How was your experience with Meredith Brower at UCLA?
I was referred to Dr. Brower by my ob/gyn after the loss of our first pregnancy. I consulted with her as we were coming up on six months (over the age of 35) without a successful pregnancy. My husband and I met with her after we got my initial blood work back. She was sympathetic about our loss, presented different treatment options, and was appropriately candid about the less than rosy statistics for them. We decided to proceed with IVF as it offered our best chance of success and we liked the prospect of being able to test to reduce the risk of another loss. I began priming and OCP suppression later that month. When our first retrieval cycle did not go well (objective was to get something to test), she gave us the option to repeat the same protocol or to try a different one for our second cycle. I found Dr. Brower to be appropriately communicative, candid, and caring.
What's one piece of advice would you give a prospective patient of Meredith Brower at UCLA?
Maybe not specific to Dr. Brower, but it's important to understand that infertility is a very frustrating branch of medicine that does not offer the same quality of data that others do. There are still a lot of unknowns and every patient is different.
During treatment, were you treated like a number or a human with Meredith Brower at UCLA?
I appreciate that Dr. Brower considers the emotional aspect of infertility and related treatment. I also appreciated seeing Dr. Brower (or her partner in Dr. Brower's absence) for my ultrasound monitoring appointments instead of an ultrasound tech. She was very responsive to email/web portal inquiries.
Describe the protocols Meredith Brower used in your cycles at UCLA and their degree of success.
My first cycle with Dr. Brower was antagonist - I testosterone primed with Androgel for 34 days and stimmed with 300 Gonal-F, 150 Menopur, and hgh for nine days (adding Cetrotide days 7-9), triggering with a single dose of Ovidrel on the 10th day. We retrieved 12 eggs, of which only 7 were mature and ICSI'd, of which only three fertilized. One became a morula, but the other two did not make it that far. We had no blastocysts to test and freeze as was our goal.
Because that went poorly, we wanted to try a different protocol to see how that would go. The cycle after the first egg retrieval, I started OCP on CD3 preparing for another antagonist protocol. I testosterone primed with Androgel for 24 days (stopping 2-3 days before beginning stims as I ran out because it had been ordered before changing to the luteal lupron plan). We had subsequently decided on a luteal lupron protocol (without OCP), but I needed to remain on the OCP for about a week for hysteroscopy visibility. After that I had to monitor for ovulation with OPKs to ensure ovulation before starting lupron suppression (10u once daily) on CD20 for 13 days. I began stimming this time with 450 Gonal-F, hgh, and reducing the lupron to 5u for days 1-4. Beginning day 5, I reduced the Gonal-F to 300 and added 150 Menopur along with the hgh and lupron through day 10. I triggered on day 11 with a single dose of Ovidrel. We decided to try half IVF and half ICSI since all ICSI didn't work out well for us last time - we admit the human element with ICSI scares us a little bit and like the idea of some natural selection. We retrieved 10 eggs, of which 8 fertilized (5/5 IVF, 3/5 ICSI), and are currently waiting to see how they fare.
Describe your experience with your nurse at UCLA. (Assigned nurse: Teri)
Teri is an experienced IVF coordinator/nurse, but I'm not sure if her workload is too much handling all IVF patients. She was very helpful in getting my IVF cycles approved with my insurance, but sometimes I would not get responses to my emails.
The other nurses I saw for blood draws and to take my vitals were pleasant and professional.
Describe your experience with UCLA.
My only comparison is with a private clinic (not affiliated with a large public university), and I had much better service (at a price!) at the private clinic. Monitoring was only every other day toward the end of stims, so I didn't know what my actual situation (E2, largest follicle size) was at trigger, whether hcg in my system was sufficient after trigger, etc. At my last monitoring appointment, I noticed that they do not measure all of the follicles (I didn't have that many being AMA), just the few largest to get an idea. While I understand that this appears to get the job done, I usually like more information when possible. Again, I like the frequency with which I got to see my own doctor, which I understand doesn't happen everywhere.
Describe the costs associated with your care under Meredith Brower at UCLA.
I had insurance coverage for my two IVF cycles with her. The office uses another fertility center or one of the university surgical centers for its surgeries, so bills came separately from different departments at UCLA (physician billing is different from hospital billing) or from the third party fertility center directly. Genetic testing (of me, not embryos) was also billed separately.
Describe Meredith Brower's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at UCLA.
Dr. Brower made clear that multiples basically increase the risk of everything that can go wrong. We would probably only transfer more than one if untested.
What specific things went wrong at UCLA?
- Failed to call in prescriptions to pharmacy