Pacific Fertility Center

Dr. Givens was the first Reproductive Endocrinologist that we met with nearly 10 years ago. After being told by many doctors that my case was too complicated and highly unlikely that I would ever get pregnant, Dr. Givens was forthcoming and honest, yet hopeful and willing to try to help us. She has never promised the impossible, always staying honest and upfront. Despite our odds, she still offered us hope and optimism, finding a way through where there has been one. Our case has certainly had it's ups and downs, yet Dr. Givens has helped us feel like valuable humans, and not just another patient. We started our journey at PFC with 4 IUI's, prior to moving on to an IVF cycle. She has always presented our options honestly, helping us make the best call, all while being conscious of our financial means. These procedures were very tricky for us, as I only have a tiny piece of one ovary left. Additionally, I have severe endometriosis, one tube left, a history of PCOS, and a complicated multiple abdominal surgical history. Our journey has been an uphill battle. After moving out of the Bay Area, we sought care at a different clinic due to living hours away from PFC. We attempted another IVF, but it was a bust after no eggs were retrieved during that cycle. We were devastated. Though the RE at the other clinic was nice, it was such a different experience. There, we felt like the doctor/patient connection was just lacking. Gratefully, the opportunity to return to Dr. Givens presented itself and we jumped on it! Being back under her care reminds us that we don't have to feel like we are just a number. This time moving on to FET with donor embryos, we now travel 3 hours away to see her, because she is worth it! In an amazing, yet heartbreaking development, she was able to do what felt like the impossible. After 12 years of infertility, she helped us get pregnant through the gift of embryo donation! Unfortunately, we lost our baby girl a day shy of 14 weeks due to a developmental abnormality. This loss was purely a rare phenomenon, having nothing to do with fertility treatments, genetics, etc. Through our heartbreak and pain, Dr. Givens personally called me to check in, and has provided support like we could not have expected. This kindness from her during our time of grief has only grown our appreciation for the amazing woman that she is. She truly has a heart of gold! It feels like Dr. Givens truly wants us to have a baby just as much as we do, and she is alongside us in this complicated journey. Always professional, and still she has come to feel like family, and that is rare in my experience with other doctors. Our journey is yet to be finished, as we are in the process of another FET with our donor embryos. Regardless of where this journey takes us, we wouldn't want any other doctor by our side, directing and advising us. Dr. Givens will always hold a special place in our hearts! Her care is irreplaceable!

Come prepared with questions, and be open and willing to listen. As a patient, I like to be informed and have always been prepared with my list of questions. Dr. Givens is very intelligent and also willing to explain when you need it. If you are a patient that advocates for yourself, Dr. Givens seems to value that.

Our first course of action years ago began with IUI's. At the time, financially, IVF was out of the question, so opted to try IUI's before moving on to the more expensive options. As time went on, I had a few more surgeries for my severe endometriosis. This likely being the reason for the unsuccessful IUI's, we had to move on. Our first IVF cycle, we learned that my body took longer to respond to the medications that the average patient. Knowing that I have DOR with a very small piece of one ovary left, Dr. Givens stayed the course. Despite the odds, 7 eggs were able to be retrieved, which was practically a miracle in my case. This IVF resulted in a chemical pregnancy. Since moving on to FET with donor embryos, Dr. Givens chose to do a controlled cycle, working with the fact that I have not been having regular cycles these days. Our first FET was a success using this controlled cycle. Though we are now on to our second FET due to a second trimester miscarriage (unrelated to this fertility process), Dr. Givens has us sticking with the controlled cycle again since it worked for us the last time.

Dr. Givens has always been very helpful and conscious of our financial means over the years. She lays out all of our options and has been honest when things are necessary and also unnecessary.

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.

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.

Dr. Agard was always so warm and made me feel so comfortable! I am a bit of an overthinker and always had so many questions (and anxieties) yet she was patient with me wanting to understand all the details and ask all the what ifs, and reassured me without being dismissive of my concerns - I really got the sense that she's got you. She also has the BEST laugh that just puts you at ease.

Don't be afraid to ask questions!

For egg retrieval we did menopur, follistim, ganirelix and she was great at tracking and adjusting as needed. A different Dr at PFC did my retrieval, and we ended up with more eggs than we thought we were going to get, and were really lucky with how many PGS embryos we ended up with. We then did a partially natural/medicated frozen embryo transfer (with Letrozole and natural ovulation) that was unsuccessful. Then she encouraged me to do an ERA so we could have as much data as possible, and we did in fact need an extra 12 hours of progesterone. Then we did another fully medicated FET with estrogen and progesterone shots, which was successful!

Most of our cycles and medications were covered by insurance, but we paid for the embryo biopsy (~$4000) and genetic testing (~$150 per embryo) out of pocket.

As I mentioned before, he treats me like a human being with feelings that are valid. He also has a very calm manner, which puts me at ease.I also never feel rushed or as if he does not have time to speak with me, be it in person or via the phone.

Be upfront with him, and he will treat you the way you want to be treated. He will respect your wishes and will not let you do unnecessary treatments just to make the clinic more money. He told me I could still attempt IVF with my own eggs, but that I would most likely end up right back there 3 months down the road with no embryo's and out $30,000. I appreciate that in. a physician.

I haven't actually done any myself. My sister donated eggs for me and went through one round of IVF. As far as I know they were very good at adjusting and gaging when to up medicines during the stimulation cycle and about guiding her through the process. I am waiting on our SIP to be lifted, so that I can start my FET protocol. They want to do a medicated cycle with medication assistance. Estrogen and Progesterone.

$21,000 for my sisters IVF cycle. $4,300 for one FET, does not include meds $375 initial intake consult $395 meeting with Psychiatrist for working with third party (donor eggs) $275 for meeting with genetic counselor, all additional follow ups associated were included

At PFC they only transfer 1 embryo at a time. Which I agree with

It seemed to me that Dr. Li adjusts her tone and demeanor to her patients' needs and personality. She was sensitive to the feelings in the room on any given day and that is an important quality for me when looking for a doctor. I would recommend coming prepared with multiple questions to appointments so Dr. Li can address all your concerns adequately. While I don't think appointments were rushed, it is a very busy clinic...Dr. Li offers phone follow-ups should questions come up and we did do that quite a few times.

Come prepared with questions. I'd also recommend doing your research before appointments to ask about her reasoning behind her recommendations. It helped us understand more about the process of IVF and our particular case and made us feel more at ease knowing that decisions were made based on our individual medical history - not clinic statistics.

We came to Dr. Li after three cycles of clomid - one resulting in an early miscarriage - and an initial consult with Kaiser Permanente Fertility. She recommended IVF from the start as the more effective treatment to achieve our family goals, but also said we were good candidates for IUI (based on age and the fact that we've gotten pregnant before, all our testing looked normal, no tube blockages). We did two Letrozole IUI cycles - both times the sperm count and motility was very good. After that, we moved on the an Antagonist IVF cycle - Follistim/Menopur/Ganirellix and about 5 monitoring appointments during the cycle. The procedure doctor on the day of my egg retrieval was Dr. Givens, who also did a hysteroscopy a few weeks later to remove some small uterine polyps. Out of 22 eggs, 12 embryos developed and 7 were deemed normal after PGT-A testing. We proceeded with a rest month and a frozen transfer of one embryo - the transfer was done by Dr. Li.

We spent about $30,000 total on all treatments and medications, incl. FET, hysteroscopy and PGT-A testing of 12 embryos.

Dr. Li had a strong preference for eSET due to the potential risks connected to a multiples pregnancy.

Dr. Herbert offered to explain everything and will answer questions if I ever have them. The office staff are very prompt and responsive. Office is busy, so I didn't get to see Dr. Herbert at every visit, but that was okay. Although there is some setback and delay with my cycle, the clinic is always in touch to keep me updated.

It's just important to ask questions. He will not go into too much detail unless you ask him the questions. Make appointments ahead of time because he is busy.

We decided to have an egg donor , with a frozen embryo transfer cycle after viable embryos are retrieved. Because only 1 viable embryo was retrieved after PGT testing, Dr. Herbert offered ERA cycle as a diagnostic test to increase success of the transfer. He offered advice and information when we were disappointed with only 1 embryo retrieved. We have not gone through the frozen embryo transfer but the coordinators and staff are always ready to help us through it all

It was costly, mainly because it's in San francisco and is a very lovely, professional looking office that takes up the entire floor in a decent sized building. Compared to other couples undergoing same protocol, I believe we paid noticeably more. But it's a good group of doctors, nurses and coordinators.

The clinic strongly endorses eSET transfer, which is a safer approach and I agree after doing my own research.

She is a wonderful doctor and we couldn’t be any happier with the results. I trust her completely and if I could do it all over again, I would still choose her as my doctor. I saw her over the course of 5 years. We originally went in just to do embryo cryopreservation, but along the way, I found out that I had a genetic kidney condition, adenomyosis, and only 1 working ovary. So we went through the whole process with her (3 cycles with PGD and PGS testing) and transferred when we were ready. The only reason we had to do 3 cycles was because I only had 1 working ovary (50% less follicles), and then PGD testing would cut that number by 50%. So we did several cycles and batch tested them all at once, rather than testing after every cycle. We ended up with 6 PGD/PGS tested embryos. When we were ready to transfer, 8 months later, our first transfer woth her was textbook. We ended up with a very healthy baby boy. We came back a year and a half later to try it again for a second, and Dr. Li started my treatment by trying to prevent my Adenomyosis from growing in preparation for another transfer, but that transfer ended up in a chemical. When it didn’t work, Dr. Li immediately did her best to give us all of our options and added a few changes to my treatment (such as adding an ERA cycle to give us more information) to help with the next transfer. I ended up pregnant at the next transfer, which was just a couple months later. So out of 3 single embryo transfers, we ended up with 2 pregnancies (I have a 2 year old and am currently 5 months pregnant)! So we are very happy with the results. I saw her on most of my visits, she did 2 retrievals out of 3, and she transferred all 3 times. Throughout all of this, I was always able to either schedule a call with her or contact her nurses and get an immediate response with any questions. They often follow up with me, even through my pregnancy, though I’m now under the care of my OB. I have been very satisfied under her care and under her team’s care. I know every circumstance is different, but Dr. Li is an exceptional results driven doctor who is very caring and compassionate, and I would absolutely recommend her.

Don’t be afraid to ask any questions or reach out to her team. She is very nice, and her team is very responsive!

I don’t remember specifics, but I do know that all of her strategies were effective, and she was very on top of monitoring me in case any changes needed to be made. I did not feel disappointed at any time, or feel like we should have done something different.

- Cycle Fees: Approx 13K - PGD and PGS Fees paid to Lab: Approx 6K - Medication paid to Pharmacy: Approx 3-4K - FET: Approx 3K

I was very confident in elective single embryo transfer at this clinic because they have very high standards when it comes to which embryos make the cut. They only choose the highest quality top grade embryos, and I am confident with that method. The process of transfer can be very exhausting, both physically and mentally, and I would only want to go through with it with high quality embryos for a higher success rate. Aside from that, there are a lot of risks associated with multiple embryo transfer, both to the mother and babies. So I’m happy that PFC only does single embryo transfer.

Dr. Ryan was very professional and compassionate during all of my appointments. She took the time to answer all of my questions and always kept me updated on where I stood in the process of my egg retrieval, embryo transfer, and post care. She is very blunt and that may turn some patients off, but I do enjoy that style because it helped me truly make realistic expectations for our treatment and make informed decisions regarding my care. This was a big help to me emotionally because it helped me stay grounded for whatever the results would be after all of our processes that include egg retrieval, genetic testing of the embryos, our own genetic testing, and chances for success with the embryo transfers and preparation of the lining. She even went as far to recommend an ERA test prior to our actual embryo transfer due to my medical history and we were allowed to do our own research and make the decision to proceed or not on our own. She did not pressure us either way. That proved that she was really paying attention to my health history and was doing all that she can to increase our chances of a successful transfer. Overall, I really enjoyed working with Dr. Ryan and her approach to care really meshed with my expectations and made me feel confident with every decision along the way.

One piece of advice to those prospective patients of Dr. Isabelle Ryan is to do your research prior to your first consultation. Come prepared with questions you may have and really use that time to dig in and have a deep conversation about your possible treatment, areas of concern, and get her opinion on your overall chances for success given your medical history and reasons for infertility. When you come prepared, that will instantly make your appointments more meaningful and keep you more informed to make decisions regarding your own care.

Egg Retrieval Treatment included daily dosages of follistim and menopur, and later included ganirelix. This was successful and resulted in 43 eggs retrieved. ICSI was used to combine my eggs with my spouses semen to produce embryos. We then proceeded with PGS testing for the resulting 9 embryos that made it to day 5. Of those 9 embryos, we had 3 healthy embryos with no chromosomal abnormalities. We also did ERA testing to make sure my lining would be receptive prior to the actual embryo transfer. Once the ERA testing came back, we proceeded with the Frozen Embryo Transfer based on the timing listed in the ERA report. Due to my age, we did ESET and implanted one embryo which has resulted in a pregnancy.

Genetic Consult - $395 Horizon Screening - $199 Medications - $2500 Single Cycle Fee which includes Office Visits, Ultrasound, Estradiol, Anesthesia, Egg Retrieval, Facility, Lab, Embryo Freezing and one year Storage, Embryo Biopsy - $13,915 PGS Testing on up to 8 embryos - $2170 ($325 for each additional embryo) Frozen Embryo Transfer - $3175 ERA Testing - $1000 + $600 for actual test at Natera

I appreciate Dr. Ryan suggesting we go with eSET instead of multiple embryo transfers because of my age and high risk pregnancy if we were to have multiples. I agree with her approach and it showed that she was not only focused on doing everything she could to increase our chances of success, but also was looking out for my own health. She took the time to explain her reasoning and I was confident with this approach given all of the facts.

Dr. Chenette is unequivocally the best fertility specialist. From his personal deamenor to his experience as a fertility specialist we believe there is no one better. We would go to him time and time again. We did extensive research and interviews with other fertility specialists before choosing to go with him and we are so grateful we did.

The clinic (PFC) is busy and you may not get Dr. Chenette for every appointment if your schedule is not flexible. You will not regret choosing him.

I had a say in all my treatments. I was given options, along with their strengths and weaknesses. Dr.Chenette was my advocate, he gave me the options and essentially let me chose what I wanted. I chose injectable cycles for both egg retrieval and FET due to the discussion my husband and I had with Dr. Chenette. He (Dr. Chenette) believed it would be the most likely to succeed. And it did.

Roughly 25k for all treatment and medication.

We did an eSET FET. Our embryos were extensively tested, genetically. Once again Dr. Chenette went over the risks, pros and cons of eSET and multiple embryo transfer. He highly suggested for an eSET and we agreed.

Dr. Li has been a great partner through this journey. She seems to truly care about her patients but is still very honest about the situation. I appreciated how she showed me all my options in a delicate but clear way. She gave her educated advice but never pushed me in one direction or another.

While Dr. Li is a great doctor. You may not always get her as your doctor for each check up. She does her best to be there for critical decision time appointments,... but if she is not working that day or is already booked and you happen to need to do an ultrasound checkup, you might get someone else. And the other doctors that I have had have been dismissive and not helpful.

Dr. Schriock is thorough, sharing the right level of detail and thoughtfully answering all of my questions. His demeanor is friendly, patient, and calm. He was realistic with me about my potential outcomes and was proactive about tuning my protocol to try to improve outcomes. He found a protocol that was ultimately very effective for me, and I was able to achieve better results (egg freezing) than I was expecting.

Do your research and ask the questions that are important to you. He will take the time to answer them and work with you on the right path for you.

For egg freezing, I did: - 1 cycle with follistim + menopur protocol, with a HCG trigger, which led to average results. - 2nd cycle with lupron, follistim, menopur protocol, with a HCG trigger with similar results. - Moved to a clomid, follistim, menopur protocol, with a HCG and Lupron trigger, which led to great results. I did 4 freezing cycles with this protocol.

Most of my costs were covered by insurance.

Dr. Li showed a genuine interest in us and was open to new things that we wanted to try the second time around. She always wrote very clear instructions on our charts so that when a new doctor picked it up on a weekend (when she wasn't working), they were able to understand it without any confusion. She was always on time, yet never rushed an appointment. There were times when I would be crying in her office, and she kept it together yet showed sympathy and care all at the same time.

Ask a lot of questions because she will answer all of them.

We found out my husband suffers from azoospermia due to varicocele veins in the testes. He had the veins repaired, but sperm counts are still too low to conceive naturally. For my first egg retrieval, we used Menopur and Follistim, then Ganirelix and Lupron. They retrieved 38 eggs, 29 of which were mature. We had to do ICSI due to low sperm counts. We ended up having zero fertilization, meaning no eggs were fertilized. We aren't 100% sure why, but all parties assume it was due to my my husbands poor sperm quality. We then decided to try it again, and the second time to add Human Growth Hormone into the mix, and kept all other injections the same. We also tried oocyte activation the second time around to give the fertilization process an extra boost. They retrieved 47 eggs this time, and 39 were mature. We decided to inject 20 eggs with the best sperm we could, and freeze the other 19 eggs. This was my decision, and Dr. Li supported me in that. I just didn't want to have to do another egg retrieval if we experienced failed fertilization again on all eggs. We ended up having 11 eggs fertilize, and 4 made it to blastocyst. We sent all 4 for genetic testing, and all 4 are now frozen. We are getting ready to begin the transfer stage where we will transfer 1 embryo.

This stuff isn't cheap! But, the financial coordinator explained what you were being charged and for what. They also tried to help you get coupons for injections. They also told me when I could get blood drawn at other labs that my insurance covered.

Because the underlying issue is on my husband's side, and we have 4 good embryos, my doctor suggests only transferring a single embryo.

I like Dr. Ryan a lot. I've read some reviews critiquing her "bedside manner" but I only experienced her positively. My partner and I were trying a second transfer with an embryo created using his sperm and a donor's egg. Unfortunately, it resulted in a negative pregnancy result, which was deeply disappointing, as it was our final option at PFC for transfer. Dr. Ryan was very caring, however when I pressed her about next steps and diagnostics, she stated that she did not think anything was "wrong" with me, and that she would want to do 4-6 more transfers before doing any diagnostic procedures. This, of course, sounded crazy to us - from both an emotional and financial point of view.

Even though we did not get the desired result, she seems like an excellent doctor and was very caring.

We did one IVF transfer, with a tested, euploid embyro created with my partner's sperm and a donor egg. I took estrogen and progesterone leading up to, and for a couple weeks after, the transfer. There was no pregnancy.

$25,000

Strengths: Set realistic expectations on number of eggs expected; explained what he was observing during the ultrasounds and when he was reviewing blood work in a clear way Weaknesses: Not warm and fuzzy, if that is important to you

He is objective and clear, but not a cheerleader if that is what you need

My protocol was the following: Follistim 200 IU for first 4 days Menopur 75 IU for first 4 days -- Ultrasound & estradiol test; medication adjusted Menopur 75 IU for 3 days Ganirelix Acetate 250 mcg for 3 days Follistim 225 IU for 3 days -- Ultrasound & estradiol test; medication continued Follistim 225 IU for 2 days Menopur 75 IU for 2 days Ganirelix Acetate 250 mcg for 2 days Retrieval injection for retrieval 36 hrs later

Medication costs were $2000-2500; doctor's services were $9000

NA

Dr. Herbert has a very straightforward manner but I don't mind it. I still felt I could joke or cry with him. Anytime I had a question and arranged a phone call I felt he took time to answer my questions. Most notably, the month I was set to begin I was extremely sick and at my baseline ultrasound pretty upset because my follicle count was lower than it had been at my consult ultrasound. He explained my options to me (go for it or wait a month to see if the count would be better). As I became increasingly upset, I think he could see how devastated I was and suggested I wait/get better. It was most definitely a human moment. There was one instance that stung just a tad, but in the moment I called him on it and I truly believe there was no ill intention. During my consult when discussing options, he assumed and suggested at some point I would pick a sperm donor. I joked and reminded him that finding a future partner was still an option. I did sort of feel just in that initial consult that some added sensitivity around me being there alone as a single person would have been nice. I only felt that way during the first appointment. In my subsequent calls or ultrasound appointments I don't recall feeling that way.

It's a piece of advice I plan to use myself which is to understand more what my blood test numbers mean/meant. During my consult, my mid-cycle ultrasound provided a surprising number of follicles as compared to my blood tests. However once I began treatment it seems what I'm seeing is more in line with those test results. I now feel I have more questions and want a better understanding of all my options. Additionally, I would say if warm and fuzzy is what you're looking for as a patient this may not be the best fit.

It was suggested I take Vitamin D, a prenatal and Co-Q-10. I had a very bad reaction to Co-Q-10 and after playing with the dosage and timing, we just sort of agreed I was done with it. I was put on 300 Follistim and 150 Menopur. After an injection class, once I realized everyone was on different meds, I did call to inquire how these decisions get made. I would say I was not super clear on the answer and now that I'm in the cycle again wondering if different meds or doses would work better (questions I now plan to ask). It's too soon for me to comment on results.

More than $10,000 when you factor in medication. Between 8-9k not counting medication.

NA

Dr. Ryan is very direct but I appreciated her frankness. It allowed us both to have open and authentic communication about expectations, treatments, and procedures. I felt very confident in her treatment decisions. We felt like she was our strongest advocate.

Have open and authentic communication. Feel confident in taking her advise as well as making the decisions that are best for your family, she will support whatever is the best decision for you.

I feel like Dr. Ryan nailed my medication dosages perfectly. I once saw another doctor at the practice for an ultrasound and he changed my medication dosage. After reviewing the doctor's recommendations Dr. Ryan's team called me shortly after my appointment to negate the other doctors recommendations and to stick to Dr. Ryan's protocol. I got excellent numbers for my retrieval and I think Dr. Ryan's medication dosage is one of the contributing factors to that.

$25,000

Dr. Ryan encouraged elective single embryo transfer over multiple embryo transfers, which was on the same page as us. But I also feel confident Dr. Ryan would of supported our decision even if it differed from her recommendation as long as it was safe.

I have only been through the first half of one cycle so far: stimulation drugs and egg retrieval. Dr. Schriock. However my husband and I have already been unusual patients because my husband was hospitalized and had a few procedures to determine if he had lymphoma right before and during my cycle. Dr. Schriock spoke with us personally when this came up, listened well and gave advice. In our first meeting with Dr. Schriock I was a little overwhelmed by the pace of his information delivery, but every meeting after that I felt he listened well and responded to me as an individual.

If you take some time to think of questions make a list before your appointment, and be prepared to ask him to slow down if necessary .

Dr. Schriock initially seemed good. He was the first doctor we worked with, so we didn't have much to compare. He is definitely more of a facts and figures guy. He pulled out all of the stats to show that at my age and with my ovarian reserve, it would be ideal to attempt an IVF transfer using an embryo created with a donor's egg. He was encouraging and we had no complaints as we prepared for the first transfer. I did get pregnant, but the embryo did not develop, and I ended up having a traumatic experience clearing the pregnancy- including two rounds of medication, hemorraging, and an emergency D&C.

I'm not sure I would recommend Dr. Schriock given so many other options in the Bay Area. He gets good reviews from other people, so I don't want to be negative, but I did not have an amazing experience.

We did one transfer with Dr. Schriock, using my partner's sperm and a donor egg to create an embryo. PFC does not test donor egg-created embryos (or they didn't in 2017), so we transferred the untested embryo and it resulted in a short-lived pregnancy and miscarriage. The only medications I took were estrogen and progesterone leading up to the transfer, and in the first weeks after transfer.

$25,000

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"

Dr Schriock has been very open to our questions, to trying slightly different approaches to our cycles, takes our feedback and input seriously and continues to apply current research to our situation. He has been open to trying things that may not be scientifically proven, but seem to make a difference for me in getting a positive pregnancy result. He has listened to us and while he gives us his medical opinion, there are decisions we are able to make based on the info he provides (rather than being told what to do). He's very open to collaborating with others and when we realized we were dealing with recurrent pregnancy loss, he created the path for me of what doctors/specialists to see (outside of the clinic) so that we could all come back together with all the info gathered to create a next step forward. He brings a wealth of knowledge and expertise to the table and when I feel all hope is lost, he brings some hope back to us.

Don't be afraid to ask questions. Even though you are the patient, be your own advocate. Speak up for what feels right for you and your situation. Dr. Schriock will answer your questions and listen to your concerns and ideas, so speak up! He tends to talk quickly so make sure if you are not done talking, or still trying to process what has been said, ask him to repeat it. Utilize Dr. Schriock's care team for asking questions during your cycle.

My IVF cycles were in 2012 and 2013 so I don't recall the precise protocols. For embryo transfers post-IVF I did a few natural cycles but then had to cancel a cycle as my body was not cooperating. For the majority of my embryo transfer cycles, I have done "controlled" cycles with Delestrogen (20mg/ml) and Progesterone in Ethyl Oleate (50mg/ml). Delestrogen is a twice a week IM injection, then Progesterone is added in 6 days prior to FET and is a daily IM injection and would continue through 10 weeks of pregnancy. One of our treatment strategies we have tried several times is to do an endometrial scratch the cycle prior to the FET cycle. While there is no conclusive evidence that this will increase the chances of pregnancy, my last two pregnancies followed this plan. (these pregnancies ended in miscarriage). Results: IVF#1: pregnant but lost at 15 weeks IVF#2: negative 1 more FET with own eggs - negative Donor egg IVF Results: (I believe these were all controlled cycles) Donor FET#1-not pregnant Donor FET#2 - pregnant twins/lost pregnancy (did endometrial scratch prior to FET) Donor FET#3 - chemical pregnancy Donor FET #4 and #5 - negative Donor FET #6 - pregnant twins/lost pregnancy (did endometrial scratch prior to FET) Donor FET #7 - negative (did endometrial scratch prior to FET)

IVF #1 and #2 approx $12,000 each (2012, 2013) FET #3 approx $3,000 (2013) All further FETs were part of a contract for the Donor egg IVF. Our entire out of pocket cost for DEIVF with one year contract for unlimited FETs was approx $50,000. Contract was extended for further FETs until March 2017. Frozen Embryo storage fee per year: $600 Sperm storage fee: $300 per year (as I recall)

Dr. Schriock's plan is to limit pregnancy risk with multiples. He's very focused on the health of the mother and the baby. He takes into consideration, the quality of embryos, health of the mother and age and our personal preferences to guide us to a decision. While he highly encourages single embryo transfer in my case, he is open to our requests and to discuss pros/cons of transferring up to 2 embryos. I have transferred 2 on our first IVF round, got pregnant with 1. On one other occasion due to repeated FET's resulting in negative results, I decided to transfer 2 embryos in hopes of increasing my chances. NOTE: This was my decision with my husband, where Dr. Schriock recommended one, but supported our decision to try two. This did result in a twin pregnancy which i lost. The bottom line, is that Dr. Schriock will highly advise doing single transfer but is open to discuss your personal wishes.

Dr. Chenette is very caring, genuine and sympathetic. He spends time going over the procedure, what he is doing or will do and answers any and all questions. He is open to setting up 30 minute phone consults to answer questions. He is extremely thorough. There was only two times where I felt he could have been more sympathetic-- both times involved him explaining about men's sperm quality vs women's egg quality. He seemed very pro-male, stating that the majority of the time the issue is in the women. Even if that is true, and I trust him, it doesn't sound great coming out. Also, after our first retrieval, he mentioned that my husband did a "great job" and made it seem like I didn't. I was overly sensitive at the time (extra hormones) and wished that he didn't say it like that but rather, be more sensitive in the way he phrased that comment. I know he means well. He is extremely genuine and overall a great doctor.

Don't expect that he will be the one doing your procedure; it may be another doctor at the same clinic. Ask a lot of questions because he is great at answering them.

First retrieval: 200 IU of Follistim; 150IU of Menopur; prenatal vitamin, HCG trigger shot and lupron two nights(?) before retrieval. Baseline ultrasound day 2 of cycle and Ultrasounds during the stim process. Second retrieval (in process): 200 IU of Follistim, Morning and evening 10 units of Lupron, .2ml LD hCG, prenatal vitamin and CoQ10 and DHEA.

roughly $22K for the retrieval and around $3K for medication (1st time) second time: roughly $15K for retrieval and around $1500 for medication

Dr. Chenette is an advocate for single embryo transfer. He strongly discourages multiple embryo transfer

Dr. Chenette was very forward but also compassionate when we first met with him during our initial consultation. My partner and I were both young and that point and were not necessarily ready to start treatment right away. We explained that to the Dr. and he was not aggressive towards us at all. We decided to start treatment about 6 months after our initial visit and he was there to greet us and explained everything in detail. Being that it was our first time going through fertility treatment we had so many questions and he never hesitated to answer any of them. Our first round of IUI treatment did not work and he changed my dosage of medication to have a better chance next time. When we experienced the pre term/stillbirth of our son we were heart broken. Dr. Chenette reached out to us and let us know how sorry he was for us. When we decided we wanted to try again he made sure that we were ready not only physically but mentally as well.

If you have any questions beforehand, make sure to write them down and bring them with you to your appointment to get as much information as you can before starting treatment.

I was first prescribed progesterone to jumpstart my period. I was than given letrozole to take on cd 3 to 7, went in for ultrasounds about twice during my ovulation phase and than gave myself the ovation trigger shot. During my two week wait I was given a progesterone suppository to take nightly. This first cycle ended in a negative test and the Dr. increased my dosage for letrozole for the next cycle. Same procedure was followed and this cycle resulted in a positive pregnancy test. I unfortunately lost my son at 21 weeks this cycle. After about 3 months of my son passing, we began trying again with the same procedure. The first cycle was a negative test and the next 2 cycles were positive but not ended in early miscarriages.

I was fortunate to have some of my expenses covered through my insurance. For each ultrasound appointment I believe I paid about $300. Most of my medication was a covered by insurance as well. I did have to pay out of pocket for the trigger shot which cost about $150. The team was very helpful in coordinating with my insurance and explaining the costs and also helped me find the best deal for out of pocket expenses.

Dr. Herbert is direct and to the pony. This may not be for everyone. I personally really liked it. He was also very compassionate and caring. He also thought outside of the box, learned from my first canceled cycle and was successful the second time. Where other doctors would have stopped he kept going and tried.

To be honest and to know that he will try his absolute best for you.

below were drugs for my first cycle where I had a positive pregnancy, second cycle was the same minus the Letrozole. Both cycles we did extended stim an additional 7 days for a total of 20 days bc of my endometriosis. Medication SIG Quantity Refill Substitution Lupron MD (1:10 dilution) 50 mcg/0.1mL - Vial 1:10 Dilution (1mg/0.2mL), final conc 50 mcg/0.1 mL) Dispense 4 mL vial. Sig: Take 10 units BID as directed. 1 1 DAW Syringe 1/2 cc (U100) Insulin - - - - As directed. 22 1 DAW Follistim AQ Cartridge 300 IU - Injection As directed. 8 1 DAW Menopur w/ Q-cap vial adapters 75 IU - Vial As directed. 13 1 DAW Syringe 3cc 20g 1.5 in - - - - As directed. 14 1 DAW Needle 27g or 29g 0.5 in - - - - As directed. 12 1 DAW Needle 25g 1.5 in - - - - As directed. 2 1 DAW Sharps Container - - - - As directed. 1 0 DAW Letrozole 2.5 mg - Tablets 2 tab po on CD3 - 7 10 1

With drugs a cycle was about $15,000 but that did not include genetic testing.

We did multiple embryo transfer for both. He let me make a decision I was comfortable with.

As a patient, I always felt that Dr. Li was there for me. We could schedule a phone call with her anytime we wanted to discuss something important, and the most difficult times, when i had the miscarriages she always took time to talk to us. She respected that i wanted to have a little time until i would feel better but at the time she would talk to her I felt the comfort that she knew what i was going thru and she cared for me. We would talk about what happened, and we would do other test like Endometrial Receptivity Array and other blood test to check Immune system issue etc. I always felt so much better after talking to Dr Li. After the transfer of my last embryo and an unsuccessful pregnancy, we had to think what to do. For my surprise, my company announced that our insurance plan added the Infertility treatment but unfortunately PFC is not in the insurance list clinics. The last call that we had with Dr. Li i was in tears and Dr Li said that my dream is the first priority that she will support me and understood that i have to choose another clinic because of the insurance coverage. Dr. Li is an amazing professional but also a wonderful human being. We always had her support and compassion in the years of our journey at PFC.

Dr. Li has lots of knowledge about the infertility issues. Make sure to schedule the appointments either in person or via phone. Make a list of all your questions because she will answer all of them.

I had 4 embryos - day 5 blastocyst and the protocol used was : 1. Ultrasound and blood test on the 2nd or 3rd day of the cycle 2. Start Delestrogene shots -every 2 or 3 days -0.2 ml 3. after 10 days ultrasound and blood test 4. Start Progesterone - Ethyl oleate 1 ml - 5 days prior to Embryo transfer 5. Emnbryo transfer after 5 days of Progesterone shots 6. Continue shots of progesterone every day, and delestrogene 2 x week 7 . after 9 days, blood test HCG Beta 8. if positive continue with progesterone and delestrogene until reach week 9

I went thru the following procedures: 1. Egg retrieval : Medication around $4000 , each ultrasound $255 , each blood test $150 , hcg test $135 2. frozen Egg donor - total $21000 each embryo transfer : $2900 Embryo Transfer 950.00 US Guidance for Embryo Transfer 315.00 Assisted Hatching 685.00 Prep Embryos 575.00 Thaw Embryos 375.00 Progesterone - $360 3 vials Delestrogene - $230 each vial each ultrasound $255 , each blood test $150 , hcg test $135

I hear a lot of debates regarding to eSET and multiple, but my reaction about just do a eSET was positive, since the goal of the treatment is to have a health baby and a health mom, which for me it's sufficient to approve the eSET