Harvard Vanguard

Although I have not been seeing Dr. Skiadas that long, I have been incredibly impressed with her. Having been through two previous egg retrievals and three failed transfers of PGD/PGS tested embryos, I feel that she worked really hard to put together a new protocol with aggressive monitoring that, so far, has yielded positive results. It was very clear to me that, prior to our initial appointment, she had carefully reviewed my previous cycles and results to find new treatment or tweaks. I had lots of questions about how to do things differently and different tests we could try and she took the time to fully respond to all questions that my husband and I had. She was very supportive of my desire to do some outside testing. Dr. Skiadas explained all of the risks and odds of success at each step of the process, something that I felt in the dark about prior to meeting with her. Although I really liked my previous doctor, I never felt truly informed about important factors to me, such as the rate of fertilization with ICSI, how many embryos can be expected to make it to biopsy, etc. Dr. Skiadas provided me with all of the information I was looking.

Dr. Skiadas seems to be a very popular doctor so make sure to always schedule a follow up appointment right away. So far I have to say that the initial delay in seeing her has been worth it!

Dr. Skiadas turned my retrieval protocol on its head, using Gonal-f and microdose Lupron with a 37 hour HCG trigger, each twice daily. I had daily monitoring and my doses were adjusted frequently. Because of my good response to this protocol, Dr. Skiadas had concerns for OHSS so she added in Cabergoline and Cetrotide post-retrieval, which was very effective.

Luckily, my insurance covers most of my fertility care and treatment so I paid co-pays for office visits, procedures and medications after meeting my deductible. I did not have to pay for monitoring bloodwork or ultrasounds. I paid out of pocket for PGD/PGS testing through Igenomix ($6k - $9k per time for both).

I feel that Dr. Obasiolu is knowledgeable and has switched our protocols based on our results after each treatment. He is kind and caring. I have run into Dr. Obasiolu at the clinic when I was not scheduled to see him and he remembers both mine and my husbands name and takes time to chat with us to check in and see how we are doing. I work in healthcare so I do know that this tends to be the exception and not always the norm with physicians.

Don't expect him to be mushy or coddling. He is very factual but he is positive and honest with his patients.

Cycle1 was estrogen priming and then gonal-f and menopure. Cycles 2-3 coenzyme q-10, gonal-f and menopure Cycle 4 coenzyme q-10, lurpon and gonal-f, assisted hatching and embryo glue For the above cycles a day 3 transfer (except cycle 1 due to freeze all with no viable embryos) with estrodial patches and crinone after transfer Cycle 5 (pending) coenzyme q-10, lupron, gonal-f, meonpure with baby aspirin after retrieval, assisted hatching, embryo glue, pio and estrodial patches.

All covered by insurance. Have only had to pay copays for medications (average $300 per cycle) and $500 for embryo glue per cycle (to date only used for one cycle)

Based on my age he encouraged multiple embryo transfer and the fact that out of all embryos only 1 has made it to freeze.

Dr. Obasiolu was very upfront that we would need IVF with ICSI to have a chance at becoming pregnant. He took the time to explain the procedure as well as a timeline for the medications I would need to take during the cycle. Dr. O was supportive of us when we had setbacks. We also appreciated that he referred my husband to a urologist that specializes in Male factor infertility. Sometimes the communication between him and that office was slow and required a couple of follow up phone calls, but that's the only negative for me. Both Dr. O and my husband's urologist came up with a plan for my husband's MFI. Dr. O warned us that this treatment plan may not work for my husband, but over a year later, his sperm count became high enough that we could finally start our cycle in 2018. I received a very detailed protocol for the IVF/ICSI cycle that with the help of Boston IVF has resulted in my pregnancy.

Dr. Obasiolu will let you know honestly how well a treatment plan may or may not work. We really appreciated his candor, but some people may find this difficult. When we had a change in our insurance plan and my husband's hormone therapy was slow to work, he discussed other ways we could start a family, such as donor sperm with IUI. I appreciated having other options to consider, but he was respectful of our final decision to continue my husband's hormone therapy. We are grateful that as a result we will have a biological child.

My husband was on Androgel prior to starting treatment. He was taken off that and started HCG. He was on that for 8 months when our insurance finally allowed him to add Menopur and Gonal F to increase his pituitary function. His urologist also recommended anastrozole to decrease estrogen production. He was on this combination of meds for about 18 months. Throughout this time, he had SA's done and his last one was high enough that we could schedule IVF/ICSI at Boston IVF. My husband didn't have to schedule a microtese surgery bc his hormone therapy was that successful. In July 2018, Dr. Obasioli gave me a very detailed protocol. I was put on estradiol to make sure my estrogen levels were low enough to start stims. I injected Menopur and Gonal F to stimulate the follicles. I also had to take cetrotide to prevent early ovulation. The dosages for Menopur and Gonal F were increased every couple of days until I was instructed to take my HCG trigger shot. After the egg retrieval at Boston IVF, I had to take progesterone cream to thicken the uterine lining in preparation for the embryo transfer. Our treatment plan resulted in 2 embryos. One was a 3 day IVF transfer and the other is being preserved. We are thrilled to expect our first child in April 2019.

The office visits I think were about $185 each and billed afterwards. Copays for ultrasounds were $35. The copays for the meds were pricey at $150 each.

Dr. Obasiolu recommended that we only transfer one embryo bc we are healthy and under the age of 35. He was concerned that a multiple transfer could result in twins or more.

Dr. Skiadas is clearly knowledgeable, compassionate, and understanding. I have chosen to try to become a mother on my own (SMC) and have never felt anything but support from her. Her approach has been clear and honest, and progressive relative to what has happened. Again, while I have primarily interacted with the nurses and other members of the medical team, rather than Dr. Skiadas, that hasn't troubled me and so far the convenience offered by the large practice has been a plus.

Because of the nature of the practice, and the opportunities to interact with Dr. Skiadas directly tend to be more limited, I would recommend being prepared to ask all your questions in those consultations if it's important for you to get answers from your RE. The nurses have also been very available to answer questions, but some patients may feel strongly about communicating directly with their physician.

Dr. Skiadas' plan and preference was to do three natural cycles of IUI. The first cycle I did was completely natural and I had a short luteal phase and early period (less than two weeks post-insemination). After that, Dr. Skiadas added a progesterone suppository to the next IUI to help maintain a pregnancy if indeed fertilization and insemination happened. IUI's 2 and 3 were natural, and 2 was with a trigger shot. The 4th was with Clomid and a trigger shot and progesterone, the 5th (due to a cyst being present) was unmedicated but with trigger and progesterone. And the 6th was with Clomid, a trigger shot, and progesterone. Cycles 1-5 did not produce a pregnancy. I am currently in Cycle 6.

To date (after 6 IUIs), I have had to pay a co-pay for IUIs and for the HSG test, as well as a copay for medication (Clomid, progesterone). Labs and ultrasound monitoring were covered by insurance.

Dr. Lee was very cautious about any supplements other than prenatal vitamins. I was advised to stop all supplements that I was taking under the guidance of my acupuncturist. It seemed a little odd not to take Vita C, D,DHA/EPA, etc.

For first timers, ask her what you should know that you don't know or haven't asked because you don't know what to ask.

Plan described below is exactly that a plan. It may vary based on blood work and Ultrasounds Overviewof situation: 40 years old, no previous children, partner had a Vasectomy 10+ years ago, low egg reserve, Hashimoto's and high prolactin Plan: Estrogen Patch - every other day - Just beginning cycle with estrogen patch and post transfer Gonal F 300ml x2 a day for 20 days - extremely long stim cycle as my body was not responding. Never added Menopur Ganirelix - 5 shots Novarel - trigger shot ICSI and assisted hactching Doxycycline- x2 a day for 4 days around retrieval Medrol - One pill daily beginning the day of retrieval and ending the day of embryo transfer Crinone once a day from transfer to loss of pregnancy

Cash Pay - No insurance Dr. Lee - $750 IVF New England - $12,900 Meds - $7500 Sperm Retrieval - $1900 Sperm Analysis - $1200 Other (Pre-IVF appointments, ultrasounds and Labs) not included in numbers above

Dr. Skiadas is very skillful as a physician and a wonderful, warm person. She is incredibly knowledgeable, but won't hesitate to consult with colleagues if a situation arises that she hasn't treated before. She was appropriately aggressive and didn't try the same thing that failed too many times. She truly seemed to care.

It is worth the wait for appointments to see her; don't settle for another doctor at the practice!

Insurance copays.

She recommended a single embryo transfer based on my age and other factors, but was very patient as I asked her about a lot of statistics, the possibility of a selective reduction if we transferred multiples, etc. She never judged but gently advised what she thought was best.

I found Dr. Lee to be a little misleading more than once. At first she said insurance would probably cover my treatment because my tubes are blocked but then the next time I saw her, she'd done a complete 180 and reversed her stance saying the probability of that happening was low because my husband had had a vasectomy, which she knew from the beginning. There were other incidents (too long to describe here) that made me lose confidence in her practice. She also didn't explain to me at all from the very beginning that she would not be doing all my procedures -- egg retrieval, egg transfer -- which would have perhaps been a determining factor in picking her and her clinic for my first cycle.

Assume nothing and double check and double confirm every piece of information coming from her office. Also, the proverbial "ask a lot of questions" -- but many people don't even know what questions to ask! Just do a lot of research on IVF cycles and potential protocols and don't be afraid to question or second-guess her.

I was never explained the rationale for the protocol Dr. Lee decided for me, but it was a patch antagonist protocol. It yielded an amazing amount of eggs: 10 were retrieved. But only 3 of those were fertilized.

We paid about $22,000 total for one cycle.

I did not get a good education on the trade offs between multiple embryo transfer vs. single.

Sadly I did not have a good experinece with Dr. Lee. She is a straightforward doctor. She dosen't show passion for her patient. She does not consider the patient's symptoms but will follow a standard procedures. This might not be entirely her fault, be due to the Harvard Vanguard standard procedure and luck of flexibility. She is fast and direct. For some this might work.

To challenge her assumptions. Be informed and prepared ahead.

Despite of my clear symptoms of endometriosis. Dr. Lee diagnose us as unexplained. This wrong diagnose lead to 3 failed IUI which could have been avoided if she would send me directly for a Laparoscopy. (Where I later find out the poor state of my tubes). It also lead to 2 failed embryo transfer. Since the protocol was not adapt for a patient suffering endometriosis. She didn't use a suppressive protocol but a standard antagonist protocol without the use of the pill in the first phase.

All costs were covered by the insurance.

Even worse than his suboptimal demeanor and professionalism, we now also retroactively question his medical fund of knowledge and treatment planning. Despite a year of "testing" and "treating" us (which included a failed IVF cycle), he never diagnosed either my husband or myself with any issues. Within a month of seeing our new physician, however, we learned that my husband had anti-sperm antibodies cross-linking his spermatids, entirely impeding their motility. Because we had such trouble communicating with Dr. Obasiolu (and there was such tremendous lack of transparency with every step of the process in his clinic), we don't know whether or not he did ICSI with our IVF. Without ICSI, there is no way that my husband's sperm could have successfully fertilized any of my eggs, and the entire cycle would have been a waste of money (not to mention a huge strain on our emotional reserve). After we switched to our current physician, we also learned that I was underproducing a specific hormone precursor, and I was started on a supplement for this. Who knows if this made a difference or not (although we did have a successful IVF cycle with our new doctor) - but we were so appreciative of the thoroughness and thoughtfulness that our new doctor applied to our case. He demonstrated a comprehensive and sophisticated fund of knowledge regarding the synthesis and metabolism of hormone precursors that we very much doubt Dr. Obasiolu had. Neither my husband nor myself pretend to have a nuanced understanding of reproductive endocrinology, but we trust our current physician implicitly, and this physician has pointed out to us (in a kind and professional way) a number of medical errors that Dr. Obasiolu made in our treatment plans.

Mostly covered by Blue Cross Blue Shield insurance, as mandated and the state of Massachusetts.

Honest and blunt when delivering us facts. Open to some supplements and acupuncture in addition to the IVF process. Compassionate after my miscarriage. Very knowledgeable of pcos. Covid-19 has complicated my experience.

Do your research and ask questions. He’ll provide answers but you need to ask questions.

Frozen embryo transfer protocol: Day 5 ultrasound, Letrezole days 5-10, ultrasound and bloodwork until trigger shot, baby aspirin and crinone 1x day until transfer and continued through pregnancy test. Due to cramping and blood test for progesterone in early pregnancy they increased crinone to 2x day. Ultrasound at 6 weeks showed that the embryo was smaller than it should be. At 8 weeks there was no further growth or heartbeat and it was deemed a miscarriage. D&C performed.

Lucky to have insurance coverage for IVF.

Strongly advised single embryo transfer.

Dr. Lee presents as a scientist, not a social worker. She's a problem solver. She presents options and explains pros/cons. The only challenge has been wait time on the phone and for an appointment - although ultrasound appointment options are great.

Be prepared to be educated and given choices, not just told what to do.

Lots of testing, then Letrozole for follicle stimulation and Ovidrel to trigger. We've varied the dosage based on my response to try to get the right number of follicles. The first cycle produced too many, the second we got the dose too low. This cycle looks good so far!

My insurance covers some, but it's been a couple thousand out of pocket so far. This was expected, and they had me check on my coverage before starting.

N/A

My experience with Dr. Skiadas, although we have not been successful yet in having a child, has been positive. I do not think that I could have made it this far without someone so intelligent thoughtful and caring.

None.

IUI and first round fully covered. Subsequent rounds I had to pay for the screenings and monitorings.

I think this clinic just takes on too many patients, they don't have the time and energy to address each one personally. Dr. Attaman is a nice person and clearly works hard and did help me get pregnant (yeah!) but if I had it to do again I would have seen someone else.

Find another fertility doctor.

Dr Obasiolu was with me for three years of treatments. He cared deeply for me, and I always felt like a person with him. Over those three years, he performed multiple treatments, including a D&E for a miscarriage, a polyp removal and the other surgeries. I felt that he was truly behind me and he always respected my choices even if they differed from his r commendations.

He is matter of fact, and his warmth may not shine through, but it is there! Ask questions, listen, trust.

I can't remember!

0. Amazing health insurance and infertility coverage

Though the recommendations were for 2 to be transferred, I was always listened to and never challenged when we elected to do a single embryo transfer.

Dr. Obasiolu was patient and kind. He was direct and honest but treated us like humans and was sensitive and encouraging. He listened to our ideas and questions and reconfigured the plans to include our thoughts. He was funny and friendly.

Listen carefully and don’t be afraid to ask questions or make your concerns or ideas know. He will listen!

checked sperm count and motility, check Fallopian tubes and uterus, IVF with Gonal F 450, HCG, and certitude, estrogen patch with progesterone suppositories, FET cycle with estrace and progesterone injections.

Insurance covered most. There were some costs for medication or co-pays. We paid for genetic testing out of pocket ($5,600).

Dr. Skiadas is sweet and seems caring but her patient load is too high and she is never the doctor that attends the retrieval or the transfer, she just sets the protocol. I also felt she could have provided more information and assistance early on and after my insurance ran out I felt abandoned and hopeless.

Just be aware she does not handle your retrieval and transfers. You also need to speak up and advocate for yourself if you have questions and concerns.

I felt it was very random and specifics weren't discussed too much. I felt so naive through the first cycle and wish I would have known more.

Insurance covered 90% of my costs.

She was nice and easy to speak with. She explained the IVF process easily so I understood. After a lot of initial testing I was told I had nothing wrong and to start clomid. I felt like she wanted to put me on medication just to start the process for my insurance company and then move forward to IVF. I didn’t get a great feeling about this since I was in pain monthly on my left side. I also mentioned this to Dr. Lee and was assured it was probably ovulation pain. After my first few appointments I decided to get a second opinion.

I used to like him in the beginning because he had an "aggressive" approach. However, he always wanted to do the same procedures over and over. Every new test I had done was because I insisted on it. After 3 failed transfers I requested an explorative surgery and he agreed. During the surgery they found endometriosis And an uterine septum. He never suspected endometriosis and was not going to check for it if I hadn't insisted. I was very disappointed. After the surgery I had another transfer that ended in miscarriage. They suspected it was ectopic at first but they didn't call me to let me know they were suspecting it was ectopic until 36 hours I did the blood test.

Don't go there

Don't expect warm and fuzzy but know that she really cares about your treatment.

Natural frozen cycle transferring one embryo resulted in a positive pregnancy test.

Around $500. This included my deductible and 10% co-insurance. Thank God for insurance in MA!

She was a good communicator and direct. She explained the process and logic of each step well. At one point we had an early miscarriage, and she was sympathetic but not overly so.

You don't see much of the dr, most everyday items are handled by the nurses and other staff.

She tended to take the more conservative method in terms of treatment and dosing (which I generally agreed with given my history)

Dr Attaman listens well and was willing to try things that I brought up while speaking with her (testing me for gene mutations, etc), whether or not they would be any help in the long run. Not that she would test me at random, but after her long list of tests I brought up a few and she was willing to indulge me.

I was first referred to Dr. Obasiolu to uncover my endometriosis. He was thorough and honest and kept my interests at heart. I say that because he understood our situation and I felt he could empathize well. I enjoyed his appointments and sometimes a quick joke here and there. :)

Ask questions since the doctors can't read your mind. They don't know what your worried about.

Can't recall as it's been a few years but it was antagonist using gonal f and menopur.

Covered by insurance

Dr. Obasiolu is clear and direct. There were often many steps to prepare us for, and he always let us know what to expect next, pausing for questions (which we always had). He did a good job of navigating the complexities and disruptions of COVID-19 on the fertility practice.

Speak up and ask all of your questions. Dr. Obasiolu will provide details and offer objective advice when prompted, but the appointments move fast so come prepared--and take notes.

Dr K took the time to explain his recommendations as to how we should proceed and why, which I appreciated. When our 2nd IUI failed, he called us to come in and discussed in person why he felt IVF was a better route for us at this point. I am glad we listened. He was confident that we would get a good number of eggs and he was right. He also explained what we should expect, and I felt prepared about everything going into the IVF cycle.

Don't be afraid to ask him lots of questions.

We started with 2 rounds of timed intercourse using clomid, both resulting in negative pregnancy tests. On the third try, we changed to femera and IUI, which resulted in a positive pregnancy test, but unfortunately ended in early miscarriage. On the 4th try, we repeated the same treatment, although Dr. K expressed IVF was a better option. However, we felt since it "worked" with IUI it could work again, so wanted to try that one more time. When that didn't work, Dr. K called us to come in and explained again that IVF would be a better route for us. So we agreed. We had to take a month off, but it was smooth sailing after that. Dr. K monitored how I was reacting to meds and adjusted accordingly. Because I ended up with 29 eggs retrieved and high estrogen levels, Dr K wanted to do a "Freeze all cycle" to improve our chances of implantation/transfer success. Again we had to take a month off, but then I had an easy protocol for the transfer. It was femera, a trigger shot, then a week later did the transfer. I asked Dr K if I could avoid the PIO shots and we did crinone (progesterone) suppositories instead. The transfer procedure went well, but it was not performed by Dr K. (The doctors rotate at our clinic for actual procedures)

We had a high deductible insurance plan, so we paid for everything out of pocket until we hit that amount. Then everything was covered. We have a lifetime max fertility policy of up to $25k.

Dr K felt we should do a single embryo transfer and gave his reasons for wanting to do so (although I can't recall them all now), but he felt strongly about it so we agreed.

I felt very listened to and respected by Dr. Kovalevsky. He always gave me time to gather my thoughts and ask all of the questions I could think of. He respected my wishes and adjusted my treatment accordingly, so I felt like I had more control over what was happening with my body. He is a straight talker; he was always very clear and easy to understand.

Be prepared for your appointments so that you can ask questions. He is very willing to answer any questions and adjust your treatment accordingly.

We used an antagonist protocol. I talked to Dr. Kovalevsky about lower doses, and he agreed, since my test results indicated I would be a good responder. I was prescribed 250 units of Gonal F and 20 units of HcG dilution. I went in for bloodwork and an ultrasound every other day, and I responded well to the protocol. We did not have to make any adjustments to my dosages. I also took 0.25 mg of Cetrotide. We used 10,000 units of HcG as a trigger shot, since my bloodwork and ultrasounds did not show a risk of OHSS. I took my trigger shot on Day 9, with my retrieval on Day 11. They retrieved 10 mature eggs, which produced 4 embryos after ICSI.

My medications came to approximately $600. My appointments with Dr. Kovalevsky had a $40 specialist copay. My egg retrieval and embryo transfer at Boston IVF came to $9,400. Freezing an extra sample of sperm was $325. I was fortunate that my insurance completely covered my IVF costs. Total cost to me and my husband was about $1,000.

Due to my age and health, we decided eSET very easily. Dr. Kovalevsky talked about the additional risks incurred with multiples. My insurance also set conditions on how many embryos could be transferred, so we would have had to do eSET regardless.