Emory University Reproductive Center

Dr. Hipp has been working with us for many years as we prepared to start our IVF cycle. Each visit she sat with us for as long as it took for us to ask any and all questions in order to leave reassured. She and her team are very quick to respond to portal messages or concerns. Dr. Hipp made it very clear throughout the process that she was invested in obtaining the best possible results for us.

I would advise any patient for any doctor to write down questions as they arise so they do not forget them when they are at appointments.

During stimulation, I was on Menopur in the morning (150iu) and Gonal-F in the evening (300iu) everyday for 10 days. Days 5-10 I added Ganirelix (250mcg) midday. I had monitoring about 4 times during stimulation. On the 10th day I took the first of my two-part trigger shot, at 10pm and again at 10am. I triggered with Lupron to try and avoid OHSS. I was higher risk for OHSS due to a high AMH. I also took Cabergoline after retrieval to avoid OHSS as well as an antibiotic for about a week to avoid infection. I was unable to do a fresh embryo transfer so that my body could rest after stimulation. About a week later, I started Lupron (20 units) daily for about a month to suppress my ovaries. About 2.5 weeks after starting Lupron, I started Estradiol patches. Started with 1 patch every other day and progressively moved up to 4 patches every other day. About 2 weeks after starting patches, I started progesterone in oil (PIO) intramuscular shots in the evening and then also progesterone vaginal pills 3x daily. Six days after starting progesterone, I had my frozen embryo transfer. I am currently 7 weeks and 3 days. I am still on the PIO shots daily, progesterone vaginal pills 3x a day, and 4 Estradiol patches every other day. I will begin tapering off of my medications starting week 8 until week 12.

We financed treatment for $14,500 without monitoring or medication. The cost for monitoring and medication brought the cost to well over $20,000.

Due to my age and health, my doctor recommended transferring only one embryo to avoid multiples which can be hard on my health and potentially dangerous to the babies.

Dr. Schirmer has shown compassion throughout our entire fertility treatment journey. He has informed us of our odds, the clinic's success rates, and our personal success rates and he has gone above and beyond to make sure that we are comfortable with every step we have taken. He has been transparent about every procedure, cycle, step, and possible outcome and he has diligently worked to develop a treatment plan specific to our needs.

Don't be afraid to ask questions! Dr. Schirmer is very open to answering every single question you have. I went into our IVF orientation with a LONG list of questions and he gladly took all the time needed to answer each and every question I had. I have never felt "rushed out of the door" or like he is "too busy to see us" because Dr. Schirmer goes out of his way to make sure we are fully informed and feel comfortable with each step.

Dr. Schirmer, like most Reproductive Endocrinologists, started with "conservative" treatments due to my age (26 years) and the length of time my husband and I had been trying to conceive at the time (1 year). During our initial consultation he reviewed possible treatment plans for us but ultimately let us decide what we wanted to do. As a team, we chose to do Timed Intercourse with Injectables which we did for several complete cycles before we decided to move to IVF. After every failed cycle, Dr. Schirmer met with us to discuss our next steps and what our desired treatment plan would be going forward. He never pressured us to move to a more aggressive (expensive) plan but laid out the facts and statistics of every fertility treatment (timed intercourse, IUI, IVF, etc.) and ultimately allowed us to have an open and honest conversation with us about our specific plan. When a treatment cycle seemed to not be going as planned, he met with us to "regroup" and figure out whether we wanted to continue with the current treatment plan or move to a more aggressive approach. We have felt valued and heard throughout this entire process.

Before each treatment plan was initiated, Dr. Schirmer and an Emory Reproductive Center Financial Counselor sat down with us to review the costs associated with our care. They reviewed different payment methods, options, and third-party companies for financial packages (particularly for IVF) that were available to us. They provided us with a full itemized break-down of all of the costs that we would be responsible for in that chosen treatment plan and worked with us to make sure we could get the desired fertility treatment.

Dr. Schirmer prefers an elective single embryo transfer but ultimately let me make the final decision. He laid out all of the facts and statistics and informed us of the increased risks to me and the babies, should we get pregnant with multiples. However, it was a discussion that we were able to talk through and voice our opinion and Dr. Schirmer let us make the ultimate decision about the number of embryos to transfer. Our clinic grades each embryo and transfers the best quality embryo first to increase the chance of a viable pregnancy. Due to conversation we had, the recommendation of Dr. Schirmer, and the results of my own research, we have chosen to transfer only one embryo and we are so happy that Dr. Schrimer heard our concerns and talked them through with us.

Dr. Kawwass was incredible. She always took so much time to sit down with me and discuss all my treatment options, the evidence-base around these options, and took the time to make sure I had time to ask any questions at all. I never felt like she was rushed and needed to move on. She also really took the time to get to know myself and my husband as individuals, not just as her patient, which I appreciated. One thing I really valued about her was that she really knows the medical literature and studies really well, and for someone like me that really likes that evidence, she was an amazing doctor.

Write down your questions in advance - she will go through each one of them with you and it was always really helpful to have handy during my visits with her.

Dr. Kawwass had a lot of great recommendations for me, and while many of them were minor "tweaks" in my care, it resulted in a positive outcome. After 2 clinical miscarriages (<10 weeks) and 3 chemical pregnancies (<6 weeks) I was at a loss of what to do. Dr. Kawwass ordered necessary tests and helped to explain to me my diagnoses of premature ovarian failure at age 35, as well as all the potential reasons for my miscarriages and what I could do. As a marathon runner, she cautioned me to run less (which seems obvious, but I had 4 different OBGYNs tell me that if I was running before pregnancy, I could continue to do so during pregnancy). She helped with treating subclinical hypothyroidism to get it under control, and she put me on progesterone at 3 DPO, which I think may have made a big difference for me. She also suggested trying Clomid prior to IVF with PGS testing first, as a less invasive method that may work to get pregnant. She also had recommendations for just two supplements that had shown some effectiveness (many others she said were a waste of money and did not work), so I took these two to help improve egg quality prior to the clomid cycle. The clomid worked in the first cycle! I am 12 weeks pregnant now. Dr. Kawwass was so amazing helping to calm my nerves, as I was able to come in for almost weekly ultrasounds when I was nervous about spotting or other concerns about having another miscarriage. Overall, all of these changes to my treatment have resulted in a pregnancy that I hope to carry to term.

My insurance covered the majority of my treatment.

Dr. Kawwass is against multiple embryo transfer because of the severe complications and health risks that multiple embryos can cause both mother and babies. I agree with this policy after she explained it to me. Though having twins sounded amazing at first after struggling with fertility, given all the current worries I have just at 12 weeks and knowing how much MORE I would worry about all the health risks of multiples, I completely understand this viewpoint as it is founded in evidence-based and scientific research.

Dr. Kawwass was compassionate and understanding. Our situation was very odd being that I am only 27 and have been diagnosed with diminished ovarian reserve. When the blood work came back and was shockingly disappointing Dr. Kawwass called me personally after hours to talk. She answered every question with sincere thoughtfulness. Even with the odds against us we were able to get pregnant through IVF with her care. Unfortunately our son was diagnosed with Down syndrome while in utero and was stillborn at 36 weeks. This tragic outcome was no way in relation to anything done through Dr. Kawwass. When she found out our son had died she contacted us personally to send her condolences. Her professionalism and compassion sets her far above any doctor I’ve ever seen.

Don’t be afraid to ask questions because she won’t rush you or make you feel silly. Nothing is too big or too insignificant to ask and she will be 100% honest with you.

We used a low dose of antagonists because of my low egg count. I took menopour, gonal-f or ganirelix, estrogen patches and clomid although I can’t remember in which order. After egg retrieval I was on progesterone injections for 10 weeks because the egg implanted and it helps to maintain the pregnancy. At the retrieval she got 3 eggs. I had 4 mature follicles so 4 was the maximum we expected so getting 3 was a positive for us. They were transferred at the cleavage stage - day 2/3 - and like I mentioned above, one took.

Our cost was roughly between $20,000-$25,000 with retrieval, transfer and medication.

I really couldn't ask for a better provider than Dr. Kawwass. She knows what she's doing, explains things clearly, and shows interest in the role that this IVF treatment is playing in our family and lives as a whole.

Just keep in mind that each provider doesn't necessarily perform the procedure that might need on the day that you need it, so you should be ready to get to know and work with other providers in the practice occasionally. Dr. Kawwass, though, regularly communicates with her colleagues. and she won't "forget" about you even if you have a procedure done with another provider.

Because we had "unexplained infertility," Dr. Kawwass first recommended that we try IUIs. She suggested doing 3 before turning to IVF. Because we couldn't make an IVF cycle happen for a few months after the third unsuccessul IUI, we did two more until we could start an egg retrieval cycle in the summer. After the egg retrieval, which was very successful given that I was 38 years old, she recommended that we test the embryos both with PGS and PGD testing. We did the former on account of our being a little older (I was 38 and my husband 41) and we did the latter to screen for a genetic condition that both of us are carriers for. We then transferred a frozen embryo and thankfully got a healthy baby boy from this first transfer. She recommended transferring only one embryo, since they had undergone the genetic testing and thus stood a better chance of implanting an developing to term. After our little boy turned two, we decided to try another transfer using one o our remaining 5 embryos. This second transfer resulted in a biochemical pregnancy that did not advance beyond the second blood test. We wanted to try again a few months later and managed to find one more funding to source to make it happen. Originally scheduled for October, Dr. Kawwass suggested that we call off the transfer about a week in advance because the lining in my uterus was not as thick as they hoped and there was some fluid between the layers. She reasoned that, since I wasn't going to be undertaking another egg retrieval cycle, we probably should be conservative in transferring the embryos. We postponed this transfer to a couple months later. That transfer at first resulted in a pregnancy. However, at the 7 week ultrasound, the fetus's heartrate was a little low and size a little small. By the ultrasound the next week, the fetus did not have a heartbeat at all. During this transfer cycle, Dr. Kawwass herself was out on medical leave, so another doctor, Dr. Marsidi performed this transfer. We met with Dr. Schirmer after the second ultrasound. They both provided excellent care and counsel. Dr. Schirmer explained that, even though we had put the embryos through PGS testing, the embryo is so small at that stage that there is much the testing cannot detect. As soon as she returned from medical leave, Dr. Kawwass reached out to me to express her concern and make herself available for any support or consultation. I have been working her on trying to resolve the bleeding that still continues from the miscarriage, about 8 weeks later. I will be going in soon for a hysteroscopy to clear the remaining tissue. We hope that we can muster the funds to try once more this summer to transfer an embryo. Since the two recent transfers have not resulted in a viable pregnancy, we have discussed whether she would be willing/would recommend transferring both of our remaining embryos. She said she would be willing in this case, though she has counseled about the significant risks o bearing twins. We still have not decided when and how many embryos to transfer.

Out of pocket $10,238 (we had grant support for the retrieval and first transfer, some grant support for the second and third transfers) $659 per IUI (x5) = 3,295 $4292 per FET (x3) = 12,876 $12,127 for retrieval (1) + hormones, parking, testing TOTAL for 5 IUIs, 1 retrieval, and 3 transfers = $28,982.66 full itemized list below Fertility costs Date Item Place Amount 2017-9 testing ERC $158.46 2017-10 hormones and other supplies Walgreens/ERC $836.70 2017-11 IUI ERC $667.04 2017-12 IUI ERC $659.00 2017-12 parking Emory Midtown $25.00 2017-7 testing ERC $272.29 2017-8 IUI hormones Walgreens Community $104.50 2018-1 IUI ERC $659.00 2018-3 IUI ERC $659.00 2018-3 IUI ERC $931.98 2018-4 parking Emory Midtown $15.00 2018-5 IUI fees ERC $265.34 2018-6 parking Emory Midtown $48.00 2018-6 retrieval ERC $12,127.00 2018-6 retrieval hormones Walgreens Community $3,350.00 2018-6 retrieval hormones Walgreens $464.48 2018-9 transfer ERC $3,750.00 2021-10 transfer hormones Walgreens Community $132.18 2021-11 parking Emory Midtown $32.00 2021-12 transfer hormones Walgreens Community $835.08 2021-5 embryo storage ERC $252.00 2021-5 FET 2 ERC $1,333.28 2021-5 transfer hormones Walgreens Community $895.01 2021-6 transfer hormones + JAX monitoring Walgreens Community $506.35 2021-9 transfer hormones Walgreens Community $664.61 2022-1 transfer hormones Walgreens Community $334.52 $28,982.66

Dr. Toner takes a science/evidence-based approach and always had data and statistics at hand when discussing treatment options. This did not come at the expense of bedside manner, as he was very kind and patient. His demeanor was a great fit for my husband and I who value science and data-driven decision making.

Come prepared with questions, and be open-minded.

For the cycle we tried with my own eggs I was on a antagonist protocol, with Ganirelix, Menopur, and Follistim. I was on high doses but I still stimmed for 16 days as it took my body longer to respond. It resulted in 9 eggs, 8 mature, 6 fertilized, 1 blastocyst. We did a fresh transfer of the 1 blast but it was not successful. Poor egg quality was suspected.

The IUI procedures were ~$2,500. The first IVF procedure with my own eggs cost approximately $30,000, but $11,000 of that was for meds. Since I was on high doses for a long time that's probably $5K more than normal. Our second IVF procedure with donor eggs was ~$15K (not including the cost of the donor eggs).

Dr. Toner established upfront that transferring single embryos is strongly recommended.

Dr. Kawwass is compassionate and enthusiastic. She makes the process seem routine and takes the scary out of it. She explains her diagnoses and treatments so that it can be easily understood and makes herself readily available to answer questions in a timely manner.

Bring your positive attitude!

All of the diagnostics for infertility were covered in full by my insurance. I was then fortunately notified by Dr. Kawwass the my IVF would be newly covered by my insurance if I could wait 3 months until the next calendar year when benefits were expanded to include IVF. With insurance coverage I paid a $1500 copay and then out of pocket for assisted hatching ($1700) for a total of $3200. My stimulation cycle medications cost an additional $500.

Dr. Kawwass is a firm believer in eSET for first timers without obvious fertility issues identified.

Dr. Hipp is amazing and so educated. She made sure to explain everything so we could understand it. If there were any set backs she made sure to call in addition to the nurses. She is just wonderful and I will definitely work with her again.

Ask as many questions as you need. Even if you feel like you are bothering them.

Our infertility was due to low AMH and male factor. We did one cycle where we started with estrogen patches when ovulation occurred. When I got my period we did the baseline and started Gonal-f and Menupur at max doses. About 7 days in we did the Cetrotide to prevent ovulation. We did the trigger shot on day 11 if I recall and the retrieval 2 days later. We got 9 eggs, 6 were mature. In the end we had 2 make it. We did a fresh transfer with a 4AA blast which ended in a chemical. We still have one frozen that we will transfer in July.

Cost was about 15K for transfer and retrieval without meds.

No

Dr. Kawwass did not perform any of our procedures, but we were aware she was consulted throughout. Our meetings with her were thorough and encouraging. When we were worried, she would always appear just to comfort us.

Know that as medical director she may not be available for the day to day, but she knows her stuff and is a great team leader to help you find the best course of treatment and hopefully positive results.

IUI 1-3: Letrozole - Ovidrel trigger Then HSG test. IUI 4 added Menopur for thin lining. IVF: reciprocal with wife's eggs. Me: gestational parent: Birth Control for 4 weeks, daily Lupron shots, estrogen patches. 2CC Progesterone injections daily from retrieval through 9 weeks. Prometrium suppositories 3x day through 12 weeks. We didn't ask why this protocol, but I had very few side effects and we were willing to try anything.

Because there were two people invovled, and we have seperate insurance, my IVF protocol was covered outside my $1500 copay. My wife's insurance did not have fertility coverage but she was given a discount. All in for 6 IUI and 1 IVF we spent just over $20,000 including donor sperm.

We only had 2 make it to Day 5, only one was transferred.

Dr. Kawwass was an amazing practitioner - she was a great communicator, empathetic, and a great scientist / up to date on the latest literature. I appreciate how she combined scientific rigor with her empathetic approach to treatment. Even though I didn’t see her at every visit I trusted her team and knew she was consulted on the decisions around my care.

We started with letrozole only cycles to stimulate ovulation with timed intercourse. At the time both my husband and I were traveling for work so it was difficult for timing intercourse so we eventually moved to stimulation plus IUI. When that didn’t work for a few months I started an IVF cycle with injectables but I wasn’t producing enough eggs so we switched to an IUI. I got pregnant with my daughter on that cycle. When I went back to the clinic 2 years later to start trying again we did a clomid+menopur cycle and IUI and I got pregnant in that first cycle.

Costs were covered by insurance so only paid $40 co pay on some visits

N/a - did not do IVf

he was super approachable and took a lot of time to explain our options and how each option would work. He was also incredibly skilled based on our positive results. I would go to him again if given the option and we plan to use him again to transfer remaining embryos from our retrieval. We are very thankful for his excellent skill that resulted in our wonderful daughter

Be sure to ask lots of questions- he was excellent at reviewing our questions and giving advice without being prescriptive

I had 3 unsuccessful rounds of clomid assisted IUIs. Then shifted to IVF. I used estrogen patches for a few days before starting stimulation. I used menopur and gonal f. I had to be stimulated for 14 days then did the trigger prior to my retrieval. They pulled out 14 eggs, 12 fertilized and 5 remained after 5 days. I did genetic testing and 3 were genetically normal. I did a frozen transfer of 1 embryo resulting in a successful pregnancy and birth.

I was able to use insurance for some costs but all costs were discussed up front with a financial person. We had to pay a certain amount prior to starting the cycle for IVF

He recommended single embryo as I was young (34). I agree with this approach.

Dr.Kawwass listened to all of our concerns at our first appointment. I advised her of the negative experience I had with my previous doctor's office and staff. She made me feel very comfortable and assured me that I would not be dealing with anything like that. She explained her plan for me in detail and answered all of our questions and wasted no time in getting started. She did not rush us and was very generous with her time.

Don't hesitate to ask questions. She was great at answering all of our questions and addressing our concerns.

Antagonist IVF treatment. BCP on 1st day of Menses. Baseline. labs and ultrasounds. Start Stims after period starts again. Egg retrieval. Fresh Transfer

Our insurance covered IVF. We did have to pay out of pocket for ICSI ,our out of pocket amounts and the patient amount for the medications

Single Embryo transfer was recommended as I was 29 yrs old at the time with no health issues.

In 2017 I did three cycles of IVF. One fresh and two frozen. After none resulted in a pregnancy, I knew I needed a break. Two years came and went and when I returned to the clinic she remembered everything about me and my husband.

Dr Kawwass will do anything in her power to help you get the baby you have always wanted.

Egg retrieval from only one ovary because I lost on to a dermoid cyst. Three cycles, one fresh with one embryo because I was young and healthy. Two frozen cycles with two embryos because I requested. This most recent cycle we re did all of the bloodwork and diagnostic tests. My HSG showed blocked tube resulting in a diagnosis of hydrosalpinx. This was removed and we will start a frozen cycle in one month

The costs included the monitoring-bloodwork and ultrasounds, all the medications. The frozen transfers included only the transfers

Dr Kawwass is against multiple embryos at one time but placed two when asked.

Dr. Spencer is always open and available to listen to my concerns and make necessary changes to my protocol after listening to me. For example, the last doctor that treated me never listened to my concerns about how the medications affected me in a major way. The meds would cause me not to ovulate properly and so when I finally went to Dr. Spencer, I informed her about this situation and she listened and made adjustments to my meds and protocol. I was sooooo happy she listened because after the medication changes I got pregnant, but it ended in a miscarriage that wasn’t Dr.Spencer’s fault. If I was ever uncomfortable during a procedure, she would even hold my hand and calm me down. I am very satisfied as a patient at Emory. Its more than excellent. Dr. Spencer is professional, patient, and kind. She takes the time to explain my care fully and also asks if I understand, if not, she fully explains until I get it. She gives me the time I need to make sound decisions and never pushy. Again, I can’t stress enough about how awesome my experience is every single time I go in for a visit at Emory with Dr. Spencer.

I would say to not be afraid to talk to Dr.Spencer. i would tell someone to let their guard down and just be open-minded and listen because ahe gives good advice and won’t lead you astray. I’d also advise them that they should set-up one on one appointments with her often to get more time to talk to her.

The long lupron protocol was done on my last cycle. I started tge lupron shots approximately 6 or 7 days before my expected period. I also would place on estradiol patches daily. Once monitored by my ultrasound shows my follicles have matured, then it was time to move into the final process. Secondly, Dr. Spencer found that I can ovulate perfectly on my own and that I would only need to do a natural FET. So we wait until my cycle came on and on a certain day of my cycle I go in for and ultrasound and look at my follicles. After they get to a certain point I have a Ovadriel trigger shot. Four days after I have a embryo transfer.

The cost of the ivf cycle was $12,000 and the embry transfers was $2700.

She had a string preference for the number transferred since most of them failed, so she recommended two per embryo transfer. She said my chances would be better. I had yet to get pregnant until I started treatment with Dr. Spencer and since taking her advice with the transfer of two.... I got pregnant with twins the last transfer, but they ended both as blighted ovums. So her recommendation to transfer two actually worked.

Dr Kawwass was very thorough and communicative. She took time to make sure I understood the process and had the support I needed. I didn’t see her every visit, but she did answer all emails and checked in on me frequently. She was a great patient advocate when I went in for surgeries and procedures.

The initial visit is overwhelming, and Dr Kawwass is straightforward, so ask as many questions as you want and she’ll take the time to go through everything.

Clomid, femara and combined with metformin. IUIs as progressive treatment. Not recommended more than three, as results don’t improve. Injections as last resort given percentage of success balanced with cost vs other option.

16k for retrieval and two transfers.

Preference for single transfer.

Dr Jessica Spencer is an amazing Doctor. She make sure she listens to you when you have questions and concerns and also answer accurately. She doesn't rush you in and out like some doctor so. She makes sure your are satisfied with whatever you come I for. She is an incredible Doctor and I would recommend her to friends and family.

I will tel them to be patient and make sure the ask all the questions needed and if they are not satisfied with the answer they should asked for in-depth answer because sometimes the doctor thinks you know everything like the terminologies that are been used during discussions.

She prescribed me clomid/Letrazole and told me to use it on day 3-7, then come in on day 12 for ultrasounds. The clomid/Letrazole did give me good size follicles which was awesome. I was also prescribed ovidrel to use per Doctors order.

The visit is usually covered by my insurance. The only thing I had to pay for was my copay and payment for the two IUI services

N/A

Dr. Hipp was a compassionate, smart, kind, and generous provider. She went above and beyond when it came to communication and relationship building. She gave us data so that we could make informed decisions, but didn’t treat us like data ourselves. She offered guidance, support, and treated me like a sister. When I needed a surgery that was outside the scope of her practice, she tracked down the best surgeon in the city and consulted with him. I always felt like I had the best of the best on my team, led by Dr. Hipp.

Be honest with her about your questions and fears. No question is stupid, and no fear unwarranted.

IUIs were about $1k with medication. Egg retrieval and embryo with icsi was about $15k. Embryo transfers were about $5k

I had a strong preference for a single embryo transfer. She supported that 100%.

Dr. Kawwass was a part of the end of our journey, as our journey began a few years prior to landing in her care after transferring clinics and our original doctor leaving the practice. At first we were disappointed our doctor was leaving at such a pivotal point in our care (transfer to gestational carrier); however, after meeting Dr. Kawwass we were smitten! She was so kind, professional, empathetic and informative. She really listened to our history and provided insight into our whole picture - my care, as well as our GC. I am proud to say she will continue to be our doctor throughout our fertility journey, should/when we decide to pursue another transfer in the future.

I encourage anyone seeking fertility treatment to take an active part in their journey. Ask the questions that come to mind, and digest the information given to you fully. You have a say, and can decide what treatments you do and do not wish to take part in. The doctors, especially Kawwass, will guide you in whatever direction they feel is best based on the facts presented to them, but this is a partnership, so don't be shy to speak up if you want to explore other treatment options (fresh vs. frozen, IUI vs IVF, etc.

Again, the majority of my journey was at another clinic, with Emory reviewing records and redoing a few tests they felt needed to be updated; therefore, I cannot provide a whole picture of Emory, as I came to them with frozen embryos. I originally saw a doctor which has since left Emory. That original doctor is who did my transfer, with Kawwass picking things up once we moved onto a gestational carrier. Our experience with Kawwass was magnificent. She treated our whole picture - not only our GC treatment. Dr. Kawwass took the time to review what the next moves for me as a patient would be, as well as placing our sweet embryo ever so perfectly to give us our sweet baby girl who we strived for over a 5 year journey. Obviously, the positive outcome helped, but aside from our wonderful outcome, we found Dr. Kawwass to be thorough with incredible bedside manner. She is highly intelligent and it shows in her treatment.

Luckily, I had insurance that had infertility coverage; therefore, my out of pocket costs were somewhat low - thousands, rather than tens of thousands. Now, with a gestational carrier, you must pay out of pocket, which also was only thousands rather than tens of thousands when it came to the reproductive piece given we already had frozen embryos which were transferred from another clinic.

During our care, Emory transferred two embryos for our first attempt with them (third overall) and 1 embryo when transferring to our GC.

I loved ERC!!! Dr. Kawwass is very knowledgeable, informative, positive, and involved throughout the process. She takes the time to answer all of your questions, and is very upfront. We went through 3 stim cycles and after the second failed she even contacted me over the weekend to see how I was doing and to give recommendations for the next cycle – which was successful! I appreciate the fact that each stim cycle was different in terms of the medication protocol that was used. I could tell the team was reviewing my chart and making adjustments based on how my body responded each time. (The last reproductive center my husband and I were at kept using the same methods each time, and didn’t bother to alter anything even though we weren’t getting any results. It made us feel like they just wanted to keep our hopes up and take our money.)

Don't expect to see her every visit; however, you're in great hands with the other staff members who will be providing you with your primary care for that particular visit, i.e. sonographers and phlebotomists. If you happen to have more questions, they're great about asking you if you'd like to speak with a Nurse before you leave. She goes into great detail about your plan of action and how the overall process works during your intake appointment. You're in great hands with Dr. Kawwass.

1st Stim Cycle - 75 iu Menopur 2x's/day, 450 units Follistim 1x/day - Produced 4 eggs, 0 fertilized, 2nd Stim Cycle - 75 iu Menopur 2x's/day, 450 units Follistim 1x/day, and Lupron - Did not produce eggs large enough for retrieval 3rd Stim Cycle - Clomid, menopur, 150 units follistim, Cetrotide - Produced 9 eggs, 7 fertilized, 4 embryos

Monitoring appointments were scheduled during the morning hours so they could contact you that afternoon about your status and when you should begin taking other meds or do your trigger shot. You simply checked in and you were buzzed back within 5 or so minutes for your ultrasound. The only time the wait was longer than usual was when the computer system was on the fritz. Other than that, the staff was always efficient.

ERC offers various financial packages. It depends on how many transfers and cycles you'd like to purchase.

The process explained to us was if we did a day 5 transfer, they'd transfer 1 embryo. If we did a day 3 transfer, they'd transfer 2 embryos. We were given the option to do a day 3 or 5 transfer.

I have only been a patient with Dr. Kawwass for a brief time, but already I have seen the excellent care she provides to her patients. She goes above and beyond for her patients and takes the time to meet with each patient and review any questions or concerns. She is extremely knowledgeable and informative regarding all parts of the process of fertility treatment.

She is always open to answering all questions so do not hold back anything.

I have not gone through my treatment plan with Dr. Kawwass yet as it will not start until January, but Dr. Kawwass is definitely providing a more individualized approach to my IVY cycle than my previous doctor. She has tailored my treatment based on my previous results. She will be increasing the dosage of my stimulation as well as performing a sonohysterogram prior to the IVF cycle.

About $10,000 for an IVF cycle, not including medications.

Dr. Kawwass recommends eSET (at least in my case) for the best possible outcome and to avoid complications that twins my cause.

She was very personal and kind. We had to switch doctors after 4 IUI because the previous Dr left the practice, which was very scary, but Dr Hipp picked right up where we left off and didn't make me repeat anything. Treatment continued exactly as planned with the previous doctor and I really appreciated that. When we got pregnant she was so encouraging and made sure we were considering our next steps and answered our questions.

The previous doctor helped with most of the strategy (Dr McKenzie), but Dr Hipp allowed us to continue with that plan when we switched to her. We had 4 IUI with Femara and 6 previous clomid cycles. We were allowed to choose to do up to 2 more IUI cycles or change to IVF. The choice was very helpful. I took a 2 month break for emotional reasons then returned for #5 which was successful!!

I paid for all IUI cycles out of pocket which was about $1500 per cycle after all bills. This was for ultrasounds, IUI and Dr bills

Dr. Kawwass and her entire staff were amazing. I had worked previously with two other doctors who either treated me like a number or their staff did. I was extremely stressed out and felt like I had to fight to get attention and the level of concern about my care that I expected. And then I met Dr. Kawwass. I can't imagine more patient-centered, positive, thoughtful, encouraging, professional care. She looked me in the eye, she followed through with questions, she was very empathetic, and her staff was all of those as well. The communication with the office (if you've been doing IVF, you know how important that is!) was fantastic, so easy, so reliable. I felt 100% safe in her care. I actually live quite far from Atlanta but ended up working with Dr. Kawwass because our donor lived close by, and I am so so glad I made that choice. Would recommend Dr. Kawwass (and her colleagues; I also worked a couple of times with Dr. Hipp) to anyone without reservation. That practice should be a model for all other fertility clinics.

Don't hesitate to connect with her! If you are at all questioning whether your current doctor is the right fit for you, meet Dr. Kawwass.

3 embryo transfers with donor egg. So sorry that I have forgotten my protocols, but Dr. Kawwass did make adjustments, and I think I don't remember the protocols because I trusted her judgment (not the case with my previous doctors).

$35K?

I believe the clinic recommends single embryo transfer.

Dr. Kawwass is amazing. It is clear she really loves what she does. She never rushed us and was sure to answer every question we had. She (and all the fellows) explain EVERYTHING so clearly. At all times you know exactly what they are doing, how and why they are doing it. It makes all of those invasive procedures feel better because you understand what is going on. Also, I love how knowledgeable Dr. Kawwass is in current fertility studies. The best way I can describe the kind of doctor she is, is by telling you about our failed transfer. This was our 2nd failed attempt, but first with her. The nurse from Emory called to give me the news as soon as the results came in, and told me Dr. Kawwass would call the next week (it was Friday). However, I got a call from Dr. Kawwass just to express her condolences and "send me a hug". This meant so much to me, I could tell she was truly upset by the result as well. She is so smart and compassionate if anyone is going to get me to the best end result, I believe it will be her.

The doctors, and fellows are fabulous; however, you have to be on top of ordering you medicine on time. This may be more of an issue for me as I am an out of state patient and have to do outside monitoring. At my previous clinic my nurses were on top of the medication, showed you how to take it, and knew exactly where to order it. At Emory, I have to tell the nurses when I need the prescription increased and where to put the orders. With all that being said, I believe it is worth it to have the knowledge of the Emory doctors. One thing I love is all the doctors have a meeting to discuss your case, so you have the opinions of multiple doctors, not just one.

For my IVF I was on the highest does of Gonal F (450 IU) and Menopur (150 IU). I ended up stimulating for 12 days, and we used Ganirelix for 5. This produced 12 follicles (almost twice the amount of my first IVF) and we got 9 eggs. Out of the 9 eggs, we got 7 embryos. After the retrieval, I began 2 estrogen patches (changed every other day) and 1mL Progesterone shot. We ended up transferring 2 fresh embryos on day 3, and freezing 4 embryos (one embryo did not make it to day 3). We decided to do this since there is so much attrition between day 3 and 5, and we really wanted some to freeze. We are now preparing for a Frozen transfer. All my meds have been increased. I will be building up to 4 estrogen patches before the transfer. We will also do 3 days of Ganirelix. After the transfer, we will continue the estrogen patches, 2mL Progesterone shot, and 3 progesterone tablets. Hopefully we will get a good result this time. This will be our first frozen transfer.

I have good insurance, so my monitoring and medicine was covered. We purchased a plan through Emory that included IVF and 1 FET. This was approximately $14k. We also did ICSI ($1.5k) and Assisted Embryo Hatching ($1.5). My meds were just a $300 co-pay.

Dr. Kawwass, like most doctors, opts for a single embryo transfer. The only reason we did two was my previous two embryo transfer failed, and the fact we did a day 3 versus day 5 transfer. We will be unfreezing 2 embryos for the frozen transfer in case one does not make it.

Very knowledgeable and passionate. I felt very comfortable and confident working with her. She communicated well and did a great job explaining the details of the procedures and processes that we underwent.

Ask any and all questions that you have. She'll answer them and put you at ease.

Dr. Kawwass prescribed a high dose protocol for egg stimulation including Menopur and Gonal F. Since we were diagnosed with unexplained infertility, she recommended that we do ICSI. My progesterone started to increase earlier than anticipated, so our retrieval was scheduled a few days earlier than anticipated. 10 eggs were retrieved, 5 were mature and only 2 fertilized. Due to only having 2 embryos, Dr. Kawwass recommended a day 2 transfer of both embryos. The Embryologist discussed the options of transferring 1 vs. 2 embryos the morning of the transfer. We decided to only transfer one and allow the other to mature to day 5 (which it did!) before freezing. After the transfer I used Estradiol patches and Progesterone shots. This IVF round was successful and I now have a 4 week old healthy baby boy!

I am fortunate to have some insurance coverage for infertility and IVF services. We used the maximum amount of that benefit (I think it was $10,000). After insurance I believe we payed Emory about $13,000 plus $7,000 for medication.

Dr. Kawwass recommended we transfer both embryos since we only had 2 to increase our chances. The Embryologist discussed our options with us the morning of the transfer. My husband and I decided to only transfer one embryo and we are confident that was the correct decision for us.

There are so many positives about Dr. Spencer -- let me list them: -She is up to date on the latest research - explaining every study and how much stock I should take in it given the population in the study, the size of the study, etc. -I NEVER felt rushed. I had multiple 2.5 hour meetings with her and not once did she say, "I need to get to another patient." -She would explain all the options - and they were often complicated with many unknowns given the research is so inconclusive. If I really couldn't decide what to do, she'd say "if you were my sister, I'd say x." She was taking into account the medical, financial and emotional aspects of my decision. -If I wanted to talk with her, the nurses/staff would get the message to her and she'd call me. She was always available when I needed her. -She is "real." She didn't take on a medical/defensive persona. When things didn't work out she would say she was sorry and hug me and we'd walk through the protocol and what she might have done differently and could do differently if I wanted to try again. She is crazy empathetic. I have no idea how she is so empathetic given all the patients and how often the news is negative -- she is a very strong person! -The only negative and it's not even a negative, is that she couldn't do all my procedures. But over 5 years and more than 20 procedures that cannot be timed to a certain day, there's no way a doctor could do that.

If you've had an experience at another clinic, share that. And explain all your concerns, hopes and fears. She's really good at addressing all of that and isn't afraid to go into the details on anything.

For all of my cycles with Dr. Spencer I used an antagonist protocol. With a prior clinic they had me on a micro-dose flare that was timed with birth control. Dr. Spencer was worried the birth control was making it to hard for my ovaries to recover from the suppression of birth control and so we used natural timing for every retrieval. I also used Ganarelix before the my cycle started to help prevent a leading follicle. I was on the highest dose of Bravelle (later Gonl-F) and Menopur for all retrievals. A few times we added in human growth hormone but on the last (and successful) cycle we dropped it b/c we didn't think it was doing enough to outweigh the high costs. I was also taking DHEA and CoQ10 for my last 4 cycles. (Dr. Spencer shared that there is no evidence that CoQ10 has a positive impact on human eggs but that it wouldn't hurt anything so if I wanted to take it I should go ahead). On many cycles we weighed the pros and cons of PGD. We did it for 2 cycles mainly as a way to reduce the chances of miscarriage given I had had many. The last, successful cycle we decided to change up everything - still an antagonist protocol, but we didn't do PGD (we started getting concerns that the biopsy, freeze and thaw could do damage to the embryo and so agreed to risk the miscarriage), and we did a clomid-antagonist cycle. So I did clomid for the first 7 (?) days of the cycle and then started with the injections. We did a Day 3 transfer (I had a couple of experiences where embryos did not survive until Day 5). On this last one the embryologist came out to see us right after the retrieval and asked to NOT do ICSI as we had done 7 times before. I had some eggs not quite mature and she wanted to give them the extra 24 hours to mature by just letting the sperm find the eggs in the petri dish, rather than do ICSI and "arrest" development and potentially lost an egg because it wasn't mature.

I had great insurance that covered almost all of my meds and 80% of procedures once I met deductible. I probably spent around $2k per cycle when you average everything out.

Given my low ovarian reserve and age (I was getting 4-6 eggs...and we presumed most were abnormal), I was thankful that Dr. Spencer was willing to transfer multiple embryos. Usually I transferred 2-3 embryos b/c that was all that I had but the last two times I transferred 4. She would walk through the risks with me and it was my decision in the end.