How was your experience with Serene Srouji at Brigham & Women's Hospital?
It is very important to understand upfront that the doctors work as a team at BWH, which means the doctor you see primarily and discuss your treatment with is NOT the one making decisions as you go through your cycle, and will most likely not be the one doing your egg retrieval, transfer, HSG testing, uterus mapping, etc. I did not realize this until after my second cycle, which would have explained so much if I had known. As such, it's kind of hard to rate any doctor on their medical decisions. I had a very mixed experience with Dr. Srouji. At times she seemed to be on our side, at others she almost seemed mad at us. I was probably not the typical patient-- I didn't go in assuming we would be doing IVF--and that seemed to frustrate her. At age 39 I was sort of clueless about the fertility process and just went because my regular doctor told me to "get checked out" after six months of trying to conceive. The assumption, however, was that you are there to sign up for IVF no matter what, and she seemed really confused about how to handle the fact that I didn't know if I was willing to go that far. She waffled on a few things-- at first she said male factor was such an issue nothing short of ICIS would work, then after my husband had a second test she said it was in the normal range and trying IUI first sounded like a great plan, then when the sperm count was low with the IUI she was almost angry with me and said the sperm count was always low and she only supported trying IUI because she knew I didn't want IVF. One of my biggest complaints is that she really didn't address--or seem to understand--my underlying medical concerns--I have been dealing with PCOS/PMDD/general endocrine issues and rough periods my whole life and wasn't sure how medications would affect me. I did have some REALLY bad side effects from both Clomid and the IVF meds that she neither warned me about, nor seemed to care about when I reported them. I think some mistakes were made during my second cycle but I will never know for sure because she abruptly dropped me as a patient. I don't know if it was Dr. Srouji's fault per se, but overall I would characterize working with BWH as traumatizing.
What's one piece of advice would you give a prospective patient of Serene Srouji at Brigham & Women's Hospital?
If you are not too interested in the details or any sort of individualized care, this might be a better experience (I felt that way at first until things started getting complicated and confusing and I seemed to have more questions the more I learned). It might also be better if you are an IVF veteran and already know the basics.
During treatment, were you treated like a number or a human with Serene Srouji at Brigham & Women's Hospital?
She did not take my individual medical history/concerns about side effects into account at all. She tried one protocol and then a more aggressive one and then pretty much gave up. The practice at BWH seems to have a real culture of not providing a lot of information, medical or process-wise. Dr. Srouji was always very late for appointments--at least 30-45 minutes--even first thing in the morning. I always felt very rushed when in appointments with her and always came out not sure of next steps and with more questions than when I went in.
Describe the protocols Serene Srouji used in your cycles at Brigham & Women's Hospital and their degree of success.
At 39 and 1/2, my AMH was 2.0 and FSH was something like 5.5, but my husband's sperm count and motility was low. So low, in fact, she said nothing short of ICIS would work (long story, but we did try IUI with Clomid first). My first IVF was lower dose antagonist (gonal-f, cetrotide, HCG trigger). Afterward she said my egg maturity rate (6/11) and my estrogen on trigger day (525) were much lower than she'd expect with my numbers so we had to go to an aggressive lupron microflare cycle (lupron, menapur, gonal-f, HCG trigger). My estrogen was MUCH higher (3260), and I had 14 follicles on trigger day, but only 8 eggs were retrieved and only one embryo was frozen on day 1. The embryo had to be frozen because my progesterone was extremely high during stimulation. She said I clearly have "an egg problem" but dropped me as a patient at the same time, so I don't have anymore information than that to work with going forward.
Describe your experience with your nurse at Brigham & Women's Hospital. (Assigned nurse: Holly)
The primary nurse who works with Dr. Srouji, Holly, is AWESOME. I just liked her style when giving results/instructions. She is upbeat but compassionate. My first interaction with her was when my genetic carrier testing came back positive for a fatal disease and she presented that perfectly. She also went WAY above and beyond to help us deal with CVS/Caremark, the most evil prescription drug plan provider imaginable. Unfortunately, some of the other nurses we dealt with when Holly was out were not as helpful at all. When I asked Barbara what happens after the cycle if I don't get pregnant (a medical question and a process question) she said, "we don't like to think about that" and wouldn't go any further. Nurse Marie told me they can't give patients all the information because "most people can't handle it." When I tried to get process information and was getting frustrated that she wouldn't provide it, she said, "I know you're upset because you always imagined you'd be a parent and now it might not happen..." um, no, I'm upset because you won't tell me what I have to do next. The other nurses I spoke with (Tricia and Amanda) seemed nice and helpful.
Describe your experience with Brigham & Women's Hospital.
I think most of the information is provided in my other responses. It's such a mixed bag. Really just don't expect a lot of information sharing-- you won't know why the doctors make the decisions they do and you won't get any process information ahead of time, even big picture stuff that seems like it can be reasonably estimated. If you want any sort individualized treatment I don't think this is the right place. Also, from my internet research it seems like I am far from the first patient they have dropped, so I think it's something you have to be prepared for (I was not). While some people are wonderful, others can be defensive, condescending, or even flat out insulting.
Describe your experience with your monitoring appointments at Brigham & Women's Hospital.
Monitoring is very early in the morning, and they seem to require more monitoring appointments per cycle than a lot of places. It's ok once you get used to it but at the beginning it was super stressful. Leave PLENTY of time in the morning for Boston traffic, parking, etc. The ultrasound and lab techs are very nice.
Describe the costs associated with your care under Serene Srouji at Brigham & Women's Hospital.
It's MA and I have BCBS, so I only paid 10% plus copays for medications (~$200).
Describe Serene Srouji's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Brigham & Women's Hospital.
BWH uses an algorithm to determine the number of embryos to transfer-- you can choose to have fewer transferred but not more than they recommend.
What specific things went wrong at Brigham & Women's Hospital?
- Provided conflicting information
- Failed to convey critical information