Phone Consult with RBA: PART ONE

I had my phone consult with Dr. Shapiro. I’m just going to jump right in, as this is a lot of information. **Please note that he spoke very quickly, and this is only my attempt to make sense of my scribbled notes—there may be many inaccuracies below. But hopefully it will give you some idea.

 

PART ONE of phone consult

(I’ll finish the second half this weekend.)

 

STATISTICS

1.) How many live births have been achieved through the Frozen Egg Advantage Program?

70 patients so far.

1st transfer:

60%: live birth.

2nd transfer:

1/2 of remaining 40%: live birth.

20%: not yet pregnant.

Therefor, from 1 egg thaw (2 transfers):

80%: live birth.

20%: no live birth.

3rd transfer:

90% overall live birth success rate.

5 patients remain of the 70, at this point. 

1 patient backed out of the guarantee, paying 3K for 3 transfers, or $9,000.

2 patients had developed uterine problems after they entered the program (otherwise would not have been accepted into program). One is considering surrogacy.

2.) I was told that no one has required a refund—is that accurate? 

Yes. No one has gone through 5 cycles (10 transfers) yet. Either the patient gets excluded from the program and gets their money back, or they get pregnant. [Which is one reason he seems to be advocating for doing the basic plan over the guarantee. More on this below.]

3. ) How many patients have dropped out of the program early?

Did not ask. 

4.) What is the live birth rate for SET?

60%

5.) What is the live birth rate for DET?

70%

6.) What is the mc rate after transfer?

12%

#1 cause: Random genetic abnormality

#2 cause: Uterine abnormality

Has nothing to do with donor eggs/frozen donor eggs.

7.) What is the total reproductive potential of an RBA frozen donor egg patient?

87 – 90% cumulative total reproductive potential.

8.) What is the overall average expenditure?

$20 – 22, 000 across 1100 cases and 690 babies born.

Other statistical/expenditure information he offered:

The Frozen Egg Advantage Guarantee is not that good of a deal, financially. You are basically paying $10 – 13,000 more (than the basic plan) for peace of mind.

Basic 2 HQE Plan: Overall expenditure: $20,000

Frozen Egg Advantage Plan: Overall expenditure: $33,000

But each plan is exactly the same, and has exactly the same pregnancy outcomes.

There is no difference in the process, the # of embryos, and so on.

There is a randomness to how it plays out, but it is very unlikely that you would not have success doing the basic plan. The basic plan would give you two tries with high-quality embryos, and if the cycle did not result in 2 high-quality embryos, then you would get free cycle and get to try again.

I interjected: “And it seems like in the unlikely scenario that I wouldn’t have success after that, I could then just buy another basic plan.”

***

Since this phone consult, however, I am gravitating  back toward the guarantee program. I trust the embryologists, and I trust the clinic, but what I don’t like about the basic plan is that the clinic/embryologists have total control  over deciding whether or not their contracted obligation has been met, by analyzing and grading the embryos.

What is a high-quality embryo, according to the embryologists? 

An Expanded Blast (XB)

Grade: AA, AB, BA, BB

With the guarantee program, the guarantee is a live birth—the embryologists do not make that decision, the decision is made by the healthy cries of a newborn baby in my arms.

With the guarantee program, I can continue to cycle under the guarantee after miscarriage, stillbirth, and most likely in the case of pregnancy termination if the fetus has Down’s Syndrome (but they have never had a case of Down’s, because of how strictly they screen donors). They did have one case of woman in the guarantee program who had a stillbirth at 36 weeks for no reason anyone could determine; even though her 2 years had expired under the guarantee, they invited her back for more treatment at no cost.

I would very much like to hear from you all about this. We are going to weigh both plans and discuss more. Which plan sounds better to you, considering the statistics? And not to sound paranoid, but what might be some reasons the clinic would be advocating for the basic plan over the guarantee (other than the honorable one: full disclosure and wanting me to be aware of what makes more sense financially)?

Thank you! (And PART TWO  comes this weekend. ) 

 

 

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8 Comments

  1. L

     /  May 3, 2013

    This is super helpful. And yes, I see the logic of doing the basic plan- but my gut says to go with the guarantee. With a 12% miscarriage rate (which would be true with any pregnancy, but these are costly pregnancies!), it’s even more reassuring.
    It’s very responsible and ethical of him to point out the realities and the fact that most people pay too much, but so far, I’ve always come out on the wrong side of the stats. So I’m willing to pay more for piece of mind.
    Yesterday I mailed a check for the full amount. It was scary, but we’re doing it.
    Thank you again for typing this all up. I look forward to part 2.

    Reply
    • You’re most welcome! And thank you hugely for the feedback. I think I just need to hear others’ voices. I’m so excited for you!!

      Reply
  2. Cecily

     /  May 3, 2013

    Thanks again for sharing your journey! This is such a tough one to wrap your head around- but I guess the question is what is the price of “peace of mind”?? I personally don’t think it should be discounted so quickly, as your Dr. seemed to suggest. For me personally, I think peace of mind is… to a certain extent, almost priceless. Not only are those additional cycles actually there for you on paper, but the amount of stress it would relieve can be a significant factor as well. Not sure if that even made sense, and this is a such a tough decision, but I don’t think that if you end up getting pregnant on the 1st or second shot of the guaranteed plan, that you would lose too much sleep at the end of the day over that 10K. Once you have your baby, even cent will have been worth it- especially the 10K stress reliever! :)

    Reply
    • I hear you! You know, that’s so true—am I really going to be regretting anything at all if I get pregnant first try? Nope. It’s seeming more and more like I should just go with the guarantee. Just having that lessened anxiety and stress could have a fabulous effect on my pregnancy outcome. Thank you for weighing in.

      Reply
  3. AB

     /  May 7, 2013

    We’re going to do a guaranteed plan too. It’s for peace of mind, and hoping that having that guarantee will allow me/us to relax and get pregnant! And, if I do get pregnant the first go, hurrah! It’s worth it for me and – in the end – I have been on the losing end of percentages for a few years now and don’t want to risk being in that minority for whom it doesn’t work. Thanks for all your details.

    Reply
  4. Hi! I’m looking at a different agency but it seems to be the same basic thing – you get 6 eggs (and all other things, excluding the FET) for ~$15,000 with the basic plan but you get 6 tries (6 sets of eggs) and a money back guarantee if you don’t have a live birth for $35,000. That’s a huuuuuge difference !! I don’t know what to do.

    Reply
    • t’s a hard decision! I keep gravitating back toward the guarantee because anxiety sucks and I want to feel peaceful as possible throughout this process. Love to hear more about the program you are looking at!

      Reply

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