Fertility Center of Dallas

I think the clinic is great. They were able to process anything that could be coded as a diagnostic through my insurance. The front staff, including Shelly, is helpful and efficient. Tina, the Administrator, put together an IVF estimate very quickly when we were thinking we needed to do it before the end of the year. The lab technician is wonderful as well. All labs and appointments are done on site. However, should an unusual circumstance arise, the clinic is connected to Baylor Hospital-Dallas so has extensive resources. For example, when I had to change my trigger shot to a Lupron shot, they had me go to different lab within Baylor to make sure that the results were expedited in order to confirm my egg retrieval.

In any practice, it is not just the doctor’s responsibility to make the patients feel like a human rather than a number. Every member of the Fertility Center of Dallas has made sure to treat me as a woman desperate for help. Certainly, Dr. Putman sets the standard, and every appointment I go to, I feel that he has familiarized himself with my file, ensuring he is prepared to answer all questions. He also includes my husband in the dialogue. He reflects on the data and manages to find the balance between simply explaining possible approaches while providing all the details.

The nursing team is phenomenal. Krissy actually performed one of my successful IUIs and was so gentle, compassionate, kind, and informative. When she had to communicate the disappointing results of the beta levels and ultimate miscarriage, she did so in a very tender manner. I appreciated Andrea’s and Jan’s organization and help in explaining the IVF process. They returned calls quickly and responded professionally. Dr. Zhang, the Embryologist, was no different. She answered myriad questions, including at the starting point when we had many questions about the consents. She was so thorough in explaining and patient with our questions. When she delivered the news about the embryos, she was so kind yet matter of fact.

Dr. Putman is a kind and gentle care provider. I have always felt that he takes the time, never rushing us through appointments. He is someone who doesn’t mess around with treatment options, yet, we never felt pressured to pursue more invasive interventions, such as IVF. Initially, my husband and I did not think IVF was right for us. Dr. Putman, suggested we start with other interventions first. When those were unsuccessful, he used that information to inform his next recommendations, and eventually, I underwent one round of IVF, producing two embryos. Dr. Putman, along with is Embryologist, Dr. Zhang, both felt like we could do better and changed my protocol accordingly for the second round, which I am getting ready to start. In addition, I felt that he was aware of my labs and results at all stages of the IVF process even changing protocol decisions along the way, including the type of trigger shot to use. Overall, I have had a very positive experience. However, I would have liked to have seen more alternative approaches incorporated into my treatment plan, including acupuncture, a review of harmful toxins, etc.

Don’t expect him to force your hand and tell you what to do. He will make recommendations, but you will also need to have voice and advocate for yourself.

DIAGNOSTIC STAGE After initial consultation with Dr. Putman, he ran all the standard tests plus additional testing he recommended after IUI #2. The HSG revealed I have a possible blocked tube. Other tests indicate good reserves and AMH and FSH levels for my age. Once we started the IUIs and before we moved forward with IVF, we ran additional testing, including genetic testing via Horizon and natural killer cell testing. All were “normal.” My husband has some morphology issues and I have slight issues with hormone levels. IUI TREATMENTS 4 IUIs: 3 with natural ovulation (no trigger); 1 with an HCG trigger; all with Letrozole - IUI #1 (September 2016): Letrozole, no trigger shot, BFN. Ultrasounds starting around CD 10. IUI around CD15, one day after positive OPK. - IUI #2 (October 2016: Letrozole, no trigger shot, BFP, chemical pregnancy. We used OPKs and started monitoring with ultrasounds around CD 9 or 10 every two days or so. IUI happened on CD 14 or 15. It produced a positive pregnancy test with an HPT and beta on CD 28. Dr. Putman ran blood work every two days. HCG increased (12, 20 +/-), but did not double and by the fifth day after the initial beta test, HCG levels started to drop. I began to bleed 8 days after first beta. - IUI #3 (November 2016): Letrozole, no trigger shot, BFP, chemical pregnancy. We used OPKs and started monitoring with ultrasounds around CD 9 or 10 every two days or so. IUI happened on CD 14 or 15. It produced a very faint positive HPT for a couple of days (over 4 tests), but I was out of town for Thanksgiving and unable to run a beta. I started bleeding CD 32, four days after anticipated cycle start day. - IUI #4 (December 2016): Letrozole, HCG trigger shot, BFN. After the last IUI, we had a follow-up consultation with Dr. Putman. He had advised us that we would try three IUIs before moving on to next steps. There is no need to continue to try something that is not successful. However, we opted for one more IUI since I couldn’t start IVF until after the New Year anyway. He also presented the option of going in surgically to see if he notices anything else going on, specifically related to the blocked tube. Ultimately, we opted for the general work-around and started on the IVF journey. IVF TREATMENT IVF Cycle 1 (February 2017): OCP/Cetrotide Protocol (Antagonist) with ICSI and PGS - Doxycycline- 10 days - Lo-Ovral Cryselle OCPs for 21 days, no sugar pills - Menses: 4 days (didn’t start until day 4 and started stimulation the next day. - Stimulation for 11 days o Day 1-Day 3: 225 IU Gonal-F in AM; 75 IU Gonal-F in PM; 2 vials of Menopur (75 IU each) in PM • Estrogen spiked significantly so Dr. Putman removed second Gonal-F injection (75 IU) o Day 4: 225 IU Gonal-F in AM; 2 vials of menopur (75 IU each) in PM o Day 5-Day 9: 225 IU Gonal-F in AM; 2 vials of menopur (75 IU each) in PM; .25 mg Cetrotide in PM o Day 10: 225 IU Gonal-F in AM; 1 vials of menopur (75 IU each) in PM; .25 mg Cetrotide in PM; changed to Lupron trigger from Novarel to prevent OHSS o Day 11: 225 IU Gonal-F in AM; Lupron trigger in evening o Day 12: Nothing o Day 13: Egg retrieval Retrieval, Fertilization, and Embryo Results • Retrieved 17 eggs; • 2 that were mature were immediately identified as abnormal; • 2 were immature; • 13 looked viable and they attempted fertilization; • Of the 13 that they attempted to fertilize, 9 fertilized normally when they checked a day later resulting in 9 embryos incubating. • The embryologist doesn't really do three-day checks or let his patients know figures until the end of the process. They just wait it out with the philosophy that the best place for those little dudes is safe and sound in that incubator. At this point, the embryologist let me know that "normally" about half will make it to the blastocyst stage to be biopsied for pre-implantation genetic screening. Could be less, could be more. • A week later…. • Of the 9, 3 almost made it to blastocyst, but the third stopped growing on Day 6. • We have 2 embryos officially frozen. One is good quality. The other is questionable because it grew very late, was frozen on day 7, and is subpar quality. • Although they didn't sound too hopeful about the second, they were able to biopsy both for genetic testing (PGS). • They are keeping the PGS culture “on ice” for a while before we they have to send it off for testing with the hopes that we will bank another round and have more embryos to send. • The embryologist believes this process verified that egg quality is very likely the issue and explains the many early miscarriages. Of course that isn’t definitive, but I can role with hypotheticals. • I am giving my body a break from March though May and will start another round in June, which will be a different protocol with the hopes to get better results with a slower growing process. • The next round will be a 4.5-week stimulation (AACEP Protocol) process as compared to a 2-week stimulation process.

Dr. Putman processed all that hey could via insurance; however, I do not have fertility treatment coverage. Therefore, we have spent around $25,000 thus far (IUS and one round of IVF with PGS).

We have discussed this vaguely with Dr. Putman and determined that we would have to wait and see what the final embryo results are from both rounds before making decisions about transfers.

Go in with specific questions. They are very routine. I'm sure everyone else that goes through that office hears the same thing.

Some staff aren't very compassionate or interactive. Last visit to his office he had me do a booster shot to force ovulation when he knows I ovulate perfectly fine on my own. I didn't speak up when I should have. It's very expensive and I regret it now. I feel like he had me do the booster just because I was probably going to ovulate on my own over the weekend and he didn't want to have to come up there. I could be wrong but who knows. Prior to the booster shot I was told to go home (45 minutes away) and take an ovulation test and come back if it was negative for the shot. The receptionist actually told my nurse to let me use ovulation tests they had there in the office instead of making me go home. Awkward and uncomfortable to be around that conversation. He's also told us that we are unexplained infertility. Last consult he told us I should go in for surgery and if he finds something while he's in there then he can fix it. I'm NOT having a surgery and paying all of that money on his whim that he might find something. I feel like that's absolutely ridiculous.

Very quiet. Not much information shared. Not very compassionate or comforting. Only one nurse I found nice.

Very nice and informative. But I feel like his consults and conversations are rehearsed and told many times over. Don't see him other than consults and the actual procedures. Definitely don't feel like I'm the focus.

Ask questions. Tell him how you feel.

Only thing my husband and I have done is consultations, multiple sono's to follow follicle growth, IUI's and one booster shot.

No insurance coverage so everything was VERY expensive. Every follicle sono was almost $75. Consults were over $100. IUI was $500 and sperm wash was $95.

N/A

The clinic is smaller and does not batch cycles. They were very accommodating of my schedule and making the cycle work for me. I felt the personalized attention was very good. The only aspect of his clinic that needs improvement is the financial department. I couldn't get any information about cost of IVF until I had completed my preliminary consult. Even then, I was repeatedly told "It's just $10,000" and had a hard time getting answers as to what that $10,000 included. After pressing for more information, I was finally given an itemized statement. It turns out the $10,000 was just an estimate and treatment could be more or less based on your needs and insurance. There was a very large range of possible price for ICSI ($500-$2500) and I never got a specific answer about how the price for ICSI would be determined. I don't mean to imply that there was any wrong doing on the part of the financial team but the lack of transparency just became very frustrating

Not much communication with Dr. Putman but was very quick and easy to correspond with nurses at any time.

Excellent. Quick responses to calls or emails and were usually corresponding with Dr. Putman to answer my questions...If I did have any concerns, it was easy to have them answered by contacting the nurses who would then check in with Dr. Putman.

Dr. Putman and his nurses and clinic are exceptional. Dr. Putman's concerns didn't always match what other REs had said, and Dr. Putman always turned out to be the one that was right. We are so thankful we went there. Although Dr. Putman was not very vocal and did not provide a lot of information during our visits, he was always very calm and made me feel reassured which helped minimize stress for me. I just decided to relax and trust his judgment without worrying over the details. If I had asked more questions, I'm sure he would have responded.

Good clinic with good personal attention. Would not recommend if you want a very talkative doctor.

We just did a standard protocol as there were no concerns other than MFI.

It ended up being around $9,000 with insurance covering some monitoring and bloodwork.

Fertility Center of Dallas is a very clean office, kind staff, always on time. They had a quick check in and check out. Exam rooms are kept clean as well. Top of the line sonogram machines. The carry some fertility medication in case of emergencies!

He took the time to talk through his plans thoroughly! Answered every questioned asked, no matter how much the answer would hurt. He knew what we wanted and worked so hard to give us our baby.

Kind, always available, responded quickly to calls and emails. Very compassionate and encouraging!

Dr Putman was extremely honest with every procedure. He walked through what medications I would take, side effects and expectations. Amazing doctor!! He had a list of probabilities and marked each one off as we walked through our journey. We now have a almost 6month old boy because of his guidance.

Dr Putman is honest! He will not sit and tell you what you want to hear every time! He wants the same outcome you want and will work extremely hard to make sure you are holding a baby in your arms!

I really do not remember protocols. I took Gonal-f, Follistem, Menapur, Clomid, Femara, Lupron, Novarel, Ovidrel and Prometrium. Once diagnosed with Abnormal Natural Killer Cells we started Intralipid Infusions.

Our services were covered under our health insurance with United Health Care. It covered $10k for medications and $10k for IVF.

The clinic was very nice and maintained well. We never had to wait long for our appointments. And any financial questions we had we always got fast responses. All I have are good things to say about this clinic.

Dr Putman was an amazing doctor. He made us feel very welcome.

They had answers to all my questions I had and was very helpful.

Dr Putman is an amazing doctor. He explained everything in deep detail and answered any questions we had. He made us feel very comfortable while going through this process. I never felt awkward around him. I like how he does a full consultation before and after the process.

Listen to everything he has to say. He for sure knows his knowledge.

Total for both cycles and including medication was about $23000

Since we have male infertility Dr Putman recommended during our first transfer to only transfer one embryo. When that didn’t work the second transfer he recommended transferring 2 embryos but did not push us to make that decision.