Dr. Patel told us his policy is to transfer 1 PGS normal embryo if the genetic testing has occurred. Transferring multiple embryos increases pregnancy risk and the potential for complications as well as risk to the growing fetuses...[he] did all my monitoring ultrasounds himself and was always familiar with my case and medications. He would joke with us, sharing really bad "dad jokes" because he realized we enjoyed that kind of humor
Everyone in the [Arizona Associates for Reproductive Health] clinic knows our names and asks how we are doing, remembering the name of our dog or activities and hobbies we enjoy and asks about them...In cycle 3 we got 7 mature eggs, 5 fertilized, 3 blasts - 2 PGS normal, 1 low mosaic; cycle 4 we got 5 mature eggs, 5 fertilized, 3 blasts - 1 PGS normal, 2 aneuploid... She genuinely cares about her patients and their lives outside of the grueling nature of infertility treatment
How was your experience with Ketan Patel at Arizona Associates for Reproductive Health?
Dr. Patel doesn't beat around the bush or raise false hope during treatment; he tells it like it is. Some people want hand-holding and that kind of comfort from their RE but we want a skilled physician who will help us make a baby. From the initial consultation and throughout the course of treatment, Dr. Patel was always brutally honest about his expectations so that we were aware of the situation and where we stood. He tells it like it is as opposed to what he would like it to be. Out of close to a year and a half of treatment, we saw Dr. Patel for every visit except 2 or 3 when he was out of town or unavailable due to emergency surgery. Dr. Patel did all my monitoring ultrasounds himself and was always familiar with my case and medications. He would joke with us, sharing really bad "dad jokes" because he realized we enjoyed that kind of humor. When we wore customized shirts from Etsy for our transfer, he loved them so much he took pictures with us and wanted everyone in the clinic to come and see. When we had our 7 week ultrasound visit to check for fetal heart beat, he got so excited and gave us a huge hug, telling us how happy he was for our miracle and that is WAS a miracle. When we lost the pregnancy in the second trimester, he called that afternoon to talk and find out what had happened, and assured us that he would help in every way he could. I'm confident that he has been thinking deeply about how to reconcile our loss of a genetically normal fetus and will have some ideas at our follow up (we are still waiting on some additional genetic testing). He is somewhat set in his ways and reliant upon evidence-based research, so he is sometimes hesitant to try new things unless you come prepared with peer-reviewed publications and a solid argument. He is willing to compromise when you make a compelling case. Although it can be difficult to reach him personally sometimes, he does review everything and knows exactly who his patients are.
What's one piece of advice would you give a prospective patient of Ketan Patel at Arizona Associates for Reproductive Health?
Don't be put off by his abruptness or direct talk; he doesn't waste time telling you what you want to hear. He tells you what you need to hear. He doesn't like to raise false hope and he will also do everything within his ability to help you be successful.
During treatment, were you treated like a number or a human with Ketan Patel at Arizona Associates for Reproductive Health?
I don't live in the Phoenix area and have to travel for treatment (no REs near me), so it was very kind at first of the front office staff to accommodate me with appointment times that took into account my travel time from home. Everyone in the clinic knows our names and asks how we are doing, remembering the name of our dog or activities and hobbies we enjoy and asks about them. When we had a cycle fail, Dr. Patel expressed his regret. When I had my fourth retrieval, the nurses brought in little stuffed animals to wish me luck and watch over me during the procedure. When we were preparing for my FET, I ovulated through the meds, so instead of waiting until the next batch of FETs, Dr. Patel got the lab to agree to do a special FET outside of their normal schedule. When my first FET was successful, all the nurses crowded into the tiny office to give me big hugs and celebrate. When I experienced a second trimester loss and told my nurse at clinic, Dr. Patel called me that afternoon after he finished seeing patients to find out what had happened, and the nurse told me everyone in the clinic had cried. When I called clinic for the first time after my loss, the receptionist cried on the phone with me. Every person who works in the clinic genuinely cares about the patients.
Describe the protocols Ketan Patel used in your cycles at Arizona Associates for Reproductive Health and their degree of success.
I did four back to back retrieval cycles because I have DOR and needed to embryo bank before my eggs got any fewer and worse quality. We started with an agonist protocol (150IU Menopur, 300IU Gonal-F). I have DOR, and when the first cycle wasn't as successful as we'd hoped (we got 5 mature eggs, 4 fertilized, 2 blasts - 1 PGS normal, 1 low mosaic), Dr. Patel wanted to try a microdose lupron flare protocol to see if we could get better results. He also added Omnitrope (HGH). The MDL protocol was terrible for me and resulted in a failed cycle (5 mature eggs, 4 fertilized, 1 poor quality blast - high mosaic), so we switched back to agonist. For cycles 3 and 4 we used 150IU Menopur, 0.4 units Omnitrope, 300IU Gonal-F, and 150mg Clomid, and were more successful. In cycle 3 we got 7 mature eggs, 5 fertilized, 3 blasts - 2 PGS normal, 1 low mosaic; cycle 4 we got 5 mature eggs, 5 fertilized, 3 blasts - 1 PGS normal, 2 aneuploid. For cycles 1-3 we used birth control priming and for cycle 4 we used estrogen/testosterone/progesterone priming. The ETP priming appeared to result in more follicles overall but after stims started my right ovary didn't respond at all, so Dr. Patel said that if we ended up doing another retrieval in the future, we would stick with birth control priming. He didn't want to use estrogen priming alone for me because he was concerned I would ovulate through the medications. He kept me with birth control because my hormonal levels didn't indicate my ovaries were oversuppressed, which can happen with some DOR patients.
Describe your experience with your nurse at Arizona Associates for Reproductive Health. (Assigned nurse: Doreen Blair)
Doreen was my primary nurse and a couple of other nurses assisted. Doreen and I get along very well because we communicate in the same way and are both very organized. Once she realized that I am a rule follower, she knew she didn't need to worry about me following directions because I wrote everything down. Doreen is one of the most caring nurses I've ever met. From the first time I met her, I could tell she was on my side and wanted to see the back of me as quickly as possible -- because that meant I would be pregnant and partway to achieving our goals of having a baby. She genuinely cares about her patients and their lives outside of the grueling nature of infertility treatment, asking us about our dog and hobbies, what fun things we'd done lately. Because we have an almost 3 hour drive to the clinic, she always made sure to accommodate us as best she could with our appointment schedule.
Describe your experience with Arizona Associates for Reproductive Health.
Because the clinic is pretty small, everyone at the clinic will know who you as a person and not as a number. The staff stay on top of things the majority of the time and the care during cycles is top notch. It can be difficult at first to schedule an initial appointment because there may be a waitlist, but after that it is easy to communicate with the office. When I first contacted the office in August 2018 the clinic was in transition to a fully private practice owned by Dr. Patel, so those first few months were less than ideal communication wise. That fall there was a lot of staff turnover, which was difficult to deal with as a patient (especially a distance patient), but once things got settled around January 2019 I found everything to be much better. Dealing with billing can sometimes be a pain because of the delays in how the paperwork processes, but Libby (the billing coordinator) is great and helps out as much as possible. As a new patient, it's important to know that it might take a couple of months to get started on any kind of treatment plan if you've never been diagnosed with infertility (that's the same as anywhere, though).
Describe the costs associated with your care under Ketan Patel at Arizona Associates for Reproductive Health.
At the time of my initial treatment in 2018/2019 I had coverage for most things under insurance (that's since changed). For initial diagnostic testing, I paid copays and some lab charges less than $100, although my genetic carrier screening cost $299 because insurance wouldn't cover it. My recollection is that for cash pay patients it's around $5000 for the retrieval + anesthesia costs + medication. If you want genetic testing of embryos, it's $1800 to test 8 embryos over 9 months. Medication costs will vary but mine was equivalent to probably $5000-$8000 per cycle. Omnitrope is not covered by insurance and can cost around $400 per vial; for three cycles I had 4 vials each (so a total of 12 vials...). I believe the transfer is around several thousand dollars + medicine (usually covered by insurance this time), but I'm not sure. I also did a diagnostic cycle with the ERA test and the ReceptivaDx test. They both cost around $800 each to the test companies + clinic fees for the monitoring appointments and biopsy. Embryo storage is $720/year and you can pay one annual fee or monthly.
Describe Ketan Patel's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Arizona Associates for Reproductive Health.
Dr. Patel told us his policy is to transfer 1 PGS normal embryo if the genetic testing has occurred. Transferring multiple embryos increases pregnancy risk and the potential for complications as well as risk to the growing fetuses.
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Clinic
Arizona Associates for Reproductive Health
Scottsdale