RMA of New York

Pregnancy did not result from my treatment with Dr. Knapman, which skews my response, but overall I thought she was fine. I wish she had considered factors such as diet, potential immune or lifestyle issues, or suggested supplementary treatment or investigation of the reason that my transfer of a seemingly healthy embryo did not work. Upon completing treatment with her, I have spoken to many other people who mention their doctors suggesting acupuncture, reaching an ideal weight, tracking basal body temperature to determine ideal transfer time, etc. There was very little discussion about any of those things - I was especially concerned with the timing of IUI because I was using frozen donor sperm which does not stay alive as long as fresh sperm, but she seemed to apply a formulaic approach. Overall, she was nice and seemed to know her stuff, and did a great job with the egg retrieval, but she did not deviate from standard Western medical procedures at all, and did not seem to take the nuanced approach that I've heard other friends describe their doctors taking. I am back to trying naturally for the time being, but will seek out a different doctor when my partner and I move on to fertility treatments again.

See multiple doctors before making your decision, and be sure to press her on questions you have related to your specific case. Ask how she plans to vary her treatment plans based on the particulars of your situation.

Letrozole with HCG trigger shot for all six IUIs, transfer at 24 hours with frozen sperm samples. No pregnancies or positive pregnancy tests resulted. During IVF cycle, used a standard cocktail with a high dose of Menopur, Gonal-F, Pregnyl trigger, and Progesterone shots following the egg retrieval. Retrieved 5 eggs, 4 became 5-day blastocysts. We transferred one, it did not work. Froze the remaining three and have not yet done a frozen cycle.

They were fine. Always a wait.

She prefers single embryo transfer which was fine with me. She explained her reasoning well and has been published on the matter.

I appreciated Dr. Klein and his honesty with my diagnosis and its relation to my chances of natural conception. He kept me informed, and was often available by email outside of business hours if questions were to arise. Although I understand he is a top rated doctor in this field, he was not the appropriate provider for me; my issues were more challenging and I do not feel that he was able to exercise any creative approaches to my care, as my subsequent doctor had done. Dr. Klein was very kind and compassionate, and a true professional.

Ask him questions, and challenge his responses if you are unhappy with them.

We had 3 unsuccessful IUI cycles. We were preparing for IVF, but my insurance changed and the new insurance would not cover the procedure.

I do not recall. Most, if not all, of my treatment was covered by insurance.

N/A

She was great and made us feel very comfortable. When we had bad news she was honest and kind and gave her opinion of what she would do if she was in our position, which I appreciated. When she had good news she was as excited as we were.

Similar to any fertility appointment I found that I often quickly forgot details after I left the office or hung up the phone. I learned to take notes during appointments, also to write down any questions in advance.

Monitoring during the week wasn't too bad. Usually in and out in an hour. On the weekends they warned us that if we weren't there right when we opened we wouldn't be seen for 5+ hours which I think is unacceptable. We always came super early on the weekends so we only waited about an hour and a half. It seems like if the wait gets that long why not have more staff on hand?

about $22,000 fully out of pocket

She offered us the option to transfer two but said with my age being on the younger side she thought we would be fine to transfer one. We said we did not want twins and she respected that decision.

When i first met Lawrence Grunfeld he mis diagnosed me. He told me i had alot of follicles while he himself was doing my ultrasound. He anticipated no issues. I then received my AMH results back of .20 and i was confused how i had many follicles in my ultrasound yet such a low AMH. I was at a loss and confused and he was nowhere to be found. When i finally reached him he brushed off this mistake like it was no big deal. Apparently i had not many follicles on my ultrasound which made more sense with my low AMH. I am till this day confused/shocked how a reputable doctor made such a mistake of telling me i had many follicles when in fact i barely had any. Makes me not trust him even if it was an honest mistake. Then we started a cycle and he canceled it because i only had 5 follicles vs 10 or 8. And then i left his clinic.

Follow up on everything dont take anything for face value

We did conventional IVF with huge dosages of menapour, follostim Etc.

It was expensive. They still wanted me to pay for a full cycle which was alot considering my cycle was canceled rather quickly.

She was okay but not very compassionate. I wanted information eggs I had donated when I was younger and she blew me off and refused to answer my questions. If she legally couldn't she didn't say that. It was upsetting. I would not recommend her, but I figured egg freezing is straightforward so why not stay with her for that. She has since left the practice so I won't be using her again. that's all.

10,000 plus meds

I met with Dr Sandler after a natural miscarriage, at first he did a sonogram, didn't suspect any issues there, ordered me a HSG and day 3 blood work and said since I am young he's pretty sure there's nothing to worry about. after my day 3 bloodwork he had a nurse tell me that I have diminished ovarian reserve and shes so sorry. i had to wait 3 weeks until he would see me to discuss options. at 28 he basically said my body is a 40+ year old woman and it would be difficult to get me pregnant, but no big deal, i could use donor eggs. No compassion. As i sat there crying he kept saying donor eggs are a great option.

he was going to do a long antagonist protocol. i didnt move forward with him.

Flisser did not seem to be an expert in diminished ovarian reserve. He was not particularly encouraging based on my high FSH numbers and low antral follicle count. He was not willing to proceed with retrieval with a low number of follicles , which for me seem to be inevitable and with a different doctor at anotehr clinic, l I was able to proceed even though I had only produced four or five follicles and I had a successful pregnancy based on that procedure . With Flisser there was also a whole situation where he thought I had an ectopic pregnancy and was recommending that I have a shot to induce a chemical abortion . I was certain that it was not ectopic but merely a blighted ovum which I had experienced in the past, and knew the symptoms of. I didn't want to take the pill because it would delay our next IVF cycle for several months, which is a bigger headache than it sounds like given the proliferation of days the clinic is closed in January, not to mention the very strong ticking of my biological clock given the DOR. In the end, I did not take the shot against his advice and it turned out it was not an ectopic but merely a blighted ovum as I had suspected. I think Flisser was erring on the side of caution, but this whole situation really left a bad taste in my mouth. He wasn't physically there for the after-hours appointment where the nurse was trying to push the abortion shot on me. He did, however, talk to me on the phone about it, which I suppose is generous of him. But in general, the situation made me feel like maybe fertility doctors like him aren't experts in early pregnancy in which case they should really refer patients to someone else instead of trying to diagnose things that are not within their realm of expertise.

Leave RMA quickly unless you have really simple problems. My friends whose only infertility issues involved low sperm count did well with RMA. Others with DOR and other diagnoses really found better results elsewhere.

I don't remember the specifics . It involved high doses of Gonal-F and estrogen priming and something else . It didn't seem particularly well suited for my diminished ovarian reserve diagnosis although I think from flexor's point of view the high doses were targeted to my non-receptive ovaries .

I never got to that point with Flisser, sadly.

I felt like he had a lot of patients. That I had 5 minutes to squeeze in his information and any of my questions (and felt more than 3 questions was a little too much or to be discussed with nurse). I felt more like he was following a set way of doing things. Like patient A comes in on first visit. Tell them to do x, y, z and then if that doesn't work do this next thing. I didn't feel it was tailored to me or my situation.

To spend more in depth time. Be open friendly and even if busy, give them a sense that you are with them in the moment and they aren't just a number.

I don't remember. I felt like the clinic had set protocols and he just tried them on me.

I disliked this, but I do understand how this can be more efficient for the clinic. Sometimes I would wait 60-90minutes and a few times more. It added to the feeling of a cattle call and seeing different people each time. I felt like a cog in the wheel than a woman who was trying to have a baby.

I believe it was $25,000 of my insurance coverage and about $20,000-$25,000 of our own money.

I was sent to RMA by my original gynecologist - who I am no longer with - when I told her I was not ovulating after going of birth control. She said Dr. Knopman saw many young women and would be great for this. Upon meeting Dr. Knopman however I was unimpressed. She was Impatient and had her own agenda. Despite the fact that I was young and had no major medical problems, almost immediately tried to push me to IVF without doing any testing and after having gone only several cycles with her without much monitoring. She wasn't very sensitive about the process and I would definitely not recommend her. You get the sense with Knopman and RMA that they have an agenda, and that is to perform IVF. They talked about IVF the first time we ever met with them, when we were simply there because I still wasn't ovulating since going of Birth Control 9 months prior. After cycling with her 3 times on medicated cycles with regular intercourse, Dr. Knopman skipped right over IUI and said we should do IVF. Her reason for this was" "Well you want to get pregnant now, don't you?" When we told her we were uncomfortable with this, she said, fine, i will let you do IUI twice, but then after that, I will only do IVF. That sort of ultimatum was a huge turnoff and we left.

Not to use her.

I honestly don't have a great memory but I felt like I was able to 2 nurses To be very close with. I also had to push dr. Copperman to do more and go stronger with medication. He was pretty lax and I knew he needed to up my doses. Some of the early treatments I felt were a waste of money. But I overall got a beautiful baby and I really did like Copperman. He was a very non-alarmist.

Be an advocate for yourself always and make sure you do your own research. You know yourself best and fight for what you want.

We started with clomid which gave me cists. They said I didn't produce progesterone but it wasnt true it was a cist instead. Then we went to another pill which didn't work. Then low dose injections and IUI servers times that resulted in nothing. Finally 3 rounds of IVF the first 2 with low dose injections and the last I told him to pump me up and that is when we got the baby and 3 to freeze.

Cattle call but in and out which was fine with me.

Around $40k

Just bad. Also, see my comments from the human section. He was hard to get a hold of. He was pushy pushy to IVG IV[F] I have to add. He dismissed my symptoms that I later learned pointed to endometriosis. AND later, I was diagnosed with stage 2 endometriosis. The funny (or not so funny) thing is, I read in NY Magazine that he is the expert in endometriosis. He totally unprofessionally told us how terrible another doctor we had met with was.

He wanted us to do IVF right away. He did not believe in immune treatment. We did a couple medicated IUIs with him.

Mostly covered by insurance bc we just did IUIS

I started fertility treatment with Coppermann be finding his name on this list of top doctors in the New York Times. He does his treatment in cycles of 3 which I liked - therefor I had 3 cycles of clomid, 3 IUI's and 3 IVF's with him. I would not describe Coppermann as particularly warm with a great bedside manner- he did explain the process and answer all out questions but at times we felt like he was bored by our questions and was too busy to really address our concerns. I did like how he did reach out personally after each failed cycle.

I would say demand the attention. Ask for sit-downs with the doctor before and after treatment. Do your research and homework.

went in for early monitoring hours before work so was convenient - 7am -9am - wait times would vary, you wanted to get there before 8 or it would be too crowded and you would wait 1/2 hour.

Very blunt. Was eager for me to start IVF right away after two miscarriages (naturally conceived). failed to mention that they were genetically normal. Misled us.

Only go if you want IVF

I wish I had seen a different doctor at RMA or gone to a different clinic. While I did get 14 eggs, I don't feel Dr. Sandler really took the time to personalize my care. I believe that with more personalized attention I could have gotten more eggs. Every time I saw him he was extremely negative and patronizing. It was emotional draining.

Don't see him.

I don't remember.

Monitoring appointments went ok if you managed to get there right when they opened. You would say a range of doctors, which was ok, and get blood drawn by different lab nurses. But if you get there mid-morning, you would have to wait for hours and people were very grouchy.

Egg freezing with the medication was about $8,000.

I don't know

Dr. Stein is an accomplished endocrinologist with a lot of experience. He was referred to me by a few friends / acquaintances who had positive views of him and his practice. When my first round of IVF did not yield a large number of eggs / embryos, his adjustments for and throughout the second round showed far better results. A third attempt may have been even more promising, but we ultimately chose to move on. In Dr. Stein's practice, there is not a lot of focus on preparation before cycles or treatment. There was very little advice on nutritional adjustments or supplements. For me, personally, I was looking for more guidance on how to possibly improve my situation from an integrative medicine perspective before jumping into another cycle. That said, as far as western medicine, I would recommend him to those that are focused on that kind of treatment.

If you have questions, continue to ask them. He can be responsive by email. If not, his office will set up a phone consult. He is direct and extremely knowledgeable, but I am not sure how much he thinks outside the box.

In my first IVF cycle, we used the microflare protocol that starts with the birth control pill. Given my work schedule, I was on bcp for a week longer than standard. I had fears that this would over-suppress my ovaries. I wholeheartedly believe that my fears were valid. The amount of eggs retrieved did not match my expectations given antral follicle count from several day 3 observations. Trust your instincts!! My second IVF cycle, using estrogen priming, yielded far more eggs. However, we opted for PGD and none of our embryos made it to blast even though they made it to day 5. Given my history of miscarriage, it was the right choice to try to test all the embryos at the time. However, for the next cycle, we will try to transfer some fresh embryos. After speaking to a couple friends that were also patients of Dr. Stein, it seems that we were all started with the microflare protocol. Personally understanding the variations of our circumstances, ages and fertility issues, I am not sure that starting all of us on the same protocol shows much consideration for individual situations. Of course, we don't know if he does this for all patients but it is interesting to note.

Monitoring appointments are only from 7 AM - 9 AM on weekdays. If your monitoring appointment falls on a weekend, you have to go the Eastside office with similar hours.

Standard costs. Other responses here are accurate. Mine were a bit convoluted given he was considered out-of-network for me.

Given my age, Dr. Stein, expressed that he was against multiple embryo transfer.