North Carolina Center for Reproductive Medicine

Bedside manner leaves much to be desired but he is knowledgeable and confident in his treatment plan and manner of approach. He does not sugar coat or coddle patients but is very upfront and businesslike.

Don’t go into his office expecting to be coddled but do go if you want the best chance of pregnancy available in our area.

Utlized gonadotropins Gonal-F and Menopur with deltoid injections versus stomach placement for egg retrieval. It was indicated they had better results with medicine objected into arm versus stomach. Beginning of IVF cycle with 2 weeks birth control then Baseline ultrasound with estrogen levels checked and then ultrasound every 2 days to check follicles/along with labs to check estrogen. Triggered with Lupron to avoid OHSS but because of this fresh transfer is not utilized due to lining issues. Dr Toma does freeze all cycles with a transfer occurring later so the lining can be monitored for implantation success. He indicated that their statistics were higher for FET than fresh transfers. I had 15 follicles, retrieved 9 eggs, 4 were mature, 2 embryos made it to blastocyst with 1 being genetically normal.

Monitoring at the clinic was between 8-9:30 on weekdays and 8-9 on weekends. I also did monitoring locally with my obgyn due to distance to travel. I usually had to wait quite a bit during the monitoring visits depending on number of patients there.

1 IVF cycle $4500 included anesthesia, facility fee, retrieval, ICSI, assisted hatching, & blastocyst culture plus later FET. IVF cycle management fee $500 Monitoring ~$1000 for their package and payment varied locally Medications $3-5,000. Mine were $2500 with $1000 worth also donated to me Medical Screening $1300-2500 (paid by insurance) Semen analysis, freeze, SCSA $650 IVF class $65 PGS Biopsy $2000 with $150 for shipping and $150 per embryo tested. FET meds $96 due to insurance coverage. IVF cycle administrative fee $30.

Dr Toma does 1-2 embryos depending upon the patient and factors specific to that patient.

Bottom line- he will not coddle or sugar coat stuff for you! He can be abrasive at first, but his mission is to get you pregnant with your take home baby. I appreciated his candor to a point- then I felt like he was trying to squeeze money out of me. I do give him credit for finding out what was wrong with me initially, but the drive to fix it was not there. I will say I did not have a good experience with Dr Hoffman. During the saline sonogram and endometrial biopsy he was rough with the speculum and made me feel like I was inconveniencing him (I had undiagnosed endometriosis). He at least apologized, but the damage was done. I had to work with my pelvic PT after the trauma healed. My results for the endometrial biopsy came back positive for an endometrial polyp. Drs Tomah and Hoffman did not want to treat it.

Have your questions ready, do your research, know what your diagnoses are, and advocate for yourself.

Femara, Ovidrel, Claritin and Medrol.

My insurance covered majority of my procedures, my husband had to pay out of pocket because they do not accept Tricare. We paid out $600 for his SA, DNA frag (which we never received the results for) and freeze.

None

Dr. Roma was very professional very blunt. He didn’t waste time with pretty words. He said exactly what we need to do and that’s how it was executed. If I had questions about any procedure it was quickly answered. I was always able to speak directly to the Dr. if I requested him specifically or if I wasn’t sure about a procedure he would explain in detail and also provide research and links were I might find more information.

If you need someone to be subtle in their words Dr. Toma is not the right person for you. His approach works well for some people, but if you need a softer touch or more hand holding he is not the one. I love that he is blunt without being rude or dismissive.

Blood work and monitoring were done only in the mornings between 8-9 am. Good luck if you were in a hurry. They did their best to not keep you waiting long but sometime that depends on what day your blood work and monitoring was.

I believe the total cost of the ivf was around $6000. My blood work was covered by insurance.

My wife and I never felt that he was uncomfortable treating a lesbian couple. He seemed very hopeful and positive. Made it all seem rather simple- Maybe too simple and could’ve found it helpful to go in to a little more detail to cover some parts more thoroughly

Know what is important to you and if not answered, ask. He is very easy to talk to but perhaps may forget that not everyone is as knowledgeable as he Is

We were monitoring my natural cycle and did a trigger shot 24 hours before insem. I had three dominant follicles. But still received a negative test.

So far it has been ever visit is about $95 co pay... $150 for trigger shot. $350 for each Insem with washed sperm. $320 for storage of sperm

Not applicable

Dr. Toma was good at giving a lot of information with data, always explained everything he had to tell us and always made us feel comfortable. We traveled 12 hours to see Dr. Toma. He cared for us and made sure to pack as much into our appointments as possible to where we weren't making unnecessary trips in between treatment.

Since everyone I know is 12 hours away from Dr. Toma, I would recommend him (and I did, I had a friend see him and is currently expecting her first child) because he knows what he is doing and is NOT in it for the money. He just wants to help couples have children

I had a typical round of IVF with ICSI. My first ER was cancelled because I didn't respond to medicine and dropped an egg on my own. For the next ER all of my doses were doubled for menopur and such. I responded well this time. They retrieved 16 eggs, 10 were mature, 8 fertilized and 3 made it to a 5 day freeze. My first frozen transfer we transferred 2 low grade embryos. All meds for me for transfer were also doubled except for my progesterone. This cycle ended up failing. The next transfer we transferred our last frozen embryo. Medicine was the same as last cycle. It also ended in a failure. They said we had poor embryos due to my husbands sperm quality.

Very efficient!

IVF was $5,000. We had to pay additionally for extra sperm samples ($300/ea) meds were all out of pocket. I don't even remember how much we paid for meds, I know it was in the thousands. I had to do monitoring at a home location and paid out of pocket for all of those as well. Which was another couple thousand

He didn't have a strong preference since we didn't have good quality embryos

Dr Toma’s personality is straight and to the point, a little blunt. He can sometimes come off as a little cold, but he doesn’t sugar coat anything, just what you need to know. Be prepared ahead of time with questions to ask because he is busy and will leave quickly if you hesitate with any questions after the visit is over.

Be prepared to ask questions

All embryo transfers are freeze all cycles FET#1 progesterone in oil injections, estradiol in oil injections, estring, antibiotic(around transfer), steriod(around transfer), baby aspirin, progesterone capsule vaginally(morning of transfer). Transferred 2 embryos resulting a positive pregnancy test, but ending in a missed miscarriage at 5 weeks. FET#2 progesterone in oil, estradiol in oil, estring, steriod (started at day 2 and ended at pregnancy test), antibiotic(around transfer), baby aspirin, progesterone capsule vaginally(morning of transfer) Transferred two embryos, negative pregnancy test FET#3 HSG Test performed before this transfer resulting in finding blocked tubes(no toxic fluid) but a normal uterus. Doctor suggested to proceed again. projesterone in oil, estradiol in oil, estring, metformin(to help prevent miscarriage), Claritin(help embryo attach, body not reject embryo), Pepcid(help embryo attach, body to not reject embryo), steriod, antibiotic(close to transfer, progesterone capsule vaginally(morning or transfer), baby aspirin. Transferred 2 embryos resulting in positive pregnancy test, but missed miscarriage at 5 weeks.

Monitoring was from 8-9:30am. If I got there right at 8, they typically would get me right in within 30 minutes, my bloodwork and ultrasound.

$4800 for egg retreaval, first Frozen embryo transfer, storage of remaining embryos up to one year. Didn’t include any medications or injections($3,500 for egg retrieval meds and $500-$1,000 for each embryo transfer meds), monitoring(during and after transfer)and blood tests after transfer.

I did not have my embryos PGD/PGS tested so Dr Toma suggested to transfer 2 embryos each transfer to increase my odds of pregnancy.

Dr. Toma was very knowledgeable and also blunt, which I appreciated. His bedside manner is good but he also doesn’t sugar coat the information he is intending to convey. He micromanaged my cycle which I also appreciate to ensure the best quality care.

Ask any questions you have and be ready to recieve the truth even if it’s not what you’re hoping to hear. Dr. Toma will be very honest with you to ensure the best form of treatment.

We started with bc pills for 2 weeks, then went in for a scan and began injections. We were using follistim 225 and Menopur 75 daily. We also did estradiol and had an ultrasound on days 2, 5, 7, 9, and 11. We introduced Ganirelix on day 6 and used daily until day 11. We triggered with lupron (hcg) on day 12 and had our retrieval on day 14. At our scans, we were measuring around 18 mature follicles, however at retrieval, some were empty so we only had 8 mature eggs. Only 3 fertilized and only one grade 3a made it to freeze on day 5. We did a frozen transfer and carried the baby to 8 week 4 days when we saw there was no longer a heartbeat.

The monitoring appointments were very quick and efficient. They were by walk ins from 8-10am and I would get there by 75 to be the first one seen. I was usually out by 8:30 if bloodwork was done as well.

I don’t remember exact costs but it was significantly lower than my previous IVF cycle with Carolina Conceptions. I want to say it was around $11,000.

I have no opinions because we only had 1 embryo to transfer.

He was to the point, which is great I am an adult and I prefer not to have anything sugar coated. We knew our risks and chances before we even started the process. We went through ivf and had a failed cycle but we plan on going back for another cycle this year and I am choosing to stick with the same clinic I did the first go around. Hes a brilliant man and I trust his decisions fully.

Avoid the bad reviews on him. Hes too the point but that doesn't make him rude, just honest. I would much rather have someone tell me okay here's your chances of having a child rather than someone blowing smoke because they want my money.

My treatment consisted of gonal f and menopur. Then ganerillix shot leading up to egg retrieval. I responded very well to this treatment, they retrieved 23 eggs from it. To prepare for my transfer I was taking progesterone shots daily and estrogen shots twice weekly. I also used the estring preparing for transfer and after transfer.

Had to be in by 9:30 to re ieve blood results by the end of the day but you had lean way a little

Had to pay for ivf and medication. Also monitoring and management of cycle. I spent around 10 grand altogether.

At my age and the fact that my issue is a tubal factor we decided one embryo. Especially with it being my first cycle it was the better option since multiple embryos could lead to multiple births

He is very impersonal. A little like a robot. He is, however, extremely good at his job. If you want a very personal doctor we spoke with another within the clinic we liked, but dr Toma is obviously in charge and calls all the shots. He was always thorough and I appreciated how straight forward he was with medical details.

The clinic is very busy. If you need assistance and are having trouble getting called back email your nurse coordinator. Carla is AMAZING. You wont speak with your doctor directly very often but your nurse will be your best friend!

I did a low stim or mini ivf cycle. All meds were included with this cycle. We chose this because I have Pcos and my AMH was so high. Despite being low stim I still produced 30 eggs. I took 1 vial of menopur daily and I think 100 of gonal f. I was allowed to mix the shots and injected in my arm. Ganirelix was added 4 days before retrieval and I triggered with lupron. Of those 30 eggs, 19 were mature, 17 fertilized, and 7 embryos were frozen. I did one transfer and it took and I am currently pregnant.

We sat in the waiting room and they called us back in the order we arrived. I never waited too long and my nurse coordinator was the one that did the ultrasound so I always had the information right away.

I paid $5900 up front that included all procedures and medication. I paid an additional $450 for freezing more than 2 eggs. I also paid $60 for an initial consult, maybe 100 for the medication class, and $300 each for my husband and I to have bloodwork ran.

My husband wanted to transfer 2 embryos in the hopes of having multiples so we could pay for less treatment. However due to my young age and good health I agreed with my doctor that implanting 2 embryos was too risky because twin pregnancies are harder on both you and the babies.

He is a serious doctor, very professional, he gave me confidence and hope. It is seen that he has a lot of experience and I made the quick diagnosis, I did surgery and everything went very well. I consider him to be the best doctor in this region. Other people recommended it to me because they achieved good results with their treatments.

Have confidence and faith in Dr. Toma, but especially in God, and during the treatment are as calm as possible.

First appointment, I reviewed my medical history, gave his diagnosis, scheduled a surgery, after the recovery, started the treatment with blood analysis, aultrasonido, then explained how to give me the injections and the amounts, during the process I drew blood in days Later, after I had the ovules removed, the second part of the medication was started to prepare and transfer the embryos. We managed to make 4 embryos of good quality and 4 of lower quality. In the transfer they gave me 2 embryos, but it does not result in a positive pregnancy. So they still keep 2 frozen. I do not remember the names of the medicines.

4,950 FIV + medications, and payment of initial consultations. 450 consultation

The doctor explained how many and because he was going to transfer 2. He said that for my case it was the best, since I have a bicornuate uterus.

Dr. Toma presents the facts and is very frank with his patients. He is very thorough and takes into account all of your medical history, diet, etc. He also shares about his own family and tries to help you understand the process so that you can make an informed decision based on what is best for your family. Dr. Toma understands that finances are a huge reason why people are not able to do fertility treatments and tries to make procedures affordable for everyone.

Expect Dr. Toma to be a straight shooter. He knows his stuff and he will give you the facts....good, bad, or ugly. That’s what I like about him.

I don’t remember this information and do not have access to it at this time (not at home).

Monitoring was during the morning hours. There were always a couple of others there for monitoring but I never had to wait very long to be seen.

IVF cost just under $4k plus medications. This was the most affordable option in our area, by far.

Dr. Toma is supportive of transferring two embryos if you are over 35.

I like how direct he was as well as thorough with everything he did to make sure you have the best possible outcome. When we were asking certain questions that pertain to the embryos he was upfront and honest in saying that there are people smarter than him that make the decisions for the best possible outcomes which proved to be true . His personality is pretty straightforward which to me is a positive because I want somebody that is not going to dance around when you’re trying to get answers

He is very directive in the way he speaks but is honest

The strategy of a freeze all cycle is that it will allow you to come down off of all the hormones to create the embryos so that your body is more receptive to carrying the embryos. I firmly believe that this angle of how they do you freeze all cycles is why they have such great results at their clinic

The entire IVF procedure was completely out of pocket however they gave you plenty of details of how to pay for it with financing companies as well as cash discount options

He was open to allowing us to transfer up to two embryos and told us that it was up to the embryologist of which ones they would transfer because they have an algorithm of what will produce the best results

Our first impression of him was that he was rude, dismissive and sarcastic. We are a same sex couple and planned on co-pregnancy, using my (younger) wife's eggs, with me carrying the pregnancy. He took no notice of this at first - not really until we practically 'beat him round the head' with the information. He walked into the room and his first words to us were, "Well I guess you've heard the bad news?" in an overly cheery voice completely lacking in anything even approaching compassion. When we finally got him to 'listen' to us, he relented slightly and listed all the tests that we would have to have/pass before we could proceed. The first of those was for me to be seen by a cardiologist to ensure my heart was strong enough to carry a pregnancy. I was referred to a local cardiologist (of his choice) where I had a stress echo test which revealed that my heart/condition of my heart was normal. The cardiologist said we could go ahead and she would inform Dr Toma. On the assumption that NCCRM would inform us whether that clearance had been received, we made (and were allowed to make) appointments for a) psych eval, b) Donor eval/sonogram for my wife (who is technically my donor), c) education classes regarding medication and administration of medication and d) saline ultrasound for me. He then said he had not seen the cardiologist report and he would 'need to.' but still sent us from the office with prescription for birth control, to synchronize my cycle with my wife's so we could have simultaneous procedures. I had to chase the cardiology report - there was no follow up on the part of NCCRM - and a week, perhaps 2 after I know the report was sent to them (the receptionist called me to tell me they had it), I had a call AT WORK from one of the clinical staff who told me that he had 'advised against' proceeding with the cycle. No one could or would give me more information than to tell me that it was due to the words 'high risk pregnancy' being a part of the cardiologist report, (I've since spoken with her, and she informed me she was basically quoting statistics in that part of her report not referencing me personally). Dr Toma wanted us to come into the office (and presumably pay another almost $200 consultation fee) just for him to tell us no to our faces. We declined/refused that appointment, as we feel that based on our previous experiences with him (numbering 2 occasions we had seen him), he would just continue to be uncompassionate, obstructive, dismissive and rude. When I went in for my Saline Ultrasound, and he came into the room, he did not knock at all, (and could have potentially exposed me to others in the facility had I not been covered), almost knocked my wife over with the door, he opened it so abruptly, and was terse, asking questions to which he had already received the answers, all while conducting the ultrasound. He was not at all gentle... inserting the speculum without warning, manipulating the internal ultrasound want roughly, and generally demonstrating little care or compassion. I felt like a piece of meat. We paid out of pocket for all of this testing, and feel that he knew very well he was going to say no, from the outset, no matter the outcome of the tests, so as well as feeling emotionally brutalized, we also feel financially cheated, and taken advantage of.

Seek another doctor, do not use him.

We did not get so far as to begin any cycles, just the 'diagnostic' testing. Donor ultrasound, and saline ultrasound for the recipient.

It was all out of pocket for us. Initial consult $165, a whole day of testing, psych evaluation and class $465 and Saline ultrasound $450

Dr. Toma is a great Doctor his experience with fertility is amazing he knows what he is doing and treats his patients with the up most respect. He made me feel comfortable with any procedure and he is trustworthy and stands by his words he was great with me and my partner. I would recommend me him to anyone and exactly I recommend him to my best friend and she is very satisfied.

That he is full of great knowledge and care about your feeling.

He did my tubal reserval and he did the HSG test which resulted that everything was still good, he find a polyp in my utrenus and it had to be removed by my ob/gyn he than asked that my OB put me on clomid and if needed to follow back up with him. I have appointment on the 21st of March to see him to consider IVF Because we haven't gotten pregnant yet but the cost is very overwhelming and he just spent so much on the one surgery and the second surgery and as well on all the meds. I trust Dr. Toma and that's why I would like for him to do my IVF.

5300 dollars for my surgery, and than my HSG was 216.00 my insurance covered the rest.

Dr. Toma was very honest and straight forward, he was not afraid to give me all of the information, risks and all. He was willing to answer all of my questions and hear my concerns. Sometimes I did feel like he thought I wasn't aggressive enough with my treatment because he would try to push me toward trying something more each time but we had our financial situation and our sanity to consider. In the end, he was supportive of our decision.

Do your research, ask the questions that you need to ask. Don't feel like you have to agree to all treatments presented, they are options and if you don't feel comfortable doing them yet, then take your time.

First month was on Clomid because Dr. Toma wanted to see what baseline looked like for me. Dr. Toma also insisted I go back on metformin at 1500 mg/day because that was the highest dose I tolerated. Second month he suggested IVF or ovarian drilling because he said I couldn't take anymore Clomid. I had reached the max I could take before I significantly increased my risk of ovarian/uterine cancer. We decided on IVF. After IVF failed, we assessed what might have gone wrong and Dr. Toma suspected endometriosis so he recommended the ovarian drilling procedure and diagnostic laparascopy and hysteroscopy. The procedure confirmed endometriosis diagnosis as well as uterine fibroids. Dr. Toma suggested another round of IVF but we declined due to financial reasons. We decided to try IUI + femara instead, and another negative pregnancy result. After that we were emotionally spent and did two more months on Femera with successful ovulation and no positive pregnancy results. Then we stopped treatment all together.

We were given slots in the early morning for ultrasounds that made it convenient to schedule work around and they were usually on time. Only once or twice I was delayed for work by 45 minutes. Blood work was also convenient and quick. I was never delayed for blood draws.

Doctor visits, ultrasounds, and labwork were covered. the IVF procedure was out of pocket and was $5000. The injectables were covered 80% so we ended up paying close to $2000 for those. IUI was not covered and we paid $600/cycle. The surgery was not entirely covered and we had to pay close to $2800.

He’s very blunt and not delicate in communication, which is ok for me. I have RPL and question doses on my treatment, we started lovenox and steroids for second FET, no change. Miscarried at the same gestational age as first FET.

Be your own advocate, ask the questions, and don’t let anyone dismiss your concerns.

One egg retrieval with standard stimulation drugs. First FET resulted in my 3rd miscarriage. Then completed testing for RPL, two positives lab results. Treatment with lovenox and steroids, unsuccessful. We have only one more try with our remaining two embryos. Then we simply cannot afford another round. Initial excitement turns to fear and now to utter emptiness and sadness.

$6300 for IVF FET $2325

Some said Toma was a tough Doc. I absolutely loved him from day 1. He listed to what I wanted to do offered suggestions but then let me make the final decision. That meant a lot to me to have a doc on my side willing to try what I wanted. At the past two doctors they basically suggested egg donation and didn’t want to entertain me using my own eggs. Toma suggested some supplements to improve the egg quality and then we moved forward with what I desired

Be honest with him. If you are not completely healthy be prepared for him to tell you to get healthy. He only wants the best possible results for you and in order to achieve that you need to take care of your body

Cost was around $6500 for IVF cycle not including meds This included monitoring and ultrasounds

He wasn't very involved, he communicated with me through the Medical Assistant. I never really sat down with him and talked about my care, it was all through her and the nurses. I was referred to him by a friend and I trusted that he is good at what he does but his communication with patients or at least with me could have been better.

To demand to talk to him instead of the medical assistant

I don't remember exact dosages but i did have to increase my usage at one point

The monitoring process was first come first serve within certain hours which worked for me since i had to drive 2.5 hours to get there

I paid about $4000 for the cycle plus $800 for cyst aspiration plus $600 for sperm analysis $60 for medicine class $165 for initial counseling and the medicine i paid about $4000 to the pharmacy Carla sent my prescription to.

We never spoke about the number of embryo transfer. I was expecting 2 embryos to be transferred at one time but only 1 embryo survived so that wasn't even a factor

He was very sweet and direct. But would have preferred to have him more involved. After canceling IVF, he did not provide many options afterwards. I thought he was great, but I was much more pleased getting other opinions and options elsewhere.

Ask questions

IVF was postponed a month due to my AMH results. I was told to take 75mg of DHEA for a month. Then we started IVF at max dosages and injecting in the arm muscles. With not much affect in the beginning, they added days to my cycle to extend it to try and produce follicles. Day 8/9 they cancelled my cycle with 1 follicle only growing.

$5,000 ivf not including meds

Dr. Toma is straightforward. He does not treat his patients like a number. He is very knowledgeable and thorough and makes sure that his patients understand the procedures. I was having some complications early in my pregnancy. He was truly encouraging, but also explained to me how this could play out. I would highly recommend this

Please be patient. This journey is not an easy one and can be enduring. Follow Dr. Tomas orders and trust him.

The cost was very reasonable. We paid $3999 for one full cycle which on included retrieval, transfer, and monitoring.

Candid, direct. Honest. I prefer direct over bedside manner, but if you are a patient who requires a lot of warmth, he may not be the greatest choice. His treatment plan didn't waste time or money in my opinion. It was a great experience. Dr. [Toma] advised the method with the highest probability of success. I appreciated his insight and his direct manner. I was seeking results. We tried a few Hail Mary IUI and Cloud attempts before going all in with in vitro. After the first unsuccessful round of IVF, Dr. Toma removed uterine fibroids and we tried again. This time with success.

Trust him

I don't recall specifics

Cost of egg donor, men's, embryo transfer

He always transferred 3 in order to achieve optimal results

Dr. Toma was very informative during our initial consult. He's not extremely nice or loving but I didnt really need that anyway. He did my egg retrieval all though I never saw him. When I had a specific question, the nurse would get it answered by him. He was great at making adjustments to meds as needed and when my cycle got canceled, made big adjustments for the next time.

Don't expect much compassion or wonderful bedside manner. Just expect knowledge and facts!

My first cycle, I started off with 225 Gonal-F and 2 Menopur powders. The foses were upped when my e2 wasn't rising enough. But then my e2 dropped significantly and the cycle was canceled. My second cycle, I started off with 300 Gonal-F and 2 Menopur but that quickly got moved up again to 3 Menopur. He also uses cetrotitde and lupron to trigger.

I did not get to transfer but I do know that he will transfer one or two because we discussed it in the consultation.

I think he is a good Doctor. I think he may not have a great sense of compassion but he keeps it real. I think he has great reviews and we will never get everything we expect but he has done great so far. Still in the early stages.

If you don't u derstand ask questions and have some prepared when you go.

Well he reccomend that we start as soon as possible due to age and fibroids. We started put treatmeant with vitimans and CoQ10 prenatal fish oil vitamin D, C & E oval vit

We haven't discussed that yet