Warning: This post is incredibly detailed with medical jargon you may find coma-inducing.You don’t have to read it all…I bolded the important parts. Mostly I want to solidify its place in the event I can help some poor woman in the future.
In most cases, I love it when something I didn’t understand finally makes itself clear to me. I also love it when I’m right. Not this time.
We just finished the IVF with Shady Grove. We don’t know much yet but I’ll report in when we do. I’m not hopeful since I’ve endured this before, only to have it fail. Having gone through the whole process at Shady Grove and finding it 1000 times better, more professional and easier than the other stimulated IVF we did, I have learned a ton.
My Ob/Gyn, who I love, recommended two years ago we see Dr. Asmar at Washington Fertility. We liked him and felt like he could help us, so we began the IVF process. From the 2nd or 3rd day of the shots I was sick. I could not understand how friends of mine did this 5 and 6 times. When I reached the point where I was homicidal and knew my body could take no more, Dr. Asmar said I needed to do one more day of shots. I was beside myself. I couldn’t believe it. I knew something was wrong with my body, we had already lost faith in them when they lost X’s sperm, when they overcharged us, when they routinely made us wait an hour even though the office was empty, when their two receptionists treated us like crap, but I just knew something was wrong. From what I know now, it appears that I was overstimulated.
When your follicles are overstimulated, you will get tons of eggs, but few of them are viable. There were 15 eggs retrieved from me on Friday, February 5, 2010 at 8:30 a.m. I went home to bed. X came in around mid-afternoon and said, “Good news, 13 of the 15 eggs fertilized!” We were so happy. What we know now from our experience with Shady Grove is that the eggs take about 24 hours to “fertilize.” So a phone call 6 hours later from Washington Fertility stating 13 fertilized eggs was clearly a lie.
That evening, as it started snowing the Great Snowstorm that gave the DC area 3 feet of snow, X and I discussed how wonderful it would be to have enough embryos frozen that we could have a few kids off this one IVF cycle. We lost power that evening, as did most of the metro area. X said to me at 11:00 Friday night, “I hope they didn’t lose power at the lab.” Suddenly our minds went to our 13 little embryos, the little Velvet/X combos and my heart sank. They had told us at Washington Fertility that they planned to stay at the lab all weekend in anticipation of the storm, but as the snow pounded the city, we didn’t hear anything all weekend long. What we know now from our experience with Shady Grove is that you should get a daily phone call after egg retrieval. The day after retrieval they call with a fertilization report. The second day they call to tell you when to expect the embryos will be transferred. For a variety of reasons they determine at this point whether you should transfer the embryos on day 3 or 5 post retrieval. We received no such call from Dr. Asmar’s office at Washington Fertility.
Monday morning, February 8, 2010, the medicine cocktail I was still taking had burned through my esophagus so badly I hadn’t been able to eat all weekend without throwing it back up. Dr. Asmar’s office called to say that “only 7 eggs survived the weekend and only 3 were dividing normally.” Because they weren’t even decent quality, they recommended an immediate transfer. We asked for a delay because of my vomiting issue (I seriously just wanted my fucking body to be normal again) and he said no, this was important to do today as the embryos typically do better inside the mother. What we know now from our experience with Shady Grove is that this transfer should be scheduled the day prior, and you shouldn’t receive a panicky phone call from your allegedly competent doctor telling you to come right away.
When we got to Washington Fertility they showed us a picture of 6 embryos and said that a 4th had “started to divide.” We never did find out why they said 7 embryos on the phone but only showed us 6. What we know now from our experience with Shady Grove is that an egg doesn’t just suddenly start dividing 3 days later. If they are going to arrest development it’s early in the process, and then they don’t keep going. Because we got no phone calls from Friday afternoon with our “fake” fertilization report, until Monday morning’s panicked “you have to come right away,” it’s obvious that these people lied. They were NOT in the lab at all, because if they were, we would have received calls, and not all of those eggs would have died. The lab needs to wash, change fluids, etc, and this probably wasn’t done. It appears they left the embryos to fend for themselves and went home to shovel their driveways.
When you reach the end of your hormone shots, the clinic calls you and tells you to take a “trigger” shot that tells your follicles to release the eggs. Exactly 36 hours later, they have you go in for an egg retrieval. I had 12 follicles this time but some were sluggish. Based on the sizes, I had thought they would have me go another day on shots, and X and I were prepared for a last minute trip to the pharmacy to pick up more. When Shady Grove called with my directive to take the trigger shot I was sort of stunned. Last IVF I was begging for that shot, but this time, I could have easily gone another day. I asked the nurse why. What we know now from our experience with Shady Grove can be summed up by her response: “Well, we watch for the estrogen jump, and as long as it jumps as much the following day, we keep going. When it levels off, your body is going to stop maturing the eggs and you could risk losing the bigger follicles as they will be too old now.” I went back to look at my records from good old Dr. Asmar.
Before I compare estrogen levels, here’s a tidbit of useful information on Estrogen and proper numbers during IVF:
Exact figures are not possible. As a rough guide, however, a level in the range of 150 to 500 pg/ml is generally considered reasonable for the eighth day of a stimulated cycle. An approximate doubling of this level every 48 hours is considered promising, as a sign of continued good follicle development.
Let’s compare Estrogen Levels for both cycles.
Day 5 149
Day 7 489
Day 10 1323
Day 11 3312
Day 12 3458
I didn’t have an appointment on Day 8, but let’s assume I was around 500 just for fun since I was at 489 on Day 7. Following with the guide above, day 10 I should have been 1000; I was 1323. Day 12, had I been 1000, I should have been 2000; I was 3458. That’s 73% higher than I should have been. Those eggs weren’t over-easy, they were scorched. While they don’t provide targets of estrogen because every woman is different, it appears from that example above that if you stimulate for 12 days with shots, the max your estrogen should reach is 2000.
Day 6 189
Day 7 302
Day 9 481
Day 11 1106
Day 12 1380
Day 13 1599
My day 8 estrogen was clearly in the range of 150 – 500 since days 7 and 9 are in that range. It’s safe to assume though that they did it right. I was responding to the meds more slowly, but when the jump from day 9 to 11 was 625 points, then from 11 to 13 it went 493 points, it was time to trigger.
See what happened at Washington Fertility with Dr. Asmar? I was right. I was totally overstimulated, could go no further physically and they should have given me the trigger shot when I asked for it. The jump in estrogen from 1323 to 3312 was the big one, but then the fact it went only another 140 points? Dr. Asmar totally missed the entire window of opportunity and all that pain, torture and money was for nothing because my eggs weren’t viable. Couple that with the fact they weren’t at that lab that weekend, and those embryos didn’t stand a chance. I love being right, but this time it’s heartbreaking.
After my experience at Washington Fertility, I left some reviews on various doctor review sites. Like clockwork, their stupid nurses would come in right after me and leave positive reviews. Except they are soooo stupid because you can tell it’s them writing the reviews based on what they say. On one of the sites they even wrote “Velvet we know who you are and we’ll call your job and tell them you’re crazy.” Um….nice. Except that their English isn’t that proper. Washington Fertility has been on a massive PR parade. They also since redesigned their website and put up testimonials that are clearly fake…just as fake as their fertility reports.
Love it when crooks get outed.
Crossing our fingers for you guys… Good to know all this, by the way. I’ve been on the fence on having kids for just about ever. Now that I’m 40, the chances of having one are getting kind of slim.
Oh lord. I feel for you. I only wish there was more that you could do to get back at them for all of your suffering and disappointment!
I don’t know why I read this whole thing but I did 🙂
This freaking sucks. Have you tried getting your money back from Washington Fertility? These things are NOT cheap, you MUST have some way to recover your expenses when it was clear negligence, no?
Hi Velvet, I’m a blogger from a bye-gone era (circa 2006ish). So happy to see how things have gone for you overall (yay Mr X!!). You must be in the middle of the evil 10-day wait (I know all about it first hand). I hope you find success this round! Best of luck!
Hi 🙂 thanks for helping me out. I am doing the research in choosing the place and our first option to consider was Washington Fertility only cuz its closer but after reading so many negative reviews and your very detailed review 🙂 we gonna pass to next option 🙂 thanks again and I wish you good luck!
I wish i read this review before I considered them for IVF. I used to go to shady grove, and was seeing Dr. Malik. I wasn’t satisfied with them. Their customer service was extremely poor…The doctor was okay, but when Dr. Greenhouse would do my US he’d tell me, you will need to take trigger shot tonight…and only to get another phone call from the Nurse instructing me to hold off the trigger shot per Dr. Malik recommendations. This happened like twice with IUI. after my first failed IUI I was recommended IVF just to avoid the emotional distress of BFN results! are you freaking kidding me??? my insurance was not covering IVF period!!!! so I thought I had it enough!
Dr. Asmar is an old greedy bastard! literally!!!! his NP lacks knowledge.big time. I work in health care …and they made fatal mistakes…can’t interpret lab results, and blindly orders repeat tests for a tiniest little increase in a lab. Was told to do a genetic testing because it’s part of the protocol, and of course she thinks I am dumb when I asked what kind of tests…like she couldn’t even list me the reasons other than just cystic fibrosis, and some muscle dystrophies and said etc….and reassured me it was covered by insurance only to find out, they are dealing with a lab that is out of network with my insurance…and if this latter didn’t contact me to verify that I am willing to proceed with the new estimated cost of the testing–I would have been definitely screwed!!!
All that and I sucked it up…and my husband kept telling me you know too much stuff that’s why you get frustrated by their lack of knowledge and professionalism…I sucked it up, and continued with the process…but them bomb literally exploded the day I was due to pay the fees to get my prescription. I was literally begging for that prescription because I had less than two weeks to order/receive my medications!! and guess what would go wrong at that point? that old Asmar increased the price from 7500 to 9900 the month of my IVF cycle. Mind you, I didn’t take any breaks from day of consultation to starting the IVF cycle. They had the audacity to compare treatment to a gas station. The gas goes up and down in price, or buying a bag of potatoes. I left the office in tears. He refused to honor the quote I was given during my consultation because he wanted to be competitive with Shady grove.
I wasted my time…but I am glad It didn’t work. This shitty business speaks out about Asmar’s character…he’s not a doctor-he’s a butcher at a grocery store.