Hanabusa IVF

Besides what many other patients mentioned that Dr. Chang is polite and professional, I'd like to add my own observations: 1. Dr. Chang keeps my medical history in mind all the time. I miscarried twice due to chromosomal abnormalities. I also have protein C deficiency and breast issues. He took these into consideration when making a plan everytime. So don't feel your description of your past experience is a waste of time. He does read and evaluate it. 2. He is very honest and trustworthy. He analyzes causes and results objectively. (see my story later) 3. He keeps learning from my previous cycles and always implements those learnings to my next ones. (see my story later) 4. Dr. Chang always gave me sufficient time to ask questions during an ultrasound appointment. He always made sure that all my questions were answered before he left the ultrasound room.

I would recommend all patients to write your medical and pregnancy history in detail. Dr. Chang would take all these into consideration when making a plan for you to minimize risks.

I've had 3 cycles with Dr. Chang so far: 1st cycle - We started with a natural cycle without prep because my AMH was ok (1.04). However, I only had 2-3 follicles during that cycle and my FSH was as high as 17 which didn't allow Dr. Chang to use many medications. He then gave me 2 options: moving forward but he said he had to be very careful with medicines not to overstimulate because my FSH was high, or I could choose to skip the cycle. I like that Dr. Chang gave me options instead of pushing me further into the cycle to spend more money when the chance was slim. So, I decided to cancel the cycle. 2nd cycle - This time, Dr. Chang used estrace prep to lower my FSH with the hope of increasing the number of follicles. My FSH was lowered to 6.4 which made it a good start. For stimulation, I used Menopur and Letrozole with the standard/typical amount that is used in Mini IVF. However, my FSH hiked to 25.3. Dr. Chang then asked me to stop all medications for several days. My FSH was finally dropped to a normal range, and this allowed me to continue medication again. I had 6 follicles this time. 2 eggs were retrieved. Both of them were fertilized, and both embryos were Grade 3. But none of them developed into a blastocyst. Before I started the next cycle, Dr. Chang shared his learnings from the 2nd cycle with me. What made me trust him more was his honesty. He didn't attribute the failure of this cycle all to my poor egg quality. Instead, he told me honestly that it was partially due to overstimulation and partially my egg quality. And he has made a plan for my next cycle to avoid overstimulation. I totally understand that it usually takes time for doctors to understand how our bodies react to medications as individuals vary largely. 3rd cycle - Dr. Chang changed protocol for me this time. He used Microgestin prep. For stimulation, to minimize risk of overstimulating which may have negatively impacted the previous cycle, he initially just used one medication Letrozole to stimulate. At a right point, he then added Menopur. My FSH and E2 were maintained in a good range before egg retrieval. I had 5 follicles this time, still 2 eggs retrieved. One was fertilized while one degenerated. And that one finally developed into a 4BA blastocyst! Though it's still under PGT testing, it's already an important step and progress for both Dr. Chang and my family. So far, I haven't got a chance to ask Dr. Chang yet, but I believe, again, he learned a lot from this cycle and will make a better next one if there is one. 

At Hanabusa, patients are requried to call the reception to arrange monitoring appointments. The reception ladies pick up calls quickly and arrange appoinments efficiently. As I mentioned earlier, I would recommend that Hanabusa deploy an appointment system. Patients arrange appointments online instead of calling the reception. The biggest advantage for patients is that we can get an email confirmation generated from the system automatically so that we have it on our calendar and don't have to memorize the date and time everytime.

Initial consultation fee with Dr. Chang: $500 (you can get $250 back if you start treatment with Dr. Chang); Ultrasound $250; Blood work $200; Egg retrieval and lab fee: $5100 (1-2 eggs); $6800 (3-9 eggs); $8500 (10+ eggs); Embryo cryopreservation fee: $1400 per cycle; PGT-a testing fee: $800 Per embryo; Fresh embryo transfer procedure: $2000; Frozen embryo transfer procedure: $2600; Medication costs for me: $2000 up to egg retrieval per cycle.

I haven't got to the transfer stage yet. For me, because of my age, I would prefer single embryo transfer.

Dr. LeBlanc embodies all of the qualities a patient would hope for in an infertility specialist. She is caring, knowledgeable and straightforward. I always felt that she was available for my questions and took her time to make sure our visits were productive. She consistently provided me the choice of options for treatment, while providing guidance when asked for her opinion.

Don't be afraid to ask questions if you don't understand a step in the process or a term being used. I think it is easy for professionals to think that patients know more than they do about treatment due to the vast amount of information available online about infertility.

$24,000-$26,000

Dr. Lydon Chang is a very smart man and also has amazing bedside manner. He adjusted my medication with my needs and based on my bloodwork. He listen to my concerns and he based my protocol on me as an individual and not an overall general treatment plan. This doctor is truly invested in his patience and he doesn’t give up hope. I am so thankful for him and his team. I was able to get two embryos when so many other doctors turn me away and said that I could never produced my own eggs.

Communicate with Dr. Chang because he is willing to listen and he is willing to change your treatment plan based on your needs and how you feel. He is a very open minded doctor and is always trying to improve and try something new. He is a definitely a doctor that’s not stuck in his ways and is always looking for the next latest innovation.

Dr. Chang started me out on birth control to help lower my FSH and LH as they were very elevated. I also had low progesterone and estrogen due to my prognosis of POF. Right away we had a retrieval opportunity but the egg didn’t make it. We went another couple months with the same protocol adjusting the amount of birth control based on my blood work numbers. It this did result in a embryo which we froze on day three. Then we went a next couple months without very good bloodwork. I had been going through some personal things and I think that stress was a main contributor. Dr. Chang did try to change my protocol a few times by either adding more progesterone and then adding some testosterone cream. But those didn’t make me feel well and I expressed that to him and then we changed back to the original protocol. We eventually took a break for a little bit and came back to Dr. Chang. I had added a little bit more estrogen with the combination of birth control into my protocol which resulted in an egg opportunity. But unfortunately during that time I wasn’t monitoring my blood work as closely. And that resulted in another failed egg retrieval. The following month however Dr. Chang monitored my blood work we added the estradiol plus a half birth control pill which resulted in a successful retrieval and a day five blastocysts embryo. With a good grading.

Total for the cycle was probably about $10,000-$12,000. The most expensive thing for me was monitoring my blood work that was $200 each time at LabCorp. It was $250 for ultrasounds. The medicines were fairly cheap because birth control is free the other drugs to stimulate an ovulation such as Gonal F Centrotide and the trigger drug was around $300 to about $600. The retrieval was only about $5900 and then the freezing was about $1400 and that was good for a year.

We haven’t done a transfer yet but he suggest a single embryo transfer

Dr. Chang is smart and knows what patient wants. He studied my medical history, he indicated if stim drugs used well, there would be 70% mature follicles and he did it at his first try. He cared about patient's feeling, he shared his reasoning for every step of his treatment. As a patient, I felt being treated with respect, not as a naive counterparty. I wish I could have found him earlier.

Trust Dr. Chang if you decide to use him as your care provider. Feel free to ask him about your concerns, but also need to respect Dr.'s time. Be prepared to study beforehand, this clinic will provide a lot of general info via their videos and PDFs.

Mini IVF, used clomid, gonal F, cetrotide, and ovidrel. Dr. Chang used these meds to control LH, FSH and E2 within an ideal range and tried to reach a optimal numbers of mature follicles and control the leading follicle not to overgrown.

They charge itemized service at a reasonable rate. No need to pay lump sum upfront. Total paid $13000 including meds used for one retrieval cycle.

Dr. Chang is intelligent and extremely knowledgeable. When I asked him questions, he would share up to date information from the conferences that he attended. He listens with a compassionate heart and responds with trustworthy advice. I trusted Dr. Chang's protocol and medical guidance.

Be organized. Be thorough. Keep good notes. Keep all paper work in a folder or a binder to help you to refer back things that happened while you are in your appointments. Do not expect Dr. Chang and the nurses to remember every little thing. Every patient's situation is completely different. It will help you and your cause immensely if you keep good notes and good accounting.

Dr. Chang discovered at our first IVF that I did not need a lot of medication to create follicles. Dr. Chang put me on Clomid with a little dose of Gonal F.

$400 ultrasound/bloodwork. $5000 IVF retrieval cycle. $1400 cryopreservation. $1000 meds per cycle.

We did not reach this step in my journey.

I have seen 4 doctors for IVF. I have done 8 cycles. Four done with Dr. Chang first and ended up freezing embryos. Left to try a few other doctors, and immediately ran back to Dr. Chang. He is an excellent communicator, he isn't stuck in a one track mindset, he is open to ideas, he is open to changing protocol and trying new things. He never gave up on me, and still hasn't just because I am a more difficult case. You can tell he really cares.

Be prepared to have a great experience. He is always present. He does every ultra sound. His nurses and staff are amazing. It really is where you want to be during a difficult time like this. Bring all your questions---he will answer EVERY single one.

All of my cycles with Dr. Chang have been with injectable Gonal F and Chlomid. I have had different preps that have included suppositories, Birth control, estrogen as well as no prep. All have yielded different results. Best result was progesterone prep Chlomid 100 mg for 5 days and Gonal F throughout.

Each round through retrieval ran about $8,000. If you froze embryos and did testing it was an addition $3-4,000. I have not made to transfer yet so I don't know that cost.

I believe he likes to do single transfers. But I can see him being open to other options as he is with most things.

Being in healthcare, I can sense when a physician or practitioner is treating me like a number or a diagnosis. Dr. Chang was the exception of all the fertility doctors. His approach was directed towards my husband and myself and our unique circumstances. Due to 'unexplained infertility' and normal labs, his approach and solution was in combination of our needs. He listened to us intently and provided solutions that were individualized and unique to husband and I.

I would like to know the difference between his mini IVF and full IVF procedure

Increased my Clomid to 100 mg for CD 3-7 (previous 5 attempts was 50 mg). He also recommended Progesterone and estrogen supplements. Here is where I knew his approach was different in comparisons to the other doctors. The other fertility doctors did not feel there was any validity to progesterone or estrogen and did not recommend taking them. Our OBGYN even recommended progesterone, but the fertility specialist did not. Dr. Chang believed in progesterone and estrogen as the woman's body naturally produces it. He did not advise me to take it immediately after ovulation. He recommended waiting 7 days to take progesterone post ovulation to supplement the natural production I will already have! This doctor knows reproduction so well!

250 initial visit

He is a very professional and talented doctor with a great skill and knowledge. He also has a very good and efficient bedside manner, making procedure painless every time. He is also kind and positive.

Trust him and follow your heart.

Cycle 1: Clomid(a 50mg tablet by mouth daily ) ,Gonal-f (injected 900IU total) & Ovidel (Trigger) Cycle 2: Clomid(a 50mg tablet by mouth daily ) ,Gonal-f (injected 825IU total) & Ovidel (Trigger) Cycle 3: Clomid(a 50mg tablet by mouth daily ) ,Gonal-f (injected 525IU total) , Ganirelix (injected 250mcg) & Ovidel (Trigger) Cycle 4: Clomid(a 50mg tablet by mouth daily ) , Gonal-f (injected 900IU total) , Cetrotide (injected 0.25mg total) & Ovidel (Trigger)

I always had a smooth monitoring experience on time except one busy time right before thanksgiving. Each monitoring was done very quickly and efficiently.

Fertility Consultation (New Patient) $250 In-Cycle Monitoring (U/S + Blood testing) per visit $450 Infectious Disease Testing Package - Female $250 Blood Testing (per visit, 1 - 4 hormones) $200 Infectious Disease Testing Package- Male $165 Outside Review Fee (Per time) $200 In-Vitro Fertilization 1-2 Eggs $5,100 3-9 Eggs $6,800 10-15 Eggs $8,50016+ Eggs $11,200 Fresh Embryo transfer Procedure Fee $2,000 Frozen Embryo Transfer Procedure Fee $2,600 Embryo Storage - One year $600 PGS test (per embryo) $800 Oocyte/Embryo Cryopreservation $1,400 Medication For Mini IVF Cycle $1500-2800 Signature Medication For Conventional Cycle $2000-$4000 Date Medication For Frozen Transfer Cycle $400-1500

haven't transferred yet

Hanabusa IVF and Dr. Chang & Staff are the absolute best. You never feel like just a number here, they treat you like family and genuinely care about your personal story. Special shoutout to all of the staff especially Alyssa and Disha for all of the help they've provided over our time working with Hanabusa.

Trust his process and know that he has your best interest in mind. It isn't an easy process to go through but can feel a lot easier and reassuring having Dr. Chang as your doctor.

Dr. Chang's strategy toward treatment is great, he focuses on quality over quantity and does not believe more drugs = more eggs and more success but rather maximizing in a healthy more holistic approach.

If i'm not mistaken there were hours that they did monitoring but it was generally pretty flexible and pretty efficient once you got there. You never had to wait very long to be seen and move on with your day.

They were reasonable. I like the way they do pricing for egg retrievals based on how many eggs are retrieved per each individual. Some women have many eggs, some have little. They shouldn't have to pay the same price.

I agree with a single embryo transfer for health risk purposes and overall success

He is professional, rigorous and careful. His idea of IVF is to adjust and improve it on the basis of letting it go. He used very few drugs, basically min IVF and natural cycle. For patients over 40 years old, if the cycle performance is not good, he will never demand, not rush, waiting for the best opportunity, so he often cancels the cycle

If you are a patient in a hurry, you must see clear results in a few cycles, or you must succeed once or twice. I don't think you are suitable for this doctor. He won't violate some rules to achieve short-term goals

1st cycle, few follicles, high FSH, could only use oral medicines safely for fear of pushing fsh too high 2nd cycle, slightly more follicles, low FSH, difficult to maintain FSH at a high enough level to allow There is no pattern, and he will have to adjust our treatments each cycle based on what my body wants to do. Up to this point, He has been conservative because he dose not want our treatment to make the situation worse. Going forward, he suggest being more aggressive with the use of medicines to try to maintain fsh in 13-18 range. The risk is that we can raise fsh too much which could harm the eggs.

Every time, the doctor himself does ultrasound for me, and explains my questions and the situation of ultrasound one by one.

7000-8000 pre cycle for MINI IVF

none.

He's very kind and asked some difficult questions in a very compassionate manner. He also answered our questions in detail and explored some other options with us. He seemed to really understand the stress of this experience and made space for that in the process.

Make sure he explain once a path starts, all of the different outcomes. We ended up having to make the call at the last minute of going forward with egg retrieval or timed intercourse and we didn't know this was going to present itself. It was stressful.

I specifically sought him out because of his experience with mini IVF and smaller needle used during egg retrieval. I had done an egg retrieval at a different clinic and my recovery was long. He put me on a protocol of clomid and follistim.

It was consults and then I paid for the monitoring fees at my local clinic and medicine

Dr. Chang was the first doctor that had hope for me, which as someone with POI was a huge motivator. I very much appreciated that each cycle was tailored to me that month. It felt like I was seen as an individual and not a number. He was also very good at explaining the rationale behind the treatment. Understanding my treatment process was very helpful for me.

Be patient. If you are dealing with DOR/POI, trust the process and be persistent.

We needed IVF due to MFI, but because of my reduced ovarian reserve this was a challenge. Conventional IVF would have been pointless because I could not produce many eggs. We started with mini IVF using low doses of clomid and gonal f to produce 1 to 2 mature eggs each cycle. The dose of medication was based on my AFC and hormone levels for each cycle and retrieval was individualized to when my follicles were ready to be retrieved based on hormone levels and follicle sizes. The clinic does retrievals every day of the week which was important for me in optimizing our results. We opted to do several rounds and bank embryos with PGS testing to hopefully have enough embryos for more than one child. We were generally able to retrieve 2 mature eggs per cycle and had about 50% blast rate.

Pricing was a la carte. Retrieval price $4200-6300, Embryo freezing and biopsy $1400, PGS $800, Transfer $2800, labs $150

Yes, Dr. Chang recommend eSET and we were very in favor of this approach.

We went to Dr. Chang after we had a failed first attempt at another IVF clinic. We appreciate that he is candid but also optimistic at the same time, and makes us feel cared for. Dr. Chang takes time to explain options and his thoughts, and he also makes sure to ask what we would like to do and respects our decisions.

I would not hesitate to ask him questions or tell him about concerns you have in the course of treatment. Dr. Chang is busy (he was running the clinic by himself until very recently, he only recently had another physician join the clinic) and sometimes forget details, so helpful if you can keep record in order to discuss future treatment plans with him.

Minimal stimulation IVF with climid (100mg daily) for a few days, Follistim or Gonal-F ~250 IU (2-4 days)+ sometimes certrotide (half dose x 2);Dr. Chang decides on the dosage and duration depending on the results of the bloodwork and ultrasound. Trigger shot (Ovidrel) 2 days before egg retrieval. The stimulation cycles yielded 1-4 eggs each time. So far froze 4 blastocysts, all of the blastocysts got tested for PGT-A, 3 abnormal and 1 unknown result.

Consult: ~$400 ultrasound:$250, bloodwork: $150 PGT-A testing: $800, egg retrieval: ~$4000-$5000, embryo freezing: $1,190

Our understanding is Dr. Chang likes to do single embryo transfer when there are PGT-A normal embryos, to minimize high risk pregnancy. If there are no PGT normal embryo, he would consider transferring 2 abnormal embryos. We are okay with his approach but we are not yet ready for trying embryo transfer yet (trying to get PGT normal embryos).

He is willing to work with “difficult cases,” he is kind with great bedside manners. The care is very individualized. He practice is getting busier and there are times when you only having one doctor is the office is a downfall.

Be open to unconventional protocols, know that with each lab drawn, your protocol and next appoint date may change.

Basically we tried to do things as natural as possible. I have DOR, I did not respond to medications, so we our goal was quality embryos not quantity .

There have been changes to the clinic pricing throughout my time at this clinic.

He was open to hearing our thoughts and suggesting what embryo he thought would be best to transfer. He was open to one or two embryos per transfer.

Dr. Chang is a unicorn of a fertility specialist & the medical field at large. He is a highly intelligent, innovative, exceptional & caring doctor. He takes an intensely considered, evidence-based approach while being on cutting-edge of current research & is willing to let the patient try new therapies. He is personally involved in all aspects of my care, performs all monitoring ultrasounds himself. His timing for egg retrievals & transfers is impeccable, a true art & science. His bedside manner, egg retrieval & embryo transfer abilities are second to none! He is extremely gentle, steady & skilled in all that he does. (It’s also helpful that the needle he uses for retrievals is half the diameter of other clinics.) He provides extremely individualized care, adjusting protocols in cycle according to my body’s need a & response. I couldn’t dream of a better doctor!

Do not hesitate to consult with Dr. Chang! Ask questions & brainstorm on potential protocols for your individual situation. You can trust his advise & timing as it is impeccable. You will be in amazing hands with Dr. Chang & the entire Hanabusa staff.

Our protocols have ranged from completely natural cycles with egg retrieval to Mini IVF with oral Clomid, Mini IVF with Clomid + Gonal F, several with Cetrotide added (tried omnitrope experimentally for egg quality for several cycles) FET protocols: Natural prep with progesterone support (vaginal & oral) starting at natural ovulation Several Medicated with estradiol oral, sublingual & vaginal if indicated by lab monitoring, Progesterone vaginal + oral Prednisone 5mg & Lovenox injections for MTHFR mutations/clotting disorder & recurrent miscarriage. (aspirin allergy) All transfers resulted in pregnancies, that unfortunately ended in miscarriage. PGS testing. Currently one of only a few doctors in the US that is willing to allow patients to choose to attempt informed transfers embryos which showed PGS mosaic or certain abnormal biopsies. (based on recent studies showing self-correction resulting in normal births in percentage of embryos) He has had successful live births of chromosomal normal babies from transfer of these embryos.

He is a very professional doctor because of his skill and knowledge. I was with my wife during egg retrieval, Dr. Chang has an amazing skill set, to make procedure painless, he is also patient and kind.

If his patient lives remotely, I would like to suggest that you should have a skype meeting with him or meet in his office in San Diego. I recommend to ask him or his staff to make sure how remote procedure work and make clear any questions.

Medicated mini IVF cycle, first time with Gonal F, Cetrotide, second time Clomid and Gonal F (for just a few days). No good results yet.

one cycle depending on how many follicles are retrieved, can cost $7,000-11,000

he prefers single transfer unless there is a chance for multiple embryo transfer would deliver better results

I was previously told that IVF would not work for me, so when I first saw Dr. Chang, he gave me hope. There's no standard protocol with him--I've done a natural cycle, injections and Clomid-only, and had two retrievals during several cycles. I'm not standard, and he works with that, seeing each patient as an individual.

I would say to be engaged in the process, sharing all your questions about what you're doing and why, because he's not just giving you a routine treatment, and so you can be part of it, not just on a standard program.

I have a high breast cancer risk, so I wanted to go with no- or low-stim treatments. I had one natural cycle, a couple Clomid-only and a couple with injections. Each produced eggs, but the quality and size differed. There were two cycles that included Clomid and a couple days of injections produced two embryos.

There is a standard retrieval cost based on your number of eggs. Mine was typically $4,900 for up to three eggs. The bloodwork was $150 each appointment and ultrasound/bloodwork was $400 each appointment.

N/A

I think his technique is incredible. When I started seeing him there were no other Dr's in my area (or outside of NYC I think) doing low stim natural cycle protocols with patient awake retrievals. That was huge for me, I hated being unconscious and hated the expense of it. (I did traditional IVF the first time). He talks you though every step of the retrieval and makes sure you understand everything going on and keeps a close eye on any pain or discomfort. He is a very compassionate and caring man.

Ask lots of questions. That would be true for any Dr though. Keep track of your cycles and results and any issues or thoughts. I do but my notes are minimal, I always wish I wrote more detail. Know you will sometimes have to prompt him or correct a statement. But know he's saying things out loud because your care is a conversation, and it should be (it wasn't so much with my first IVF Dr).

Dr Chang is a minimalist, unless you tell him you want to do higher stim (and your body cooperates). He uses natural cycle with minimal stimulation, very little to no prep. This makes is possible to cycle every month if you want to. This was key for me as I make very few eggs it was really important to me to closely examine every possibility. With him I have taken clomid, as well as injectables like Gonal F and Centrotide, BCP was the only prep I ever did as I have a tendency to create a large early lead follicle so we were always trying to slow that down in the hopes of getting more than 1.

We have some insurance coverage, and this was difficult to manage with them in the beginning. They don't take insurance, so it has to be reimbursement style. But the girl in charge of giving codes and handling doesn't speak english very well and had a generally negative attitude. She would often say things like "oh they are not going to cover that". Well, its your job to try. We multiple times had to ask her to call insurance and advocate for us. My husband was in charge of all the $$ so he had to deal with her and our insurance for the most part and I know it was frustrating for him. But ultimately we ended up getting some things covered that she said we wouldn't and we have gotten into a routine now for reimbursement submitting so we feel like we are doing ok. Cost wise, monitoring appointments are at $400, just blood work is $150. Retrievals are like 5K I think and transfers are around the same I think. Like I said I didn't have to handle the billing thank goodness, I would have a panic attack. I do know that cryopreservation is $800 and PGS testing (for 1 embryo) is about $1200 because insurance won't cover either of those things anymore.

Dr Chang would do what I wanted if i had strong views. He's open to multiple or single, whatever you want to do. If we had a normal embryo we would only transfer one (also we would most likely only ever end up with one), we are still working on that one normal though. But when we tried the abnormal embryos (all we have gotten so far during this process of trying for a second baby), we transferred 2 because the odds of either of them working were very slim.

I like Dr. Chang. He's really thoughtful. At each appointment he was very professional while also being sensitive to our situation and our feelings. At each appointment he would explain all the possible next steps, then take some time to digest this information himself and formulate a plan of action. He gave us options for treatment, and his recommendations, but ultimately let us choose our course of action.

Understand the infertility jargon so you know what your doctor is talking about.

Dr. Chang started with the least invasive treatment and as that did not work, he individualized treatment for us. We started with just medicine and timed intercourse, then we moved to IUI, and finally we tried IVF.

In total, we spent around 18,000. This included medication and timed intercourse, IUI, and IVF without embryo transfer. No viable embryos were created with our IVF cycle.

My experience with Dr. Chang has been wonderful. He is truly one of the best fertility doctors out there. Not only is he very skilled, he is honest & genuine. He has great bedside manner and is knowledgeable. He welcomes questions and doesn't make you feel inferior for asking them. I can tell he cares about me as a patient and he treats his staff and patients with care. His staff love him and say he is a good man.

My advice would be to come prepared with all of your treatment notes so that Dr. Chang will have a good overview of your medical & fertility history. The more information he has, the better he can treat you.

Dr. Chang has me on oral estrogen & vaginal progesterone pills regularly. Right before an egg retrieval, he puts me on Ovidrel trigger shot, Cetrotide, & Gonal F. I am unsure of how he chooses to use these meds, but I fully trust he knows what to do with them far more than me! I know the estrogen is used to keep my FSH & LH numbers lower (mine tend to be quite high).

Dr. Chang's prices are very reasonable. Lower than most other fertility doctors charge. I appreciate that because not everyone can afford IVF. It just goes to show how much he cares about his patients. He has a very good understanding of how financially straining IVF cycles are to a patient.

Unsure of my doctor's viewpoints on this topic.

Dr. Chang is VERY knowledgeable. He is cutting edge. He is an out-of-the-box thinker and doctor. He takes some of the most difficult cases with woman such as me whose egg count is diminishing significantly and whose egg quality is not always the best and gives them hope. I was told to use donor eggs after our embryos didn't make it past day three during our first egg retrieval with another doctor. I found Dr. Chang, who uses a unique approach called "Mini IVF," which simply means less medication so as to coax out the eggs and not drown them with medicine. At first, it was tough, because each new cycle, Dr. Chang would check my hormone levels and follicles and if they weren't perfectly balancing each other, he didn't want to move ahead with the cycle. He taught me patience in that respect. But eventually, his methodical approach worked and we got two normal embryos after cycle 3 and 4. Following those cycles, we didn't have much success with retrievals 5, 6, and 7, all of which ended in abnormal embryos. While we had a few issues with communication with Dr. Chang from time to time, he eventually understood how important it is to me to promptly return my emails and calls. He provides thorough information and ensures I gain clarity.

Make sure you tell Dr. Chang how you best prefer to communicate and what works for you in regards to communication. He is an amazing doctor--so progressive. However, his clinic is getting busy, so it's really important that he knows you need very quick communication, if necessary.

With Mini IVF, you approach each cycle quite methodically. I often have a dominant follicle that is very quick to develop. So, at first, I hated cancelling a cycle, but I soon learned how to be more patient and wait for the "right" cycle, so that my dominant follicle didn't kill off all the rest. With each Mini IVF cycle, on day 4 or 5, you typically take Clomid. Then, around day 7 or 8, you begin taking low doses of Follistim. Ganirelix might be added around day 10 to avoid premature ovulation. But each cycle could be different. For example, I would sometimes start Follistim earlier, or take Clomid for less time. It just depends on how many follicles I have and what my hormone levels indicate. For Dr. Chang, it's a balancing act--one that requires patience and precision. I would trigger and 36 hours later go in for egg retrieval. Because Dr. Chang is San Diego, and I live in Los Angeles, I did all of my ultra sounds and blood work with Dr. Jain in Los Angeles, and he would fax the results down to Dr. Chang. It was a little tiring, because I'd often not get results back until later in the day. Nonetheless, come egg retrieval time, my fiance and I would drive down to San Diego the night before, get a hotel room, and then wake up the following morning for the procedure. During the procedure, I am completely awake. I don't take any medication, aside from a few IbuProfen. I am not medicated because Dr. Chang uses a very tiny needle to extract the eggs and has a unique method where you breath very deeply as he pulls out the eggs. Most of my procedures didn't hurt; however, for some of them, they were painful. But, I liked not being zapped out for the rest of the day, as you would if you were under normal anesthesia. As a result of such a unique method, one cycle one with Dr. Chang, we got 4 eggs. All fertilized and 2 made it to blast. They came back abnormal. Cycle #2, we got three eggs. 1 fertilized normally, and 1 abnormally. The other didn't fertilize. One made it to blast and came back PGS normal. One cycle #3, we got 4 eggs. All 4 fertilized and 2 made it to blast. One came back PGS normal. On cycle #4, 3 were retrieved, 2 fertilized, and only one made it to blast, which was abnormal. For cycle #5, we got 2 eggs and both fertilized; one made it to blast and was abnormal. On cycle #6, we retrieved 5 eggs, 3 fertilized, and none made it to blast.

I did outside monitoring at another office, since Dr. Chang was not in my area.

Because it's Mini IVF, it's less expensive. Nonetheless, we did 6 retrievals with them. They gave us a discount for doing so many cycles.

She explains clearly about my status. She is not going too optimistic without evidence which helped me to stay calm during the process. She has a good bedside manner and it was nice to have only her doing my ultrasound.

Trust her during the process

Mostly oral medication Gonal-F 1 time Ovidrell 1 time

I had a LCIVF and it was under $5000 total.

I had only 1 egg to transfer but she was open to transfer up to 2 embryos(3days) in my case

Dr. Chang is a phenomenal doctor who is very knowledgeable, patient, and always shows care to his patients. He is good at what he is doing as a fertility doctor. He does not take profit as his first priority and does not just recommend patients to use the most expensive medicine or unnecessary medical treatments. He always takes patient's needs and medical situation into first consideration. He is a fertility expert that you can trust.

Trust Dr. Chang! Dr. Chang is a fertility expert who has not only profound medical knowledge but also well culture cultivation and magnificent medical ethics.

Mini IVF is an approach to IVF that focuses on prioritizing quality, safety, comfort and success.

They have a billing department to provide the price for each treatment.

Normally speaking, one embryo per transfer.

Dr Chang is knowledgeable and extremely intelligent. He is reasonable and open to modifying the treatment plan according to my wishes. He listens and is responsive to my questions and concerns. Treating another physician can often be difficult, but he has treated me fairly and compassionately. He is able to speak to me as a medical professional without condescension or judgement.

Be patient with the process- I’m still working on this myself

Dr Chang specializes in mini-IVF, so I took clomid and lower doses of gonal F the weeks leading up to egg retrieval. He was able to retrieve 5 eggs and 4 made it to PGS testing at day 5, unfortunately every embryo came back abnormal. Currently gearing up for my next round

Egg retrieval $6800; PGS testing $800 per embryo, lab draws $350 per draw, medications $1800, frozen transfer $3500; total for one cycle approximately $13500

Excellent surgeon and mini ivf expert. Very positive, enthusiastic doctor who is trying to bring the best out of a patient. At times could communicate more with patients especially at time of crisis or stress. Most of time nurses do the communicating vs. doctor. Unfortunately the procedures cost a lot of money so at some point have to evaluate cost/benefit.

Do your own research and discuss with doctor openly as he is very understanding.

Mini ivf produced good amount of embryos but not many pgs normal blasts.

$70,000

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