How was your experience with Kate Devine at Shady Grove Fertility?
Dr. Devine is not warm and fuzzy, as noted above. But she is really really good at setting expectations and I appreciate that. I went to her to preserve my fertility because I had a difficult time getting and being pregnant with my first child. That evolved into me actually trying to get pregnant with a second child - this has not happened yet and we've moved onto getting a gestational carrier and will be working with Shady Grove to do this. We decided it would be a good idea to create embryos right away after having our first child (in part because my insurance actually covered it and I had the time). I got amazing results from the one IVF cycle that I did at Shady Grove: 28 eggs retrieved, 24 were mature, 21 fertilized, 16 made it to day 5 embryos and were frozen, and 8 were genetically normal (2 of the 16 were re-biopsed because they didn't get conclusive results and one was normal and the other was not). That was awesome. However, during the IVF cycle, we discovered that I had "Asherman's Syndrome" still or again - I had it before my first child was born but thought it was treated. It either wasn't totally treated or it recurred from a c-section. We then discovered that even when the scars sticking the sides of the uterus were cleared I still seem to have an abnormally thin lining that tends to collect fluid during treatments that raise my estrogen level - there seems to be a trade-off between thickening the lining and increasing the fluid. Neither of these things is good for implantation. Ugh. I've now had 3 more hysteroscopies since doing IVF (I had 3 prior to having my first child)and done 2 questionable transfers of genetically normal embryos to suboptimal lining conditions at Shady Grove (under the theory that I got pregnant before with a very thin lining - 4mm). My lining does not make it out of the 4mm range. We've now called it quits on the transfers and we are officially moving onto a gestational carrier, as noted above. Dr. Devine actually thought I should go straight to a GC the first time I met with her based on the trauma of my first pregnancy (di-tri triplets, multi-fetal pregnancy reduction, debilitating nausea, intrauterine growth restriction, c-section at 36 weeks and 3 pound 11 ounce baby). But I insisted on trying again to get pregnant. I am calling it quits because it's been 4 years of infertility taking over my life, more than 5 different fertility doctors (not to mention the other ob/gyns and MFMs involved), 2 miscarriages, 2 partial ovarian torsions, 1 botched D&C, 1 multi-fetal pregnancy reduction, 1 c-section, 1 amazing baby with scary terrible pregnancy, 6 hysteroscopies, 2 unsuccessful frozen embryo transfers, and countless random doctors and nurses telling me that my uterus doesn't look good on ultrasound. I can honestly say that the least stressful part of this whole experience was actually my IVF cycle at Shady Grove. That was a total nothing. Worked out great. Can't ask for better results.
What's one piece of advice would you give a prospective patient of Kate Devine at Shady Grove Fertility?
If you want someone warm and fuzzy, I would not go to Dr. Devine. If you want someone who will be straight with you, Dr. Devine is amazing. I must tell you that because of how Shady Grove works, you end up seeing whoever is there that day so I didn't always see Dr. Devine. She will call you to follow up but sometimes it's not at a convenient time for you so you end up relying on what other doctors and nurses are saying. This is not a problem with Dr. Devine; this is more just about how the Shady Grove practice works. Everything is high quality, but you don't get your hand held by one person. You have A LOT of access to your nurse, but not as much access to your doctor.
During treatment, were you treated like a number or a human with Kate Devine at Shady Grove Fertility?
It is so hard to review doctors when you are still in the process of being treated by them and don't know what will result! Things I like about Dr. Devine: she always takes the time to talk to you extensively about results (good and bad) and about the prognosis. She is really, really good at setting expectations (low ones in my situation). She is the first doctor who said I might need a gestational carrier and I was actually able to hear that. HOWEVER, Shady Grove is kind of run like a factory, but I think there are totally upsides to that depending on what you are being treated for. So I do sometimes feel like a number there. It's not a warm and fuzzy place. But I'm in a spot with my fertility issues where I don't really need warm and fuzzy right now. I just need the care to be good and I do think Shady Grove has an excellent lab. One thing to watch for is that you have a ton of access to nurses and other ancillary staff at Shady Grove but it can be hard to schedule time to actually talk to your doctor. On the other hand, I don't really need to talk to my doctor all of the time now anyway. I am not having any medical emergencies, etc. Mixed feelings. But yes, when I talk to Dr. Devine, she treats me very much like a human.
Describe the protocols Kate Devine used in your cycles at Shady Grove Fertility and their degree of success.
I actually don't remember the specifics of the drugs I took for my one IVF cycle with Dr. Devine. She was concerned about over-stimulating me (I have PCOS and am very responsive to fertility drugs and have had partial ovarian torsion twice). She managed to maximize the number of mature eggs while not over-stimulating me which was great. The rationale for doing IVF was to preserve my fertility since I was 36, my insurance covered it, and I had a hard time conceiving my first child due to Asherman's Syndrome. It's now totally awesome that we have the embryos because we are pursuing a gestational carrier. Okay, here's the complicated thing that happened while I saw Dr. Devine: I wanted to get a hysteroscopy from my old doctor in San Francisco because he had already performed 2 hysteroscopies. I went to him in December of 2016. On hysteroscopy, he thought my uterus looked pretty good and put me on an estrogen therapy protocol. Every single time I went in to have my lining checked at Shady Grove during the estrogen therapy protocol, the lining was still really thin and my California doctor thought I should keep taking the estrogen. Dr. Devine didn't think the estrogen therapy was working. I went with the California doctor's advice because he had helped me in the past and I had had a successful pregnancy. Dr. Devine might be right that it wasn't working. I don't really know. Anyway, I did the estrogen therapy for 3 months. Then I did two unsuccessful frozen embryo transfers. Both cycles were really confusing because my lining didn't look great (still thin and fluid-filled), I was in the process of moving to New York City and was doing outside monitoring and seeing random clinicians for the measurements/assessments of my uterine lining. I would take a picture on my phone of the image of my uterus and send it to Dr. Devine's nurse because outside monitoring does not actually send the images (just a written report). I don't even know what to say about that experience. Outside monitoring is just a really really terrible experience if you have a uterine lining problem. It was terrible but not because of anything Dr. Devine did. She was very clear about the likelihood of success with these transfers not being great (as mentioned above, she is very good about setting expectations - and in my case, setting them low). This all prompted me to actually get another doctor in New York City. This New York doctor partnered really well with Dr. Devine and that was great. They knew, liked, and respected each other and I felt like I was in much better hands once that occurred. I really wish someone at Shady Grove had encouraged me to actually see a doctor in New York sooner (and not just do outside monitoring). I only got another doctor because I took the initiative. The nurse at Shady Grove made it seem like it was no big deal to do outside monitoring and let me tell you it really really was for me. It was expensive, time-consuming, and frustrating.
Describe your experience with the nursing staff.
I would say that the nurses are highly variable. I had a few nurses who were absolutely amazing (Sheila Ormond, most notably). They are so responsive and compassionate and because of how the practice is run you end up interacting with them a lot and they really know and understand your situation. However, it's uneven - I randomly had a nurse for a few weeks during a time when I was doing outside monitoring who was unresponsive and had no idea what was going on with my case. She got re-assigned (perhaps after I complained, though I'm not sure). I now have a gestational carrier coordinator who seems great. But yeah, I would say it's variable. The nice thing about a "factory" place is that because of the sheer volume of nurses, you can probably complain and get re-assigned easily to someone really good.
Describe your experience with Shady Grove Fertility.
I'm repeating myself. Shady Grove is a "factory" and there are pluses and minuses to this. I think the doctors, nurses, and other staff there really know what they are doing and you get great care overall. Everything is convenient and efficient. However, if you want your hand held by a specific doctor, this is not the place to go. I am happy with Shady Grove because I did a successful cycle of IVF there and I feel like they have adapted well to my evolving situation (moving to New York, involving another doctor, moving onto a gestational carrier).
Describe the costs associated with your care under Kate Devine at Shady Grove Fertility.
They weren't too bad. My insurance actually covered a round of IVF so that was minimal cost. We also had a physician discount of 20% (my husband is a physician) on other procedures. The thing that was really expensive was actually the outside monitoring that I did in New York City. So be prepared for that. Shady Grove is really good about preparing you for the costs of things in general. But I was not prepared for the cost of outside monitoring.
Describe Kate Devine's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Shady Grove Fertility.
Dr. Devine is a huge advocate of eSET. I'm sure there are specific situations where she would be okay with a multiple embryo transfer. But not for me!
What specific things went wrong at Shady Grove Fertility?
- Failed to call in prescriptions to pharmacy
- Provided conflicting information
Describe the specific things that went wrong at Shady Grove Fertility.
A couple of issues - because you are always seeing different nurses and doctors, sometimes they don't know the whole history and things get lost in translation. My situation is legitimately confusing so I'm not blaming anyone. However, I had a saline ultrasound test where the doctor (not Dr. Devine) flipped what side of my uterus was collapsed and this mattered because it made me feel like I now had scarring on the opposite side. We figured out that it was a mix up. Also, when I had a random nurse for a few weeks who I did not like, I found her to be unresponsive so it was harder to do things like get prescriptions sorted out.