Institute for Reproductive Health

Dr. Burwinkle was down to earth and to the point. He communicated well about our treatment plan and was very kind after our failed cycle. He might have even used a light-hearted curse word once which made my husband feel at ease (haha). Although our results were not what we had hoped for, doctors are humans, and we know it’s a risky business anyway. I truly feel like Dr. Burwinkle had our best at heart to achieve a healthy pregnancy.

Dr. Burwinkle does have a good bedside manor but a slightly dry sense of humor so don’t expect him to paint a pretty picture- he is going to be honest (in a kind way) with you.

I have never been diagnosed with PCOS but my AMH level at the time of treatment was high. Because of that, we used a fairly low dose of injectable medications (Gonal F @ 125, a couple of doses of Cetrotide and Ovidrel). I produced approximately 8 follicles with 7 mature eggs of 4 fertilized. Unfortunately only one of them were able to be transferred and none left to freeze. Dr. Burwinkle stated after that he would increase the dose of medications in future cycles.

One full cycle including ICSI, medications, the whole nine yards, cost approximately $15,000.00.

Our clinic prefers to transfer single embryos which I was fine with at the time. Knowing what I know now, I wish we would have transferred more but hindsight is 50/50. No one to blame for that. I understand and respect the reasoning behind only transferring one embryo at a time based on a fairly healthy and hopeful scenario.

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.

I felt that he was thorough when discussing my protocol and I understood everything. I feel like the retrieval caught me off guard because it was a light twilight sedation so I was awake during the surgery. I was never awake with my 3 previous retrievals at another RE so I was not expecting this. I was not informed beforehand that I would be awake. It was not pleasant. Transfer went smoothly. When I got the negative BETA I feel like the news was said to me in a gentle manner.

Same with all doctors and that is to ask a LOT of questions!

We prepped with birth control and lupron beforehand to suppress everything before I started. I am a high responder so he chose to use a menopur only cycle 225iu per night. We continued lupron though stims to prevent ovulation. For transfer only crinone vaginal cream twice daily.

8200 self pay for IVF cycle which included a fresh transfer PGS, ICSI, FET was additional

I only had two embryos from this fresh cycle and I had two failed transfers previously so he recommended that we transfer both to increase our chances.

I feel as if IRH does not care to educate their patients or provide individualized information. They repeat the same responses over and over and don't seem to want to deviate from their "recommendation." If I don't come up with the question myself, there's no way the doctors, nurses, or billing will voluntarily give me any extra information I need or let me know what's going on with my body. I would hear one thing from Dr. Scheiber and something different from the nurses - Which happened on multiple occasions. I feel like since day one the lack of organization, incompetency, inconsistency in knowledge of anything in general (mostly from particular nurses) has been a negative experience. My biggest issue at the moment is my husband and I were thinking about if we should have genetic testing done. We don't want to keep transferring embryos if they're not good embryos. (I personally think this should be part of the IVF process in general, at least to transfer the best one's first, but that's just me.) Anyways, no one discussed the option of testing and the pros/cons of doing so during the IVF process and fresh transfer (yet we found out they advise testing on fresh rather than frozen). We were told by Dr.Scheiber "There's no reason to test unless you have multiple failed transfers." Well we've had one fail and just started researching the idea of screening the other frozen embryos. At my ultrasound on Monday, we asked what Dr.Scheiber thought about testing. He said, the same as before, "let's wait." Well, we called the day after my ultrasound and left a voicemail. A nurse called us back and said, "We don't do genetic testing on frozen embryos." I cannot believe they're just now telling me this. I've asked about testing my embryos multiple times and no mention of this. After a frustrating conversation, she got off the phone, talked to Dr.Scheiber and called me back saying, "Well, we can test them, but it's not advised." Moral of this particular story and situation is the inconsistent information from doctor to patient, to nurse to patient, and so on. This is a huge deal. Testing embryos is a newer procedure, so if that decision should've been made earlier on, they need to make sure that's a heavy conversation and discuss the options with their patients. Last week I spoke to the nurse manager and her answer to a question about my period was, "Well, that's like looking into a crystal ball." Are you kidding me? That's how an infertility clinic is talking to patients? It's already an emotional time, they are supposed to be the experts and professionals. Compassionate and knowledgeable. I'm having a very hard time processing my present situation. This grant could help me start my journey at a new facility and I would be over the moon to receive such a gift.

I would advise a new patient to ask him as many questions as possible and do not leave the appointment until he's answered everything as clear as possible and in as much detail as you need. Also, write everything down!

I was on birth control for a couple weeks to stop my ovulation, then moved on to my injections to stimulate my ovaries, follicles and eggs. I was on Gonal-F 175 and Menopur 1 vial for 10 days. I added Cetrotide halfway through that, and my trigger shot Oviderel 26 hours or so before my egg retrieval. I didn't have to increase or decrease my dosages and my hormone levels adjusted as they were supposed to. We retrieved 17 eggs, 13 fertilized, 8 developed into embryos. I started vaginal progesterone supplements 3 times/day on the day of my egg retrieval. My fresh transfer was on day 5 blastocysts. I transferred 1 blast but received a negative pregnancy test two weeks later. Fast forward a couple months and I'm now scheduled for a frozen embryo transfer in two weeks! I'm on estrogen 3 times a day and I start Progesterone again 6 days before my FET.

Ultrasounds ran smoothly. I was always able to get in and out.

We've gone through IVF with ICSI and have a FET scheduled and we've spent around $15,000.

Dr.Scheiber and every other doctor at IRH recommends and highly suggests 1 single embryo transfer for patients first and second transfer. I thought about transferring 2 on my first fresh transfer, but then decided to go with 1. I believe they allow it, but you must sign consent forms. I'm 75% sure I'm going to transfer 2 on my next transfer.

During my initial consult he was very thorough and detailed about our medical history and our plan. He can sometimes talk quickly leaving me with questions and not quite understanding everything. However, anytime this has happened I have had my questions answered promptly. I do feel that he is extremely knowledgeable and caring, especially in these situations.

Come prepared. Think of questions you may have and have any tests results or medical history available. This helps you get the most from your consult and future appointments.

So far I have done three rounds of Femara, to help with follicle formulation and growth. From there I had follicle scans to determine when they were adequate size and mature enough to release the egg. After follicles were appropriate size I was given a trigger shit called Ovidrel to release the egg and cause me to ovulate. Approximately 36 hours later I would go in to have my IUI. We started with IUI due to months of trying with timed intercourse and husbands low sperm account.

Each IUI cycle has been approximately $1200 for me and then the cost of my husbands sperm washing which was $250

No comment at this time

I feel that Dr Scheiber has a great deal of experience and is very knowledgeable. He tends to be more on the business side with the right amount of compassion. He is very detailed and I felt as if he gave me all my options at each step and made sure I knew what would be happening.

I would suggest to have a list of questions ready and now be afraid to ask all of them. Doctors are busy but don’t feel rushed. It’s your appointment.

The reason my husband and I needed IVF was because of a failed vasectomy reversal and there was no signs that I had an fertility issues so our protocol was pretty simple. Low dosages and we were able to have a great egg retrieval. After the first fresh transfer I miscarried and knew of was semi normal for that to happen since we didn’t do any embryo testing. Now that I have miscarriage twice, Dr Scheiber plans on doing more in depth testing to see if there is potentially something wrong with me.

Ivf cycle with fresh transfer and medication roughly $14,000 (cash only) Frozen transfer with medication $5000 (cash only)

Dr. Awadalla seems like a true expert and was very professional. I couldn't always see him because he doesn't work everyday and my cycles didn't work out that way, but he was there for the two biggest days (egg retrieval and embryo transfer).

Do your research ahead of time and make sure that you come in with questions because otherwise you will get hustled out of there. He'll answer questions but he doesn't chat through everything in detail otherwise.

After doing a round of clomid+intercourse with my OB-GYN, Dr. Awadalla did a round of IUI (femara+IUI). Because I have PCOS, we moved to IVF for the next step. We did birth control for 3 weeks so that I could go on a vacation, then 10 days of injections at a very low dose (150). We triggered with lupron and a normal trigger at a lower dose. They retrieved 33 eggs, 31 of which were mature, and 29 fertilized (no ISCI). We ended up with 23 embryos (19 day 5 blasts, 4 day 6 blasts). We did not do PGS. Just yesterday, we did a single embryo transfer after freezing for a month because I developed OHSS.

I was fortunate enough to have most of my costs covered by Fertility insurance. I did pay about $500 for medications/injections and about $250/appointment.

The doctor strongly recommended eSET based on the quality of our embryos and my age. We agreed with this recommendation based on the risks to mother and child(ren) associated with multiples.

Dr. Scheiber has been a great doctor for us! Before coming to Dr. Scheiber we had honestly almost given up on being able to have another child. We will be starting IVF with Dr. Scheiber next week, and though we know there isn't a guarantee that everything will work out, he has taught us that we have so many options and different ways for us to be able to have another child.

I will be starting IVF next week so I haven't started injections yet. Dr. Scheiber has had me taking birth control until my baseline appointment because I have PCOS, the birth control is being used to shrink any follicles before starting the injections.

I immediately felt like Dr. Awadalla was incredibly knowledgeable. I was put at ease because in my opinion he was trustworthy. My husband and I could always ask him any question. This was also how the other doctors in the office were.

I would say to trust Dr. Awadalla’s knowledge and process and know that he will do what is best for you.

The first time he had me on birth control before starting injection medication. I didn’t have as many eggs as he would like to have so he adjusted and took away the birth control. Then the third time he decided to add Femara. We did ICSI each time because we had male factor infertility and each time we put back 2 embryos.

We did a money back guarantee. After we found out we qualified we did the guarantee that said if after 3 IVF fresh cycles and 3 frozen cycles we still didn’t have a baby we would get a percentage of our money back.

Dr. Awadalla made it clear it was our choice about how many embryos we transferred.

Dr Burwinkel is more dry and matter of fact, but seems to be very caring. He is very open to answering all of your questions and talking through steps. We are just now starting the IVF process, but I have heard nothing but good things about him as a doctor from others who have successfully gone through IVF.

Know that he is very dry and matter of fact, but does seem to care for his patients and their success!

I have lean PCOS and am very healthy and active. I had previously taken five rounds of unmonitored clomid with my gynecologist, and they did not show ovulation when looking at my basal body temperature. Dr. Burwinkel suggested trying Letrozole and then Ovidrel to trigger ovulation along with timed intercourse for three months before moving on to IUI or IVF. During this first cycle with these drugs, he performed an emergency laparoscopy on me due to an ovarian torsion. He believes it was caused from the combination of infertility meds. He managed to save the ovary (it was twisted three times). He has me waiting two full cycles and then we are looking at IVF to hopefully be able to retrieve eggs from the ovary that was twisted and then remove it if it causes another torsion.

Each ultrasound cost me $50 due to being coded as PCOS. Lab work for one cycle was $255 (not covered). My genetic test was covered due to meeting my deductible, but it would have cost me several hundred dollars. My emergency surgery is costing me around 2000.

Although it might not seem that always is the case he really does want to do everything for you to have an outcome of a child. Remember to always ask questions he can be in and out and short but if you ask he’s definitely going to be straight with you. I feel that the more questions you ask the better you’ll feel about everything and it helps keep your nerves calm during a very anxious roller coaster time in your life!

Ask lots of questions all avenues that you could possibly explore

Gosh it’s hard to remember we’ve been at this for so long but we started off with pills then shots in each are you why it got more aggressive with stronger doses more shots and we are now in the process of our first IVF treatment staying positive keeping fingers crossed

Expensive! Unfortunately we did six rounds rounds of our UI is equaling three to $4000 each adds up very quickly sometimes I wish that we would’ve stopped with so many rounds and put that money toward her an IVF cycle

I think that Dr. Scheiber is really a great doctor. There isn't much negative to say at all. He seems to share in our frustration that the process isn't working and we don't know why. He's also been very upfront with his recommendations. I really appreciate that he also gives levels of treatment. Everything from "the gold standard" to something a little less expensive but he still fully backs. Also - he understands my need to try to do every little thing to try to help the process along - so he was ready with recommendations for acupuncturists and supplements. I always feel like he's one step ahead.

Ask a LOT of questions and don't be worried if you think your question is stupid. He's had almost every question asked before and there isn't anything stupid you can ask. He is VERY patient and will say the same thing a few times if you need that.

This cycle is fairly similar to all my other cycles. He started me off with 14ish days of birth control ( to get control of the cycle), then a baseline scan, Then a few days of just gonal-f ( 200 units) and Menopur (one vial). After my second scan, cetrotide was added. I've had a couple scans since the addition of my cetrotide, and my gonal-f was bumped to 250 to try to encourage a bit more growth. I'm taking ovidrel for my trigger shot

I know the cost of medicine for my full ivf cycle is around $4,000. I don't remember the exact cost of the procedure as they are now covered by insurance. But I believe around $15,000

Usually Dr. Scheiber only does single embryo at a time. Mostly this is because a singleton pregnancy has fewer complications then multiples. If you are older or - like me- have had several unsuccessful cycles and/or chemical pregnancies etc...there is a case to be made for doing multiple. It seems like he's trying to make sure that as far as can be controlled - everything is smooth as can be

Dr. Burwinkel is one of the best doctors that I have ever had. He actually listens to what you have to say, and he doesn’t belittle or make you feel you’re questions or feelings are silly, stupid, or unimportant. He’s optimistic and has a great bedside manner and attitude. I was diagnosed with PCOS (before Dr. Burwinkel) and my weight is a problem resulting from my diagnosis. I know a lot of clinics want you at a specific BMI or weight before they even consider tresteing you, and I was worried about that the most before meeting Dr. Burwinkel but that definitely wasn’t the case! He had a game plan and we started treatment right away! I have nothing bad to say about Dr. Burwinkel! Every meeting I’ve had with him has been as perfect as I could imagine.

Don’t be afraid to ask your questions, no matter how silly or stupid you may think it is! He knows this is hard, he gets it and he understands. He will hear you out and give you the answers you need!

With Dr. Burwinkle I was prescribed 1400mg of metformin daily. He then prescribed me to take 5mg (two pills) of letrozole on days 3-7 of my cycle. We then would schedule a scan to check follicle progress on day 11-13 of my cycle. Depending on the progress and maturation of the follicles, I was told when to take my ovidrel trigger shot to induce ovulation. 36 hours after the trigger shot we had our IUI. The first cycle I had one mature follicle and I took my trigger shot approx day 16-18 of my cycle. The second cycle I had to be prescribed more letrozole in the middle of my cycle due to my follicles not being as mature when the doctor wanted. I had to come back for a second scan and was given my trigger shot around day 18-19. The third cycle I had one good mature follicle, and a second one that may or may not have been mature by ovulation day. None of my cycles resulted in any type of pregnancy or success.

Copay for appointments: $35 Sperm wash: $225 IUI procedure: $250 Ovidrel trigger shot: $95 Letrozole: $15

Dr. Burwinkel is great! He is very kind but also does not sugar-coat things which I like. I feel like he gives us his honest opinion of our treatment options. He speaks to us like actual humans, not just a number or patient. My husband has no medical background or experience and Dr. Burwinkel speaks to us in terms that he understands. He treats us in a way that makes us feel like he truly cares about us and is doing everything he can to help us start a family. I highly recommend Dr Burwinkel!

Have questions ready to ask before your appointment. He has been great at answering any questions we have. I feel like he gives us his honest opinion of our treatment options.

We started with using Letrozole, Ovidrel, and timed intercourse. I had taken Letrozole with my regular OB doctor and knew it worked but Dr. Burwinkel increased the dose and also continued Metformin I had previously been prescribed for PCOS. After 3 rounds of timed intercourse we moved on to IUI.

I was surprised by the cost in a good way! Much more affordable than most clinics I have heard of which is important because my health insurance does not cover fertility treatment.

It’s hard to trust someone in this very sensitive process. However, Dr. Scheiber was kind, consistent and confident in his manner when meeting with us. He also was always warm and understanding when we displayed strong emotions just providing us with all the information his recommendation but allowed for us to feel like we were making the decisions. Having him as our doctor makes me feel more calm in a setting that I naturally feel very anxious.

I wish we had discussed having a diagnostic procedure done such as an HSG before moving forward with donor sperm due to the cost of donor sperm. We did an HSG after 4 unsuccessful medicated IUI’s. It made me feel like we wasted vials and had to switch donors to move forward.

I am 28 in good health with no known fertility issues, after 3 medicated IUIs femara and ovidrel, an HSG was recommended to explore reason for not being successful, the diagnostic procedure found no concerns with my Fallopian tubes or uterus, we then tried a fourth unsuccessful attempt medicated IUI with femara and ovidrel. We were then recommended for IVF, we were offered to do double IUI with injectibles but our doctor expressed concern about high risk for multiples and IVF being safer for my body. Based on cost comparison, percentage of success; we decided to do IVF. We have male factor because of donor sperm female couple but other than that I at this point have unexplained infertility.

125 for a consult, 300 per unltrasound, 250 per IUI, 92 per ovidrel shot, 275 per Sperm wash, we did four cycles that way. It may cost us 2200 for the HSG we are waiting on the bill currently we have also spent 7,000 in donor sperm so far.

I don’t have any experience with this. We talked about transferring the most of 2 embryos if we make it to that stage with IVF.

Dr. Burwinkel was always available for whatever we needed. He never rushed our visits, he was kind and patient, he was always thorough in explanation of drugs, procedures, next steps, risks, and outcome probability. I had to have a surgery at a local hospital and Dr. Burwinkel was right there updating my husband and performing the surgery before going into the clinic for the day. We couldn’t have had better care.

Don’t be afraid to ask questions and express your concerns. He will address any concern you have as many times as you need.

We started with a routine clomid cycle with an ovidrel trigger because my cycles were normal and everything seemed to be “okay” with us. After that cycle failed, I had a hysteroscopy which showed some uterine polyps. Not long after I had a polypectomy and D&C to remove the polyps and thin out my uterine lining. Once that healed, we went back for another clomid cycle + IUI and that also failed. By this time, we had spent a lot of money out of pocket and had to take a break to recover.

I honestly can’t remember. We spent a lot of money in a short period of time, but I can’t remember any specifics.

Dr. Awadalla has taken extremely good care of me during my treatment at IRH. He has always maintained a positive outlook for our eventual outcomes and is proactive in adjusting treatments based on the results of our previous cycles. His strengths lie in his knowledge and expertise in the fertility practice as well as his bedside manner. At times I did feel like he was trying to protect my feelings a little too much, which I appreciate, but being a person who requires lots of details and direct communication, it did sometimes leave me uncertain or with questions. However, once I was able to gather all of my questions, I was always able to get the answers and clarity I needed. I would most certainly recommend Dr. Awadalla to any patient as I feel like we are getting the best care possible with him and IRH.

Make sure to educate yourself and do not be afraid to ask questions, even if you call back after your appointment. They process a lot of patients at IRH but they are really great about taking the necessary time with you if you ask for it.

Cycle 1 - Femara, Ovidrel, Timed Intercourse - Negative Pregnancy Test Cycle 2 - Femara, Ovidrel,Timed Intercourse - Negative Pregnancy Test Cycle 3 - Femara, Ovidrel,Timed Intercourse - Negative Pregnancy Test Cycle 4 - Femara, Ovidrel, IUI - Negative Pregnancy Test Cycle 5 - Femara, Gonal F (Doses of 75iu to 150 iu), Ovidrel,IUI - Miscarriage, D&C, Genetic Testing showed Trisomy 22 Cycle 6 - Femara, Gonal F (Doses of 75iu to 150 iu), Ovidrel,IUI - Negative Prenancy Test Cycle 7 - Femara, Gonal F (Doses of 75iu to 150 iu), Ovidrel,IUI - Miscarriage, Cytotec Cycle 8 - Birth Control, Gonal F (Doses of 175iu), Cetrotide 25iu - Terminated Cycle due to poor follicle response Cycle 9 - CoQ10 & DHEA Supplements, Gonal F (Doses of 225 iu), Menopur 75iu, Cetrotide 25iu, Ovidrel - 6 Follicles, 3 Eggs Retrieved, 3 Eggs Mature, 3 Eggs Fertilized, 2 Embryos made it to Day 5 Blast and tested with PGS, 2 Abnormal Embryos (Trisomy 6, Trisomy 9) Cycle 10 - CoQ10, DHEA & Vitamin D Supplements, Gonal F (Doses of 250 iu), Menopur 75iu, Cetrotide 25iu, Ovidrel - TBD. Will do PGS Testing again if we have embryos to test.

Femara - Covered by insurance Ultrasound Scans about $300 per scan, covered by insurance IUI $250 plus cost of sperm washing (covered by husband's insurance) IUI Medications - Ordered through SMP Pharmacy $500 to $1.5K for Gonal F & Ovidrel IVF with PGS - $15,900.00 is their discounted rate and does not include medications or the PGS Testing Lab Fees (Ovation) PGS Testing Lab Fees - about $1,200 for a single cycle with 2 embryos tested, about $2200 for multi-cycle plan for up to 8 embryos tested IVF Medications - $2-5K for Gonal F, Cetrotide & Menopur per cycle

Dr. Awadalla is very pro-single embryo transfer and anti-multi embryo transfer except in special circumstances.

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.

He made my husband and I feel comfortable immediately. He made sure both myself and my husband understood everything, and made us feel comfortable asking questions. He is honest and to the point, and has incredible bedside manner. We did one round of ivf with no eggs that survived to freeze and did not get a positive pregnancy test. He was so kind and called to check on us and offered an updated treatment plan. He is amazing.

He is great and they will love him.

After 4 failed IUIs his recommendation was to go straight to IVF with ICSI. His plan was to transfer 2 embryos however we went in over the weekend and another physician was on call and only transferred one. Unfortunately it did not result in a positive pregnancy and our other 2 embryos degraded before they were able to be frozen. Dr. Awadalla called and discussed a plan for higher stim with drugs next cycle to hopefully get more embryos and with a plan to do assisted hatching as well.

One cycle with ICSI that included a self pay discount was around $10,000 not including meds. My insurance covered visits and labs.

Due to my age, he wanted to transfer two.

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.

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.

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.

Dr. Burwinkel's strengths are he is very kind, his bedside manner is great. His cons are not taking time to explain why decisions would change so quickly. He did well in explaining the course of treatment, but when the course of treatment didn't work, we felt as if the course of treatment was never changed. MFI wasn't deeply explored or even suggested we should see a reproductive urologist, we took that initiative on our own. After the chemical pregnancy, we went back to our obgyn and she found that I had FVL and MTHFR as reasons why we could be miscarrying.

Ask lots of questions. Be educated on what options are available to you with all scenarios.

IUIs- Femara with Ovidrel trigger shot Retrieval #1- BCPs, Gonal F, cetrotide, ovidrel trigger Retrieval #1- Gonal F, Cetrotide, Menopur, Ovidrel trigger FET- Estradiol orally, prometrium vaginally

Our first two cycles we were blessed with insurance coverage, however our copay on each cycle was 1,000. Medications for the two cycles ran us 7,000. FET cost us 4,500, medications were covered under insurance.

IVF #1- single embryo transfer at age 29 IVF #2- double embryo transfer at age 30 FET- single embryo transfer, only had one embryo left