Arkansas Fertility Center

In order to get IVF treatment, we were told we need an initial consultation with Dr. Moutos, which we came in with the expectation that everything will be scheduled that day, but we were wrong. We first waited for 1.5 hours and a resident took some medical history. Waited another 45mins then Dr. Moutos came in and reviews our chart, and says that he thinks IVF is the right course of treatment for us (which we already knew since our OBGYN referred us to him after 3 failed IUI). And he proceed to explain how IVF works, and at that point we already read up so much that nothing new was offered. We were scheduled to come back in a month for an ultrasound and semen analysis. That was our first visit. We took off an entire day of work and spent $250 just for that. I felt that we could have easily done this over the phone. Second appointment I had an hysterosonogram, which is an ultrasound with saline injected into the uterus. Dr. Moutos performed the ultrasound himself. Prior to that, I've had numerous ultrasound done from IUI, and I also had another hysterosonogram done at my hospital after, so when I say Dr. Moutos's ultrasound is quite uncomfortable, I have some point of reference. I've noticed at that point that Dr Moutos is more of a numbers guy, so if you value bedside manner with a warm personality a lot, he will likely disappoint you. Another example is after my first cycle was cancelled, Dr Moutos adjusted the treatment protocol, but I was still not responding well. He was honesty with his feedback that he's not sure why, but did not offer reassurance or alternative treatment plan. He's not one to sugar coat things and he spends very little time in his visits. I suspect it's because the clinic is very busy since the waiting room is always full and each time I go in the wait time is always more than an hour unless it's timed like retrieval or transfer. I'm sharing this not because I don't think he's a good doctor, but I want people to be able to manage their expectations, so they're not frustrated like I was.

Expect a long wait time, and have all your questions prepared before he rushes out of the room. If he won't answer them in detail, the nurses usually will. You will also likely see Dr. Batres even though your primary doctor is Dr. Moutos.

Prior to each cycle starting, I was on birth control pull for about 2 months. The first cycle he started with 150 IU Gonal-F and 150 IU (2 vials) Menopur for 3 days. The fourth day ultrasound and lab work showed a minimum estradiol increase so he increased the injection to 225 IU Gonal-F 150 IU Menopur for another 5 days, and my cycle was cancelled on day 8 since the estrodial level and follicular development wasn't as high as they had expected. The second cycle added 1 pump of 1% Androgel each day for 22 days prior to the injection. He started me at the higher dose of 225 IU Gonal-F and 150 IU Menopur, which continued with frequent ultrasound and blood for 8 days. On the 9th day, they added 250 mcg of Ganirelix in addition to 225 IU Gonal-F and 150 IU Menopur for the following 5 days. On day 14, I injected 250 mcg Ovidrel in the evening for my scheduled morning retrieval 2 days later.

Initial consultation: $250 IVF flat rate for monitoring, egg retrieval, and transfer: $11,000 (also including the initial blood work, HCG blood work, and semen analysis). If you're doing distant monitoring at Parkhill Fayetteville, the case flat rate is $8000. Any additional ultrasound and blood work done in the office: $585 on the weekend, $490 on a weekday. Ultrasound and blood work at Parkhill (cash rate): $402, insurance rate (about $90/visit depending on your insurance). Standard medication from freedom pharmacy: $4700 Frozen cycle: $3000 Embryo cryopreservation, billed annually: $250

During my initial consultation, Dr. Moutos indicated with my age (34 at the time) and a high AMH level, he'd recommend eSET. After my egg retrieval, he let me choose to transfer either 1 or 2 embryo since we had 5 fertilized and surviving embryos on day 3 transfer. We chose to transfer 2.

Horrible experience. He has an accent and is very hard to understand. He does not go in to detail on anything and left us in the dark on most things. He has a nervous laugh that he does that always came at the most inopportune time. I have no doubt that he was very smart and capable. But he did not give us the experience we needed and we are switching doctors.

Don't let his nervous laugh get to you. Just know he isn't meaning to be insensitive. Do your own research because you're not going to get any detailed information out of him.

He did not give us any details as to strategies or why he chose them. Part of the reason for our horrible experience.

I don't remember. Tried to block that out of my memory.

He’s strength is very smart. Weakness is too busy. Too many patients I think. Staff are medical assistants and not nurses. Ivf coordinator is lpn. She always seems in a hurry. Not as compassionate as I would have liked. Dr Moutos probably has too many patients at one time to really focus on individuals. He does try tho. Also Arkansas has only two reproductive endocrinologist so they are real busy. Usually runs an hour behind schedule. Not always but might count on it if you’ve got an appt

Try to ask questions and make him make time for you.

Antagonist protocol for ivf. I had almost hyperstimulated. Probably should have been given less dosage but that’s always hindsight. I did have issues and he tried to keep monitoring me. I think he did his best with what he had to work with - my body.

Had to be first thing in th morning typically. Had to wait an hour sometimes just for these appts once I got to the clinic.

I forgot the costs. My husband dealt with this. Too stressful for me. We actually took out additional insurance policy that helped with some of the costs. Also there are rebates on medication online on each medications website.

More risks for twins. I had uterine septum so higher risk for rupture.

He was very upfront with potential success rates, I only felt slightly pushed straight to IVF, which we declined. I have declined cyst aspiration but when I asked questions about risk vs benefit of aspiration, i never got a clear answer. He carefully monitors me and i feel confident he will eventually get me pregnant.

Go somewhere else. But, since they’re the only IVF clinic in the state, you basically have no choice. So, if you do go; Ask questions. If you don't understand, keep asking. Advocate for yourself. Don’t be afraid to get confrontational if needed.

I have DOR diagnosis. He told me success rates are better with IVF but i wasn't ready to get into that. We started IUI with 100mg clomid and ovidrel trigger. We are about to start cycle 3 doing the same since I respond well to the clomid for a DOR patient.

Cost for IUI cycle $1200 includes all appointments, monitoring, and procedure After 1 IUI cycle, we opted to pay for appointments as we went. I had only needed 1 monitoring appointment before trigger. The billing lady told us paying as we went would cost us more, but it didn’t. Total was $200 less for us. Not everyone would save, maybe, but we did. Run the numbers yourself, don’t take their word for it. I asked for an itemized cost for IVF, which the person responding to my message, refused to give. She said 15-20K Plus Meds.

Dr. Moutos was very knowledgeable but he didn't always have the best bedside manner. He was very blunt and direct. I appreciate the directness however I felt like he could have had better delivery when communicating with me.

Be your own advocate, do your research, and ask questions. Each time I would go in for a visit I would tell Dr. Moutos that I had some questions whether I did at the time or not. That way after he performed the ultrasound he would give me and my husband some time alone while I got dressed. We used that time to get our thoughts together to determine what questions we had (we always ended up having questions.) He would come back in a few minutes later to answer my questions. However, if you don't tell him that you have questions he will leave after the ultrasound not to be seen again.

IUI- 1 round letrozole with ovidrel (Dr. Batres said letrozole was better for unexplained infertility) IUI- 3 rounds clomid with ovidrel (Dr. Moutos said we needed to produce more than the one egg letrozole would produce) IVF- Cetrotide (used instead of Lupron for cycle 2) Lupron (caused cycle to be cancelled because it caused me to produce an egg and not supress production) Gonal-F Menopur Ovidrel Follistim

I believe that IUIs were around $1500 each. I think IVF was around $18,000 but they did offer a discount if the 1st round wasn't successful and you needed to do a 2nd round.

Our doctor recommended eSET but let us choose. We chose to transfer 2 embryos. He said that was our choice and he was ok with our decision. He felt that it would still be safe to transfer 2 embryos but of course would not let us transfer more.

His accent is very thick and he speaks quickly so he is hard to understand. While he does thoroughly explain things, he uses medical terms and speaks fast opposed to “dumbing it down” for you to understand.

Ask lots of questions and tell him when you don’t understand something

Started off with letrozole and then switched to clomid while doing “intercourse cycle” before switching to iui.Each month I was told there were good results to the medication but there would be no explanation to why I wasn’t getting pregnant. Then I was told the only way we could move forward was to do ivf, which we could not afford. They stopped treatments altogether and said when we were financially ready to start ivf to let them know.

My insurance covered most appointments and treatments. Just had a copay, and it would not cover certain injections I was prescribed. It did not cover xrays or the surgery I had. Also, when we reached where they wanted us to do IVF, my insurance did not cover medications needed and I was told I needed $8,000 to even begin the process

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He is not a good communicator which is partly due to a language barrier. He also laughs at inappropriate times and made me feel like he really wasn’t interested in my issues. I was seen in this clinic for 2-3 years and also felt uncomfortable as a patient. Dr Batres and his partner are not patient advocates at all. They give the impression that they are in it for the money and do not care about their patients feeling or emotions.

Do not expect good communication.

I had multiple blood draws to check for thyroid issues, ANA, lupus anticoagulant, etc. Also had an HSG done and multiple rounds with fertility drugs. Received multiple vaginal US’s to look at uterus and uterine lining. Achieved pregnancy twice but miscarried both times.

About 70% of my care was covered by insurance.

Overall good experience with the Dr. Batres. He was patient and thorough. He does have an accent that makes it a little hard to understand. He also draws upside down while he's discussing your assessment which was distracting for my husband. Poor experience with the clinic and nurses.

I would ensure that you're educated on your diagnosis and very well researched. He does talk quickly so you have to keep up.

Dr. Batres works at the only clinic in Arkansas so if you want to pursue IVF in AR, you don't have any other options. We never moved passed the assessment stage with Dr. Batres. Things were progressing much too slowly. At every step, the would request information from past treatments that we'd already shared over. We eventually switched to Tulsa.

I only paid for the initial visit and I don't remember the exact amount.

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Dr. Moutos was brash and difficult. He is known to not have a good bedside manner but for a while that seemed ok until it was clear he was not explaining the process to us completely at each step. He initially told us that I could start medication whenever I wanted, but when we came in to start medication he said we should do a test and then we could start medication. We did that test, came back, and it had not been made clear to us that the test results may result in surgery. So I had surgery and were told after that we could start medication as soon as we wanted. We came back after surgery and were told that while the surgery went fine that we would need to wait two months and that was always the case, no one could start without a two month wait. He also talked me into a laparoscopy that I did not necessarily need. He claimed that insurance would not pay for the procedure if we found I needed it later in treatment and while he was nearly certain there was nothing to find it made sense to cut now and know for sure. It was a shock when he said very nonchalantly that he found stage 2 endometriosis "all over the place" (he never specified what that meant) and seemed to be irritated by my shock and dismay. After going into treatment with a different doctor at a different clinic later I asked her if it was a concern and she said no, and that she was surprised I had a laparoscopy in the first place given my history and records from Dr. Moutos's office (which were entirely complete). I also had a hysterosalpingogram (HSG) prescribed by Dr. Motous but performed by his partner Dr. Batres. I was not told that Dr. Motous would not be performing the procedure and was not given an option on what day to do the procedure. After that procedure I developed mild chronic uterine pain and GI issues that Dr. Motous discounted. I was not given antibiotics after the HSG or the surgery by Dr. Motous. I ovulated spontaneously and became pregnant 2 months after the surgery and subsequently miscarried. The chronic pain and GI issues never abated but they were the least of my worries at that point. During a second hysteroscopy by a different physician/clinic 6 months later it was discovered that I had endometritis, which is common after having a uterine procedure or surgery without prophylactic antibiotics. Some of the symptoms are mild chronic uterine pain and GI issues. Endometritis is also a cause for miscarriages. Ultimately I left Dr. Motous because I felt bullied generally, pushed into surgery I did not need, and that he was irritated and appalled when I asked questions. I know many women have given him good reviews elsewhere but those women have also gotten pregnant and had children while being treated by him. I try to be objective and avoid bias in my reviews of him as a result, but ultimately it comes back to the fact that I felt bullied and he was mean to me. Given how hard fertility treatments are to begin with to have your physician be mean to you is the exact opposite of how any woman and couple should be treated. Kid gloves aren't always necessary or appropriate but being a decent human being and nice to your patient is necessary.

If you are going to see him, don't let him bully you into anything and don't expect him to know who you are, what your history is, or your name. And don't bother asking questions, it just pisses him off.

HSG to find out if tubes were blocked, then hysteroscopy to examine uterine obstruction (determined to be large polyp) and laparoscopy to determine if there was endometriosis, then Clomid. It was never clear how much monitoring/how many ultrasounds I would receive while on Clomid to make sure that I wasn't at risk for Ovarian Hyperstimulation Syndrome (OHSS) and OHSS was never mentioned as a risk of Clomid despite it being a high likelihood given my medical history. Ultimately I left his practice before treatment started because I felt bullied and worried that his treatment protocol would not be individualized to me or necessarily safe.

I paid up front for the HSG and surgery without knowing at the time that it is a practice that is discouraged by insurance companies because negotiated rates change the billing amount so the patient is expected to pay a co-pay up front and then whatever is owed after the negotiated rate on the back end. At Dr. Moutos clinic it is a flat fee up front and then they will ask you for more money if it is owed. Ultimately, they owed me money and it was incredibly difficult getting a refund from them. I was also never told that I would owe money for any appointments beyond the co-pay for a specialist before I started treatment. I only found out when I received a late notice without having received an original invoice. When I questioned it and asked them to submit it to insurance anyway they stated they had told me about it, given me a rate sheet (I never saw one and I'm completely OCD about keeping things like that for budgeting), and insurance would not pay for it. I submitted it to insurance myself and insurance paid for it because it was considered diagnostic and not treatment.

I explained this in a previous comment section. I guess I jumped the gun. I do feel like he could have done more to see what was wrong. I was not told that Batres would do my IUI. I was expecting to see Moutos.

To make sure you have all the tests you want run told to him, otherwise he will jump right into doing an IUI without running all the tests.

He ran blood tests on me and my husband. A sperm analysis on my husband and performed a HSG on me. He then prescribed me clomid. Told me to come back when I was ovulating. I never saw or was able to speak to him again.

It was around 1500-1800. We were told my insurance would cover some of my husband's test, but they didn't. We received a bill for more than 800. Then about $800 for the IUI and injectable hormone to cause me to release an egg that I didn't need.

Very intelligent in his field but understaffed and no bedside manner at all. Very harsh and lacks compassion. Hard to get in touch with at the clinic and communication is extremely difficult. He is good at what he does but his clinic needs more doctors and a more patient-centered practice.

Injections to prepare for egg retrieval after surgery to remove a uterine septum. Used icsi to fertilize eggs. Transferred three embryos. Excuse quality wasn't good. Had a 3 day transfer because of the low number of embryos to pick from. First cycle failed and second cycle was exactly the same with no fertilized eggs. So we transferred donated embryos.

$7000 to the clinic plus meds

The clinic usually transfers two but did three for us because of lack of quality.

He met with me initially twice and then the next time I saw him was when he did the IUI treatment. In between, I saw the other doctor. The other doctor did my ultrasound exams and discussion over treatments and next steps.

He is nice, but he doesn't seem to spend much time with the patients.

Ultrasound $350 IUI-$400+

I felt like Dr. Moutos had a poor bedside manner with little personality and felt like I was talked down to when I could not tolerate certain fertility drugs. I also was passed off to Dr. Batres at times, who frankly, was creepy has he had a nervous laugh whenever telling me that the lining of my uterus was not thick enough for implantation. This is not how I want to be told.

Leave and go to another clinic.

I was put on estrogen and progesterone to prepare my body for implantation. When the first embryo did not take, they put me on Lupron, which I reacted terribly to.

I am not sure as my insurance paid for a lot of the transfer and my embryos were created at a different clinic. I did pay $600 to transfer my embryos elsewhere and had over $1000 that was out of pocket.

Didn’t trust his practice and he didn’t seem to really care and if you didn’t ask questions you wouldn’t know and did not follow up I had to call to get certain results and I just didn’t feel like he cared enough because he felt I was already too overweight for and ivf or tubal reversal

Find a place with holistic care because he didn’t seem to care a lot at all

Lose weight before he would consider to do surgery on me

Not sure

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