I'm starting my physician consults for DE this week and I'd love everyone's input on the list I've put together. If you have suggestions for other questions you asked or wish you had asked your RE before getting started, fire away!
Some of the questions are clearly specific to my situation, but I thought the rest could be helpful to others.
Questions for my DE consult:
What testing to you require prior to being cleared for a cycle?
Does any of that have to be done at your center or can it be done at home?
How long are tests good for?
I just had a d&c is a saline hysterosonogram sufficient to check the uterus for problems, or do you prefer another test?
Do I have to do a mock cycle or can I use the results from the FET just completed? Would you use my same FET protocol?
Do I need to come to your center prior to the cycle for any other reason?
Assuming I have all of the above completed, is there anything else I need to be medically cleared for starting a cycle?
Considering my medical history, what do you feel my chances of success are? What makes me different (or not) from other patients you treat? Does using frozen donor sperm change anything? What are your current overall 'take home baby' stats? Why have your stats have improved (or not) over the past few years? Why are your stats so much better than the typical center? (or why are your stats not as good as the reputedly top centers?)
During the cycle, can I use my OB-GYN to do the lining checks/bloodwork?
When would I need to be at the center for the cycle (before retrieval?), considering I am using frozen donor sperm?
Using your in-house donor pool, what are the typical number of eggs retrieved (or hoped for)? Is a previous retrieval predictive of future response rate to stims?
What happens if a donor is not responding well during the cycle? At what point do you cancel? Do I get any notice or can I be involved in that decision-making?
If a donor produces a much lower than expected number of eggs, how is that handled?
What is your criteria for using ICSI?
At what point are embryos transferred (day 3, day 5, etc)? One size fits all or based on other criteria?
How many embryos do you typically transfer? How is that decision made? Do you ever do or recommend eSET? What is your rate of twin pregnancy with DE? What is your rate of HOM with DE?
What type of progesterone and estrogen support do you use post transfer? What kind of monitoring do you do? When do you typically wean patients from both?
How do you freeze embryos (vitrification or?). How strict are your freezing criteria? What percent of embryos are frozen? How many do you freeze per straw?
What are your survival rates post thaw? What are your current FET success rates? Why have they changed (or not) over the past few years?
Prior to an FET, what additional testing would I need to do? How long after a failed DE-IVF attempt would I have to wait to do an FET attempt?
How often do women need to do a second DE cycle to achieve pregnancy (take home baby) (meaning, how often does an entire DE cycle fail combining fresh and FET?) Is there a typical patient that falls into that category?