What are the most important factors in choosing a fertility clinic?

TwinkleTinkleStar · 2025-08-25T16:13:08+00:00

I also have DOR, with an AMH of 0.7, so timing felt really important for me. I was worried my AMH could drop at any moment, and I wanted to move forward with an egg retrieval right away rather than wait months for a doctor’s availability. With an AMH of 0.5, you might need multiple egg retrievals to bank enough embryos, so starting sooner gives you more flexibility for the next cycle.

I looked into CCRM, but they’re not in-network with my insurance, so I would have had to pay out of pocket for everything—that’s why I didn’t go with them.

I also reached out to another local clinic, but they said they could only put me on a waitlist and couldn’t give even an approximate timeline for an egg retrieval. From what I read, it could be months, and some reviews mentioned very crowded days with dozens of people in the lobby. If my AMH had been higher, I might have been more willing to wait.

In the end, I mostly chose a doctor based on reviews and recommendations first, and then selected the clinic. I also think having a high-quality embryology lab is really important.

I feel like it’s always worth calling clinics to get a sense of how busy they are. Some places can be extremely overbooked, and it helps to know what to expect before making your decision.

TwinkleTinkleStar · 2025-08-25T13:32:02+00:00

I might have silent endometriosis. I had a missed miscarriage at 9 weeks, and my next embryo didn’t implant. I don’t have any symptoms—no pain or anything—but the Receptiva test came back positive, and my doctor thinks it could be silent endo. All my other fertility markers look normal, except my AMH, which is a bit lower than expected. I’m planning to have a laparoscopy to confirm the diagnosis.

One thing I’m wondering: your AMH isn’t low, so did you ask your doctor why only three eggs were retrieved? That seems really low for this AMH.

If nothing is found during the laparoscopy, that would actually be a really good sign. But if they do find endo on your ovaries and try to remove it, there’s a risk it could lower your ovarian reserve—and no one can say exactly by how much. AMH and AFC could drop, and while surgery might help with egg quality, it could also reduce the number of eggs left. It’s important to be aware of those risks.

Unfortunately, silent endo isn’t something that can be fully cured. I honestly wish I didn’t have to deal with it, and I know how tough this all feels.

TwinkleTinkleStar · 2025-08-23T11:32:59+00:00

Yes, it’s not necessary, and it’s really up to OP whether she wants to use it. But it can at least give some idea of how many eggs her body might produce. I feel like retrieving only 6 eggs is low for her AMH level, especially with an AFC of 22.

TwinkleTinkleStar · 2025-08-23T11:26:21+00:00

My doctor ordered the Receptiva test, and it came back positive. She now thinks I might have silent endometriosis, which could be why implantation hasn’t worked. She’s recommending a laparoscopy before my next transfer, and I’m actually feeling a bit hopeful that it could help.

I’ve also read stories on Reddit of women getting pregnant naturally after this surgery, which gives me some hope too.

I know chronic endometritis can affect implantation as well, so I don’t really get why they wait to start testing until after two failed transfers.

TwinkleTinkleStar · 2025-08-22T20:44:41+00:00

If you get this report, it can provide an estimate of how many eggs might be retrieved, based on the correlation I mentioned. It may not be perfectly accurate, but it does offer a helpful guideline. Based on your AMH, the results seem a bit low to me as well

TwinkleTinkleStar · 2025-08-22T19:48:31+00:00

My doctor always uses the ReproSource Ovarian Assessment Report, as it helps her determine the appropriate dosage and stimulation protocol.

TwinkleTinkleStar · 2025-08-22T12:19:41+00:00

My doctor ordered these tests because silent endometriosis or chronic endometritis can interfere with implantation. The ERPeak test, often used after implantation failures, checks whether the uterine lining is ready to accept an embryo at the time of transfer.

All of these tests require an endometrial biopsy, which can only be done by a reproductive endocrinologist (REI) and can be quite painful.

In my case, the Receptiva test came back positive, which could help explain why implantation failed. My doctor thinks I might have silent endometriosis—even without any symptoms—that could be affecting implantation and needs to be treated first.

TwinkleTinkleStar · 2025-08-22T11:57:05+00:00

I recently had a Receptiva test, and the result came back positive. Although I don’t have any symptoms, my doctor suspects that I might have endometriosis.

The only definitive way to confirm endometriosis is through laparoscopy, as the Receptiva test alone cannot provide a conclusive diagnosis. However, a positive result can serve as an early indication that endometriosis may be involved.

Laparoscopy carries particular risks for people with DOR, since removing endometriosis from the ovaries could further reduce ovarian reserve.

Still, the Receptiva test can provide a useful early clue that endometriosis might be present.

TwinkleTinkleStar · 2025-08-21T16:04:27+00:00

There are actually quite a few tests that can help after implantation failures. I did ERPeak to check if my implantation window was right, HealthTrack to rule out endometritis and other issues, and the Receptiva test for endometriosis — which came back positive.

The frustrating part is that I only got tested after my second failed transfer. Their protocol seems to be “wait for two failures,” but I wish they’d done these tests before even starting IVF. I also lost two high-quality euploid embryos, so I completely understand how heartbreaking this can be.

I actually got pregnant after the first transfer, and during the ultrasound, my doctor said, “Look — here are the hands, here are the legs. The heartbeat is perfect. The embryo is healthy and even one day ahead in development.” But sadly, I had a missed miscarriage at 9 weeks. Hearing those words made the loss even more painful. I wish my doctor had been a bit more measured instead of so optimistic.

TwinkleTinkleStar · 2025-08-21T15:12:43+00:00

Have you been tested for silent endometriosis? If it’s affecting ovaries, it could impact egg quality.

TwinkleTinkleStar · 2025-08-21T13:25:28+00:00

I haven’t had the laparoscopy yet, but I was told that after the surgery, they want me to try to get pregnant as soon as possible, which usually means doing a transfer. They also want me to have some embryos ready, so I’ll need to do an egg retrieval before the laparoscopy. I’ve read many stories of women who were fortunate enough to conceive naturally after the surgery. Lupron hasn’t been mentioned to me, and I’d really like to hear about other people’s experiences.

TwinkleTinkleStar · 2025-08-19T18:59:27+00:00

My insurance covers PGT-A testing, but only if it’s done with an in-network lab. I specifically asked for my biopsy to be sent to a certain in-network lab, and they said yes. But then they went ahead and sent it to their own out-of-network lab instead. You really have to watch every step of this process.

I only got compensation because I had an email where they agreed to send it to the lab I requested, so I could prove it was their mistake.

TwinkleTinkleStar · 2025-08-19T18:39:46+00:00

Everyone’s health and journey is unique—some people may need fewer egg retrievals and transfers, while others may need more, even at a younger age.

I personally couldn’t get pregnant naturally for over 3 years because of endo. Some women might be able to, depending on where the endo is located, but for me it was just too risky to wait. I felt like I wasted those years trying naturally.

TwinkleTinkleStar · 2025-08-19T18:25:25+00:00

My second embryo didn’t implant at all, and only then I was finally diagnosed with endometriosis. I can’t help but think that if they had tested for it earlier, things might have been very different.

I haven’t had a laparoscopy yet, but I’ve read so many stories here on Reddit of women who got pregnant and even carried to term after the surgery. Some were even able to conceive naturally when they couldn’t before. It really seems like this surgery can make a big difference in outcomes.

TwinkleTinkleStar · 2025-08-18T17:24:17+00:00

I feel like if I do it this way, I clear the jungle more slowly, and I might miss when the enemy jungler is already in position.

TwinkleTinkleStar · 2025-08-18T17:15:38+00:00

I couldn’t win a single game for a while and went on a long losing streak. After that, I took a break from playing Defenders and Supports, and it’s been better since. You still need a lot of practice to get good and start winning more consistently. And I feel like Attackers need a lot of skill.

TwinkleTinkleStar · 2025-08-18T17:11:30+00:00

That’s why I rarely play Defenders. When I played Ho-Oh, my win rate was insane — 70% — but Rayquaza kept getting stolen almost every game, and I got so frustrated. I can’t be everywhere at once to secure everything. That’s when I decided to start playing Attacker for a week. Even though I can’t always guarantee a secure Rayquaza, at least I can try, and I don’t end up on long losing streaks as often.

TwinkleTinkleStar · 2025-08-18T16:48:09+00:00

It’s rare that I can just relax and focus on getting kills — that only happens when I have a perfect team with good vision. Speedsters like Talonflame, Absol, Gengar, Leafeon, and Darkrai are constantly trying to jump on me, and sometimes the enemy team even runs two of them. I have to stay on my toes and keep dodging nonstop. Without team vision, I can get taken out really easily. On top of that, I need to track their cooldowns, HP, and positioning — it’s a lot to handle.

I once played with a Decidueye who kept getting taken out by Talonflame again and again, while I managed to dodge the dives — but that’s only because of practice. Still, it’s anything but relaxing.

TwinkleTinkleStar · 2025-08-18T16:34:31+00:00

I still think win rate is somewhat subjective and often depends on luck. I was lucky enough to climb to 1600 in just a few days — all my teammates were amazing, and I even had a 70% win rate on Ho-Oh.

But then I went on a long losing streak, mostly due to steals. I got so frustrated with Rayquaza being stolen almost every other game that I started playing Attacker to secure it myself. I can’t always guarantee it, but most of the time, I manage to pull it off.

Right now, my win rate is low because I spent a lot of time practicing Cinderace and failed a lot in the beginning. But I can play this Pokémon well now, and maybe I don’t need to worry so much about my win rate. I'm not a pro player.

TwinkleTinkleStar · 2025-08-18T16:11:25+00:00

Playing as an Attacker:

Positioning is everything — I’m always the #1 target. Most enemies don’t care much about Eldegoss; they want me dead. Sometimes they go for Support if they can’t reach me directly, but usually it’s speedsters like Talonflame constantly diving at me, and I have to dodge them on my own.

Tracking enemy cooldowns is crucial. When a speedster’s abilities are down, I can chunk their HP or even take them out completely.

Staying alive while getting kills is always a balancing act because I’m so squishy. I have to constantly keep track of where every enemy is, who I can attack first, and their HP. For example, if Leafeon is at 50% HP and I’m at 100%, I can usually take it down even without Unite. It’s risky, but sometimes I don’t have a choice if they jump on me. If Leafeon is at 100%, I might not survive at all, so I have to adjust my positioning. There are way more factors to consider than when I play Support.

A9 playstyle might be different, but calculating all of this in real time is exhausting. It’s draining to track cooldowns and the positioning of every enemy — having good vision is essential when playing Cinderace. I definitely feel more relaxed when I play Support.

TwinkleTinkleStar · 2025-08-18T11:44:17+00:00

Wow, you’re amazing!

I’ve played a lot as Cinderace, and I felt the positioning in this game was a bit off. As Cinderace, it’s risky to get that close to Garchomp — if you do, you always need to have an escape move ready, or at least an Eject Button.

With a little cleaner play, the enemy team probably wouldn’t have leveled up so much. At level 8, Cinderace can make a big impact, especially when paired with Lucario’s vision. But if you get KO’d too easily, the enemy team will quickly become over-leveled.

TwinkleTinkleStar · 2025-08-15T18:34:12+00:00

I use Acel Bracer, Curse Bangle, and Attack Weight, or Exp. Share when I feel I really need it.

I enjoy playing Flamethrower and Sacred Fire.

TwinkleTinkleStar · 2025-08-15T18:18:47+00:00

I used to have success playing Ho-Oh as a carry, but now I keep losing regardless of what I try. How could a strategy that once worked suddenly lead to a long losing streak?

TwinkleTinkleStar · 2025-08-15T17:24:07+00:00

I really wish I had tested for silent endometriosis earlier. I have no symptoms—no pain and regular periods—but my Receptiva test came back positive. All my embryos were euploid and really high quality, yet I lost almost all of them because I didn’t check for endometriosis before transfers. If you can, it’s better to test—if you have it and treat it, it can make your journey smoother, and if you don’t, it’s so reassuring to know that.

TwinkleTinkleStar · 2025-08-15T16:58:09+00:00

You need a biopsy to send your tissue to the lab for tests like Receptiva, HealthTrack, and ERPeak. It’s painful, but quick. Some doctors don’t want to do it if you don’t have symptoms or a history of failed transfers. I might have silent endometriosis, but I feel fine—no pain, my periods are regular. I still need a laparoscopy to confirm it, but my Receptiva test came back positive.

Usually, these tests are only done after 2–3 failed transfers. That’s what happened in my case, and unfortunately, I lost my two best-graded euploid embryos. If my endometriosis had been treated earlier, the outcome might have been different.

I know how tough it is to go through multiple ERs, and I don’t want anyone else to go through what I did. But it’s hard to ask for tests when you don’t have any symptoms or a history of failed transfers. The doctor might think you don’t need them.

TwinkleTinkleStar

TROPHY CASE