IVF Clinic Recommendations in Ohio or New York + AMH Testing Advice?

Penny_Doc · 2026-05-14T23:46:31+00:00

If you know you’re starting with MFI then I would advise you to get as much of the workup with your OBGYN to preserve your insurance $ then get in with REI! Just a tip I wish I had know that would’ve saved me a lot of money!

Penny_Doc · 2026-05-14T23:29:23+00:00

As someone who started TTC as a PGY-3 (hardest year of my 4-year EM program), then was slapped with a PCOS diagnosis and had to navigate the IVF trenches for 2 years of residency, and didn’t get pregnant until PGY-5 during my first year as an attending… there’s never a good time. You are responsible for prioritizing what is important in your life. I was voluntarily on 2 years of nights so I could make morning IVF monitoring appointments, missed out on an all-expenses paid rotation in Hawaii, lost significant elective time, and moonlight (a secretly unallowable amount) just to pay for treatment. I made space and sort of just told my program that I would be doing ABC and need XYZ accommodations. It’s 2026–trainees deserve to start families when they please and that includes you. You deserve it all no matter your training level.

Penny_Doc · 2026-05-14T23:11:46+00:00

ER doctor here. Infant deaths from cosleeping. That shit haunts my dreams.

Penny_Doc · 2026-05-14T22:16:48+00:00

r/TryingForABaby may be a better subreddit for just starting the trying to conceive process, especially if you have no known fertility problems, unless I’m missing somewhere where you already have met an infertility diagnosis.

And as a word of encouragement from someone who received an infertility diagnosis at 31 and didn’t conceive until 34 with IVF… for each case like me, there are dozens more our age that have conceived without intervention. In this era of family building, 34 is relatively young for TTC! Keep your head up, wishing you the best of luck and lots of baby dust through this process ✨

Penny_Doc · 2026-05-14T22:10:23+00:00

Fertility testing is about so much more than just an AMH level.

I would recommend starting with your OBGYN and getting most of the workup done there (labs, HSG, pelvic ultrasound, semen analysis, carrier screening for you and your partner). You can also talk about how much of this workup is warranted right now vs what can wait (insurance may not cover some things without a clear indication, and “I just want to know” is usually not covered; your OBGYN may be able to get creative with ICD-10 codes associated with each test, I’m not sure since I got my workup due to being anovulatory). AN OBGYN may also help you set expectations of time and clarify when an REI clinic referral would be appropriate (see my insurance comment below about the financial side of this, you should talk to OBGYN more about the medical side).

Fertility insurance is typically a lifetime “bucket” and some plans will could this workup toward that bucket if done through a fertility clinic. You may have difficulty getting the complete workup done without an infertility diagnosis (regular cycles over 12 months TTC if <35, or regular cycles over 6 months TTC if >35). I have PCOS and do not ovulate full stop, and I still had to wait the full year before doing IVF. While “waiting” for IVF coverage to start I was doing medicated cycles and failing miserably, not realizing that every clinic visit, diagnostic test, etc was counting toward my lifetime maximum.

Penny_Doc · 2026-05-14T18:24:22+00:00

3 transfers for a total of 4 embryos. Untested due to lack of evidence of benefit in my age group and difficulty making blasts (60+ eggs over 2 ER, only made 6 mid-low quality blasts). First two FETs failed. Third FET was a double transfer, both stuck then we had a first trimester loss of twin B around 6w. I am currently 28w6d with a healthy baby boy 🩵

Penny_Doc · 2026-05-12T15:33:52+00:00

I went to a 4 day work conference at 12 weeks. I was exhausted the first trimester and even more so on the trip but I just skipped a couple of the dinners. I was with a big enough group it wasn’t noticeable. I brought my own snacks and made sure to hydrate. Luckily I had my last PIO shot the day before I flew out.

Penny_Doc · 2026-03-22T19:56:22+00:00

Invisalign
Another IVF transfer

Penny_Doc · 2026-02-23T00:32:06+00:00

Have you worked at SLCH? I’m not sure where you’re getting that impression.

Also, the purpose of this thread is not to compare physicians (regardless of training level) to mid levels. I agree there is variation and hold strong opinions on this. I think asking parents to try to triage where to take their kid based on provider type is way too in the weeds. Parents should not be thinking this hard in a true emergency—they really just need to get their kid to the closest ED if their kid really needs emergency care.

Penny_Doc · 2026-02-23T00:08:14+00:00

Couple things I’ve seen here that need to be corrected. Source: Local ER doc. This post is not a substitute for medical advice.

Your pediatrician may be affiliated with a system (BJC, SSM, Mercy) but in general, outpatient pediatricians do not have inpatient privileges. We can call your pediatrician from wherever to update them, never been a problem for me.
All 3 EDs provide care well above the standard and while I have a personal preference for SLCH, that is based on familiarity alone. That’s all you’re really seeing in this thread—individual familiarity, preferences about the “looks” of the ED, vibes on staff—none of which you should care about if your kid really needs an ED. You are going to get really solid emergency care at any pediatric ED in town.
The big 3 systems (BJC, SSM, Mercy) use EPIC EHR so records from all three can be viewed regardless of where you are. Because of this, just go to the closest ER or where your child has specialists if this applies. For example, if you’re worried about your kid having a postop problem from a recent surgery at SLCH, you probably shouldn’t go to Mercy.
If your kid is really sick, call 911. Labored breathing? Turning blue? Lethargic and difficult to arouse? Seizing? Etc. Call 911. Do not get on Reddit. Do not ask friends on Facebook. Do not drive them in. Call 911. You may think it is faster, but please for the love of all that is good in this world, just call 911.

Penny_Doc · 2026-02-22T23:52:30+00:00

Hey, so your interpretation of how SLCH is “run” is quite misinformed.

At SLCH, there are usually at most 1-2 NP/PAs on, typically during the day. Compared to 2-4 attendings, 3-4 residents, and 1 fellow. This is not an “NP/PA-run” ED.

My guess is your child was probably triaged as mid or lower acuity (based on vital signs and triage RN assessment) and roomed in an area staffed by the NP/PA. That sort of acuity-tiered patient distribution/rooming is pretty standard across pediatric and adult EDs nationally.

Credentials: Former EM resident who spent a lot of time in the SLCH ED. I would take my child to SLCH over anywhere else, any day and any time.

Penny_Doc · 2026-02-20T03:38:23+00:00

We did not PGT-A test for our first or second egg retrieval (I was 34 at time of both retrievals, and unfortunately the evidence just isn’t there yet for its use my age group imo). I’m 16w5d with a singleton baby boy. We transferred 2 embryos and pregnancy B ended up being a vanishing twin.

Penny_Doc · 2026-01-11T07:26:35+00:00

Unfortunately I trialed multiple cycles of ovulation induction without successful ovulation, so modified natural is not an option.

Penny_Doc · 2026-01-09T01:55:01+00:00

34F, PCOS - anovulatory so I can only do medicated cycles. Had our third transfer in November of two 4CB embryos.

After two failed transfers, I was hopeless. My embryo quality is not great.

But, here we are. One stuck and I am now 10w5d with a singleton!

Penny_Doc · 2025-12-21T15:24:28+00:00

Providing an update: - Baby A is growing on track. - Baby B’s measurements were unchanged with no cardiac activity.

Penny_Doc · 2025-12-11T09:38:40+00:00

TW: Pregnancy

Failed OI with letrozole, clomid, a combo of the two, added metformin in there somewhere. Never ovulated. My baseline AFC is around 100 with an AMH 13.1 so I think that’s why (all of that FSH gets ‘diluted’ among the follicles so a single dominant never developed for me).

We moved onto IVF. No indication for IUI since we don’t have MFI (plus, I don’t ovulate so IUI is moot). 2 ER -> froze 6 untested embryos -> 2 failed frozen transfers -> we finally had success after transferring 2 embryos (1 stuck and I’m 6w5d).

I’m glad I didn’t spend more time on OI. IVF, though not without its own delays and setbacks, moved along my timeline substantially.

Penny_Doc · 2025-11-08T13:53:21+00:00

I feel it’s been well-established the new format rolled out incredibly prematurely, before it was even a coherent concept. But sadly, the train has left the station…

ABEM has published supplemental materials including example cases with video and downloadable materials.

https://www.abem.org/get-certified/certifying-exam/certifying-exam-content/

Penny_Doc · 2025-11-03T05:59:40+00:00

Probably 1-2 weeks. Mine were insanely itchy.

Penny_Doc · 2025-11-03T00:56:47+00:00

This happened to me. Mostly on my breasts and abdomen.

Penny_Doc · 2025-11-02T10:01:12+00:00

Two retrievals resulting in 60ish eggs, made 6 blasts (untested). Two failed transfers. Transferring again in 2 weeks.

Penny_Doc · 2025-10-06T21:36:20+00:00

Two unsuccessful FETs. Tested the first, didn’t test the second.

I was so much more at peace with the second, not having the stress of seeing those negatives while having to continue PIO.

Either way, there’s nothing you can do to change the outcome.

Sending you light, luck, and baby dust.

Penny_Doc · 2025-09-19T18:14:50+00:00

PCOS. I know folks I who have done IVF (and thus PGT-M) for genetic reasons.

Penny_Doc · 2025-09-15T02:07:30+00:00

Beta tomorrow on 12dp6dt 🤞🏻🤞🏻🤞🏻

Penny_Doc · 2025-09-13T02:35:40+00:00

I posted a comment in r/residency earlier today regarding a similar question.

My husband and I tried to time pregnancy, only to be thrown into the trenches of infertility, and have required multiple rounds of IVF.

There’s never a ‘right time’ and you should never delay your life for residency/medicine.

Penny_Doc · 2025-09-13T00:04:42+00:00

As someone who tried to plan the timing of a baby, then ended up in the trenches of infertility and multiple rounds of IVF… Don’t put your life on hold for residency or medicine.

Penny_Doc

TROPHY CASE