Palo Alto Medical Foundation

From our first appointment dr Ezzati was very good at explaining fertility and the process. He was very patient and easy to understand and follow. He explains odds and use analogies and visuals to explain things better. I never felt rushed during our appointments. He was genuinely happy and sad with us throughout the va process. He has been curious about us and kept in touch even now 7+ month pregnant. He has gone out of his way to accommodate us when treatments were not going right but ovulation was happening. Helping with a unscheduled ultrasound and guidance for timing.

Ask questions and mention your fears and worries to Dr Ezzati. The will be able to explains things to you to keep your optimism up.

I don’t remember all protocols. I know with the first IVF treatment some eggs were growing too fast and about to ovulate so it got switched into an IUI. Dr Ezzati then changed the treatment so I do stimulate my eggs too fast. This resulted in 5 5-day embryos with 2 fresh transfer and 3 frozen embryos. Unfortunately this pregnancy didn’t work out. Because of timing we got another IVF turned into IUI and we also got an impromptu IUI because I was ovulating at the right time... after a couple of miscarriages we got two successful IVFs with genetic testing. 1xday5 embryo and came back genetically good but turned into a chemical pregnancy and the other one with 4xday5 embryos (2 bad dna, 1 good and 1 inconvlusive). I’m pregnant (7+mo) with the good embryo now. Things are a bit blurry with all the treatments and ups and downs now.

Don’t know, insurance covered most of it. Used HSA for drugs but can’t really remember the cost. Genetic was expensive too but can’t remember the final cost.

Dr Ezzati talked to us about the benefits and risks of multiple transfers. Our first IVF we transfer 2 (untested). I always felt confident with the proposed transfer.

It was a very long journey but Dr. Kim and his team ultimately delivered (I graduated from the clinic after my fifth transfer which resulted in a pregnancy). Dr. Kim is kind, calm and patient. He has a really steady and gentle hand in procedures - other doctors will ram a probe painfully but Dr. Kim avoids that. He takes the time to explain things too. He doesn’t over promise and is science based. What I appreciate about him is that he doesn’t push outlandish IVF add-ons, but he is still willing to try things when you specifically request it (for example, I asked to do karyotype testing even though it wouldn’t be super helpful or didn’t seem particularly needed, and he was willing to let me do it upon request). At many points during the process, I wanted to change things up or do things a certain way, and while Dr. Kim indicated that we didn’t have to do things that way but was willing to accommodate, a lot of his advice (especially around luck of the draw) ended up being true in the end. One thing that I appreciated too was that given some of my complicated history, he made it a point to see me every time, even on his surgery days and for basic monitoring. (That is pretty rare at other clinics.) I was happy in the end with my treatment.

Dr. Kim is solid if you fit in a box or are an easy case. If you are a hard case, it may be harder to find the cause quickly because PAMF doesn’t automatically do things like DNA fragmentation tests, karyotype testing, ERAs, Receptiva testing, etc. You have to be an advocate for stuff like that. But if you raise it, PAMF will entertain the request but discuss the facts and science with you (and if the benefit is only marginal, they may be discouraging of pursuing it).

Ultimately what worked was antagonist and Day 5 transfer with no PGS testing.

I had unlimited IVF coverage through my employer so I have no idea what anything cost. But I was impressed that they processed my insurance efficiently and never tried to unfairly bill me for things covered by insurance.

PAMF is pretty strict if you are under 35 with single embryo transfers.

From our first meeting with Dr Ezzati, we felt confident that we picked the right doctor. He took the time to explain everything to us fully and answered all of our questions. He always greets us with a smile and puts us at ease during our treatment by explaining things to us in layman’s terms. It feels great to know what’s going on through every phase of treatment instead of going in blind.

Don’t be afraid to ask Dr Ezzati your questions. He is more than happy to explain things to you and give you the time you need and deserve.

I’ve tried two cycles of clomid with my obgyn (which were unsuccessful) before I started seeing Dr Ezzati. Dr Ezzati wanted to track my baseline measures with clomid and iui before adding any other medications. We used 100 mg of clomid days 3-7, which produced two dominant follicles, but the iui was unsuccessful. The second cycle he added gonal-f injections in addition to the clomid and made sure to track my progress. Unfortunately, the second cycle also did not work. He recommended continuing with iui for 1-4 more cycles, but I wanted to proceed with ivf, which after explaining the risks and benefits, he agreed to if we were ready. I am currently in the middle of my ivf cycle and am happy with the care that I am receiving.

I do not remember

Dr Ezzati and the other PAMF Doctors are all about single embryo transfers and making a single healthy baby. He understands that there are increased risk with multiples, which could be a danger to both mom and the babies, and does not want to take any risks. There are exceptions including age that might change that, but generally they seem to aim for one healthy baby at a time.

He is kind and caring. He takes the time to talk about treatment, next steps, and what each step will entail. My first visit, he spent 2 hours talking through IVF and what I could expect. He took the time to answer my messages at 10:30 at night and was always willing to talk when I had questions.

Get on his list! He cares deeply about each of his patients. I would also recommend asking as many questions as you feel you need to understand the process. He’s willing to answer them

For my retrieval, they used ganarelix, follistom, and menopure. I was on low dosages of each because of my PCOS and I could be easily over stimulated. I stimmed for two and a half weeks. I had 44 eggs, and did an ICSI split. 19 fertilized with ICSI and 1 the traditional way. I ended up with 9 day 5 blasts. We transfered one fresh on day 3. This did not result in a pregnancy. My first FET we did oral estrace 3 Times a day and then vaginal estrace after 10 days to increase lining. Also used Lupron for two weeks. PIO shots began 5 days before transfer. This resulted in a blighted ovum at 7 weeks. Since this protocol was successful in getting me pregnant, we used the same protocol with the addition to estrogen patches for lining support. This resulted in a miscarriage at 5 weeks. My final FET was similar with the addition of baby aspirin and 2 estrogen patches. When beta was confirmed, he started me on lovonox for 12 weeks. This resulted in my 5 month old daughter

Initial cost for retrieval, fresh transfer, and one FET was $14565. Cost of meds was $1500. For each FET after that, it was approx 4,500 and meds were $400-500.

He suggested because I was 29/30 at the age of transfers, one embryo was our best shot because I had a high chance of multiples with more than one embryo

Although I was with Dr. Salli Tazuke from an initial consult until before the first IUI (at which point we moved to another country), I felt that Dr. Salli Tazuke was very considerate and intelligent, and gave me a very accurate picture of the road ahead. She fully informed me of my diminished ovarian reserve, and said that we should do only 3-4 IUIs instead of the recommended 6. She also recommended starting IUIs directly, instead of timed intercourse with Clomid/injectables. She gave me plenty of reading material and was always available to meet me, and to answer my questions directly or via email. She was up to date with my test results and sent me notes on what the results meant, through the hospital's web interface.

Book an appointment well in advance. All the doctors at PAMF's fertility practice were booked solid for 4-8 weeks at any given time.

I did not get to the treatment stage with Dr. Tazuke (I moved before then) - but she recommended 3-4 rounds of IUI with injectables, which is what my next doctor started me on.

None. Our insurance covered all of it.

We’ve only gone through consultation and baseline testing with Dr. Ezatti but he has done a great job explaining every step of the process, thoroughly reviewing our test results, and setting expectations and timelines for next steps.

Would highly recommend him. He is caring and compassionate and wants to do everything to ensure treatment works for you.

~$25k for IVF with PGT

He is intelligent and sincerely wants to help me with my end result. Sometimes I didnt want to hear what he was saying; he was caring and compassionate and kind. This was reassuring. If I had questions he was patient and took the time to listen to me. I was very appreciative!

He is honest and direct yet kind and supportive. Listen and ask question even if you feel the questions will are a repeat of what was discussed earlier.

We used estrace priming protocol due to low ovarian reserve. We did a 3 day transfer.

$10,000 without meds

I will be trying donor eggs moving forward. I was monitored heavily to see if follicles where ready for egg retrieval. 3 of the six eggs retrieved where immature and 3 were fertilized. Only 2 fertilized correctly.

Dr. Mary is kind and compassionate. She spent good time reviewing our case and created a clear plan going forward. She has been available for communication thus far and has not run over 20 minutes late for any of our appointments.

You may not be able to see Dr. Mary for each treatment. She acknowledged that she does not specialize in autoimmune infertility, but makes appropriate referrals to a clinic nearby that does with whom she works closely.

The plan so far is: estrogen priming followed by a lupron downreg protocol. St in meds include: Follistim or Gonal-F and menopur. We will use conventional fertilization.

We're still figuring this out. Estimated to be $15,000 for IVF. Additional for our FET.

With PGS testing , the recommendation is a single embryo transfer

Dr. A told us what the normal protocols were, but was also flexible and patient when I asked about possible deviations. It took a lot of effort for me to go to a fertility doctor, and at first I was very scared. Dr. A was incredibly understanding and supportive of me going at my own pace. I never felt pressured or like a number in any way. A year ago I would have never believed that I would be brave enough to undergo a hysteroscopy and do 4 medicated Luis. Dr. Abusief's support all the way through was really key in helping me overcome my fear.

Be honest and ask a lot of questions.

Letrozole, progesterone, orvidrel

Dr. Abusief was very kind and compassionate. She even called me the night that my fresh transfer did not work to make sure that we had a plan I felt comfortable with going forward. She goes above and beyond.

PAMF Infertility Group is a collection of REIs, so expect to see her colleagues along the way. The good news is that you have many people thinking about your case, the bad news is that you won't see her every time. I didn't mind because I understand that she has a family too and cannot be there every day.

Don't remember the details.

Covered by insurance, except meds.

PAMF's primary goal is a single healthy delivery as this is the healthiest for baby and mommy. I did only single embryo transfers.

Dr. Ezzati was excellent, very thorough and kind.He explained everything and was realistic and optimistic at the same time. He answered all my questions. He put me at ease and made me feel comfortable.

I would recommend seeing him. He's a good doctor.

I am still in the IVF process using frozen eggs. We discussed the reality and cost of doing another IVF round with my own eggs but ultimately the donor eggs are a better fit for me. Right now everything is on hold due to Covid 19 but once things reopen we'll proceed to the embryo implantation step.

16,000 for frozen eggs , 13,000 IVF treatment without insurance.

Dr. Abusief has been a part of our fertility journey for about 5 years. From the first moment I met her, she was warm, caring, understanding, and reassuring. My husband and I move 2 hours away and still chose to see her while struggling with infertility. Dr. Abusief is very thorough away makes sure to lay out all of your options as well as advise of any supplements or medication that you may need. I appreciate that she isn't judgmental and never makes you feel uncomfortable. I'm obese, but I'm healthy and have gained weight because of hormone imbalances and she has always made me feel very comfortable and laid out all of my options from the beginning. I would recommend her over any other doctor in the area.

Know that she will always have a plan and your best interest at heart.

She's great. Felt like a personal, caring environment

None

As expected and covered by insurance

Excellent physician and excellent bedside manner.

You found the right person. Be grateful to be getting excellent care.

I don't feel comfortable sharing this here.

Dr. Keyhan is very professional and compassionate. She always took her time during her appointments with us and ensured all our questions and concerns were answered. Most importantly you can feel her sincerity and care for her patients. She brings a warm, friendly and positive vibe every single time. Sometimes I came in with questions based on my own research and she would always come back to me after looking into it herself. I appreciated her openness. There were also a couple of times where she ensured to meet with us even on days where she was scheduled for surgery. She also personally checked in with us via call when we were concerned early on in our pregnancy even when she was on vacation. Dr. Keyhan’s personality and knowledge certainly made fertility treatments easier for us.

As i have anovulation/PCOs. We did timed intercourse by starting on a 5 day treatment of Letrozole (starting around day 3 of cycle). Initially we started with 2.5mg but eventually ended up using 7.5mg as my body did not respond to the lower dose. Each month I ovulated with about 3 times using ovidrel to trigger ovulation (I had high fertility detected via ovulation kit but did not reach peak fertility by the time expected). Along with Letrozole I took 10mg dexamethasone for 10 days at the start of the cycle to lower DHEAs levels.

Per my Anthem Blue Cross insurance, for timed intercourse and oral medication and injectables I only had to pay co-pay of $25 per visit and about $100 for the injectable medication which I didn’t need each cycle.