Johns Hopkins Medical Institute

As a new patient you should know that this is a group practice. This means that when you go for monitoring you may meet with whatever doctor is scheduled that morning. I liked that they did monitoring in the morning because I didn't need to miss time from work. Also the changing of doctors during clinics can be a good thing because you become comfortable with all of the doctors and they may be the one completing your transfer or retrieval so its good to at least be familiar with them. Sometimes I do feel that they may not remember me personally but I dont take it personal since they see so many people in the mornings for monitoring.

It is easy to feel like a number because it is a group practice and you may see a different doctor each time you go in for monitoring. However, Dr. Christianson is very responsive on the online portal and responds to all of my questions no matter how many I need to ask. She also makes it a point to call personally when trying to adjust a plan or testing etc.

As a patient I feel like she is doing everything in her power to help us conceive. When my first ivf cycle failed we changed the protocol by adding an endometrial scratch. She also did further testing. The second cycle also failed and we are in the process of completing a more aggressive protocol and testing before moving forward. I do wish that all of the testing would have been completed at the beginning so that we could have known more of what to expect. I think that at this point it really is a puzzle because all of the tests show that it should have worked by now. I do feel that she is being diligent about trying to troubleshoot where we can.

Be your own advocate. She is definitely going to give you the best care but if you have a test or supplement that you would like to know about, she will take the time to tell you the pros and cons of it. She will also thoroughly explain every step so be ready to take notes. *smile* But seriously, if you want to know something, don't be afraid to ask. She is very open to the steps that you feel comfortable with taking. For instance because of my age they would only usually transfer one embryo but she let me decide how many I wanted to transfer. After my first failed cycle she asked if I would be comfortable with two being transferred and ultimately let me make the finally decision.

Cycle 1: Stimulation- gonal f and menopur with cetrotide. I ended up being high risk for OHSS so she decided to do a freeze all cycle. I had about 30 follicles and retrieved 15 mature eggs. FET-after my period started I was able to do a frozen embryo transfer. We decided to do 1 embryo because of my age and the likelihood that it would be successful. I used estrogen patches for 14 day, crinone for 5 days (there was a progesterone in oil shortage at the time), medrol and doxycycline (those are standard at the practice before a transfer). That cycle resulted in a negative pregnancy test. FET2- When my period started from the last failed cycle, I took birth control because the clinic was closed for the holidays. When they reopened I went in for a saline ultrasound to check for polyps and an endometrial scratch. I stopped the birth control then started the estrogen 2 days after. I began the progesterone in oil on day 14 of my cycle and had a transfer of 2 embryos 5 days later. That cycle also resulted in a negative test. Now: We are in the process of developing the protocol for my next transfer. I will complete an ERA to make sure that we are transferring at the right time. Then I will wait for my period to come. Once that ends, I will have a hysteroscopy to ensure that nothing was overlooked in the saline ultrasound. I will also be completing an immune protocol for the next cycle which will include a higher steroid dose and lovenox.

For monitoring the clinic opens at 630, the lab opens at 6 am. Usually your lab tests for the cycle are already in the online portal so I would arrive early, go get blood work done, then go upstairs and sign in to be seen. They would go in a first come first served fashion. If the list was already long when I arrived, I would sign in, then go for my blood work and come back.

the ivf cycle was about 10K and the FET cycles are about 5600. Freezing of embryos was $600 and thawing was $250 per cycle.

I was advised to transfer one embryo initially because of my age. The second cycle she suggested we do 2 and I agreed.

This clinic is highly knowledgeable in areas of infertility. The clinic is clean and the staff is organized and available to patients at all hours. Weakness is lack of time for extremely personalized care due to the number of patients

Limited amount of time the doctor is able to see each patient and the amount of women using the clinic services.

Dr Jairo’s education is definitely a strength. The clinic operation is the weakness. Which is less to do with doctor and more to do with management. Communication across the clinic is a weakness. You kind of have to be an advocate for yourself regarding your own healthcare but that is the way the healthcare industry operates as a whole.

Be your own advocate. Know what is going on with your body and don’t be afraid to speak up and ask questions as this is a large investment and undertaking.

Due to the fact that I have endometriosis and my having had surgery in 2015 to remove my left tube and ovary we knew there was a huge chance we would have to use donor eggs. However we tried to perform an egg retrieval using my remaining ovary but the endometriosis returned in the right ovary and in my pelvic cavity due to the stims so I had a subsequent surgery July 25th 2018 to remove my remaining right ovary and tube, and endometriosis from the pelvic cavity. However my uterus is fine and has no endometrisis with in. We meet with our doctor on September 17th 2018 to move forward with the process for donor egg transfer.

My insurance paid for much of the services. Donor eggs however cost $15,000.00 and the storage for one year cost $500.00.

our doctor prefers a single embryo transfer for donor egg transfers.

Strengths would be the great doctors and nurses. I also really like that I can see all the visit notes online in my mychart. Weakness would be the cost associated with IVF is high. I had med students in a few of my appointments and you would think this should drive the cost of care down some since they’re using the clinic as a classroom.

Dr. Christianson is really nice and makes the process go by as easy as possible.

We are a same sex couple so there were a couple mixups between who was retrieving and who was transferring early on, but she was quick to make the changes when we called. She is a great nurse that has been very nice and accommodating.

Dr. Christianson is great. She is kind and genuine. We had her as our doctor for IUI two years ago (successful after 3attempts) and are going back to her now for RIVF. She understands our goals and gets us in for appointments on our time rather than forcing us on a certain schedule. She communicates very well through their online database as well.

I would say this for any doctor, but know your goals going in so the doctor is able to tailor their plans to your goals. For RIVF, be clear on which partner is doing what, we had a couple mixups, but Dr. Christianson's assigned nurse has been quick to check with Dr. Christianson and make the necessary changes.

For IUI, my wife was young (25) and didn't have an fertility issues, so Dr. Christianson only had her do the trigger shots. After the 3rd IUI she was successful. For RIVF, after telling Dr. Christianson that our goal is to have one child from this process, she was quick to note the proper treatment strategies, minimizing medications, to ensure we don't have a bunch of leftover embryos. We plan to retrieve and transfer in the summer.

Approximately per cycle OOP costs not including medicine: $11,000 for IVF $5400 for frozen embryo transfer $2400 for IUI

She recommended single embryo transfer because we are relatively young with no fertility issues. We would've went this route either way since we do not want to risk having multiples.

The morning scan system is painful. I usually arrive there at 6am in order to be first in line. By 645 there are usually at least 15 people in line. The clinic opens at 7. If you are one of the first 2-3 people, you can be in and out quickly. If not, it can take well over an hour to be seen- then you have to go for labs downstairs. If I arrive at 6 am and am first in line, I am usually only one hour late to work (supposed to be there at 7am). It's exhausting though. The insurance/financial folks have been truly excellent. Dr Garcia's office coordinator (Melony) has been helpful- she fbelped me with my FMLA forms and was able to schedule procedures quickly when I needed them. I would have liked for someone to speak with me about counseling. When I asked about it, I was first given the contact of someone no longer practicing. Then it was suggested I go to a free support group- but the doctor running it wasn't offering them any longer. I found some resources in my own instead.

I know that Dr Garcia does truly care about me, but at times I have felt like he was rushing. This was moreso in the beginning. Now that we've been through an awful lot together, I feel that our questions are answered with more patience. He has always been excellent about responding to emails, although I have kept those to a minimum out of respect for his very busy schedule.

Good about returning phone calls same day. Would have been good to learn some tips about how to maximize insurance benefit. I used $12k of my $30k lifetime benefit on meds that would have cost me less than $6k out of pocket (it would have been smarter for me to pay oop for the meds and save the $12k of insurance coverage). The nurses were aware of this but no one warned me. They do a 2 hour mandatory IVF class which was informative. I am a nurse so some of it was redundant to me but I was glad my husband could go and learn about it. The nurses on a whole are excellent. On a few occasions I have felt like they were very rushed but usually they are great.

Dr Garcia has been very open to listening to what our preferences have been all along. He offers suggestions about treatment or procedures and then let's the patient decide. He doesn't push us one way or another. I believe he doesn't push donor eggs as a first option, which I have heard from other clinics. I never get the feeling that he is concerned with his clinic's annual statistics. They take patients that have failed elsewhere. He has taken my thoughts and suggestions into account. I had 4 IUI (the most he will do before IVF). The last one was positive but ended in a miscarriage. Dr Garcia performed my d&c. We did another five IUI hoping for a positive. After those we moved to IVF but I had some false starts and my meds needed to be tweaked. Unfortunately that took some time and in the end the IVF failed. He had offered a laproscopy after IUI and prior to ivf but at that time I wasn't interested. After our failed IVF I was almost out of insurance money for treatments. So we did the laproscopy and Dr Garcia found. Oth Fallopian tubes blocked. He opened one up and got rid of lots of adhesions as well. We went back to IUI- and had success the second month. Unfortunately that also ended in a miscarriage and again Dr Garcia performed my d&c. I am currently waiting for the genetic analysis of the conception tissue in order to determine our next step.

Understand the he does truly care, he has a HUGE amount of expertise and experience. Sometimes he is not he best communicator, go in with questions written so you can ask them all.

First we started stims (gonal f and menopur) immediately after a failed IUI. I didn't make many follicles which we were all surprised by (I respond well to Clomid). He stopped the cycle and I was to use ganerelix prior to my next period. Unfortunately it came early and I only got a few doses in, and that wasn't enough suppression. Next time we got enough doses of the ganerelix prior to my period starting and were able to make it to retrieval. I didn't produce many eggs. Next time we will add Clomid three times a day on cd2-5. It's frustrating to think that cheap old Clomid could have helped us in the last ivf cycle. It's so inexpensive and with two previous false starts I wish that we had done it in our full IVf cycle last year.

See previous comments. This is not an ideal system.

Using insurance through my employer. I have received 11 IUI, one full ivf, and two false start ivf for about $30k. We paid about $3k or so for some IVF meds due to the false starts.

We were comfortable with multiple embryo transfer. No real comment here.

The clinic is run very efficiently. All of the staff have been fantastic.

Dr. Zacur clearly cares about his patients and goes out of his way to be available to his patients instead of letting the on-call/covering doctor in the practice handle things whenever possible. I suffered a miscarriage while under his care and the level of compassion he showed was amazing.

The nursing staff are extremely efficient and reliable. I've had every question or request attended to promptly. The IVF classes taught by the nurses are so helpful.

Dr. Zacur is outstanding. I completely trust him with my care and have complete confidence in his abilities. He is kind and compassionate but also very honest when necessary. He takes the time to make sure I understand and am comfortable with the treatment plan. Even though he is an older doctor with many years of experience, he is knowledgeable about most current research and standards of practice.

I was diagnosed with a unicornuate uterus which limited my treatment options to only IVF. Dr. Zacur stressed the importance of reducing the risk of multiples and strongly recommended transferring only one embryo. I was on follistim, cetrotide and ovidrel. We did a retrieval and froze all embryos and did a frozen transfer later. Dr. Zacur recommends frozen over fresh transfers to his patients because he feels there is a better chance of success especially when your body has a chance to recover from stims and retrieval. I became pregnant after my first and only transfer but miscarried at 7 weeks. I am currently doing stims for another retrieval, we are planning to freeze all again and transfer an embryo in a later cycle.

Ultrasounds and labs are done every day on a first come, first serve basis from 6:30-8:30 am. This has worked great for my schedule. The clinic moves through a large group of patients very efficiently yet you still feel like you are getting the individual attention you need. The nurses call you a few hours later after your lab results are in to update you on the plan/medication doses/next step.

An IVF cycle not including medication costs about $11,000. A frozen embryo transfer is about half the cost of a full cycle. I am fortunate enough to have insurance coverage for fertility so I'm only paying co pays at this point.

Probably the only weakness this clinic has is that they get super busy. If you work or do not live nearby, the appointments could be tricky to keep. The waiting room is always packed with patients waiting to get ultrasounds. If you're not there early enough, be prepared to wait over an hour.

Dr. Garcia always answered my questions and was always attentive. He has a thick accent but still explained things well and repeated himself if I asked for clarification. He was very apologetic when I would get a negative pregnancy test.

The nursing staff has been absolutely incredible. Each one of them has been understanding, sweet, showed compassion, were patient, answered any questions I had and were very reassuring. They always called me back to make sure I knew what the next step was and made sure I was on track.

It's easy to get frustrated with a doctor due to fertility. He can only assist you in increasing your chances. He can't cure every fertility issue. Every body works differently and each doctor has to use their expertise to help you conceive. With that in mind, I can't blame my doctor for how my body works. Dr. Garcia is very knowledgeable and I trust his experience and treatment. We've already established what is wrong with me and we are now working to increase my chances. I've been very happy with my experience so far even though I am not pregnant yet. His accent makes it difficult to understand but he takes the time to make sure I understand him.

Probably the hardest advice any fertility patient could hear but to have patience and understanding that English is not his first language. Despite the language barrier, he is very knowledgeable and experienced.

I started seeing Dr. Garcia because my husband and I were having trouble trying to conceive after 6 months of trying on our own. I had a feeling it was because I had spotting for a week before my menses began. The first test I received was a biopsy to confirm that I had low progesterone. We tried a few cycles of Femara and timed intercourse. I took 2 Femara tablets from day 2-6 of my cycle. When that did not work, we moved on to three cycles of IUI with Femara. A couple of times I needed a booster shot to force ovulation. The IUIs were not successful and I decided to have an HSG test done. It showed that one tube had some resistance (probably due to a mucous plug) but was now open. The left tube had no dye going through. I then decided to get a laparoscopy done. They found a rare congenital defect hanging over my tube which was pinching it closed. The defect was removed and my tube was open after that. My tubes are now both open but I still have low progesterone. I am now on my 4th IUI. I just finished my Femara medication and will be going in for an ultrasound next week and then will try another IUI. If that does not work, we will try one more IUI before moving on to IVF.

My insurance pretty much covered everything. The only thing insurance did not cover was going in to receive my diagnosis. All the medications and procedures were covered and I paid $30 copays for most of it. My most expensive procedure so far was my laparoscopy that cost $1400 but I only was responsible for paying $30.

The financial staff is awesome and helps you navigate the horrible expense and insurance hoops. The nurses are great, but will not generally be flexible with your treatment and or blood draw dates. The morning clinic times work well for working ladies and the earlier you can get there the better. (There's usually a line before they open).

Dr. Garcia has a very kind bedside manner. He listens to concerns, and considers them even if he ultimately disagrees with a change. He also was willing to try different protocols and adjust the protocol when not working well. In addition, he never discouraged us from trying with my own eggs.

Most nursing staff were great and very compassionate. There was some miscommunication of information with one of my cycles (for my 2nd). The nurses are not in charge of cycles or changes, however, and if you want something changed, you need to talk to your doctor!

Dr. Garcia is very experienced and willing to try out of the box protocols. He is willing to take on older patients and still allows them to try IVF with their own eggs (multiple times) without refusing to cycle. His bed manner is kind. He can be a little distant when dealing with very emotional times (for instance he seems interested in looking forward rather than backward at losses or failure), but in general is very kind and patient with his patients.

He comes with tons of knowledge and hands on experience. He generally wants you to succeed and will be flexible if something isn't working.

We tried once cycle with birth control suppression and then antagonist cycle- this resulted in no growth and canceled cycle. We then did antagonist cycles without prior literal phase suppression and also with antagonist literal phase suppression- both of these yielded eggs that were viable- the ones without suppression had more variability.

Clinics started at 7:00. There was usually a line waiting for the nurse to open the door by that time. Blood draws opened at 6:30a, but were a mix of patients so wait was sometimes long.

Primarily Covered under insurance - 20% copay and standard prescription drug coverage applied to meds (except PGS testing and biopsy- which was OOP).

more flexible on protocols and who they accept as patients. not as much organization or policies/procedures as larger clinics. since part of hospital billing insurance seemed to cover more than might at stand alone clinic. lab is in building and has early morning hours as does clinic.

During gyn surgery with her, she rubbed my hair as I fell asleep. She was interested in my success personally. And we still communicate by email a year after successful treatment

not extremely organized or the best at communicating. You have to be organized for yourself. They rarely answer the phone but can be paged for emergencies or leave a message and they'll get back to you by the end of the day. I went to this clinic more for dr kolp than the nurses.

She is pretty blunt and honest but also laid back and willing to listen to what you want. I didn't feel like we had a specific office wide protocol or process to follow like other major clinics have. And no board to really answer to. She was willing to try things maybe other doctors wouldn't want to risk.

She takes MONTHS to get an appointment, but we instantly started our cycle with her after our initial consult, so things moved relatively fast after that.

She couldn't locate my ovaries via vaginal ultrasound, so she wasn't sure about my AFC or if a retrieval would be possible. She did a test cycle of clomid to see how my body would respond and sure enough my ovaries plumped up and were easily accessible. With that knowledge and blood work she automatically put me on the max doses of stims (age was 28). With that I still only produced 6 follicles. 5 eggs were retrieved. all 5 fertilized and made it to 5 day blasts. She was skeptical about methods to increase egg health (acupuncture, diet, etc) but wasn't against it and allowed me to do whatever made me happy.

Early morning (I believe 6-7:30am in 2014) if you get in immediately it went quick. the later you got there the longer it took. lab opened a bit earlier so I would go there first (sometimes the wait was longer there since other patients not just infertility patients were there) then go to the clinic for monitoring.

With no health insurance coverage for infertility treatments, our IVF retrieval, freeze and then transfer to gestational surrogate including all medications (I bought most from Israel) was about 12-13k. My insurance actually did cover a substantial amount, anything that was explicitly for infertility (like all of the monitoring and bloodwork) was covered.

Disorganized. No phone support at that time. Given very high expectations. Always left confused, or became confused about treatment cycle after the fact.

I never felt like anybody at the clinic knew who I was and after 4 cycles, I only saw the same doc once.

I left utterly confused almost all the time. Like a doc or nurse would say "uh oh" and then that would scare me and make me feel uncomfortable, but I couldn't get any answers about why they said that. Impossible to get anybody on phone.

Dr. Garcia has a fairly thick accent, so that was an initial struggle. He told me that 85% of the women who could get pregnant on their own, with DOR, with his treatment, had success with getting pregnant. I asked him why the other docs had me jump straight to DE and he told me that they over-medicalize, which is pretty much what I wanted to hear. During the time I was waiting to see him (about 4 months, and we specifically avoided getting pregnant during that time period) and the subsequent 4 months of treatment, my AMH went from super low to negligible and my FSH went high (so pretty much full into peri-menopause--yes, it can happen that fast). He still thought the next step was IVF with my OE and genetic testing. However, bc my experience there had been so confusing and the travel time so intense, I went back to SG with the intent of doing OE IVF (which they wouldn't do with my #s). By that time, I was emotionally exhausted and we decided it was in the best interest of our family to cough up the money, and let go of the idea of me having my own genetic child.

Like any fertility story, some things work for some people. Who knows if I had kept on. My gut was telling me that I could not take the 2+ hours of travel time and disorganization of the clinic any more. It was a PT job and often I was given misinformation (like, you are ovulating 2 days into your period, when in fact, I had the very common condition of having left over cysts from previous eggs. That necessitated multiple visits in a week and should not have been that confusing). So, go with your gut and don't push yourself to the bitter edge.

They had me come in for an U/S on Day 2 of my cycle, if it looked good, they had me take Femara for 5 days, then check me again on Day 8 (I ovulated early), and then do the trigger shot, then sex within 24 hours. Only 2 of my 4 cycles even worked and they wouldn't let me do the trigger shot on that first cycle bc I had 4/5 eggs and they didn't want me to get pregnant with high order multiples. I didn't know any better and they didn't know me, but that was best I got during my time there and I feel it was a wasted cycle when I could have had a lucky outcome, esp considering my MC history.

Insurance paid their part of it. I had co-pays for blood draws, meds, appointments.

The best. Great doctors, caring staff, all the reasearch and knowledge in one place. With the exception of one Fellow (doctor in training), I was always treated with the greatest care. The office was not the prettiest/newest, but is that really important??

From the moment we met Dr. Garcia, he treated us with the kindest, most caring, most professional care.

At Hopkins, every appointment is handled by a doctor. It is amazing and is very reassuring.

He was great! Extremely smart, knowledgable, caring and reassuring. Even when we faced difficulties, he remained informative, but positive. What was also great about choosing Dr. Garcia was that I got to meet and receive care from other highly trained physicians as well; from sought after Hopkins doctors like Dr. Lisa Kolp. I attribute my successful cycle in large part to her, because she was willing to LISTEN and made a slight modification to my meds (added some thyroid medication to my borderline hypothyroid-ish results). She told us right before transfer during our last (6th) ivf cycle that our embrio was "perfect". That, is still the codename for our baby!!

Be patient!

Dr. Garcia cared about how many shots needed to be taken, so he prescribed a protocol that allowed various medications to be combined into one shot. It was a much easier protocol than what I had with Dr. Timmreck. I took 2xMenopurs, 4xBravelles for four days, then reduced the Menopur, then added the Ganirelix, then used Ovidrel. After transfer, I used Endometrin. I have a beautiful two year old.

Insurance covered everything, but the copays and the medications.

Clinic when I used it (2010-11) was very easy to use, and its procedures were easy to follow for morning monitoring to go smoothly. I liked seeing different doctors each time, and I thought that they worked well together. It felt less authority-driven that the doctors cooperated.

Clinic was really easy to navigate. The clinic made it easy for patients to do morning monitoring, and the nurses gave helpful tips, so I got into a routine with morning monitoring, and it was easy to do, even on days that might have been stressful like after a snow storm when I had moved away to DC. Likewise, nurses gave useful tips for injection.

Nurses were really the best. I was intimidated by the whole situation b/c I was single and not trying to conceive yet. The nurses made the whole procedure very doable, and I learned how to do the injections very well with tips that they gave, like to transfer Ganirelix from a pre-filled syringe to a regular syringe with small gauge needle because the Ganirelix needle is so dull. And indeed once I tried the Ganirelix needle, and it was terrible.

She was in touch with me by email when I was inquiring about egg freezing, and she answered all the emails herself, which was impressive given how busy her schedule must have been. The clinic operates as group model, with each doctor making decisions on the day they were on duty, and that model worked fine, so Dr Kolp did not make many decisions for me personally. I was happy with clinic and my treatment, however. I was paying out of pocket for drugs + retrieval, and she did make sure that each cycle, I got free Follistim or equivalent so that I did not have to buy all drugs out of pocket.

Follistim/Gonal + Menopur/Bravelle + agonist like Cetrotide/Ganirelix. I had good results. She was okay with substituting, and I could be flexible and order the cheaper alternative when ordering from abroad. I ordered the drugs from Israel and paid out of pocket.

Very easy to do morning monitoring --- they gave tips like sign in upstairs for u/s and then go downstairs for blood work, and by the time blood work finishes, it's your time for the u/s. And so it went smoothly with little waiting.

My health insurance ended up covering all the imaging, blood work, and anaesthesia. I paid for egg retrievals and drugs, but under Maryland's laws, I was billed the same out of pocket as an insurance company would be billed. I do not remember exact costs, and it was years ago, but it was much less than they had quoted for me because insurance covered so much unexpectedly.

NA. Did not transfer embryos, just egg freezing.

The financial counselors are not great. I have two insurances and they keep billing the wrong one, which means I have to spend hours on the phone trying to correct this. I keep calling them to ask them to make sure to bill the correct insurance, but they never do. They say the billing is not their fault, although everyone else in the clinic tells me that they do the billing. I do not like wasting my time like this.

Dr. Garcia has a very warm bedside manner. He is very truthful about prognosis and expectations, but remains very caring. During part of my treatment I did not have insurance coverage and he worked with me to minimize expensive monitoring while still keeping things safe. He is also very quick to respond to emails.

All of the nurses are excellent. They also respond to phone calls within a couple hours, even on weekends.

I would recommend Dr. Garcia to anyone. He is very caring and patient, and quick to respond to emails. He is also very up to date with the literature. In addition, all of my procedures and ultrasounds are performed by physicians, never nurses or ultrasound technicians, and I like that.

Ultrasounds start at 7 in the morning and there is usually a queue already. However, it moves pretty fast, and the medical assistants are very good at keeping things moving.

I paid cash for my first IVF cycle which was around $12,000 including meds. I have been insured for the subsequent cycles and had to pay 20% of costs.

They are a great staff quick and efficient. They also always return my calls and I’ve never had a issue at anytime with my care. The staff is kind and joyful which is contagious! I also like the music in the waiting area because I’m usually balked up with nervousness so it’s a welcoming distraction

My experience was pretty neutral

Quick, efficient

He was kind and gentle bedside manner. He explained to me in detail his plan for me and I trust him. Dr Zacur was also very thorough and informative, also I felt like his regimen for me agreed perfectly to my natural cycle!

Stay positive

50 mg of clomid cycle days 2-6 uncomfortable side effects from the clomid at such as hot flashes, headaches, major bloat/gas and cramps from cd 8 till ovulation! They were uncomfortable but not unbearable and to my understanding those are pretty common effects and I was lowest dosage. I reacted great to meds peoduced 2 mature eggs one on each side and I ovulated on my own , no need for trigger shot.

I don’t know specifics off the top of my head but it was covered 80% by my insurance company

They play a lot of doctor roulette, if youblike consistent care with one doctor, they may not be the right fit.

I have PTSD and had issues with the male doctors in the practice (not fully their fault, mostly my PTSD) and Dr Christianson worked her schedule so I saw her, not other doctors.

She was easy to reach, especially by email. She responded promptly, and took a direct interest in my care. Of everyone I met at JH fertility I would go to her again and again. Without her I would have transferred my care.

If you don't want to play doctor roulette, let her know.

I used a low dose injection and Clomid, as well as a trigger shot each cycle. She adjusted dose each cycle depending on egg numbers, I used injectibles and clomid with my toddler, so she used a similar protocol as I was used to with the other practice.

He did give time for all questions, but sometimes got frustrated when I wanted to know details. The way Hopkins monitoring is set up, you feel like they're trying to herd a lot of cattle through the ultrasounds.

He's not terribly sensitive and tends to swallow his words. I wouldn't recommend him for DOR patients - he's not the one to propose different treatment protocols, which is important for poor responders.

To manage your own care and stay on top of all the details.

High sim with ganirelix priming.

Cattle call! And waits are long.

I paid entirely out of pocket. The finance team tries to help, but...they're up against insurers who don't want to provide coverage. I think one cycle would be more than $10G including meds.

Did not always feel that info elaborated as much as I would like. Often did not get response to emails

caring and compassionate

Dr Garcia is very nice and caring but not a good communicator for me. I felt that he was not compassionate about my situation of recurrent loss. I switched from Dr Garcia to Dr Kolp at Johns Hopkins. Dr Garcia is very nice but didn't seem as understanding as I needed nor was he willing to think outside of the box to help us. Dr Kolp has a great bedside manner and very open to talking about new and less researched ideas even if she doesn't agree that that is the way to go.

Good for some people but has to communicate in a way that works for you; not good fit for me

Dr Kolp takes the time to explain things very clearly. Front office staff and nurses are friendly and seem to be rooting for good outcomes for all the patients.

compassion

Kind and caring doctor, very patient and understanding...I switched from Dr Garcia to Dr Kolp at Johns Hopkins. Dr Garcia is very nice but didn't seem as understanding as I needed nor was he willing to think outside of the box to help us. Dr Kolp has a great bedside manner and very open to talking about new and less researched ideas even if she doesn't agree that that is the way to go.