I have to chime in on the TFC vs Dr. Youngkin issue. I posted this some of this story on the other Austin OB thread, but I think it has relevance on this thread too.
I went to TFC in February 2005 from a referral from my old GYN at Women Partners in Health (she's since moved out of state, so no reason to state her name). I saw Dr. Vaughn, and neither DH or I were very impressed with him. My GYN had been seeing me for several years, and we had been trying to get pregnant. She ordered an u/s to "check" for PCOS, and I just happened to have the one cycle that I ovulated in about 3 years during that u/s. So, they ruled out PCOS because I was ovulating. She did the standard fertility workup, and found that my progesterone was low and my estrogen was high. So, I had a hormonal imbalance and she sent me to TFC.
Dr. Vaughn met with us, and told me that based on my records from WPinH that I had a hormonal imbalance based on me being overweight. That's it. Nothing else. He didn't do any tests, didn't look at other factors like my overall family medical history, my appearance, etc. He said that I needed to go on BCP to regulate my hormones, I needed to lose 40 pounds, and then, and only then, would he start me on Clomid.
I started seeing a new Family Practitioner in April 2005, and she diagnosed me with PCOS right off the bat from medical history and my appearance (where I carry my weight, hair growth/loss, hormone profile from the GYN tests, etc). Her blood tests and putting me on Met confirmed the diagnosis.
I started seeing Dr. Youngkin in November 2005 on my old FP's recommendation, and at his office we finally saw the string of pearls cysts on my ovaries during an u/s. I talked to him about starting Clomid, and we elected to wait until after the beginning of the year (DH's benefits started covering infertility then) and for me to try to lose 5% of my weight. I had an appointment on Feb 28, 2006 to talk to him about starting Clomid, and I got my BFP for DD#1 on Feb 24 from Avandamet alone.
The moral of the story is that I went for 3 long years not being properly diagnosed, and I feel Dr. Vaughn at TFC was part of that. I don't know if I would have had a different experience if I had seen a different doctor at TFC, but if nothing else, the attitude I got at TFC and Dr. Vaughn regarding my weight put me off of them entirely. My FP who diagnosed me thought that putting me on BCP when I was TRYING to get pregnant and needing infertility treatment was the dumbest thing she had heard of. She was also not happy that a fertility clinic/reproductive endo office missed the PCOS diagnosis when I exhibit pretty much all the clinical symptoms.
Just my $.02. I've been with Dr. Youngkin for almost 3 years now, and it's been a good experience.