RBA

Dr. Toledo's assistant - Melissa - is amazing and returns calls quickly. The front office staff, particularly Mary Ellen, is a delight and calls you by name when she sees you come in. They do have a policy that no children are allowed, which I appreciated as a patient before we had our girls and respected as a patient who has had two successful pregnancies. If you are bringing in new babies to meet Dr. Toledo, they ask you to wait across the elevator bank, just so you do not upset couples who have not yet had successful pregnancies. The only complaint I had about the clinic was their financial/accounting people. They often tried to bill us for things we hadn't had done, and one lady was particularly insensitive when I had to check out after I'd found out we wouldn't be able to go forward with the second planned IUI. The parking is also kind of expensive, so I would recommend carpooling with your significant other for appointments so you don't have to pay two parking fees.

Dr. Toledo is the most kind and caring doctor I've ever had. He has a wonderful bedside manner. Every time we have been back to see him, he remembers us, our kids, and things we like to do. When we did our egg retrieval, we got fewer eggs than we expected, and he let me cry on his shoulder when I found out.

Megan and Lisa were my primary nurses during my IUIs, egg retrieval, and first transfer. They were both wonderful and responded to all of my emails quickly. I did not have as much interaction with Krista because I treated there for a relatively short period of time with my second transfer (Megan and Lisa had both left by then), but she was always kind, called promptly with lab results, and answered emails quickly too.

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.).

From the moment you walk in, you are greeted with a smile. We got called back quickly and efficiently most of the time. The only thing I would say is that maybe more exact instructions for egg retrieval and procedures. Sometimes we get a little confused. But we were always able to email the nurses to ask questions so that helped. One thing I wish they would change is that they should validate parking. We are already paying enough for treatment without having to pay for that every time also.

Doctor Toledo was very personable and even shared his own journey doing IVF. He was very casual and confident in this working for us.

They were all really wonderful. Especially Jennilyn. She always shows so much enthusiasm and excitement during this process. We always felt like we were welcomed like we were family.

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

Strengths of this clinic would be getting patients in to see the doctor quickly, waiting room time is short, front desk staff are kind and friendly and responsive to needs while keeping confidentiality a main concern. I have not really seen any weaknesses, we have always been accomodated, even last minute.

I felt like a human because I was petrified going in. I am a bigger girl and there is A LOT of bias against obese women trying to get pregnant. Dr. Shapiro addressed it directly which was totally appropriate but also very gently and respectfully.

Both nurses (Kelly and Diana) are responsive, kind and compassionate. They alternate working the phone and seeing patients in the office but it is so comforting to k lnow that you are seeing or talking to one or the other.

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.

Strength would be the kindness of the staff and they make sure you get prompt responses. Weakness would be information regarding the financial aspect, which was overwhelming. Though there is not a straight path to follow, I was a little taken back at the fact that everything had to be paid up front before starting. Once starting, we had a cancelled retrieval and now we are on a waiting period for 2 more weeks with $14,000 sitting in their account.

Dr. Straub is very professional and straight to the point with keeping the facts at the forefront of the conversation, but he also does a great job of bringing light and humor to the situation.

Jennifer Cunningham and Amy Zimmerman are the two nurses assigned to me. They were very informative and communicated with me via email

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

They are really efficient once you are a patient! Since you need to be in the clinic so often, you don’t want to wait 30 mins just to get blood drawn (like my previous clinic). RBA is great with this, always prompt and communicate very well on the process.

The clinic is so well run that you are never left in the waiting room for more than 15 minutes while the “number” of other patients walked in.

There has been turnover in the nursing and support staff. This is one pain point with the clinic. My experience this time around was much better than previously and Dr Shapiro was honest with us letting us know that the nursing staff is fairly new but learning everything quickly.

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!

The clinic runs pretty efficiently. I've never waited more than 10-15 minutes, at the longest, for my appointments. I've never had trouble with scheduling. The receptionists are friendly and know me by name. The same is true for the billing team. You definitely feel like the whole clinic is rooting for you.

Dr. Shapiro has always been optimistic, but realistic throughout our testing and treatment process. I always feel like he's giving me the time I need to talk through options and get all my questions answered. He never pushes us toward a treatment plan we're not comfortable with or interested in. We also greatly appreciate his sense of humor, especially during the stressful moments.

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.

Overall I have no complaints about the clinic itself. I wish it was a little bit cheaper obviously but no problems! The billing department was probably the most friendly department I was able to speak with, aside from the surgery staff.

From the initial consultation, Dr. Shapiro asked us how we pictured our family to look down the road. He was trying his best to get us into the baby guaranteed program but I produced more eggs than he was predicting. He reassured us the whole way.

My primary nurse was Diana and she's very nice but sometimes didn't get the warmest feeling from her. I'm sure she's incredibly over worked given how popular Dr. Shapiro is but I guess from the nurses stand point I was hoping for a warmer feeling. Cossandra is the care coordinator and I really like her! Although you do have to wait for a return call, I find it easiest just to shoot her an email and she gets right back to me. I had to have some paperwork filled out for work to make sure I didn't get fired for the time off I had to take and she make sure everything was handled.

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.

Clinic seems to really value each patient as an individual vs a number. Weakness- i think they could do some upgrades to their facility and accommodations for patients in waiting area but I really do not think the clinic has any true clinical or relationship weaknesses. Overall, a great experience.

Dr. Rubin introduced herself to us and I knew she was going to treat us as people not a number. She remembered specific details about our lives that were unrelated to our treatment and made it a point to come visit us after our retrieval even though she wasn’t on call. In addition, she called and essentially talked us off the ledge when we almost backed out of Ivf due to fear. She engaged with me on a personal level that was beyond her clinical expectations as a provider. She truly seemed to care about our outcomes as a couple instead of statistic. Using her own experience with egg freezing, she was able to make a connection with me on a level beyond that of another RE.

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

The clinic could use some more pep in their front of house crew’s attitude. We have never been super impressed with how we are greeted or spoken to when we arrive or when we call. The clinic does have things going for it like cleanliness, multiple locations, lab on site, spacious, etc.

Dr. Straub is a very “cut-to-the-chase” type of guy. He can come off very “dry” at first. But he explains the information well and thoroughly. We are still waiting to see the results of our first treatment with him. But he and his practice seem to pay detailed attention to our care. So far, Dr. Straub has done nothing to rub us the wrong way. My husband also liked him for his straight forward and knowledgeable personality.

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.

RBA went through a tough time in 2018 with a few doctors and staff turning over midway through the year. There was some initial confusion during the transition but I never felt my care was lacking during those few weeks. Now they are very prompt with appointments and answering calls back. I still never felt like a number here.

After going to another top clinic in Atlanta where we felt like a number we were pleasantly surprised by RBA. Although my initial doctor left the clinic midway through the year Dr. Slayden picked up right where she left off and continued treatment.

Lacie Bean at the Marietta office was the best when it came to treatment, compassion, and answers. She was always there with a smile and a good story whenever we would come in. I think we will probably miss her the most! All the other nursing staff and coordinators were lovely as well.

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.

The phone system is a little bit complicated. You have to call and leave a VM and wait for someone to get back to you. I understand this approach but there were times that waiting for the return call was very stressful. The office staff and billing teams were friendly and easy to work with.

I was treated very well while going to RBA. The doctors and the office staff were responsive and kind when communicating about treatment.

Overall the nursing staff was great. There was some minor confusion at the start of my cycle but it was quickly resolved and my treatment did not need to be changed.

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

Not speaking about Shapiro, but the rest of the clinic kind of makes you feel like a number. I know they’re busy, and the clinic is huge, but I don’t like feeling like they’re trying to get me out of there as quickly as they can. The front desk ladies are very nice. A couple of the billing people you check out with are nice, but one is an absolute nightmare to speak to. The sonographers are nice, as are the ladies who take your blood. The patient coordinators aren’t easy to deal with. They don’t respond in a timely manner. And the girl who does all of Shapiro’s scheduling is terrible to deal with. She literally never answers the phone when you call. You have to wait every time. I will say that the major drawback about this clinic, and one that has made me reconsider using them for future treatments is that I was told both my consultation and my SHG would be covered by insurance. I was only required to pay my $40 copay for the consultation, and that $287 was my portion of the SHG. My insurance covers testing, and every consultation I had with my old RE was covered. But because of the diagnosis code (female infertility not specified) that RBA is using on these claims, my insurance is denying them. I was never told that the diagnosis code might prevent them from being covered. I’ve asked them to please use a code that doesn’t indicate infertility like my old clinic did, but they’re refusing to. This really upset me considering I had my insurance verified by them, and they told me these two things would be covered, but now they’re coding them in a way to keep them from being covered. I’m not asking them to commit fraud, there are a lot of other valid codes that could be used. It really makes me reconsider using them again.

At the initial consultation with Shapiro, he spent almost 2 hours with us. He really seems to enjoy explaining things and going into great detail, and I really appreciate that. I didn’t feel like he wanted to rush us out of there at all. He genuinely wanted to be talking to us I think, or else he wouldn’t have spent so much time.

Majority of communication with the nurse is done via email which I was fine with. She was pretty quick to respond which was nice. I had a rough start with her, as I couldn’t get a call back. But then I quickly realized email was my best bet. She doesn’t elaborate a lot in emails, or go into much detail, but I assume that’s because she’s busy. Dealing with her in person wasn’t as pleasant as I got the sense she was in a hurry and trying to rush me through my appointments with her after my ultrasounds. That’s something I cannot stand. I drove over 2 hours for every appointment, only to be rushed.

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.

There are honestly no weaknesses with Dr. Best or the Marietta office. Everyone there is spectacular. The main office in Sandy Springs is busy so you feel a bit more like a number, but everyone there was kind and easy to work with. Probably my only big complaint is the cost, but I think that is pretty standard when it comes to IVF. It's not cheap!

Dr. Best is one of the best doctors I've ever worked with. From the first moment we met with her, she was warm, she listened, addressed our issues and explained our options in a very clear and concise manner. She has called me on weekends and I even have her cell number (though I try not to use it!)

Julie was my friend, psychologist, nurse and cheerleader through the process. I had zero understanding of this process and had never even given anyone an injection. She taught me how to inject the meds and how to make it less painful. She gave me samples when I was running out of meds and she was just awesome to work with.

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.

Overall, I enjoyed coming into RBA. The front desk staff was always friendly and willing to help in any way they could. Strengths-Friendly, Good Communication, Great group of Doctors and Nurses Weaknesses-Paying for parking every time, Cost, Uncertainty

Dr. Toledo has the best bed side manners I have encountered with a doctor. He treated my husband and I like a true patient. He did pronounce my name wrong though.

It was hard to get a grip of contacting the nurse team when I had a question at the beginning. Calling them is impossible. I learned soon after emailing my two primary nurses was the best way to get any of my questions answered. They were very quick to answer when I emailed them. They were always on top of it. Krista and Lindsey were my go to nurses during the process. I enjoyed working with them.

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.

Again educate yourself on the process, ask a lot of questions,Take notes and be prepared to be the squeaky wheel. They should have someone on staff just to answer phones and answer questions. Calling and getting someone on the phone is an act of God. Most times I would have to call and email and call again and again.

Dr. Brahma is great! She is very sweet and reassuring of the process. The process in general in regards to the office and getting people to call you back and give you all the details you need was less than great. I felt like I had to be on top of all phone calls and calling and or emailing several times in order to get an answer.

I felt that they forget we don’t know the process of what is happening. There are some things you don’t know to ask or to do if you aren’t told or haven’t been through this before. Some vital information was not effectively communicated.

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.

There are no weaknesses at RBA. This clinic is wonderful. The office staff, nurses, and doctors simply are amazing. I feel welcome and cared for each time I step in and out of that office. This office has made our process if unexplained infertility much easier with their love and care!

He gives 100% of his time to his patients. Answers and elaborates on the treatment process. Answers all our questions thoroughly.

The nursing staff is excellent! They return all calls within the same day, spend time goingover results with you in person and on the phone if I call with questions. They show professionalism, love, and compassion every time I step in the office. They want my treatment to be a success just as much as I do and they provide me 100% of their time always.

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.

RBA is huge and it is a pretty well oiled machine. The most annoying part for us has been the billing office which took forever to return my calls or emails. Everyone else has been mostly kind. I had one rude person answer the phone but that’s all.

Dr. Straub is very matter of fact. He doesn’t give any emotional support. He did make a joke at the end of my second appt with him and it was kind of a shock because his personality is so straight forward.

The nurses have been wonderful. They answer all of my questions and put up with my crazy. They tell me of their own personal experiences with IVF. They are quick to respond and always thorough. They made me feel like they cared.

Dr. Straub is direct and to the point. He draws a diagram as he speaks and lays out all of the details for you. He answered all of my questions and was pretty patient with me because I had a lot. He is not emotionally supportive at all. I cried when he told us ivf was our best option and he pointed to the box of tissues on his desk and kept talking.

Go with this doctor if you want an efficient, smart doctor who will cater to your timeline. Get a therapist elsewhere.

We had a lot of tests run on me including amh level, hormone levels, femvue test and maybe more tests. My husband had to do two semen analyses and ultimately they found male factor infertility was the issue. Due to his numbers ivf using ICSI and a frozen transfer were presented as our best option. We are about to start the egg retrieval process.

So far we have paid about 13,000 but expect to pay 26 or so for IVF with ICSI.

He recommended transferring only one embryo for us as it is lower risk.

It’s a big clinic. Things run smoothly and I’ve never had issues with billing or scheduling but I know some people are turned off by that big box feel. It doesn’t bother me. The admin assistant at the front is amazing. So kind and warm. The lab and ultrasound techs are also kind and compassionate. I always leave feeling happy.

Dr. Toledo is warm and caring. He always comments on things in my life we’ve talked about in the past, I’m sure he doesn’t remember, he probably makes notes and then reviews his notes before our appointments BUT he takes the time to do that. He’s caring and compassionate. When my beta came back negative he called me himself and talked to me while I cried. He’s simply the best.

Dr. Toledo’s main nurse, Krista, is amazing. She never seemed bothered by my calls or questions and she was kind and compassionate. He had another nurse or assistant, I don’t remember her name, who is also ok, but not quite as warm as Krista. But she wasn’t mean and she got the job done, just not with that warm fuzzy feeling. His NP is also great!

Like I said before, he’s warm and compassionate. He is friendly and funny. He takes the times to answer questions and doesn’t make me feel rushed. When the first plan didn’t work he made a new one. He’s open to things I suggest or ask about.

Write down your questions ahead of time. Write down his answers. Know that once treatment starts you won’t see him frequently but he does look at what’s happening and have his nurse call with the recommendations and changes.

We did a cycle with follistim and ganirelix. I don’t remember dosages but do know that my dose never changed from the starting dose bc I responded well. They retrieved 19 eggs but only 8 were mature. Six fertilized with ICSI and one of the immature eggs did fertilize in the dish overnight. On day 3 the embryos looked good and they pushed me back to a day 5 transfer. On day 5 all the embryos had stalled in the day 4 stage so we transferred 2. Unfortunately, we didn’t get pregnant and the remaining 5 embryos died in the lab the day after transfer.

We had some insurance coverage so paid a deposit of about $3000 and about $2500 for meds. We also did two IUIs. We submitted one to insurance and maybe paid a couple hundred dollars out of pocket for that but I can’t remember exactly. The second one we paid for ourselves and it was probably about $2-3000

RBA is a great clinic overall. They are easy to get ahold of and worked with us in scheduling a time to meet with the first available doctor and his team. I've had some issues with the billing office and my insurance company covering some items that should be covered; however, I hope this can be worked out.

Dr. Daniel Shapiro was great at addressing my and my husband's concerns and explaining the details involved for the surgery I had in 2017 to remove my left fallopian tube and clean the adhesions & scar tissue from endometriosis. He also has a great sense of humor, which helped alleviate my anxiety.

For the initial visit, my husband and I met with a nurse practitioner, who was very helpful in answering our questions and who showed compassion. After my surgery, I saw another nurse for the post-op visit, who was good, but not as great as the first nurse was.

Dr. Shapiro was very detailed in his explanations and, in particular, explained the next steps needed. He also helped me feel calmer before undergoing surgery. He is a forthright and direct communicator, which I appreciated.

Feel comfortable asking questions, even if you think they are minor or irrelevant.

Dr. Shapiro removed my left fallopian tube, which was blocked, and cleaned the adhesions and scar tissue present as a result of stage 3 endometriosis. I did not know I had endometriosis, but I did find that I had a blocked fallopian tube after having done the HSG test. The surgery was necessary to remove the blocked fallopian tube and to diagnose if I had endometriosis.

The surgery I had was around $3-4k, though most was covered by the insurance company. It was less expensive because the clinic has an out-patient facility. The office consultations were $100-$300/visit. The bloodwork was about $300-$900 for my husband and me. Most of these costs were covered by my insurance company, though we did pay money for co-payments and co-insurance. Right now, I have been billed by Lab Corps to cover the lab work done with our initial visit, which should've been covered by the insurance company. I have been in touch with the billing office; however, it has not yet been resolved. RBA needs to resubmit the claim with the diagnosis code that will be covered by the insurance company. The billing office person said they've had several of these returned claims and are working on handling them. However, this has been the most frustrating part of the process so far.

It was relatively easy to get appointments, the lab staff were friendly as well as the front desk and check-out personnel. My appointments were usually on time which was nice. The surgical staff were very kind as well.

Dr. Toledo always addressed us by our names and has a great bedside manner. He understands how hard this process is and is upfront but also compassionate.

The nurses were easy to reach via email or by calling. I had a few nurses who responded, mainly 2 that seem to work for Dr. Toledo. I would not say the nurses are very compassionate but they answer your questions and communicate to Dr. Toledo as needed.

Dr. Toledo was upfront when things were not going as well as expected. He laid out a clear plan of what our next steps were and provided us with sound and logical information. He always was kind and open to discussion regarding what we were comfortable with.

He is a great doctor who cares and wants to help in any way. He is also very open to what your wants and needs are and bases his recommendations on that information.

We decided based on how many embryos were produced if we were going to genetically test them or not. If there were 3 or less embryos, we were not going to test them and take our chances. We ended up with 2 embryos so we did not test them and transferred 1 embryo in July 2018 that resulted in pregnancy and ended in a miscarriage at 8 weeks. Looking back I wished I had gone ahead with genetic testing. We are now testing the remaining embryo, not on Dr. Toledo's recommendation but because I have had 2 miscarriages consecutively and cannot fathom going through that process again.

$14000 for first egg retrieval, additional 6-8K for meds, $4k for transfer.

Dr. Toledo and my husband and I decided for eSET due to the fact we have had a previous successful pregnancy (my 2 year old) and that multiples for me could be high risk since I am a petite person and complications could be high if I had multiples. Also we discussed that we knew we wanted 1 more child, but we were not sure if we wanted a total of 3 children.

RBA is at the cutting edge of research in the field....but there is still no consistent use of any type of electronic medical record systems. Everything is sent through secure email or by phone. If you travel between offices your physical records are transferred by carrier - keep this in mind if you get bloodwork at a different location than your care team is located - it can cause a delay.

Dr. Best always had the perfect balance of compassion and scientific facts to back up her reasoning.

Nursing staff was always quick and efficient in answering calls and emails.

I saw Monica Best beginning of January 2018 after switching clinics. We had a wonderful first consultation where we went over everything that took place during my previous cycles as well as what she would suggest we do moving forward. Before being able to start treatment I ended up pregnant with what ended up being a molar pregnancy. Dr. Best handled this horrible situation with care and compassion but always made sure to tell me the risks involved and 6 month monitoring during this process. After my HCG hit negative we were able to begin preliminary testing for an egg retrieval cycle with protocol suggested. This was as far we got before she left the practice.

She is no longer practicing at this clinic but if you find her at another clinic she is amazing! The best choice of doctor in the Atlanta area.

For treatment of Molar pregnancy I had a next day D&C followed by weekly blood draws until my HCG hit negative followed by monthly negatives for six months to ensure HCG did not rise again. We also performed an SHG and routine genetic testing as well as infectious disease screening before starting an IVF cycle.

They are familiar with IVF for reasons other then infertility, ie: avoiding specific genetic diagnosis. The billing/financial department is not helpful at ALL in determining what the out of pocket cost will be to the family. they will give you a price breakdown sheet but that is it. We were left on our own to call insurance and see what/ if anything they would cover. RBA will not bill insurance for anything if you do not have an IVF policy so it will be on you to request reimbursement. The cost of how much IVF will be is literally one of the hardest items to nail down.

Dr. Brahma has 2 nurses that are responsible for responding to emails re: concerns, treatment plan and follow up plans... Both are very nice and prompt to respond. However, we never received proper training for injection administration and/or location. We were told the pharmacy would do that to which the pharmacy said they do not do that anymore, so we were left to learn off of videos on YouTube. Looking back now I should have messaged RBA to say "They won't teach us, when would you like for us to come in for you to show us how?" Feeling like a number: We did our transfer 2 weeks before Christmas so right around the Christmas is when I needed to do my bloodwork to confirm pregnancy. Because we were traveling I went to an offsite 3rd party facility who ended up taking 4 days to send it the results (should have been next day). No one at RBA seemed concerned when I would call to ask if they had received results, which was very disappointing. I wish someone would have lit a fire under the 3rd party company to send results but RBA seemed to only feel it their responsibility to merely wait until the company sent (in their own time)... Then after 'regular hours' were established again Dr Brahma said 'Yes, quite often they do not get us the results next day." That was infuriating to hear this was common and no-one mentioned it to me when I told them I would be going to a 3rd party location as I have to believe we would have changed our travel plans. Feeling like a number: Often when orders would be sent or a plan put in place there would not be much explanation on the details of that plan. I felt as if they forgot this was my first time doing anything with IVF and it was all new to me. They do this day in and day out so Im sure its routine but I needed more hand holding because this process is mentally taxing and financially very expensive as insurance did not cover the process. Feeling like a human: Dr. Brahma has an amazingly kind disposition. She is soft spoken and quick to acknowledge any concerns or worries presented. She will reach out to fellow practitioners if she has a question. Meetings with her were clear and we left feeling like she cared about us and the outcome.

Crystal (and Caitlin) were overall quick to respond to questions we had and also share protocol plans. Be mindful that any communication over major holidays the communication is very very delayed.

Dr. Brahma is soft spoken and will answer any question asked. She can move through the material quickly as I'm sure she has many patients to get to and this material is routine for her. She was clear in her concerns at the beginning. We met with her twice in person and once by phone for the entire cycle process beginning to end.

Take notes and when you are unsure what she is saying speak up, right then, to ask her to elaborate. Also, every visit seemed to feel somewhat 'cut short' as her nurse would knock on the door and saying something along the lines of 'they are ready for you when you are' as if to very politely say 'Times up". Just know that will happen. I do wish our appointment times were longer.

I was on the highest dosage of medication allowed as my AMH is low and 'egg age is older then my biological age'. We built a probe through Cooper Genomics for PGS and PGD testing to look for cystic fibrosis.

We built a probe through Cooper Genomics to PGS and PGD testing for cystic fibrosis. The cost for that was $4,500 and $1000 for up to 8 embryos. The probe is kept to be used for any additional cycles/embryos. Medication was ~$5300 Single transfer was $4500 Multiple transfers (until a live birth) was $6000 (The is PER retrieval) Overall we gathered our out of pocket costs to be $35,000. Ours was more because of the extra genetic testing and lack of insurance paying. There is no discount for paying cash for a cycle.

She stated that single embryo transfers are more successful so multiple transfers were not common in their facility.

Strengths: great success rates, many offices so it’s convenient, very knowledgeable drs and nurses Weakness sometimes it can take a little while to get an appt bc they are busy. The sperm freezes have to be done at one location in Atlanta and the latest you can do it is 9 am so that is inconvenient if you live for away like we do. (1.5 hours)

Dr. Best has been through IVF herself and took the time to share with me how she understands going through infertility. She made me feel comfortable through the whole process. She’s actually the only doctor that found the issue with my husband and I because she took her time and didnt rush through the testing!

All nurses are very caring and helpful! They always email me back if I have questions within a few hours!

I’ve never felt more comfortable with a dr. She told me at my first visit with her to put all the stress on her and for me to relax and I’ve honestly done that for once. I trust Dr. Best because she knows what it’s like to have infertility problems and I know she’s going to help us start a family! She’s very patient and answers all questions and I always leave understanding what our next step is.

Make sure you have your past history all printed out, it helps to have it there to look at when you’re going over what’s next.

I did two IUI prior to Dr. Best so when we went to her I wanted to try timed intercourse to see if my eggs would even respond and they finally did. We did clomid 100 and a trigger shot and both cycles I had 4 and 6 follicles!! We didn’t get pregnant unfortunately because we later found out my husband has a morphology issue so we are seeing the male specialist now and hoping to improve sperm quality and then go back to iui or ivf!

Consult is $250, hsg was around $700 I think, sperm freeze was $650, ultrasounds around $200, husbands ultrasound was $510, IUI is around $1700, IVF starts at $14,500

I haven’t gotten this far yet.