How was your experience with Lorna Marshall at Pacific NW Fertility?
Dr. Marshall is very knowledgeable, experienced and open about unknowns. She has been in the business for a very long time, I think over 30 years and she is one of the founders of PNWF. You can look at her bio and see all her credentials, its pretty impressive! And she utilizes her knowledge well. I really felt that my plan was catered to me, not a blanket protocol. She explains well without going into too much medical jargon that would overwhelm, which I really appreciated. The process is overwhelming enough and being on tons of hormones its very easy for her to say a word I'm not familiar with and make me crazy googling that word! She doesn't bog you down with unnecessary details. For example while we were waiting for my lining to be thick enough to transfer, she would say "almost there, i think next check you'll be ready" but she didn't disclose what "almost there" meant. At first this annoyed me but what would I have done with the information? There isn't anything I can do to make my lining get thicker other than do what they are telling me to do already. She provided necessary information : next time the lining will be thick enough. As far as experience, I think it really shows in how she anticipates every turn. She was right every time. And she rolls with the punches. After a very long period of waiting to complete my IVF cycle with the FET of my one and only good embryo, I messed up my medication regimen (I forgot to switch to progesterone 6 days prior to my FET). I panicked and called the clinic who had to contact Dr. Marshall off-hours and within 10 min. I was set-up with a new game plan. I guess after all this time she really has seen very possible patient mistake!! I'm devastated that I made a mistake that cost me my transfer. Dr. Marshall undoubtedly knows the heart-ache my mistake costs me but she also knows that my one embryo and 3+ years of trying isn't worth risking until everything is perfect. This makes me truly believe that she really wants this to be successful. As far as disclosing unknowns, we have had several conversations about the advancements of science and the lack of understanding of what make embryo(s) stick. They make the uterus as receptive as possible, gently place the embryo in and hope it sticks.
What's one piece of advice would you give a prospective patient of Lorna Marshall at Pacific NW Fertility?
Make your call to the clinic early - I had to schedule my first consultation three months out and when I decided to go ahead with IVF I had to wait two more months to start. She is highly sought after. I have no advice specifically related to working with Dr. Marshall. Regarding infertility in itself, I strongly suggest that people do not read forums. The fertility team is a group of experts with lots of direct patient experience, just because someone has been though IVF 3 times does not make them an expert.
During treatment, were you treated like a number or a human with Lorna Marshall at Pacific NW Fertility?
As a RN I asked the clinic to not treat me as someone 'in the know' because I work in a completely different area of specialty and I didn't want to have to teach my husband about all of the lingo and meaning. Dr. Marshall definitely respected that, deciphering ultra sounds and going into great details of procedures and offering descriptions that we would understand (e.g. during FET the uterus is a like an English muffin, not smooth and hopefully the little embryo will nestle itself into a pocket or shelf). She also shared personal stories with me and seemed interested in hearing about our lives as well. If we ever waited a long time in the exam room, she apologized.
Describe the protocols Lorna Marshall used in your cycles at Pacific NW Fertility and their degree of success.
I was diagnosed with low ovarian reserve (AMH ) and probable poor egg quality, other than that I don't know why the meds and doses were chosen. my IVF regimen was as follows:
3 weeks of BCP
suppression check/blood work
Follistim 450 IU and miniHCG 20u for 12 days
Meanwhile reporting to the clinic day 5 (9 follicles), day 7 (12 follicles), day 9 (14 follicles), day 11 (13 follicles), and day 12 (12 follicles) for ultrasounds/blood work
Started Ganerelix on day 9
On day 12 max follicle size was 18.6 so HCG Trigger shot was scheduled for that night with retrieval the next morning.
Egg retrieval in the morning, 10 eggs retrieved, 7 of those were mature
Day one report - 5 fertilized
Day 5 - 1 blastocyst and two more still growing
Day 6 - 2 blastocysts, both biopsied and frozen
PGS report a four days later (we were told it would take 2 weeks) - 1 chromosomal normal blastocyst
About a week after the retrieval I had a hysteroscopy and removal of some polyps found during the Saline Sonogram. Then I took a month and a half break (continuing birth control pills) to allow healing. For the FET, I did 2 weeks of lupron at 10u (some overlap with the BCP). A suppression check and blood work prior to starting Estrogen patches. The patches started at two every other day for a week then increased to 3 patches every other day for a few days then up to 4 patches every other day. Lupron had been reduced to 5 units every day. My first lining check was not thick enough so I continued with 4 patches. Still continuing with Lupron. Finally my lining was thick enough (it took 5 weeks instead of the 4 that was initially outlined). Progesterone was to start 6 days prior to transfer, meanwhile continuing with 2 estrogen patches and 5u of lupron.
Describe your experience with your nurse at Pacific NW Fertility. (Assigned nurse: Emily Gray)
Emily is the perfect fit for this role. She is friendly, very easy to talk to, compassionate without crying all the time (which is what I wanted to do), concise and organized. I never felt that she didn't know what she was talking about. And if she didn't know, she readily told me she would find out from Dr. Marshall. When all is chaotic (in my head) Emily is like a lighthouse. When I really wanted to fixate on something, she wouldn't let me. For example, when the embryos were growing I asked her to tell me the grades of them, she kindly told me she could tell me that information but that the grades don't reflect quality so... she was totally right. I would have taken that information and spent hours researching it on the internet and stressing out. She gave very clear instructions - demonstrated injections, gave us a print out, sent us a video and email reminders. Even after all those tools and I messed up, she assured me that it was ok and they (she and Dr. Marshall and all of PNWF would fix it and set me up for success. She was fun to joke with. She always called or emailed when she said she would.
Describe your experience with Pacific NW Fertility.
everyone is very kind. Its a nice, inviting space.
All the magazines a girl could dream of.
Suzanne, the phlebotomist, is amazing. She is so gentle. She never bruised me. She took her time and really treated me with care.
The location is perfect for me, as I work 3 blocks away.
there does seem to be a lot of turn over of the front office staff. When Suzanne didn't draw my blood there was always a different face - none of them 1/2 as good as Suzanne. Once when I called in with a question the front desk staff said they would have a RN call me back right away, four hours late I still hadn't heard from anyone and I knew they had weekend hours so I called again and the same woman said "yes, they know you have a question and will call soon" well about 10 min late I did receive a call and the RN said that they were just closing up for the day. If I hadn't followed up, I wouldn't have gotten a response for 24 hrs.
If you have to park, its very expensive.
Describe the costs associated with your care under Lorna Marshall at Pacific NW Fertility.
Physician fees and embryology fees were approx $18,000. Plus about $3,000 for PGS. And now $800 for FET. Meds for IVF were about $4,000. Meds for FET about $1200
Describe Lorna Marshall's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Pacific NW Fertility.
Dr. Marshall had a strong preference to transfer only one embryo from the beginning (stated at our initial consultation). We were every happy with that. Other clinics leaned strongly towards multiple embryo transfer. We only ended up with one anyway
What specific things went wrong at Pacific NW Fertility?
- Failed to call with results