Ratings of 1 indicate that a clinic was poorly operated.
Ratings of 10 indicate that a clinic operated very well.
Scheduling
8.8
8.8
Scheduling
Ratings of 1 mean it was difficult to schedule appointments with this clinic.
Ratings of 10 mean it was easy to schedule appointments.
Billing Department
7.7
7.7
Billing Department
Ratings of 1 indicate an unsatisfactory billing department.
Ratings of 10 indicate an excellent billing department.
Nursing Team
8.9
8.9
Nursing Team
Ratings of 1 indicate an unsatisfactory nursing team.
Ratings of 10 indicate an excellent nursing team.
LGBTQ+ Care
10
10
LGBTQ+ Care
Ratings of 1 indicate an unsatisfactory LGBTQ+ care.
Ratings of 10 indicate an excellent LGBTQ+ care.
Attention to Detail
8.1
8.1
Attention to Detail
Attention to detail is on a 1 - 10 scale, and is scored based on the rate, and severity, of errors committed by the clinic according to the patients.
For example, a severe error might be failing to inform a patient of critical information, while a small error might be failing to call a patient with results.
CDC Success Rates
This is the most recent data from the CDC. The CDC cautions that it should not be used to compare doctors and clinics. This data represents the outcomes of IVF cycles when using a person's own eggs.
For more information please see our FAQs.
Where you see a “?” on the chart, a clinic has done fewer than 20 cycles in this category and age range, so the CDC says showing percentages from this small data set would be misleading and unreliable.
He [Dr. Toledo] is warm and friendly. Always includes my husband in the conversation and gives big hugs...My egg retrieval was rough. It was the max dose you could give someone to maximize their egg retrieval outcome. I had a lower AMH and that’s why he chose this. We did frozen transfers every time using lupron, estrogen, progesterone...He only likes to implant 1 at a time..
I felt like a number [at RBA] in some ways because I never actually talk to the doctor unless it’s for bad news, or my post IVF failure. But the nurses have always been great, and once I did talk to the doctor he treated us like family...They need free parking. After all the money you spend on IVF, it’s the least they could do! Other than that, I feel like it it a great place. It’s definitely not small a quaint. So you will feel part of masses, but it’s a great place.
How was your experience with Andrew Toledo at RBA?
He is warm and friendly. Always includes my husband in the conversation and gives big hugs. We have had a hard journey together, we don’t know why it’s not working but we are all trying to figure it out together.
What's one piece of advice would you give a prospective patient of Andrew Toledo at RBA?
Get a good relationship with the nurses.
During treatment, were you treated like a number or a human with Andrew Toledo at RBA?
I felt like a number in some ways because I never actually talk to the doctor unless it’s for bad news, or my post IVF failure.
But the nurses have always been great, and once I did talk to the doctor he treated us like family.
Describe the protocols Andrew Toledo used in your cycles at RBA and their degree of success.
My egg retrieval was rough. It was the max dose you could give someone to maximize their egg retrieval outcome. I had a lower AMH and that’s why he chose this.
We did frozen transfers every time using lupron, estrogen, progesterone. As the transfers were failing we kept adding more medication such a prednisone and lovenox.
We tried doing a uterine biopsy to test when my implantation window was.
All of these procedures and still no pregnancy
Describe your experience with your nurse at RBA. (Assigned nurse: Jennilyn )
I usually spoke to two nurses. Jennilyn and Lindsey. Lindsey was direct and to the point, Jennilyn was so sweet and compassionate all the time. She felt like a friend. Both good qualities for nursing. The made the perfect pair!
Describe your experience with RBA.
The need free parking. After all the money you spend on IVF, it’s the least they could do! Other than that, I feel like it it a great place. It’s definitely not small a quaint. So you will feel part of masses, but it’s a great place.
Describe the costs associated with your care under Andrew Toledo at RBA.
Out of pocket expenses have been about 16,000.
Describe Andrew Toledo's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
Dr. Rubin treated my husband and me with nothing but kindness. She took time to explain things where we could understand them and didn’t hesitate to answer any questions. At the time of my miscarriage, she personally called me a couple of times to check on me...For me personally, Dr. Rubin recommended single embryo transfer...
[staff of RBA] Medical assistant seemed a little short with me when asking questions. Nurse was very compassionate during miscarriage. Prompt communication via email, but phone communication was a little slow...Surgery center is also conveniently located in same building so egg retrieval’s and embryo transfers are performed in main office location.
How was your experience with Jessica Rubin at RBA?
Very thorough- at my initial consultation it was obvious that she read all my medical records (size of a book) and had even made notes and marked pages. Very kind and explained all steps of the process and what to expect.
What's one piece of advice would you give a prospective patient of Jessica Rubin at RBA?
Write a list of questions before appointment so that you don’t forget.
During treatment, were you treated like a number or a human with Jessica Rubin at RBA?
Dr. Rubin treated my husband and me with nothing but kindness. She took time to explain things where we could understand them and didn’t hesitate to answer any questions. At the time of my miscarriage, she personally called me a couple of times to check on me.
Describe your experience with the nursing staff at RBA.
Medical assistant seemed a little short with me when asking questions. Nurse was very compassionate during miscarriage. Prompt communication via email, but phone communication was a little slow.
Describe your experience with RBA.
Multiple locations makes it a little more convenient for people traveling from out of town. The doctor who is on-call performs the procedures. Some of the other doctors do not seem to be as personable as Dr. Rubin. Surgery center is also conveniently located in same building so egg retrieval’s and embryo transfers are performed in main office location.
Describe the costs associated with your care under Jessica Rubin at RBA.
I was accepted into the baby guarantee program. It was a flat fee that covered monitoring appointments, egg retrieval, and embryo transfers. Medication was not included. If no live birth in 2 years, then we get our money back.
Describe Jessica Rubin's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
For me personally, Dr. Rubin recommended single embryo transfer.
[Dr. Rubin] Stated the facts plainly, which I wanted, but excellent care and bedside manner when I was grieving an outcome or expectation...Fully answered any questions I had, compassionate bedside manner, upbeat, but always forthcoming regarding risks/outcomes. She fully explained when or why we needed to change course and I always felt like a very active participant in the decisions and direction of treatment....
[nurse at RBA was] Very compassionate. Due to my incessant phone calls, she was the one to inform me of my chemical pregnancy. She handled the whole situation perfectly — looking back, I wouldn’t have her change a thing, given the circumstances...Appreciate the Piedmont location. It was easy to get in and get out. The office at Sandy Springs is also becoming more updated. The staff that handle transfers and the embryologists are also excellent!...
How was your experience with Jessica Rubin at RBA?
Wonderful, kind, competent doctor. Fully answered any questions I had, compassionate bedside manner, upbeat, but always forthcoming regarding risks/outcomes. She fully explained when or why we needed to change course and I always felt like a very active participant in the decisions and direction of treatment.
What's one piece of advice would you give a prospective patient of Jessica Rubin at RBA?
Think about what matters to you — trying low intervention treatment first, trying to achieve pregnancy as quickly as possible, how much you’re willing to disrupt your life with medication and appts. Then she’ll work with you to help achieve those goals.
During treatment, were you treated like a number or a human with Jessica Rubin at RBA?
Stated the facts plainly, which I wanted, but excellent care and bedside manner when I was grieving an outcome or expectation.
Describe your experience with your nurse at RBA.
Very compassionate. Due to my incessant phone calls, she was the one to inform me of my chemical pregnancy. She handled the whole situation perfectly — looking back, I wouldn’t have her change a thing, given the circumstances.
Describe your experience with RBA.
Appreciate the Piedmont location. It was easy to get in and get out. The office at Sandy Springs is also becoming more updated. The staff that handle transfers and the embryologists are also excellent!
Describe the costs associated with your care under Jessica Rubin at RBA.
Approximately 4K for ea transfer
Believe egg retrieval was 10-15k
Describe Jessica Rubin's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
Dr. Toledo was very honest and straight to the point with me, but at the same time, he was very personable and genuine with his delivery...he entertains transferring multiple starting at the age of 35...He always finds a way to connect with me. He uses humor to lighten the mood...He was very direct with how he wanted to proceed with my situation/case and didn’t waste any time making it happen...he encourages me to get second and third opinions if I feel that I need to
[The staff at RBA] were all very knowledgeable about the protocol and how everything goes. They communicated well with me for monitoring appointments and made me feel comfortable at all times...it is still very important to do your own research and stay on top of your situation...Ask questions and do your own research. Don’t be afraid to get other opinions
How was your experience with Andrew Toledo at RBA?
He always finds a way to connect with me. He uses humor to lighten the mood and make things more personable. He is very knowledgeable about updated research and protocols. He recommended supplements for me to start taking to increase egg quality right away. And he is always open to hearing others’ opinions, my opinions and suggestions from my own research, and he encourages me to get second and third opinions if I feel that I need to. He has instilled a lot of confidence and hope in me and my situation.
What's one piece of advice would you give a prospective patient of Andrew Toledo at RBA?
Ask questions and do your own research. Don’t be afraid to get other opinions!
During treatment, were you treated like a number or a human with Andrew Toledo at RBA?
From the start, Dr. Toledo was very honest and straight to the point with me, but at the same time, he was very personable and genuine with his delivery. He was very direct with how he wanted to proceed with my situation/case and didn’t waste any time making it happen! I connected with him immediately and I feel very supported and “in good hands” with him and the whole RBA staff.
Describe the protocols Andrew Toledo used in your cycles at RBA and their degree of success.
I started taking CoQ10 and DHEA for low AMH levels following my first appointment with him and he also had me do an HSG test. I have one open tube and one blocked tube. He suggested 3 rounds of IUI before proceeding to IVF, but my husband and I decided to jump right to IVF because of the success rates of the two and because of my good insurance coverage. I completed my first round of IVF this past March. I started the cycle with Lupron on day 1 of my cycle. I then did 300 units of Follistim am and pm in addition to the Lupron starting on day 2 continuing through day 12. I did an HCG trigger shot on day 13 and I had my egg retrieval on day 15. 10 eggs were retrieved, 8 of those being mature. 6 fertilized and 2 made it to blast. We sent the 2 off for PGS testing and both of them came back abnormal (chromosomes). We did not do a transfer. Both are still frozen but we will not be transferring them. I am gearing up for round 2 of IVF soon.
Describe your experience with the nursing staff at RBA.
They were all very knowledgeable about the protocol and how everything goes. They communicated well with me for monitoring appointments and made me feel comfortable at all times.
Describe your experience with RBA.
A ton of patients walk through the doors of RBA everyday. Though the doctors and nurses are good at what they do, it is still very important to do your own research and stay on top of your situation. Call them and make sure you communicate well. Don’t leave it up to them. Take your situation into your own hands and make sure you do everything in your power to stay organized and on top of your treatment plan.
Describe the costs associated with your care under Andrew Toledo at RBA.
My insurance covered most everything. I had to pay $900 out of pocket for my medication through Avella. And then I had to pay $1000 to meet my out of pocket deductible and then another $2000 for PGS testing. My insurance did not cover that.
Describe Andrew Toledo's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
We didn’t have any embryos to transfer but we were planning to transfer 1 because of my age (34). He said he entertains transferring multiple starting at the age of 35.
We had an initial appointment where he [Dr. Straub] 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...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.
$100-250 range for consultations. A few hundred for HSG testing...They [RBA staff] are the absolute worst communicators and make everything extremely difficult because they never contact you on test results or next steps. If you do not call them to follow up, they simply won’t. It’s all up to the patient to coordinate the next steps and try to get any answers, which is very frustrating...
How was your experience with Robert Straub at RBA?
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.
What's one piece of advice would you give a prospective patient of Robert Straub at RBA?
Don’t be afraid to ask questions, he will answer and explain well if you are confused or need more information.
During treatment, were you treated like a number or a human with Robert Straub at RBA?
He was personable and straightforward while not harsh.
Describe the protocols Robert Straub used in your cycles at RBA and their degree of success.
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.
Describe your experience with the nursing staff at RBA.
Did not have much interaction, they were always so quick to be in and out.
Describe your experience with RBA.
They are the absolute worst communicators and make everything extremely difficult because they never contact you on test results or next steps. If you do not call them to follow up, they simply won’t. It’s all up to the patient to coordinate the next steps and try to get any answers, which is very frustrating.
Describe the costs associated with your care under Robert Straub at RBA.
I don’t remember exactly, but $100-250 range for consultations. A few hundred for HSG testing.
Describe Robert Straub's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
No
What specific things went wrong at RBA?
Failed to call with results
Failed to convey critical information
Describe the specific things that went wrong at RBA.
Same answer as before- They are the absolute worst communicators and make everything extremely difficult because they never contact you on test results or next steps. If you do not call them to follow up, they simply won’t. It’s all up to the patient to coordinate the next steps and try to get any answers, which is very frustrating.
So our first appt was a phone consultation. We talked to him [Dr. Scott Slayden] for about an hour, and he really got to know us. I was surprised at how well the appt went just having it over the phone...Due to my age (35) he doesn't recommend IUI and recommends IVF for us so we can also freeze embryos and build a larger family later...
It is tough to rate [RBA] clinic during a pandemic. We had our consult, and his MA emailed us right away to contact them the first week of April for updates and unfortunately we couldn't do anything at this point. I have had trouble getting in contact with anyone since then, but all satellite offices are closed and the Main office is open, however I am unable to get in touch with anyone there. Again, we are in the middle of a pandemic and they are not starting anything new.
How was your experience with Scott Slayden at RBA?
We have only had a phone consult to this point due to the coronavirus pandemic. He made us feel pretty good about our chances of conceiving via IVF. However due to the timing of everything we cannot get any tests or start any cycles at this point. So we are just WAITING and it stinks, but I understand.
During treatment, were you treated like a number or a human with Scott Slayden at RBA?
We had waited a few months to get a consultation with Dr. Slayden. When it was time for our appointment the Coronavirus pandemic was just beginning and the office had closed. So our first appt was a phone consultation. We talked to him for about an hour, and he really got to know us. I was surprised at how well the appt went just having it over the phone.
Describe the protocols Scott Slayden used in your cycles at RBA and their degree of success.
Due to my age (35) he doesn't recommend IUI and recommends IVF for us so we can also freeze embryos and build a larger family later.
Describe your experience with RBA.
It is tough to rate a clinic during a pandemic. We had our consult, and his MA emailed us right away to contact them the first week of April for updates and unfortunately we couldn't do anything at this point. I have had trouble getting in contact with anyone since then, but all satellite offices are closed and the Main office is open, however I am unable to get in touch with anyone there. Again, we are in the middle of a pandemic and they are not starting anything new.
Love [Dr. Scott Slayden]. He is very compassionate. He does not sugar coat anything. He is very thorough and wants to see me succeed at becoming a mother. He always answers questions and gives any information that is helpful for his patients...I felt like a human. He is always super through with me...he is blunt and gets to the point which is what I want to know.
Treated like a patient not a number [at RBA], they know you my name here and you are not just a statistic. All staff her are very compassionate and care about the well being of their patients. This office is very organized and have good communication. All staff here seem to be very experienced...My nurse is very compassionate always willing to answer questions no matter how many I have.
How was your experience with Scott Slayden at RBA?
Love Dr. Slayden. He is very compassionate. He does not sugar coat anything. He is very thorough and wants to see me succeed at becoming a mother. He always answers questions and gives any information that is helpful for his patients.
What's one piece of advice would you give a prospective patient of Scott Slayden at RBA?
Trust your doctor. While you may not like what he has to say, he knows what he is doing so just trust his treatment and guidance.
During treatment, were you treated like a number or a human with Scott Slayden at RBA?
I felt like a human. He is always super through with me. He does not sugar coat anything he is blunt and gets to the point which is what I want to know.
Describe the protocols Scott Slayden used in your cycles at RBA and their degree of success.
1st IUI - Letrozole- negative pregnancy test
Moving own to IVF in May this will be my protocol Flare FSH 300/300/hCG 20/ICSI/freeze all at blast/No PGT due to young age.
Describe your experience with your nurse at RBA. (Assigned nurse: Jennifer (nurse))
My nurse is very compassionate always willing to answer questions no matter how many I have.
Describe your experience with RBA.
Treated like a patient not a number, they know you my name here and you are not just a statistic. All staff her are very compassionate and care about the well being of their patients. This office is very organized and have good communication. All staff here seem to be very experienced.
Describe the costs associated with your care under Scott Slayden at RBA.
IUI - $1500
IVF - $12,100. $4,200. $7,500
Describe Scott Slayden's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
I have not made it this far yet. Still waiting on egg retrieval
Dr. Best stayed positive and frequently encouraged myself and my husband. She was not just thoughtful but very thorough with her treatment plan. She made adjustments when needed. The blend of her knowledge and positvity while managing your expectations made our experience a great one. We had been through previous doctors however she was truly our “ Monday Morning Quarterback “ she took our history and utilized it and adjusted where needed. After 17 years of trying to conceive, Dr. Best transferred our 1 embryo that is now a 10 month old baby girl.
Very compassionate staff [at RBA]. Everyone communicated well. They were very responsive and polite. No matter what time of day it was you felt as if you always mattered. The staff was extremely easy to work with. Never felt rushed for appointments...Dr. Best stayed positive and frequently encouraged myself and my husband. She was not just thoughtful but very thorough with her treatment plan. She made adjustments when needed.
How was your experience with Monica Best at RBA?
Dr. Best stayed positive and frequently encouraged myself and my husband. She was not just thoughtful but very thorough with her treatment plan. She made adjustments when needed. The blend of her knowledge and positvity while managing your expectations made our experience a great one. We had been through previous doctors however she was truly our “ Monday Morning Quarterback “ she took our history and utilized it and adjusted where needed. After 17 years of trying to conceive, Dr. Best transferred our 1 embryo that is now a 10 month old baby girl.
What's one piece of advice would you give a prospective patient of Monica Best at RBA?
Trust the process, both good and bad times.
During treatment, were you treated like a number or a human with Monica Best at RBA?
Dr. Best was very compassionate and had great bedside manner.
Describe the protocols Monica Best used in your cycles at RBA and their degree of success.
Lupron
Gonotrophines
Describe your experience with RBA.
Very compassionate staff. Everyone communicated well. They were very responsive and polite. No matter what time of day it was you felt as if you always mattered. The staff was extremely easy to work with. Never felt rushed for appointments
Describe the costs associated with your care under Monica Best at RBA.
Dr. Slayden is a wealth of information and such a compassionate doctor. He understood our desperation for a baby and very clearly laid out a plan of treatment. He is both warm and factual, and put both my husband and myself at ease...He answered all of our questions patiently and thoroughly.
Dr. Slayden and his staff [at RBA] want the best outcome for you and will work with you to develop the right plan. Be prepared to hear a lot of big words and ask questions as much as you need to...Take notes at your consult. Dr. Slayden talks quickly because he has so much to say!
How was your experience with Scott Slayden at RBA?
Dr. Slayden is a wealth of information and such a compassionate doctor. He understood our desperation for a baby and very clearly laid out a plan of treatment. He is both warm and factual, and put both my husband and myself at ease.
What's one piece of advice would you give a prospective patient of Scott Slayden at RBA?
Take notes at your consult. Dr. Slayden talks quickly because he has so much to say!
During treatment, were you treated like a number or a human with Scott Slayden at RBA?
Dr. Slayden spent over an hour with us discussing his diagnosis and plan for treatment. He answered all of our questions patiently and thoroughly.
Describe the protocols Scott Slayden used in your cycles at RBA and their degree of success.
No protocol used yet, still in the waiting period.
Describe your experience with RBA.
Go in with an open mind. Dr. Slayden and his staff want the best outcome for you and will work with you to develop the right plan. Be prepared to hear a lot of big words and ask questions as much as you need to.
[Dr. Jessica Rubin] was very easy to talk. She explained how fertility and infertility works. She helped us to understand the tests and processes we would go through. She included diagrams to visually show how it all works! We arrived at our appointment and was seen right away.
[The staff at RBA - Sandy Springs] is very nice, everyone that works there are pleasant and always smiling! They make you feel comfortable when you arrive, until you leave. The environment is really nice. They get you in and out, with your appointments...They are excellent
How was your experience with Jessica Rubin at RBA?
She was very easy to talk. She explained how fertility and infertility works. She helped us to understand the tests and processes we would go through. She included diagrams to visually show how it all works! We arrived at our appointment and was seen right away.
What's one piece of advice would you give a prospective patient of Jessica Rubin at RBA?
Be open-minded
During treatment, were you treated like a number or a human with Jessica Rubin at RBA?
She was extremely nice and helpful with explaining everything
Describe the protocols Jessica Rubin used in your cycles at RBA and their degree of success.
i have only done the tests - covid19 put a pause to our progress.
Describe your experience with the nursing staff at RBA.
They are excellent
Describe your experience with RBA.
The clinic is very nice, everyone that works there are pleasant and always smiling! They make you feel comfortable when you arrive, until you leave. The environment is really nice. They get you in and out, with your appointments
Be prepared to wait for your initial appointment, but he [Dr. Toledo] is worth the wait...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.
Megan and Lisa were my primary nurses during my IUIs, egg retrieval, and first transfer [at RBA]. They were both wonderful and responded to all of my emails quickly... 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...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.
How was your experience with Andrew Toledo at 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.
What's one piece of advice would you give a prospective patient of Andrew Toledo at RBA?
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.
During treatment, were you treated like a number or a human with Andrew Toledo at RBA?
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.
Describe the protocols Andrew Toledo used in your cycles at RBA and their degree of success.
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.
Describe your experience with your nurse at RBA. (Assigned nurse: Megan, Lisa, and Krista)
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.
Describe your experience with 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.
Describe the costs associated with your care under Andrew Toledo at RBA.
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.
Describe Andrew Toledo's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
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 always came away from my appointments [with Dr. Daniel Shapiro] 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...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.
The procedure costs [at RBA] are comparable to other Atlanta facilities. I know there are payment options available, as needed...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.
How was your experience with Daniel Shapiro at RBA?
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.
What's one piece of advice would you give a prospective patient of Daniel Shapiro at RBA?
Don't expect him to sugar coat information, whether good or bad. He is supportive and compassionate, but also direct in his delivery.
During treatment, were you treated like a number or a human with Daniel Shapiro at RBA?
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.
Describe the protocols Daniel Shapiro used in your cycles at RBA and their degree of success.
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.
Describe your experience with RBA.
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.
Describe the costs associated with your care under Daniel Shapiro at RBA.
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.
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!...my endometrial lining wasn’t where we wanted it to be on day 10 so we increased the estradiol orally and vaginally...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!
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.
How was your experience with Daniel Shapiro at RBA?
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.
What's one piece of advice would you give a prospective patient of Daniel Shapiro at RBA?
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!
During treatment, were you treated like a number or a human with Daniel Shapiro at RBA?
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.
Describe the protocols Daniel Shapiro used in your cycles at RBA and their degree of success.
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.
Describe your experience with the nursing staff at RBA.
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.
Describe your experience with RBA.
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.
Describe the costs associated with your care under Daniel Shapiro at RBA.
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!
Describe Daniel Shapiro's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
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!
What specific things went wrong at RBA?
Failed to call in prescriptions to pharmacy
Describe the specific things that went wrong at RBA.
In 2016 (different nursing staff then now), it was a mess trying to get prescriptions ordered to start my egg retrieval process- super stressful!
I liked him [Dr. Robert Straub]. He was very straight forward, very smart, answers all questions... 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.
I hate the location of the main office [of RBA]. It is far from Fayetteville where Dr Straub sees people for consults. Youhave to get all your test done there and it is a drive. The facility itself is very clean and nice.... 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 like Amy. She always response to emails usually same day. I never had an issue getting questions answered. She did tell me about my 2nd cycle not resulting in a pregnancy, she was straight forward.... but I am sure that news is hard to give.
How was your experience with Robert Straub at RBA?
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 .
What's one piece of advice would you give a prospective patient of Robert Straub at RBA?
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.
During treatment, were you treated like a number or a human with Robert Straub at RBA?
I liked him. He was very straight forward, very smart, answers all questions
Describe the protocols Robert Straub used in your cycles at RBA and their degree of success.
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.
Describe your experience with your nurse at RBA. (Assigned nurse: Amy Zimmerman)
I like Amy. She always response to emails usually same day. I never had an issue getting questions answered. She did tell me about my 2nd cycle not resulting in a pregnancy, she was straight forward.... but I am sure that news is hard to give.
Describe your experience with RBA.
I hate the location of the main office. It is far from Fayetteville where Dr Straub sees people for consults. Youhave to get all your test done there and it is a drive. The facility itself is very clean and nice.
Describe the costs associated with your care under Robert Straub at RBA.
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.
Describe Robert Straub's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
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. 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. ... 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. ... He recommended single embryo transfer with PSG testing
Strength would be the kindness of the staff [RBA Cumming] 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. ... $14,100 for monitoring, transfer and PSG testing. This does NOT include $5700 that was paid twice due to one cancelled round.
How was your experience with Robert Straub at RBA?
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.
What's one piece of advice would you give a prospective patient of Robert Straub at RBA?
Bring a note pad to write info discussed down because he tends to talk fast.
During treatment, were you treated like a number or a human with Robert Straub at RBA?
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.
Describe the protocols Robert Straub used in your cycles at RBA and their degree of success.
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
Describe your experience with your nurse at RBA. (Assigned nurse: Amy Zimmerman)
Jennifer Cunningham and Amy Zimmerman are the two nurses assigned to me. They were very informative and communicated with me via email
Describe your experience with RBA.
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.
Describe the costs associated with your care under Robert Straub at RBA.
$14,100 for monitoring, transfer and PSG testing. This does NOT include $5700 that was paid twice due to one cancelled round.
Describe Robert Straub's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
He recommended single embryo transfer with PSG testing
Dr. Straub never made us feel rushed or that any questions were ridiculous or not important. He took the time to explain the process while not overwhelming us with details. He always answered all our questions. He didn't make us feel like we were just another case he was reading from a file. ... We attempted 2 rounds of IUI prior to IVF. IUI was a long shot due to a blocked tube.
The strength of the clinic [RBA] is getting back to patients in a timely manner and not having a long waiting period to get the process started like many clinics do. The weakness of the clinic is the response from the on call after hours phone service. ... They [nurses] were very supportive and available while going through IUI and IVF. Even when an appointment did not have a nursing consultation if I had any questions they were always available to help and did not make any questions seem rushed, unimportant or a waste of their time.
How was your experience with Robert Straub at RBA?
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.
What's one piece of advice would you give a prospective patient of Robert Straub at RBA?
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.
During treatment, were you treated like a number or a human with Robert Straub at RBA?
Dr. Straub never made us feel rushed or that any questions were ridiculous or not important. He took the time to explain the process while not overwhelming us with details. He always answered all our questions. He didn't make us feel like we were just another case he was reading from a file.
Describe the protocols Robert Straub used in your cycles at RBA and their degree of success.
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.
Describe your experience with the nursing staff at RBA.
The nursing staff has always been available to answer questions and to help go through the process. They were very supportive and available while going through IUI and IVF. Even when an appointment did not have a nursing consultation if I had any questions they were always available to help and did not make any questions seem rushed, unimportant or a waste of their time. The nurses returned phone calls quickly and always responded to encrypted emails promptly.
Describe your experience with RBA.
The strength of the clinic is getting back to patients in a timely manner and not having a long waiting period to get the process started like many clinics do. The weakness of the clinic is the response from the on call after hours phone service. Although the phone service is contracted the people taking the messages should understand the need of the facility they are taking the message for, the answering service was occasionally insensitive and rude.
Describe the costs associated with your care under Robert Straub at RBA.
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$
Describe Robert Straub's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
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.... 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.
Strengths of this clinic [RBA- Sandy Springs] 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....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.
How was your experience with Daniel Shapiro at RBA?
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.
What's one piece of advice would you give a prospective patient of Daniel Shapiro at RBA?
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.
During treatment, were you treated like a number or a human with Daniel Shapiro at RBA?
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.
Describe the protocols Daniel Shapiro used in your cycles at RBA and their degree of success.
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.
Describe your experience with your nurse at RBA. (Assigned nurse: Kelly and Diana)
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.
Describe your experience with RBA.
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.
Describe the costs associated with your care under Daniel Shapiro at RBA.
We have great insurance and our out of pocket costs for IUI was about $400 each IUI including medications, ultrasounds, and insemination.
Describe Daniel Shapiro's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
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. Shapiro spent so much time with us discussing every aspect of our treatment plan. We expected someone as busy as him to rush us through the initial conversation, but he took his time and made sure every single one of our questions was answered. He was blunt in a way I appreciated and never seemed condescending or like he was judging our questions.
It’s a giant practice [RBA] - lots of doctors and a few different locations. While your specific doctor remembers your case and information not every single person at the office location will. One great aspect has been that pretty much everything can be done in house. From bloodwork to genetic consults and everything in between. I rarely have to go anywhere else to get a test done.
How was your experience with Daniel Shapiro at RBA?
Very knowledgeable about what seemed like our very specific set of circumstances, which I think speaks to his overall expertise. He made us feel comfortable discussing topics we hadn’t discussed with anyone else yet. Most importantly he eased a lot of the concerns I had about whether or not it was even possible for me to use my eggs in our course of treatment. The only weakness I’d say we’ve encountered is that it took awhile to get the initial appointment-approx. 6 weeks - but we were lucky to have the time to wait.
What's one piece of advice would you give a prospective patient of Daniel Shapiro at RBA?
Come in prepared with all your questions, he’ll have the time to answer them. Be willing to be open about exactly what your expectations are with him so he can set realistic goals for you.
During treatment, were you treated like a number or a human with Daniel Shapiro at RBA?
Dr. Shapiro spent so much time with us discussing every aspect of our treatment plan. We expected someone as busy as him to rush us through the initial conversation, but he took his time and made sure every single one of our questions was answered. He was blunt in a way I appreciated and never seemed condescending or like he was judging our questions.
Describe your experience with your nurse at RBA.
There was some initial confusion with the care coordinator on exactly what types of tests and blood work needed ordered for my first few appointments. But every other nurse in the office always worked extremely hard to get it sorted out when I was there. Everyone has been very responsive to emails and questions and we’ve never had trouble getting in touch with anyone.
Describe your experience with RBA.
It’s a giant practice - lots of doctors and a few different locations. While your specific doctor remembers your case and information not every single person at the office location will.
One great aspect has been that pretty much everything can be done in house. From bloodwork to genetic consults and everything in between. I rarely have to go anywhere else to get a test done.
Describe the costs associated with your care under Daniel Shapiro at RBA.
$14K
Describe Daniel Shapiro's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
He only does single embryo transfer - something we were ok with.
What specific things went wrong at RBA?
Provided conflicting information
Scheduled the wrong procedure
Describe the specific things that went wrong at RBA.
During the initial bloodwork and ultrasounds there was an instance of the care coordinator ordering the wrong ultrasound and ordering the bloodwork twice. It was frustrating in the moment but the nurse assigned to me that day was incredibly helpful about getting it all sorted out.
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...He listened, took a look, and was appreciative of all I had provided...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...has exceeded every expectation I ever had of a RE...He had a bit of a waiting list, but I took that as I good sign. I
We qualified for the “baby guarantee” program [at RBA]. 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 central clinic is great. Friendly staff from the second you walk in and there is always someone with you at any time. The great thing about RBA is there are several satellite offices...I can visit any satellite office for monitoring or labs and they all communicate.
How was your experience with Andrew Toledo at RBA?
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.
What's one piece of advice would you give a prospective patient of Andrew Toledo at RBA?
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.
During treatment, were you treated like a number or a human with Andrew Toledo at RBA?
Dr. Toledo has exceeded every expectation I ever had of a RE. With a troubling and disappointing 2018, we scheduled and appointment with Toledo. He had a bit of a waiting list, but I took that as I good sign. I had four unrelated individuals recommend his name to me, so when our appointment day came I felt as though I was meeting a celebrity.
Toledo sat with my husband and I and went page by page over our history. He was so compassionate and thorough. We left with a renewed sense of hope and peace. Every appointment since has been better then the last. Being in his care as where we are supposed to be.
Describe the protocols Andrew Toledo used in your cycles at RBA and their degree of success.
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.
Describe your experience with your nurse at RBA.
At RBA we work with the same staff from the beginning to the end. Dr. Toledo has an admin who scheduled our first consultation and has always been available for general question. Then there is a separate young lady to go through our protocol, next medical steps, consents, etc...
Tay is his financial contact. She had a separate meeting with us to talk solely about financing, insurance, and drug costs. We have also met a team of nurses and his medical assistant who have guided us through everything at this point. We feel like we are in really good hands.
Describe your experience with RBA.
The central clinic is great. Friendly staff from the second you walk in and there is always someone with you at any time. The great thing about RBA is there are several satellite offices. I live in the city but work about an hour north. I can visit any satellite office for monitoring or labs and they all communicate.
Describe the costs associated with your care under Andrew Toledo at RBA.
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!
Overall, I had a great experience with him [Dr. Daniel Shapiro]....He is extremely personable and will be very honest and upfront with you on treatment and potential roadblocks...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...He took the time to get to know me. I ran into him outside the office and he knew and said hi to me.
Strengths [at RBA] - doctors all truly care and are compassionate. Check-in and check-off staff are so nice. Check out system was down a few times during checkout, meaning I couldn’t pay and got a very large bill with all of my “past due” payments at once, which wasn’t fun. Be patient, as cycles take time...Some nurses were better than others. Some acted as though they hadn’t read my charts and I was practically telling them what to do. Some understand my case and advised accordingly...I showed up once for a midcycle ultrasound, and the ultrasound person said they had me down for a baseline
How was your experience with Daniel Shapiro at RBA?
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.
What's one piece of advice would you give a prospective patient of Daniel Shapiro at RBA?
He is extremely personable and will be very honest and upfront with you on treatment and potential roadblocks.
During treatment, were you treated like a number or a human with Daniel Shapiro at RBA?
He took the time to get to know me. I ran into him outside the office and he knew and said hi to me.
Describe the protocols Daniel Shapiro used in your cycles at RBA and their degree of success.
I took Femara for each cycle, along with Progesterone shots, ovidril to trigger ovulation, and IUI
Describe your experience with the nursing staff at RBA.
Some nurses were better than others. Some acted as though they hadn’t read my charts and I was practically telling them what to do. Some understand my case and advised accordingly.
Describe your experience with RBA.
Strengths - doctors all truly care and are compassionate. Check-in and check-off staff are so nice. Check out system was down a few times during checkout, meaning I couldn’t pay and got a very large bill with all of my “past due” payments at once, which wasn’t fun. Be patient, as cycles take time.
Describe the costs associated with your care under Daniel Shapiro at RBA.
One IUI cycle including medicine was between $2,500-$3,000
What specific things went wrong at RBA?
Provided conflicting information
Scheduled the wrong procedure
Describe the specific things that went wrong at RBA.
I showed up once for a midcycle ultrasound, and the ultrasound person said they had me down for a baseline
Dr. Slayden will give you a lot of information about pros and cons but will also give you the wiggle room to decide. ... 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. ... We were able to start the new more intense FET protocol the next day after surgery (uterus was all clear).
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. ... 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.
How was your experience with Scott Slayden at RBA?
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!
What's one piece of advice would you give a prospective patient of Scott Slayden at RBA?
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.
During treatment, were you treated like a number or a human with Scott Slayden at RBA?
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.
Describe the protocols Scott Slayden used in your cycles at RBA and their degree of success.
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.
Describe your experience with your nurse at RBA. (Assigned nurse: Lacie Bean )
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.
Describe your experience with RBA.
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.
Describe the costs associated with your care under Scott Slayden at RBA.
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.
Describe Scott Slayden's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
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. 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. ... My husband also liked him for his straight forward and knowledgeable personality.
The clinic [RBA - Cumming] 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. ... $1200 self pay for an IUI cycle. $250 for consultation.
How was your experience with Robert Straub at RBA?
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.
What's one piece of advice would you give a prospective patient of Robert Straub at RBA?
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.
During treatment, were you treated like a number or a human with Robert Straub at RBA?
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.
Describe the protocols Robert Straub used in your cycles at RBA and their degree of success.
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.
Describe your experience with RBA.
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.
Describe the costs associated with your care under Robert Straub at RBA.
$1200 self pay for an IUI cycle. $250 for consultation.
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...I'm grateful for what we retrieved (19!)... only transfer one embryo at a time due to risk of multiples...
Cossandra is the care coordinator [at RBA] 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...[Monitoring] Felt like a pretty well-oiled machine. Bloodwork usually first and then the ultrasound...Overall I have no complaints about the clinic itself...The billing department was probably the most friendly department I was able to speak with, aside from the surgery staff.
How was your experience with Daniel Shapiro at RBA?
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.
What's one piece of advice would you give a prospective patient of Daniel Shapiro at RBA?
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.
During treatment, were you treated like a number or a human with Daniel Shapiro at RBA?
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.
Describe the protocols Daniel Shapiro used in your cycles at RBA and their degree of success.
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!)
Describe your experience with your nurse at RBA. (Assigned nurse: Diana)
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.
Describe your experience with RBA.
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.
Describe your experience with your monitoring appointments at RBA.
Felt like a pretty well-oiled machine. Bloodwork usually first and then the ultrasound.
Describe the costs associated with your care under Daniel Shapiro at RBA.
Without the cost of medications, about $23,000
Describe Daniel Shapiro's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
Dr. Shapiro and his clinic only transfer one embryo at a time due to risk of multiples.
What specific things went wrong at RBA?
Provided conflicting information
Describe the specific things that went wrong at RBA.
One time, one of the other nurses advised me that my follicles were bigger than they actually were. No biggie but I did get a little prematurely excited.
Scott Slayden takes an extraordinary amount of time with his patients. He listens, he talks with you as an informed patient who has a huge stake in their treatment, he offers up different solutions and paths to consider, and, above all, he is kind, compassionate, and caring while not sugar-coating the truth of the situation. He delivers news in a gentle, straightforward manner that gives you hope while also keeping a grasp on the reality of the difficult circumstances.
Their [RBA] absolute strength is the excellence of the embryo lab and it’s director, Dr. Nagy. It is world-class and has incredible results. Their multiple Atlanta-area locations are also a big plus. They are very willing to coordinate care with out-of-state patients. At one point, I was out-of-state and they were willing to have me do as much of the testing and monitoring possible with my local Dr before traveling to be seen at their location. During retrieval rounds this helped a lot.
How was your experience with Scott Slayden at RBA?
I recommend Dr. Slayden every chance I get. He is very smart, up on the latest news, trends, and treatments, but not afraid to reach back to something tried-and-true if it might help the patient. I was a patient with a lot of complications, that kept getting worse. He was always kind, encouraging, helpful, and compassionate. More importantly, he is EXCELLENT at his job. He seems to enjoy the challenge of a patient who is not cookie-cutter and he has an amazing success rate. He is willing to go outside the box, willing to listen to patient’s ideas, will discuss different options at length, and will fight for a patient to have success. He stuck with us when other doctors may have given up or told us to stop trying. We regularly thank God for him.
I recommended him to my best friend after she had failed attempts with an out-of-state clinic. I believed in his care so absolutely that I convinced her to travel to see him. And it was the right decision that resulted in a beautiful baby.
What's one piece of advice would you give a prospective patient of Scott Slayden at RBA?
Even if you don’t live locally to his office, it is more than worth it to travel to be under his care. He is very willing to manage out-of-state patients. He is worth it.
During treatment, were you treated like a number or a human with Scott Slayden at RBA?
Scott Slayden takes an extraordinary amount of time with his patients. He listens, he talks with you as an informed patient who has a huge stake in their treatment, he offers up different solutions and paths to consider, and, above all, he is kind, compassionate, and caring while not sugar-coating the truth of the situation. He delivers news in a gentle, straightforward manner that gives you hope while also keeping a grasp on the reality of the difficult circumstances.
Describe the protocols Scott Slayden used in your cycles at RBA and their degree of success.
I had had a failed fresh transfer cycle at another clinic and transferred to Dr. Slayden upon the recommendation of several friends who had had success with him.
He recommended being strategic and aggressive with getting the most eggs and embryos possible, as quickly as possible. I had a very low ovarian reserve and had only 4 eggs retrieved at my first cycle with the first clinic, with a failed transfer of the one resulting embryo. He wanted to back-to-back retrieval rounds to get as many embryos as possible, freeze them, and then do a frozen transfer when my body was as ready as possible. We did that, got many more embryos, and then did a day-3 transfer that resulted in a pregnancy that unfortunately later miscarried. While my body healed from the miscarriage, we did another retrieval and froze all embryos to add more to the “bank”.
We did another frozen transfer but my lining wouldn’t prep correctly, so we cancelled that, and he tried multiple rounds of different therapies and medications to help get my lining to respond. We attempted a “natural” transfer with a frozen embryo, timing it to my body’s cycle. That resulted in a good lining, but a chemical pregnancy.
We took a break, attempted another frozen embryo transfer with a natural cycle and got our miracle boy.
We had 3 more frozen transfers after him, all with “natural” protocols that times it to my body’s cycle (which doesn’t always work with the lab’s schedule, or our schedule, and we had to try different cycles before they would line up, but Slayden was willing to go that extra mile to get us our babies). That resulted in our daughter, and current healthy pregnancy.
Describe your experience with your nurse at RBA.
All of RBA staff are kind and compassionate, take time with their patients, and have genuine joy and heartache for you. I have not had a single bad experience.
Describe your experience with RBA.
Their absolute strength is the excellence of the embryo lab and it’s director, Dr. Nagy. It is world-class and has incredible results.
Their multiple Atlanta-area locations are also a big plus.
They are very willing to coordinate care with out-of-state patients. At one point, I was out-of-state and they were willing to have me do as much of the testing and monitoring possible with my local Dr before traveling to be seen at their location. During retrieval rounds this helped a lot.
Describe the costs associated with your care under Scott Slayden at RBA.
Over $100,000 because of multiple rounds of IVF, frozen transfers, surgeries, etc.
He [Dr. Scott Slayden] 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.
They [nurses at RBA-Marietta] are great- always get back to me quickly when I call, appointments are on time and efficient...Clomid check $470...Mid cycle ultrasound $200...IUI $600...I love that they have several different office locations and I can go to anyone for the ultrasounds and bloodwork. I wish there was more of a support network while in treatment. I think they have a group at the main office but it has never been mentioned. This process is hard physically and emotionally and wish they had more to offer in the way of a community feeling.
How was your experience with Scott Slayden at RBA?
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.
What's one piece of advice would you give a prospective patient of Scott Slayden at RBA?
This is a long process and you have to be flexible
During treatment, were you treated like a number or a human with Scott Slayden at RBA?
The staff are great and try their best to
Work with your schedule. Everything is explained well and they always get back to me when I contact them.
Describe the protocols Scott Slayden used in your cycles at RBA and their degree of success.
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.
Describe your experience with your nurse at RBA. (Assigned nurse: Selena)
They are great- always get back to me quickly when I call, appointments are on time and efficient.
Describe your experience with RBA.
I love that they have several different office locations and I can go to anyone for the ultrasounds and bloodwork.
I wish there was more of a support network while in treatment. I think they have a group at the main office but it has never been mentioned. This process is hard physically and emotionally and wish they had more to offer in the way of a community feeling.
Describe the costs associated with your care under Scott Slayden at RBA.