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11-12-2012 at 7:53 AM
MrsRedVelv...
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MrsRedVelvet is not online. Last active: 04-29-2013, 9:45 AMBronze

When to seek a 2nd opinion...(long)

I'm contemplating seeking a second opinion but DH thinks we should try one more cycle at my current REs.

Some background, first IVF was an IUI to IVF conversion (antagonist protocol) and of the 7 embryos we had, only 1 made it it transfer and it was a BFN.

The second IVF we tried antagonist again and though I had 23 follicles, my E2 level after 10 days of stims was only ~800 so I voluntarily cancelled that cycle rather than have a disappointing ER and ET.

We just tested my AMH and my level was 1.2 however at 31 years old this is quite low considering my age.

RE wants to proceed with a long-lupron protocol for the next IVF; he thinks due to my past 2 performances that I may have an egg quality issue and we should change up the protocol.  Even though my practice has about 10 docs and they all reviewed my case at their weekly meeting, I can't help but think maybe I should seek a fresh pair of eyes.  Cornell has a satellite office by my work so I'm thinking of pursuing them for a consult.

Would love to hear others opinions and experiences on this, especially those that have not been successful with IVF#1.  Just kinda feeeling bummed recently...thanks for reading, enjoy the cupcake ;)
My Chart Anniversary Unexplained IF || TTC #1 On and off since July 2010 || IUI#1 = BFN || IUI#2 = BFN || IUI#3 = Cx, overstimulated || IUI#3.1 = Converted to IVF || IVF#1 = BFN || IVF#2 = Cancelled due to low E2 || IVF#2.1 coming Nov/Dec 2012 
11-12-2012 at 8:08 AM
firesiren
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firesiren is not online. Last active: 06-18-2013, 9:42 PMBronze
A second opinion can never hurt.  Maybe there's something your RE is missing.  I did a second opinion and was so glad I did.  Good Luck to you!
Me; 35 DH 32 TTC for over 2 years First mini-IVF Sept 2011... Only 1 egg! ... BFN Switching RE IVF#2 May 2012 9 eggs and only 2 sperm, WTH! BFN IVF#3 Chemical... FML. 2 frosties. SAIF/PAIF ALWAYS WELCOME!!!!!
My Idle Oven Blog!
*~God gives his hardest battles to his toughest solders. Unknown.
 
11-12-2012 at 8:11 AM
kflynn81
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kflynn81 is online. Last active: 06-19-2013, 1:33 AMBronze

Like your RE, after my first cancelled IVF, mine met with the other 7 doctors about my case as well and decided to put me on the MDL for my next attempt.(microdose Lupron). That worked so much better and I was able to get to ER and ET....BFN but I made it that far. I'm currently going in for ET #2, with an even better % of fertilization this round so FX.

As for getting a second opinion, it could never hurt, however if I were in your shoes I'd probably hold off another cycle since they're changing your protocol and just see what happens. Plus, although the AMH is low, I've seen stories around here of women getting pregnant with much lower AMH.

GL!
Anniversary
Me(31): Some sort of endocrine malfunction that even the major Chicago hospitals can't diagnose. Yay me!!
I also have Factor V Leiden...yay me again!
DH (31): Borderline low morph, but not considered a problem
"Baby dancing" with no protection or BCP since July 2009
IF testing started March 2011
Endocrinology related tests from October 2011-February 2012
March 2012--Clomid --No response-Straight to injects!
April & May 2012-- IUI#1 & #2 = BFN
July 2012- IVF#1 cancelled
September 2012-IVF#1.2--BFN
November 2012- IVF #2 --BFN
January 2013- IVF #3-- BFFN
February 2013--June 2013 Back to the Endocrinologist for more diagnostic testing
IVF #4 --June 2013
PAIF/SAIF encouraged...give me some hope!!
For detailed cycle info. see right side of blog... Kate's IF Blog
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11-12-2012 at 8:33 AM
MandaS08
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I think if you're questioning it, I would get a second opinion.  It doesn't mean you have to move for your next IVF cycle, but it can't hurt to have another opinion, and should at least give you some peace of mind moving forward.

TTC since 5/2010
DX with Diminished Ovarian Reserve
AMH of 1.1 - 7/2011; AMH of .29 7/2012; AMH of .42 8/2012
BFP 9/1/10-M/C confirmed 9/8/10-Methotrexate 10/6/10
IUI #1 (w/clomid)-9/5/11-BFN
IUI #2 (w/clomid)-10/5/11 - BFP
11/1/12-No sac seen; 11/2/11 and 11/9/11-Methotrexate
IVF #1- ER 2/2; ET 2/5; Two 8 cell embryos transfered Beta 2/16 = 5 = BFFN
Surprise BFP - 5/7/12
U/S on 6/8/12 - H/B at 128 BPM; U/S on 6/14/12 @ 9wks-No H/B-D&C on 6/17/12
Baby Bean-We miss you
IVF 2.0- ER 10/17; ET 10/20
One 12 cell, one 10 cell and one 8 cell embryo transfered
BFP! Beta #1 650; Beta #2 1200; Beta #3 5700
11/16/12 U/S- Two nuggets with perfect heartbeats! BabyFruit Ticker
My Blog- http://waitingonaangel.wordpress.com/
 
11-12-2012 at 9:01 AM
BzeetyD
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BzeetyD is not online. Last active: 06-18-2013, 10:13 PMSilver

MandaS08:
I think if you're questioning it, I would get a second opinion.  It doesn't mean you have to move for your next IVF cycle, but it can't hurt to have another opinion, and should at least give you some peace of mind moving forward.

I agree with this. 

Also I would say you've done about 1.5 IVFs and that makes a big difference than just 1. Going through stims twice can be useful information moving forward.

I've got egg quality issues too and it's a very tough nut to crack but Corn.ell is a very good clinic from what I've heard and is highly respected. A 2nd opinion from them should be weighed heavily.

Most guys are 1 or more steps behind in this process, so it's not surprising that your DH is still very hopeful with your current clinic. Mister D keeps saying he's going to "knock me up naturally in December" - gotta love his optimism!

 
BzeetyD = 37, Mr. BzeetyD = 43 together 12/02 married 9/08
TTC #1 since 1/10
DX: Unexplained/MFI issues

Our lil' lost sparks:
5w3d loss 7/30/10 - EDD March 2011
8w loss 4/15/11 - EDD November 2011
8w3d loss 8/2/12 - EDD March 2012
4w c/p loss 10/29/12 - EDD July 2012

Long story: trying on our own + testing testing testing with 6 rounds of Clomid, more testing, injectables + TI, laparoscopy - one tube blocked, 2 IUIs with Follistim...BFNs.
RPL testing all normal, Karyotyping normal

Moving on to IVF.

IVF #1 April 2012 = BFN, IVF #2 June 2012 = BFP. U/S 7/23 = saw heartbeat but measuring behind. Follow up U/S on 7/30 - no heartbeat. D&C 8/2. Trisomy 12. IVF #3 Oct 2012 = Chemical Pregnancy

Phone consult with CCRM on 12/12/12 - ODWU 1/4/13 - both tubes clear(!) - AFC 24, AMH 3.2, FSH 9.6, LH 5.4, E2 25. DH has high frag rate but improved!
IVF #4 March 2013 CCRM. EP protocol w/ Menopur, Gonal-F & Dexamethasone. ER 3/29 & IMSI, PICSI. 43R 13M 10F 6blasts bio'd. CCS testing reveals 3 normals!!!
FET 5/31/13 of 1 4AA blast - thawed and expanded. 4dp5dt BFP.
Beta 9dp5dt = 181, 11dp5dt = 427




"I'm not telling you it's going to be easy, I'm telling you it's going to be worth it."

Everybody is welcome!!!  
11-12-2012 at 9:17 AM
MrsRedVelv...
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Joined on 01-19-2010
NY
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MrsRedVelvet is not online. Last active: 04-29-2013, 9:45 AMBronze
BzeetyD:

MandaS08:
I think if you're questioning it, I would get a second opinion.  It doesn't mean you have to move for your next IVF cycle, but it can't hurt to have another opinion, and should at least give you some peace of mind moving forward.

I agree with this. 

Also I would say you've done about 1.5 IVFs and that makes a big difference than just 1. Going through stims twice can be useful information moving forward.

I've got egg quality issues too and it's a very tough nut to crack but Corn.ell is a very good clinic from what I've heard and is highly respected. A 2nd opinion from them should be weighed heavily.

Most guys are 1 or more steps behind in this process, so it's not surprising that your DH is still very hopeful with your current clinic. Mister D keeps saying he's going to "knock me up naturally in December" - gotta love his optimism!

 

One can hope, right??  I'm thinking that a second opinion may be helpful while I'm waiting to start IVF 2.1.  Since I won't start stimming until at least the end of Dec, I may as well use this time to see what else can be offered.  Just the fact that they are Cornell is mighty tempting.

Now comes the awkward process of requesting medical records...geez, this is almost as bad as breaking up with your hairdresser if it gets to that point.
My Chart Anniversary Unexplained IF || TTC #1 On and off since July 2010 || IUI#1 = BFN || IUI#2 = BFN || IUI#3 = Cx, overstimulated || IUI#3.1 = Converted to IVF || IVF#1 = BFN || IVF#2 = Cancelled due to low E2 || IVF#2.1 coming Nov/Dec 2012 
11-12-2012 at 9:31 AM
arbutusbri...
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Joined on 04-02-2004
the OC
426 Posts
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arbutusbride is not online. Last active: 06-18-2013, 10:58 PMNewbie
When I requested my records, I just told them it was for my regular OB/GYN who wanted to be kept in the loop. (Which is true. I made a second copy myself.) Can you pick them up instead of having them mailed? That may make it a little less awkward.  
We have moved on after IF treatments to domestic infant adoption. While we wait my dog is my surrogate baby. Bumping from Portland, OR.  
11-12-2012 at 10:40 AM
MsGMChick
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Joined on 01-27-2009
VA
3,874 Posts
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MsGMChick is not online. Last active: 04-21-2013, 8:40 AMSilver

Second opinions are always a good idea, especially if you're feeling like you need one. Either you find someone new you love! Or you find out you really did like your current RE's plan. 

Also, (I'm not an RE so take this with a gain of salt)... An AMH of 1.2 is still good! Even at 31. Anything over 1 is considered good. There's a chart here from Advanced Fertility and a lot of great info.  http://www.advancedfertility.com/amh-fertility-test.htm

Good luck! 
. .
|| 3 years TTC, 2 M/Cs 4 failed IUIs, 1 failed IVF...
and we're moving on! Domestic Infant Adoption ||


He who has a why to live, can bear almost any how... 
11-12-2012 at 11:32 AM
baker916
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baker916 is not online. Last active: 06-18-2013, 5:46 PMBronze
MsGMChick:

Second opinions are always a good idea, especially if you're feeling like you need one. Either you find someone new you love! Or you find out you really did like your current RE's plan. 

Also, (I'm not an RE so take this with a gain of salt)... An AMH of 1.2 is still good! Even at 31. Anything over 1 is considered good. There's a chart here from Advanced Fertility and a lot of great info.  http://www.advancedfertility.com/amh-fertility-test.htm

Good luck! 

I agree with all of the above.  My Re also told me an AMH above 1 is considered "normal."  Good luck!  
TTC #1 7/10, Me (31)- Dx DOR (AMH 0.6); DH (30)- normal
BFP on Cycle #8. Natural M/C at ~8 weeks
IUI #1 and #2 (8/12, 9/12)- 50 mg Clomid + Ovidrel = BFNs
IVF #1 (EPP) 13R/10M/9F, 5DT 1-4AA blast, beta #1-148, beta #2-322, 5 frosties!
3/18/13 - It's a Girl!
4/18/13 - A/S- baby looks perfect, but partial placenta previa
6/10/13 - Partial PP not resolved. :-( Likely scheduling c-section for 36 weeks
Lilypie Maternity tickers 
11-12-2012 at 12:15 PM
ksfrye
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Joined on 02-27-2007
Peoria, Arizona
753 Posts
3,230 Points
ksfrye is not online. Last active: 06-18-2013, 2:08 PMBronze
I would highly suggest getting a 2nd opinion.  Many RE office will do a free 2nd opinion consult.  I'm currently on my 4th RE and finally feel like I've found "the one".  Another RE might have a fresh idea of what protocol to take.  GL!
Happily married Since May 2008. TTC#1 Since May 2010.
Me: 29, Mild DOR
DH: 31, SE mostly normal, 1st SE morph 5%, 2nd SE morph 15%...yeah!.
BFP July 2011, Natural MC August 2011.
3 cycles of 50mg Clomid = BFN
*New RE* Feb/Mar 2012 100 mg Clomid + Trigger + IUI = BFN
*3rd RE* April-June -Break Cycles begin prep for IVF by doing 2 Heparin injects daily....fun fun!
IVF #1 - ER 7/19, ET 7/24, 2 beautiful embies transferred. Beta 8/2 = BFN
*New RE...yes again* FET Nov 2012 with our lone ranger = BFFN
RE Suggests Trying IUI Again, Jan. 2013 IUI #2 =BFN
Feb. 2013 IUI #3 = BFP!!!, Beta #1 (15dpIUI) = 90, Beta #2 (17dpIUI) = 210, U/S Scheduled for 3/18
BabyFruit Ticker 
11-12-2012 at 12:51 PM
MrsRedVelv...
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NY
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MrsRedVelvet is not online. Last active: 04-29-2013, 9:45 AMBronze
baker916:
MsGMChick:

Second opinions are always a good idea, especially if you're feeling like you need one. Either you find someone new you love! Or you find out you really did like your current RE's plan. 

Also, (I'm not an RE so take this with a gain of salt)... An AMH of 1.2 is still good! Even at 31. Anything over 1 is considered good. There's a chart here from Advanced Fertility and a lot of great info.  http://www.advancedfertility.com/amh-fertility-test.htm

Good luck! 

Thanks for the reply :)  My RE did relay that although the value "1.2" is within the normal reference ranges, for someone at 31 my value is typically seen at about a 3.  So compared to other healthy normals in my age group, I'm low :(

I agree with all of the above.  My Re also told me an AMH above 1 is considered "normal."  Good luck!  
My Chart Anniversary Unexplained IF || TTC #1 On and off since July 2010 || IUI#1 = BFN || IUI#2 = BFN || IUI#3 = Cx, overstimulated || IUI#3.1 = Converted to IVF || IVF#1 = BFN || IVF#2 = Cancelled due to low E2 || IVF#2.1 coming Nov/Dec 2012 
11-12-2012 at 3:10 PM
cupcake201
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cupcake201 is not online. Last active: 06-16-2013, 7:59 PMBronze

I am in a similar situation and just recently had a second opinion appt and switched REs. 

For IVF #1 we did a long lupron protocol and it seems I was over suppressed.  My E2 rose very slowly and they ended up getting 7 eggs, although only 3 were mature.  All 3 fertilized, and 2 made it to freeze although they were not great quality.  We did not do an ET because we have to do PGD and wanted to do another cycle and get more embryos to test since the cost of PGD is high and they will test up to 8 embryos for that cost.

I am 30 and my AMH is 1.17- I had asked my RE about it and he said it was fine.  I felt given my age it was low, but went with what he said.  For our next cycle I felt he wasn't being aggressive enough and sought a second opinion.  The new RE is more aggressive and said that while my AMH is considered normal (above 1 is normal), that it is right on the edge and that for my age, it is low.  I felt 100% more comfortable with this RE than I do with my previous one, and I am so happy I got a second opinion.  (He is doing an antagonist protocol with estrogen priming for IVF #2). 

IVF is so hard because you really have no control over the situation, so I think it is really important that you completely trust the RE you are working with.  Initially I was kind of feeling "should I get a second opinion? And am I just doing this because our cycle failed?" I think that it is normal to kind of feel that way.  I also know that if we did stick with our RE for IVF#2 and had similar issues, I would be kicking myself for not getting a second opinion.  I sort of already feel like we "wasted time" with our first RE, and do not want to feel that way again.

I totally agree with PPs about getting a second opinion.  I felt so much better after ours and feel excited about moving forward with a doctor I am comfortable with and confident in.

As far as requesting records or letting them know you are switching - they see it all the time.  I was open with my RE and told him I was going to be seeking a second opinion because I just was not 100% comfortable moving forward at this time.  

Phew, this was long! Good luck with whatever you decide, and keep us posted!   
Image and video hosting by TinyPic

TTC#1 since 4/11 : m/c in 9/11 & 11/11
DH dx with Balanced Translocation 5/12
10/12 IVF#1-7R, 3M, 3F- No transfer - Froze 2.
IVF#2 1/13 - 11R, 10M, 6F, no transfer
IVF#3 4/13 - 8R, 6M, 6F, 1 passed PGD and was transfered 5/2/13
S/PAIF Welcome
 
11-12-2012 at 6:43 PM
MrsRedVelv...
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Joined on 01-19-2010
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MrsRedVelvet is not online. Last active: 04-29-2013, 9:45 AMBronze
cupcake201:

I am in a similar situation and just recently had a second opinion appt and switched REs. 

For IVF #1 we did a long lupron protocol and it seems I was over suppressed.  My E2 rose very slowly and they ended up getting 7 eggs, although only 3 were mature.  All 3 fertilized, and 2 made it to freeze although they were not great quality.  We did not do an ET because we have to do PGD and wanted to do another cycle and get more embryos to test since the cost of PGD is high and they will test up to 8 embryos for that cost.

I am 30 and my AMH is 1.17- I had asked my RE about it and he said it was fine.  I felt given my age it was low, but went with what he said.  For our next cycle I felt he wasn't being aggressive enough and sought a second opinion.  The new RE is more aggressive and said that while my AMH is considered normal (above 1 is normal), that it is right on the edge and that for my age, it is low.  I felt 100% more comfortable with this RE than I do with my previous one, and I am so happy I got a second opinion.  (He is doing an antagonist protocol with estrogen priming for IVF #2). 

IVF is so hard because you really have no control over the situation, so I think it is really important that you completely trust the RE you are working with.  Initially I was kind of feeling "should I get a second opinion? And am I just doing this because our cycle failed?" I think that it is normal to kind of feel that way.  I also know that if we did stick with our RE for IVF#2 and had similar issues, I would be kicking myself for not getting a second opinion.  I sort of already feel like we "wasted time" with our first RE, and do not want to feel that way again.

I totally agree with PPs about getting a second opinion.  I felt so much better after ours and feel excited about moving forward with a doctor I am comfortable with and confident in.

As far as requesting records or letting them know you are switching - they see it all the time.  I was open with my RE and told him I was going to be seeking a second opinion because I just was not 100% comfortable moving forward at this time.  

Phew, this was long! Good luck with whatever you decide, and keep us posted!   

Thanks so much for your input; I did the opposite of you where I did antagonist first and am now doing long lupron (but I fear I may be oversuppressed).  I asked my current RE about this and because of my response to antagonist he felt we had to change protocols; I'm just not 100% confident it's the right protocol.

I will likely go through IVF#2(2.5?) with my current RE but will get my second opinion in parallel.

Good luck with your next round moving forward :)

My Chart Anniversary Unexplained IF || TTC #1 On and off since July 2010 || IUI#1 = BFN || IUI#2 = BFN || IUI#3 = Cx, overstimulated || IUI#3.1 = Converted to IVF || IVF#1 = BFN || IVF#2 = Cancelled due to low E2 || IVF#2.1 coming Nov/Dec 2012 
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