How was your experience with April Batcheller at CCRM Minneapolis?
Dr. B is very kind and caring about her patients. She is knowledgeable about the various developments and innovations in IVF treatment, and I felt like she allowed us to be part of the decision-making process. When our first FET resulted in chemical pregnancy, we reviewed some unique symptoms I presented with and she listened to my ideas on how to adjust treatment, gave us the scientific reality of those ideas, and we made a joint decision to try an anti-histamine approach. Dr. B also is understanding that since we were paying for everything out-of-pocket, we should skip some tests for the immune theories, and just treat me as though I had tested positive. Overall, even though we still haven't had a successful pregnancy, I feel Dr. B cares for and is passionate about her patients.
My only concern now, is with two failed transfers, she had initially told us she expected a 60% chance of success. My only criticism is that her optimism can be a bit misleading or insensitive. It's nice to have that hope when you first meet and are nervous, anxious, or uneasy about the whole process. But I think I would have rather she not so confidently given us a percentage of success when I asked for it, or tempered her optimism when she said, "Let's talk about your options!" after our first FET resulted in chemical pregnancy. I'm sure in this line of work, you have to be a positive person to stay in it, but a touch more compassion isn't a bad thing either.
What's one piece of advice would you give a prospective patient of April Batcheller at CCRM Minneapolis?
Just know that Dr. B is super positive and optimistic. I think she presented the risks of anti-histamine protocol well, but also dismissed the one birth defect she's seen with the protocol she's done it to something else... so, again, she's very optimistic about what she does. If you are in in a bad place, and need that boost to come back to, she's great. But if you prefer a very realistic and honest assessment, I felt like things were maybe presented a little more positive and confident than I would have liked in hindsight.
During treatment, were you treated like a number or a human with April Batcheller at CCRM Minneapolis?
Dr. B does genuinely know and care about her patients. She had a good understanding of our previous efforts in our initial meeting, and answered all of my questions (and I had a long list of them) without rushing or or being dismissive.
Describe the protocols April Batcheller used in your cycles at CCRM Minneapolis and their degree of success.
Our stim phase was "Luteal Patch (Protocol 3 with Patches)" in CCRM categories. We worked with my natural cycle at my request due to some bad experiences with BCPs. I was instructed to use ovulation kits to catch an LH surge, and then begin cetrotide and patches post-surge. The next cycle, we started stim with Menopur and Follistim on CD2. We upped the Follistim from 150 to 225 on the 4th day of stim since my eggs were going a little slow, and after that, things progressed nicely. After 10 days of stimming, Dr. B cancelled our fresh transfer because my progesterone levels were higher than they wanted. We triggered after 10 days of stimming as well. My US on that day showed at least 8 eggs on each ovary between 17.5 and 20 mm in additional to many smaller eggs. Retrieval was two days after trigger shot. They retrieved 25 eggs, 15 were mature and had ICSI, 11 successfully fertilized, and 7 were frozen for transfer.
For our first FET we used my natural cycle again. Used Lupron to suppress cycle before using patches and endometrium vaginal inserts to build up lining. Had to add 1mL of PIO every other day 4 days before transfer due to low P4 levels. After transferring they upped PIO to 1mL every day due to low P4 levels. My lining grew perfectly, and once it reached 8 mm, they scheduled a transfer for 8 days later. (It’s my understanding CCRM will not transfer if the lining is not at least 8 mm.) Our transfers went perfectly, although, we requested last minute to thaw two embryos for transfer, and one did not survive. They thawed a third one in order to still transfer two. (When I asked at our pre-transfer nurse meeting about embyos not surviving the thaw, a nurse told us she had never heard of that happening at CCRM. If they would have asked us what to do when the first embryo did not survive, I would have told them not to thaw a third one. That was frustrating and I expressed that to Dr. B at our regroup. She said CCRM only has 2% of embryos that fail to survive the thaw.) 9 days after transfer, Beta #1 was over 180 and the nurse indicated a number that high (they like it to be over 50) could mean both embryos implanted. Beta #2 did not double, it was just over 200. No changes in protocol. Beta #3 was in the low 30's, and the cycle was deemed a chemical pregnancy.
One frustrating part was that Dr. B insisted I get a fourth HCG test 4 days after the Beta #3 to confirm the pregnancy was over, even though I had started a heavy period three days after Beta #3. That was both a hassle and frankly, somewhat traumatizing to experience in the aftermath of things. I didn't see any reason I couldn't have waited out the period and tested afterwards to give me time and space to grieve.
After discussing some symptoms I had in FET #1 (two instances of severe nausea, cramping and sweats/fever for 20-30 minutes several days after transfer) we decided to try an anti-histamine protocol in case I was having immunological issues. We also did a long-Lupron cycle due to a previous diagnosis of endometriosis in case that left me with a specific type of cell that can affect implantation.
Our initial attempt at a second FET was cancelled when my lining failed to thicken, even after adding estradiol tabs, and eventually developed fluid in the lining. We induced a period with 2mL of PIO in each hip. I never really got a clear reason why might have caused the fluid, but the nurse said unless it happens again, they sort of chalk it up to a fluke and try again.
FET #2- Natural cycle again, this time with low-dose meds. Instead of steadily increasing from 1 to 4 patches every other day to help grow the lining, we let it grow on its own. My lining grew a little more slowly than they like, but no fluid and it had the trilaminar layers they want to see. Once my lining was an 8 on it’s own, we added 2 patches every other day for the entire transfer, along with endometrium vaginal inserts three times a day.
Anti-histamine protocol was Claritin and Prednisone once a day and Pepcid AC twice a day, beginning 2 days before transfer.
Again, transfer went perfectly, we only did one embryo this time. I also didn't need PIO shots every day and could stick with every other day. However, when I presented the same symptoms of nausea, cramping, and fever/sweats, Dr. B didn't have anything specific to change initially. She did suggest we could up the PIO to every day after the second instance occurred in case the fluctuation of Progesterone was causing the symptoms. I declined since we had been doing PIO every day in our first transfer and I still had the same symptoms. Beta #1 was less than 1 and the cycle failed.
Describe your experience with your nurse at CCRM Minneapolis. (Assigned nurse: Maria)
Initially, we were assigned Maria and she was wonderful, kind, compassionate, and she had great follow-up. One thing that I don't think was communicated to us was that she only did fresh transfers. When we switched to a FET, I started hearing consistently from a new nurse, Andrea. Anrea is also very kind and compassionate, but she was the one who told that she had never heard of embryos not surviving the thaw, and that happened to us. Recently, Maria left CCRM and I've been hearing from Andrea and another nurse, but neither of them had communicated if they were going to be my primary nurse. I will say that all of the nurses are very friendly, kind and knowledgeable. However, IVF is complicated, and you have to pay attention and ask questions not matter what. One failure from the nurse staff with our second FET had me waiting for a transfer calendar until 5 days before my transfer, and only once my transfer was set. I like to have as much information available to me as soon as possible, so that was a little frustrating when a fourth nurse told me I should have gotten it when I started coming in for lining checks.
Describe your experience with CCRM Minneapolis.
CCRM is new and while I think they have worked through some of their growing pains, they still have issue with communication. Specifically, I sometimes don't get a call back when I leave a voicemail first thing in the morning. I've also been routed to a receptionist that is clearly not in MN and can only send messages to nurses and schedule remotely.
On a positive note, the clinic is clean and spacious, and I've repeatedly heard and been told that Dr B is very particular who she hires, and she wants to hire the best. So, even if you wait a little longer for your Ultrasound or blood work, the medical work has always been done well and is incredibly thorough. In particular, the US nurses are a delight. They both have a joy in their work. I prefer Margaret because she is pretty upfront with how things are looking to her.
it's probably true of every clinic, but because I have some issues with getting information, always ask questions and be your own advocate. Dr. B didn't make me feel stupid or annoying when I had a list of questions for our meetings, and I think everyone should do their prep work before sitting down with any RE to make sure you don't get pushed along like a cattle herd.
The CCRM nurses are happy to answer things as well, you just sometimes have to ask them for the information. I would get varying responses back after an US from "everything looks good, stay on course", to "your lining was only a 5, and the eggs are a little small, so we want to give it a few more days..." Just ask them what you want to know, don't expect them to give you a standard set of information.
Describe the costs associated with your care under April Batcheller at CCRM Minneapolis.
Initial consult: $205
Communicable/Vitamin D, TSH: $300
LH Check: $115
Progesterone Check: $115
IVF Costs (Stim appointments and clinic surgery) $13,510.00
Baseline ultrasound and Hysteroscopy: $1,795.00
Regroup (phone) $112.00
FET transfer is in the range of $7,000
Overall, we've spent $24,702 at CCRM with both the consult, stim, retrieval, two transfers, and two re-groups, one in person and one on the phone.
Describe April Batcheller's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at CCRM Minneapolis.
I specifically asked Dr. B about the risks of double embryo transfer a few days before our first transfer. I had to ask, because it was never offered to me. I think CCRM assumes eSET unless they are told otherwise.
Dr. B said for our situation, if we transferred two, we had a 65% chance of twins. She explained there is a slight increase in HBP and Diabetes risks, but those exist anyway. The bigger risk is a 25% chance of pre-term labor and bed rest for some portion of pregnancy. However, Dr. B was comfortable with doing 2 for us.