Kaiser Permanente NorCal

Dr Ikhena-Abel is knowledgeable and caring. I trust her because of her attention to detail with my case. I first saw her when I miscarried my second baby and she showed compassion, yet also eager to get going with my case because of my age. She always responds to my emails by taking action.

Be prepared for her schedule to be booked. She’s a wonderful doctor, but access to her is not easy

For our cycle she prescribed a very aggressive medication regime, ICSI and PGS to try and get as many eggs and embryos we could, but also test them to try and minimize another miscarriage

We were not covered by insurance. Each egg retrieval was a new fee. They didn’t over packages with multiple retrievals, which some friends of mine have had in other clinics. They also were not familiar with federal drug savings plans that other friends got through other clinics.

He's warm but didn't seem to consider my particular situation or priorities much. It was hard to get a response from him because Kaiser encourages you to reach out to the nurse practitioners instead. He was encouraging in that he thought I could eventually get pregnant from lower-intervention methods but didn't consider what my timelines and goals and urgencies might otherwise suggest.

You have to be willing to advocate for yourself and know what your priorities are. Come prepared with questions written down.

Because I didn't proceed to IVF at Kaiser, everything was covered under my plan.

Dr. Farah-Eways is compassionate and really wants to make your dream of having a baby come true. You should note she is quite the multitasker, so when you have an in person consultation or phone appointment with her you may notice that she’s typing/performing computer task while talking to you. Please don’t mistake this for her not caring or not being focused on you and your treatment. At the end of your consultation/appointment you will have a summary in the form of emails with all things discussed, recommendations, plan of care and a detailed summary of your visit. Her typing/inputting things on the computer as she is discussing processes with you, I believe, is her way to ensure that no information during your conversation is missed in the hard copy of your plan of care and that all test you need to have done are ordered as soon as she decides you need them. Because she documents things while she’s talking, you end up having a complete reference in terms of next steps. This is important because there can be so much information, many dates, and timed studies to complete. I’m the type of person that comprehends and processes information quickly, so I prefer information to be delivered straight forward in the form of what the plan for me is, what my next steps are, and when they steps need to be completed. Having a hard copy plan of care with dates/times to complete and contact numbers has helped me feel more control in a situation that can be so out of your control. If you like information delivered this way I think you will be happy to work with Dr. Farah-Eways, also note that if ever there is a time that you feel you didn’t understand or you need to verify what the plan is, she responds best by email to address your concerns.

Understand that she works within the Kaiser Permanente health system, so at times because the Kaiser process calls for systematic approach since they see a greater volume of patients than private REI clinics, you won’t always see her at appointments for procedures such HSG test, IUI or ultrasounds to verify meds such as clomid, femara, etc produced sufficient follicles for IUI. While you have a care plan by Dr. Farah-Eways, these procedures will be performed by her Nurse Practitioners (NP) and not necessarily the same NP each time. It comes down to who is available at the time you need the appointment. As for diagnostic procedures such as Hysteroscopy, endometrial biopsy, trial transfers, and saline sonograms you will see her or one of her colleagues that is an REI doctor. If you want her specifically for those procedures , this goes for IVF retrieval and transfers as well, you would have to wait for an opening on her schedule. If you don’t want to wait there are other REI doctors that can perform the procedures at the earliest date and report the findings to Dr. Farah-Eways. The process at Kaiser works where a REI doctor like Dr. Farah-Eways may be doing diagnostic test 1 day, clinic appointments the next day and IVF retrieval and transfer the all day the entire next week. So if you’re looking to see the same REI doctor/nurse at each appointment and it wouldn’t be okay with you if you didn’t, she may not be the REI doctor for you.

Lab work was completed to rule out any clotting disorders or genetic abnormalities prior to IUI Pre-IUI supplements: -Prenatal -Co-Enzyme Q10 600mg/day -Methylfolate 1mg (folic acid in prenatals may not be absorbed in its form) 2000U of vitamin D (prenatals amount not enough) -Probiotics ( to help with gut health) For each IUI the medication protocol was used to make me have a stronger ovulation and produce more than one egg in attempt to increase the chances of successful IUI. Dr. Farah-Eways confirmed with tests and from multiple previous pregnancies that unfortunately resulted in losses, I ovulate regularly on my own. The progesterone was used to proactively to help aid in preservation of pregnancy if the IUI was successful. IUI was chosen as a first line of treatment because we had not been able to conceive naturally for close to 1 year after our 3rd miscarriage: IUI #1: femara 2.5mg/ twice per day x 5 days Ultrasound day 7 (verify mature follicles) Ovidrel for timed ovulation IUI 24-36hr following Ovidrel injection IUI #2: femara 5mg/ twice per day x 5 days Ultrasound day 7 (verify mature follicles) Ovidrel for timed ovulation IUI 24-36hr following Ovidrel injection Progesterone vaginal suppository 1x/day IUI #3: femara 7.5mg/ twice per day x 5 days Ultrasound day 7 (verify mature follicles) Ovidrel for timed ovulation IUI 24-36hr following Ovidrel injection Progesterone vaginal suppository 1x/day IUI #4: femara 7.5mg/ twice per day x 5 days Menopur 150units 1x/day x 5 days Ultrasound day 7 (verify mature follicles) Ovidrel for timed ovulation IUI 24-36hr following Ovidrel injection Progesterone vaginal suppository 1x/day Neither of the 4 IUIs were successful We had a natural conception 1 month after the 4th IUI attempt. That natural conception resulted in our baby not growing after week 6. I had a D&C in February. Followed by a saline sonogram, endometrial biopsy and trial transfer done in March by Dr Farah-Eways to clear me for the IVF process. The IVF protocol will include a Retrieval with Freeze All and Frozen Embryo transfer so that the embryos can have PGT testing to rule out genetic abnormalities. The medication protocol for IVF retrieval will include Follistim, Menopur, Omnitrope For FET, it will include Estrace tabs, Climara Patch, and progesterone vaginal suppositories

IUI covered by Kaiser Permanente insurance with $20 copay IVF NOT COVERED BY INSURANCE IVF: 1 Freeze all + Frozen transfer $15,455 Meds: $5,000-8,500 PGT testing: $3,500 (hospital fee) plus additional fees paid to outside genetics lab roughly $250/egg or can opt for package deal Each additional Frozen transfer: $4,150 plus meds ($800-1500) Fresh IVF cycle $13,100

Dr Farah-Eways only performs single embryo transfer and cautions against multiple embryo transfer. She informed me that many studies have shown that single embryo transfers have less risk And higher success rate of making it to term live birth

He is very warm and caring. He answers all my questions and responds to my emails promptly. He makes sure both my husband and I understand what is going on. I had a hysteroscopy performed with him and he did a wonderful job making sure I understand everything pre, intra, and post op. He doesn't confuse you will medical jardin and makes you feel comfortable to answer any type of question.

I would say to be patient because everything is a process, and he does give all sides as far as explanation and then he gives his recommendation.

I had an initial consultation with him, and currently are waiting to start IVF. I had a surgery with him prior which was a hysteroscopy. I was on birth control 3 months prior to that surgery and once that was completed I was able to get off it. As of now I am not taking any medications yet

We got an estimated cost based on Dr. Joshi's recommendations which estimate at $23K

For us he recommended a single embryo transfer. He stated that is is much safer, and we both agreed with him

It always felt like Dr. Eways went above and beyond and she truly cared. Never having done this before (but consulted and almost started the process with another clinic) she made us feel safe and explained every step and process and was candid. It didn't feel like I was speaking to someone who was reading a process or procedure out of a book (as with my previous experience), she actually made sure that we understood exactly what was happening, what she was doing, what to expect and what to consider and like we were people with feelings and emotions to consider trying to grow their family and not a next number in line. She was always honest and didn't sugar coat anything which I really appreciated because the process itself can be very stressful so to know exactly what to expect was reassuring. She was always gentle and caring and honest in her approach and when she met with my husband and I, we felt like we were the only patients she had as she never rushed any of our meetings. She treated both of us as a couple and was inclusive with conversation making sure we were both comfortable with next steps and what to expect. No words can explain her genuine, caring and helpful nature. She truly has redefined the way patients need to be handled and treated because her ability to make you feel safe and to build an immediate trust connection (regardless of outcome) is unmatched. We've been SO LUCKY to have had the opportunity to work with Dr. Eways and if we decided to do this again, no doubt in my mind as to who I would be calling. She's been an angel in our lives!

Keep an open mind and trust the process. Don't stress :)

The medication was very straight forward and I was given a calendar with a breakdown of what to take and when and Dr. Eways reviewed it in addition to her staff following up to make sure that there weren't any questions. The pills were easy and when it came time for the shots, it wasn't bad at all and I was able to administer them myself without any issues. There was also blood work along the ways to readjust the amount of medication to take based on how your body was responding so constant check up along the way.

Dr. Eways educated me on options and we talked about transferring one embryo if genetically normal or 2 untested embryos.

I would describe my experience as a patient as perfectly average. Dr. Hirata was nice and approachable but didn't necessarily wow me with information or style. I got the sense that she uses the same approach for each patient, but that could be an unfair assessment. She gave a helpful overview of IUI and the medication options. She was very willing to change courses and order certain tests, but only after I asked for them, so I felt I really needed to do a lot of my own research. She would advocate for me, but only if I specifically asked for something. There were times she was a little forgetful about things we'd done in the past, so again, I had to be quite diligent. After 2 IUIs with her, we decided to move on to IVF, so I had to change clinics because she does not offer that.

Do your own research prior to meeting with her.

First IUI was 7.5mg Letrozole, no trigger shot (we planned to trigger, but when I went for a monitoring ultrasound, I was about to ovulate so she determined there was no need for a trigger). Second IUI was 10mg Letrozole, trigger shot. Both resulted in negative tests. She explained the option of using Clomid, but it seemed to have too many side effects with not as positive of results. She also explained using gonadotropins but said not many people use those with IUI. She also performed an HSG and Saline Sonogram, but only after I asked for them.

I have 50% coverage so the IUIs were each about $200. HSG and Saline Sonogram were about the same.

NA - they don't do IVF at Kaiser Oakland.

In the year and a half working with Dr. Nelson and team at kaiser, we saw him once and maybe spoke on the phone three times. I would have looked for a clinic that would have given us more time to answer questions and outline options.

If you have fertility benefits through kaiser it may be worth it. For those who have no fertility benefits I would look elsewhere.

First he recommended I get an Hsg to rule out tubal blockages. When that was ruled out, we did IUI despite my husband’s poor semen analysis. He referred him to a urologist who gave him some supplement recommendations which helped but obviously not enough because after 3 failed IUIs Dr. Nelson backtracked and said we should look at IVF with Icsi.

386 for IUI, 196 for ovidrel shot, 5 for letrozole, 196 for ultrasound (two per IUI cycle).

Dr. Moy was a great doctor who explained things clearly and showed care for us during the process. She adjusted treatment as necessary and gave us the information we needed to make key decisions. She is very responsive via email, but getting time in person is a bit challenging with the number of patients she has at Kaiser.

Make sure to be informed, ready with questions & ready to advocate. Use your time with her wisely.

Letrozole, Ovidrel trigger shot + timed intercourse & IUI for 3 cycles. Letrozole is usually better for patients with PCOS. I grew ~2 mature follicles during those cycles. Then, we switched to Clomid, Ovidrel trigger shot + timed intercourse & IUI for the 4th cycle where I grew 3-4 mature follicles.

Without insurance Letrozole/Clomid, Ovidrel trigger shot, + IUI was about $800 per cycle. My insurance covered 1/2 to bring my total to ~$400/cycle.

Dr. Moy is very smart and direct. She appeared to be in a rush and mentioned the clinic was short on staff. I felt that she was honest and direct but that in the short amount of time we spent together I had to really dig to get the level of information that I believed I deserved as a patient. Overall she is nice and smart and trustworthy, the issues seem to be be more linked to the time constraints she had when seeing patients.

Be persistent, come prepared with your list of questions and ask her to explain when something isn't clear.

It cost with insurance somewhere around $130 for an ultrasound, $100 for the trigger shot and about $200 for the IUI

Fully understanding how busy Dr. Moy must be worth numerous patients, I still wish I could have been told in person, rather than over the phone, that I have a uterine malformity that makes everything about getting and staying pregnant so much harder. My email and phone interactions with her have shown her ability to be compassionate and understanding.

Be prepared to interact with nurses more than your RE.

For clarity, I have a Unicornuate Uterus with a communicating Rudimentary Horn. To reduce risk, I had surgery to remove the Fallopian tube that was attached to the Horn, and had the Horn sealed closed. Our treatment plan was Letrozole, timed intercourse, a trigger shot, and IUI. Cycle one we started with Letrozole 5 mg a day for CD 3-7. I went in for an ultrasound on CD 12. The medicine worked but on the ovary without a fallopian tube. Cycle 2, we did Letrozole 5mg CD 3-7. At the CD 12 ultrasound, my ovaries and uterine lining showed zero reaction. Blood work showed I had yet to ovulate. So we intiated a second course for this cycle. CD 9-13 I took 7.5mg Letrozole. An ultrasound on CD 15 again showed no response. Cycle 3 and 4, my husband and I decided to take a break for the sake of mental well being. Cycle 5, we did 10 mg Letrozole CD 3-7. An ultrasound on CD 12 showed some activity, but measurements were still less than ideal. We did a second ultrasound on CD 15 to recheck measurements. Uterine lining looked perfect, but the only true growth in follicles again happened on the wrong side. Dr. Moy is urging us to go with IVF as it is the safest option. Since we can't seem to get past the ultrasound to the trigger shot and IUI phase of our treatment plan, she feels this is the best option. Since IVF is not achievable financially, she has agreed to switch to Clomid. However, it is Dr. Moy's belief that we will see similar results.

My insurance covered exactly zero of treatment. Everything was out of pocket. Consultation- $560 Phone appointments- $40 MRI- $811 HSG- $600 Laparoscopic removal of fallopian tube- $3,400 Letrozole- $13 per round Ultrasound- $340 each

Dr. Telles showed compassion and empathy for what I was going through. She agreed that it’s not fair for anyone to have fertility issues and she was very gentle during every ultrasound. She always asked how I was doing first but wasted no time coming up with a treatment plan for my partner and I. When it came time to move on rob IFV she explained the process in an easy to digest way but also reassured me that I was strong enough to handle it.

Write down all your questions and ask them, because she will sit down and answer every single one.

Tracey Telles had me move on from using only injectables for IUI cycles to injectables and clomid for IUI cycles. Before this transition I developed too many follicles and the cycle was cancelled, she then had me move on to IVF.

Tracey Telles prefers women to transfer 1 embryo but is willing to listen to anyone who would like to try 2.

She was incredible and while it was a very long process, we trusted her and she told us more than once she “plays to win”...she is quite the perfectionist, but we appreciated her for that. I was supposed to have a fresh transfer March 2017 but my lining didn’t get thick enough, so she cancelled and had me wait to do a frozen transfer until August. All summer she was trying different medication combos to get my lining thick enough...the August date even got changed a few times and I don’t think my lining got to highest she would’ve liked it to, but she felt good about it and gave us the green light. I highly recommend her. I also remember when we had our initial consultation, that evening she called me just to check in on me. She is extemely responsive as well.

You might find her personality at times rigid because she is a perfectionist but her main goal is to get you pregnant and have a healthy baby, so you just have to trust her. She is extremely knowledgeable.

To get my lining thick enough she recommended acupuncture and she was also OK with me taking the tincture they prescribed. She also adjusted my meds taking me off the estrogen patch and instead having me take it as oral pill and vaginally. Towards the end we ended up adding baby aspirin and eventually vaginal viagra. She also had me on terbutaline to prevent uterine contraction and gave me stronger dose of Valium the morning of transfer. I have a heathy 11 month old :)

From my understanding Kaiser does single embryo transfer and there are some criteria but if it’s not successful then it’s like a buy 1 get 2 free...like 3 tries for price if one. But ours ended up being successful on first try.

Dr. Grosskinsky is a fear monger omg doctor. He told my partner and I that if I didn’t follow his exact instructions I could end up “in a body bag” and my children would end up “on the short bus”. He would blame me if treatment didn’t work. He’s very blunt, has no bedside manner, and doesn’t seem to care if treatment works or not. He found out that I had complained about him and confronted me about it, chewing me out for doing so.

If you must see him, ask if you can record him or have your partner in the room. He made me feel very threatened and having a recording or partner with you makes the appointment more bearable.

Dr. Grosskinsky started me on 3 vials of menapur injections for 3 days. This overstimulated my ovaries. He then gave me 1 vial of menapur for 3 days followed by 4 days of final f. This also overstimulated my ovaries. He never tried 2 vials of any medication. He also refused to see me and do ultrasounds to check on my follicles at times despite my pleading that something was wrong.

I’m with kaiser so my co pay was $5 for almost everything.

I never told Dr. Grosskinsky that I wanted twins or triplets or more. He still felt that he should tell me if I ever did decide I wanted multiples that they would “end up on the short bus or die.”

Dr. Grosskinsky has a great personality and sense of humor. He knows how to lighten the mood during awkward situations without discounting the emotional nature of fertility treatment. He showed genuine concern for my well-being when I presented him with a medical concern that had nothing to do with my fertility treatment. After seeing another fertility doctor I realized that Dr. Grosskinsky may not have been informing me when I was not facing optimal circumstances for IUI but I am not certain about that. Overall, I felt like his personality was a great fit for helping a stress-case like me deal with the realities of fertility treatment.

Ask questions, make sure you understand everything about your process and the recommendations being given to you.

I started with the least aggressive approach; femara pills, trigger shot and intercourse. The second time; femara pills, trigger shot and IUI. The third try; a combination of femara pills and menopur shots, trigger shot and IUI. The forth and final try; 3 vials of menopur, trigger shot and IUI. After that we decided it was time for IVF and started seeing a different doctor.

The medications cost the most, about $600 when doing all menopur shots. The IUI cost about $400 each. IVF through Kaiser will cost about $25,000.

Dr. Hirata was on time and tried to get me in and out of appointments quickly unless I had questions or concerns or fears, then she would sit down and talk me through my anxiety and answer all my questions. She was compassionate and understanding of I needed to sit and cry for a few minutes, always having tissues on hand. She adjusted my medications when needed and always had a next plan of action. She told be the truth about everything without being too blunt or making me feel hopeless.

If you’re a nervous person like I am, go to Dr. Hirata. She’s very good at calming your nerves and having next step plans ready to go.

I believe Dr. Hirata has me start on 50 mg of clomid & then increased it to 75, 100, 150 etc until there was an egg. When we did our first IUI with no success she switched me to letrizol which also didn’t work. She wanted to treat me slowly as to not give me OHSS.

I had a $5 copay per procedure/visit

Dr. Moy is very friendly, has thr ability to explain things to you without bias, and is very knowledgeable about the processes of your diagnoses. She's an amazing provider and with her schedule being so busy, I had to see other providers for follow-up appointments. Sometimes I would prefer a continuum of care with one provider.

Come prepared with questions and or concerns to your appointments.

I did 3 cycles of letrozole, increasing dosages as one cycle with not result to a pregnancy. I've had success with maturing multiple follicles then self-injected the prescribed Gonadotropin to assist in releasing the follicle. Unfortunately, with the three cycles, it didn't result in a fertilization and pregnancy. Now, I'm recommended we go through IVF.

I am fortunate that my insurance covered half of my IUI cycles so each visit would cost me $120; Letrozole pills were about $6.00 per cycle; about $100 for the Gonadotropin injection.

I went to see Dr. Nixon after having been trying naturally for a while. I had already done rounds of fertility medications and over a year of acupuncture. I felt like he explained the cycle and the process of getting pregnant naturally, which I was already very aware of. I went in with specific things I wanted to try and I felt like I really had to push for them and that he wasn't listening to me. But he's a nice guy. Seems caring.

Stick up for yourself. If you already know what you want to do going in, make sure you advocate for yourself.

We started with the typical bloodwork. I already had done a lot of diagnostic work and 3 rounds of clomid. We skipped straight to IUI with letrozole, HCG trigger shot (make sure I ovulated), and an ultrasound (make sure follicles were good and ready).

IUI - $343 New patient visit - $340 HSG - $253

N/A

Dr. Abel listens to you and I loved that she did all the monitoring and the procedures. She is very personable and I was transferred to her care after the initial consult with another doctor in the clinic because I wanted to have my cycle earlier. I was on the antagonist protocol and we were initially concerned about the risk of OHSS, which fortunately we avoided. While the cycle ended in a chemical pregnancy, she offered a lot of suggestions on what to do moving forward and was open to suggestions.

Get her from the start if you can. Ask about supplements.

We used the antagonist protocol because I have irregular cycles and a high AMH. I was on BCP 2 weeks at a time for about 3 weeks before starting injectables. We did ICSI although we didn't have MFI. We expected to retrieve a lot of follicles given the monitoring results but we only retrieved 7 eggs, fertilized 5 via ICSI, 2 fertilized normally and ended up with 1 day 5 blastocyst. Fresh transfer.

You are lucky if you get to the Fremont REI early but there were times when I had to wait an hour.

ICSI was an additional $1,500. My HDHP plan covered 1 cycle of IVF and medications.

We only had one embryo to transfer but the clinic prefers eSET.

Sadly, Dr. Nachtigall has retired so I can’t recommend him to others. My husband and I loved our visits with Dr. Nachtigall. He was realistic, supportive, blunt and kind. The only downside was that we were not able to communicate with him via email as much as he was “old school” and preferred speaking over the phone. We loved our conversations but sometimes it had to be passed through assistants and we would have preferred to speak to him directly.

He has retired.

On our very first visit with Dr. Nachtigall, he told me I was misdiagnosed all these years and that I really had something else - which was causing me not to have a menstrual period and ovulate. He recommended that I start taking medications to prepare me for infertility treatments leading up to IUI or IVF. I was able to start getting my periods regularly with the medications he prescribed. I trust him completely with all of the treatment he has provided. He also referred my husband to the top male infertility doctor within the Kaiser network!

It was covered under my insurance

N/A

His communication was great. He worked with us on what was most cost effective for us. Some times it treatments and medication prices were overwhelming. He let us know I could get medications to get to my next appt then we could do an ultrasound to see how my body was doing. If we needed more meds we would go over it then and not to stress about it.

To go with him his has great bedside manners and is very easy to talk to about treatments

We started with low dose Femara because of my history of migraines. We went in for IUI 1 and my body responded fairly well to Femara. IUI 1 failed. Over the course of our next 4 IUIs we added injections. The last IUI was only injectables. All IUIs did fail. We asked for another opinion from a urologist on my husbands sperm count. We were denied by several kaiser doctors. We decided to look outside of kaiser for another doctor whom we will be seeing next month. I did not have any major side effects from medication. I was a little sick and my body was sore. But that was about it.

Our insurance only overs 50% of IUI and some medications. When we went to our consult. They kept pushing IVF even though we let them know that our insurance wouldn’t cover any of IVF. The doctor almost insisted that we did that without any further testing. I didn’t like that because we were still told IUI was still a good option for us.

Dr. Nelson requests calls shortly after each treatment to review how I was feeling and potential next steps. He always greets each call asking how I'm doing and if I have any questions. He ends each call confirming that I'm clear with next steps and making sure all of my questions and concerns are answered.

Be as honest as possible. He's very compassionate and non-judgmental.

We initially attempted a Clomid cycle with no IUI. Unfortunately, the medication left me with some unwanted side effects so he switched me to Letrozole for the next cycle. After a couple of Letrozole cycles with IUI, we decided to try Menopur with IUI. The Menopur did not yield greater results so we resumed Letrozole and waiting for another IUI. Dr. Nelson did recommend IVF after our first consultation but due to costs, we decided to go this route.

My husband has a good health insurance plan so costs of medications and co-pays are minimal. His insurance covers IUIs but does not cover IVF. Insurance through my employer does not cover IVF and IUI costs are higher.

Dr. Nelson was an IVF doctor but Kaiser does not offer that service at the Oakland facility so he did not make any recommendations regarding embryo transfers.

When I first met Dr. Nelson, we had a lengthy appointment to go over all of my lab results and talk through next steps. It was a lot to absorb since I was just starting this process. He took time to answer all the questions my husband and I had at the time and really provided a lot of information. He was super attentive, thoughtful and a good listener. However, I realized later that when I left, I really wasn't sure how to move forward. He talked through all the benefits of IVF but didn't necessarily recommend that I start that immediately. Should we just keep trying? How soon should I start fertility treatments? At what point do I need to seriously consider or move to IVF, etc? I had a lot of information but really wasn't sure how to move forward. After a couple of months with no success, I expressed this frustration to him and we started putting together a plan. One of the hard parts about this process is never knowing when to start something different. I kept getting pregnant every few months, which gave me hope but the pregnancies didn't last. Once I expressed all of this to Dr. Nelson, he was really helpful in starting to put a plan together, which included beginning to take medication and then a few months later moving to IUI. Kaiser has a team of fertility doctors all working together. Every month I would put a plan together with Dr. Nelson but wouldn't see him for my visits; my baseline appointments, my check ups just before ovulation and IUI were all with other doctors. I would then have a phone appointment with Dr. Nelson around the time by period was due to talk next steps and a potential plan for the next cycle. At first the interaction with all of the other doctors was a little challenging, this is hard and emotional and it was difficult for me to share some of this with a small group of physicians, even though everyone was professional and thoughtful. After a couple of cycles, I got more comfortable with the process and the team. Since I have been unsuccessful with IUI, I'm now beginning the process of preparing for IVF. Dr. Nelson used to perform IVF and has a wealth of information to share about the process, what to expect and how my body might react to the medication. Although I have watched videos and read books about the process, his consultation has been comforting and really informative. I feel like I understand the process much better and what I might expect. Overall, Kaiser moves slowly with fertility- I was frustrated by the initial process of getting my lab work done, identifying needed tests and treatments. As a patient you have to be really proactive and articulate what you are looking for and what help you need. Once the process started moving and I got connected with Dr. Nelson, it was important to maintain regular communication and let him know what I was looking for and what questions I had. Once he was aware of what I needed, we mapped out a plan for my care and how best to move forward. Overall, I have been really happy with him.

Think about your questions ahead of time (if you can) and be upfront about your needs. He has a ton of information but none of that matters if he doesn't know what you are looking for. He is much more comfortable with phone calls than email but his schedule fills up so its good to get on his calendar regularly.

We tried three cycles of ovulation stimulation (one round of clomid and two of letrozole) with timed intercourse. When those didn't work we tried three rounds of IUI- all with letrozole. I initially wasn't ready for IUI so we tried the first process to see if we had any luck and then moved to IUI. I got pregnant my second cycle with IUI but my HCG levels were low (around 10) so I knew the pregnancy wouldn't last. I got my period 3/4 days later.

I have good health insurance coverage for Kaiser so all of my appointments and treatments were covered. I had $10 co-pays for some medications but overall very little out of pocket costs. If I move to IVF- at Kaiser or elsewhere none of those services will be covered.