How was your experience with Nora Miller at Greenwich Fertility and IVF Center?
Dr. Miller is straightforward, honest without being cold, and very up-to-date with the latest research on effective treatment strategies. I always had total confidence in her treatment approach (wish I could say that about my new OB).
Even though we were unexplained (which tends to mean "throw shit at the wall until something sticks"), it always felt like each round of treatment was tailored to my individual response in previous rounds. When Clomid thinned my lining, we immediately moved to injectables despite an otherwise good follicle response. I reacted strongly to injectables but the IUI failed, so my IVF meds dose was scaled back to make sure I wouldn't be put at risk of OHSS.
Overall a great doctor-patient relationship.
What's one piece of advice would you give a prospective patient of Nora Miller at Greenwich Fertility and IVF Center?
Be up-front about how you want to receive information. She is incredibly knowledgeable, so will get into as much (or as little) detail as you want. I did this early and was glad that I did.
During treatment, were you treated like a number or a human with Nora Miller at Greenwich Fertility and IVF Center?
Dr. Miller previously ran her own practice, but now has joined with the team at Greenwich Fertility (located in Greenwich and Stamford). With only a handful of exceptions when she was not available, she walked us through the treatment plan each month, did every ultrasound, every IUI, and transfer. The only appointments where I wasn't scheduled to see her were just blood draws, and even then she'd usually poke her head in just to check on how things were going, see if I had any side effects, or just chat.
I'm a scientist, so I asked to know blood and guts, and she explained every detail about what each medication does, how it interacts with everything else you're taking, and what kinds of side effects to expect. When you're on so many different meds, understanding what everything does can be crucial for catching errors (pharmacy sending something incorrect, etc.). When she does ultrasounds, she takes the time to point out and explain every feature that she sees. One of the few times she was not available, I got one of the other doctors in the practice who wouldn't even let me see the screen - I can't imagine doing that every other day for weeks at a time.
She also makes patient-centered choices on treatment setup. There are various steps along the way where the outcome is the same, but the logistics can be significantly worse - for example, taking 3-4 shots a day vs. mixing meds when stimming for IVF. Dr. Miller went out of her way to choose the technique that she felt would be the easiest and offer the least interference. Where that wasn't possible, (I had to be on PIO injections due to trigger type), she adjusted needle types and gave tips on improving the injections to make the process more tolerable, and got me off of those injections as quickly as possible rather than the "better safe than sorry, but your ass will be a pincushion for 3 months" method used by many clinics.
Many fertility practices treat women like they'e at a cattle call, but I never felt that way with Dr. Miller.
Describe the protocols Nora Miller used in your cycles at Greenwich Fertility and IVF Center and their degree of success.
Cycle 1: Clomid + IUI, with a trigger shot. Did not do a medicated-only cycle, as newer research shows that in my situation, it would have produced little benefit beyond good old-fashioned sex. Produced 2-3 good follicles, but cycle failed.
Cycle 2: Continued with Clomid + IUI + trigger, since my response was good the first month. Only one follicle this time, and uterine lining dropped from excellent to just ok. We proceeded with the cycle, but cycle failed.
Cycle 3: Given the lining issue and weaker Clomid response from the prior month, switched to injectables (Gonal-F). I asked about Femara instead, but Dr. Miller suggested that although it is helpful in women who don't ovulate, since I ovulate every month anyway, we needed a treatment that would produce multiple follicles, which Femara typically doesn't. Anyway, early ultrasounds showed a ton of follicles developing, so we backed my dose way down. Ended up with 4 or so good follicles, but cycle failed.
Cycle 4: Initial fast reaction to injectables left me with several cysts. Benched 3-4 weeks on birth control to let those shrink.
Cycle 5: IVF cycle. Antagonist protocol, with (relatively low dose, after the injectables) Gonal-F, Ganirelix, and a combined Lupron + hCG trigger since I was already retaining fluid even on the injectables cycle. 13 follicles retrieved, 12 mature, 9 fertilized, 6 day 5/6 blastocysts. Single embryo fresh transfer due to my age and diagnosis, other 5 were frozen with no PGS. Currently 7 months pregnant.
Describe your experience with the nursing staff.
The vast majority of the nurses were excellent, personable, and efficient. One was actively not good with blood draws (I got some pretty spectacular bruises from her, rarely the others), which was mostly an issue for me because I have a pretty strong needle phobia - not great for fertility treatment under the best of circumstances.
Occasionally I would come in for monitoring and no one would realize I was supposed to be there, but this was rare and quickly rectified.
Describe your experience with Greenwich Fertility and IVF Center.
In general, this was a very efficient clinic. I never had any issues with billing or insurance, which is pretty spectacular considering how often I was in there, and they made scheduling very simple. Updates on blood work or other test results were always timely.
Only a few minor criticisms. The Stamford clinic could really stand to open earlier - they officially open at 8 (although monitoring starts around 7:50 or so). Working a regular office job that also starts at 8, I was late every day that I had to go in for monitoring. I was rarely at the Greenwich clinic, so can't speak to that location.
Also, one of the staff at the front desk regularly lectured me on how I was going to have to stop working or cut way back or whatever once I had kids, and told me all about her experiences with pregnancy. Not something I was interested in hearing about in the midst of a long struggle to even get pregnant, and I'm pretty sure plenty of people work for a living, even with kids.
Describe the costs associated with your care under Nora Miller at Greenwich Fertility and IVF Center.
Most of my costs were insured, so I paid for copays and embryo freezing only.
Describe Nora Miller's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Greenwich Fertility and IVF Center.
For my age and an unexplained diagnosis, Dr. Miller strongly recommended a single embryo transfer, and I believe that is her typical practice unless there is a strong reason to choose otherwise. I was definitely on board with this.
What specific things went wrong at Greenwich Fertility and IVF Center?