn't find my ovaries during one ultrasound, and she's a little colder and more formal than the rest of the staff, but that's it. I've been at the clinic now for three years. Her care coordinator who I adored took another job, but their replacement (Jessica) was just as great. You can tell a lot of thought goes into their hiring. My husband faints on blood draws, and they were always supportive and put him in a private room with a bed and made sure to have smelling salts and juice/cookies for him. They made him feel comfortable and it took the embarassment out of it (he's 6'2" and passes clean out). They're good people.
Describe your experience with Valley Center.
There are two doctors in this clinic and they switch off working weekends/holidays. This is a major strength, because patient procedures, where timing is critical, isn't relegated to 9-5 M-F. I had an IUI on July 4th. My friend had one on Christmas day. Both doctors sacrifice a bit of their personal lives for their patients. That's amazing. Their waiting room is also great - they have an elliptical machine for patient use, as well as an area for mindfulness exercises, just in case the doctors are running behind.
I've literally never had time to use them, they've always gotten me in and out, but knowing it's there is incredible. I've referred a friend and she's had the same experience, and I have other friends with other clinics, and in speaking with them, I know I'm recieving the best care. It's a great, patient-focused clinic.
Describe the costs associated with your care under Melanie Landay at Valley Center.
Ultrasounds for IUI monitoring were $300. I think the IUI itself was around $600. I think i was spending about $2500/month, total, during the IUI process, which included 2 IUIs each cycle (day before and day of ovulation). They do take insurance, but my insurance doesn't cover fertility, so everything was out of pocket. She would still try with blood work, etc, to get it covered by insurance, and a lot of my blood tests were covered. For IVF, she has a flat fee of $10,000, which covers everything (lan work, ultrasounds, appointments, and the retrieval itself) except medication and anesthesia. FETs vary depending on the site she uses, but run between $3700-5200.
Describe Melanie Landay's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Valley Center.
She discussed my age (34, then 35) and showed me the AMA recommendations. For a woman under 35 with no history of pregnancy complications, she recommended only transferring 1. Women 35-40, with no history of complications, she recommended 1 or 2. Women over 40, that was pushed to 2 or 3. That's it. No more. No Octomoms :)