CCRM Minneapolis

Dr. Batcheller is extremely knowledgeable and competent, as well as friendly and always willing to answer questions or explain things in more detail. She's very up to date with fertility research. The only time I felt that her recommendations were not 100% evidence-based were after my embryo transfer and in early pregnancy (before I transferred back to my OB). She is extremely conservative and cautious about early pregnancy, and gave me a lot of restrictions that seemed unnecessary and that did not line up with the research I found (for example, 2 days of bed rest after embryo transfer). Overall, my experience with Dr. Batcheller was extremely positive, and she got the job done! Although I only had a handful of appointments and conversations directly with her, she communicated well through the clinic staff and never seemed inaccessible.

Don't be afraid to ask lots of questions! She is very good at explaining things clearly and concisely.

The cost for IUI varied between about $2,000 and $3,500, depending on how many ultrasounds were needed and what medication was used. The cost for IVF was about $14,000, plus about $7,000 in medications.

Dr. Batcheller did not actually ask if we wanted one embryo or two to be transferred until the day of the procedure, which I found a bit odd. We did not have a prior conversation about the pros and cons of single vs multiple embryo transfer, but when I said I only wanted one transferred, she said "That's probably a good idea, if we transfer 2 there's about a 60% chance of twins".

Dr. Batcheller has a record of success, and we are hopeful this round will be successful. She is always friendly and appears knowledgeable. Our last RE indicated, after one failed round of IVF, that our chances of a successful round of IVF would be low. April reviewed our records from that round and made significant adjustments to our protocol.

Be persistent. We had to persist to convince Dr. Batcheller to test us for infertility issues. She recommended we try for a year, though after persisting, testing showed severe male factor infertility that requires IVF.

We are coming to April's clinic with a history of one failed round of IVF. She's recommended a number of changes, and we're happy with her ability to adjust course from our last failed round. Priming: Estrogen and progesterone Stimming: Menopur, steroid, human growth hormone; cetrotide; lupron and novarel We'll be doing a frozen transfer after all embryos are genetically tested.

We haven't completed the process yet. We are 100% out-of-pocket for clinic services.

April recommends one embryo transfers due to my age and the high risk of multiples.

The patient has to be comfortable dealing mostly with staff at this clinic. For me that wasn't a problem, and Dr. Batcheller was clearly monitoring my progress behind the scenes, as she is clearly very busy. I felt my care was well handled and had a very good cycle to begin with seeing as I have low ovarian reserve. The protocol seemed very fitting for a first round based on my situation, and I will only be requesting small adjustments for round two.

If you want a very personalized plan this is the place to go, but you should be prepared to have somewhat limited interactions with the doctor herself.

I did a high dosage protocol for my low ovarian reserve. I was on both Clomid and Dexamethasone, alongside 300 units Follistim, two vials of Menopur, and about halfway through I started one prefilled syringe of Ganirelix. I triggered with both HCG and Lupron. Toward the end of my cycle my estrogen was very high, so there was some concern for overstimming. They had me trigger according to our original plan, even though I was hoping to let a few more follicles catch up. They focused on my body and safety when I didn't, which I think is very important. They put me on Cabergoline to help this as well. I am currently one day past retrieval and have had no weight gain, no trouble urinating, and otherwise no signs of ovarian hyperstimulation syndrome. Being below age 35 and having been on such high doses of hormones this was definitely a concern, and I'm glad that my doctor took this into account.

Initial Consultation: $200 One Day Workup (Hormone Testing, Hysteroscopy, Sperm Analysis, Disease Testing, Other Blood Tests): ~$2,100 in house, ~$2,000 to Quest Diagnostics (disease testing) Round One (Monitoring, Surgery): ~9,400 Anesthesia: $475 (Check Only)

Because I am doing PGS testing and am under age 30 I believe that when we get to the transfer I will only be allowed to do one. The risk of multiples is too high, and the success rate should be around 70%. For me this is a non-issue as I would like to avoid multiples if possible, as the risk to myself and the babies increases significantly in this case.

I went to see Dr. Batcheller right after I was diagnosed with cancer. She and everyone at the clinic, got me in urgently, helped me understand my options, moved quickly and treated me with compassion. I tried to get two retrievals in, but my cancer grew too quickly so I had to cancel the second one. Dr. Batcheller gives all of the pertinent information and allows the patient to make the decisions that are best for them. I could not recommend her and her clinic more highly. While she was on maternity leave, I also saw Dr. Salem at the same clinic, and he was amazing too! I highly highly recommend this clinic and these doctors!

Choose Dr. Batcheller and CCRM for your fertility needs.

It cost about $15,000 for the egg retrieval, fertilization process, and genetic testing. That also included all appointments, ultrasounds, blood draws, and the actual retrieval procedure. That did not include medication.

I was sufficiently educated about about the number of embryos that should be transferred. Since I have a limited number, transferring them one at a time will give me a better chance of success.

Dr. Batcheller has slowly gotten much busier over the last 3 years. It is definitely more challenging now to get in touch with her directly than it was back in 2016. She still performs all of her own procedures but often the diagnostic testing is now done by nurses or the other physician on staff. I also often wonder why the nursing staff has as much control over patient calendars. The nursing staff says that they review all calendars with Dr. Batcheller on a weekly basis but if that is true I question some of the decisions that have been made on some of my calendars and would expect Dr. Batcheller to know based on previous cycles what works and what does not work for me.

Be very clear what type of communication you expect from her so that she can meet your expectations or so that you know what you can expect from her.

1 IVF cycle with 4 successful embryos and a fresh transfer leading to a successful birth (September 2016) 1 frozen transfer cycle with a negative pregnancy test (January 2019) 1 frozen transfer cycle canceled due to illness (September 2019) 1 frozen transfer cycle pending (October 2019) All frozen transfers included lupron with two weeks of estrogen

Frozen transfer cost approximately $5,000 plus medications, IVF cycle with fresh transfer cost $12,000 plus medications

No concerns, we wanted to transfer only one embryo

We have only completed our initial work up and are starting down the path of IVF with the genetic testing, after finding out we are both carriers of CF. This came as a shock to both my husband and I, but Dr Salem discussed the risks and options we had and let us choose which path we wanted to take. He was sympathetic and kind during this stage, especially as I found this out on the anniversary of a dear friend passing of CF. He reassured us that we can work around this risk factor but also explained the challenges.

Trust him. I am so thankful we found Dr Salem and CCRM

We are just starting with creating the probe for our genetic mutation so we have not begun our IVF cycle yet. We have to wait until the probe is ready.

We have not reached this stage of our plan yet

Dr. Batcheller always made us feel like we were making progress, even when things didn’t go our way. She was always up on the latest research and was very forthcoming with us when things she recommended were experimental vs. proven. She is compassionate, yet still candid, which I appreciate.

Be your own advocate and ask for tests you want right away vs. waiting until you have a failed transfer.

I don’t have the details.

$14k for Stim/Retrieval (~$10k for meds) $4k for Transfer ($5k for meds)

She had a strong recommendation for a SET given our “unexplained” diagnosis and the risks that come along with a multiple pregnancy.

Dr. Batcheller, when I saw her which was not often, was kind and patient. She fully explained the procedure and risks and answered all of my questions. My interactions with her have always been pleasant.

More time with each patient and more availability for patients. I was not able to talk to Dr. Batcheller directly at all over the phone and when I asked for an email address to send her an email, I was given a non-functioning email address. When I tried, via the portal, to obtain a working email, I received no response.

$3500 for transfer plus the cost of medications

Dr. Batcheller prefers a single embryo transfer for good candidates due to the likelihood of twins.

Dr. Salem has been very compassionate and great at communicating. He is the only doctor on staff right now while the other is out on maternity leave but he still took the time to call with updates and give us next steps. Everyone at the clinic has been wonderful and caring and patient with all the questions we’ve had throughout the process.

Ask as many questions as you want. He’s extreme patient and kind and really makes you feel like he wants to help, you’re not just a number.

Due to my husbands abnormal sperm sample and the fact that we had tried other approaches prior to going to CCRM, Dr. Salem thought our most efficient and best option would be IVF since my tests showed normal results. We are currently in the transfer prepping phase of the cycle.

So far the costs have been surprisingly minimal through our insurance. I do wish we could have gotten a better estimate up front on what the cost of the entire cycle was going to be including medications.

My doctor does the single embryo approach. When I asked about doing multiples to possibly have a better shot, he explained the benefits for the mother and child if only one is transferred and that made me feel better about the approach and care for myself after getting pregnant.

Dr. Batcheller was always pleasant when I met with her. She explained step by step what was going to happen when she was doing procedures or if we needed to change treatment course (which happened multiple times). I do wish I would have had more face time with her vs. the nurses but if I ever needed to get a hold of her for questions - she was available. I loved her and will continue to go back to her for all my fertility treatments!

Ask lots of questions and tell her how you would like to communicate. I preferred a more direct approach and she respected that.

Egg Retrieval: Normal protocol using Gonal-F, Menopur, Cetrotride. We STIM'd for 10 days and retrieved 24 eggs on the 11th day. Embryo Transfer: We attempted 3 times for a transfer but due to having a thin lining we had to cancel 2 times (was successful on the 3rd). After the first transfer attempted was cancelled, I was worried and unsure about the future and if we would be able to transfer. She calmed my worries and looked at my medicine and changed course accordingly, always trying to find the right mix of medication. I was so discouraged when we cancelled but she was always positive and assured me that sometimes when bodies have a hard time getting a thicker lining they just have to change the medicine protocol. I have been on Estrogren (oral and patches), Vaginal Viagra, Progesterone, Baby Aspirin, Endometrin, etc.

Medicine (Egg Retrieval + 3 Transfers attempts + 1 successful Transfer) = $15,000+ Care: Unsure - at least $7,500. My insurance coveres a specific amount (which has now been used up). Our costs will be different when we do this another time.

I trusted Dr. Batcheller's approach to transferring just the 1 embryo.We only had 2 good embryo's and we did discuss transferring both but she wanted to make sure that we had the best chances for success - which meant transferring only the 1, which was successful.

Dr Salem takes the time to be prepared for our appointments and spent time to understand our goals before we developed a treatment plan. While we have not had a complete cycle due to setbacks, he has adjusted our plan to ensure that we are setting ourselves up for the best results.

Bring all of the questions that you can to understand the process, He was able to break down our plan using our results. It was helpful for me to have my questions written down so that I was sure I got all of the answers that I needed to feel good moving forward with our plan.

I have PCOS and my husband has a normal sperm count/motility so we are good candidates for IUI. With the success rate of IUI (about 20%) the plan is to do 3 rounds of IUI and if not successful moving on to IVF. We were ready to start an IUI procedure using letrozole to trigger ovulation, sadly the lab found that one of my ovaries had an active cyst which would interfere with the treatment plan. So we did a 3 week cycle of birth control pills to quiet it down. We are currently waiting to see if that did the trick to move to doing a full cycle.

$383 was the cost for a sperm analysis and cryopreservation $253 is about what a monitoring appointment costs (day 2/3 appointment)

The first time I met Dr. Salem, he provided us with clear timelines and what things would look like. He was very thorough and has a personality that helps to make people feel comfortable. I have twins that were done previously through IVF at a clinic that is no longer open and he was diligent in getting all of that information to help inform him on my care.

Don't be afraid to ask questions. He is very open and honest about what to expect and outcomes.

The first thing that I did at CCRM was to get a full workup. They took blood and did ultrasounds to be sure that I was in good health. It was at this time that he prescribed me with thyroid medication to be sure that I had optimal levels. Then I went on birth control for 3 weeks before beginning my stimulation meds. I am on the last day of my stimulation meds now. I take 2 vials of menopur in the morning with my thyroid medication. At night I take Follistim and Dex. On day 5 I also began taking Gonirelix in the morning with the Menopur. I have had daily ultra sounds and blood work for the last 5 days. I will likely trigger tonight.

Cost of medication was about $7,000 Cost of everything else was about $20,000 We did IVF with CCS testing. They also had sperm thaw.

Dr. Salem prefers single embryo transfer as he believes that with added testing the results are likely going to be positive.

As a patient I feel like Dr. Batcheller did really took the time and effort to review my history and go over our treatment plan. Dr. Batcheller also very details in her explanations. Love her energetic approach and how knowledgeable she is.

Don't loose HOPE until you see Dr. Batcheller.

Too early. We just finished our consultation, done labs and ultrasound. Still need a hysteroscopy and regroup before we can start IVF treatments

Consultation $205 Labs $1083 Ultrasound $397 Hysteroscopy $970 Regroup $224 IVF Pack $15104 Anesthesia $475 Annual Storage $408 PICSI $408 FET package $4208

No comments. Didn't get that far yet.

Dr Batcheller made is feel comfortable and confident throughout the process. She was blunt when we had to be and gentle when we needed it. We recruited our own egg donor which is something I don't think they'd gone through very often which made our journey a little bumpy. We asked a lot of questions I don't think she was used to answering and could tell that she wished we had been less complicated. But it ultimately worked out and we trusted her. She did not offer embryo testing at the time of creation and I wish that she had.

Ask as many questions as you have. She'll answer them all. But doesn't necessarily bring things up if you don't ask. She brings up the things that are medically important. But maybe not extra things that might be important to crazy infertiles lIke us!

My AMH was .05 and AFC around 4 when I first saw Dr B. She suggested we start with a medicated IUI. I did triple Menopur for 14 days and had 1-2 follicles. It was not successful. Given my poor response and low AMH/AFC she suggested we either do multiple rounds of IVF with high doses of stims and CCS testing bto hopefully get 1-2 normal embryos if we wanted to it my own eggs or move on to donor eggs. We opted for donor eggs. Knowing we wanted more than one child. The cost of using my own eggs would be too high.

Our Dr strongly encouraged eSET and we agreed.

Dr. Salem primary did phone consists with me as we were far from the clinic. He always explained things in a way I could understand and made me feel confident our cycle would be successful. He explained his experience and how it compared with our expected treatment plan and I never doubted his expertise. He was caring during painful procedures and his knowledge of infertility blew me away. When answering questions I had, he did so in a way that didn’t belittle my lack of knowledge and explained everything so wonderfully.

If you’re unable to get the answers you need from his nursing staff, ask to speak directly with him. He’s more than happy to set aside time to speak with you.

For our Egg Retreival process, I was on 150units of Gonal F for 10 days starting day 16 of my cycle. I also did 1 vial of menopur for those 10 days and 5 days of cetrotide starting day 21 of my cycle. For my trigger prior to retreival I did leuprolide and novarel. I was also placed on a medication to lower my estrogen levels 2 days prior to retreival.

Ivf Egg retreival with Genetic testing and 1 frozen transfer is approximately $25000

Dr. Salem stated he prefers single embryo transfers

I’ve met Dr. Batcheller once or twice, but she’s always been super helpful and friendly. In our initial consult with her, we talked about our plan being 3 months of IUI and then evaluate from there. At that point, she was so optimistic for us that we never spoke of what would come next and that was comforting. Unfortunately IUI has not worked for ya yet. We’re trying a 4th round with some new meds and if that doesn’t work, we’ll have our regroup appointment next month. Honestly, we see more of the other staff and they’ve all been great.

Stop in and say hi during appointments every now and again if you’re available!

IUI with Clomid (1pill x 5days), Ovidrel and Progesterone. Our second cycle, I ovulated on my own, so Ovidrel wasn’t needed. In our upcoming 4th round, we’re adding in 3 injections of Gonal-F. So far, no positive tests, but we’re optimistic about this round.

Our insurance is taking a while to process things, so I know we’re not up to date. So far we’ve spent around $2000. I anticipate it will be more though.

I met with Dr. Salem after having a bad experience at another fertility clinic. He is incredibly kind and compassionate. He is also incredibly smart and up to date on the latest information about fertility treatments. He worked really hard to get me the maximum number of eggs for freezing and tailored my treatment plan specifically to my issues (I ended up getting nearly double the number of eggs that I got at the previous clinic!) I sent my sister to him also because I was so impressed with his services.

Go see him! He is a great doctor! If you are a woman who its hesitant to go see a male ob/gyn, don't let that stop you - get the best treatment possible from the best doctor.

My treatment protocol was "Luteal Oral-Clomid Protocol 5 - freeze all only." I did a round of egg freezing at a prior clinic and got 7 mature eggs. Dr. Salem's goal was to get me at least a few more the second round. To do that, he advised me to wait 3 months after stopping birth control pills to see if my AMH would increase (it did! went from .5 to 1.78). Based on that, Dr. Salem concluded that birth control pills had a very suppressive effect on my ovaries, so rather than start my cycle with down-regulation by taking birth control pills, I waited for my natural LH surge and then started priming my ovaries by taking estrogen (estrace 2 mg tab twice a day). On day 3 of my next cycle I stopped taking estrace and started taking the stim meds (2 vials of menopur in the morning, 300 units follistim in the evening + 2 tabs of clomid for 5 days + dexamethosone). On day 7 of the stim meds I added in ganirelix in the morning. Triggered after 11 days of stims with HCG and Lupron. I got 13 mature eggs this round - almost double what I got at the previous clinic. I feel that Dr. Salem is directly responsible for the improvement - he really looked into which treatment plan would work best for my circumstances. The other clinic planned to do their exact same protocol a second time (birth control pills for 2 weeks to down-regulate, then start with 1 vial of menopur in the morning + 225 units of follistim in the evening, add ganirelix and then trigger with just HCG). It didn't work well the first time and they had to increase the medication half way though - I believe that if I had done that protocol again, I wouldn't have gotten as many eggs. In addition, they made it seem as though that was the best they could do for me - that because of my low AMH I should just be happy with the number I got. It was very frustrating. Dr. Salem's approach was much more tailored to me and really addressed the concerns I had at the first clinic. He is optimistic and tries to do the best for all of his patients.

$8,754 for an egg freezing cycle + $475 for anesthesia. The clinic also offers to reduce the fee for a second cycle by 20% and 15% for each cycle after that.

If you can get in-person or phone contact with Dr. Batcheller, she is knowledgeable, willing to discuss and answer questions, and provides a sense of understanding. She is kind and approachable. She emphathetically discussed our situation and offered counsel. She is great... when you can see her. For me, during our IVF process we didn’t see her enough and ultimately wonder if we would have had a different outcome if we had.

She is the only doc at her practice currently so you won’t have to confirm if she will be doing your retrieval. My recommendation would be to have Dr. Batcheller/the staff outline the access/contact you will have with Dr. Batcheller during the process you are completing and adjust as you see fit. Either request additional consults or schedule and pay for them.

To my understanding, she has protocols based on intial testing that she will recommend. I didn’t come in armed with knowledge about the many and varied protocols that are out there so I took her recommendation at face value. I responded well to treatment and follicle maturation looked great trending on the 9-10 we anticipated. At our follow-up after our failed transfer Dr. Batcheller confirmed that on examination the 3 eggs retrieved were likely the 3 least mature further indicating that I ovulated early and the retrieval missed the best quality eggs. So... it’s hard to say but considering we had 1 normal embryo from 3 lower quality eggs... I would trust Dr. Batcheller to select my protocol again.

$25k+

She makes a suggestion, but will support a decision of 1 or 2 embryos transferred.

I highly recommend Dr Batcheller. She has a great bed side manner, explains everything in a straight forward way that is easily understood. I felt confident that we were at the right place and getting the best treatment available.

If you are struggling with infertility, CCRM-Minneapolis is the place to go in the Twin Cities metro area.

We went with my natural cycle for IVF instead of picking a date on the calendar that fit the schedule (like the other clinic I went to was going to do). She said I was an excellent candidate for IVF, and had a successful cycle with the medication and protocol she used.

We have always put in 1 embryo. I was able to freeze 5 embryos.

She’s very well versed in different options. She is also thoroughly prepared to speak on your specific issues even before you even meet her, just based on your records. She presents options and plans, strategizes with you on timing and always makes you feel comfortable speaking to her throughout the process.

Have your questions ready because she will be ready to answer all of them

Dr. Batcheller was the first doctor to find my uterine polyps. Based on our previous meetings with other doctors for ivf consults we asked Dr. Batcheller if she would put me on birth control, which was suggested by other drs to boost egg production and she said no, because of my low AMH, it wouldn’t be helpful. I throughly enjoy that she doesn’t treat us as if we are just another couple with the same issue as everyone else. Our plan is unique to us.

The costs seem normal compared to other ivf locations in MN

Dr. Batcheller is not opposed to multiple embryo transfers but did suggest not transferring more than 2. She thoroughly explained why this is safer for me and the embryos as the risk of multiples increases.

Dr. Batcheller sits down with each patient and really gets to know them. She meticulously plans out every aspect of your treatments, what you are going to need for meds when, do on. If you have questions she will answer them and explain to you in terms you will understand. She cares about your well being during the whole process.

I had to start with egg retrieval. I had to start taking Doxycycline for 10days. Cycle day 10 start an ovulation kit testing. 10days after surge I started my Vivelle 0.1mg patches switching them every other day. The next day I started taking Cetrotide 0.25mg for 3 days. I continued with the Vivelle patches for that week and wore the last patch for 7 days or until it fell off. 3 days after I started with my Stim meds, 2 vials of Menopur in the morning and 300 units of Gonal-F and Dexamethasone in the evening for 10days. After 6 days of starting Stim meds I started taking Cetrotide again. 2 nights before the retrieval I had to start my trigger meds, Pregnl and then again 12 hours after the first does then I had retrieval.

Everyone’s IVF story is different therefore everyone’s cost will be different. But I strongly believe that the cost was comparable to other clinics.

Dr. Batcheller is such a blessing. She is intelligent, warm, and honest, a combination that is so hard to find. Dr. Batcheller has always given us the impression that she is fully invested in seeing us succeed in this process and doesn't shy away from trying new things or tweaking things as needed. I have worked with another RE in the past and while the outcomes of my cycles have been similar the experience of working with Dr. Batcheller far exceeded my previous experience. Can't recommend her highly enough!

Don't be afraid to ask questions.

To date I have done one egg retrieval with Dr. Batcheller. I did androgen and estrogen priming followed by an antagonist protocol (ganirelix + 300IU Follistim + 150IU Menopur) and simultaneous Clomid (100mg), Saizen (8.8mg total), and dexamethasone (0.5mg). Trigger was Lupron + Novarel (5,000IU). This protocol was chosen due to my history of being a poor responder to IVF medications, and having poor quality eggs.

At the end of the day after diagnostic assessment and egg retrieval (+ CCS testing) including medications the cost was approximately $25,000.

Prefers eSET for CCS tested embryos but open to multiple embryo transfer in my case. Can't comment on her approach when genetic testing is not used.

Dr. B is very kind and caring about her patients. She is knowledgeable about the various developments and innovations in IVF treatment, and I felt like she allowed us to be part of the decision-making process. When our first FET resulted in chemical pregnancy, we reviewed some unique symptoms I presented with and she listened to my ideas on how to adjust treatment, gave us the scientific reality of those ideas, and we made a joint decision to try an anti-histamine approach. Dr. B also is understanding that since we were paying for everything out-of-pocket, we should skip some tests for the immune theories, and just treat me as though I had tested positive. Overall, even though we still haven't had a successful pregnancy, I feel Dr. B cares for and is passionate about her patients. My only concern now, is with two failed transfers, she had initially told us she expected a 60% chance of success. My only criticism is that her optimism can be a bit misleading or insensitive. It's nice to have that hope when you first meet and are nervous, anxious, or uneasy about the whole process. But I think I would have rather she not so confidently given us a percentage of success when I asked for it, or tempered her optimism when she said, "Let's talk about your options!" after our first FET resulted in chemical pregnancy. I'm sure in this line of work, you have to be a positive person to stay in it, but a touch more compassion isn't a bad thing either.

Just know that Dr. B is super positive and optimistic. I think she presented the risks of anti-histamine protocol well, but also dismissed the one birth defect she's seen with the protocol she's done it to something else... so, again, she's very optimistic about what she does. If you are in in a bad place, and need that boost to come back to, she's great. But if you prefer a very realistic and honest assessment, I felt like things were maybe presented a little more positive and confident than I would have liked in hindsight.

Our stim phase was "Luteal Patch (Protocol 3 with Patches)" in CCRM categories. We worked with my natural cycle at my request due to some bad experiences with BCPs. I was instructed to use ovulation kits to catch an LH surge, and then begin cetrotide and patches post-surge. The next cycle, we started stim with Menopur and Follistim on CD2. We upped the Follistim from 150 to 225 on the 4th day of stim since my eggs were going a little slow, and after that, things progressed nicely. After 10 days of stimming, Dr. B cancelled our fresh transfer because my progesterone levels were higher than they wanted. We triggered after 10 days of stimming as well. My US on that day showed at least 8 eggs on each ovary between 17.5 and 20 mm in additional to many smaller eggs. Retrieval was two days after trigger shot. They retrieved 25 eggs, 15 were mature and had ICSI, 11 successfully fertilized, and 7 were frozen for transfer. For our first FET we used my natural cycle again. Used Lupron to suppress cycle before using patches and endometrium vaginal inserts to build up lining. Had to add 1mL of PIO every other day 4 days before transfer due to low P4 levels. After transferring they upped PIO to 1mL every day due to low P4 levels. My lining grew perfectly, and once it reached 8 mm, they scheduled a transfer for 8 days later. (It’s my understanding CCRM will not transfer if the lining is not at least 8 mm.) Our transfers went perfectly, although, we requested last minute to thaw two embryos for transfer, and one did not survive. They thawed a third one in order to still transfer two. (When I asked at our pre-transfer nurse meeting about embyos not surviving the thaw, a nurse told us she had never heard of that happening at CCRM. If they would have asked us what to do when the first embryo did not survive, I would have told them not to thaw a third one. That was frustrating and I expressed that to Dr. B at our regroup. She said CCRM only has 2% of embryos that fail to survive the thaw.) 9 days after transfer, Beta #1 was over 180 and the nurse indicated a number that high (they like it to be over 50) could mean both embryos implanted. Beta #2 did not double, it was just over 200. No changes in protocol. Beta #3 was in the low 30's, and the cycle was deemed a chemical pregnancy. One frustrating part was that Dr. B insisted I get a fourth HCG test 4 days after the Beta #3 to confirm the pregnancy was over, even though I had started a heavy period three days after Beta #3. That was both a hassle and frankly, somewhat traumatizing to experience in the aftermath of things. I didn't see any reason I couldn't have waited out the period and tested afterwards to give me time and space to grieve. After discussing some symptoms I had in FET #1 (two instances of severe nausea, cramping and sweats/fever for 20-30 minutes several days after transfer) we decided to try an anti-histamine protocol in case I was having immunological issues. We also did a long-Lupron cycle due to a previous diagnosis of endometriosis in case that left me with a specific type of cell that can affect implantation. Our initial attempt at a second FET was cancelled when my lining failed to thicken, even after adding estradiol tabs, and eventually developed fluid in the lining. We induced a period with 2mL of PIO in each hip. I never really got a clear reason why might have caused the fluid, but the nurse said unless it happens again, they sort of chalk it up to a fluke and try again. FET #2- Natural cycle again, this time with low-dose meds. Instead of steadily increasing from 1 to 4 patches every other day to help grow the lining, we let it grow on its own. My lining grew a little more slowly than they like, but no fluid and it had the trilaminar layers they want to see. Once my lining was an 8 on it’s own, we added 2 patches every other day for the entire transfer, along with endometrium vaginal inserts three times a day. Anti-histamine protocol was Claritin and Prednisone once a day and Pepcid AC twice a day, beginning 2 days before transfer. Again, transfer went perfectly, we only did one embryo this time. I also didn't need PIO shots every day and could stick with every other day. However, when I presented the same symptoms of nausea, cramping, and fever/sweats, Dr. B didn't have anything specific to change initially. She did suggest we could up the PIO to every day after the second instance occurred in case the fluctuation of Progesterone was causing the symptoms. I declined since we had been doing PIO every day in our first transfer and I still had the same symptoms. Beta #1 was less than 1 and the cycle failed.

Specifically: Initial consult: $205 Communicable/Vitamin D, TSH: $300 LH Check: $115 Progesterone Check: $115 IVF Costs (Stim appointments and clinic surgery) $13,510.00 BETA: $70 Baseline ultrasound and Hysteroscopy: $1,795.00 Regroup (phone) $112.00 FET transfer is in the range of $7,000 Overall, we've spent $24,702 at CCRM with both the consult, stim, retrieval, two transfers, and two re-groups, one in person and one on the phone.

I specifically asked Dr. B about the risks of double embryo transfer a few days before our first transfer. I had to ask, because it was never offered to me. I think CCRM assumes eSET unless they are told otherwise. Dr. B said for our situation, if we transferred two, we had a 65% chance of twins. She explained there is a slight increase in HBP and Diabetes risks, but those exist anyway. The bigger risk is a 25% chance of pre-term labor and bed rest for some portion of pregnancy. However, Dr. B was comfortable with doing 2 for us.