How was your experience with Paul Dudley at Seattle Reproductive Medicine?
I was under the care of another doctor who just happened to retire while I was her patient. During that time, I had my first embryo transfer that resulted in a pregnancy. Sadly, I suffered a miscarriage after finding out there was no heart beat at my ultrasound appointment. I was just a day shy of my 11-week mark. I chose to miscarry at home. I chose not to have a D&C with the fear of uterine preforation. Instead, I used the medication misoprostol to induce the miscarriage. After heaving cramping and extreme tissue loss, our baby presented himself. My husband placed the baby and tissue into an Anora Kit that we had obtained and sent our baby in for testing to see what might have gone wrong. Thus, my follow-up appointment was with Dr. Dudley and I reestablished care with him. Since we live out of state, our appointments are over-the-phone. We happened to speak with him while we were still waiting for results from our miscarriage. Dr. Dudley immediately expressed genuine compassion and made us feel like he really cared about our situation. He seemed disappointed and was very empathetic. Furthermore, Dr. Dudley expedited the results that we were anxiously awaiting. Additionally, Dr. Dudley implemented a new protocol and further testing before beginning another retrieval cycle. He also explained potential risks of starting a new cycle too soon. He talked to the company that completed our PGS testing and had our date extended for another few months. This meant we would not have to pay another base fee for our next retrieval. His assistance made us feel hopeful again! We have since completed another egg retrieval in July of 2108. We have one embryo from that cycle. However, since I am almost 38, we have chosen to complete two more cycles of egg retrievals before a transfer. We shared our concerns with Dr. Dudley and he agreed that by choosing to do this instead of another immediate transfer would definitely help increase our chances of getting pregnant. I definitely do not want to go through what I had just experienced and then not only loose another baby, but be older and have poorer egg quality. Dr. Dudley reminded me that I did have implantation on my first transfer and was positive to point out that is was a good thing! He explained to my husband and I both what to expect during treatment. We are scheduled to have another egg retrieval in a couple of weeks and meet with Dr. Dudley. I am so far very impressed with Dr. Dudley and his professionalism, along with his expertise.
What's one piece of advice would you give a prospective patient of Paul Dudley at Seattle Reproductive Medicine?
One piece of advice I would give to a prospective patient about Paul Dudley is to not be afraid of asking any kind of question. Dr. Dudley is very knowledgeable and respectful. He communicates effectively and will explain things thoroughly so that you will understand.
During treatment, were you treated like a number or a human with Paul Dudley at Seattle Reproductive Medicine?
After my doctor retired I established care with Dr. Dudley. I had just experienced a miscarriage during this time. Since I live out of state, I spoke with Dr. Dudley on the telephone. He immediately expressed genuine compassion and made us feel like he really cared about our situation. He seemed disappointed and was very empathetic. I definitely felt human and honestly cared for and far from feeling just like a "number." Dr. Dudley talked to me about conducting further blood testing to determine if I have a clotting factor before we attempt another cycle. This proactive approach by Dr. Dudley definitely made me feel human and like he was going a step further to help us figure things out. Furthermore, Dr. Dudley expedited the results from our miscarriage that we were anxiously awaiting. Dr. Dudley also reached out to the company that did our PGS testing and had our date extended for another few months. This meant we would not have to pay another base fee for our next retrieval. His assistance made us feel hopeful again! I am just very impressed with Dr. Dudley's knowledge and ability to help guide us during this journey. He has a way of eliminating the overwhelming feeling that this situation presents just by hearing his voice. He is very responsive, respectful, trustworthy, and explains in detail what to expect next. Dr. Dudley also translates complicating medical lingo into a language that my husband and I can understand. In closing, I have always felt human and not like a number when communicating with Dr. Dudley.
Describe the protocols Paul Dudley used in your cycles at Seattle Reproductive Medicine and their degree of success.
After my miscarriage, Dr. Dudley immediately ordered blood tests for genetic thrombophilias, specifically Factor V Leiden, which is a mutation that can increase your chance of developing abnormal blood clots. Moreover, he recommended another blood draw three weeks after the previous one to rule out any antithrombin activity, anti-thyroid antibodies, anti-cardiolipin antibodies, lupus anticoagulant, and beta-2 glycoprotein antibodies. My results for blood clotting and immune panel were negative. Dr. Dudley's treatment strategy was the antagonist protocol for both my egg retrieval in July of 2018 and also the one coming up in a couple of weeks. However, my medication doses are different. For the first retrieval, I was on 450 units of Follistim and 75 units of Menopur. For the upcoming cycle, I am to take 375 units of Follistim and 150 units of Menopur. A blood test is taken on day five as well as day eight for both cycles. I fly from Alaska to Seattle for the day-eight appointment. After arriving in Seattle for monitoring, each appointment is contingent on the one before. I am to be notified when to start my antagonist medication, Ganirelix. In July, I started on day seven with 0.5 mL and continued on until day eleven. I take this medication to prevent ovulation. An ultrasound and blood test determine when to take my trigger injection. With the retrieval in July, I used the medication Lupron and for the upcoming retrieval I am prescribed 10,000 units of Pregnyl for my trigger shot. The rationale for using the Lupron trigger is that it stimulates your own pituitary to release a large amount of LH and FSH. In contrast, the Pregnyl trigger releases hCG, which itself acts like LH and causes ovulation. Dr. Dudley is hoping for better results with the hCG trigger in terms of egg maturation. Only time will tell! With my first cycle with Dr. Dudley I produced six eggs. Only four were mature and two made it to day blastocysts. After biopsying the two embryos and sending them in for preimplantation genetic screening, it was found that one embryo tested normal and the other one has less than 85% chance of harboring abnormality of chromosome 21 (Down syndrome). The plan is to possibly thaw and rebiopsy the embryo with another cycle and send for PGS testing again.
Describe your experience with your nurse at Seattle Reproductive Medicine. (Assigned nurse: Lindsay Craig)
When I first became a patient at Seattle Reproductive Medicine, I was assigned to a fertility coordinator named Sarah Thompson. She was a great coordinator, however, she received a promotion as physician liaison and I was then reassigned a new one. My new coordinator at the time, Lexie Bemis, was great to begin with. However, over time I found myself not getting return phone calls in a timely manner and she was messed up on days with my calendar and I had to correct her myself. I grew especially frustrated when I learned that she wasn't located in Seattle at all and I was unable to meet with her when I came to SRM. It turns out she was actually telecommuting out of her home in Idaho the whole time. Most recently, after my last egg retrieval, I have elected to have a new coordinator. Currently, I have a nurse coordinator, Lindsay Craig, and she is absolutely fantastic. She is compassionate and explains all details to me. Lindsay is really organized and communicates well. I met with her last time at Seattle Reproductive Medicine because Lexie could not be there. I would fully recommend Lindsay as a nurse coordinator to any potential patient. She responds in a timely manner and covers every aspect of your treatment plan.
Describe your experience with Seattle Reproductive Medicine.
Seattle Reproductive Medicine has many strengths. The first one that appealed to me was their success rates. For example, in 2016, the preliminary live birth rate per new patient was 47.5% for a woman my age. After comparing this rate with other clinics, I was convinced that I needed to go here. Also, I live in Alaska and Seattle is only a three hour plane ride. SRM is located in Washington state and have five different locations. Seattle Reproductive Medicine participates in the Regional Access Network (RAN), which is designed to make treatment as easy as possible for patients who are not located in Washington. This is a high strength for me since I do live in Alaska and am able to have tests conducted here. Another huge strength for Seattle Reproductive Medicine is that they also participate in the Attain Fertility program that makes paying for IVF as easy as possible so that the patient can focus on what matters most and the success of the treatment. They offer multi-cycle programs. Furthermore, Seattle Reproductive Medicine has a very unique patient portal. It is easy to access and is a great way to communicate with the fertility team. It is uniquely color-coded so that a patient can decipher between clinical, financial, scheduling, etc. Moreover, a patient can access their treatment schedule, treatment estimate, lab results, document management, request appointments, and pay your bill. Seattle Reproductive Medicine consists of long-tenured fertility experts who are passionate about helping people grow their families. Some of the team members are former fertility patients themselves, which gives them an uniquely compassionate perspective. Another strength that Seattle Reproductive Medicine has is that they use only the most recent technology and methods, which contribute to their high success rates. Finally, As of January 2015, SRM became the largest clinic on the west coast to be recognized as a Center of Nursing Excellence. In regards to weaknesses, I would have to say that having a care coordinator telecommuting from home is not an effective way to communicate with patients. With that being said, I would tell other patients to make sure they find out where their coordinator is actually located.
Describe the costs associated with your care under Paul Dudley at Seattle Reproductive Medicine.
My husband and I are on our second Attain package and have already spent over $30,000. Our upcoming treatment is going to cost $22,000.
Describe Paul Dudley's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Seattle Reproductive Medicine.
Dr. Dudley explained that he would not transfer more than two embryos at time. He did also explain the greater risks of transferring two embryos as opposed to just one. Dr. Dudley explained that any pregnancy has risks, however many risks are greatly increased with twin birth.
What specific things went wrong at Seattle Reproductive Medicine?
- Failed to call with results
- Provided conflicting information