Describe your experience with Florida Institute for Reproductive Medicine.
FIRM is a very well-respected clinic with good results and a long track record, and where I live, it's really the only option within driving distance. For the first part of my experience, I regretted not living in a bigger city and having more options and access to research, but after switching doctors and finding the right fit, even if I were to move away, I'd likely still come back for care. It's also convenient with parking and in a good hospital.
My experience wasn't all perfect, however. I chose my first doctor in the practice based on location and though I know a lot of people like him, he was not a good fit for me. Were I to do it again, I'd ask more questions of the nurse coordinator upfront about the different physicians' styles and try to determine who I should see. And I'd be more quick to advocate for myself and switch to one that met my needs.
Finally, I wish there was more transparency and communication with personal medical records - perhaps either through a patient portal or other access. I like to have a lot of information and found it frustrating not to be able to keep up with my treatment plan/records. After multiple requests since leaving the practice, I was finally able to obtain a copy of my own records and reading through the summary of my initial visit with the first doctor, I found several inaccuracies about my history. It's likely nothing that affected my treatment, but I wish I'd had the chance to correct it. I also wish they had a more informative Facebook page with current articles and links to resources (like resolve.org, for example).
During treatment, were you treated like a number or a human with Michael Freeman at Florida Institute for Reproductive Medicine?
Switching to Dr. Freeman was a real turning point for me and one of the best decisions I made during this entire 3-year process. I'd felt that my previous doctor dismissed my concerns and refused to deviate from a predetermined, one-size-fits-all procedure. Dr. Freeman took time to answer my questions and considered my ideas. I felt heard for the first time at this practice, even if we disagreed. And he didn't act as if my questions were a nuisance, even when I had a lot of them (which was more often than not). When my transfers didn't work, he was willing to change course and worked very hard to find a solution that was right for me. Throughout, I was grateful that he took time to understand my case, my history, and my concerns.
Describe your experience with your nurse at Florida Institute for Reproductive Medicine. (Assigned nurse: Patty Jossim)
As grateful as I am to Dr. Freeman, Patty, my IVF coordinator, was the best thing about my entire experience. She was always there to answer questions and help me find solutions. She kept me going through the darkest of days, and I'll remember her kindness for the rest of my life. I know I'm not alone in my gratitude, but it's such a personal thing - I wouldn't be having a baby without her help - that I'll always be thankful for her.
The rest of the clinic staff - from the nurses to the assistants and front desk - were also very kind. Hearing how happy they all were when I finally, finally, finally got pregnant was such a joy - and a demonstration of how supportive they were throughout. And while it's easy to remember how people treat you in happy moments, there's a lot of grief that goes into this process. I am most grateful for their compassion during those difficult times.
How was your experience with Michael Freeman at Florida Institute for Reproductive Medicine?
I switched to Dr. Freeman after about 1 1/2 years with another doctor in the same practice, who was not a good fit for me. The nurses recommended Dr. Freeman when I requested a change, and I'm grateful I took their advice. (For what it's worth, he seems to be genuinely liked and respected by the clinic staff.)
I've read many posts describing 'miracle babies' and while I appreciate the idea, I don't think this pregnancy (now in my second trimester!) happened by luck or accident. It was the result of good medicine and a skilled physician who worked hard to ensure a positive outcome. Dr. Freeman was open to innovation and new ideas, willing to change course, and put in time and effort to devising the best, most personalized treatment for me. Most importantly, he treated me with respect, kindness, and, often, humor (much appreciated during what can be a very trying time). Whereas I felt like some other doctors can get hung up on their title and dr/patient dynamic, he was more approachable. He provided me the detailed information I asked for and didn't talk down to me. That is what I am most grateful for - if my pregnancy hadn't happened, I would have been devastated, but I still would have been grateful to have been treated with such compassion. Given how gut-wrenching and humiliating this infertility journey can be, I can't emphasize enough how much his respect and kindness meant.
What's one piece of advice would you give a prospective patient of Michael Freeman at Florida Institute for Reproductive Medicine?
Throughout this entire process, I learned how to be my own advocate, and that helped me get to a better result. Come prepared; ask plenty of questions and share your concerns. Understandably, the doctors are very busy, but in my experience, Dr. Freeman will take time for you. For me, it helped to do research ahead of time and bring my questions to the visit. Also, I found my nurse coordinator to be a great resource and liaison.
Describe the protocols Michael Freeman used in your cycles at Florida Institute for Reproductive Medicine and their degree of success.
By the time I switched to Dr. Freeman, I'd already undergone several IUIs, an egg retrieval, and several frozen embryo transfers with another doctor. During my first visit, he diagnosed my uterine septum (which my previous dr had said wasn't an issue) and later removed it successfully - as someone who has had multiple miscarriages, I'm relieved and grateful to have that obstacle removed. He performed an ERA test and recommended, for the first time, a battery of blood tests that indicated a MTHFR mutation, for which he prescribed corrective medication. Following these procedures, Dr. Freeman did my fourth FET with two embryos. While we disagreed on whether to transfer one or two, his advice was sound and he was respectful of my decision.
Unfortunately, that transfer wasn't successful, and I was devastated. We met to discuss, and I will be forever grateful for his compassion during a very difficult time. He listened to my concerns and though he didn't profess to have all of the answers, came up with several new ideas for the next transfer (my last remaining euploid embryo). He also retested my AMH level to help me decide whether or not to proceed with another FET or go into another egg retrieval. Having had so many prior losses and disappointments, I was skeptical, but I trusted that he was trying to do the right thing and figured it was worth a shot. To my surprise, it worked. The magic formula turned out to be a 'natural cycle' FET, meaning a transfer timed to my body's own ovulation and without estrogen supplementation and only minimal progesterone. He also prescribed steroids to ward off any immune issues and blood thinners (baby aspirin and Lovenox injections). While I don't necessarily have a diagnosed immune or clotting issue, I appreciated his willingness to deviate from my previous regimen. As he said at one point, "if it walks like a duck and talks like a duck, let's treat it as one." I don't think I would have been able to try something like this with the other physician, and I wouldn't have gotten this outcome if I hadn't switched to Dr. Freeman. My regret is that I didn't change sooner- I can't help but wonder how much heartache I could have avoided if I did.
Following my positive pregnancy test, I've remained very anxious given past experience and loss. He was understanding during each visit, and I appreciated his patience and candid feedback. I've since transferred to an OB, but if everything goes well, I hope to come back for a future cycle.
Describe the costs associated with your care under Michael Freeman at Florida Institute for Reproductive Medicine.
Unfortunately my insurance won't pay for anything infertility-related, so I had to finance my egg retrieval. Initial costs were $18K- $15,000 for FIRM plus $3,000 for stimulation medication during the ER. That included PGS-testing, which as a patient in my late 30's, I'm very glad I did. I think that also included the fee for my first transfer, but I can't remember. Each subsequent FETs cost $3,000 plus $1000+ in medications each cycle and about $100/month in medications to treat my MTHFR condition (also not covered by insurance, even once I had a confirmed pregnancy). I also had to pay out of pocket for my ERA test (can't remember the exact costs, but I believe it was close to $1,000) and anesthesia related to my septum removal ($500-ish?) and other per-visit costs. This was after my IUIs, which I think ran about $800-1,000 each (but it's been a while). Co-pays once I had a confirmed pregnancy were generally about $50, depending on other tests. All in all, a very expensive couple of years - it's hard to budget just based on the base price list on the website, because (at least in my experience) there were a lot of extras that added up quickly. I don't think FIRM was necessarily much different than other clinics, but lack of insurance coverage for infertility is something that needs to be addressed nationally.
Describe Michael Freeman's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Florida Institute for Reproductive Medicine.
He strongly advocated for a single transfer vs. two, but let me make the decision in the end. At that point, it was my fourth transfer overall and given the emotional and financial toll, I wanted to be more aggressive. I listened to his arguments (which were certainly valid and based on good medicine) and did agonize over the right thing to do. When I decided to transfer two, he didn't try to shame me or make me feel like a bad person. Again, I felt much more respected than in previous situations. In the end, however, that particular transfer wasn't successful and I only had one embryo left for my final transfer - and that was the one that stuck.