How was your experience with Norbert Gleicher at Center for Human Reproduction?
I was grateful to Dr Gleicher and CHR for taking my case, as another clinic had rejected me after my DOR diagnostic. I gave me hope that someone was willing to take on a difficult case (so that is very positive and I am very thankful for that).
It is important to note that Dr Gleicher does not perform any procedures. So while you have appointments with him to discuss protocol prior to starting a cycle and you meet with him in case of negative outcome, only Dr Barad and Kushnir do the ultrasounds/retrievals/transfers etc. So this already adds a challenge, as I sometimes had the impression that the communication between doctors was not up to par, and therefore I ended up falling through the cracks. Also, the communication after the first appointment is exclusively done through the coordinating nurse. So whatever question you may have about ANY thing goes through the nurse, except if you keep your list of questions for when you do the monitoring and then you get to ask Dr K or Dr B in person (but even that is not necessary great as I just feel more reassured knowing that there is ONE doctor who has the complete overview of my case).
My first cycle went well (all the way to transfer but had a BFN) as I felt that, as a new patient, the Doctors were paying attention to each step of the cycle and were closely monitoring me. That feeling started to fade at the second cycle, where the decision to trigger was taken by the Dr on call for the weekend (and I think without consultation with Dr Gleicher) and ended up being too soon and with absolutely no egg retrieved. I was pretty distressed at that point but still felt new to this whole IVF thing and did not learn to advocate for myself yet.
For the third cycle, Dr Gleicher proposed to put me under a new protocol. This gave me renewed hope. However, when I started the new cycle, I ended up ovulating spontaneously very quickly despite being on Lupron. The feedback I got was that maybe I had not taken the meds properly (I knew I had respected the protocol but was very willing to blame myself for this failure...). During the follow up appointment I was even more lost as it was clear that Dr Gleicher had not read my file and was just discovering some of my hormone levels as we were talking... He suggested doing another cycle back to back with the exact same protocol, which I did, paying even more religious attention to the time of my injections! We started the fourth cycle, and after about a week, I got the news that I had ovulated - again!! This time I was absolutely sure I had taken the meds perfectly. I was so distressed that I asked if there was any chance we could retrieve anything. The nurse told me that if I wanted I could convert this to an IUI (if I want it??). Which I did (only to discover during a second opinion appointment with another Dr that my hormone levels clearly showed that I had ovulated at least a couple of days before and therefore the IUI was just pointless). Overall, I have the impression that the level of attention paid to my case decreased tremendously after the first cycle, and I just became a number.
What's one piece of advice would you give a prospective patient of Norbert Gleicher at Center for Human Reproduction?
Of you are keen on trying CHR, I would recommend going with Dr Kushnir instead of Dr Gleicher. He is the one doing the monitoring during the week (and on rotation every other weekend) so at least there would more consistency and less risk of info falling through the cracks. They have weekly staff meetings so the 3 Dr talk and if there is a need to consult Dr Gleicher Dr K would surely do it.
If you already are with Dr Gleicher, I would just recommend that you warn the nurse that you will have loads of questions when you meet Dr Gleicher at the beginning/end of your cycle so that he will be more prepared. For the follow up of my 4th cycle, I had told her that I was expecting a full review of my 4 cycles during that discussion and that led to a more substantive discussion...
During treatment, were you treated like a number or a human with Norbert Gleicher at Center for Human Reproduction?
While the relation with the coordinating nurse was good (although far from perfect), I have had meetings with Dr Gleicher where it was absolutely OBVIOUS that he had not even read my file prior to the meeting and he was just making comments on the spot (flipping the pages on my file while talking, making mistakes on test results, not remembering the outcome of previous cycles...). This really gave me the impression that he was not paying attention to each case. This was particularly shocking when I met him for a follow up appointment after a failed cycle where I was really hoping to use that time with him to have a substantive talk about what happened and what the next steps would be.
Describe the protocols Norbert Gleicher used in your cycles at Center for Human Reproduction and their degree of success.
- priming with estradial patches or pills
- follistim 450/day
- two vials of menopur/day
- estrace 3x/day orally and vaginally to support lining growth (I was on vaginal viagra for one cycle but the combo of that and loads of estrace led to my lining crashing before the retrieval)
- prednisone and baby aspirin (he said that some of my test indicated a hint of auto-immune problem)
- lovenox and PIO after transfer
Describe your experience with your nurse at Center for Human Reproduction. (Assigned nurse: Dorota)
Dorota is very kind and warm. You truly feel that she knows you well and is with you in this.
The only challenge they have a small team of very busy nurses who are the only point of contact between you and the doctor. Therefore when I sent her questions by email 1) I sometimes did not get an answer or very late, 2) sometime I would get ye/no answers without much explanation, 3) I was not always sure that the questions were communicated to the Dr.
Describe your experience with Center for Human Reproduction.
It is good clinic that does quite a bit of research so you know that they will consider "difficult" cases. They also do clinical trials and take out of State Patients.
The main challenge is that it is a small team with one Dr that does not perform any medical action (so only two Dr on that front) and a small team of coordinating nurses. I think my feeling of them dropping the ball and treating me as a number might be due to the fact that they have more patients that what they can really handle. So you need to advocate for yourself all the time and be on top of everything (which ends up being a bit exhausting during a process that is already not very easy...).
Describe your experience with your monitoring appointments at Center for Human Reproduction.
It was a relatively well oiled machine that was convenient for my schedule.
Describe the costs associated with your care under Norbert Gleicher at Center for Human Reproduction.
First cycle was out of pocket and cost about 13K (without meds) and another 10K of med from their recommended pharmacy (as I was on very high doses of stimulation for about two weeks and I did not know I would shop around...). After that I changed insurance and the cycle and some of the meds were covered.
Describe Norbert Gleicher's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Center for Human Reproduction.
in my case I only had two embryos and he indicated that for my age bracket it was better to transfer both to increase my chances.
What specific things went wrong at Center for Human Reproduction?
- Failed to convey critical information
Describe the specific things that went wrong at Center for Human Reproduction.
When they offered to convert my IVF into an IUI because I asked them if there was anything they could do after I had ovulated, it really felt that they were throwing a bone at me to keep me happy but it was not a well thought through decision at all. I discovered later that my hormones clearly showed that it was way too late for an IUI.