How was your experience with Dana Ambler at Denver Fertility Albrecht Women's Care?
Dr. Ambler is the exact person who I would want with me along in this journey. First point being that my husband walked out of our first meeting with her and said, "She's got this, I can feel it. She cited papers!" My husband is not particularly trusting of doctors, and his immediate comfort with her and her abilities made me feel more at ease. She is a no bs kind of woman, but somehow is still incredible compassionate. At one point I ran into her in the hall after talking with the nurse about my lining finally being up to where we wanted it, and she gave me a huge smile and told me (something along the lines of), "I'm loving that lining, girl! Let's do this!" We're finishing our last IUI cycle now, and if it's a negative, I have no doubt in my mind that Dr. Ambler is who I want doing my IVF. Something about her just releases all my tension about it. I walk out of her office truly feeling a "We got this." sentiment.
What's one piece of advice would you give a prospective patient of Dana Ambler at Denver Fertility Albrecht Women's Care?
Be completely honest about your concerns. I felt a bit intimidated by her presence at first, but after a few interactions, I was more comfortable in asking my "dumb questions", which of course were never actually dumb, and she never once made me feel like they were either. Whenever I was actually honest with how I was feeling and what my concerns were, she always alleviated them with her thorough answers and cautious and practical optimism.
During treatment, were you treated like a number or a human with Dana Ambler at Denver Fertility Albrecht Women's Care?
I truly felt like Dr. Ambler and the entire clinic, were rooting for me. Every time I walked in, they greeted me with a smile, and if I was out in the waiting room, nurses who had an extra minute would come out and ask how I was doing, personally. They asked about my weekends (and remembered what I told them!). They gave me hugs when things didn't go well, they held my hand when I had to go through painful procedures, and I always felt like they were on my side. The only reason I didn't give 100% is because there is always a little bit of disconnect within the office, and often times I have to correct a few things with the nurses or the back of house staff, like I would call in on CD 1-3 for a baseline and I always need to have a dilation and an ultrasound, but when I called in once for my dilation, they forgot to also schedule me for a baseline ultrasound. Or a nurse might forget what dose of medications I am on and I need to correct them (it's always on my charts, but they don't always read through before every appointment). From my understanding of other clinics though, no clinic has perfect communication, and I personally would honestly rather be slightly more vigilant with my numbers/dosages/etc and have a friendly face to chat with about this difficult time than the opposite.
Describe the protocols Dana Ambler used in your cycles at Denver Fertility Albrecht Women's Care and their degree of success.
So, I have diminished ovarian reserve, and when we started going to Dr. Ambler, I had an AFC of ~3-6, AMH level 0.6, FSH 19, super low testosterone, low TSH, cervical stenosis, and suspected endometriosis (never been confirmed, but now seems less likely). She had me immediately get on a DOR supplementation schedule - Vitamin D, Fish Oil, CoQ10, Prenatal, DHEA, Ovasitol, and PQQ. Since the studies have shown that egg development begins 3 months before ovulation, she had me stay on these for the 3 months before beginning my first IUI. That one was purely Clomid 100mg Day 3-7, and progesterone suppositories (I have low luteal phase progesterone) in the luteal phase. I had a ~7mm lining and an 18 mm follicle. That resulted in a negative test. My second IUI was Letrozole (with the hopes of improved lining, as Clomid is known to decrease lining), 10 mg CD 3-7, with luteal phase HCG (I had bad side effects from the progesterone, so we switched to the HCG to increase my luteal phase progesterone). Side note, in both of these, I ovulated on my own ~CD 16. I had 6-7mm lining with a 21mm follicle. Also resulted in a negative. My third IUI was same protocol, but added Estrace, 1 mg vaginally CD 5-surge (hoping to increase my estrogen, and therefore, lining). My follicles went weird, and turns out I had an anovulatory cycle, so that IUI was cancelled. We did a reset cycle - estrogen for 21 days, then progesterone to start up my period again. IUI #4 I did the Letrozole, and then added micro HCG (for lining), instead of Estrace (thinking maybe it did something weird - turns out it didn't), CD 6-surge. I had a positive OPK way too early, so the cycle was cancelled (we now know that I apparently sometime have false positives, as my LH was still low). I am currently on IUI #5 (and last). We did Letrozole, micro HCG, and Estrace. My lining has been dragging along, so we went ahead and added Ganirelix to delay my ovulation until we could build that up. Since it's my last IUI, we're putting everything into it. I do have a couple of follicles in the mature range, so we're hoping that everything lines up this time. I'll go back in for an ultrasound to check my lining and trigger tomorrow if it looks better, with hopefully an IUI the following day. (By the way - there is no male infertility to speak of in our case). Then I'll be on the luteal phase HCG 2.5 ml 3, 6, and 9 days after IUI. It has been really helpful that they have monitored me really well throughout all of the cycles - with ultrasounds 2-3x/week during stims.
Describe your experience with the nursing staff.
There are three nurses and one NP that I would interact with on a regular basis. Stacie was always nice and compassionate, though sometimes it seemed like she hadn't read through my current cycle before calling me back, sometimes referencing prior cycles, or sometimes getting me confused as a Dr. Albrecht patient instead of Dr. Ambler. Kathy (nurse) was always very nice, always double checked with Dr. Ambler before telling me anything, and always seemed on top of my chart. My only complaint about her is that she sometimes said fairly insensitive things, like, "What did you do?!" during my anovulatory cycle, further enhancing my fears that infertility is "my fault". Otherwise though, she would always come out and greet me, or give me a smile, even when she wasn't my attending nurse for the day. Heather is apparently a new nurse, and I just met with her for the first time yesterday. She was incredibly kind and familiar with my chart. Apparently she had just come over from Conceptions, so seemed really familiar with the infertility world, and answered my questions well.
Kathi is the NP in the office and is also very nice. She, somehow though, seems the least familiar with my chart, and has made several mistakes with me, like telling me to get off of one med, when I wasn't supposed to (as I found out when I showed up for my next ultrasound). It cost us some money, because we have to stretch out the cycle longer, but otherwise I don't think will be the reason this cycle doesn't work.
Describe your experience with Denver Fertility Albrecht Women's Care.
The back of house staff is probably my least favorite part of the office. Specifically Anne C. She makes mistakes regularly in scheduling (will tell me one time only to find out she booked me for a half hour earlier/later), or will forget to book something when I am coming in for more than one procedure. The staff has always found a way to fit me in when that happens though. It's just frustrating. Missy and the other woman at the front desk, though, are wonderful. Always cheerful, always remember my name, always ask about my weekend. Brittany and the other lab techs are also wonderful. They are chatty and as sweet as can be. Also, I'm a pretty hard stick, but they never seem to have trouble getting blood out of me. It's excellent.
I haven't had much interaction with billing though, and I've heard they can be a little frustrating, but I have nothing to speak of in that department.
Describe the costs associated with your care under Dana Ambler at Denver Fertility Albrecht Women's Care.
My IUIs were covered under insurance, so costs so far have been minimal. $25/ultrasound, $30 for a visit with a nurse, $50 for a visit with Dr. Ambler. Labs were done in house. Not sure about IVF costs.
Describe Dana Ambler's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Denver Fertility Albrecht Women's Care.
What specific things went wrong at Denver Fertility Albrecht Women's Care?
- Failed to call in prescriptions to pharmacy
- Lost appointments
- Failed to call with results
- Failed to order appropriate test
- Failed to inform you of changes in protocol
- Lost results
- Provided conflicting information
- Failed to convey critical information
- Scheduled the wrong procedure
Describe the specific things that went wrong at Denver Fertility Albrecht Women's Care.
I've mentioned this before, but I've been given wrong appointment times, not had certain procedures scheduled when I've come in for more than one thing, not been called with test results, etc. My trick to avoiding appointment issues is to try to always interact with Missy, or always schedule before I leave the office. I also just call in and leave a message on the day results are expected, just to avoid them forgetting to call me. And like I said earlier, they've always fit me in if the staff have messed up in scheduling. I also just make sure to have everything written down (particularly changes in protocol) when I go in for an ultrasound.