RBA

Dr. Toledo has a wonderful bedside manner. He is friendly and personable and has been doing this a long time. It takes a long time to get into see him, but there's a reason for it. You won't be sad you waited an extra few weeks. Some of his explanations are technical, but for the most part, he explains things in terms non-medical people can understand. He will take as much time as he needs with patients for consultations - I think those are booked in one hour blocks, just so he doesn't have to get to another patient. I think we spent one hour with him in our initial consult (not including exams, bloodwork, and meeting with the nurses before and after). He answers questions patiently and is happy to take follow up calls. Once we had decided to go forward with IVF, I had questions about the drugs and injections I was prescribed, and I was able to get on the phone with him personally within a couple of days to get answers from him.

Be prepared to wait for your initial appointment, but he is worth the wait. And have a list of questions ready to go and be prepared to take notes.

We started with IUI on Femara. (I had been prescribed Clomid and timed intercourse with my OB/GYN but that had not worked, so we moved onto Femara.) Each IUI cycle also included a trigger shot 12 hours before the first insemination, and then 24 hours, there was a second insemination. The first IUI cycle was negative, so they changed the timing of my progesterone. The second attempted IUI did not make it to insemination because I did not get any follicles, so they reversed on the progesterone timing. The second and third IUI were identical in terms of medications, and both resulted in chemical pregnancies. My beta with the second IUI stalled at just below 50, and the beta with the third IUI barely made it above 10. Dr. Toledo did give us the option after the second failed IUI to start IVF, but we elected to try one more. After the third failed IUI, we were told our best option was to proceed with IVF. We had a whole lot of bloodwork done (on both me and my husband) and a meeting with a genetic counselor. Dr. Toledo suspected that we were getting "bad eggs" (resulting in the chemical pregnancies), and he therefore recommended pre-implantation genetic screening to screen for embryos with abnormal numbers of chromosomes. He also suggested ICSI to directly inject the sperm into the egg. We did our first and only retrieval in November 2013, and came away with 9 eggs, 8 fertilized, and 7 made it to day 5, at which point they froze and biopsied all of them for genetic screening. I was on Bravelle and Menopur at the lowest doses recommended (I believe 2 injections of each, each day) because I have PCOS and they were worried about overstimulating. We then stopped the medication since we would be doing a fresh transfer. We ended up with 4 genetically normal embryos, and planned to transfer one of them in January. For the transfer, I was placed on birth control to level off my hormones and then put on estrogen (patches) and progesterone (suppositories) on the first day of the transfer cycle, which I was on till the pregnancy reached 12 weeks. (They will normally wean you off these starting at 8 weeks when the placenta has taken over, but I was traveling around week 10 and was being extra cautious, so they let me stay on it till 12 weeks, when I started seeing my regular OB/GYN). The transfer took place on day 20 of my cycle, and Dr. Toledo did the transfer himself. We got a positive pregnancy test, and that baby is now almost 4.5 years old. Dr. Toledo also did an "uterine scratch test" at the beginning of the cycle, which has shown increased pregnancy rates. We did a second frozen transfer in October 2016 with the same protocol and steps as our first frozen transfer, but Dr. Toledo did do an HSG test to make sure my uterus was still in good shape (no fibroids, cysts, etc.) It was all clear, and one of his colleagues did the second transfer. That baby is now 1.5.

The IUIs cost around $1500 ($500 per insemination, plus ultrasound monitoring and meds). For IVF, we used a financing plan that totaled approximately $22,000, but included 3 fresh cycles and 3 frozen cycles (and the benefit stops after a successful pregnancy). We only ended up needing one of each, so we probably overpaid. We were told when we went back for our second transfer that they had changed the program such that we could have used the funds leftover after our first successful transfer to put toward the second transfer. Medications for the egg retrieval were probably in the neighborhood of $4,000 to $5,000, most of it being out of pocket. My husband changed insurance plans for our second transfer, which had an allowance for fertility coverage, and it cost us approximately $600 or $700 out of pocket (including meds) . I think the frozen transfer without insurance would have been around $3000.

Dr. Toledo was strongly in favor of a single embryo transfer - I was 31 and 34 at the time of both my transfers - and he did not see a reason to consider a multiple embryo transfer at my age. Given our circumstances, we also had a very good chance of one working (and those odds only increased with two), and he reminded us that twins is twice the cost at the same time (two daycare payments, two college tuitions, two of all the baby gear, etc.).

I was very pleased with Dr. Straub and the nursing team at RBA. I felt taken care of each step of the way. All of my questioned were answered and they were always available. I was very nervous and unaware of what to expect and they went above and beyond to make me feel comfortable.

It's okay to not know. Go in and have your questions ready to be answered.

We used a traditional IVF with ICSI. My protocol included Gonal F and Ganirelix. We had a very successful cycle resulting in 19 eggs and in the end we ended up with 7 healthy embryos.

We paid for about $15,000 up front because our insurance did not cover anything and then another $3500 in medications

I only met with him once. His clinic and staff are great. He is a clear communicator, although I am in medicine, and his nurse told me that many people don't understand him, so she went through everything again. There were a couple of comments that were difficult to hear, particularly an analogy of my eggs having rusty rails, but I like that it kicked my partner into gear to say that. His clinic staff have followed up with me comprehensively, even during the coronavirus outbreak. I also liked that he didn't try to mess around with IUI and got right to IVF since I had recurrent pregnancy loss.

Bring your partner with you to the appointment, especially if they are on the fence about fertility treatment.

I haven't gone through a cycle yet.

$18,000 plus medications ($4000-$7000). They also offer a guaranteed baby program starting at $19K, but given my age (37), my estimate, before review by the board, was around $29K.

Overall, I had a great experience with him. My first 2 pregnancies everything went according to his plan and I got pregnant very quickly. We are trying for our 3rd, with the same plan as before, and are having an insanely hard time getting pregnant. It is frustrating because to him, this is normal and is unexplained infertility, but knowing I got pregnant so easily the first two times makes this even harder. He understands our frustration, but has changed the plan on us a few times. I will do whatever is best, and appreciate his explanations of treatment.

He is extremely personable and will be very honest and upfront with you on treatment and potential roadblocks.

I took Femara for each cycle, along with Progesterone shots, ovidril to trigger ovulation, and IUI

One IUI cycle including medicine was between $2,500-$3,000

Dr. Toledo got to know my husband and I as individuals and not just patients. He wanted to know about our stresses in life, occupations, how our journey had been. Our first appointment was an open dialogue about what we had experienced. I was certain he would push IVF from the start. Isn’t that what they do at a reproductive clinic? To our surprise, he didn’t. After several appointments and honest conversations with Dr. Toledo we have decided to pursue IVF. I’m confident he has the hope that we do.

Come prepared. Don’t feel like you are coming with too much history because you are not. Dr. Toledo will look at everything and anything you bring. I predicted that I had a thyroid problem so I pulled blood labs from three years back (non related to fertility). He listened, took a look, and was appreciative of all I had provided.

Dr Toledo immediately took a look at my thyroid levels and put me on medicine. In his opinion, I should have been on it already. My levels were in perfect range after few short weeks. He ordered another sonohysterogram. I had one done a year before with my OBGYN but he wanted to run one again. I can’t even begin to explain how easy that procedure was at RBA compared to my first. The ladies at RBA explained that that was something they do daily whereas an OBGYN might know how to do it but they don’t practice it that often. Dr. Toledo also ordered a few tests on my husband so we could have the most current information. He then sat down with us and went through everything, thoroughly explained our options, and gave us his opinion.

We qualified for the “baby guarantee” program. You and your spouse have to meet certain criteria pertaining to your health and specific tests to qualify. The initial fee for this program is 25k. The program lasts for two years or one live birth, whichever comes first. If this does not happen you get the majority of your money back. If you choose to leave the program you also get the majority of your money back. We looked at all options and financially this made the most sense. It’s a great program and we are lucky to be in it!

We signed up as another doctors patient, by the time we were ready to start the cycle we had found out that our doctor had left the practice. We were heartbroken! We were back to square 1. We then decided on doctor Toledo. He was very informative and eased our nerves when we first met him. He put us on a strong protocol. Which we were unsure about, but the outcome was good! So we were happy with that.

Book your appointment sooner than later, it takes a while to get your first consult.

My AMH showed that my egg storage was on the lower end of normal, the protocol that I was put on was 600 unit gonl-f and Lupron. With an HCG trigger shot. I did this for about 2 weeks.

Because of the aggressive treatment, the medication cost was about 5000, our deposit amount for the treatment was 5700. And then the FET cycle meds I have not purchased yet.

He likes to only transfer one at a time because it is more beneficial for a full term pregnancy. He said twin pregnancies are tough and more likely to not carry to term

Dr. Shapiro is sensitive and caring and made us feel as if we were family, which i suppose you are to a degree when you conceive with his expertise and guidance! Dr. Shapiro explained the whole process overall and then explained our case with our factors specifically. He is laid back, very funny and you leave with a sense if being in good capable hands.

One piece of advice I would give a prospective patient of Dr. Shapiro is to not be worried about what he may say to you. I was so nervous because I felt like the only obese person to walk in there but he was so respectful and kind. He really looks at the whole picture and does not judge his patients. You can feel secure knowing he has your best i terests and outcomes at heart.

In my treatment we did four rounds of IUI Dec 2018-March 2019. Protocol for treatment was an ultrasound on day 3 of my cycle to check ovaries and lining of uterus; Femara on days 5-9 of my cycle, testing for peak LH (Lutenizing Hormone) and since I never received a peak we did another ultrasound around day 14 to see if my follicles were ready to release an egg. HCG trigger shot was given to induce ovulation when egg was ready and insemination followed two days later.i would then have to wait two weeks to take a pregnancy test.

We have great insurance and our out of pocket costs for IUI was about $400 each IUI including medications, ultrasounds, and insemination.

Dr. Shapiro will only transfer ONE embryo at a time. His reasoning for this is that it does not really increase liklihood of implantation versus multiple pregnancy outcome and complications associated with same. I would like to transfer more than one if available as I am hoping one round of IVF will be enough but I understand his rationale and I like him so much I would rather stay with him, even with his one embryo approach.

Dr. Straub's strengths are in the way he explains the processes and makes you feel comfortable to ask questions. I never felt rushed through the process and my questions were always answered. One of the weaknesses I believe is the sheet that is filled out when he is explaining the process. He draws out the chart while explaining the process. This all makes sense in the visit however I think there should be a form with some info printed and then he could draw the process for the situation. I understand everyone's situation is different and a template can feel a little impersonal however after the visit the writing is hard to read and it is hard to review the sheet later.

If you are from Fayetteville or the surrounding area be prepared to travel. Many of the appointments will have to be at the main office in Sandy Springs. He is only at the Fayetteville office twice a month and they do not do ultrasound or blood work.

We attempted 2 rounds of IUI prior to IVF. IUI was a long shot due to a blocked tube. For the process I did clomid, vaginal estrogen and a trigger shot. Neither attempt worked. IVF- blood work and ultrasound on day 2 of cycle. Started taking 225 iu/ml gonal F. Ultrasound and blood work on day 6 of cycle. Continuing with gonal F and started Ganirelix. Completed the gonal F day 11. Completed ganarelix day 12 and took Lupron trigger shot night of day 12. Egg retrieval day 14. 16 eggs retrieved, 9 were mature, 8 were able to fertilized, 4 made it to blastocyst. Waiting on PGS results to see how many are normal and to do FET.

Approximately 1200 for each IUI IVF- process 14,100 includes all blood work and ultrasound and retrieval Medication for IVF- 2700 PGS-550 Unlimited FET until a viable pregnancy- 7000$

We have not had the consult for this yet.

He was very straight to the point and helped us make the most realistic decision that would best fit what we were wanting to achieve. He was very informative and was clear on the plan. I had surgery to remove a polyp in my uterus and he did a great job. He does a great job of comforting during this emotional time.

Bring a note pad to write info discussed down because he tends to talk fast.

We first tried IUI which I started on 100mg of clomid daily and triggered with HCG on day 12 and underwent IUI 36 hours later. After the failed attempt, we embarked on our IVF journey. We started on a high dose of Gonal-F for my age due to my AMH being low. I started with 300units twice daily. On day 7 it was determined my ovaries were not responding and we cancelled egg retrieval. So the next protocol is called a "flare" protocol and Ill will be the max dose of Gonal -F 600units twice daily with Lupron. Have not started yet, if this doesnt work we will try max dose of other protocols

$14,100 for monitoring, transfer and PSG testing. This does NOT include $5700 that was paid twice due to one cancelled round.

He recommended single embryo transfer with PSG testing

I really liked him. I saw him about 6 times, either for consults, plan of action, scratch biopsy and he called when I was pregnant the 1st time. I felt like he was very smart a knew what he was doing .

ask questions. He always ask if you have any questions and it's your own fault if you don't ask them. He is willing to answer anything, even multiple times.

1. We did fresh transfer with ICIS. I was young and my fertility issue is a tube blockage and my husband had a vasectomy reversal so his sperm was an issue as well. It worked the 1st time, our baby is 2.5 years old 2. went in to use one of our frozen tested (PCG and PDG) embryos) did a typical transfer (BC, Estrogen, PIO). 1st beta was 20. 2nd beta was 6. 3. Currently in cycle. This cycle we did Lupron and a scratch biopsy.

RBA gives a military discount. Our Fresh cycle was about 8K and our 2 frozen were 2K a piece. We had genetic testing that was 1000 to take the sample.

I asked on our 1st consult if we could do 2 embryos and was told no. I was also 26 and it was my first cycle. I understood why he said no, the risk associated with multiple is high.

Dr Shapiro is very knowledgeable in his field. He can over explain certain things but that only makes you feel more confident in the plan going forward. He properly assesses the pros and cons of each situation and let’s you and your partner make a decision.

Be knowledgeable walking in and have somewhat of a plan as to the outcome you want and timeframe. Dr Shapiro is flexible and can tailor treatment plans that work best for you! I am terrible with shots so during the transfers I was able to do a crinone gel instead of progesterone shots everyday!

I was on estradiol, baby aspirin and crinone for both embryo transfers. On the second, my endometrial lining wasn’t where we wanted it to be on day 10 so we increased the estradiol orally and vaginally.

Thankfully IVF is covered under our insurance for this clinic. Egg retrieval + embryo transfer came to about $3,000. The latest embryo transfer was $900!

Dr Shapiro was very upfront with us and would let us decide whether to transfer multiple embryos or not. My first transfer he recommended one as I had unexplained infertility so we wanted to see if that took - and it did! On the second we did the same given the success of the first!

Dr. Shapiro does not mince words. I always came away from my appointments knowing exactly what to expect, the probability of success and the potential risk. He creates a warm environment, often infused with humor. He gets to know his patients as people. For instance, he actually gave me his family's recipe for latkes (hand written) when he found out I was planning to include the dish over the holidays. When we miscarried after a second round IUI he sat with us for as long as we needed. He gave me a hug (after asking permission) and walked us out the backdoor, so we wouldn't have to go out through reception. I highly recommend working with him.

Don't expect him to sugar coat information, whether good or bad. He is supportive and compassionate, but also direct in his delivery.

I went to see Dr. Shapiro for secondary infertility. After laparoscopic surgery I was diagnosed with mild endometriosis. Given that I had a previous pregnancy, my AMH was high and there were no male factor issues, he recommended IUI with Clomid. The first cycle produced one follicle and didn't result in a pregnancy. The second cycle produced three follicles, my husband's sperm sample was 84M, and resulted in a pregnancy. I actually had a consult midway through my second cycle requesting to skip a third and move directly to IVF. Dr. Shapiro was so confident in the progression of my second cycle he told me that he felt fairly confident it would end in pregnancy, which it did. I did miscarry at 5 weeks, unfortunately, but the IUI was a success. I'm now waiting for my regular cycle to return and a consultation with Dr. Shapiro before proceeding to my next treatment option.

I'm lucky enough to work for a company that provides fertility benefits, so I paid little out of pocket. The procedure costs are comparable to other Atlanta facilities. I know there are payment options available, as needed.

He explained everything very well. I had to have surgery initially which turned out to just be a uterine polyp but he was awesome and very personable. When was pregnant but my HCG levels hadn’t increased as they should he called me to tell me and did it in a very compassionate but factual way so I understood exactly what was happening. When I had the miscarriage the ultrasound tech was out so he personally did the ultrasound. He remains positive but realistic about the treatments.

This is a long process and you have to be flexible

I am currently in the middle of the last cycle of IUI we can do before having another consultation and moving to other treatments. It’s been straight forward so far: Clomid check- iltrasound, clomid 2 tabs x 5 days then a mid cycle ultrasound and then IUI the day after positive ovulation test.

Clomid check $470 Mid cycle ultrasound $200 IUI $600

Those have not been discussed

Dr. Shapiro has a very goofy sense of humor, he really likes Star Wars and makes references that make me laugh when I feel stressed out. He is incredibly knowledgeable and we are so grateful for that.

He can be more on the blunt side when it comes to diagnosing you and giving you your options but that's not a bad thing in my opinion. You come to him for answers and he gives them to you. You should not get your feelings hurt when any doctor is giving you additional information related to what you already know.

So I was supposed to do a medicated IUI with LDHCG and GonalF but on CD 9 I had my bloodwork/ultrasound appointment and lucky enough for me, we couldn't almost 8 mature follicles. Unfortunately, that meant the IUI was too high risk and we converted our plan to IVF with a retrieval just days later. Triggered with HCG and although I did feel pretty terrible for about 5 days after retrievable, I felt better after that and I'm grateful for what we retrieved (19!)

Felt like a pretty well-oiled machine. Bloodwork usually first and then the ultrasound.

Without the cost of medications, about $23,000

Dr. Shapiro and his clinic only transfer one embryo at a time due to risk of multiples.

Dr. Rubin greeted my husband and I as people instead of patients. She introduced herself by her first name and really seemed to make a connection with us on a personal level. Due to our concern with our diagnosis, we saw her multiple times prior to making a decision on a treatment plan and those visits were more like therapy than clinical. She shared her personal beliefs and then discussed science. When we went into the retrieval, I was panicked about a low projected number of follicles the night before the procedure. Dr. Rubin called me at home at 8 pm when I was flipping out (she was not on call) just to reassure both my husband and I. She went above and beyond and made me feel safe in her care. I may need to do additional retrievals and I will only do them under her guidance.

Be open to tough discussions- she will give you the information in a straight forward way

Initial worktop was diagnostic labs for my husband and I, HSG for tubal testing, and follow up saline sonogram. IVF for unexplained infertility. Ultrasounds starting on day 5 of Protocol cycle- every other day until retrieval. Retrieval day 14. CoQ10 recommenced for egg quality. Meds- Gonal 5-150 mg at bedtime, HCG in am (10 mcg for egg quality) for entire cycle. Add Cetrotide daily staring on day 7 to prevent ovulation.

Labwork- roughly 500 for spouse and I HSG-roughly 2000 IVF round- 15,500 Embry Tranfer- 4500 per transfer Meds- 4-5000 ( IVF cycle 3000 plus embryo transfer prep- mine were 5700) Additional Visits- 150 per visit

Only single embryo transfer. Statistical evidence that proves that single embryo transfer produces higher success rates and safer pregnancies and outcomes for mom and baby

Dr. Straub is very knowledgeable and explains treatment thoroughly, but can come off as dry. I can’t say I imagine him to have the best bedside manner, but I would say he’s trustworthy and takes his patient’s care seriously.

Don’t take it personally when you first meet him and he doesn’t seem thrilled to see you. Be patient and you’ll see that he draws out your entire care plan and explains your history to you. You’ll appreciate his knowledge and personality in the end.

I had already been prescribed clomid and letrozole at my OB. But I had not yet done an HSG. And my OB didn’t think I needed metformin. The first thing Dr. Straub did was order the metformin 1500mg and HSG. It was clear. I took the metformin for a month and a half before we started a new cycle with a doubled dose of letrozole (5MG) and an IUI. We are waiting to see the results. But the actual IUI procedure was done by another doctor in the practice who was fantastic. Great experience. We feel heard and we feel this was the appropriate protocol for the moment.

$1200 self pay for an IUI cycle. $250 for consultation.

Dr. Slayden is pretty easy going and gives patients room to make their own decisions in most cases unrelated to safety. He also was compassionate when delivering bad news or change or plans during a treatment cycle. Some of the information comes at you pretty fast so be sure to take notes and do your own research!

Dr. Slayden will give you a lot of information about pros and cons but will also give you the wiggle room to decide. Make sure to weigh each option before starting treatment.

We started with Dr. Slayden right from egg retrieval. We followed the plan set out by my initial doctor which he agreed with. Stimming was rather uneventful as I was only on Gonal-f and ganirelix towards the end and triggered with lupron. From that cycle we ended up with 11 genetically normal embryos. We met with the doctor to discuss plans for an FET and created a plan about a moth after egg retrieval. I started on the course of medicines prescribed (lupron, estrogen patches) but on lining check day my lining was still quite thin a week out from scheduled transfer. Dr Slayden called me personally and explained why he wanted to cancel the cycle and do a hysteroscopy before proceeding just to make sure nothing in my uterus was preventing my lining from thickening after having a D&C earlier in the year. While extremely disappointed we agreed and were able to get the surgery scheduled within a week. We were able to start the new more intense FET protocol the next day after surgery (uterus was all clear). We transferred at the end of November and I am currently a week away from my second trimester. Can’t thank Dr. Slayden enough for letting us make informed decisions along the way.

At RBA at the time a full cycle of IVF was about $14,000 not including medications and a frozen transfer was about $4000 not including medications.

For my age and number of embryos we were both pretty adamant about transferring one. I had done my own research and was uninterested in doing more than one embryo. Dr. Slayden and I agreed and the discussion around this topic was minimal.

Dr Shapiro was very direct- which my husband and I appreciated. He was clear in our treatment and was quick to adjust our treatment so that I didn't have to abandon our cycle. There were points in our treatment that I felt frustrated how many times I had to go into the office but looking back I am glad I was monitored so closely and it led to success.

If you are looking for a doctor who is warm and fuzzy Dr. Shapiro might not be for you. If you want direct, quick and sort of quirky Dr. Shapiro is right for you!

I have PCOS and was initially prescribed Provera and Clomid to have a cycle because I don't ovulate on my own. That cycle did not work. The second cycle I was given Provera and clomid and then injections of Follistim. I was monitored very closely on the Follistim, ultra sounds and blood work every 2 days (at the time this was very overwhelming) but we were able to closely track my cycle and determine the best time for IUI which in my case was cycle day 23. My cycle was successful. In hindsight all the appointments were 100% worth it and I appreciated Dr. Shapiro's attention to detail.

We have great insurance so it was mostly covered.

N/A

I feel like Shapiro genuinely cares about getting you pregnant, and not by doing it the most expensive way possible. Unlike our old RE, he didn’t think we needed IVF based solely one one low number (2% morphology) on my husband’s SA. He talked about completely different possibilities of what could be preventing us from getting pregnant that my old RE never even remotely explored. He spent almost 2 hours in our consultation and goes into great detail when explaining things. He’s very smart, and a little hard to keep up with at times, but you get the sense that he genuinely wants you to understand. I enjoy listening to him, and wish I could have seen him at all of my appointments. I could probably talk about infertility with him for hours. He seems passionate about what he does, and he cares about helping you.

Don’t be afraid to ask him questions if you don’t understand something. Sometimes he can explain things to you as if you were another doctor he’s speaking to, but don’t let that intimidate you. He’s just very smart, and seems to really like talking about infertility. Have questions ready in case he spends a lot of time on one subject, that you forget you wanted to ask him something else. He’s very humorous as well and likes to joke, which totally took me by surprise. I really enjoyed the times I got to speak with him.

He believed there might be an egg quality issue, and that oral medication (Femara) with IUI isn’t enough for me. He had me do a low dose HCG injection lead in for egg quality (started day 15 of the cycle before the cycle with the IUI). This continued up until trigger shot. I then started 75 IU of Gonal F in the next cycle on days 8-12. Ovidrel was used for trigger, then the IUI was scheduled for 36 hours later.

We ended spending about $2500 for one IUI with injectables - that included all appointments, blood work before cycle and during, medications, and IUI ($600 by itself). But now we probably owe $500 or more due my insurance claims being denied that they told me would be covered.

My husband and I opted for assisted reproduction after an unexplained miscarriage and inability to get pregnant again. Dr. Best listened to our story with compassion and took copious notes on our issues. She ordered every test in her "arsenal" to try and help us figure out what was going on. She explained the results of the tests and then explained our options (IVF v IUI, etc). I can honestly say that I enjoyed every appointment with her and actually looked forward to seeing her (something I can't say about most doctor visits). She kept my hopes up and was there for me during the difficult moments as well. She is a model doctor.

To be completely open and honest with Dr. Best about your fears and expectations and concerns. I had concerns about having a trisomy baby due to my age and Dr. Best reviewed with me how we could handle such a situation if it arose. She also had referrals to other doctors I could speak with (MFM's). If money is an issue, let her know and she will try to work out a treatment plan within your budget.

I can't remember the exact protocol used, but the first egg retrieval produced a disappointing three eggs so we banked those and did another retrieval that resulted in 12 more eggs! Using ICSI, we then created 12 embryos which we froze until I was ready for a transfer.

We spent about $40,000 for two egg retrievals, three embryo transfers and this includes medicine.

This was something I agonized over quite a bit. Dr. Best was good at showing me the ASRM standard for number of embryos transferred due to age, but she listened to my concern about multiples and helped me reach an informed decision each time on how many embryos to transfer.

Dr. Toledo is the most compassionate doctor we have came across. He was very good at explaining the process and showed he truly cared as he was talking to us about our options. My husband and I had a male factor infertility and he showed us that he cared and felt bad that I had to go through the medication and shots. He really showed his fatherly side when he truly felt bad that the woman had to go through everything regarding our situation. Dr. Toledo explained things thoroughly but it was hard to keep track of the language during the infertility process. He always explained when we asked so we were glad he took the time to talk to us in detail every time.

Don't be afraid to ask your questions. You are paying a lot of money, you have the right to clarify all of the details.

First we went in for our IVF consult. We then had some factors checked out with the in house urologist. We then started the IVF Egg Retrieval Protocol. I took Lupron and Gonal F. I went in every few days for an ultra sound and some blood work. My estrogen level was out of this roof close to 6000. They found a fibroid or a Polyp so I had to do a frozen 5 day transfer as they said my uterine lining wasnt thick enough to hold the baby. I didnt have my egg retrieval until 14 days later. I also had a hysteroscopy done to remove the fibroid...which they discovered was only a polyp. That was good but also frustrating as I felt this could have been done closer to the time they discovered something was not right rather than closer to the transfer time. I had a different doctor conducting my egg retrieval, hysteroscopy and then finally had Dr. Toledo conduct my embryo transfer. I made sure it was Dr. Toledo. This is the frustrating part about an infertility clinic since there are lots of doctors on staff and their schedules and on call schedules are already set while your schedule is so unpredictable as every women is different with the protocol. Prior to the egg retrieval I had to take a baby aspirin, pre-natal vitamin, vaginal progestrone twice a day and estradiol patches every three days. All the medication put me on a very regimented schedule for 4 months! He did say if we were to do this again he would change the protocol and take out lupron and use another drug.

Initially our cost was $10,000 where insurance paid 80% of it. Then, my insurance changed and nothing was covered. We then paid $4300 out of pocket for the Hysteroscopy. We paid $5000 out of pocket for the Frozen Transfer and $270 out of pocket for my HCG, Progestrone, Estradiol levels 10 days after the transfer. We also paid $6000 out of pocket for medication. We started with Aetna PPO then had Kaiser HMO. Kaiser didn't cover anything.

Dr. Toledo mentioned since I am little in stature and for the health of the mom to be and the baby it is safer to just have one embryo transfer. My husband and I agreed.

Dr. Brahma is very compassionate and knowledgeable. I feel like some extra communication could have been better for example I did not realized that eggs were graded and actually asked afterwards and then was explained.

Be prepared to be very persistent and knowledgeable on the subject yourself.

I was on the highest dosage of meds for the egg retrieval and wasn’t expected to result in many eggs as my AMH was a .42. My egg retrieval was the highest dosages of Lupron and Follistim. The Lupron gave me migraines. Although the 2nd transfer using it maybe my body adjusted as I didn’t have the headaches like the first two times. I responded very well during the egg retrieval. I produced 15 eggs. 10 mature. 7 eggs fertilized. 5 made it to the 5 day blastocyst stage. After genetically testing those 3 came back normal. My transfer protocol was 10cc Lupron then down to 5. With Estrogen and Progesterone. My first transfer resulted in a chemical pregnancy. The embryo started to implant but ultimately did not. All my levels were perfect and everything should have worked but it didn’t. Additionally after the failed transfer I had a scratch biopsy and was put on antibiotics. My 2nd transfer is scheduled in 10 days. In addition to the medication I have been receiving accupuncture treatments.

Approximately $14k for the retrieval process. Then an additional cost of a choice of $4k for one embryo transfer or $6500 for multiple transfers up to a live birth. The second round cost was unexpected and not communicated until it was necessary. I was not able to have My medications ordered until everything was paid upfront.

At first I really wanted to do multiple embryos in the transfer. Due to having a myomectomy in 2014 Dr. Brahma recommended that I only do one at a time due to the potential my uterus may not be able to take getting so enlarged. She also explained that if the uterine environment were to be the cause of a transfer not taking I would most likely lose both embryos in a multiple transfer.

He is filled with knowledge about his profession. I felt hopeful and at peace each time we left his office. He gives 100% of himself to his patients. He answers any and all questions thoroughly. I wouldn’t trust anyone more with the future of growing our family than I do him. He is a contributing factor to my mother in law’s IVF transfer which resulted in the live birth of my husband! He is a wonderful doctor!

Trust him wholeheartedly over any article or research you read, he knows exactly what he is doing.

I was given instructions to avoid alcohol and hot tubs before and after my IUIs. This prevents a rise in my body temperature potentially putting my inseminations at risk. He put me on an antibiotic to take Agee the IUIs to avoid any potential infection since the uterus is sterile and that barrier was crossed with the IUI process.

Unexplained infertility is not covered under insurance. We have spent an estimated $5,000 in bloodwork, ultrasounds, IUIs, and consults.

He is the professional when it comes to any and all fertility treatments. Having suffered two miscarriages naturally, now under his care I know he knows what is best for my body and the potential risks that come with multiple transfers. I trust him 100% in his approach to eSET.