Pacific Fertility Center

In the consultation Dr Li set expectations about the procedure and explained options. This included a lot of numbers, and estimated results, which was appreciated. Since then I have not heard from her at all.

Don't expect follow ups or communication.

Dr. Li said we would decide on doing a natural or controlled cycle at a later date, and noted my preference for a natural cycle.

Seems pretty old school and set in his ways. Dr. Chenette is not really open to doing "additional" testing and treatment, even when pushed. His care plan for me involved doing the same thing over and over and hoping that one embryo would eventually stick. He did not seem inclined to explore the causes of my 4 miscarriages (3 natural, 1 IVF) or use my history to inform my treatment. His bedside manner is generally fine, with the exception of how he handled my last miscarriage, which was frankly atrocious and traumatic. The last thing I did at PFC before leaving was a biopsy to test for endometriosis, which he performed during the wrong time in my cycle, rendering my results invalid. I was the one who caught the error and presented it to my care team. I expected better from the medical director of the clinic and with decades of experience.

If you have a very straightforward case (which is often hard to know), he might be the right doctor for you, but do not expect any innovation, thoroughness, or exploration.

I did a pretty standard antagonist protocol. I had a dominant follicle at my baseline ultrasound, so I did 2 days of Cetrotide before starting Gonal F (200 IU) and Menopur (150 IU), then resuming the Cetrotide on day 5 of stims. I triggered on day 10 with Pregnyl (10,000 U). I was a quick responder, so I was quite bloated and jiggly. Retrieved 22 eggs, 20 of which were mature.

I had insurance coverage for most of my treatment with a few exceptions.

Dr Givens was a good communicator, empathetic and professional. She has a conservative approach. She recommended the same protocol 9 times, all which failed, and when I asked multiple times if there was anything experimental I could try she said no, you should think about using a surrogate. Come to find out there are experimental things located within 2 hours of her office. She wrote a paper in 2010 around immunology and IVIG. Her paper was not supporting this treatment, but that's not what I asked. So, if you have a typical case I would recommend her. If you don't and would like to think more outside the box with your treatment, I would recommend you go to another clinic.

If you have a typical case and do not need a touchy feeling Dr, she is a good fit. She is quick, direct and to the point which I actually appreciate. I don't want to hang out at the clinic any more then I have to. If you want a doctor that is going to think outside the box, do research on your behalf and bring you all the latest information available whether she agrees with the treatment or not, she is not the right fit for you.

Round 1: age 36; retrieval using Follistim, Ganarelix, Menapure; great results; recommended against genetic testing as I had never been pregnant before; 29 eggs; 15 embroys (all excellent grade); Fresh transfer of 2 embryos; negative pregnancy test (Dr Given's said it was because I hyper stimulated but I had so many embroys she decided to move forward. Round 2: Frozen natural cycle; cancelled due to lining being too thin Round 3: Frozen cycle using stim drugs to help with lining; cancelled due to me ovulating Round 4: Frozen cycle using progesterone and estrogen injections (Dr Given's called this the gold standard to help with thin lining) Lining only got to a 6. Dr Chenet told me I "needed to buy a uterus" at a lining check but that it was Dr Given's call. I requested NOT to see Dr Chenet at future appointments. Dr Given's decided to give it a shot. Transfered 2 embryos; resulted in birth of 1 baby 9 months later: Rounds 5 & 6: Used same protocol as Round 4 both ending in chemical pregnancies Endometrial biopsy - Dr Given's didn't get enough tissue the first time so I had to do this twice. It's painful and delays the process. Biopsy came back fine meaning we were doing transfers on the correct day Went through the rest of the embroys using the same protocol as round 4 with negative pregnancy tests each time. Now out of of embryos Dr Given's reason was that they were not genetically tested. Retrieval #2: 15 eggs; 6 embryos; 3 genetically normal 2 transfers using the same protocol as round 4. Negative pregnancies both times. Thin lining continued through out each round (between 6 and 7) - reco is a 10 With 1 embro left Dr Given's recommended another retrieval and using a surrogate. I did the research and decided that route was not for me. Moved embryo to a new clinic and started from scratch.

My first cycles were on a special value plan. I can't remember the exact costs but because I was only 36 and using my own eggs I qualified. Everything outside of that was a la carte. My insurance didn't provide coverage so everything was out of pocket. There were no payment plans offered.

Dr Given's and the staff at PFC have a conservative approach. When asked about alternative medicine, experimental treatments, ways of eating, etc. they all seem to blow it off as there is "not sufficient research"

Isabelle Ryan has a very direct, succinct, blunt manner. That didn’t bother me at first, but at a later stage in my care I realized that many crisply communicated statements really glossed over important nuances, and areas of uncertainty. Our meetings were always very quick, and I left thinking I had gotten all the information I needed, but it’s hard to know what you don’t know. As a small example, I was a first-time patient, and it was never communicated to me that at PFC my doctor likely wouldn’t be performing my retrieval surgery. I now know this is very common, but this shouldn’t be communicated to a patient the first time in the middle of a stimulation cycle. Most importantly, I feel she handled my case poorly from a medical standpoint, and made critical errors which, subsequent doctors pointed out, introduced unnecessary risk. She and her care team overlooked disturbing symptoms that I had and, in retrospect, gave me a treatment which was dangerous rather than helpful. This aspect of my case would not apply to most patients, but I think it speaks to a lax attitude about complications, and an unwillingness to take the time to think beyond the obvious norms. Finally, she was coordinating care with an outside specialist, and the communication about the status of this coordination was bad -- I realized months later that the tests from the outside specialist had actually given me the opposite results that Dr. Ryan had used in her assumptions and care.

I probably would see a different doctor unless you are ready to go home and independently fact check what you hear, and almost act as your own secondary doctor.

Before cycling she had my husband and I do prophylactic antibiotics (zithromax and cipro). First cycle (which ended in a cycle cancellation with no retrieval): 3 weeks birth control pills, started 200 IU Follistim & 75 IU Menopur, this was increased but not sure to what levels. Never triggered because cycle was canceled for poor response. Second cycle: Removed IUD; no birth control pills. Estrace priming before cycle start (4 mg daily). At baseline ultrasound start micro-dose lupron (10 units, twice per day); then starting dose 300 IU Follistim and 150 IU Menopur. Trigger 10,000 IU hCG. Resulted in 19 eggs retrieved.

Not sure how much we paid for the first canceled cycle. Second cycle where we did a retrieval was about $12,000, though they gave us a $1,500 discount because of issues in our first cycle, and because we were self-pay patients. This did NOT include all of the lab tests and drugs, which added several thousand dollars, or the $1500 to Natera which is the outside reference lab used for PGS testing.

Recommended eSET with PGS, but did not do a transfer at PFC so it wasn’t a lengthy discussion.

He started with very negative and scary data on our first visit (That has turned out to be debunked) And, one of the protocols ended in a cancelled cycle and I never had that happen on the 5 following ones. Also, the doctors after that were not impressed with the protocol he suggested for the 2nd round after the first one didn't meet his expectations. So, that concerned me too

FSH 240 and ganirelix for the first one. 7 eggs retrieved and 5 were frozen. (This was the best result I had from any protocol, but every doctor after that did more 'complex' ones.) Then a lupron pill for the 2nd attempt, which failed.