How was your experience with Ramchandra Rao Ayyagari at Ayyagari Ramchandra MD?
Dr. Ayyagari was informative, to a point. He was a little outdated in some of his practices (which I only found out recently seeing a new doctor) so he didn’t offer much more beyond the basic IUI with Clomid (no injectibles were ever discussed). He always kept me at 50 mg of Clomid and never increased the dose, despite no results from the dosage with and without IUI. He doesn’t perform IVF, so that was never an option, nor did he ever discuss referring me for IVF. He just kept saying that the chances of successful pregnancy would increase between three to six IUIs. So I made sure to at least make it to three IUI treatments before deciding to seek a second opinion (since treatment isn’t cheap). Because there was no use of injectibles nor trigger shots, I had to track my own temperatures and ovulation using ovulation strips. Once positive, I would call his office and they would bring me in to assess when they would perform the IUI. Sometimes he seemed unsure that we had timed in right. I don’t hold that against him because he didn’t want to mislead me but, on my final IUI with him, he seemed hopeful and said that he thinks we made it in time. Turned out negative. When we kept failing, he never discussed WHY. He never talked about other options or reasons why, nor did he suggest further testing. He never even outright stated that he thought I had unexplained infertility, but prescribed steroids for me after my second and third IUI treatment which were used FOR women with unexplained infertility. He would perform the IUI and then I would have to take progesterone suppositories and heparin shots twice a day as well as one baby aspirin daily. Nothing was working or successful but nothing was changed with treatment. If he had discussed other options, maybe I would be more satisfied as a patient. I understand infertility is difficult and complicated, but there just wasn’t any discussion WHY things weren’t working. WHY aren’t we changing things if it continues to NOT work. I decided to not spend anymore money with him and got a second opinion. That’s when I found out he did things that were outdated. I had saw him originally because I knew many women who WERE successful with him and his treatments. Plus, he was local and he was very caring when it came to finances, knowing that infertility was expensive. He tried to help patients with financials. I also had a laparoscopy and hysteroscopy done with him since my HSG didn’t come out very promising. He found endometriosis and cleaned it up during surgery. Otherwise, just Clomid and IUIs we’re done with him without any success.
What's one piece of advice would you give a prospective patient of Ramchandra Rao Ayyagari at Ayyagari Ramchandra MD?
Be your own advocate. If you’ve done research and want to know more about different options for treatment or why something isn’t working and what can be done about it, don’t be afraid to ask. I didn’t do this and regretted that. If you don’t get the answers or options you want or need, go elsewhere.
During treatment, were you treated like a number or a human with Ramchandra Rao Ayyagari at Ayyagari Ramchandra MD?
He did take the time to talk to me and I never felt rushed, despite his dry and blunt demeanor.
Describe the protocols Ramchandra Rao Ayyagari used in your cycles at Ayyagari Ramchandra MD and their degree of success.
For IUIs, he would put me on 50 mg of Clomid for 5 days starting on cycle day 3. Then I would chart my temperature and start doing ovulation strips. Once I got a positive ovulation strip, I would call the office and they would have me come in the day of or the next day depending on the time I received it. He would do a transvaginal ultrasound in the office and decide from what he saw when we were going to do the procedure (either the next day or the day after that). I would do the procedure then go home and start the progesterone suppositories and heparin shots twice a day as well as a baby aspirin daily. The baby aspirin and heparin was for my clotting factors. The progesterone was to “calm my uterus” and help my lining. I was also taking methylfolate daily for my MTHFR. I did this regimen for two weeks but he had me take a pregnancy test within 10 days to see if it took. Once I received a negative test, I stopped all the meds except the methylfolate. I did have to take a steroid for unexplained infertility after my second and third IUI, but he never told me that it was for unexplained infertility (I researched it myself). He explained the procedure while doing it but never explained why treatments were failing. None of the treatments worked for me.
Describe your experience with the nursing staff.
The nurses were very friendly and helpful. The one that would usually assist in IUI procedures was always very positive and hopeful and would tell us that we were pregnant and to just keep thinking we were pregnant. While I appreciate their positivity, because all my treatments failed, I was thinking I’m pregnant just to find out I wasn’t every time. It became disheartening. But the nurse would say that I was pregnant after every treatment. Maybe they should find a way to state things a little differently- be positive, but maybe not tell the patient they’re pregnant (?) During my time with Ayyagari, they were training a few nurses, and so things got a little confusing for the new nurses. Aside from that, the nursing staff was decent.
Describe your experience with Ayyagari Ramchandra MD.
The clinic was fine. It was a little outdated and older but that never bothered me because I had heard he was successful. But some of his equipment was a little older. And they don’t have electronic records (I don’t believe). But overall, the clinic functions fine. But not state of the art or modern looking without modern equipment.
Describe the costs associated with your care under Ramchandra Rao Ayyagari at Ayyagari Ramchandra MD.
The ultrasounds were around $130 I think. Unfortunately, I don’t remember. But I usually paid a total of $1000 for the IUI procedure, not including the medications that came with it (like the progesterone and heparin, along with the needles, etc.). If we had to perform an IUI over the weekend, he would charge an extra $500 to pay for staff being on call for the procedure. With his IUI he would do an insemination and then I would come back two days later to catch the egg on the other side, each cost $500 equaling $1000. But if he did an ultrasound and saw that he may have caught the egg too late and it just ovulated, he would only do one insemination, therefore it would cost only $500. I don’t remember how much the medications cost unfortunately. But that was it as far as the procedures. The HSG cost $500 or less I believe. And my insurance covered my laparoscopy because it was to rule out endometriosis.
Describe Ramchandra Rao Ayyagari's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Ayyagari Ramchandra MD.
Never got to that point nor discussed it.