My experience with Dr. Guarnaccia wasn't negative--he was nice and friendly, but the treatment felt rote, and his medication recommendations were very standard combinations of medications for me that had also been recommended to other women at the follow-up experience where you're taught how to inject yourself
Extend Fertility had a very calm, soothing atmosphere, patient privacy seemed paramount, and it didn't feel like a clinical environment. Those are the positives. The negatives are that they don't--or didn't, in my case--seem to offer any flexibility in terms of caring for patients with co-morbidities that may affect egg retrieval cycles.
How was your experience with Michael Guarnaccia at Extend Fertility?
I explained at the outset of my first consultation that I'm not the average patient, given my conditions, but Dr. Guarnaccia launched into the general statistics for egg freezing/fertility by age, the relevance of AMH, potential side effects--the standard dog and pony show (Extend was not the first clinic I visited--I also went to NYU, but the doctor there acknowledged me and handed me a packet and told me to schedule an appointment). My experience with Dr. Guarnaccia wasn't negative--he was nice and friendly, but the treatment felt rote, and his medication recommendations were very standard combinations of medications for me that had also been recommended to other women at the follow-up experience where you're taught how to inject yourself. I had specifically asked if he'd be willing to consult my endocrinologist and rheumatologist and my pain management doctor who manages my MCAS diagnosis, and he demurred. It's such an enormous investment of time, money, physical pain, psychological pain (I'm terrified of blood draws) that I wasn't satisfied I'd get the tailored treatment a patient like me probably needs, which was disappointing.
What's one piece of advice would you give a prospective patient of Michael Guarnaccia at Extend Fertility?
If you're young and healthy, he'd likely be a good choice for you. I think I'd heard he's not known for his bedside manner, but I found him to be likeable enough. I actually cared less about those metrics and much more about my doctor's commitment to tailoring my care/medications to fit my needs, and I didn't have enough confidence that my concerns about that were being heard.
During treatment, were you treated like a number or a human with Michael Guarnaccia at Extend Fertility?
I was and am an extremely informed patient wanting to pursue egg freezing at the time, but concerned because of my medical history, which includes autoimmune issues. I had been led to expect that I would get tailored information during the consultation and afterwards, and during my appointments for bloodwork which would be tailored to my conditions, and could help decide whether egg freezing would be right for me, which medications might work, which ones might cause flare-ups, etc. What I got from the doctor was instead a very rote, paint-by-numbers list of statistics and charts of what to expect success-wise by age and AMH, with no accounting for other factors. I expected doctors to meet me where I am, as a person and a patient with co-morbidities, but instead this made me feel like I was a potential customer being offered standard packages.
Describe the protocols Michael Guarnaccia used in your cycles at Extend Fertility and their degree of success.
I have them written down somewhere, but I don't have access to them at the moment--basically, Extend has four medication packages they offer in conjunction with the pharmacies they partner with, with varying strengths/dosages of medications. On a scale of 1 (being the least intense) and 5 being the most intense, he recommended dosages of Gonal-F and Menopur (I believe) at the 4 level/amount/dosage. I wish I could be more specific.
Describe your experience with your nurse at Extend Fertility. (Assigned nurse: Kezia Onel)
Kezia was, I believe, my overall coordinator, but my questions were about my current autoimmune medications and conditions (thyroid levels, other medications I was/am on, etc), so I was referred to a nurse, Stephanie. She didn't really have any answers for me--which wasn't entirely unexpected, as she wasn't a rheumatologist or endocrinologist, which is why I was really hoping that my doctor would consult with my other doctors to provide the right course of treatment for me. But otherwise my nurse and care coordinator were very personable and friendly.
Describe your experience with Extend Fertility.
Extend Fertility had a very calm, soothing atmosphere, patient privacy seemed paramount, and it didn't feel like a clinical environment. Those are the positives. The negatives are that they don't--or didn't, in my case--seem to offer any flexibility in terms of caring for patients with co-morbidities that may affect egg retrieval cycles. What they offer are packages (dosages of medications and treatment schedules)--and my sense was that they fit the patient to the package, not the package to the patient, which someone like me needs. If you have thyroid issues, rheumatology issues, MCAS, a condition like Ehlers Danlos, or really just any medical issue that requires you to take medication(s) that affect your endocrine system, or if you receive more specialist care than you do from your GP, Extend Fertility may not be the right place for you.
Describe the costs associated with your care under Michael Guarnaccia at Extend Fertility.
At the time, with a promotion, a single egg freezing cycle was $5500, not including medications. My medications (the ones/dosages recommended to me) were in the $4500 range. So, about $10,000. I believe the costs now are about $12,000.
Describe Michael Guarnaccia's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Extend Fertility.
I was not enquiring about IVF at the time so this was not applicable to me.
What specific things went wrong at Extend Fertility?
- Provided conflicting information
Describe the specific things that went wrong at Extend Fertility.
I sent in all of my labwork from other clinics and my personal specialists, and there were major inconsistencies in my bloodwork done at Extend vs. not only my regular endocrinologist, but also at Cornell and NYU. My Day 1, 2, and 3 results were wildly inconsistent with other labs; for example, my AMH was 2/3 lower than each of the other labs (Sunrise as well as Cornell and NYU's labs). My E2, FSH, and LH were also wildly different at Extend's lab vs. the other labs, which were in the same general range, and the Extend Lab values made me seem less likely to succeed with one cycle only. I asked about this, but got a general answer that "lab results differ." It seemed an odd coincidence, though.
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Clinic
Extend Fertility
Extend