Brigham & Women's Hospital

Dr. Keefe Smith is an exceptional doctor. She does an excellent job of communicating her thought process and really felt like a partner throughout our whole time working together. She listened to what was important to us and happily answered all of our questions. She never rushed us or made us feel bad for asking (a lot of) questions. Most importantly, I felt so cared for during a very difficult IVF journey. After two failed rounds we did seek a second opinion at another clinic (which she was completely understanding about!) but the experience there was much worse and we went back to Dr. Keefe Smith. I just felt that I could trust her to be honest with us and I knew she always had our best interest in mind. I knew if we had success, I wanted it to be with her and if we didn't, I also knew we could count on her to be compassionate and help guide us through next steps. We ultimately did have a successful FET, but I would write the same review even if we hadn't had success.

She often runs a few minutes late but thats just because she is so thorough and takes her time with her patients (even when she's running behind you never ever feel rushed). So it's worth it (but maybe plan ahead for that).

Antagonist protocol did not work well for me. I had the most success with the very low dose lupron (VLDL) and ultra low dose lupron (ULDL) protocols (this one is BWH-specific).

Mostly covered by insurance, we paid out of pocket for PGT-A.

strong preference for eSET

Dr Ashby is wonderful. She focuses on getting the best outcome for the patient and takes into account their specific circumstances. She is highly skilled with complicated cases. She is direct and explains the medical protocols and procedures in a very approachable way (often drawing pictures). She takes the time to answer questions and thinks about the patiently holistically - including your emotional and mental health.

Lupron Flare protocol with Dr Ashby (after 2 other protocols recommended for DOR / poor responders at another clinic); we timed the start of the cycle to coincide with natural cycle (as opposed to using birth control) - since I do not have a uterus, this requires more blood work with the nurses at the beginning. My egg retrieval was expected to be done transabdominally (even though I have a healthy BMI) but ultimately both ovaries were not able to be accessed abdominally and the procedure was completely vaginally. We retrieval 9 eggs, 5 fertilized (in my prior cycles at another clinic we retrieved 1 eggs, 1 fertilized and 2 eggs, 2 fertilized).

I have fertility coverage with my insurance: out of pocket costs were $800 for embryo freeze storage and $140 for scripts

I froze 2PN embryos and will be using a gestational carrier; Dr Ashby was supportive of using two embryos given 2PN embroys have a lower chance of pregnancy

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.

Mark Hornstein met with us over zoom and was kind and had a good sense of humor, which hooked us. What we did not realize was that he would not care to even communicate with us during the IVF process itself. 5 months, we waited and waited doing paperwork and having to schedule and miss cycle after cycle due to Hornsteins unavailability. after we were finally ready and injections started, I knew my ovaries were being hyperstimulated and notified the nurse. Hornstein took no note and had no contact what so ever. suddenly, I get scheduled in for egg retrieval with a DIFFERENT doctor with no explanations, the same doctor did the embryo transfer. They retrieved 23 eggs, only 5 embryos were made and 1 was transferred. the transfer failed, I ended up in the ER after trying to communicate with hornstein and the clinic-- we even went there IN PERSON- in agonizing PAIN. and were told to leave because there was no one there. the day after I explained on patient gateway what happened, Mark still had not scheduled to see me or even call.

Please, for the love of God, avoid this pain, do not out yourself through this hell with this doctor. He does not care about his patients and will not have time for you.

Mark used the most standard antagonist protocol on me without making ANY adjustments, including my petite built etc., leading to hyperstimulation and underdeveloped eggs -- only 10 out of 23(!) were mature. I am doubting the practices of embryology as well because we had 4 embryos set to freeze and nobody explained why they were discarded. after 23 eggs, we are left with NO EMBRYOS AT ALL!

Cattle call line, I was yelled at, never explained what they are looking at even when I asked questions.

insurance covered

I wanted 2 embryos transferred but he insisted on 1. I agreed

This provider and BWH took six months to get the process moving from meeting to my first IVF cycle. Some of this timeline did have to do with outside genetic testing. I have a specific fertility issue that I should have sought help for elsewhere at a more cutting-edge facility. This provider/practice treated my issue and infertility treatment as what I felt was a "one-size-fits-all" treatment and that it did not apply to me. If you have more of a textbook infertility case, you might have a chance at this clinic. Even so, I was willing to move forward with another treatment plan or intervention. The follow-up from my failed cycle was dismissive and emotionally taxing. I was told I should seek donor eggs after my first-ever cycle with no possible solutions on how to move forward or rework the gonadotropin protocol in a future round. I was first told of the donor egg recommendation in a mailed letter to my house and as well as the patient portal. This provider or the team couldn't even pick up the phone first to tell me. They only called me after I received the letter. After a regroup appointment and requesting for the chance at another cycle the provider said they would submit for a prior authorization for another treatment, but this provider and their team did not and I waited two months for updates, which slowed me seeking care at another facility. I felt like they took on too many patients, that it should be smoother than this being a top-rated facility. I was also unimpressed by some of the education on taking injections. The only administering of medication training I received was from an online video, with no nurse assistance. I will say that Kerry is a top-quality nurse and truly cares, she was able to provide me any assistance I needed. She never made me feel like I was annoying her by asking questions. After my failed cycle my partner and I strongly felt that this provider was dodging questions and unable to answer our straightforward inquiries. This provider was also not present during the actual cycle. We also found the appointments at BWH to be quite cumbersome. I advise going to a clinic where everything is under one roof. Running from door to door trying to find the lab, the ultrasound clinic, the testing labs and more was very frustrating. If you want careful, thoughtful care where you feel valued, respected and treated with dignity I would go to another provider and I would stay clear of BWH. I felt like a number and after a failed cycle, totally disposed of and vulnerable. The follow-up from this provider/team was lackluster. This practice doesn't take into account the fact that we are women going through one of the greatest challenges potentially of our lives. If you have complex fertility issues, I would not go here.

Make sure you ask all of your questions & do your research. In this hospital clinic type setting, you really do need to be your own best advocate. Make sure going into the process with this provider, you know your fertility issues, you agree with the proposed medical protocol and all of your questions are answered. Ask this provider what the solution will be if your first cycle is cancelled or doesn't work. Is there going to be follow-through.

Compassionate, able to explain the process, options, risks and benefits clearly. Willing to do additional research and consider alternatives when treatment was not proceeding as hoped. When we raised some concerns and interest in seeking a second opinion (actually more related to the facility than to her), she was understanding and helped to make a referral. In the end, although we had a consultation with another physician, we ended up continuing out treatment with the same clinic and with her.

Don't be afraid to ask questions!

We started with Clomid and IUI with close monitoring (US and labs). Dr. Keefe-Smith discussed with us at each stage when we were ready to proceed with IUI (each time there was more than one leading follicle, so discussed potential risk of multiples). When we started IVF, I started a pretty standard antagonist protocol with FSH and menopur and Lupron trigger. I had high ovarian reserve, with numbers bordering PCOS territory, so wanted to avoid ovarian hyperstimulation. Had a good response, but no balanced embryos. Used same protocol next cycle, but had to increase med doses part way, with similar results (although fewer viable embryos). 3rd cycle tried VLDL cycle (low dose lupron prior, then FSH/menopur and HCG trigger). Really no better with ~same # eggs and viable embryos. 4th cycle went back to the original protocol with thought that I had responded best during that cycle. Also added ICSI after discussion (and additional research) to suggest this might be helpful. Had great response, slightly more viable embryos, and 1 euploid. Now just awaiting FET

Most of my costs were covered by insurance. I had to pay out of pocket for a lot of the genetic testing, but the clinic was helpful in getting this partially covered.

Provider had strong preference for eSET, but I think this was mostly due to my age and the much higher risk of pregnancy complications.

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

Dr. Anchan is the kindest and most thoughtful doctor I have ever had the pleasure of meeting. He is extremely bright and you can tell that right away. He thinks outside the box and suggested we collaborate with Dr. Joanne Kwak Kim a reproductive immunologist to look for other reasons I had so many unexplained failures. I appreciated that he was humble enough to suggest we look outside the box, rather than jumping to just PGS. He also suggested doing day a 3 fresh embryo transfer to ensure that I had something transferred. He really is so humble and knows that the human body is smarter than the doctors and kept saying that. He also said PGS testing is not a guarantee and he has done research studies on this himself. He also felt that there must be an immune factor for my failures and miscarriages rather than just blaming my egg quality. As someone coming from another well known clinic, it was refreshing to hear a doctor blame something other than egg quality for IVF failures. As I was immediately told at the other clinics that my failures were from egg quality, even though I had 7 blasts and was 31 at the time of the retrieval.

This process may take time as Dr. Anchan wants to do his research on your case before doing anything right away. Be patient.

I will be doing the patch protocol

I live in Massachusetts and most of the care was covered by insurance.

He will be doing a fresh day 3 transfer given that I am now 35 with diminished ovarian reserve. If the fresh fails we will do a natural frozen transfer, with the use of progesterone IM only.

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. Yanushpolsky did minimal testing on me, declared me as having "unexplained" infertility, and put me on a standard IVF protocol that led to ovarian hyperstimulation. In my cycle with her at age 34, I ended up with only two euploid embryos from 25 eggs retrieved. I transferred these embryos at a different clinic, and neither worked. I was finally diagnosed with PCOS and endometriosis at another clinic, and got three euploid embryos in another cycle at age 39 (more than I got at age 34 with Dr. Y) because the new clinic gave me a completely different protocol to account for these conditions.

Dr. Y is very experienced, ethical and evidence-based. But if you're at the point you need to do IVF, you also need a doctor who is not willing to accept "unexplained" as a diagnosis. You need someone who will take the time to dig further so that she is putting you on the right protocol. Dr. Y is not this type of doctor.

Agonist FSH 112 Menopur 1, HCG/Lupron trigger; 25 eggs retrieved, 16 fertilized, 6 blasts, 2 euploid

MA requires insurers to cover IVF, so I didn't have many costs besides the drugs.