How was your experience with Daniel Stein at RMA of New York?
He can certainly be very candid - I have a uterine factor issues which precludes me from carrying a child, and he was quite blase to say "you are super healthy, except for the bad uterus!". This really didn't hurt my feelings - I've known about my condition for a long time, but if a patient were more sensitive, I suppose this could be a weakness of his. His pros outweigh the "con" in my mind - he's thorough, aggressive in treatment, and does listen to questions and walk you through next steps. My first cycle was fine - I ended up getting 12 eggs, 7 mature, 6 fertilized. Of those 6, 3 made it to blast and all 3 were "chromosomally" normal. That's a great yield, but for this next round, we're taking a different approach to try and get more mature eggs and hopefully have more embryos to work with.
What's one piece of advice would you give a prospective patient of Daniel Stein at RMA of New York?
Be prepared with a list of questions and paper/pen. He can be quick when he walks you through problems/next steps/etc. Very open to answering questions, but if you don't have any prepared, the meeting might be over before you had time to think of them.
During treatment, were you treated like a number or a human with Daniel Stein at RMA of New York?
Dr. Stein is very direct and to the point. I wouldn't ever describe him as warm, but he listened to my concerns and answered all my questions, spoke with me on the phone when I asked for a call, and has been quick responding to my emails (I am undergoing a second round with him this spring). He'll tell it like it is without sugarcoating, but honestly that's the type of person I want in charge of my care.
Describe the protocols Daniel Stein used in your cycles at RMA of New York and their degree of success.
We used an antagonist protocol. Because we'll be using a GC, I was basically treated like an egg donor. Had to undergo FDA testing, genetic testing, etc before starting. I'm only 30, but egg quality/quantity was seemingly not an issue to begin with - we just wanted to retrieve eggs, make embryos, and freeze them for future use. It turned out my reserve is more diminished than AMH originally indicated, so I was put on doses more commonly used with 40 year olds. Can't remember specific doses, but all were quite high - 225 Gonal H, 3 or 4 menopurs a day in the beginning. Given that 5/12 eggs were immature, we're changing it a little this time to try and get more mature eggs. I was not put on birth control the first cycle, which apparently can promote consistency in follicular growth, so less of a chance of some follicles beating others.
Describe your experience with your nurse at RMA of New York. (Assigned nurse: Kiran was my coordinator. I was seen by a few of his nurses.)
The IVF coordinator I worked with - Kiran - is/was lovely. She's quick to respond over email, call, etc, and always had a great disposition, even when unmatched by mine. My only frustration came from the coordination between Kiran, the nurses, doctor, and 3rd party reproduction team a few times. Because there are so many cooks in the kitchen, communication failed a few times. IE, I was told that I'd be starting another cycle in April this spring, and learned (quite late) that it wouldn't be able to take place until May. This wouldn't have bothered me except that no one really told me - I had to find out myself. All a result of each team member thinking that someone else was going to tell me. I don't think this would be a problem for most, but if you're using a GC, you'll have to work with 3rd party repro and IVF, and those two need to communicate just a little bit better.
Describe your experience with RMA of New York.
RMA is, for the most part, extremely organized. I felt well-cared for 99% of the time - nurses always called when the said they would, I never had to wait longer than 10 minutes for monitoring (and that would be when the waiting room was packed!), and everyone really seems to know what they're doing. Every fellow/doctor I saw while monitoring was incredible, and the people who performed my retrieval seemed great. Very pleased with the outcome of the cycle, and I'm sure I have to credit the clinic and the doctors/embryologists for their great work. That said - it is a big place. As I mentioned earlier, if your situation is slightly out of the ordinary and you need to work across a few teams, it sometimes feels like you need to stay on top of everyone. I was a little surprised that it took nurses/coordinators a while to realize that I was waiting for their next steps, only to learn they all thought I was in touch with one of them the whole time. You do need to be organized with multiple teams. If you're just working with one coordinator though, I think RMA has it fully in hand.
Describe your experience with your monitoring appointments at RMA of New York.
Monitoring hours are from 7 - 8:30 am, but they definitely saw people after the end time (I'd always see women running in super late). The good thing about RMA is they have locations all over the city, so it's pretty convenient (ie, I had a meeting one morning on the east side. RMA UES is not my primary location, but I could be monitored there and then went right to my work meeting after). Sometimes the waiting room was crowded (usually on weekends, when only one location is open), but honestly there were always chairs and you always got in and out very quickly. I still felt like I had time to talk to the doctors and nurses on busy days, too. Overall a pretty easy experience.
Describe the costs associated with your care under Daniel Stein at RMA of New York.
The total cost of embryo freezing was about $17,000. Embryo testing was about $150/embryo plus a fee. We had 3 embryos tested and it was $600. I've heard others with much higher expenses (RMA uses a third party company).
Most of my regular visits were covered by insurance, but I have had to pay about...$500 or so (maybe more) in testing, which was partially covered by insurance.
Describe Daniel Stein's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RMA of New York.
We haven't crossed this bridge, but my doctor and the clinic do not believe in multiple embryo transfers unless the mother is over a certain age or there's another medical reason to do so.
What specific things went wrong at RMA of New York?
- Provided conflicting information
Describe the specific things that went wrong at RMA of New York.
Just minor - this round, I was told by a nurse to start birth control, and that I would be starting stims in mid April. Cut to a few days before I thought this was starting, and I learned from the coordinator that I wouldn't be able to go ahead with the cycle until May. This was mostly due to the fact that I had travel scheduled that could potentially conflict with a retrieval date had I started stims in April. However, I'd communicated this travel with everyone, and the nurse I spoke to earlier said "this won't be a problem." There was just a miscommunication. Not the end of the world for me, but given we pay so much for this service, isn't something I'd be happy to experience again.