Today I'm contemplating the question of whether to get a second opinion before IVF. Or maybe even before the surgery. There are two clinics in my area. Let's call my current clinic David. David sees about 100 patients a year, right at that too small cutoff. David has an affiliation agreement with Mediocre Institution, which means I get a 30% discount on IVF. As a self-payer, this factor is not insignificant. David is across the street from my office and I walk past it every day on my way to work. Extremely convenient--as a lazy person, this factor is also significant since I hear tell IVF involves a lot of appointments. David's rate for number of cycles resulting in pregnancy varies between 58% and 48%, and the average my RE cites is 50%. David has no shared risk program, but it's not clear that shared risk is the right choice for people like us with (as far as we know) healthy gametes. I like my RE despite his sometimes weird manner. I trust him because his logic has always made sense to me. He's an experienced surgeon and a researcher, which I find comforting. He says David has excellent embryologists, and I don't think he's lying. He encouraged me to check out other clinics, so I feel he's being truthful.
Let's call the other clinic Goliath. Goliath has about 300 patients a year. Goliath's rate for number of cycles resulting in pregnancy varies between 44% and 49%, so 46% is probably a good estimate. There are no real differences between the clinics in terms of patient profile (male factor, female factor, etc.) Goliath is walking distance from my office, so not necessarily a problem for a one-car family, but would definitely add an extra half hour to any appointment. I'd pay full price at Goliath, though they do have a shared risk program. Goliath has a habit of stealing embryologists from David by paying them more than David can afford to, according to my RE, so it probably has good people.
David's comfortable--the staff and the building feel familiar and reassuring (in a totally depressing way) now. I don't want to switch clinics. I'm so lazy I don't even want to investigate my other option. So I need a reality check.
My first question: is it unwise to do IVF with David before even meeting with someone at Goliath? I'd likely have time to set up a consult while recovering from the myomectomy. But here's my second question: is it unwise to go ahead with a surgery before getting a second opinion? And here's my third question: are there factors I'm not even thinking about? Any opinions would be appreciated.