RBA

He seemed to care about my husband and I growing our family whenever met with him. He did not perform my egg retrieval and I was not aware that he was not going to be there. I had a lot of unanswered questions and felt he didn't follow-up with notes from appointments to refer back to.

He's great doctor but please provide note for your patients to refer back to because somethings makes more sense on paper.

my protocol seemed to be very generic. The proctor didn't seemed tailored for me and my fertility issues

It was expensive a d differently not worth the price. I feel like I could have taken the money threw out the window. It was a waste!! I didn't feel important at all.

Nurse Caitlin was fantastic. It’s a shame she is so kind and compassionate that works with a doctor who is the completely opposite. Dr. Rubin barely explained the IVF and IUI procedure. She didn’t even take the time to educate us in depth but gave us the Spark Notes version of the explanation; uhm social media bloggers were much more helpful than Dr. Rubin. My husband and I did not move forward with her. We did not feel she was the right doctor for us.

Choose a doctor and team that you feel comfortable with. Someone you will have faith in and you can trust in.

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Consultation was $270.

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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 makes a good first impression. He is friendly and comes across very personable. I now realize, he is a good salesman. Many of the facts and numbers he gave us were confusing. He used a bunch of metaphors that really downplayed what we were going through. ("If we were playing football and I were the quarterback, here's what I would do...") This is a turning point in our family, not a football game. My husband and I consulted with Dr. Slayden after 3 consecutive unexplained miscarriages. We were looking for options. Dr. Slayden explained to us that IVF with genetic testing was our best option because he felt 99% sure that genetic abnormalities caused our miscarriages. Dr. Slayden all but guaranteed us we would find success through IVF. After running all of the tests, he compared my chances to that of an 18 year old. My husband and I were thrilled. We completed the egg retrieval, genetic testing, and embryo transfer without success. Dr. Slayden called to tell me the pregnancy test was negative and said, "I'm ready to try again." I had JUST found out our time (6 months), money ($25,000), and emotion (inexplicable) had been wasted. I was not ready. We decided to take a break to let my body and our bank account adjust from the whole ordeal. When we were ready after a few months, Dr. Slayden suggested we try a natural/non medicated cycle. We first did an endometrial biopsy (I'm not exactly sure why). Unfortunately, we tried for 2 months- but my cycles were inconsistent so we weren't able to do the transfer. Each time, Dr. Slayden suggested we move to a medicated cycle. My husband and I weren't sure why the change of treatment plan was so quick. We felt very confused about what our best option was. For 5 months after our first transfer, my cycles remained inconsistent. Most were upwards of 35 days. I spoke to Dr. Slalyden about this and he casually said, "That is common since you have PCOS." He had NEVER mentioned PCOS in any of our communications. I questioned him and his reply was, "You COULD have PCOS. It can develop over time." He then told me he thinks I should move forward with a surrogate. That was so absolutely confusing since he always seemed so confident in our chances of success through IVF on my own. His reasons for why he said that was even more confusing...I can't begin to explain it here. He scheduled me for some blood-work and the resulting diagnosis is I "may possibly" have PCOS. That diagnosis is frustrating in itself, aside from the fact I certainly thought we would have tested for something so common prior to this point in my treatment. Especially something that can be treated without IVF. My husband and I are now more confused than ever. We did all of the initial work to make as many embryos as possible and now they are 'owned' by Dr. Slayden and RBA. We feel very helpless and it seems like our only option is to move forward with another medicated cycle. There is no change in the treatment plan although our first attempt was unsuccessful. I now "may possibly" have PCOS. We aren't sure if a surrogate is a better option. We are out of money and our patience is running thin.

Research other options.

Egg Retrieval Protocol: Birth Control with start of cycle for 25 days (regulate my cycle) Ultrasound and Blood-work Gonal F after BC for 5 days (produce eggs) Ultrasound and Blood-work Gonal F and Ganirelix for 5 more days (produce eggs and then ovulate) Ultrasounds and Blood-work every-other day Egg Retrieval Surgery (39 days after staring BC) Frozen Transfer Protocol: Lupron on Day 21 of cycle (not sure what the purpose is) Estrogen Replacement on Day 1 of next cycle (prep body for pregnancy) Begin Baby Asprin, Progesterone, and Medrol (prep body for pregnancy) Decrease Lupron, increase Estrogen Antibiotic for 5 days prior to transfer (in case of infection) Ultrasound and Blood-work (determine if lining is adequate for transfer) Embryo Transfer (approx 30 days after starting Lupron) Negative Pregnancy Test 7 days after transfer

I was always able to go first thing in the morning to get my ultrasounds and blood-work done. I rarely had to wait more than 10 minutes. The ultrasound tech is efficient and knowledgeable.

$14,500 egg retrieval $3,000 medication (not paid to the doctor) $3,000 (approx) genetic testing (not paid to the doctor) $4,000 transfer cycle $1,000 medication (not paid to the doctor) $500 yearly for frozen embryos

Dr. Slayden is a technically proficient physician. And he can be charming to most patients. However, the charm (his primary bedside manner) masks a lack of personal interest in helping patients understand treatment decisions. He seemed happy to continue unrealistic treatments for us (IUI) either because it would bring more revenue or because he knew we would eventually need to do IVF. The problem with this was that for every year and dollar wasted our chances of a pregnancy with even IVF would have been more difficult. Be prepared to ask him hard questions to make your treatment something worth your time and energy.

Educate yourself before any visits/treatments, ask him hard questions every time, demand clear answers about chances of success, and make sure you understand the window of time you have to be most successful with your goal to have a family. Do not rely on him to be in the driver seat for you to get the best care.

Femara for IUI, Femara with injectables for IUI, Antagonist protocol for IVF

Transportation, Medication, Lost wages, Cash pay for consultation by phone or in person, Treatment

Dr. Best was the first doctor I saw regarding infertility. I went to my initial consult alone. I felt like a deer in an open field on the first day of hunting season at that appointment. I also felt very dumb. Something is wrong, but I have no idea what and I am sitting on the other side of a desk with a woman in a white coat, who is looking at me with the most gentle eyes and kind smile, and I just want to crawl in a hole and hide. The things that we talked about and the ways Dr. Best educated me are things that I still remember, fondly. I was hellbent on freezing my husband's sperm, he has a chronic disease that is half of why we needed IVF, and she was very nicely explaining that, yes, that's fine, but we really want embryos. Embryos equal babies. She was very knowledgeable and well read on current literature/studies/research, which is very important to me.

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We only met with Dr. Best maybe three times total, and did not pursue treatment with her/RBA. We learned that the work up/diagnostic testing was covered under my husband's insurance at Emory. After further research, we also learned that the cost of a fresh IVF cycle with ICSI was dramatically less expensive at Emory. Dr. Best/RBA wanted my husband to see a urologist for his junky sperm. This would not be covered by insurance. When we discussed this at Emory, they said, (paraphrasing), "who cares, we know it's bad, let's make you a baby."

When we got pricing sheet for RBA, everything was listed "a la carte". It was nearly impossible to follow, a lot of it because we were still (blissfully) unaware of all the medical terms and meanings and also because it was so extensive. Because our insurance offered ZERO coverage for anything done, we got bills immediately, had to pay a lot of money up front for things, and just were not prepared. My husband was the cooler head, for sure. I was very much, "just take my money and make me a baby, I will pay anything". It was insane how much money we paid, and we hadn't even gotten to the actual baby making part yet! This is the biggest reason we did not pursue treatment with RBA.

I highly recommend Lisa Hasty. She was personable, communicative, professional and honest. Lisa was caring, warm, empathetic and I had complete confidence in her word and her medical abilities. She was committed to me, and did not push treatments on me, understanding all I had been through she recommended considering adoption rather than pursuing further treatment.

Trust in her.

We did the usual clomid, then IUI, then IVF. I had a history of ectopic pregnancies so when I had a positive pregnancy test she would follow my hormone levels very closely, and if the pregnancy was ectopic she would send me asap for a methotrexate (?) injection to end the pregnancy. I hyperstimulated on my IVF cycle and had to have albumen. I developed a cyst at one of the injection sites so she immediately switched the drug delivery medium. Had ICSI to increase number of embryos produced.

It was a long time ago, so don't completely remember, and we were fortunate to have primary and secondary insurers paying for some aspects of treatment.

I do not feel like we often had experiences with Dr. Toledo. We saw him for an original consultation - but he did not perform any of the three IUI treatments. We met with him after the failed IUI cycles and that was our second and last time meeting with him.

Find a doctor who will be there for you and to address your concerns.

I would highly not recommend this doctor. We wasted time and a lot of money and he did not catch something that was highly influential to our success rate. It is beyond me why a very standard test was not performed by him so that he could identify a major problem. Instead, he did a transfer that failed and had no plan for next steps. He did not perform a very standard test that would of helped to increase our chances of pregnancy and a full term live birth by 100%. We are very disappointed with his lack of care.

get a second opinion

There was no methodical plan. My second doctor could not make sense of his protocol.

Dr. Shapiro is able to speak to me; explain the process and relieve my anxieties . He has a very comforting presence and can relate to me personally. I feel he understands me; where I come from and is able to anticipate my questions. This process is very anxiety provoking and he does a great job to calm his patients.

Dr. Shapiro is great! Be patient with staff; they are often cold not as helpful but he is worth it!

Dr. Witt was the primary doctor we were referred to in regards to male infertility. Dr. Witt is very knowledgeable in this area however we feel that Dr. Witt was never certain of an action plan to take. After multiple trials in medication it appeared Dr. Witt only wanted to change medicine not any other factors.

Be knowledgeable of potential risks and outcomes

Still in treatment process.

Estimated costs of treatment: Medication has costs$800 so far. Sperm Extraction surgery $6000 then IVF cycles

He was very good at explaining things. Very nice doctor and straightforward without being harsh. We liked how he drew things out to explain and answered all our questions. He wasn’t outwardly expressing that he was empathetic, but he also wasn’t showing that he had no empathy, he just acts more professional to fix the issue.

Don’t be afraid to ask questions, he will answer and explain well if you are confused or need more information.

We had an initial appointment where he explained thoroughly what can cause infertility and the course of actions that can come from it. I went through bloodwork and an HSG test to make sure my tubes etc. we’re not blocked. My husband went through several sperm tests as well as bloodwork. He came back low each time, low enough that IUI seamed to not be favorable. He was recommended to a urologist to try to get an answer on why his sperm results were not ideal and try to fix the issue to try IUI.

I don’t remember exactly, but $100-250 range for consultations. A few hundred for HSG testing.

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