Thursday, 7 January 2010


The first time I went to the US, I had been working in China for 18 months. It was the early 90s - before the big cities started to have Western supermarkets and stock Western goods in a lot of places. You could only get cheese in Beijing - there was only one type available, and the excitement when we had visitors from Beijing and they would bring a block of standard Beijing cheese with them was huge. Deodorant had to be sent from England, and even if Cadbury's chocolate had been available locally, my volunteer's salary wouldn't have been enough to allow me to buy it.

I went straight from there to the US, and the biggest feeling I remember on my first trip to Walmart is of bewilderment. There were such riches in there - you'd have something on your shopping list and not only would you be able to find it, but you had a choice of several different brands. The choice paralysed me - I wasn't familiar with these American brands, and I just didn't know which one to pick. I ogled and admired, and then I left the shop with empty hands.

I'm facing the same problem now.

When we first realised we might have a problem, I discovered that there was a hospital five miles from our home which offered fertility treatment. It was the natural choice, and the only one we could get to without travelling for at least an hour each way. When I realised how intensive the treatment was, and how many visits to the clinic would be needed, I was grateful that it was so close.

After Mr No Nonsense was so dismissive of our chances at the follow-up appointment after our first IVF, I wondered if we might be better off going somewhere else. But there was nowhere else nearby, and proximity and the fear of the unknown won out over the thought of having to juggle travelling for a couple of hours a day during treatment with working full time and everything else. Plus, although Mr No Nonsense was a little brusque, Nurse Perfect was, well, perfect, and I was happy to stay with her and the other staff, all of whom knew my name and treated me with friendliness and consideration.

Now we're looking at it again. I've come round to the idea that if we chose somewhere near where we both work, we wouldn't have so much added travelling time, because I could just nip in there on the way to work.

And this is where our problem begins - because halfway between my office and DH's office, and about five to ten minutes' walk from both, is Harley Street. And Harley Street is stuffed with fertility clinics. So suddenly I'm that 23-year-old in Walmart again, bewildered and dithering.

Do we go to the chap who specialises in couples who've had failed treatments elsewhere, who gets the best results in the country and who gives you a blood test every day during treatment (including Saturday and Sunday - eurgh, more travelling into London) and adjusts your medication according to what it shows? But he's also the most expensive in the country, and I've read a number of complaints about the impersonal way patients are shuffled through the waiting-room and the fact that they're often seen up to two hours after their appointment time - which would negate the advantage of being near the office.

Or do we go to the chap who used to work with that one and has now set up on his own? He uses similar methods, has studied under the master, but is less well-known and so less busy (and less successful).

Or do we go to the clinic that's attached to one of the famous teaching hospitals, where the daughter of one of my colleagues had a successful treatment last year? That may not be possible, because I've heard that they have quite a low cut-off limit for FSH levels, and mine is probably above that.

Or do we try the one which offers a deal on three treatments for the price of two? We did say we'd try three times in total, and this will be our third attempt. Can I cope physically and psychologically with another three attempts?

Or do we go to the one which specialises in treating older women with gentle IVF, where they use lower doses of the stimulating drugs and aim for fewer eggs but higher quality? Fewer eggs than I had on my last cycle would mean one mature egg - that really would be putting all my eggs in one basket, but if the quality was better...?

Or do we choose one of the others that I haven't even looked into yet - but maybe I should, because one of them might be the perfect one?

I think I'll be happier once we've made a decision - in reality, that means once I've made a decision and then explained my reasoning to DH, because he takes no part in all of this research, however much I try to get him interested - and presenting him with all these options would just upset and confuse him.

But who's to say I'm not upset and confused too...?


  1. I know exactly how you feel and completely understand the comparison to going to Walmart for the very first time. I did the exact same thing when going out to by flour, stared in bewilderment at the wall of different types and brands of flour and came home empty-handed :)
    Sorry I can't help you with your decision on a new RE, but I would probably go with the one with highest success rates...

    Good luck!

  2. I never really thought what it might be like to go to a Wal-Mart for the first time. I am very used to that (well, in Texas where I grew up I went a lot, but near me now those are much less common). I guess it would be rather overwhelming. I DO remember my first trip to a Slovak grocery store as a teenager and wondering why I had no choices at all -- kind of the opposite situation, I suppose.

    You have a difficult decision to make, but you have already made a HUGE step by deciding to go to a new clinic. I really believe that was the right choice. I would also rank convenience fairly low on the scale, too. You are going to try this for one cycle -- it will be draining, stressful, and trying. Yes, the travel/time commitment will make it worse, but it sounds like the actual travel time won't be insane (like my commute to NYC was) so it's just missing work or sitting in a waiting room for a long time. These things are stressful, but do you want to put yourself through IVF at all if you don't have the best shot at success? That was how I tried to look at it through all the crazy train rides, hotel stays, and impersonal/rude doctors. I think high-volume clinics are often impersonal, partly because you don't see the same doctor/nurse every time since they're open 24/7 and partly because there's so many people that it's run more like a business. I truly disliked that but if it worked I didn't care how cold they were.

    Take some time to carefully consider each option in detail. Ask them if they'd be willing to let you get your blood draws with Nurse Perfect sometimes. I'd be happy to help via email if you can't talk with DH about it and want to bounce some ideas off someone.

    You CAN do this, and I am confident you will pick the perfect clinic with some time and a little digging.

  3. Hi Hon, I can totally understand that dilemma (and like your analogy!). I know it was different becuase we had not had previous attempts, but we had a clinic with low success rates on our doorstep, a clinic with a bit of a commute with a cons we had already met for investigations, one near my work who never got back to me, and London (and the many many clinics there). It feels like an impossible decision at first, but you will get there. I was advised to phone the clinics and visit your favourite ones. Pretty soon after doing that we'd made our mind up. We had a long commute to our clinic and actually the travel was probably the most intrusive inconvenient thing about IVF for me, but it was worth it for high success rates and feeling confident in the care we received. I don't know if this is on your shortlist, but I'd highly rec the Lister and they have a lot of success with poor responders and older women....defo worth a look, some of the top rates in the country. There is a thread on fertility friends which really helped me out loads. Good luck with your decision xx

  4. Wow. That is a lot of choices. We had two within 30-40 minutes of our house, and 2 others within 1.5-2 hours. Ultimately, the choice was very easy, and we're thrilled with our choice (despite our current circumstances, which has nothing to do with them). I would have gone crazy had we more choices than that. Feeling your pain.

    The upside is, too many options is better than no options, yes?

    Finally, in terms of DH, PB was the same way. However, we talked about the why's and he explained to me that as long as there was one expert in our family (me) he felt we were headed in the right direction. He also argued that, ultimately, it was I going through the treatments, so I should be the one to choose. We make joint decisions about embryos, etc. but he really leaves the ball in my court. The ball is pretty heavy sometimes, but the reality is, I wouldn't feel comfy handing it off to him...loss of control thing.

    Has DH explained why he doesn't get more involved?

  5. I think you're doing a brave and excellent thing by trying a new clinic. IVF is horrendously expensive and the goal is to get a baby, right? The goal is not to go to the most convenient or cheapest RE just for fun.... WE WANT A BABY. I hope I don't come accross as being pushy, but if it were me I'd go for the first option. Yes he might be more expensive, but holy moly, everything is expensive and whats a few more thousands on top of it all? It's better than going to a 'cheaper' RE who doesn't have the speciality to deal with your situation, and that could end up being more expensive in the long run if you get another failure because of it. Of course there are no guarantees, we both know that, but you are far enough into this game to know that you are special (this is what my current clinic call me.. in other words it means "difficult patient") and so you need to go to someone who is used to dealing with special people like you!
    Like the others have said, its a fabulous that you have a choice so think of yourself as a future employer and the clinic as your employees.. go 'interview' them and find out which ones suit you best.
    My current clinic is located 5.5 hours drive from where I live and the other clinic i'm looking at going to is way up the other end of the country (mind you, our country is tiny!) and i'd have to fly there as it's too far to drive. Yes it's an inconvenience, but I figure that the 3 failed IVFs are even more so inconvenient, and i'll do ANYTHING to avoid that feeling again. As far as I'm concerned if it costs more and means I have to take extra time off then I don't care. I'm in this journey to get a baby and if that means I have to travel a bit further then I don't see that as a major hurdle. But I know everyone is different, and maybe you're not as bloody minded as me!! I'm sure you'll find the right option for you! x

  6. Thanks so much for all your comments. I think you're right - I probably will end up going with the impersonal, high volume clinic which doesn't stick to appointment times but does get good results (assuming they'll take me, as I think they also have a cut-off for FSH levels).

    TBD, I have the Lister at the back of my mind as an option, but it's not one of those I listed out here. I thought it was near London Bridge, but the website says Chelsea Bridge Road - is that where you went? That's a REALLY awkward place to get to, either by public transport or by car.

    Myndi, I think my DH feels the same as PB. He doesn't feel comfortable weighing up different options and would much rather be presented with the results of all the research and told what we're doing. That's fine as long as he doesn't then reject it out of hand without listening to the arguments for and against and seriously considering it, which is what he did with adoption at first.

  7. Hiya, yes it's on chelsea bridge road. I didn't find it too bad to get to. You can wlak from victoria station or another tube station which I've forgotten now. And you can drive there without entering the congestion charge and park just over the bridge (which is what we usually did). But I guess it depends where you work. As I had to travel 2 hours to get to London it didn't make much difference to me! The travel aspect was a real pain but I'm really glad we went for the Lister. I would seriously consider it as they do have one or two consultants who are particualrly specialist with poor responders and also seem to often treat immune issues with these patients as well.
    I agree with the others, it is very brave of you to think about changing clinics hon.
    Love TBD
    ps. you are not mad for SS even though there's little chance....we all do it!!

  8. BTW, just remembered, Lister has a satellite clinic at London Bridge and also others around the country. Hope I don't seem like I'm trying to sell it to you, just trying to give you info that may be helpful! I think you have to go with whatever feels right for you and your husband x

  9. Thanks TBD - it's useful to know about the satellite clinics. I'll keep it in mind in case the other one doesn't work out... x