How was your experience with Russell Foulk at Utah Fertility Center?
Since I've been there so long, there may be another doctor I would be interested in talking to (Dr. Gertcheff - she works at the same clinic) for a 2nd opinion. She seems to have just a bit more compassion (she had to be the doctor to tell me during an ultrasound that I lost my baby, and she rubbed my arm while I sobbed, very soothing and sympathetically). I still adore Foulk, but have been considering switching to Dr. Gertcheff. I may not though, because of my history with Dr. Foulk and because I think he is great at what he does too. He bounces back between clinics in northern and southern Utah so he isn't always the doctor on hand to help me when I am doing procedures, etc. When he has been there though, he always remembers my husband and me (which is important to me, to feel like a human and not a number). He has tried to help lighten the mood when we are stiff and anxious. He is very realistic about expectations (careful to not get my hopes high when I've had poor quality embryos). He takes time with me when I need it, which I very much appreciate. Infertility has turned me into a very type-A person, where I (likely, to a fault) micromanage my cycle. He doesn't scoff at me for it, but instead works with me to make sure mentally, I am taken care of (since IVF is such a huge undertaking anyway). When I start getting really nutso (because of all the stories online) he is careful to guide me back onto the course and explains that not everything I've read online is accurate. He has let me invite my acupuncturist to appointments and makes space for her when I do transfers. He has been very accommodating. Before I met Dr. Foulk, my husband and I had spent 6 years trying to get pregnant. We had seen several unqualified doctors who made grandiose promises to us, that were unsuccessful. Dr. Foulk was the first person who gave us hope. Not even necessarily hope for babies, but hope for answers. For 6 years I was told there was no reason for my infertility, but after seeing Dr. Foulk, we now have tons of answers as to why I haven't been able to get pregnant (endometriosis stage 4, and MTHFR). I still do not have children, but the answers have provided a massive relief, for which I am very grateful. One of my biggest let-down's with Dr. Foulk was simply that he didn't test me for endometriosis until after my 1st failed IVF with them. I wish that was something we would have done from the start, just because the 1st IVF felt like a bit of a waste. To be fair though, I didn't understand that the severity of my symptoms were abnormal so I didn't explain that well enough to urge for testing. I can't blame him for thinking I didn't need a laparoscopy. Other than that, I am very pleased.
What's one piece of advice would you give a prospective patient of Russell Foulk at Utah Fertility Center?
I'd say to be patient because he has so many clients (all over the state of Utah) and he works in two different clinics so you may not see him often. I would also say that he is very by-the-book with western medicine, so if you're a little on the eastern medicine side of things, he won't discourage you, but he may not see the purpose. I'd also say that you're in great hands, and that all my friends who have seen him (seriously, everyone but me, haha) has ended up pregnant. I'd say, if you explain to him how infertility has impacted other aspects of your life (emotionally, financially, spiritually, etc) he will have a resource to help you. He really, really, knows his stuff.
During treatment, were you treated like a number or a human with Russell Foulk at Utah Fertility Center?
Dr Foulk has let me call him and barrage him with questions. I walk into each consultation with a long list of questions, and he patiently takes the time to review each of my concerns, and give me resources to his answers. I've experienced a lot of loss at Utah Fertility Center, and he has always been very sympathetic and kind.
Describe the protocols Russell Foulk used in your cycles at Utah Fertility Center and their degree of success.
This is long! Here we go.
2014 (6 years into my infertility at this point) = 29 years old
I still have the paperwork. My daily meds are:
Lupron, prenatal, baby aspirin, coq10
Stim meds (10 days): follistim 225, menopur 1 powder
5 days before transfer I start HGH 50 units
Feel so bloated.
10 days of stims, then trigger shot. Egg retrieval 2 days later.
31 eggs retrieved. 26 are mature enough to inseminate with ICSI.
2 grade C (heavily fragmented) blastocysts by day 5 (the rest have arrested). We transfer both.
Use progesterone suppositories after transfer.
10 day beta = 21 HCG ("your number is low but we will be cautiously optimistic!").
Spot and bleed the entire time. I'm instructed to switch to PIO (progesterone in oil) shots (because of the irritation the suppositories are causing to my cervix).
It rises appropriately until 600 and then slowly peaks at 700. At my 6 week ultrasound, we see my uterus contracting, and the blood draw that day comes back at 90. I am told to stop all meds.
We save for a year to do another IVF. Before the next IVF...
Dr. Foulk readdresses the idea of me possibly having endometriosis (because of how many eggs arrested and I was still considered relatively young). I go in for a laparoscopy in 2015 and am told I have stage 4 endo. He removes as much as he can, then puts me on a 3 month treatment of depot lupron to shrink any left over endometriosis.
2016 - 2nd IVF (31 years old)
Protocol: Estrace 2 mg vaginally daily, prenatal, coq10, baby aspirin.
10 days of stims: Follistim increased to 300, menopur 1 powder vial, begin HGH 5 days before egg retrieval
36 eggs retrieved. 23 are mature enough to inseminate with ICSI.
3 grade B embryos make it to blastocyst stage.
We transfer 2, and freeze one.
Go on the strongest dose of PIO to help prevent spotting/bleeding.
Day 10 beta HCG comes in at 5.1. Am told to continue with meds. It climbs up to 114, and then drops to 19.
I get tested for MTHFR - am tested positive for homozygous C667T. Could explain the recurrent miscarriage.
November 2016 - Frozen Embryo (of 1 grade B blastocyst) transfer (am now 32 years old)
Protocol: Prenatal with FOLATE (instead of folic acid), estradiol valerate twice a week, baby aspirin, progesterone in oil 1 ml, after transfer I begin heparin (blood thinner) twice a day.
10 Day beta/HCG blood draw: Negative
No frozen embryos.
Husband and I decide to give IVF one last shot. We want to give it everything we've got. We save for another year. We decide to PGS test the embryos this time.
November 2017 egg retrieval
Protocol: Prenatal with Folate (for MTHFR), coq10, baby aspirin, Follistim increased to twice a day (morning is 300 mg, night is 225), menopur 1 powder vial, HGH begins 5 days before retrieval, dexamethasone (steroid) starts about 9 days before retrieval. It takes a few extra days of stims this time to get my eggs to the right size.
26 eggs retrieved. 22 are at the right size to inseminate with ICSI.
13 Fertilize properly.
All look bad by day 5. But one, shifts and suddenly starts doing better. They call it my FIGHTER baby. One more pulls through. They tell me this one looks pretty bad and give me the option of tossing it. No way. Keep it. Because both my little blastocysts are fragile, I opt out of PGS testing and don't want to damage them. We freeze them while we work on moving out of my in-laws. So in total, I have one grade B blastocyst, and one grade C blastocyst.
April (sigh, one year ago) 2018 - 33 years old
FROZEN TRANSFER FOR BOTH EMBRYOS
They thaw very well.
We transfer both. I begin dexamethasone again to suppress my immunity from possibly kicking the babies out. I also start an immuno-suppressant treatment (where I get hooked up to an IV every other week, to flush my body full of intralipids... another attempt to help me from kicking the babies out). I am on heparin (blood thinner (for MTHFR)), prenatal with folate, and the strongest dose of progesterone in oil that I can get.
Day 10 beta HCG blood draw = 38 (highest I've ever had, but still considered low)
It raises up to 3100 and when I go in for my 6 week ultrasound, I begin bleeding profusely on the table and am told that my baby had died.
My 6 week ultrasound turned into an immediate D&C.
I walked in pregnant and left empty.
My pregnancy tissue is tested and the results come back that I was pregnant with one, chromosomally normal, boy. No frozen embryos. No closer to having a baby than where I was 10 years before.
At this point, I've had 93 eggs retrieved from Utah Fertility Center, 7 embryos that made it to blastocyst stage (4 that were grade B, and 3 that were grade C). I've had 2 fresh transfers, and 2 frozen transfers that resulted in 2 miscarriages, and 1 chemical pregnancy. No babies yet.
2019 (currently 34 years old)
Dr Foulk recommends I do a donor egg cycle. He says with my age, and how well I responded to meds that he thinks my endometriosis is inside my ovaries and has damaged all my eggs. This has been a LONG process of letting go of the babies we've lost, and trying to figure out what the right step going forward is for my husband and me. We're discussing embryo adoption, foster care, adoption, and yes, donor egg. We have been saving since our miscarriage last year for whatever we attempt. My husband will be going through a DNA sperm fragmentation test this summer to ensure his sperm is chromosomally normal (we have no reason to suspect it isn't, all his semenalysis's have been normal) but he doesn't want to proceed with donor egg until we get those results. Assuming the results come back good, then we will begin the process to use a donor for a donor egg IVF cycle and then will attempt to transfer the embryos back into me. Wish us luck!
Describe your experience with your nurse at Utah Fertility Center. (Assigned nurse: Chelsee Young and Danica Gilbert)
Wonderful. I have no complaints. They took the time to reassure me when I was anxious, let me vent, explain and answer questions to me. When I experienced my last miscarriage, every nurse I worked with came into the room to give me a hug and tell me they were sorry. It was such a bitter-sweet moment. They really made me feel cared for. My dreams were there dreams.
Describe your experience with Utah Fertility Center.
The building is beautiful. The staff knows their stuff. The only issue is possibly that they are quite busy (not really their fault though). So, when I recommend people I let them know in advance that you have to practice a lot of patience because you generally have to wait until the end of the day to receive a call back. The staff works their tails off though. Some clinics wrap up everything at 5 and call it quits. I've received calls at 7 pm before because they are still calling patients. They leave no stone unturned before they wrap up for the day.
Describe the costs associated with your care under Russell Foulk at Utah Fertility Center.
One of the reasons I chose Utah Fertility Center over Reproductive Care Center in Utah was because RCC made you choose a package based on a gamble ("You can pay $20k up front for 3 egg retrievals and transfers and if it doesn't work we will refund 80%! But if you get pregnant on your first attempt, we won't refund any... and you'll have paid twice the amount that someone who just pays for one cycle gets..."). Utah Fertility Center didn't want to prey on my emotions and said that with each IVF attempt, they will discount the cycle more and more. By the end I was paying a very inexpensive price (well... for IVF anyway) which was very appreciated. They always gave us free ICSI too.
Describe Russell Foulk's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Utah Fertility Center.
My doctor recommend a single embryo transfer if you are young and the embryo quality is strong. If you are a little older and/or the embryo quality was poor than he recommended transferring more than one (if that was an option). Because of my low embyo quality, we always transferred two.