North Carolina Center for Reproductive Medicine

Wait time can be long within the office, some of the staff from the embryology department is difficult to understand over the phone, office is calming/soothing, financial staff was very helpful in explaining all fees. The front desk staff were very helpful and friendly as well.

The nurse in charge of IUI/IVF seems very busy and doesn’t always respond in a timely manner to phone calls or emails.

Carla is very clear with information provided but not great at getting back to patients when questions arise. I found emailing her worked much better than calling to leave a message.

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.

The clinic and laboratory seem to be very experienced with the freeze all cycles. All my embryos have survived the thawing so far. I was able to recouperate and rest my body to prepare for my first frozen embryo transfer after the egg retreaval. This clinic seems to be more affordable than most clinics in the research triangle area. Carla, Brenda(the receptionist), and Carolynn are super friendly and caring.

Clinic is very busy at times. If I was not in a current cycle, it is sometimes hard to get a prompt call back from the nurse assigned to me. It was easier to email her.

She was very busy, so it was hard to hear back from her at times especially between active cycles, emailing her was better that calling her. She was very friendly, caring, patient, and understanding. Overall, I had a positive experience with her despite my current outcomes.

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.

They were awesome. For our ultrasounds to see our baby once we were pregnant, we did have to routinely wait in the ultrasound room for about 30 min. Before the doctor and nurse came in, but that is our absolute only complaint. When we saw there was no heartbeat, they changed their schedule around to fully accommodate my husband and I and get us in for our D and C.

They always knew my name as soon as I walked in the door and where I was in my cycle. They also dedicated as much time as I needed when they were with me to answer any questions I had.

Awesome! They were there day and night to answer and questions we had. They had great bedside manner and we loved having them on our team!

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.

Brenda the receiptionist is amazing and so friendly. She gets you where you need to be and addresses any issues going on! Just be patient with them getting back to you as it is a very busy office. The clinic feels like a spa which I greatly appreciate as this whole journey is nerve wracking.

While Dr Toma is direct and can come off as “stern” when you first meet him, he does have a very caring and compassionate side to him. His end goal is to get you your healthy baby, affordably. He explains what’s going on in layman’s terms and then explains how he’s going to fix it. He does take his time with his patients.

His nursing staff is amazing. They are so kind and compassionate. They make you feel like family.

Dr Toma can come across as abrasive at first- however towards the end of the consultation you can see his commitment to getting you the results you want. He does not hold anything back that could be preventing you from getting pregnant and addresses it. He is extremely thorough and does all the testing endometrial biopsy, saline sonogram, sperm DNA,etc). He doesn’t want to waste embryos for things that can be addressed beforehand. I personally really appreciate that because I feel like it’s protecting my future kids and my money from being wasted.

Try to see his abrasiveness in the beginning as a positive. Think of him like the squadron commander of a military unit- he has a mission and he’s gotta have you on the same mindset to succeed!

My AMH dropped two years after my last AMH test. While I have not yet started my stims (will start up in May), he is having me take a prenatal, co-q10, HGH, Vitamin D, and ovasitol to keep my egg quality up. He’s also keeping an eye on my thyroid levels as well.

$4200 not including drugs, the sperm part was $650 and that includes a freeze and the sperm dna assessment.

He will do two FET if they are not PGS tested. Which I have no problem with as we are not planning on PGS testing

This clinic is always there for you and I need given time, their responses are usually very quick and the staff as a whole is just always ready to help and answer any questions you have. They are always available even on holidays and Only a couple times today I have to call the answerin only a couple times today have to call the on call service before I got a response but that was usually only when Rochelle was on call. Carla is seriously one of the best nurses I’ve ever met

He was very blunt in his consultation of expectations which may come off to some people as cocky but I felt more comfortable knowing that he was successful . He and his team seemed to make sure they were available at all times for you Regardless of the day or time

Carlo was absolutely impeccably amazing and made the whole process so much more stress-free than I would’ve expected. She was always very professional and compassionate. Rochelle that works in place of her and very few instances where is sometimes nice but her bed Side manner was not nearly as good as Carlas

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

If you don't get a call back within 3 hours of leaving a message call again until you get someone. They are sometimes lax in returning calls, depending on what the call was for. The reception staff, particularly Brenda, are awesome! The nurses and nurse practitioners are mostly (with one notable exception) wonderful caring people who truly listen. Such a shame their doctor doesn't do likewise.

His PA took one look at my age, said that she thought I was too old and that he would refuse treatment. He came in and started to list all the reasons a woman of my age couldn't carry a pregnancy without taking into account my family history of older women as mothers, or the fact of my wife being my donor. He simply ploughed ahead with his own agenda, and in the end, despite us jumping through all his hoops, passing his tests and a cardiological exam, he still pulled the plug a week or so before our cycle was due to begin - this /after/ we had paid out of pocket for all his diagnostic testing.

Folita was very open and a good communicator on the few occasions we saw her, during our 'class' and when we asked questions of her. It was wrong that it was given to her to pass on Dr Toma's decision. He should have made that call himself, rather than expect her to make that telephone call.

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

Overall the clinic is wonderful, it is clean, neat, organized and well staffed and all the staff is polite and kind and they all care about their patients feelings and what they are going through. I would recommend tis clinic to anyone that is going through fertility issues.

He was very kind and he cared about my feelings, he was very helpful and he wanted but the best treatment for me and he never gave up on me and he still hasn't, also he has a big heart.

They were great,helpful, and considered my feelings and what I was going through.

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.

The nursing staff was for sure a great strength for this clinic. Everyone I interacted with was so kind and compassionate. I felt like I had my very own cheerleaders. The facility had everything you needed as well, so it was nice to be able to go to the clinic for the IVF procedure. I was a bit odd that it shared space with a plastic surgery office as well. I felt more vulnerable knowing that people there were not all there for the same reason.

Dr. Toma really took the time to listen and was no nonsense. I had done my research and work by this time and so I had a lot of questions and he was willing to answer all of them. I always saw Dr. Toma anytime I came in for a check-up or procedure, even if it was just to say hi how are you feeling? That meant a lot to me. I also had an amazing dedicated nurse that was so kind and compassionate.

My assigned nurse was amazing! Carla was compassionate, kind, cheerful, and always willing to answer my questions. She saw me after every visit even if to say hi and sat down with me if I wanted to talk about the procedures, or side effects or anything like that. She was the best medical staff I have ever had.

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.

I loved the clinic. The only thing I would suggest is that the price stay the same. If I come in and it’s offered at a certain price at my original visit it shouldn’t go up by the time I start my meds. This did happen to me but it was only a minor jump

With this being my 3rd fertility doc I wanted a doctor that treated me like family like they cared. Dr Toma is the only doctor that acted like they cared about my outcome

I cannot day enough good things about Carla. This can be a crazy experience with lots of knowledge to retain. Any time I had a question I reached out to Carla and she responded so quickly. I looked forward to seeing her every time I went and she knows her stuff inside and out

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

I loved Brenda, the front desk lady. She was so helpful and very nice. The facility itself was great! Well kept and made you feel welcomed

I understand he sees a lot of patients but while he was doing my saline ultrasound he started asking me questions that he already asked me before. He should have known all that information already.

Carla was great! She answered every question and made sure to repeat instructions to make sure i understood. She always called me back and was very nice and caring. She showed my husband a good technique to give me the shots.

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

Front desk staff and office staff are only sometimes polite and efficient. At other times they are rude and disorganized.

Not much communication directly through him.

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

The clinic is good at communicating with its patients. We are contacted daily about any changes to our protocol. Our nurse is always available via email. The receptionist would always greet me with a smile and get us checked in a quickly as possible.

The team was great. Dr. Toma was straightforward and very knowledgeable and thorough.

Very caring and compassionate.

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.

Easy to work with and friendly. The clinic is well-run and accommodating. Very organized. Flexible hours. Knowledgeable nurses. No billing problems.

He was candid, direct, concerned. Recommended treatment aimed at desired results

Very good. Knowledgeable

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