Fertility specialists in the east bay, ambivalance

hi everyone, i have been working with dr. chetkowsky for about 4 months now and am starting to consider switching to dr. hinckley because i think i'd be more comfortable with someone with a better bedside manner. the main thing holding me back is the longer commute (i live in albany and i have a 3 yr. old). do any of you have had any experience with either one of them and could say--''it's definitely worth the commute, or not''. any advice would be appreciated, i'm feeling pretty down about the whole process at this point. i'm 38 and we've been trying for 2 years on our own. with dr. c we've done 3 rounds of clomid/iui so far and i'm seriously thinking of switching to ivf sooner rather than later just cause each month when i find out i'm not pregnant i'm more and more devastated, not sure how many more of those i can take. oh, and i'll add just in case any of you have any experience with this--another challenge for me is that my 3 year old is a real handful, and so i sometimes question if i really even want a second or not, mostly i wonder if i could handle it...but then i really want him to have a sibling so i just feel deeply conflicted about the whole thing. if anyone else has been in this situation i'd love to hear about what helped, if anything thanks so much

I did get pregnant via stimulated IUI with injectables, but unfortunately had a few early losses. Dr. Chet cared for me and did the surgeries. I trusted him completely and always felt I was in the good hands of a very experienced doctor.

My final success story was due to IVF, which I did at age 42. It was a tough decision financially and emotionally to advance to such measures, but Dr. Chet provided honest guidance about my declining odds, without pressuring me. I have great respect for him because of this.

While I agree that his demeanor is different and not touchy-feely, I sensed his caring and concern in a different ways. He scheduled my IVF procedure on the July 4th holiday which fell on a Saturday. I was surprised that he would be working that day, but he said time was of the essence.

I also felt very comfortable with his nurses and staff who were personable in the conventional ways he might not have been. They were always accommodating to my schedule and I was able to get last minute appointments easily.

As I now have the child I had wanted for so long, I definitely feel it was all worth it, and I would do it again in a heartbeat. Dr. Chet was the right doctor for me and what I needed, and he lead me to a successful outcome. I hope some of my experience can be helpful in the decisions you will be facing. Best of luck to you. -Fellow Dr. Chet patient

First, travel: We mostly went to her Orinda office, but occasionally went to the San Ramon office for special procedures or weekend measurements. It's certainly not super convenient, but it was doable. Frequently for weekday visits I would just Bart there and back to avoid traffic. It's an easy walk from the station... Maybe 5-10 minutes.

Second, they take this very seriously and don't mess around. Granted we didn't start seeing her until 9 months of difficulty (2 early miscarriages, then nothing for several months) by which point I was already 39. We bypassed clomid altogether to do a couple of rounds of injectibles with IUI; she encouraged me to use use an acupuncturist to supplement however needed. While we did get pregnant, we had a miscarriage at 12 weeks due to Turner's syndrome. She let us grieve without pressure for a couple of months, and when we returned she encouraged us to consider IVF (with the option to do genetic testing on the embryos). Sadly, we discovered my egg quality was just really poor. When we reached this point (I was 41) she again laid out our options and encouraged us to consider alternative routes rather than continuing to pursue more IVFs with my eggs. I'm happy to say we're 30 weeks pregnant with a donor egg from a single round of IVF. I've not always been in love with the various staffers at RSC, but I've never questioned my respect for Dr. Hinckley. She does an amazing job of balancing all the contradictory emotions involved in the infertility process: compassion and sympathy/ hope and encouragement, urgency and moving forward/ reflecting and caution, reason and logic/ irrational desires.

Best of wishes as you make your choices. Should you decide to seek out Dr. Hinckley, I trust she will help you navigate this often tortuous and torturous path. Robin

I will tell you my story and then some thoughts on the bedside manner issue. I saw Dr. C because I had plans to do IVF with PGD due to genetic issues. During my workup for the IVF, he discovered that I have a fertility issue with my uterine lining not developing adequately (in addition to my genetic concerns). He addressed this using a treatment option that had only recently been published which indicated to me that he is still concerned with being at the top of his profession rather than relying on older methods. Then, during my HSG there was a major problem with my cervix and despite 30+ mins of painful trying, the doctor performing the procedure was unable to insert the catheter to squirt the dye. He was going to give up which would mean postponing everything by a month. He offered to call Dr. C before I left the room and upon receiving the call Dr. C left his office immediately, came across the street to the hospital in the poring rain, scrubbed in and did the procedure himself. He then stayed with me when I was in so much pain I could not get off the table. No other Dr. I have ever had would have done this for me.

After 6 months of work together, my IVF was scheduled which required careful planing on his part due to the PGD component. A few weeks later, after a lot of contemplation, I changed my mind about the IVF and decided I wanted to conceive naturally. When I called the office to say I thought I was pregnant, he called me back personally to tell me the test was positive and celebrated with me even though he had also just lost a 20 thousand dollar client. He continued to monitor my pregnancy throughout the first trimester, adding progesterone when my numbers dipped, being there for me (again a personal call) when I had sudden bleeding at 7 weeks late on Friday night and performing an ultrasound the next morning just to make sure everything was still good. My point is if you want to get and stay pregnant and there are fertility or genetic issues, I can not imagine a Dr. who will be more able and more committed to this outcome and work from the heart to get you there. So, Id say, dont commute when the best doc is right near by.

Regarding the bedside manner, I did hear this about him before starting treatment and I did a couple things to address it. Overall, my goal was to change the dynamic from that of typical dr/patient to that of two colleagues working towards a common goal. I achieved this by asking highly technical questions forcing him to really get inside his brain to get to the answer at the level I was asking for. I also didn't hold anything back when it came to sharing my opinions on things that I liked, didn't like, etc. When he was direct at me, I was direct right back. He seemed to really respect this approach and this changed the way he interacted with me. For you, tell him straight up that you want to go straight to IVF and why. Stand up for what you want. He will probably respond well to that. I will see Dr. C again when its time for #2 whether its just to get my uterus ready for conception or going with the full IVF PGD. Good luck with your decision and if you chose to move forward, conception and pregnancy! A Dr. C fan

Reproductive Endocrinologist in East Bay

Can anyone recommend a good RE in the East Bay? I don't seem to have trouble getting pregnant but I have had 3 miscarriages in the last 7 months and I think it's time to see a specialist. Thanks.

Reproductive Endocrinologist covered by my insurance?

Hello - I am looking for a Reproductive Endocrinologist in the East Bay - preferably someone who is friendly to Single Mothers by Choice. My insurance is tricky, it covers A LOT if the Dr. is under my plan, nothing if they are not. Here are a few RE's who had popped up when I searched - if you have any experience with the following please share: Sanjay Agarwal or Sonya Kashap
Thanks so much! Hoping to be a mom soon!

Recurrent miscarriage - resources & fertility recs

Having just suffered my third miscarriage in less than a year (after the birth of a healthy child two years ago), I am finally looking at getting tested for a whole variety of things that could be causing the miscarriages. Right now, I am under the care of my OB/GYN (who is relatively new to me - only seen her for the past ~6 mos since my old OB retired). Should I be seeing a fertility specialist instead? If so, can you recommend someone? I'm in Oakland and have blue shield PPO. I always kind of thought fertility specialists were for people who had trouble conceiving (we definitely don't) or who wanted to do IVF, but now I wonder if I'm mistaken about that. I'm really just looking for someone who will take his/her time and be patient and thorough in helping me get to the bottom of this - also taking into account my other health issues and health history. (I have autoimmune hypothyroidism - currently treated by my fantastic endocrinologist, but still... I keep reading about autoimmune this and that and... ugh. It's all so confusing.) Finally, if you have suffered through recurrent miscarriage and discovered any resources that were really helpful for doing your own research and bringing questions to your doctor, could you point me toward them? Many thanks. Grateful for the wisdom of your experience

He specializes in women over 40 which makes his statistics even more impressive. Some, if not all, of your diagnostic work should be covered by your insurance.

You may also need to work with a perinatologist once you do get pregnant again since you're at high risk of having another miscarriage. Good luck! Sabrina

If you do go the RE route, I highly recommend Dr. Richard Chetkowski who is a Reproductive Endocrinologist with his own practice near Alta Bates. I find, and know myself, that there can feel like a huge barrier or committment to talk with a RE. But, I highly recommend setting up an appointment to talk with someone like Dr. Chet. He is very clear-thinking and will be able to very quickly help you understand where you may fall in the realm of fertility issues and considerations. Of course, they will always be willing to move forward into helping you (i.e. starting fertility based assistance), but he would be a very clear and kind, experienced doctor, for helping you understand how your situation fits in the fertility world.

My experience is based on using Dr. Chetkowski & Leslie to conceive one healthy daughter (now 2), after dealing with an ectopic pregnancy & a number of fertility issues. I also worked with others, who were *not* good, and so have a strong basis for recommending these two. Good luck. reba

Infertility with donor eggs

My husband and I are looking for subjections about your experience with donor egg and clinic. We're currentle with a clinic in Berkeley and we have done a IVF and IUI. still not be able to get PG. Does any one have a place for us? and a good doctor who will espend time with us and not only business with us. Thanks!!!! luli

Nevada Center for Reproductive Medicine
645 Sierra Rose Drive, Suite 205
Reno, Nevada 89511
Phone: 775-828-1200
http://nevadafertility.com

When is an RE necessary?

I am beginning to look into becoming a single mother by choice. It is overwhelming! I have done the initial blood tests (through my FNP) and was told things look good but am wondering if I should make an appointment with an RE. I have an OB/GYN, but don't know where to go from here. Since these initial tests are normal, is it necessary to see an RE? How would what he/she tells me be different from my OB/GYN or the folks at the sperm bank? I am almost 38 and have somewhat irregular periods and would like to take the route that is moste effective in getting me pregnant. Also, does anyone have recommendations for a good, reasonable RE in the Oakland/Berkeley area? moving forward with motherhood

1. The book: Taking Charge of Your Fertility (this book may help you decide if you need to see a specialist).

2. Pre-seed lubricant. (If you attempt vaginal inseminations you will need this at your age as a vehicle for the sperm).

3. Clearblue Easy Fertility Monitor. (It is worth the money to know exactly when you're ovulating). Best of Luck!

OB/GYN with fertility expertise

hi there, Can anyone recommend an OB/GYN in the east bay that specializes in fertility issues? I recently had a missed abortion and also have been diagnosed w/ hypothyroidism. I'm a little concerned that my current OB/GYN thinks my thyroid levels are ''normal'' especially given the fact that I've been trying to conceive for a year and had a miscarriage in March. My acupuncturist was actually the one who suggested I have my thyroid checked out and has been more helpful with fertility information than my OB/GYN. Thanks in advance for your recommendations!

Note that this is not a full service OB/GYN office; now that I'm nearly 10 wks. pregnant, I'm transitioning to another provider in the East Bay for prenatal care and delivery. However, I would absolutely do it again despite the hour each way to get there. If you can time appointments so you miss rush hour (and I usually could), you can get there with minimal hassle, and you will have some of the best care that's available. Happily Pregnant at Long Last

Seeking information on local fertility clinics

I'm looking at past posts to the BPN site and wondered if there was more up to date information on local fertility clinics. I just had a horrible IVF experience at Stanford and am looking at other options. I'm considering either Dr. Chetkowski at Alta Bates, or the Zouves Fertility Clinic in Daly City. Does anyone have any recent experience with either? Zouves has higher statistics of live births, but I've also read many positive posts about Chetkowski on this site. Any advice would be really appreciated. K

I think that statistics are very important but that they can also be misleading. One clinic may have a higher number of live births simply because they only treated those patients who had a high chance of success. A frequent use of donor eggs could also make the numbers higher. There are a lot of factors that go into these statistics and they all need to be separated out to be accurate. The first fertility doctor I saw had great numbers. After seeing her a few times she told me (very coldly and over the phone) that because of my high FSH it was impossble for me to get pregnant (wrong!). Devastated I went back for another appointment where I was told (again very coldly) of my options. After I declined the use of donor eggs she refused to try IVF with my own eggs and said if that is what I wanted to try I needed to go somewhere else. At UCSF there was none of this arrogance. They gave me the information I needed to make informed decisions and then supported me. Best Wishes from Someone Whose Been There

We ended up using UCSF, which was fabulous. UCSF is a non-profit as compared to many fertility centers, their prices are lower, their staff is top notch - on the cutting edge of research, they are very pleasant, and very accessible. I couldn't recommend UCSF more highly!

The way to become their patient is: 1) schedule a 1-hour telephone consultation ($250) 2) fly to Denver for your one-day workup, in which they will repeat all testing including hysteroscopy and sperm analysis 3) cycle with local monitoring until you fly to Denver for 4-14 days, depending on the protocol. You can see all the clinic outcomes on www.sart.org or get them as a downloadable excel spreadsheet from http://www.cdc.gov/art/

This may not show up niceley in the BPN newsletter but I took the excel spreadsheet, deleted all the clinics except California and CCRM (I had previously figured out CCRM was the best), deleted non-Bay Area clinics, deleted clinics that were too small to have any statistically significant results, and sorted the outcomes by the live birth rate for the youngest patients (see key at the bottom). The youngest are the easiest to get right.

good luck! A tough case, I wouldn't go anywhere else

I had a negative experience at UCSF, where I felt like I barely had a relationship with my primary physician there. I saw whoever was on call. Dr. Zouves is unique in that he's a one man show. It may take a little longer to get in to see him, but I really think the quality of care is worth the wait. I don't know anyone who has done IVF at Alta Bates, so I can't speak to that, but you have a ringing endorsement for Zouves Fertility Center here. Rebecca

Speaking of which -- PFC is also not SO aggressive (at least Dr. Schriock isn't) that you'll end up with a scary number of multiples, which is something to consider. I wouldn't necessarily go on pregnancy rates provided by clinics, either. Technically, a twin pregnancy I had that only reached implantation and no heartbeats, goes down in the stats as a pregnancy. It's more important you go with a place that makes you feel comfortable and confident - because that will help you conceive as well. -- Anon.

The day before I was to go in for the FET, a nurse called to confirm the medication I was taking. It turned out that one of the necessary medications had not been prescribed, after a brief silence on the phone, the nurse said that she would call me back. When she did she said it was still okay to proceed. The next day, I asked the staff if not having that medication made a difference. All assured me it would be fine. Well, that cycle also failed, maybe because of the medication or not, who knows.

I decided that after spending thousands of dollars and having nothing to show for it, I wouldn't proceed any further. I told RSC to either discard or use the remaining embryos for research. Several months later they billed me for several months of storage saying that I needed a notarized document to discard. Of course, it would have been nice if they had told me that originally instead of waiting several months and racking up more fees of $250/quarter.

To add to the already pleasant experience of two unsuccessful procedures, shooting needles in my legs for months, and spending thousands of dollars for failed treatments, they then disputed a $500 discount that had been offered for 2nd cycles and threatened collections. Happy Mom Of Beautiful Adopted Son

NOVA in vitro fertilization?

I am trying to find out if anyone has had a good experiece with NOVA. I am 39 and they seem to be the only program in the area that offers the guarantee or multi-try packages for women over 38, but I haven't seen any postings about them. Also, if people know of other places in the bay area that offer this to people over 38, I'd love to know that as well. I also heard that Kaiser Walnut Creek and Hayward do IVF, but can't find success rates anywhere, so would be interested to get feedback on them too. You can also email me at rebdwlng@yahoo.com. Thanks

My advice to you would be to look beyond whether a clinic offers a guarantee/discount plan and instead focus your efforts on the clinic that will give you the very best chance of success. Surprisingly, while the Bay Area has so much to offer in so many areas, our infertility clinics do not have the highest success rates. I ended up going to Portland Center for Reproductive Medicine in Oregon, and it was surprisingly easy, with comparable costs and very little travel necessary. The Colorado Center for Reproductive Medicine also has excellent stats for older women.

Good luck to you Anon

Blue Shield HMO-Ob/Gyn-fertility issues

Hello: I am thinking of switching to Blue Shield HMO from Kaiser. I am just starting to be seen at the Kaiser fertility clinic, and both my Kaiser and potential Blue Shield only pay for 50% of treatment. I am wondering what current recommendations might be for a Blue Shield OB/gyn in the area who also deals with fertility issues. I'm also wondering if more simple fertility issues (non-IVF)could be addressed as a regular office visit to an Ob/gyn, and not a fertility specialist, which would be covered in full as opposed to 50%. At Kaiser you are automatically transferred to the fertility clinic so everything is only covered at 50%, even though I would imagine some of the tests could be done by a regular ob/gyn. So, I guess I'm trying to find a good ob/gyn who is good with fertility issues and might also be willing to see patients for this as part of a regular office visit. Thanks, Rebecca

We recently switched to Blue Shield HMO. As you know the fertility coverage is not great in California. So I completely understand why you are trying to find an Ob/Gyn rather than a Reproductive Endocrinologist (RE). However, speaking strictly from a medical point of view, I would urge you to go straight to an RE if at all possible. Though some Obs do have an interest and experience in fertility, I don't think it can compare with that of a specialist in this field. I have read countless books and articles on the topic. The consensus in the infertility community is that it's best to go straight to an RE if you have been trying to have a baby for 12 months or more and have been unsuccessful. The number of months goes down to 6 if you're 35 years or older.

So I guess I would answer your second question by saying that yes, it may be possible to address ''simple'' fertility isses at a regular office visit with an Ob.(I'm not sure there is such a thing...) I realize I am speaking without any knowledge of your fertility problems. Even so, if you truly do have infertility, your very best bet would be to see an RE at least once. Hope this helps, and best of luck to you. Anon

Experience with Bay Area Fertility clinics?

I'd like to hear from women who've done IUI or IVF recently at some of the Bay Area clinics and to get feedback on their experience. My husband and I recently tried Reproductive Science Center in Orinda and I'm not sure how we feel about the experience, and would like to compare to other people's experiences. If you're reading this and have recent (2004 and after) and relevant experience, or know someone who does, we'd really like to get some feedback. thanks.
Re: Experience with Bay Area Fertility clinics? (June 2005)
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