Institute for Reproductive Health

Nursing staff is fantastic, doctors are knowledgeable and ahead on all current and future technology. The laboratory is best in class. I never had trouble getting in for any appointments and never had to wait for an extended period. They also have great access to resolve resource groups as well as girls night in support groups.

The battle to conceive was long and hard but Dr A kept fighting. He never gave up hope which gave us continued hope for success. He performed two D&C’svand a tubal pregnancy removal and always showed compassion. He was very candid that he thought my egg quality was the issue but gave me time and space to work through those thoughts. Ultimately he was 100% correctvand got us to the donor coordinator for further information. We gave two beautiful little girls now and are family is complete. Rainbows do come after storms.

He is an amazing doctor. Sometimes he can be a bit blunt but that’s just because he is trying to get you the results you are trying to achieve. Trust him he’s brilliant.

PGD was prescribed with IVF after multiple IUI miscarriages with chromosome abnormalities. With PGD we discovered that 80-90% of our embryo is had issues. When healthy embryos were unsuccessful. He recommended egg donor cycle. Once we went that route we only had one cycle and now gave one fresh baby and one frozen

IVF with ICSI and PGD was around 12-15k and donor cycle was 20-25k. Donor cycle charges in Clyde freezing of embroyos and frozen transfer. Cycle resulted in two Singleton pregnancies.

You may not see "your" doctor for everything but it is okay. I saw all 4 doctors at different points and liked them all. Dr. Schrieber did most of my scans, Dr. Adawalla did my retrieval and Dr. O'Leary did my transfer. All were really nice and good at what they do.

The appointments were always on time but were also very fast, albeit effective. Sometimes if I didn't ask a question I didn't have things explained, but they knew what they were doing and were ALWAYS polite and the important bits made sure to make you aware.

They were always quick to respond to messages no matter how silly I thought they were. They were very positive and the nurses all seem to be in the right specialty. Each one told me good luck. One even made sure that my progesterone was no red pills because no one needed the additional stress of the pink. It was the little details.

He was always polite to us, and prior to treatment after my baseline he was extra nice getting me ready for my injections. I went into it more than feeling prepared for the cycle to begin. I had my options already laid out and decided.

Do it. The office is a great place. I love all the doctors.

Took the pill for about 2 weeks. Then had a suppression check. Got my initial doses, which were updated at my first scan and adjusted from there. Adjusted again at my next two, and ended up with 100% fertilized from mature eggs!

They offer global billing with my insurance so the pricing was great. Even without insurance it was a fraction of the cost of a normal cycle.

At first I was hesitant but then I understood. If the cycle isn't successful I will approach the issue of transferring two.

The biggest strength is the people - everyone is so friendly that it really puts my mind at ease. But the biggest weakness is the telephone system. Being basic therapy and never being able to get through to an actual person is irritating. Running late for an appointment? There's no way to let the staff know. Trying to decide if you need to go to urgent care/ER or if you might be overreacting? Leave a message and they'll call back "sometime". Both of these are situations I've experienced and it has been incredibly frustrating each time. Being a non-IVF patient is like being a second class citizen - you're not really important in their grand scheme of things.

Dr. Burwinkel has typically made a lot of time to answer all of my questions, but sometimes is busy and clearly trying to get through his patient list as quickly as possible.

Nursing staff actually seem to care about patients. I don't feel like "just another number" when I talk to them. They give the easiest and most painless blood draws I've ever experienced, and they actually seem interested in getting to know patients beyond what's on the chart.

Dr. Burwinkel is definitely a straight shooter. He's not one for false promises of success or sugar coating a point. However, this doesn't mean he's without empathy. He's provided wonderful care through my unsuccessful pregnancies and has always given me clear next steps for things we'll try next time. In 2018, we had success with his treatment and welcomed our daughter into the world.

Be completely honest about your history and situation in your consultation. He can't help to the best of his abilities without full and complete information.

Metformin for PCOS, folic acid/COQ-10 supplements for healthy eggs, Letrozole to boost egg health at time of ovulation, Ovidrel to stimulate ovulation. (RPL, basic therapy only)

Do not remember all costs.

The clinic is organized, clean and runs well. The low-tech billing seems to happen very rapidly. The IVF billing seems to be delayed, which means a longer delay before I can check the claims status online with my insurance company.

Dr Awadalla was honest with me and my situation at every step. He was compassionate when he delivered the news that I had miscarried.

Most of the nurses that I have dealt with have been wonderful. They are familiar with the treatment regimens and able to answer questions. When I did call to report a Day 1 and ask if we should continue with the same approach, the nurse I spoke to told me it was up to me. When I counted that I would like a recommendation from the experts, she continued to tell me that it was up to me. I had to push to have Dr Awadalla contacted to give input. When he called me, he actually had a different recommendation, so I felt validated in pushing. That has been the only interaction that I was not satisfied with, however.

Dr Awadalla determined why I could not conceive (missed by my GYN) and recommended surgery, which he performed. I conceived naturally in 3 cycles after that. For TTC#2, I was older and he shared his concerns with the likelihood of success. Early IUIs were successful, but did not result in live births. After 10 total IUIs, my course of treatment was only adjusted because I asked if it made sense to continue or to look at other options. We have moved on to IVF, but it is still early in the first cycle. I find Dr A to be very accurate in his assessments and knowledgeable. I trust that I am in good hands, for as much as medical science can help me at my age.

Ask a lot of questions. Dr Awadalla is happy to explain the details to patients who are interested. Also ask at what point you should have a consult to evaluate the plans, so you know what to expect.

TTC #1 (age 38): Dx: uterine fibroids, blocked Fallopian tube. Tx: Myomectomy, salpingectomy (tube could not be saved and was removed). Resulted in live birth, conceived naturally in 3 cycles. TTC #2 (age 41): DX: unexplained infertility (age). Tx: IUI with 5mg Femara CD 3-7. IUIs 1 and 4 resulted in pregnancy, but not live birth. Likely due to poor egg quality. Repeated for IUI 5-8 because successful getting pregnant, but waiting for a better quality egg. For IUI 9 and 10, added Follistim (IUI 9: CD 7-10, 50IU; IUI 10: CD 7-11, 100IU). BFN. Given option to select surgery to recheck remaining Fallopian tube or IVF. Started IVF. Currently on CD 9: 5mg Femara CD 3-7, Gonal-F 300IU CD5-10, Cetritide CD10, rest of days/dosage TBD.

With insurance (assuming deductible was paid and yearly maximum for benefits not met), an IUI cycle was roughly $75 out of pocket, not including medications.

The clinic is very clean and professional. The front desk person was always friendly and helpful! The donor coordinator was so helpful during the whole process, making me feel very comfortable. The main drawback was feeling like a number in the clinic without getting any further testing that was requested.

explanations of treatments were never given. Monitoring visits were always very rushed, and when I asked questions during he would refer me to the nursing staff as if he couldn’t be bothered to answer.

The nurses were very knowledgeable and answered questions very thoroughly.

Appointments always felt very rushed. If I had questions during the appointment, he didn’t answer, but referred me to the nursing staff. When asking for further testing after an early loss, I felt treated as a child asking for a second piece of cake. Treatment plans never changed, nor were any further tests recommended after several failed transfers. The only solution seemed to be to throw another complete round of donor egg ivf at us.

Be very knowledgeable about treatment options and advocate for yourself! Be very blunt in asking for answers to any questions you may have!

For frozen embryo transfers 1-3, estrace was started at day 1, 3X per day. Progesterone was started 5 days before transfer. 1 early loss and 2 negatives. FET 4 was a “natural cycle” with with follicle monitoring. Once follicle was big enough, we did the trigger shot to release the egg. FET was then a week later. Progesterone was started 5 days before the transfer. Transfer resulted in a negative beta.

IRH has no weaknesses. I would, and have, recommended IRH to anyone who is going through fertility problems. I never had an issue with scheduling or appointments. The wait time in the waiting room and the treatment room was minimal. My husband and I were very lucky to be able to cover the cost of our fertility treatments; however, I know that they are great with working with families on payment plans if they cannot cover the cost at once.

Every time I walked into IRH, I felt as if people knew who I was. There was a receptionist who greeted us upon entry. We never had a long wait time in the waiting room, they valued our time as employed adults. Dr. Burwinkel and staff always greeted us by name and remember what it was that we were here for. He celebrated with us in successful treatment and mourned with us with each loss of pregnancy.

I love the IRH nursing staff. They showed as much compassion as the doctors do. Many times I saw the nurses more often, due to blood draws. They are just as informed as the doctors and always answered any questions that I had.

I owe my chance at becoming a mother to Dr. Burwinkel. From our first visit he treated myself and my husband with respect and always gave us the most honest information. He never promised that he would make me a mother, but told me that he would do anything to help me become one. He answered every question that I had, and I had a lot of them. Every treatment was fully explained. I never felt as if I was unaware of what was happening to my body. He was compassionate with each loss that we experienced and gave us the facts each time there was a setback. When we were finally able to have a full term pregnancy and I gave birth to my little boy in April 2018.

Do your own research and never be afraid to ask questions.

I took Letrozole (similar to Clomid), we did the injection to release my eggs and then did IUI. I had four rounds of IUI. Two resulted in miscarriages and one was a viable pregnancy.

Fertility treatment is not cheap. Each round of IUI cost about $900 including pills, shots, doctor appointments, and procedures. In addition to the IUIs, I had to have laparoscopic surgery for the chemical pregnancy and a D&C for the miscarriages. Each of these procedures was an additional cost.

I have to say this clinic is great so no negatives to note. Very professional and courtesy as well as caring staff. They always make you feel welcome and have never made us feel unwelcome or a bother to them.

Dr. Scheiber always put my feelings first and was very understanding with my problems and what I was going through. He is a very caring doctor.

Nursing staff had always been pleasant to work with. They are compassionate and always get back to you in a timely manner.

Dr. scheiber helped me understand fully everything that would be done and was so positive through our entire process. He never once made me feel like our IVF wasn’t going to work. He was always very upfront and honest but also caring and helpful at the same time.

He’s the best! There isn’t anyone better! We made the mistake of seeing another RE (because we thought it would be cheaper) and have since went back to him!

I was on stims like most and our first cycle was cancelled because I had one follicle taking over on one side. He cancelled and started a new protocol that worked better for me. We ended up with 6 eggs and 3 fertilized. The first two were transferred and we were pregnant but miscarried and the last egg was put in from frozen and we became pregnant again. She is 3 years old and the best blessing ever!

For self pay we paid around $20,000 in 2014 with meds and all. This included a failed cycle and a full IVF cycle then our last egg was frozen which resulted in a baby girl. We now have insurance and it’s nice that they have a global with our insurance because that helps a lot!

I agree with whatever he thinks is the best.

Both the Cincinnati and Florence locations of the clinic are clean and organized. The Cincinnati location in particular is actually quite beautiful! The environment is warm and professional, with elegant furniture and a clean space.

Dr. Awadalla was so warm. He always seems excited to see me. He is open and direct, while also taking emotions into account. Our whole infertility experience changed when we went into his office.

The nursing staff is always friendly and knowledgeable. Prior to conceiving my first born, they always showed compassion and interest. Once I had conceived, before being released to my OBGYN, the nurses were always quick and happy to answer the many questions I had and to offer comfort and understanding for my concerns.

Dr. Awadalla is wonderful: he is both kind and extremely knowledgeable. My experience conceiving my first son was vastly different from attempts with a previous doctor. I felt Dr. Awadalla was taking care of me and my family rather than just trying to help us get pregnant.

GO FOR IT!

I have PCOS. I took progestin to induce a period and then took Femara for (I believe) about a week. Then I went in for an ultrasound to determine if my follicles were ready. As they were, that night my husband gave me a triggering shot in the thigh and the next morning we went to the Cincinnati office to collect my husbands sample and complete the IUI. We found out several weeks later that we were pregnant with our son. We are now preparing to attempt baby number two and will follow the same process, minus the progestin as I have had a period since I stopped breastfeeding my son.

The strengths I would hit on when I talked to a new patient would be about waiting. I would tell the patient that the wait time is not long. They get us in and out in a timely manner. I would also tell them that their opinions do matter, and their wants also matter to this medical team. The weakness that would hit on would be about awkward situations. Fertility procedures can get awkward. This is something that they do every day, not much can surprise them. An example, when my husband went in to give a sample of his sperm, we were taken back when the nurse asked, "Would your wife like to join you." Yes we are all adults, but that was just not something that we thought would be asked or even thought about. To them though, it happens, and its ok.

He has always called me by my first name, and he doesn't have to look at my chart to remember my history. When we did get pregnant, and we went for the first ultra sound he asked us to come to his office, told us delicately that we would only have a 50% chance to carry the baby because of a small sack. After the second ultrasound he said "go ahead get dressed, and meet me in my office." I told Dr. A that I didn't want to meet in his office because last time we didn't get good news. He complied, let me get dressed, and he came back into our room. We found out that the baby had a heart beat, but the sack was just getting smaller. Dr. A then gave us a 25% chance. He let us come back for a third ultrasound. and that's when we found out that the baby no longer had a heartbeat. Dr. A gave me the options that I needed, a box of Kleenex, and let me cry in his office until I was ready to leave. He has also called me himself, and asked me not to give up because the embryos we have now are high quality, and he believes that we will have a healthy pregnancy.

The nursing staff works very hard, yet they always have a smile on their faces. When we received that dreaded phone call that says "I'm so sorry, but your test was negative," the nurses were compassionate, and disappointed along with us. You can just tell that phone call is one that they absolutely do not like making. It is not routine to them. When I have called, and been sent to voicemail they always have called me back in a timely fashion, and any paperwork that I have needed has also been sent quickly.

Dr. Awadalla has great bed side manners, patience, and compassion for his patients. He gives time to explain what needs to be explained, and questions that need to be answered. He also abides by our wishes. I have a very short stature, one of the first things that I told Dr. A was that I was not ok transferring more than two embryos. Dr. A completely understood, and actually the clinics policy is to only transfer one or two embryos.

I would tell a prospective patient to be ready. Dr. A and his team are on it. It's a tough journey, but it can also be a quick journey. After meds, and cycles are figured out its a whirl wind from there. Everything with fertility has to be timed just right, and from my experiences Dr. A has timed it just right. I would also tell them to listen to the doctors, they know what they are doing.

Both my cycles have been very similar. I have started off with about 17 days of birth control. I was then off three days, and than I started injections for 10 days. I had injected Gonal F, Menopur, and Centrotide. I can't remember which injection out of the three, but he only added it during my second cycle. After that, I had taken my trigger shot. He also had me taking Estrodial and Progesterone. I was taking those two even after my transfer.

I don't remember the full cost, but I believe around $8200 for a fresh cycle, and $7000 for a frozen cycle.

The Cincinnati of Reproductive Health approach on multiple embryo transfer is most usually only two at the most, but from my experience if the embryos are high quality they only like to transfer one.

The clinic is very nice. They have a few satellite offices that really help since Greater Cincinnati is so big. They have recently added a nurse practitioner who is able to help with some appointments which makes wait times better and scheduling easier. I know they often have support group nights but I have never attended. My biggest suggestion would be for them to have an actual counselor on site who is able to help couples mentally and emotionally prepare. It is by far the scariest and hardest thing I ever had to go through and I felt like I was just winging it so much of the time. Someone like this or even information on resources that people can reach out to on their own would be a giant help. All of the doctors are really great. I can't speak for any other clinics, but overall I have been very happy with Dr. Scheiber and IRH. We are just still waiting for our happy ending. Sadly, a lot of times things just come down to finances and that is just a sad fact of life in this country.

Most of the time I completely felt like a human but there were a few times that it was so busy that I could tell I was being rushed through.

They were always very warm and caring. They work very hard. Sometimes it would take awhile to hear back but that is only because they are busy with their patients in the office too.

He is a wonderful doctor and person. I don't think the reason we have been unsuccessful is his fault. I wish we hadn't rushed into IVF, but he did feel that my age was a bigger factor than I feel it is. He is warm and caring but he is very by the book and often hesitates to change protocols. But he knows what he is doing. He has been in the business a very long time.

Understand that he is a human doctor, not god. He has limitations and nothing is guaranteed. Know that he is always willing to sit down and talk to you, just make sure you call and schedule the time for the sake of his time and yours.

We started out with Letrozole, which I did respond to, but I was not conceiving. We moved onto Letrozole with Trigger Shot and IUI, and I still was not successful. I took a break for a few months and then did IVF. We did this because I was approaching age 35. 8 eggs were retrieved and we ended up with 3 embryos. My first transfer was fresh and it ended in a Chemical Pregnancy. I took a break for several months before I transferred a frozen embryo but that failed. Right now we are just waiting before we do anything else because of finances.

Pretty efficient. I definitely never waited in line or anything like that. My appointments were scheduled within the monitoring window and it worked out well.

I know our insurance helped cover our inseminations, so I can't remember the cost of those. I believe our fresh IVF cycle was $9000 and my frozen cycle was $4500, not including meds.

Dr. Scheiber always let me choose. He is very pro eSET, which makes a lot of sense. Financially, I see why people often transfer more than 1, but eSET is the safest option for the health of the babies should you conceive so that is what we always did.

The clinic was clean and support staff was great. Be prepared for several canceled appointments due to scheduling issues on their part, we had about 5. Ask all of the questions and do your own research.

Never present, never remembered us.

The nurses were kind and patient but we had many scheduling mistakes. On more than 3 occasions we had to change appointment times because of a scheduling conflict on their end. They also wrote down a protocol completely wrong & scratched out everyone to rewrite it after we pointed out their mistake. Another big reason you should educate yourself. My husband has very low spent count so we wanted to freeze a few vials to be safe before egg retrieval. There was a miscommunication there & they were never frozen so he had to go back in. We were 100% out of pocket so taking time off of work & scheduling these appointments was very hard for us.

Several miscommunication errors. On our first day one one D.R. Schiber had us down for an IUI when we have to do IVF, we were prescribed the wrong medicine and 2 months lost. (Travel following month). Once we started our IVF cycle we were anticipated to get 4 eggs but only retrieved one. We did know that there was this possibility but we never got a clear answer of why. The retrieving doctor (Dr Awadalla) told us something different from Dr Schiber. Dr Schiber said he would get back to us after discussing with Dr Awadalla but that never happened. We never had a follow up call after our one embryo arrested. I had to follow up and wait two more months for another ‘consultation. Our next IVF cycle was canceled due to inconsistent growth. Following the canceled cycle we decided to go with donor embryos. Our nurse practitioner told us that the quality of the two donor embryos was good & great. Once I received my medical records from the Institute for Reproductive Health it showed that the embryos were actually rated good & poor. The donor cycle resulted in a chemical pregnancy and once my beta numbers dropped I never received a call from the doctor. I even went in with terrible left side pain and never received a call following up with me. We have very specific fertility problems yet didn’t feel like we were on a tailored plan. I left the practice and found that my next doctor did throughout testing before starting an IVF cycle with us. We felt as if they just wanted out money and did not truly care if it worked for us, especially since we would never receive a call when each cycle did not result in a pregnancy. We never felt like Dr Schiber truly knew who we were and he was very quick during office visits. We never felt like we had a chance to ask him questions & felt as if we were a bother to him.

Ask questions even if you feel rushed and educated yourself before your visit. You know your body best and if you have specific concerns do your best to be heard.

Antagonist - Femara, 75 Menopur/200 Gonal F adding certrotide. Canceled cycles was a Microdose Lupron flare.

9500 for full IVF cycle not including Medication. 4500 for donor embryo transfer.

We did not make it this far with our own embryos and we had to transfer the two donor at the same time because they were frozen together.

The clinic definitely has strength in numbers based on the number of patients they have, however you are treated like that, a number. I believe their intention is great but not having any email access and only voicemail makes for a challenging communication exchange throughout the day. Not being able to contact them in any other way but voicemail is next to impossible in my line of work. We couldn't get our questions answered in a timely fashion based on this.

The care at IRH is set up to be treated like a number. There was no personal care and i'm not even sure they knew my name. I had to repeat my issues, why we were there and our current status multiple times.

I am sure Dr. Burwinkel is a find physician but I wouldn't know too much since I saw him only twice during my care. I did not feel as though he was treating me but rather the entire staff at IRH. Had we had a consistent set of information and communication we would have made different choices. I feel I wasted time and money going there.

Know what you need and expect in your fertility treatment before you go.

The costs were pretty straight forward. They provided a pricing sheet up front for all of the procedures but there was no coordination with my insurance company beyond the pre authorization paperwork. I had to contact the insurance company in order to determine what would be covered. I was never able to get a straight answer from either party. It was unclear to me how much I would owe. In total with my company's coverage ($5,000) and I paid $6K out of pocket for a round of IVF and single transfer. We had no embryos left to freeze and did not do ICSI.

It would have been nice to discuss this strategy and options before the transfer. We had no idea we would be faced with the choices while i was in the transfer procedure. These important details of how many and odds should be discussed in advance.

The clinic is large with multiple providers which can be good or bad. They always have someone to take care of you, it just may not be someone who is super familiar with you in particular. It is easy to get an appointment and their multiple locations are helpful. For the most part they are compassionate but I did have one provider who somewhat scolded me that I needed to make IVF a “priortiy.” This was after I had gone through several less invasive procedures and a previous egg retrieval and transfer over the course of a year and a half. I was also continuing to work full time and drive 90 minutes one way just to get to my appointment. I think I was making it a priority and was kind of offended by how that was mentioned to me.

I really enjoyed Dr. Burwinkel’s bedside manner however, a couple times I felt like he wasn’t 100% informed on who I was in particular. I had to have surgery and saw him for a post-op appointment which was fine. I then started back on treatment which was a timed intercourse cycle and when I came in for an ultrasound to check for follicles, he just looked at my uterus with the ultrasound and didn’t measure any follicles. He made it seem like he thought this was a post-op follow up and didn’t really provide the correct information for me for my trigger timing. I started to lose confidence after that visit but continued with him for multiple other cycles, eventually leading me to IVF.

The nurses were always nice and caring. They didn’t however provide a lot of detailed information.

Dr. Burwinkel has 2 partners that cover him when he is off which is really nice. However, after my first IVF cycle did not result in pregnancy and few eggs/embryos with nothing to freeze, the protocol was not really changed. I don’t know if this was because his partner was covering but I never understood why a similar protocol would have different results. When I had even fewer eggs retrieved and only 1 embryo, I started to wonder if something else was wrong with me as I knew I had a high AMH and should have a lot of eggs. That transfer did result in pregnancy but ended in a second trimester miscarriage due to Down’s syndrome. When I saw Dr. Burwinkel following my miscarriage, he was very compassionate but was unable to come up with a plan for me to get more, better quality embryos in a future cycle. I think I lost all confidence at that time.

Provide details and keep patients informed.

My first IVF cycle was done with Follistim which was initially started at a moderate dose. When my estrogen jumped up, the dose was greatly reduced which later caused my estrogen to drop and I was offered to the chance to cancel the cycle. Since I had insurance coverage, I decided to proceed. I had 5 eggs retrieved. On day 1, none had fertilized so we did rescue ICSI that resulted in 2 embryos which were both transferred on day 3. This resulted in no pregnancy. For my second cycle, the Follistim was pretty much the same. I did take letrozole in the beginning with this cycle. Again my estrogen quickly increased so my Follistim was decreased and again my estrogen dropped and resulted in fewer eggs. I did have one 3 day embryo with ICSI which resulted in pregnancy, but later a miscarriage.

I had insurance coverage so I can only guess for the cab pay price. I believe IVF with ICSI and hatching is around $12,000 a cycle. A transfer is about $1000.

IRH is a fantastic clinic all around. The staff are people too, so even though service is provided every day, you may not have the same staff each visit. This didn't bother us at all since they work seamlessly together and we had regular check-in visits with our primary doctor (Dr. Scheiber) there.

Dr. Scheiber always treated us like people. He was patient to explain our case and options with us.

All of the nurses we encountered during our treatment were professional and caring.

We were thoroughly impressed with Dr. Scheiber and the entire team at IRH. He was very personable and extremely professional. We ended up relocating to a different state without getting pregnant, but even after we left, he and his staff were helpful in providing necessary records and recommendations to resume treatment elsewhere. We'd highly recommend Scheiber!

The team at IRH work seamlessly to provide care every day of the week. For the in-office treatments and some investigative procedures, you will probably be seen by other doctors. They're all very good at IRH.

We started on a low-dose pill I took during 5 days of my menstrual cycle. I didn't respond as much as hoped (in terms of follicle growth), so the dosage was increased 50% for the remaining 4 cycles. We tried IUIs 4 times. Had we not relocated to another state, we would have skipped the intermediary option and gone straight to IVF. This was recommended because of my age (and weight).

Our medical insurance coverage was quite good. I don't remember exact costs, but we found the costs to be competitive (for the U.S.)

IRH strengths: -The Drs/nurses work well together. They all enjoy being there. That makes their patients more comfortable about being there. -they’re knowledgeable about their field. They’re very confident on their treatment plans. -the wait times aren’t usually long. I don’t think I’ve waited longer than 10 minutes in the room. - they have 3 offices for patients convenience. The only weakness is their new phone system. I’m not a huge fan of automated. But I know it helps them help more people. I would just like to talk to a real person.

Dr. Schieber always greeted me with a smile, and was always positive about the treatments I was doing. He answered mine and my husband’s questions. He was always approachable.

I wish I was better at names. Everyone at IRH is amazing and kind. I never came across any rude people in all my many visits to the office. I remember being told good luck by other nurses who I had before, just not that day. I believe they all genuinely care for all their patients and they all want to help you have a baby.

Dr. Scheiber was very quick to diagnose me with PCOS. A quick ultrasound confirmed his diagnosis. I had to have a surgery before we started treatments to clear tissue out of my uterus. We started with femara. That wasn’t working well so I was given injectables. We did 5 or 6 iui’s all with femara and injectables without success. Dr. Scheiber was positive during the whole process but also realistic. He saw that iui’s weren’t working and suggested a meeting to discuss new ideas. Which was IVF. We were lucky to have some insurance coverage so we were able to start right away. We did education day the middle of January and injections started the second week of February. I had my first retrieval 2/24. Transfer was 2/27. We transferred two 3 day embryos. They didn’t stick. Second retrieval was 4/14. Transfer was 4/19. We transferred two 5 day embryos. They also didn’t stick. That was a very low point for me. If it wasn’t for Dr. Scheiber I would have quit right there. He convinced me to try a frozen transfer with our remaining 2 embryos. Our last chance. Dr. Scheiber was super upbeat and during the transfer on 5/25 he was like this is it! This time is going to work! On June 8 2016 I received the best phone call ever. I was pregnant! We had our first 2 ultrasounds at IRH then we graduated to my OB/GYN. On February 10,2017 I had a healthy baby boy!!

You’ve made the right choice choosing IRH and Dr. Scheiber. He’s kind but will tell you the truth. Don’t be afraid to ask questions.

I was going like every other day or every 2 days for like two weeks during the cycle. I was usually able to schedule appointments when it was convenient for me. But obviously some days don’t work as well as others.

We were lucky and had insurance coverage. The drugs were expensive. I think for the Iui and ivf cycles we paid close to $10,000 on drugs and $10,000 for the cycles. Our costs would have doubled or tripled had we not had coverage.

We chose to transfer two embryos. We thought it would give us a better shot at atleast one sticking. The office suggests one, but won’t do any more than two.

The clinic was very clean and organized and there was a private place for us to discuss our cycle and plan with the nurse and with the doctor. The check in and check out was always fairly smooth. Getting financial information for bills and services paid was difficult at times and there was some confusion about what had been paid for and what was still owed, but they were able to make some calls to get it figured out.

Early in the treatment process we were treated very well by all the staff and the doctor. We were given high expectation throughout the process and everyone was very positive and reassuring. After the retrieval and fertilization results came in we were told we’d be a freeze all cycle due to hyper stimulation but then received multiple calls the following days saying we were a fresh transfer, when in fact we were not able to go that route. It was rather upsetting. After our last frozen embryo transfer we were notified of the negative hcg via phone by one of the nurses and had expected we would hear from the doctor as we used our last 2 embryos. When we didn’t hear from him after a few days of getting the results, we called the office a few times to speak with him because we were never given the opportunity to discuss what happened or what the next steps are or what our options were or what could possibly be done differently if we chose to continue with another retrieval. We felt like we were just unsuccessful and dropped from the radar with no guidance or explanation as to where to go from there. Overall the people seemed to care throughout the process but after we felt like we were left in a cold and limbo like state.

The nurse I seen in the office and the one who reviewed the plan and medications were absolutely amazing. The one making the call didn’t seem to care and I was just a number she was reporting information to in order to cross me off the to do list. There were also multiple times I was contacted by the same nurse who gave me false (and very upsetting) information, she didn’t seem to know my case or what was going on.

He reviewed all of my medical records and discussed options in detail with us during our initial consultation. He made of feel very comfortable, hopeful, and informed. During each visit we got additional information to help guide us with medications and what to expect. When we were unsuccessful after our last frozen transfer we were never contacted by him to discuss the cycles or any future plans of continuing treatment. We contacted his office and were given a time he would call back for us to ask questions. I don’t feel like we really got any answers as to why the cycles failed or what the next course of action would be or what could be done differently if we decided to do an additional retrieval and transfer.

Ask a lot of questions and be well informed every step of the way.

Cycle day 3 started birth control pills and a profilactic antibiotic, last bcp was day 22, had an ultrasound for follicles on day 23, cycle day 2 started using follistim 200 IU SQ at a given time daily for 4 days and then had a repeat follicle scan on day 6 with lab draw and continued on follistim 200 IU SQ, day 7 I took the follistim 200 IU SQ and Ganirelix SQ, day 8 follistim 200 IU SQ and ganirelix SQ, cycle day 9 had follicle scan and labs and changed follistim dose to 125 IU SQ with the ganirelix SQ, cycle day 10 follistim 100 IU SQ and ganirelix SQ, day 11 follicle scan and labs and took follistim 100 IU SQ and ganirelix SQ, cycle day 25 follistim 25 IU SQ and ganirelix SQ, day 13 Lipton trigger shot and started destinex tablets, day 14 dostinex tablet, day 15 egg retrieval (15 eggs retreived). Day 16 six eggs fertilized and told we would be a freeze all cycle due to ovarian hyper stimulation, day 18 above average growth and development on 4 of the eggs and regular on 2. Next cycle started - day 2 three embryos made it to blast stage and were frozen and need to postpone frozen transfer to next cycle. Started birth control pills for a few weeks and then started cycle day 1, started taking estradiol 3 times daily, day 13 had ultrasound and labs, day 18 started prometrium 3 times a day, day 23 frozen embryo transfer, negative hcg 11 days later, after the next cycle started and completed we did the 2nd frozen transer with our last 2 embryos which were grade A, 14 days later we had a negative hcg.

$8500 to begin the process (MD visit, ultrasounds, labs, retrieval and one fresh transfer, nurse education day) they wouldn’t let us do the fresh transfer so we did frozen which cost an additional $5000 (counting the second frozen transfer), medications and travel expenses roughly $3500 - totaling around $17000

I feel like at least 2 embryo transfer is the best route when you are doing IVF.

The only weakness is when you call the office, you always have to leave a voicemail. However, the nurses/staff are quick to respond.

I always felt like a human and not just a number. Dr. B did what was right for me and my situation and always gave me the honest information.

I absolutely LOVE the nursing staff. They are ALL caring and compassionate and go out of their way to help us. I could not imagine going through this journey without them!

Dr. Burwinkel is such an amazing doctor. He has gone above and beyond to help get my pregnant, and always listens to me. I had a miscarriage after an IUI in the summer of 2016. During my D&C, right before I was put under, I started crying. Dr. B. came to my side and held my hand as I was put to sleep for the procedure. I will never, ever forget the compassion he showed during that difficult time. Dr. B is always honest with me and does what is right for me and my situation. I could not ever imagine seeing another doctor or going ot another practice.

Be open and honest with Dr. B about your thoughts on your protocol. He WILL listen! Advocate for yourself, too.

IUIs 1-4: 5mg Femara and Ovidrel IUI 1 resulted in miscarriage with a D&C at 9 weeks. IUIs 2-4 were negative. IVF 1: 175 Follistim, then increased to 225. Ganirelix and Ovidrel--rationale, I have PCOS and did not want my to hyper stimulate. Prometrium after retrieval and through transfer. 2 Blasts, 1 transferred and did not result in pregnancy. FET 1: Estrace 2mg a day, then PIO. Frozen embryo transferred and did not result in pregnancy. IVF 2: 150 Follistim and 75 Menopur. The last twp days of stims, we upped the Follistim to 225. Ganirelix and Ovidrel. Added in medrol and baby asprin after the retrieval. Added PIO after retrieval. 7 total blasts. 2 transferred. Currently pregnant and waiting for my first ultrasound to determine if it's a singleton or twin pregnancy.

We used insurance for the IUIs, so the cost to us was around $100 per IUI. For IVF, we did the money back guarantee program with ICSI and that was around 22k (or 70% back if no live birth).

With my first IVF cycle, we did one embryo. Same with the FET because we only had 1 embryo left. After those two cycles failed, Dr. B decided to transfer two embryos moving forward. I trusted his judgement with the single and multiple embryo transfers.

Weaknesses: the phone system is a bit confusing, even for seasoned patients. Also really have to pay attention to your bill for errors. Strengths: multiple locations around the city. Drs belong to The Christ Hospital which is the best in Cinci in my opinion. They offer an online and inperson support group which has been so wonderful.

Dr. Scheiber always takes time to explain everything and makes sure I understand. He answers my questions thoroughly and honestly.

All the IRH nurses are wonderful, but every time Heather was working when I was there she requested to work with me. We really connected at the West Chester office and she remembered me each time I was in. She has such a positive energy and exudes the hope all staff at a place like this should. She was a huge cheerleader for us through the whole process and when we got our positive. She was in the room when we found out we lost our baby and cried right along with us. I will never forget her or her compassion.

Dr. Scheiber is very much to the point but makes sure I understand what's happening. He listens and responds to my questions no matter how long it takes. He was very straightforward about our chances of conceiving without giving false hope or seeming overly negative. What really makes me feel great about seeing him is the way he treated me when I miscarried. He had to deliver the news to us and even though he sees this all the time was visibly upset, which made me feel he truly cares. He then came in several hours early on his surgery day to fit me in so I wouldn't have to wait several days for a d&c. We are about to do our first frozen embryo transfer with him this month. We were having trouble getting the money together so shopped around for a cheaper clinic. We found one and I called IRH to see if he would match their price. He did far better than match it to keep me there and to not risk transporting our precious embryos elsewhere. Because of that we're able to do the transfer now rather than 6 months to a year from now. I feel like every bit of my treatment protocol has been spot on and I trust him implicitly. I know we're in excellent hands and feel 100% confident we'll have our miracle baby soon!

Ask questions! Even if you think of them later. He gives minimum detail unless you ask.

3 IUIs: only medication used was Ovidrel since we have male factor infertility. All 3 resulted in negative tests. IVF: can't recall the protocol but started birth control to suppress my cycle so it could be easily fracked and timed. Went off that and began stim injections to produce a number of eggs. Was closely monitored via ultrasound to check progress and retrieval was set based on follicle size. We had 12 follicles, 9 eggs retrieved, 6 5-day old blastocysts. We transferred 1 embryo which resulted in pregnancy but ended at 10 weeks due to chromosomal abnormality. Dr. Scheiber did not recommend pre genetic screening for the embryos because I do not have infertility and have high quality eggs. FET#1: prescribed Estrace beginning cycle day 1. Will be monitored for ovulation via ultrasound. Once I've ovulated the transfer will be scheduled for 5 days later. Upon transfer I'll begin progesterone therapy until at least the beta test 8-10 days later, longer if the test is positive.

IUI: about $1k/cycle IVF: $10k plus around $4k for medication FET: $4500 plus about $350 for medication

Dr. Scheiber is a huge proponent for eSET unless there is a strong medical reason to transfer more than one. His logic is technology has advanced to a point it's no longer necessary to transfer multiple to be successful and since a multiples pregnancy is riskier than a singleton he avoids recommending it if possible. At the end of the day though it's the patients decision, but he will make sure you have all the facts to make an informed choice.

The clinic was wonderfully decorated with big windows in the waiting room. The lab was right down the hall so we didn’t have to travel far to pick up our specimens. Almost every time I was there I was taken back early and never had to wait past my appointment.

Dr Awadalla was excellent. Our first first visit we were emotionally drained and frustrated. Dr Awadalla did an ultrasound and reviewed the tests from my OB and then took an hour to explain what was causing our infertility, answered our questions, and formed a plan to help get us pregnant. He was easy to talk to and really made us feel at ease and hopeful. Every time I went in for an IUI it was like he knew exactly how I was feeling and knew what to say to make us confident to continue treatments. He even called me on my cell phone once to help me to decide my next step in treatment. He is excellent!

The nursing staff always responded quickly when I called the office. I had a terrible time with my insurance and the specialty pharmacy it used to get my injections and the nursing staff handled it very well (even though I probably drove them nuts calling so much). I had to come in on several saturdays for IUIs and the staff was always friendly and welcoming. They never made me feel like an inconvenience.

Dr Awadalla was compassionate, easy to talk to, thorough in his explanations, so easy going he made us feel like there was no doubt we would get pregnant, and very knowledgeable. Every time we came in after a failed attempt we would review the statistics of the treatments, form a plan for the next cycle and he would hand write the exact dosages of medications I needed to take and when. He would also draw little cartoons/symbols indicating us getting pregnant at the end. He really helped keep our stress levels down while giving us all the facts we needed which is not an easy task. Even though I didn’t see him every visit I saw him most of the time. The other doctors and NP were also very good so I never felt uncomfortable having them do a treatment for me.

You are in the best place for getting pregnant. It’s an emotionally difficult journey (sometimes physically difficult), so going in make sure you ask questions. Dr Awadalla is very approachable and smart so knowing all the facts will help put you at ease a bit.

We tried a new treatment every three months until I got pregnant. It was explained to me that after three rounds of a treatment not working statistically my chances of getting pregnant with that treatment dramatically decreased. I started taking metformin daily to help counteract some of my hormones with PCOS. So first I did oral medication and IUI for three rounds, then Injections and orals for three months and got pregnant on the third round. We started with oral medication and IUI first because I had tried oral medication and timed intercourse for three months with no result with my OB. I also switched from clomid to femara with Dr Awadalla because I did not ovulate with my third round of clomid. Every time we did a cycle before I took my ovulation injection Dr Awadalla did an ultrasound to verify how many healthy eggs I had so I didn’t have too many or too little. That also helped him adjust my medication doses as needed. So after 6 IUIs 3 with orals and three with injections I got pregnant and now have twin boys:)

My insurance and my husbands insurance covered most of the cost.

We never had to do IVF.

Very nice facility. Clean and comfortable. I always got a call back when calling with questions from for the staff. The clinic seems to be organized, overall and it was not overcrowded. I never had to wait too long. They also helped me to find my medications at the best possible price at that time.

When consulting with Dr. S via phone after my failed IVF cycle, I felt like he was not even looking at my chart. He mentioned uterine fibroids, when previously he mentioned my uterus looking perfect. I didn’t feel I was getting the individual treatment I was wanting at this moment when discussing this huge disappointment in my life.

The nursing staff was overall very caring and more willing to spend time answering questions I had.

Dr. Scheiber performed a laparoscopy on me and I was under his care for IUIs and IVF. He was very comforting at the time of surgery. He does explain things in a way that it is easy to understand. I did not like the fact that I barely saw him after my surgery. The majority of treatment was performed by his counter parts. I was surprised when I went in for my egg retrieval that he was not even there for that. I thought for sure I would see him then, and I was disappointed that no one informed me he would not be doing the procedure. I did not see him one time during my IVF cycle, and it was pretty much the same for the IUIs I had the year before. When consulting with him after the egg retrieval (failed cycle), I felt as though he offered generic advice and did not have my chart to look at. He offered no change in protocol when I asked about future treatment, which was discouraging.

Don’t expect to see him much.

I do not remember specifically the protocols that were used specifically for me. I used injectables for three IUI attempts (one was cancelled due to large follicle being on the side where I did not have a tube) and an IVF cycle. I will say that the protocol that was used and rationale behind it was not explained to me. Maybe I should’ve asked more questions, but I just followed directions. There was no explaining of ‘why’ they were doing things this particular way.

I do not remember specifically.

No comment

Strength: efficiency, high reported success rates Weaknesses: human compassion, personalization of treatment, making you feel like they have time for you Do your homework before you go

Other than passed tissues across a table and a few reassuring head nods, the doctors seemed to have minimal empathy for the pain and frustration associated with this invasive, frustrating, and traumatic process. My miscarriage was described (by another doctor at the clinic) as "disappointing." I'm sure it was disappointing for them and their statistics, but for me it was one of the saddest experiences of my life. Disappointing doesn't begin to cover it. There are also so many different nurses there that until IVF, I was just another patient. Once a nurse called me back and asked if my partner and I were having sex to increase our chances of IUI success. I'm a lesbian, so this wouldn't have helped. The nurse simply didn't think to open our chart before calling us...the first page would have told her that we're two women. The number of LGBT related microaggressions we experience is through the roof. We cross out mislabeled forms and correct their language on a regular basis. They also failed to manage my thyroid condition appropriately or advise me to seek treatment from an endocrinologist who could. This clinic has the best success rates in the area and switching at this point would cost us an additional thousand dollars at least, but I wish I had other options.

This is so mixed. There might be 50 nurses working there. The IVF nurses are mostly good (though the other day one contradicted the doctor so that was frustrating), and they are more professional and compassionate than the other staff. Other nurses have been rude, homophobic, incompetent, or unprofessional. One seriously offended me and then had the dr. apologize on her behalf instead of doing it on her own like an adult.

I answered this on an earlier question. On one foot, this experience has been very frustrating and sad in its own right but also additionally so because of issues at the fertility clinic. Dr. Scheiber himself has been the best out of the three doctors we've seen but is still only so so, and I wish it felt more like he cared about me as a person rather than a case.

Make sure you do your homework and ask lots of questions along the way. There are times when my treatment course was adjusted or explanations were corrected because of information I supplied as opposed to information that they offered.

5 natural iui at my request. 1 iui with femara (bad reaction). IVF #1 fresh transfer, 225 follistim, ganirelix, ovidrel. Eset. Pregnancy...missed miscarriage at 9 weeks. D&C. IVF #2 in progress, 225 follistim, 75 menopur, ganirelix, ovidrel. PGS (to reduce chance of additional miscarriage...at my request)

IVF with ICSI 9,600. IUI total about $1000 (x7).

I'm young (27) so he prefers eSET, and I had "success" with it once and we will probably do this again this cycle.

Strengths- Multiple locations, flexible hours, reasonable cost, good success and quality doctors and staff. All three doctors are great. Weaknesses- I didn't like when I was given an appointment to see the nurse practitioner (or felt like I was forced to see her) when I was told I was seeing one of the doctors. She, in my opinion, is very rough during examinations.

Dr. Scheiber and his staff have always been very warm and compassionate. When I had a chemical pregnancy he called me after I had had several conversations with the nursing staff. He had very kind words for me and gave me some peace in a very emotional situation.

I didn't like that you can never talk to a live person but they are very prompt about returning calls. I never had a bad experience with a nurse on the phone or in person.

He was extremely caring and always asked about our daughter when we saw him. He had a great sense of humor during the whole process (which was appreciated!) while being frank with us about the challenges we would face trying to conceive at our ages.

Trust him. He will be frank with you.

For my first pregnancy it took several rounds of Clomid before I ovulated. When I did finally ovulate I took Ovidril and he gave us the option to do IUI or not. We elected to do IUI (because we didn't know how long it would take before I would ovulate again) and I got pregnant. The second time around was not so easy. I had three IUIs (with Clomid and Ovidril) and had a negative result, a chemical pregnancy, a month off and a negative result before taking another month off to mentally regroup. After that month to regroup (and stop stressing about it!) I got pregnant on our fourth IUI (still with Clomid and Ovidril).

I think it was $475 for my first IUI in 2015 and $500 per IUI in 2016/2017.

N/A

You cannot speak to someone directly. You must leave a message and wait for a call back. Inconvenient for me working In healthcare field as well. Billing/financial is helpful but not as helpful as I wish they would be when it comes to insurance benefit and helping me figure out what is best. Nursing staff is helpful. Catering to me when I need to lay down for bloodwork. Drs schedules are hard to work with if you only want to see one doctor! Need to be flexible but everyone has been great!

Dr. Scheiber was always very welcoming, accepting, and comforting. He spoke to both myself and my husband frequently in the office. He cared & answered all of my questions.

Nursing staff is great! They're helpful, but hard to get ahold of. We have to leave a message every time we have a question. We request they return a call between certain times and they do their best with that. A trend we have seen is they tend to return calls around 3:45-4:00 pm which is inconvenient because they don't return calls after 4. So if you miss the call between 3:45-4:00 you have to wait until the next day.

We enjoy seeing Dr Scheiber. He cares for us and answers our questions. We have been with him from October 2016-current. We had done a lot of leg work in the beginning of treatment so he was ready to get started with us as soon as we arrived. We had all of our info in place and were just as eager to get started with treatment! We wish we were able to see him each time we went but there are 3 locations and 3 doctors. We have had to be flexible.

You will not see Dr Scheiber at every appointment. All of the doctors in the practice have different bedside manners and some are way different than others! I was shocked! He is a very smart man, & I believe has the best interest in all of his patients.

IUI with Femara days 3-7, once IUI was complete we had intercourse that evening and the next day - negative Another semen analysis was completed and nothing had changed since husband changed diet and started Clomid. IVF - BCP, Menopur, Follistim, Ganirilex, & HCG trigger - egg retrieval while under conscious sedation. ICSI performed, 5 day transfer of one blastocyst rated perfect. Started endometrin -negative test at 10dp5dt. Beginning 1st FET - Estradiol & baby aspirin day 1-day20. Day 14 ultrasound and will start endometrin at that time. Day 20 thaw and transfer of hopefully two blasts.

IUI - $350ish IVF w/ ICSI - $20,000 billed to insurance. Roughly $11,000 if self pay. Meds were ordered through online pharmacy at $3,000 FET - $8,000 billed to insurance, $4500 if Self pay

Drs only wanted to transfer 1 embryo first cycle. We were disappointed as we wanted to transfer two. We were told it would only increase chances by 2%. We "had great odds with my age & the rating of our embryo". Resulted in negative pregnancy test. We are pushing for 2 embryos transferred this time. We had a lot of pushback transferring two the first round and was talked down upon when we asked about transferring two from another dr within the practice.

I really can't speak about any weaknesses, other than maybe billing. They submitted some things to my insurance and I'm a self pay patient, my insurance covers nothing for infertility. They have GREAT success with IVF so that's why I chose to go there!

He has a wonderful bedside manner, he also really cares about his patients and even when things don't go the way I wanted he called me to answer my questions and to genuinely check on me.

I am a nurse, but being a patient is totally different. The nurses there are sweet and always considerate of your feelings. They know what to say when your feeling nervous and overwhelmed. Very comforting

Again he was really compassionate and he also was very truthful from the start and took his time with us and answered all of our questions. He's awesome! He was the doctor that I saw every visit during my first IVF round, only one time during that 1st round I had to see one of his partners (it was a holiday weekend), but he told me that I was going to have to see one of his partners, so I was prepared and I was ok with that.

Come prepared to answer some questions from him and know that he is ok with you having a voice in your treatment!

I was on birth control for 22 days, started a period and the started follistim, then added menopure, and ganarellix. Then eventually a Hcg shot and progesterone vaginal suppositories. I can't exactly remember how many days of the follistim, I think it was 12, I remember I had to increase 1 time and then had to order more of it and the menopure. My egg retrevial was intense, I was hyperstimed and he retrieved 21 eggs and I was put on some medication to help with my HSS. Out of the 21 eggs we had 5, 5 day embryos. We transferred 1 and froze the other 4. BFN on day 14, post transfer, I also started my period that day. I'm currently waiting to test, I will on Thursday, we used 2 frozen embryos on Friday March 24th. I don't think I am pregnant though.

IRH has the best price for IVF in the area.

I told him whatever he thought was best I trust him and that's why I travel over an hour to see him.

New patient is a bit of a wait and you need to be aggressive and direct about what you want.

He gave me a grant to do another frozen transfer with our last two embryos we have. But we and he feels the fresh cycle is going to give us the best result. We cannot afford another Ivf fresh cycle at this time though.

They are all great as well. I think the only weakness could be they are so busy at this clinic the office phone is always a call back but other than that they do call back

The clinic is great at what they do if your specific provider isn't available the other two will see you as well and are just as good. Dr. Schieber saw me as well and did the transfer for two cycles I had. I love all the providers there. Dr. Awadalla has a great bedside manner and is very compassionate to my situation that is why I prefer him. But I do see other providers there as well. He is very detailed and is not pushy. I wouldn't choose another clinic to do Ivf.

Be direct with what care you want and they will do their best to make it happen.

I did 4 iuis before going to Ivf. I did 2 previous iui I believe with another provider and clinic. We did the fresh cycle Ivf and it went very smoothly. I took femara. I did menapur injections along with Follistim. It was 2 years ago so I don't remember my exact doses but my charts would have all this information. I think I was going to have to icsi but then the egg and sperm were good so I didn't have to. We retrieved 7 eggs 5 of which were all day 5 embryos. One was transferred and resulted in my son. And 4 were frozen. We used 2 this past year and they did not take. I only have tubal blockage and endometriosis which makes me a good candidate for fresh cycle Ivf. The frozen I am not sure about how well since the last one didn't take. We cannot afford to use the last two yet. But would really like to do another fresh since this is more promising outcome

They will call you back to get an appt by the end of the day that you call. So prompted based on what they are dealing with

So far we have spent near 19,000

They do what is best based on history they will not transfer anymore than 2 at a time though