Brigham & Women's Hospital

As I mentioned, Dr. Garguilo has a phenomenal bedside manner. I cannot get over how incredibly kind he is, and how positive I felt every time I left an appointment. He is very honest and encouraging and evaluated me as an individual rather than a statistic. He kept my husband involved in everything, including visits to see him in the waiting room both before and after my procedure (I had a robotic tubal reanastemosis done, not IUI, but that's not a selection on this web site). When I brought up an issue with billing, something that I did NOT feel was part of his performance but wanted him to know, he immediately took steps to have me speak with someone who could help. Dr. Gargulio is a fantastic doctor and I highly recommend him to anyone looking to have a tubal ligation reversed.

My one piece of advice is to not bother calling anyone else - call Dr. Gargulio's office. I went through three doctors - one of whom treated me so poorly that I had given up on ever having children again - and my only regret is that I hadn't found him sooner.

I would like to repeat that I didn't have a fertility procedure or analysis done, but this particular website doesn't allow for that. I went to Dr. Gargulio because I wanted my tubal ligation reversed. The procedure had been done by my Ob/Gyn when I was in an abusive relationship (and I felt pressured by her nurse to have it done instead of another method of birth control) and began to regret it as soon as that relationship ended. I had an initial visit with Dr. Gargulio where we discussed IVF or tubal reanastemosis, with my very strong preference being the surgery. I was given some statistical information, then came back for a pre-operative visit where risks and statistics were discussed in further depth, and I signed my consent. I then had my surgical visit, followed by a post-operative visit where I was told that I can schedule a dye test to ensure my tubes remained open at my convenience. I am still within one month of post-op, so I don't have any results aside from the overwhelming satisfaction of having my fallopian tubes intact.

There was a one time bill of (approximately) $8,500, which would include a refund if I did not require an overnight stay. This included my consultation, pre and post op appointments, the surgery, and a hystogram (dye test) following the surgery.

This is not applicable to my situation. My doctor's approach of using a robot to perform my tubal ligation reversal laprascopically made my recovery time quick and easy, with a much lower risk of complications and infection.

Dr. Ashby is as knowledgeable as they come and it shows in her delivery. She is kind and patient, has good bedside manner and is caring but she is also direct and to the point and doesn't sugarcoat things but she is flexible and listens to the concerns of the patient.

Come ready with questions, be open and honest.

2 round of IUI on clomid, meds for retrieval were minimal with desired results, mock transfer to measure placement. Retrieval and fertilization without ICSI for first round. We did PGS so froze embroys after Day 6.

Insurance covered 90% for us. IUI was $300 range and IVF retrieval and testing was $875. Meds were $2,500 before deductible for retrieval

Dr. Ashby is a big proponent of single ET vs multiple. I would not suggest Dr. Ashby if you're looking to implant multiples

She's very clinically focused, and does use a lot of examples from studies. But she also uses her own experience. She's very upfront and honest, but is also kind. She has been willing to switch up medications and protocols, and uses your past cycles as reference. There have been multiple instances when she's called me personally instead of the nurses, and she always answers all of our questions. We never feel rushed when we meet with her, and she answered all of our questions. She's honest, which quite frankly, is what women need during this process. She's never offered us false hope, but she's also never deterred us either. You can tell she has the same end goal as you--to get pregnant. I don't feel the same way about the other clinic or physician I was with before Dr. Ginsburg.

I was highly recommend her to anyone going through fertility treatment. She truly has your best interests at heart. She may seen "cold" to some, but I believe that's her being clinical. I never felt she was cold. She's only been kind, and really helped us explore every option while never pushing things on us.

The first two IVG cycles I did before Dr. Ginsburg were antagonist with Gonal-F, low dose HCG, Cetrotide and a lupron trigger. For the first cycle with Dr. Ginsburg we used the antagonist protocol with Gonal-F, Menopur, Cetrotide and a lupron trigger. For the next cycle we completely switched it up and used the long-lupron protocol and an HCG trigger.

My insurance covered my rounds of IVF with my own eggs. They covered some but not all of the fees associated with genetic testing. We also looked at donor eggs and that was not covered by insurance.

Because of my age, she prefers doing a single embryo transfer. Also, because of my fertility issues we need to do PGS and PGD teting on all embryos, so we would only transfer testing, normal embryos.

Before coming BWH and seeing Dr. Ginsburg, I was a patient at a much smaller fertility clinic called Fertility Solutions. The difference between the two clinics was considerable. At FS, there are just 3 doctors and over the course of my two year treatment there, I got to know each doctor very well and all the nurses as well. Dr. Ginsburg is one of about 12 (this is just a guess) Reproductive Endocrinologists at BWH and she sees hundreds of patients. This does not mean she cares less about each individual, it just means (in my opinion) she has a more streamlined and matter of fact approach simply due to the volume of people she sees. I came to her because my treatment at FS came to a screeching halt due to having to make incredibly difficult decisions. The doctors wanted to help, but I just felt like they didn't have the experience or knowledge at this point to help me make important choices. They were willing to try new things, but it was all up to me. Dr. Ginsburg had seen other women in my situation (severe endometriosis and multiple ectopic pregnancies) and she was able to give me clear direction and guidance. It was refreshing to hear someone make the call for me, when all I had experienced was "sure, we can try that if you want". Sometimes you just want someone to tell you what to do. Dr. Ginsburg is not warm and fuzzy, but she's brilliant and confident, and she shows her true compassion in her own special way.

If you're okay with a direct approach and matter of fact guidance, Dr. Ginsburg is the doctor for you. I would recommend her to anyone because of how brilliant she is at her job, but I would absolutely warn them that they will not be seeing her much (only for initial consultations or meetings to discuss big decisions) and make sure they are okay with very little handholding.

Unlike my other two cycles, Dr. G had me on menopur and much less progesterone in oil. She also increased my Gonal F a considerable amount. I produced about 20% more eggs with her protocol.

I shared this in my review of the clinic itself, but monitoring is very impersonal here. It didn't bother me because I have fairly thick skin, but for those who are more nervous and triggered by the site of pregnant women literally everywhere, the monitoring experience would be difficult. Your ultrasound will be done by a different person every time so becoming comfortable with the process is necessary

My insurance covered most of the costs of my IVF treatment here, but we are moving on to using a gestational carrier and insurance does not cover this at all.

I did not end up transferring at BWH

Dr. Ginsburg is intelligent, funny and straightforward. She is kind but does not give false hope. She listens to our concerns and did not push anything that we were not comfortable with. She explained things to us completely and made sure we had clear instructions for the next steps.

I would say that if you are overly sensitive to prepare yourself for science and straightforwardness. I appreciated this with her, but I have also had my diagnosis for years.

First, she put me on metformin ER 1500mg with the plan to take until 2nd trimester of pregnancy. The side effects were too much for my body so she reduced it to 750mg after 3 months. During the first first she also gave me a 6 month prescription for letrozole 2.5mg to be taken days 3-7 of my cycle until pregnancy occurs. She also had my husband do a sperm analysis and did not assume the problem was me even with my diagnosis. She also suggested I get an HSG done. We decided to hold off on that until the 6 month period was over. I was only 30 at the time so she was fine with that. After the six months, I had the HSG showing no issues. She doubled the dose of letrozole and I am currently on my second cycle of that level dose. The first cycle drastically increased ovulation so they are hopeful it will take this round. If not, we are going to try one more cycle and then discuss IUI.

Some were covered by insurance as it was “Diagnostic”. Consultantations that are not diagnostic are around $200. We have not had many other bills yet. It costs $9 an hour to park in the garage.

Dr Ashby is extremely intelligent and a great communicator. She will explain everything in detail without having anything be misleading or related without clarification. She has shown that she has been doing this for quite some time so she doesn’t give way to sympathy however her tone and manner shows she cares. She treats you like you are the only patient. When there was an issue with my insurance she called them the day it happened to resolve the problem. We absolutely adore her and love that she doesn’t sugar coat anything and gives false hope and emotions.

She will tell you everything in detail and assertively. She is extremely talented and intelligent. She has the same goals as her patients and strives to get you to achieve that goal.

In process now

5,000

She has a strong preference towards SET. She explained the risks which we were not comfortable with. I don’t know that she will do a DET as we have the same feelings.

Dr. Hornstein very patiently answered our many questions when we met with him in person. He always treated us with kindness and care. His nurse answers most of the day to day questions by email or phone .

Make sure you know your treatment plan and know what the next steps are. The doctors and nurses at B&W are all good at their specific roles, but the communication between them can sometimes be missing. Because Dr. Hornstein may not be actually doing your procedure, make sure you have really discussed and agreed on important things like numbers of eggs to transfer before you get to the implantation day.

Three rounds of Antagonist protocol. The second and third rounds were far more aggressive than the first and produced many more eggs and embryos. The third round led to the most eggs and embryos and had some to freeze. I did a fresh transfer after each round of IVF. Had a successful pregnancy with a FET, which was the fourth transfer.

The ultrasounds monitoring appointment were started before 7am. It is first come, first served and operated pretty efficiently.

Some was covered by insurance. It's around $8K - $12K out of pocket per IVF cycle depending on your treatment plan. That does not include meds.

He helped us make an informed decision based on risk and insurance coverage.

Dr. Gargiulo had performed a myomectomy for one of my friends several years earlier. When I was diagnosed with multiple fibroids, she asked him whether he would consider consulting with me long distance (I reside in Virginia). He immediately said yes and provided his email address. We discussed my case via email and he ordered an MRI, which I obtained locally. He requested that I send a disc with the images so that he could evaluate my condition himself, rather than relying on the radiologist's report. He provided an assessment and recommendation (all remotely at no cost) but didn't pressure me to travel to Boston or make a decision. After nine months' hesitation, I opted to move forward with surgery (laparoscopic robotic myomectomy). Dr. Gargiulo never criticized or commented on the delay, other than ordering a new MRI to ensure that he fully understood the fibroids current state. He and his staff quickly arranged both a half-day of pre-op appointments across the hospital (so that I would only have to be in Boston for one day) and a surgery date. When I finally met Dr. Gargiulo in person, he was welcoming, kind and cheerful. He walked me through the MRI images and thoroughly explained what the surgery would entail and possible additional elective procedures (but with no pressure to authorize them). My uterus was riddled with fibroids, three of which were the size of a small fist; unlike my regular gynecologist, he never suggested a hysterectomy. His entire focus was to preserve my uterus, even though at my age a spontaneous pregnancy is extremely unlikely. On the day of surgery, he stopped in to chat during my prep (he hadn't even changed into scrubs yet), spoke with my mother immediately after surgery, and came back once I was reasonably coherent. He took the time to remove more tumors than originally planned and, when he discovered adhesions holding my ovaries and fallopian tubes to the pelvic wall, removed them. He accelerated my post-op appointment by a few days so that I could return to Virginia more quickly (though I am certain he would have requested I stay had I not been healing well). During that appointment, he went over all of my surgery's details, offered images of the procedure and discussed potential pregnancy options. At all times, he was kind, thorough, patient and positive. He never condescended or tried to rush me; he never tried to badger me into making a particular choice.

Don't hesitate to ask questions via email or in person. He will answer all of them completely and in a timely fashion.

I only pursued removal of fibroid tumors. Dr. Gargiulo wanted a current MRI to ensure that he fully understood the landscape before arriving in the O.R. Because I had delayed making a decision for almost nine months, that meant getting a second set of images. I have good insurance so it wasn't an issue. He predicted he would remove the three largest tumors but ended up taking out seven, which together weighed almost a pound and were five times the size of my uterus. My menstrual cycle is no longer debilitating; my abdomen has returned to being flat; and I've lost about 8 lbs (taking my rather old body back to what I weighed 25 years ago!). If I choose to become pregnant, Dr. Gargiulo strongly recommended I deliver via C-section.

All appointments, surgery and medicine were covered by my insurance with relatively small co-pays (combined, less than $600). I did notice on a co-pay statement that the stated non-negotiated cost for the laparoscopic robotic myomectomy was $61,000.

Dr. Ashby is pretty straight forward, she definitely gives you a dose of reality, but in a compassionate way. Prior to seeking her help I had one cycle converted to IUI, and one cycle where I ovulated prematurely when I went in for retrieval of two follicles (both at Boston IVF). My numbers were not good when we met - my FSH was basically 12, and she did not think my chances of getting eggs were great. We discussed considering donor eggs, and tried to help me see that a child that wasn't genetically mine would still be a child worth loving. She also said that she felt IVF cycles might be robbing me of getting pregnant naturally, because I was spending a lot of time to get one egg, which I was already getting each month on my own. I left her office a MESS. My previous doctor had mentioned donor eggs, but had seemed more optimistic about my chances of conceiving with my own eggs. It was definitely a hard conversation to have, but I appreciated her candor. Despite her concerns, Dr. Ashby said she would try her most aggressive approach (Lupron flare) to see if she could wake up my ovaries. It felt like it was going to be a last ditch effort, and if it didn't work, I was likely to stop trying. Well it did work. I stimmed for 18 long days, but they retrieved 4 eggs, all which fertilized and were frozen (my progesterone had spiked so I had to freeze all and wait to transfer in the next cycle). Dr. Ashby was SO happy for me. She said she had hoped for 2, and was amazed I got 4, and they all fertilized. She was newly optimistic for me - and said she would definitely do it again if this time didn't take, based on those results. Ultimately 3 were transferred (4, 7, 10) but none stuck - so we are back at it again next month. But Dr. Ashby is confident now - and said the two larger embryos were really nice - so my chances aren't bad.

Dr. Ashby wants you to succeed in getting pregnant, that is her goal, she is on your side.

We did a lupon flare protocol. BCP for 10 days before cycle, then 300 iu Menupur and diluted Lupron in AM, and 300 iu of Follistim and diluted Lupron in PM. The downreg of Lupron really slowed me down so they could kick as much FSH into me as possible. My follicles grew really slow, then in a day grew 5mm all of sudden. Ultimately I stimmed for 18 days before an Ovidrel trigger and retrieval.

the appointment was $645 to meet with the doctor, my meds were about $30k (but that was billed to insurance so I don't know the real cost) my surgery for retrieval was $12k and the transfer was $4,500. I am so fortunate to have had insurance coverage.

We transferred 3 - Dr. Ashby said she would transfer 2 if they looked good or 3 if they looked not great. The embryologist said the algorithm they use said to put back 3 - but the smallest was only 4 cells so I kind of felt like that one was a low chance shot of 'why not?' since the 4th was only 3 cells - it didn't make it to refreezing.

I am a 27 year old female who lives in the DC area who was born with a unicornate uterus with a rudimentary horn. I was diagnosed when I was 22 while I was trying to get to the root of my painful cramps. I had an ectopic pregnancy when I was 23 and wanted to be proactive for future planning. My OB/GYN recommended I have a laparoscopy done to diagnose endometriosis and take a loser took at my abnormal uterus. We did extensive research in efforts to finds a specialist in the area but no luck and since my family lives in Massachusetts we began our search there. We came across a colleague of Dr. Gargiulo and after speaking to his colleague, sending my MRI, and medical records, he stated Dr. Gargiulo would be the best fit to assist. When I met Dr. Gargiulo he was very personable, kind, and empathetic of my situation. We spoke about my history and I was able to express my concerns surrounding infertility. He recommended getting a laparoscopy and removing the non communicating horn to prevent future ectopic pregnancies. He made me feel confident in trusting him for next steps. We scheduled a "Laparoscopic Excision of Right Rudimentary Uterine Horn, And Fallopian Tube". His staff along with him were so kind, wonderful, and accommodating from beginning to end. It was a successful procedure and I am pleased with the small and not very noticeable incisions.

Have questions ready to ask.

We focused on preparing my uterus for fertility. I have not yet began attempting.

not sure

Dr. Ginsburg has been very considerate of our desires and our treatment. She has considered all factors, but also been willing to work around situations and numbers. She has explained information thoroughly, and has been available when we've had further questions. She has been open and flexible and has truly made us feel like she is working with us.

To be sure to ask a lot of questions and to be completely open.

We have not yet started our cycle, but we are doing a complicated reciprocal IVF. She had us meet with maternal fetal medicine due to us both being overweight. She tested both of us thoroughly to help us make the best decision as to who will undergo the egg retrieval and who will undergo the embryo transfer.

$22,000

We have requested multiple embryo transfer. Here, we feel that we are slightly being treated like a number now, but there seems to be some flexibility and willingness to work with us there.

Dr. Walsh has been great. He is compassionate and attentive to my needs and questions. When things don't work out we have tried others and have done a plethora of tests to ensure all bases were covered (testing chromosomes, clotting factors, endometrial biopsy,etc after 2 CPs. Ensuring my miscarriage had pathology done, doing more tests. Creating a new plan for the next egg retrieval with PGS testing). The one negative would be that sometimes this information and appointments can be overwhelming and I felt like I had to decide to move forward quickly when maybe I'd want a cycle off. I also had my first egg retieval when Dr walsh nurse had retired and I was bounced around by nurses.

Just to ensure you always are on top of meds and instructions. Don't be afraid to ask questions.

First we began testing. Hormone levels for me, hsg, and hysteroscopy. My husband had 2 sperm analysis done which showed male factor. My husband was also sent to a specialist. We tried clomid for 2 rounds as we were doing testing which did not work based on my husband's male factor issues. Due to mfi we were told ivf was our only option. Since I am borderline on fsh and amh the protocol was semi aggressive with 2 vials menopur and 150 iu follistim which was increased to 225. I stimmed for 13 days and had a duel trigger lupron and HCG. I had 16 eggs, 13 mature, 8 fertilized with ICSI. We ended w 3 day 5 embryos of great quality. I did one fresh transfer w crinone that ended in a CP. We next did a natural FET without meds except for crinone support after transfer that also ended in a CP. We decided to try the last FET as a medicated cycle with 3 mg of estrace twice daily (6mg total) and once my lining got to 7mm we added progesterone a few days before the transfer and after. I had a positive beta HCG test 3 times and we set up an 8 wk ultrasound. Unfortunately there was no heartbeat and I had an enlarged placenta. Dr Walsh wanted to do a d and c to determine the cause and to check for a molar pregnancy ( I had high hcg). The results came back that it was NOT molar but the miscarriage was due to trisomy 18. We went into see Dr Walsh for a post on and we discussed next steps which was additional tests to determine any other reason for my 3 miscarriages and another hysteroscopy before we started IVF again. We also discussed PGS, genetic counseling, and higher doses to get more eggs for pgs testing. We will also freeze all day 5 embryos for ogs and do a medicated FET as I preferred the shots to crinone and I had the most successful pregnancy when we did the protocol medicated. I am currently waiting for my ultrasound to start stimulation for egg retrieval. My doses are going up to 3 vials of menopur and 225 iu of gonal f ( and we will bump up to 4 and 300 iu)

Efficient well oiled machine with sign in sheets and call backs

Dr Walsh follows SART recommendations and I only have had a single embryo transferred based on quality and age.

Dr. Yanushpolsky has been awesome so far. She’s thorough, kind, and compassionate. She reassures me and doesn’t mind to take the time to answer all of my questions. She listens to me and plans my treatment accordingly. As a single woman trying to have a baby, it’s easy to lean toward judgement but Dr. Yanushpolsky didn’t seem to mind; she was just as glad to help me. I found the idea of going to an RE intimidating and still do but Dr. Yanushpolsky makes it less stressful. I don’t have any complaints yet but I’ll be sure to update you if things change.

Dr. Yanushpolsky is upbeat and tends to move fast- don’t be afraid to ask questions! She’s happy to answer them.

Dr. Yanushpolsky and I decided to do four rounds of natural IUI. She explained that because of my age (27) and the results of my blood work/HSG we would try without medication and follow up if I wasn’t pregnant after four cycles.

I paid a little over 200 before the procedure, which was the fee for the doctor. The remained was billed to me- I think around 500 dollars.

Dr. Ginsburg is a very intelligent, calm, confident, and compassionate doctor. She has made me and my fiance more than comfortable and confident that we will be able to become parents via gestational surrogacy. She has walked and talked us through the necessary steps towards gestational surrogacy and has explained everything in great detail. She takes her time when meeting with us and genuinely cares about the success of our future embryo transfer. She has given us hope after cancer took our opportunity to become parents naturally. We met Dr. Ginsburg during a very difficult time in our lives and she gave us the hope that we so desperately needed back in 2015. Having a family of our own is the single most important thing in the world to my fiance and I and Dr. Ginsburg demonstrates that she cares about the success of the embryo transfer just as much as we do. Examples of her compassion: She has helped me fill out fertility grant applications immediately after I emailed her asking if she had time to do so. She made me feel important and hopeful. She recommended different grants/financial assistance options to help pay for fertility preservation costs. She was very easy to get a hold of when I had questions during my IVF cycle regarding medication. She made quick adjustments to a similar medication when my insurance did not cover a specific medication during IVF. She suggested testing my ovarian reserve level every 6 months to help me feel more involved and aware of the changes my body was going through and would email me my lab results as soon as they became available. She remembered little details I would tell her at past appointments about my family and hobbies/social life, she paid great attention to details. She makes me feel like part of the treatment time and keeps me hopeful through her kind/warm personality. She has more than 1 clinic location and has flexible hours making her very easy to get in touch with.

Dr. Ginsburg will explore every aspect of your fertility needs and if there is a way to help you start a family she will most definitely find it.

Dr. Ginsburg had me do 1 cycle of IVF while on tamoxifen (due to stage 3 estrogen positive cancer) back in 2015. My treatment plan consisted of injections and pills. Together, we discussed the options for eggs and embryos and the pros and cons of each. She helped me decided how many I was going to create embryos with. We froze 4 eggs and 4 embryos (originally had 6 embryos but 2 did not make it). She explained that the embryos would be frozen on day 3 to get "as money in the freezer as possible". Her plan is to transfer 2 embryos to a gestational surrogate as each embryo has a 40% chance of success. Her strategy to transfer 2 lines up with our goals, financial needs, and of course safety concerns. She explained everything in great detail.

There was a high volume of patients waiting for ultra sounds during my IVF cycle but I was never waiting for a long period of time. They were open 7 days a week and I was always seen when I needed to be. The results were always available online within a couple hours and my clinic would always call me as soon as they got results. They were very on top of my care during my IVF cycle.

My IVF cycle was covered in full by my insurance. I did have to pay about $500 out of pocket for medications. My estimated hospital costs for gestational surrogacy services were quoted at 10K. The billing coordinator, Gene Diaz, has made herself very available for questions and has broken down the costs to me in great detail both over the phone and email. She emails me back very quickly and provides much detail for each one of the fees I will eventually need to pay for surrogacy.

We prefer to transfer 2 embryos to increase of chance of success on the first transfer. She was completely on board with this decision and also agreed that it was for the best. She assured us this choice is safe and is confident it will result in a live birth.

Dr. Fox is highly intelligent, and has a practical approach to treatment. She is compassionate and understanding, and made me feel hopeful and at ease the whole way through. She never gave me false hope, and kept the data real, but she did give me confidence in going forward with a second cycle after the first failed.

Trust her method!

We used antagonist protocol, and I had a very good response both cycles I did.

pretty easy process- you were given a "window" of time, early morning, which worked well for me.

This was completely covered by insurance. I only had to pay Dr. visit copays, and a portion of the prescription fertility meds.

Dr. Fox was aggressive with how many we transferred, so we did 3 embryos for 4 of my transfers, and 2 for the last (only had 2 remaining).

Dr. Gargiulo is a truly excellent doctor and I can't recommend him enough. I initially came to him years ago seeking to freeze my eggs due to a severe case of endometriosis. He helpfully guided me through the process, and I was happy to complete several successful cycles of egg freezing under his care. Years later, after meeting my husband and deciding to start a family, I returned to Dr. Gargiulo, who talked through our plans for addressing infertility from every angle. When we decided to do a fresh cycle of IVF and ran into a terrible dispute with my insurance, he and his assistant went above and beyond what I would expect of anyone in that situation. They were always ready to help at the shortest notice during the weeks of the dispute. We won the case, and my husband and I went on to have a successful cycle of IVF at our first attempt despite a very low number of eggs retrieved. We were thrilled! I never once doubted Dr. Gargiulo's expertise, judgment, or advice. He explains everything in great detail and treats you with respect rather than talking down to you. He answers all questions with care and attention. What stands out as well are his kindness, humor, and genuine human touch. He is a generous doctor who clearly loves helping his patients. I will continue to seek treatment for infertility and endometriosis from him and cannot think of a better place in the area in which to do this than the BWH Infertility/Reproductive Medicine Center.

We haven't gotten our baby yet but I am confident that in the course of my treatment, no stone will be left unturned. She is known for having conceived and delivered her twins through IVF. That edge is what sealed the deal for me but the case was already pretty strong. When we were looking to switch practices, we asked around and she was recommended to us by friends who have a 1 year old son. They also experienced a previous loss and an early miscarriage with Dr. Ashby and described feeling very well cared for and supported.

No practice or physician is perfect - the important thing is finding a clinician whose style matches your needs. She is very in demand but if you need extra time and attention, she will accommodate you. Dr. Ashby is positive and forward moving but not one to sugar coat things. For me, that is a positive but everyone is different.

My 1st retrieval with another practice was antagonist. I got 5 blasts but it was absolute torture and was switched to freeze all because I was at risk for OHSS. My 1st cycle (2nd overall retrieval) with Dr. Ashby was also antagonist. It was also torture - though not as bad. The results were abyssmal - 1 full day 5 blast and two morulas were transferred. My 2nd cycle with Dr. Ashby (3rd overall retrieval) was an agonist micro flare protocol. It produced 5 day 5 embryos and 1 day 6 embryo. We did PGS and had 1 PGS normal, 1 mosaic and 4 abnormals. We are starting stims for the next cycle later this week with the same micro flare protocol starting with slightly higher doses of gonal and menopur. Results TBD.

Other than PGS, my care has been covered by insurance.

We only had one PGS normal to work with so we went with that. We opted not to transfer the mosaic with a normal. If we had had two normals, with the prognosis for my age we probably would have been advised and opted to transfer more than one so that we could move to the next retrieval since time is of the essence. Before my last retrieval Dr. Ashby made sure to explore my feelings about multiples and explain the risks involved.

It is very important to understand upfront that the doctors work as a team at BWH, which means the doctor you see primarily and discuss your treatment with is NOT the one making decisions as you go through your cycle, and will most likely not be the one doing your egg retrieval, transfer, HSG testing, uterus mapping, etc. I did not realize this until after my second cycle, which would have explained so much if I had known. As such, it's kind of hard to rate any doctor on their medical decisions. I had a very mixed experience with Dr. Srouji. At times she seemed to be on our side, at others she almost seemed mad at us. I was probably not the typical patient-- I didn't go in assuming we would be doing IVF--and that seemed to frustrate her. At age 39 I was sort of clueless about the fertility process and just went because my regular doctor told me to "get checked out" after six months of trying to conceive. The assumption, however, was that you are there to sign up for IVF no matter what, and she seemed really confused about how to handle the fact that I didn't know if I was willing to go that far. She waffled on a few things-- at first she said male factor was such an issue nothing short of ICIS would work, then after my husband had a second test she said it was in the normal range and trying IUI first sounded like a great plan, then when the sperm count was low with the IUI she was almost angry with me and said the sperm count was always low and she only supported trying IUI because she knew I didn't want IVF. One of my biggest complaints is that she really didn't address--or seem to understand--my underlying medical concerns--I have been dealing with PCOS/PMDD/general endocrine issues and rough periods my whole life and wasn't sure how medications would affect me. I did have some REALLY bad side effects from both Clomid and the IVF meds that she neither warned me about, nor seemed to care about when I reported them. I think some mistakes were made during my second cycle but I will never know for sure because she abruptly dropped me as a patient. I don't know if it was Dr. Srouji's fault per se, but overall I would characterize working with BWH as traumatizing.

If you are not too interested in the details or any sort of individualized care, this might be a better experience (I felt that way at first until things started getting complicated and confusing and I seemed to have more questions the more I learned). It might also be better if you are an IVF veteran and already know the basics.

At 39 and 1/2, my AMH was 2.0 and FSH was something like 5.5, but my husband's sperm count and motility was low. So low, in fact, she said nothing short of ICIS would work (long story, but we did try IUI with Clomid first). My first IVF was lower dose antagonist (gonal-f, cetrotide, HCG trigger). Afterward she said my egg maturity rate (6/11) and my estrogen on trigger day (525) were much lower than she'd expect with my numbers so we had to go to an aggressive lupron microflare cycle (lupron, menapur, gonal-f, HCG trigger). My estrogen was MUCH higher (3260), and I had 14 follicles on trigger day, but only 8 eggs were retrieved and only one embryo was frozen on day 1. The embryo had to be frozen because my progesterone was extremely high during stimulation. She said I clearly have "an egg problem" but dropped me as a patient at the same time, so I don't have anymore information than that to work with going forward.

Monitoring is very early in the morning, and they seem to require more monitoring appointments per cycle than a lot of places. It's ok once you get used to it but at the beginning it was super stressful. Leave PLENTY of time in the morning for Boston traffic, parking, etc. The ultrasound and lab techs are very nice.

It's MA and I have BCBS, so I only paid 10% plus copays for medications (~$200).

BWH uses an algorithm to determine the number of embryos to transfer-- you can choose to have fewer transferred but not more than they recommend.

Dr. Anchan was very patient with us and let us take our time with our treatment course. I was very much into taking steps slowly and progressing through each step at my own pace. He was wonderful in allowing this, I always felt like my feelings were taking into consideration and he was always able to provide steps I was comfortable with. He was amazing at explaining each step, medication, hormone and included diagrams when needed. He was always straight forward about our chances and possible success rates. I never felt blind sided at all through the process.

Trust the journey and Dr. Anchan. He has your best interest in mind and the same end goal as you.

I was not ready to jump to the big guns right away do we did a few letrozole cycles with timed intercourse. We stepped up to letrozole with IUI a few months in. When I was finally ready to accept IVF we did a antagonist cycle due to my higher AMH. The cycle was textbook and we had a high fertilization report and many embryos. We did use ICSI for the likelihood of having the most possible.

Monitoring is done first thing in the morning at a first come first serve basis. On weekends it is a scheduled time slot. I never waited more than an hour before I was out and onto the rest of my day. The techs were hit or miss with friendliness and gentleness but the phlebotomists were very pleasant. Even though this is a hospital setting they brought a phlebotomist to the ultrasound department which is very convenient.

The council we received in deciding how many to transfer included statistics and their reasoning. Both transfers we were able to explain our reasoning as well and it was always respected. Since I had a highly graded embryo we chose one for the first transfer. Our second transfer we were able to transfer 2 since we at that point had a unsuccessful transfer.

Dr. Srouji was a caring, friendly doctor. She took the time to explain the surrogacy process and answer any questions that I had brought with me. She was genuinely excited by our success and wanted to be updated when our daughter was born. She is very busy so there were times that communication as slow, but I understand that just as I am given the time and effort, so are her other patients.

Be patient with the wait times in between appointments/phone calls. Brigham is a busy clinic!

Dr. Srouji created a very specific IVF plan based on my medical issues, and monitored me very carefully, explaining her decisions along the way. We did a very low dose of hormone stimulation with constant US and blood tests to check levels along the way. Our cycle was effective and produced several viable eggs for transfer.

I did all of my monitoring appointments at the local clinic, it was very convenient and wait times were minimal, staff was very helpful.

The total cost for the clinic and hormone meds for our GC was around $10,000

I first saw Dr. Hornstein at the recommendation of a good friend who had seen him for years to manage her endometriosis. I had previously been seen by his partner, but I wanted a doctor who could do both the surgery for the endometriosis and oversee fertility treatments. Dr. Hornstein was very thorough with our initial work up and let us take our time before going to IVF. Dr. Hornstein presented all of the option and let us decide. We wanted to do PGS testing and even though Brigham doesn't recommend it, Dr. Hornstein was understanding.

Dr. Hornstein is incredibly busy and a lot of your care will be done by the nurses/fellows/other REs. If something urgent came up, Dr. Hornstein would call.

4 cycles of clomid - 3 IUIs (one was cancelled) Agonist protocol that was a freeze-all cycle for PGS and to prevent OHSS. Relatively low doses of stims (Follistim - 112.5) and Cetrocide. I used a dual Lupron and HCG trigger.

Monitoring hours during the week were from 6:45-7:45 and by appointment on the weekends. Even when it was crowded, they moved fairly quickly. The results of the bloodwork were available on Patient Gateway within a few hours and you would usually get a phone call that afternoon from the nurse.

In Massachusetts, most fertility treatments are covered by insurance with co-pays. We did pay out of pocket for a few elective things - freezing samples, ICSI and PGS but all told it was under $10k.

I really like Dr. Fox personally and she was very candid on the statistics for success as well as other options. She won't actively put herself in our position and say what "she" would do which I sometimes want her to do, I understand these are very personal decisions and she tries to give us all of the information we need to make the decisions. She is very sensitive to our individual situation and it feels like she is personally committed to us becoming pregnant and having a successful pregnancy.

She doesn't sugar coat but she's very smart and experienced. She'll answer anything you ask, just make sure you ask! It's sometimes hard to get a hold of her outside of normal appointments and she often runs behind so our appointments didn't run on time.

I did 2 patch protocol cycles and 1 micro dose Lipton cycle. I am currently doing my 3rd patch protocol. In both protocols, I was on the highest dose of medication (4 menopur in the morning) and 300 of final-f in the evening. This was because my test results showed a diminished ovarian reserve. The first cycle we had 7 follicles, 5 eggs retrieved and fertilized and all transferred. The 2nd cycle we had 7 eggs retrieved 2 fertilized and both transferred. The 3rd cycle took much longer for stimulation (30 days Vs 12-14 for the first two) and resulted in 3 eggs, 1 fertilized and 1 transferred. All were a negative result. This current cycle Dr Fox and team decided to give us one last chance on the patch protocol since my stimulation was materially better. We are self-pay and while a significant burden we were willing to spend the money on a 4 th cycle before deciding potentially to do egg donation.

11k

Dr. Ashby always treated me like a friend. She was open, compassionate and really took her time to explain my diagnosis and how we were going to move forward with a plan. I had 3 egg retrievals and 0 embryos from all 3 combined. I have Diminished Ovarian Reserve and outlook was looking bleak. She had the difficult conversation with me and my husband about exploring other options like donor eggs or adoption. This was very upseting to us but she gave us examples of couples she had treated in the past who were successful with donor eggs. She never made me feel bad about my diagnosis and was always very positive and said that we will have a baby one day and she was going to help us get there one way or another. She had a gentle bedside manner but at the same time was always very candid with the reality of our situation. She never forced us to move forward with donor eggs. She explained she would continue to treat us and try another protocol but after 3 failed cycles, it wasn't looking good. She also recommended a 2nd opinion just so we could feel good about our decision moving forward.

Trust her advice and opinions. She isn't super clinical but still explains the clinical side of fertility treatments. Ask lots of questions.

I don't remember the exact treatment plan but considering I have diminished ovarian reserve (at 35), I went through 3 very aggressive treatments.

They were pretty efficient for the most part.

My insurance covered the majority of the meds and procedure costs. I was lucky.

She has a strong preference for one embryo transfer. Her end goal is healthy mom and healthy baby.

Dr. Hornstein is an excellent communicator. He seems aware of the power differential between patient and doctor, and actively mitigates it during consultation by listening actively within the time constraints of the visit. By the time I became his patient, it was clear that I likely had endometriosis that previous doctors failed to take seriously as a reason for both my infertility and severe pain. My goals closely aligned with his, which likely made him a good fit for my case (single embryo transfer, plenty of cool down time between failed transfers, aggressive pain management of my endometriosis during the process). I came to him in crisis and feeling hopeless. He validated all of my anger and frustration, and my sens that "something just wasn't right." He had me in the OR within 6 weeks to remove endometriosis and we were on to infertility treatment from there, quickly moving to IVF. His approach is wholly evidence-based, which I appreciated greatly. Dr. Hornstein never did any of my infertility procedures because you get who is on the schedule. But there was never a moment that he wasn't up to speed on my care. I had a lot of setbacks: return of endometriosis, two canceled transfers, two failed cycles, some complications post second retrieval. It was a long road from the start of my care to the MFM hand off once I finally got pregnant (2 years, 4 months), but there was never a moment where I doubted his clinical judgement. I have no regrets about choosing him, and would feel the same way had I not ultimately been successful (my husband agrees). I hesitate to write this because it may identify who I am as a patient, but it's very important. As a woman with a significant physical disability, Dr. Hornstein never once questioned my ability to be a mom. Other doctors had, in ways that were unfounded and not evidence-based. He cared about my disability when it was relevant, and didn't when it wasn't. It's hard to put into words how refreshing that is, as OB/GYN care is particularly challenging due to my disability. He always took the extra time needed for pelvic exams and procedures (HSG, SIS), and collaborated with my physician who cared for my disabling condition when necessary. I would not hesitate to recommend him to any woman with a mobility-limiting disability.

Come in with your questions ready, trust his judgement, be patient with the process.

I do not remember specifics, but I do remember his approach changed with each failed cycle or canceled transfer. We were constantly balancing increased endometriosis pain while during ovarian stimulation. So his approach to stimming was a bit conservative with me. However, we were very much in alignment, going for quality over quantity. I stimmed with GonalF for my first retrieval and got quite a few low quality embryos. He adjusted the approach for the second retrieval, adding in Menopur, resulting in better quality embryos, and my pregnancy.

Very busy at BWH Boston on the weekends. There will be children in the waiting room, so prepare yourself if that is a concern. I did weekday monitoring at Foxborough, and once at Chestnut Hill. Foxborough was, for the most part, a well-oiled machine. But, factor in time for traffic if you are taking 495. The courier service that picks up the blood for analysis at the main hospital is always on time and if you miss the window you are out of luck. No exceptions. As a patient driving in from central MA I often had to just judge by traffic whether I could beat the courier at Foxborough or if I just needed to drive into Boston.

We have a state mandate in Massachusetts that requires private insurance to cover a maximum of six fresh cycles of IVF. IUIs, drugs, and infertility testing are also covered. My daughter is a $200k kid. I paid, maybe $2,000 of that once you figure in copays for office visits, surgery and meds. If you don't live in Massachusetts, my advice is to get here now. No one should have to go broke to have a kid. You're supposed to go broke after you have the kid. ;-)

I opted for elective single embryo transfer because of my physical disability. We were in agreement about that. As the process dragged on and treatment wore me down, at one point I suggested trying two. He was gentle in his reminders of why I chose eSET and I agreed. I did not push back on this.

She goes directly to the point and is very clear about possibilities and scenarios. She was quick to adjust my protocol when she did not get the amount of eggs expected. She is knowledgeable about insurances and will keep contact with other providers to ensure everything is ready

Most treatments were the same, Lupron as well as GonalF. My last cycle where she adjusted the protocol to try to increase the egg yield, she added a birth control patch and Menopur

Everything was covered by insurance, we only had to pay deductible, but I believe a full cycle with retrieval and transfer was around $15,000