Thursday, July 10, 2008

Protocol Differences Part II

I was going to leave this as a comment to my last post, but it was getting too long. And this is my blog, so what the heck.

It occurs to me that clinics don't have a real incentive to have better success rates if women continue to support them. More failures = more cycles = more money for them. That's a cynical view, I know, but ever since I was pg with DS, I am much more cynical about the medical profession. I'd rather think success rates in different DE clinics is due to differences in donor pools, but when their protocols significantly vary from the best (e.g., Crinone vs. PIO), I have my doubts.

Also, DE Daddy's father was a doctor. The protocols are not propietary. So if clinics aren't using the best methods, it's not because they are not available to them.

Of course, after our failed frozen egg cycle, our RE did discuss a learning curve. So changes in protocol do incur a learning curve. Our first clinic had a real set back moving from thawing 3 day old embies to thawing 5 day old embies. But by the time they learned how to do it, their success rate for FETs nearly doubled and approaches the success rate for their fresh cycles.

To be honest, we would have stayed at our first clinic if they had not failed so miserably at the frozen egg cycle. But then we finally understood that you can use any clinic in the country, or the world for that matter, for your IVF or DE cycle. Your home clinic can do all the monitoring and the more successful clinic can do the procedure. All you have to do is get to the clinic in time for the man to make a deposit and the woman be available for the transfer. What's an extra $1000 in plane tickets and hotel rooms when you're talking about a $25,000 procedure?

I think that's the only way we can get all the clinics to step up their success rates.


midlife mommy said...

Those are interesting thoughts. But since they are required to report things out, wouldn't that be a disincentive to use methods that are not as successful? Before we chose our clinic, we compared their success rates with others.

As an aside, which is better, Crinone or PIO? My clinic used to use PIO, then it was PIO until the pregnancy test with a choice to go to Crinone, and now, they don't use Crinone at all (I'm using Endometrin, which I don't like because it's 3X a day rather than two, and can be more messy than Crinone, if you can believe that).

Anita said...


It is my understanding that PIO is a much more effective delivery system for progesterone. I think that's why they use Crinone or other suppositories for use during natural or IUI cycles and PIO for ivf.

I hope that helps.

Anonymous said...

I understood why your protocol would differ so much from mine since we were at seperate clinics, but now that you are going where I went, I wonder about the differences. I never used estrogen "patches," and I never took "Lupron." And we had success, as you know, with 5 day xfers. Email me and explain the differences, if you have a moment...I imagine it to be because our situations have been different??? I dunno. I'm really curious. Obviously all women don't use the same protocol, but since I had success...