Describe your experience with Yale University.
Strengths: morning monitoring visits are fast and efficient. Do not expect this to be a time when you'll ask a lot of questions or consult with anybody - they are trying to get everyone in and out in time for work! Show up by 6:30-6:45 am if you want to be toward the front of the line if you need to get out quickly.
Weaknesses: NOT holistic - overly medicalized and seem to scoff at supportive measures like fertility, emotional support like groups or psychotherapy, nutritional support, yoga, etc. You will likely see a different doctor/fellow at every visit, except for your scheduled cycle planning visits with your main doctor. Not all the fellows are as skilled with that vaginal wand...
During treatment, were you treated like a number or a human with Emre Seli at Yale University?
I felt Dr. Seli works hard to be personable, caring and to answer all questions thoroughly. My husband very much liked him and felt comfortable with his care and he tends to hate all doctors! However there have been times he has forgotten important details during my treatment - like medications I was taking/not taking, which I believe adversely affected one of my IVF cycles. I also found him to be focused on the treatment part of things to the point of being dismissive of the human repercussions of undergoing years of fertility treatment, both physical and emotional. For example, when I asked if they had recommendations for local support groups, he seemed taken aback and made me feel very uncomfortable, stating, "well if YOU'RE having a really hard time with this..." as if I was particularly weak or overemotional in some way. Every time I have mentioned struggling with some painful or invasive aspect of the protocol (such as doing multiple SHGs which have been painful for me) he has brushed it off - literally just chuckling when I mentioned how much I was struggling with the daily progesterone injections for weeks on end. So I have had multiple negative experiences over the years, but thank god for the nurses who take the time to explain everything in depth, provide a listening ear, acknowledge the emotional strain of the process, and have given me practical and helpful ways to manage the physical symptoms and side effects (e.g. prescribing smaller gauge needles which have helped with the bruising, etc).
Describe your experience with the nursing staff.
The nurses have kept me going during my years of treatment here! They are so compassionate, kind, knowledgeable and if there is something they don't know, they get answers for you right away. They are very response to the online portal for messaging (MOST of the time...) My only complaint would be that none of the morning nurses that do bloodwork seem to be very skilled - anytime I go to an actual lab, the phlebotomists have NO trouble finding a vein, and it is usually quick and painless. I have NEVER been told I have "bad" veins before coming to this clinic, where I am regularly stuck several times, left badly bruised, and the nurses often move the needle around or go in at a weird angle that makes it very painful. This wouldn't be so bad if I wasn't sometimes going every 1-2 days during a cycle! Once I learned that I can ask to have my blood draw done at the actual lab downstairs outside the clinic, it dramatically improved my experience as they do it in seconds, though I always fee bad/uncomfortable asking!
What specific things went wrong at Yale University?
- Failed to call in prescriptions to pharmacy
- Failed to call with results
- Failed to inform you of changes in protocol
- Provided conflicting information
- Failed to convey critical information
How was your experience with Emre Seli at Yale University?
I covered most of this in the "number vs human" questions. Dr. Seli is extremely knowledgeable, but he does not always explain things in a way I understand clearly so I rely on the nurses to take the time to clarify. He is also dismissive of the emotional/physical costs of fertility treatment - I do not expect him to hold my hand, or even to listen to emotional concerns, but any concern I have brought up about struggles with the process has usually felt like he just brushes it off. He is also dismissive of any supportive or holistic modalities to improve fertility - he told me acupuncture would have no benefit unless "I was just feeling really stressed out" maybe it would help me relax - again always this response that made me feel an implication I was weaker than other women or struggling more than I should! I finally consulted a nutritionist and acupuncturist on my own, without telling my doctor, and that was the cycle when I finally conceived!
Describe the protocols Emre Seli used in your cycles at Yale University and their degree of success.
I did 4 cycles of IUI - the first was canceled due to hyperstimulation with Clomid. I used Letrozole all of the other cycles, and used Ovidrel for the trigger shot. All were negative.
I did one IVF cycle during which, due to elevated progesterone levels, we could not do a fresh transfer after so froze all embryos. I used Follistim, Menopur, Cetrotide, Crinone, and hcg for the trigger shot. I used birth control to time my cycle. During my frozen cycles, I have used progesterone in oil injections, Crinone vaginal progesterone inserts, and Estrace pills. Typically a few weeks of estrogen supplementation prior to starting injections and vaginal progesterone supplementation for 6 nights prior to the transfer, then continuing all meds until the pregnancy test. My first FET was negative, the second was chemical pregnancy, and I am now 6 weeks pregnant after completing my third transfer. All were single embryo transfers.
Describe your experience with your monitoring appointments at Yale University.
Morning monitoring is done between 7 am and 8 am on weekdays, and 7:15 to 8:15 on weekends. Some days there are only a few of us, on others there are over 20. It's on a first come, first served basis, so many are waiting by 6:30 am so they can get in and out and to work on time. I always found the actual process quick and efficient once they started and I was typically out within 10-15 min of signing in. I have heard others in line complain about delays but after 7 different cycles here, I always found it incredibly efficient!
Describe the costs associated with your care under Emre Seli at Yale University.
Not sure, as I was lucky to have insurance cover most of my costs. I had a high deductible plan when I started and I hit our $6000 deductible just from the testing procedures they required! I changed jobs/insurance and since then have paid nothing out of pocket but I have used up all my benefits now so if we have to continue, we'll find out how much everything will really cost....
Describe Emre Seli's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Yale University.
Dr. Seli supported my decision to transfer single embryos each time. I was on the fence after two failed cycles, but he told me the chances of conceiving with multiple embryos is only marginally higher, but for those who do conceive, the chance of have multiples (which I REALLY do not want) was at least 30%. I initially opted to transfer two embryos for my final cycle, but after considering the risks of a multiple pregnancy, I changed my mind and went back to SET. Dr. Seli allowed me to make the choice of what I felt most comfortable doing.