How was your experience with Adrienne Neithardt at Reproductive Associates of Delaware?
Dr. Neithardt was the best thing about working with this clinic. It's rare that I've found a doctor so respectful and happy to work with her patient (participatory medicine) as her, even when I consider non-fertility related areas of medicine. It is very important to me to fully understand my treatment plans and how each piece works. I also want my own ideas to be fully considered and either incorporated into the plan, or to have someone explain why that idea does not apply. Furthermore, I have run into some complications which cannot be fully explained by any of the testing performed, and Dr. Neithardt had the experience as well as the common-sense approach to work with me on how to approach these things - most doctors, in my experience, will not do this if they cannot see conclusive objective proof (such as a lab test result).
What's one piece of advice would you give a prospective patient of Adrienne Neithardt at Reproductive Associates of Delaware?
Ask every question you can think of and keep asking until you get an answer that makes sense to you. Take advantage of working with a doctor who will make sure you understand and are on the same page.
During treatment, were you treated like a number or a human with Adrienne Neithardt at Reproductive Associates of Delaware?
Dr. Neithardt always clearly remembered all relevant details of my history and treatment plan whenever we met. Additionally, she took every concern or question I had seriously and treated me as a partner in my care, not a subject under her rule.
Describe the protocols Adrienne Neithardt used in your cycles at Reproductive Associates of Delaware and their degree of success.
I have done one retrieval cycle with Dr. Neithardt. This was a light stim, because I had some indicators that I would be a good responder (age and ovarian reserve were in my favor). On this protocol I only did about half the dosages, injections once a day instead of twice, etc. We wanted to avoid having a large number of "extra" embryos so this approach worked for us. In the end we still had a high number - 21 mature eggs, 19 fertilized, 15 made it to day 5/6 blastocyst.
Having had a trisomy miscarriage in the past, we chose to freeze all embryos and do PGS testing. Due to cost, we could only afford to test 8 embryos at the time but had the remaining 7 biopsied for later testing if needed. Of the 8, 2 came back non-viable which is typical.
I needed a hysteroscopy before transferring, so about 2 months after retrieval I was able to do my first FET. We used a Lupron protocol. I did have to push back the transfer by one week because my lining was not thick enough at the first check, but we added a half pill of estrogen vaginally (in addition to the oral doses) and it was ok a week later. That transfer resulted in my daughter. I went for weekly ultrasounds through week 10 or 11 at the clinic then fully transitioned to my OB.
About a year and half after having my daughter we were ready to try again. We worked with Dr. Neithardt, repeating a saline sonogram and mock transfer. We agreed to follow the same protocol that worked the first time, the only change was adding the vaginal estrogen earlier since we knew I needed it before. I became pregnant but the numbers / trends were all over the place and I ultimately miscarried. We had a D&E done to test the fetal remains and unfortunately could not find a clear cause. The fetus was genetically normal and no physical causes could be found.
This is where I really appreciated Dr. Neithardt - I have a complicated medical history including several autoimmune diseases. We retested for additional diseases that would be known to cause this type of problem, and the results were negative. However, Dr. Neithardt and I trusted our gut instincts that this is somehow related and discussed how we might change the protocol. We theorize that my body is rejecting the pregnancy and cutting off bloodflow, causing it to terminate. It took a few months for my body to be ready for another try but we eventually began another cycle. This time we added prednisone to further suppress my immune system. I again became pregnant and the numbers all appeared robust. Unfortunately, at my 6 week ultrasound we discovered the gestational sac had continued growing but the fetus had not. I had another D&E but this time I could not emotionally handle doing more testing on the fetal remains.
Dr. Neithardt agreed with my husband and I that there wasn't likely any information to gain from testing any remains, if any could even be identified, which gave us a modicum of peace on the issue. She still feels that this may be an autoimmune response (as do I) and suggests another cycle include both the prednisone as well as Lovenox, a blood thinner to try to prevent clotting to the fetus. However, at that point I was relocated for work to another state and we have not yet decided if we or when we will pursue more transfers.
Describe your experience with the nursing staff.
Most of the nursing staff at this practice is very nice to work with. There are always the exceptions - a new nurse who told me to go to the bathroom before my appointment then found out I needed to provide a urine sample before we could perform my test that day which caused a delay, for example. My most frequent frustration was when a nurse would answer a question based on the typical protocol even when I knew there was an unusual factor in my case and I wanted to escalate the question to my doctor. I eventually was given instructions for how to handle those questions to my satisfaction.
The staff was interested in my comfort, tried to answer my questions fully to the best of their knowledge, and tried to be as comforting as they could when we discovered my losses. That experience in particular stuck with me because my first loss had been when I was seeing a different provider and they had been very distant and clinical when I was completely disoriented and heartbroken.
Describe your experience with Reproductive Associates of Delaware.
I had only positive things to say about this clinic after my first experience with them (IVF stimulation & retrieval and one FET). They worked well as a team, tried to accommodate my needs as much as possible, were always friendly, etc.
By the time I was working with them again 1.5 - 2 years later, there had been some changes in their internal structure and processes which unfortunately caused a few problems for me as a patient. They were still friendly and usually accommodating, but their internal communications had broken down at times. This caused me some frustrations trying to reconcile the plan my doctor and I had laid out with the actual steps being performed as well as some issues after my losses regarding medication decisions (due to other medical issues, I wasn't doing well with the "normal" protocol and needed my doctor to give personalized instructions). It was not a terrible experience, but when it happened twice in the span of a few months even after I discussed my concerns with everyone involved, I began to question how well I could work with them if we decide to try again in the future.
Describe the costs associated with your care under Adrienne Neithardt at Reproductive Associates of Delaware.
I was lucky to have excellent insurance so my only costs were for genetic screening, medications, freezing and thawing costs, and $10 visit copays. I paid about $450 plus copays for a frozen transfer cycle. I no longer have this insurance, and when I inquired about the out of pocket costs I was told that their fee is $4,500 for one FET cycle (not including retrieval which I had done previously).
Describe Adrienne Neithardt's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Reproductive Associates of Delaware.
I was only willing to transfer one embryo at a time anyway, as were my other care providers, so this was not an issue for me.
What specific things went wrong at Reproductive Associates of Delaware?
- Provided conflicting information