RMA of Philadelphia

Communication is not the greatest of strengths which I think is needed when dealing with patients who are going through such a difficult time. The ones who drew blood were nice but I feel that only 1 out of the 5-6 I saw actually knew how to do it without being painful...the rest hurt quite bad each time. the nurse staff with the doctors were pleasant. the call backs were always inconsistent and the information provided sometimes were thorough and sometimes was not. ifeel that they should provide you with the same numbers each time and then when you are on another round, they should give you your previous to compare to versus us trying to keep track of it all.

we were in and out and although dr freedman and guttman knew us, the rest were nice but were like an assembly line.

Most of the nurses were nice. Jen though was only nice sometimes and not too personable.

We went to Dr. Freedman based on a recommendation. However, we barely saw him or spoke to him. He put us on some medications and supplements and then we had a retrieval 2 weeks later. Both our retrievals resulted in eggs but they didn't fertilize. However, after the second he said there is nothing he can do for us and we should look at adoption and/or donor eggs. I spoke with other doctors who said that it would take a minimum of three months for the metphormin and supplements to fully make an effect on my body which he didn't give a chance. When we went through the percentages in the beginning it wasn't until the third chance where we would reach a higher percentage chance. We weren't given a proper explanation when we were told this almost a week after our retrieval (the week was the worst). I believe the clinic is more concerned with their national success rates.

If you prescribe and recommend medication and supplements, give the patients a fair chance in allowing them to work. Also, provide better communication methods if you are not available have another doctor call. Do not leave hopeful patients waiting for over a week to get any answers.

VERY high dose shots of Gonal F/Follostim with Menopur and then a trigger shot (cetrocide).

I like that the location I go to is small. I see either the nurse practitioner or doctor every visit. Monitoring on weekends is convenient, I'm lucky to live 10 minutes from the office and hospital (where weekend monitoring appointments are). For major procedures like egg retrieval, FET, etc we had to travel to the King of Prussia office but other than that all procedures were done locally.

Dr. Gutmann and the staff have been great in communicating and answering questions. For our current treatment cycle she has agreed to do a mock Natural FET which is something she normally doesn't do but has agreed to let us try. She is willing to collaborate with us while giving us her professional recommendation.

Melissa is the glue that holds the Mechanicsburg office together. She is extremely knowledgeable, compassionate, and caring.

Dr. Gutmann is very candid and thorough. She is very blunt and straightforward, but underneath there is a wicked sense of humor, which both my husband and I appreciate. Her personality fits well with us and we appreciate her ongoing collaboration in our treatment.

She is very thorough and knowledgeable. She is a straightshooter and is very clinical in her assessments. Some people not like or appreciate that, but I do.

We started with clomid and timed intercourse. I did not like clomid and the side effects that occurred with it and we quickly moved on to injectable meds with timed intercourse. She was very candid about her treatment plan and why she recommended moving on to IVF when she did.

It was very smooth, they take patients for sonograms on a first come, first serve basis. Bloodwork can take a bit more time since it is done in the outpatient lab but is not usually too long of a wait. RMA patients are expedited in the outpatient center.

Our treatment leading up to IVF was covered under insurance. I appreciate that she did not recommend IUIs (which would not be covered under my insurance). Stating that they don't produce good outcomes and we would most likely end up needing IVF. Total cost of IVF cycle with medication cost approximately $16k

She prefers to transfer one embryo at a time due to the risks multiples create. I wanted to have a discussion about transferring two, which she happily obliged.

The Hematologist at RMA Center City are fantastic. Caring, let you know exactly what was going to happen step by step. The Hematologist at RMA King of Prussia are dry and seem not to be that interested in their patients.

For such a personal process I consider Dr. Gutman and her team very impersonal and not very caring. When you first go to RMA the entire team, from the receptionist to the doctors to the finance team advises you, "We will take care of you"."Once you pay, you can come through anytime you want" However, it seems that as soon as you hand over your money, they forget you literally. A nurse is assigned to you when you go to RMA who is supposed to provide info. to Dr. Gutman about your case. However, everytime except for once when I have called I have spoken to a different nurse and every time they seem to somehow kinda conveniently forget that you are a patient. Dr. Gutman may know her medical stuff but, she seems to only want to deal one on one with patients when a check is involved. When there is not there is no follow-up, no explanation, and no support.

My nurse was very interested and seemed caring when it came to making sure t the paperwork was signed by me for the procedure. However, after that, I was bounced around from nurse to nurse which made the whole process seem to be very unorganized because I would have to explain myself over and over again to the new nurse.

None supportive, None caring. She sent most of her messages through her nurse. Spoke to me via phone one time because it was protocol. If the process was successful or unsuccessful. You still expect your doctor to show some tact and not be so cold. Dr. Gutman was very knowledgeable but very, very cold in her delivery of any news. I guess it makes it easier to give people info. that way, but it's very weird none the less. Poor bedside manner overall.

Don't let them(the RMA Team) push you into purchasing medication right away so that you still have the option of getting out of there and finding another Doctor.

I paid $16,000 for IVF treatment which was never received

I like it, but I wish the same Dr were available at the location each time I went (more or less). They rotate locations though so I saw the 2 other drs more than my primary. Staff is nice and helpful. They seem to understand that fertility is a stressful/touchy subject so they make the visits nice. Waiting room is nice. Clinic is clean. I've brought my 4 year old daughter to most visits with me and they always welcome her and give her stickers.

I really like Dr Gutmann. She's present when I'm with her, I think she definitely considers me as an individual in my treatment, she answers my questions, she has a sense of humor, and she's empathetic. My only issue is it's hard to actually see her. An appointment takes a while to get if I want to talk to her/reassess. I usually end up seeing one of the other Drs on call when I go due to my cycle and the Drs schedules.

Really like the nursing staff here, they're all sweet. In the beginning I had some confusion- I guess they're used to people coming in for multiple cycles and knowing the routine, but at first I didn't know what the steps were and not everything was fully explained. Once I got used to the basic routine, it was fine.

I feel like I did this a few questions ago... I like her, she answers questions, treats me as an individual, good sense of humor, seems to know what she's talking about, etc. I wish I could see her for all of my appointments for continuity, but I usually end up seeing a different Dr due to my cycle and the schedules of the Drs on call.

That FYI, you won't be dealing with just her, you get whichever Dr is in. Which isn't bad, they're all good. It would just be nice for continuity and questions.

I started out the first cycle without drugs because I got pregnant easily the first time. Second cycle I used Letrosol because there is supposedly a slightly lower risk of multiples than Clomid. Didn't like the side effects of Letrosol. Next 3 cycles with Clomid and Ovedril. 5 cycles total of IUI. About to start trying with IVF.

$1200 per cycle for IUI, then additional cost of buying donor sperm online.

We haven't really dealt with this yet.

Their physicians and staff are their biggest strengths. The multiple locations are another strength. The facilities are well designed and comfortable. Their surgery center is extremely well run. Weaknesses- I can't think of any.

Dr. Gutmann has been very invested in giving me the best possible chance of success. She has always gone the extra mile to respond to my questions and anxieties. She has called and emailed me directly, and she has helped me when I miscarried. She's been encouraging without sugar coating the odds. She's always been honest.

There were two primary nurse practitioners who worked with me since I was using donors. They were both very responsive to my questions. The other nurses were also responsive to my questions. I felt confident in their knowledge. They were all very compassionate and also invested in the success of their patients.

Dr. Gutmann is a wonderful physician. She is knowledgeable, compassionate, understanding and patient. She is very empathic. She always explained what to expect. If there were any complications or concerns, she would explain what they were and the best course of action. She didn't hesitate to ask her colleagues for their opinion in my care, when needed which I respect and consider a sign of confidence in her abilities. She doesn't allow pride to keep her from getting answers for her patients to obtain the best care possible for them.

Understanding that she may be a bit conservative in her approach.

She had me undergo a hysteroscopy prior to beginning the cycle. A fibroid was found and surgery was advisedly. On repeat scope, another possible fibroid was found which wasn't clear and so an MRI was recommended and showed that there were two small fibroids which wouldn't interfere in pregnancy given their location. Even though this delayed the cycle it gave me the beatbox chance of having success and peace of mind. I did become pregnant with that first cycle

Last year, I had a different insurance which covered most of my expenses. However, this year, my insurance isn't willing to cover more than 1 IVF cycle and only if done before April 29th. So, I'm not sure of out of pocket costs

I completely agreed with her reasoning for single embryo transfer given the increased risk to me and any potential fetus with multiples. MFM agreed as well.

 We really felt like a number there. This is something we've realized more as time goes on, especially with our current RE who is so specific and personal. A strength would be that overall,RMA is very successful. However, this is only true if you have an easily fixable issue. Friends have gotten pregnant there within only a few cycles. But with us, they seemed content to just "go through the motions," and when the typical methods didn't work, they went right to IVF as though it was no big deal. Everything seemed "scripted" in a way, without really trying to look for an issue and individualize our care.

Dr. Castlebaum immediately suggested IVF after we had gotten pregnant with our most recent IVF. The manner in which he discussed it was very cavalier and detached. When we finally asked about IVF packages and what he suggested for our situation, his response was "I always like a money back plan, " as if we were purchasing material goods. This was a huge turnoff and a big reason for leaving RMA altogether.

Nurses provided basic information but didn't offer helpful suggestions or further explanation. Really just felt as though they read from a script.

As stated before, RMA is fine if you have an easily fixable problem. Otherwise, RMA, and especially Castlebaum are content to just go through the motions and then immediately move to IVF when the typical treatments don't work. Our least personal experience was with Castlebaum.

Expect blunt information and insensitive jokes if you are sensitive . Do your research beforehand and have questions prepared. Question the statistics of treatments.

Castlebaum basically told us to request what we wanted if we weren't going to do IVF. He did not think outside the box or offer alternate options. We tried 3 IUIs with progesterone as this had worked (though resulted in miscarriage) with our 4th IUI. On the final IUI ,I asked if there was anything else and he said we could perhaps try Follistim (no real explanation why). We also added Ovidrel, and he told us it was up to us which day we used it rather than monitoring and figuring out the most optimal time. All 3 IUIs resulted in negative tests.

Copays for office visits were $20.

No comment

Highly queer competent, they do a lot of outreach in the community. We saw all the doctors in the practice at different times over the year we worked with RMA, and though Dr. Gutmann was in charge of our care and was our point of contact, we didn't have a problem with any of the other doctors on staff. Overall, RMA does a great job of being extremely clear in all forms of communication, and they are great about letting you know exactly what is happening and what will happen next.

Dr. Gutmann was a godsend. She did a fantastic job of communicating with us throughout a very long and draining process. She was extremely responsive, including replying to emails outside of business hours, and answered all of our many detailed questions.

The nursing staff was so supportive and seemed very up to date on our specific needs and situation each visit.

Dr. Gutmann was very clear, thorough, and extremely knowledgeable. She was instantly able to answer every question we asked with specifics. Was is a bit blunt and will absolutely "tell it like it is" but I felt complete trust in her and felt very respected and 100% included as the non-gestational partner (my wife carried our child). Dr. Gutmann made herself very available to us over email at any time. We had a difficult situation regarding a non-viable pregnancy through the course of our journey, and though Dr. Gutmann was aware early on that it would almost certainly end up as non-viable, she gave us the information but didn't pressure us at all in making our own decision as to how to proceed. She is very, very queer-competent, and was super respectful in her language. I could not be happier in our choice to work with her, and hope to do so again when the time is right to try for a sibling!

I would strongly advise people to work with her, particularly if you are queer or trans!

We used Letrozole to regularize ovulation, plus bloodwork and ultrasound monitoring to track the process of ovulation. Then, when the follicles looked good, we would use an HCG trigger shot to trigger ovulation, followed by an IUI. After the IUI we used progesterone suppositories.

Bloodwork only monitoring visits were free, ultrasound monitoring visits, IUIs, and longer personal meetings with Dr. Gutmann were a $35 copay.

n/a

They are very organized, follow the rules and try to have a good system in place. The rooms are always clean and waiting rooms are quiet. As a new patient, if you need hand holding see Dr. Freedman, he has great empathy and explains things well. If you want someone direct, data driven, and up to date on research see Dr. Castelbaum. Unfortunately, they work out of the other locations not center city.

Each person reacts differently to the medication and there are things that should change after reflecting or taking into account what worked and didn't work last cycle. Unfortunately, I didn't feel that this was being done. It felt like a one size fits all kind of approach.

Most nurses are great and feel for you. Some prefer to give you their advice instead of having the doctor call you about your concerns but if you ask to speak with the doctor they will do that. As with everything, make sure to stay on top of your treatment, ask questions and be clear about your steps because they will miss things and forget to tell you things.

Dr. Guttman is very knowledgeable and up to date on latest research. I trust her medical advice but her communication is not good. She does not explain things in detail. For example, she just says "looks good". Other REs that I have seen in the same practice actually explain to you the ultrasound, what they see on the screen, not just "looks good". It is important to know for yourself what is going on because how else will you be able to make a decision.

If you need hand holding find another doctor. If you go, you'll need to be a very strong advocate of your options.

Strong preference for eSET not multiple.

This clinic is clearly very skilled in reproductive medicine; I describe them as a "well-oiled machine." Almost all staff were warm and caring, while being very thorough. Another big strength and appeal for us was their inclusivity of the LGBT community. Some weaknesses would be that every now and then, another doctor would do the vaginal ultrasounds, and they weren't as warm as Dr. Gutmann. Also, we did have a frustrating conversation with a financial planner when we made the decision to go from IUI to IVF. She didn't know our situation and actually was almost pressuring us to go with an anonymous donor over our known donor due to cost.

Dr. Gutmann remembers details about your life and is very personable. She's blunt, but very caring. While going through a procedure, I was visibly uncomfortable, and she had amazing bedside manners. She ensured I was ok, and definitely tended to me until she knew I was comfortable again.

The nurses were all very efficient during appointments, which was appreciated when rushing to get bloodwork done in the morning before work! The nurses remember the patients and are usually very warm. When calling to talk to a nurse, they always respond quickly and have thorough answers.

Dr. Gutmann is clearly very knowledgeable and skilled in this area. She helped us make a plan that fit our lives and was very honest with us. I appreciated this because I just wanted to know what to expect. I was really thankful for her honesty when we hit an unexpected delay with our sperm donor. She let us know what to expect, and then gave us space to make some decisions. At times, her blunt responses were initially shocking, but it doesn't take you long to realize that she truly cares and also is quite funny!

Be prepared to be told the absolute truth. If you're somebody that needs any potentially tough information given "sugar-coated," you may be surprised by Dr. Gutmann's blunt repsonses; just remember it comes from a caring and knowledgeable place.

We are still in process with Dr. Gutmann and needed to have a change of course, so I don't have current specifics.

RMA is a fantastic clinic. All the doctors are knowledgeable and friendly. The space is clean and warm. The connection to Jefferson Hospital makes procedures like the hysterosalpingogram easy. The one big downer to RMA is that the only clinic open on Sundays is in King of Prussia, so if you need to see a doctor on Sunday you must travel to the suburbs. It's highly inconvenient if you do not have a car.

Dr. Gutman was always clear about what to expect from the fertility treatments - she has a positive outlook without ever giving me false hope. She also had an air of authority while still making me feel comfortable to ask questions. At my last consultation I asked her what I felt was a stupid question about cervical mucus and she answered me without a hint of condescension and said, "Don't hold back your questions until a consultation. If there is something worrying you, you can call anytime." Her dry sense of humor makes me laugh every time I see her, but I never feel like she is holding something back that I need to know. Most importantly​, I always feel like she is tailoring my treatment to my specific fertility and financial needs. This has never felt like a one-size-fits-all process with Dr. Gutman.

The RMA nurses in Center City are warm and inviting. They are good at every part of their job - from taking blood to showing compassion when you have a negative test. I love seeing the nurses when I arrive at the clinic. I was on a first-name basis with many of them after only a few appointments. I have felt less warmth from the nurses in King of Prussia, but that is not my normal clinic, so I don't feel like I can really speak to the atmosphere there.

Dr. Gutman has a dry sense of humor and can be very brusque. I found this to be a positive about her personality - she never made the fertility treatments feel precious. Her personality demystified treatments and made the whole fertility process seem more "normal." She's honest about what to expect and what statistics around pregnancy are for each treatment type. When planning your treatment she takes multiple factors into consideration including your fertility Heath, of course, but also your finances, your reaction to drugs, and your access to sperm, for example. I've always felt very taken care of by the doctor. I have no complaints - I wish she were my primary physician, too.

Don't be turned off by her brusque-ness! She's actually a really warm and caring person.

Dr. Gutman first worked with me to identify if I could ovulate normally on fertility drugs since my PCOS kept me from ovulating normally naturally. She proscribed me Letrozole (after explaining the risks, giving me literature about the risks, and having me sign a consent form​ for the drug). I took two 5mg tablets (I think) of Letrozole on cycle days 4-9. After coming in for monitoring it was clear that I responded well to the Letrozole, so we started IUI cycles thereafter. I've been through 4 IUI cycles so far. I start with Letrozole, I'm monitored throughout the cycle, I take a trigger shot of Ovidrel when I have mature follicles and come in for insemination ~36 hours later. After 3 unsuccessful cycles I had a consultation with Dr. Gutman where we went over my body's responses to each cycle according to the monitoring. After reviewing each cycle she gave me multiple options for moving ahead which included more expensive and less expensive options - at no point did I feel pushed toward one option over another. I decided to continue with the Letrozole IUI cycles for the time being. We're still trying at the moment.

$1200 per monitored IUI cycle

RMA as a clinic is excellent. They are open every single day of the year, so you never have to worry about cycle timing due to the clinic being closed. Their surgery center is also very comfortable and easy to access, given that it is attached to their KOP office and shares much of the same staff. The nurses and other staff in the surgery center are great. The doctors rotate, so you may not see the same doctor during each visit, but I do not mind this feature because it allows the clinic to be open every day.

Dr. Castelbaum and the RMA staff are busy, but take the time to greet and talk with everyone. This is especially true in the surgery center--the nurses there are truly kind and caring. The office usually runs on time and seems to prioritize getting patients in and out of the office within a reasonable amount of time. If there is something you need, they will put you in touch with the right person to get your questions answered.

The RMA nurses are excellent and very communicative. They are also very compassionate and take the time to get to know you as a patient. They are quick to respond to email and phone calls. In any case, it is still important to take the time to keep yourself organized when it comes to your medication supply and dates for upcoming cycles, and notify them quickly if you notice any problems or discrepancies.

Dr. Castelbaum is a very experienced, knowledgeable, caring, and personable doctor. He is straightforward about his decisions and doesn't shy away from giving bad news when he needs to. He takes the time to answer questions during appointments and will schedule consults as needed. He is very responsive by email, as are the nurses who work at RMA.

Don't shy away from asking questions, even if you are bumping up against the limits of knowledge in the field of Reproductive Endocrinology. If he doesn't know the answer, he will tell you. He is a great doctor with a great deal of experience, but there are a lot of unknowns in this field, and being a well-educated patient is so important.

My first protocol was a typical antagonist protocol. It went worse than expected, given my age and other lab test results, but still yielded mature eggs that fertilized with ICSI. We decided to have another egg retrieval in order to bank more embryos prior to doing a transfer. Dr. Castelbaum recommended a micro flare protocol, which unfortunately yielded no mature eggs. We are trying again with another antagonist protocol.

It is bright and welcoming they have separate locations for consultations and where they tell you about billing so it is not all clinical. The rooms are warm and bright and the whole place is very clean. They have artist pictures on the wall a lot having to do with fertility that you can purchase if you like it.

I am in a same sex marriage and he listens to everything we have said along the way we even went to another doctor for Ivf and when we returned to him for my wife to get iui all he wanted to know was if we were successful at the other office. He's amazing and we will never seek care from anyone else again!

From start to finish they were incredible with the loss and the BFP they were a great source of comfort and compassion I cannot say enough about the staff.

My wife and I originally went for me to get inseminated and after many heartbreaks we turned to Dr. Castlebaum for my wife's insemination. After two iui procedures she became pregnant with our son. After the nurse called with the results he followed up with my wife to express his excitement. After Tatum was born we sent Dr. Castlebaum a birth announcement he again called us to express his delight and tell us how adorable our son is. To him it is not a job he genuinely wants you to have a baby and just wants to help you along your journey. We had been to another place where all I can describe it as is being cattle herded we were literally just a number and a paycheck and with no fertility coverage that's not what you want. Dr. Castlebaum makes you feel like part of his family and when you're struggling to have a baby that is so important.

Ask him anything he loves questions and he loves to hatch the plan with you. He doesn't tell you what "his plan" is for you instead it's your collaboration.

Iui twice with me using letrezol and hcg trigger shot one was positive pregnancy that ended in mc the other did not work. With my wife he did two iui no med assist and the first did not work the second did!

I believe the iui was 1,000 plus the cost of meds but I'm not 100% sure I took a new job and it did have coverage for iui so with my wife there were specialist copay so 40.00 each visit. The sperm cost 890 per vial and we have purchased a total of 9 and if costs between 250-400 to ship.

We really felt like a number there. This is something we've realized more as time goes on, especially with our current RE who is so specific and personal. A strength would be that overall,RMA is very successful. However, this is only true if you have an easily fixable issue. Friends have gotten pregnant there within only a few cycles. But with us, they seemed to just "go through the motions," and when the typical methods didn't work, they went right to IVF as though it was no big deal. Everything seemed "scripted" in a way, without really trying to look for an issue and individualize our care.

At RMA, you are not always treated by the same doctor, although Freedman generally "oversaw" each cycle. Still, he often forgot how many cycles we'd done or which procedures we'd done. We never discussed IUI in detail at first but got the call to "come in for insemination." It felt like there was a lot missing in terms of communication.

Nurses were average. They didn't really provide any extra information and at times were even too sympathetic. By this I mean that they made us feel terrible coming in after our miscarriage because their demeanor was a little too "sad" rather than helping us to be optimistic (making sad faces, saying "I'm so sorry" repeatedly).

In person, Dr. Freedman is great, answers your questions, and is very calming. However, as questions started to arise, it began to feel as though more information should have been shared and more options discussed. The communication was really our biggest issue, as we never really understood why certain treatments were being administered or what more could have been done.

Do your research beforehand and have questions prepared.

We began with Clomid only for a cycle. With the 2nd cycle, IUI was proposed by a nurse over the phone without any explanation or prior conversation. This was alarming since this was our first RE and we had no idea what to expect. We did Letrozole only for the next cycle, then 4 IUIs with Letrozole. On the last IUI, Dr. Freedman added progesterone (without any explanation, but again we didn't know any better amd just went with it). We got pregnant with this last IUI, but miscarried at 7 weeks with an empty gestational sac. I had a D&C, then once my levels returned to normal, we decided to take a break from ttc. Eventually, we decided to go with a new RE who might be more aggressive.

We paid a copay each time except for blood only. Billing was the biggest disaster at RMA. we received many bills for hundreds of dollars for procedures that were covered by insurance. I would speak to someone in billing who would tell me they'd "write it off" ( not correct it), only to receive the same bill again. We ultimately left because the billing issues became so stressful. In the end, I resorted to crying to billing personnel on the phone saying that I was forced to leave and figure out something with another clinic because we couldn't continue to accrue unnecessary charges if we weren't even seeing results. The woman's response was to offer a 3 way call with my insurance company to "figure something out." They refused to look into the issue. Later, we received more bills months after leaving... for my D&C no less, which was a painful reminder. Also the bills were in my husband's name this time, for "tramsvaginal ultrasounds." He called and they again "wrote it off."

No comment

The strengths of RMA of Philadelphia include multiple locations across the Philadelphia area, weekend hours at their King of Prussia location, and a strong and devoted nursing staff. Weaknesses include not seeing your physician regularly, seeing sonographers for monitoring appointments, and not having an assigned nurse to oversee your care.

The way that RMA of Philadelphia works is that, while you have one doctor overseeing your care, you are part of a practice with five locations in the area. The doctors switch locations every day. When I first I went to RMA at the beginning of 2016, there were 7 doctors. By the time we finally decided to switch practices 13 months later, 3 had left and there were only 4. Suffice it to say, 4 doctors cannot cover all 5 practice locations. As a result, you are seen by different doctors at each appointment, rarely see "your" doctor, often see a sonographer, and (in addition) you don't have an assigned nurse. I would receive updates on pregnancy monitoring and next steps by personnel I had never met at locations I had never been to. As a result, you feel like you are part of a machine instead of like a human being.

The nursing staff at RMA of Philadelphia are the glue that holds the practice together. The nurses work very hard to answer your questions and address any concerns. Unfortunately, however, you are not assigned a primary nurse at this practice, so every phone call come be from a different person - often someone with no knowledge of your case and someone you have never met. This lack of continuity can be challenging as you relay your story and details over and over to new people. In our case, multiple clerical errors occurred, such as a blood test once being "lost." I don't blame the nurses, as I believe they are working very hard. But there is clearly a lack of cohesion at this practice that I believe would be improved by assigning patients to a single nurse or team who can keep track of details in a single place.

We met wth Dr. Gutmann on a handful of occasions, although we rarely saw her for monitoring appointments or heard from her otherwise (all communication is through the nursing staff). Dr. Gutmann is an intelligent physician with exceptional training and expertise in the field. Unfortunately, she lacks a warm bedside manner. Her reaction to our miscarriages at the practices was robotic and jarring. Ultimately, we decided to switch practices because of this. As our case became more complicated, we needed someone with a more gentle touch and we wanted to have more contact with a single physician.

Dr. Guttman is a highly trained and experienced physician. She would be a good fit for couples or individuals trying to conceive who are interested in simply receiving clinical care and who do not need additional support.

We did Clomid + IUI cylcles with Dr. Gutmann and one Clomid alone cycle. Neither the dosage was ever changed nor was the protocol. Our result was multiple miscarriages and we ultimately switched practices and doctors after searching for a second opinion.

We incurred few costs with this practice as IUI was covered under our insurance. We did pay out pocket for medications, but these were inexpensive.

Treatment at RMA is flexible and individualized. They open early at 7 am each morning for monitoring, and will readily call back even if you try to get in touch after hours or on weekends. They're open 365 days per year and will work with you to design treatment plans that cater to your specific situation.

Dr. Gutmann individualized treatment each cycle. Each time we failed, she would call - no matter the time of day or the day of the week - to review what had happened and plan next steps. She was sympathetic and helped us maintain a positive attitude through some very difficult losses. She never once made us think she she didn't believe we'd ultimately find success.

The nurses at RMA are excellent! They respond to emails and phone calls in a timely manner, explain bloodwork results fully, and provide emotional support like no other medical practice. They literally and figuratively held my hand through every setback, and even came in early one Saturday morning to administer methotrexate so that I could spend the rest of that weekend regrouping and trying to stay positive after being diagnosed with an ectopic pregnancy. I wouldn't have made it through treatment without their excellent support.

My husband and I went through over two years of fertility treatment before welcoming our daughter. This included an IUI cycle that resulted in the premature birth and loss of a son at 22 weeks of pregnancy, three ectopic pregnancies during subsequent monitored and/or IUI cycles, removal of my Fallopian tubes, and one cycle of IVF. Through it all, Dr. Gutmann was patient, caring, compassionate, and encouraging. Her wet sense of humor helped us through even the darkest of days, and her clear and concise communication style helped us understand our current plan. There aren't words to express how thankful we are to have had her guidance and expertise as we worked through each failure and ultimately found success.

Don't be afraid to take notes. You will have questions, and Dr. Gutmann will have a lot of answers and information...sometimes all at once, and it won't always be easy to remember everything that was said. That's ok. She's also open to your suggestions and will guide you...don't be afraid to advocate for yourself! In a best-case scenario, you'll feel an active part of the "team" at RMA.

For my IUI cycles, I took 5 mg of Femara on days 4-8 and was monitored via bloodwork and ultrasound before IUI. For my IVF cycle, I underwent an antagonist protocol with follistim and menopur before freezing my embryos and surgically removing my tubes. My FET cycle involved orsl and vaginal estrace, as well as baby aspirin, estrogen patches, and eventually both progesterone in oil injections and Crinone. Adjustments were made after each monitoring appointment as we went.

Monitoring innthe mornings was well-run. Rarely would I wait more than 15 minutes, and rarely were patients overscheduled, but if I required and early-morning appointment they were always able to squeeze me in during a convenient time. The clinic strikes a great balance between giving patients their time and making sure everyone is seen.

The clinic offers various treatment package, including a shared-risk program for IVF. For us, we were lucky that insurance covered most of our testing and procedures. We only paid co-pays and coinsurance.

Due to my age and history of pregnancy loss due to cervical insufficiency, Dr. Gutmann and I both agreed to transfer only one embryo at a time.

Strengths- small, well managed, concerned about the level of patient care and taking steps to improve patient education over the year and a half I have been there. Weaknesses- have to travel for Egg retrieval and Embryo transfer procedures (although not exceedingly far, but turnpike closed for first Embryo transfer and had to fill my bladder twice! 120oz's over the course of 2hrs!). Sometimes miscommunications happen in the Pinnaclehealth system when testing needs to be done on weekends at Harrisburg hospital, or at outpatient testing clinic in the Fredrickson building during weekday monitoring. Communications seems to have also improved since I first started with Dr. Nguyen, and was not really the fault of RMA.

My "chemical pregnancy" during IUI was actually presumed ectopic and my "miscarriage" from a PGS IVF fresh cycle was unfortunately a termination for medical reason at 21weeks. We received a non-compatible with life fetal diagnosis at our 19 week anatomy scan. I wasn't sure how best to mark this loss on the survey.... My daughter could have survived to full term, but had a prognosis of living for only a few minutes to days at most after birth. Even though I was no longer in Dr. Nguyen's care at the time in my pregnancy, she called me the day after diagnosis as soon as she was informed by Maternal Fetal medicine. My regular OB has not demonstrated the same level of compassion and care that Dr. Nguyen has consistently given me and my husband as we have struggled with infertility and pregnancy loss. It is a small office. Dr. Nguyen is efficient, but always makes sure if she does not have the time to answer your questions at a monitoring appointment, a nurse will follow up before you leave. She has gone out of her way to schedule consults for us when needed and they have always been within a week of our initial request. She and her staff are a big reason my husband and I felt comfortable continuing with FET cycles after the devastating loss of our daughter and why we have not given up on having a biological child altogether.

Melissa, Stephanie and the other staff at RMA Central PA (Landy, Jamie and new hire Kristy) are very professional and compassionate. Melissa is the only other staff member who will perform ultrasounds. She handles medication protocols and will go the extra mile to make sure you understand medication changes and administration. Steph is extremely organized, knowledgeable and a calm reassuring presence. They have helped me tremendously through two terminations, and are always improving customer care so that visits are efficient but I never leave without feeling that my needs and concerns have been met.

We have been through a lot of ups and downs in Dr. Nguyen's care. On the compassion scale she gets a 10 out of 10 every time. I have needed to seek outside resources to better explain protocols at times, but she does a great job of explaining the basics and nurse consults have always filled in the gaps. She is not one to push for excessive testing when not called for, but does listen and supports patients needs. She is a very scrupulous and skilled provider.

Don't hesitate to ask questions. They will get answered one way or another in her office. You're in good hands so relax:)

Monitoring hours - 7am to 9am, M-Fri STAT blood drawn at onsite clinic, transitioning toward in office blood draws. (I'm a tough blood draw so very happy to go to seasoned phlebotomists;) Weekend monitoring done at Harrisburg Hospital and only time you will have an ultrasound performed by non-RMA staff (between 7am-9:30am) Bloodwork results and medication adjustments provided same day by nursing staff (usually between 2:30 to 3:30). Dr Nguyen will generally call with initial Beta results or if complications occur. IUI 1 & 2- Day 3 baseline u/s & E2, LH & Prog. bloodwork, clomid (can't remember when started, probably Day 2 or 3). Monitoring Day 9 (or perhaps earlier) thru LH surge, Ovidrel trigger night before IUI. Semen sample taken to office 45 minutes prior to IUI procedure for processing. Private room available for men if traveling a distance for procedure. Done during monitoring hours in a relaxing room. Beta hCG, E2 and Progesterone levels tested 9DPO. If positive, Beta and hormone levels taken every two to three day at least twice more. If normal- U/S follow up week 5 or 6 through 9 when referred back to OB. If abnormal- options for termination discussed or consulted through miscarriage. If negative, IUI 2 Beta was positive, but slow rising and indicative of possible ectopic implantation. In addition to Beta monitoring, had a diagnostic transvaginal u/s at 6 weeks, however Beta levels were too low to confirm place of implantation, tubes appeared normal. Pregnancy was terminated with Methotrexate injection and Beta was followed to 0. Liver panel and CBC was monitored prior to and after in office injection by nurse. IVF- estrogen primer protocol for low responders selected due to maternal age and unexplained infertility history (just turned 38 that month). Counseled to have PGS testing also due to age and hx-- Select CCS (Comprehensive Chromosome Screening). Monitored cycle prior to Stims to start estrace a week or two before Day 1. Day 2 AM u/s & bloodwork (E2/LH/Prog./FSH?)/PM first dose Gonal f & low dose hCG subcutaneous injections. Monitoring continued every other day to daily with medication adjustments, cetrotide added sometime around day 7-9 to suppress ovulation, hCG injection trigger 2 nights prior to retrieval with bloodwork monitoring the following AM to confirm it was administered properly. Egg Retrieval and Embryo transfer procedures are preformed at the King of Prussia surgical center NE of Philadelphia (1.5 hr from Harrisburg). ER scheduled generally before 9 am. Given a report of egg count post procedure after anesthesia recovery. Restart estrace (vaginally), start steriod, antibiotic, and crinone (progesterone vaginal gel). Fresh embryo transfer scheduled for same time as ER on Day6 (if embryos make it to blastocyst stage by Day 5 and test euploid). Given report by embryology Day1, Day3 and Day5. Reports- 21 eggs retrieved, 17 fertilized normally by Day1, 10 Day3 with normal cleavage, 3 Day5 blastocyst tested- 1 euploid, 2 Day6 blastocyst tested, both euploid and frozen. Day6 fresh transfer (It's a girl!) (No anesthesia necessary, but have to drink 50-60oz water starting 1.5 hour prior to procedure. Very uncomfortable!) Beta follow up was normal. Embryo measured normal week6Day0 u/s. Heartbeat detected in week 7 Day 0 u/s. Continued monitoring through week9 and referred back to OB. Was told to follow up with NT scan and amniocentesis, but no further genetic screening was necessary due to PGS. We ignored Dr. Nguyen's advice and did not have an NT scan done between 12-14 weeks, thinking we had it covered on the genetic defect front and I was eating well/taking prenatals so not overly concerned about NTD. Unfortunately at our week 19 anatomy scan our daughter was diagnosed with Exencephaly a fatal NTD. Amniocentesis results indicated that karyotype was also normal. It was a "fluke" developmental defect. Follow your RE's advice, get the NT scan. FET cycles- Dr. Nguyen allowed me the choice of having a synthetic or natural cycle (with estrogen primer control of ovulation or without estrogen) I opted both cycles for the greater predictability of synthetic cycle. Estrace started orally Day2 in the PM after AM u/s and bloodwork- taken AM & PM, dose upped then taken back down at ovulation. Progesterone in oil intramuscular shots started evening of ovulation (1/2cc) as well as steroid (7days). Progesterone upped to 1cc until Beta and continued to 10 weeks is positive. Both cycles failed so I discontinued PIO and estrace day of Beta. Have consulted with Dr. Nguyen on next possible steps- Another stim cycle with either same estrogen primer protocol or a lupron microflare with PGS-- both are low responder protocols. My AMH has dropped from 2015 (2.27) to this September (1.32). Egg quality is a major concern, but Dr. Nguyen believes I will have a similar outcome to my first IVF cycle. Genetic screening protocols are changing in their lab, so we will not have the option for fresh cycle transfer, but will have both chromosome and karyotype testing performed for frozen transfer. She is also willing to perform an endo/scratch the cycle prior to our next transfer because we have had two implantation failures with euploid embryos. We may choose to have further immunological testing done prior to our next cycle due to our multiple losses (a blighted ovum- spontaneous conception, a presumed ectopic with IUI and our daughter's NTD, also euploid), and am in the process of looking into reproductive immunologists to work in consult with Dr. Nguyen. We are still unsure if we how far we will pursue further testing.

IUI cycle- $1,200 includes bloodwork through first Beta, u/s monitoring and IUI procedure Does not include medication- Clomid covered by my insurance with copay. Ovidrel- ~ $100 including shipping w/pharmacy discount through RMA (Note: options are changing in 2017 due to new PGS protocols) IVF Multicycle Option w/RMAid 7.5% discount & Select CCS-~ $13,400 includes Dr. & Nurse consults mock embryo transfer (cycle prior to stim), bloodwork through 1st Beta, monitoring, anesthesia, egg retrieval, ICSI, embryo culture/embryologist fees, fresh cycle embryo transfer, also covers one Frozen embryo transfer in the event that fresh cycle transfer cannot be performed, fresh transfer failure or loss of pregnancy if FET can be performed within a 9 month period. (We ended up not having to pay additional fees for our first FET after our loss at 21weeks post fresh transfer). I believe this may have also covered vitrification of frozen embryos. Additional costs- $3,000 genetic testing (covers 10+ (don't remember exact #) of embryo biopsies and can be transferred to multiple stim cycles if you do not meet the maximum number in any given cycle. We had 5 tested from our first IVF cycle, so will most likely not have to pay more for additional preimplantation genetic diagnosis in future cycles. I've talked with finance at RMA and this will be honored with the additional karyotype screening that will be added to the protocol in 2017. (Note- all RMA multi-cycle options will be changing in 2017 due to new PGD protocol. My next stim cycle will likely be a single IVF cycle paid "ala" carte by service since I will not need to pay additionally for PGD. I was quoted and expense of ~$12,000 in expected costs including one FET transfer. Stim cycle medications (gonal-f 900cc injections pens, cetrotide, low dose hCG, hCG trigger shot & pregnancy support (Crinone 8%) through 10 weeks- $~6,000.00 with 25% compassionate care discount through Freedom Pharmacy. I was not aware to shop around for Crinone coupons and additional discount programs. I could have saved more. Co-pay through insurance- ~$30 to 60 for estrace pills, medrol (steroid) and antibiotic FET cycle- $3,500 (without RMAid discount, but possible to qualify for financial aid through practice based on income/insurance coverage). Meds- estrace copay ~$20 -30, progesterone in oil intramuscular injections ~$40.00 for 30 day supply including shipping. Not covered procedures not covered in RMA plans- diagnostic exams and tests like maternal and paternal genetic screens, salinesonograms, hysteroscopy. I've had several genetic screens, (2) salinesonograms, (2) hysteroscopies including (1) endometrial polypectomy performed by Dr. Nguyen and all were covered by insurance. The RMA financial team and staff work hard to code procedures accurately, but in a way that will be accepted by most insurance carriers. I have a very restrictive HMO that does not cover any infertility treatment, but diagnostic screening and tests short of an infertility diagnosis are covered.

I felt very comfortable and confident in this office's ability to get me pregnant. I never felt stressed or rushed while I was at the office for my exams. I had seen another doctor prior to this office and it was a huge difference on the good end of the spectrum. I could not have been happier with Dr. Nguyen's office and this includes their staff in King of Prussia. The doctors that did my egg retrieval and transfer were very nice with good bedside manners. The one doctor had me laughing so hard after the retrieval. I'll never forget the wonderful experience I had compared to the other clinic I had gone to.

Dr. Nguyen made sure to address all of my concerns without making me feel stupid for asking. She seemed genuinely interested in my feelings throughout the entire process.

Landi made it super easy to get updates during my stimulation phase. She emailed me my status along with any medication changes. She was always available to answer my questions and she was always so upbeat and welcoming during my appointments. The day I went to get my beta test (I had already told her that I got a positive home pregnancy test), she ran out into the waiting room and gave me the biggest hug.

Dr. Nguyen is a very sweet and kind person. I felt like she was a friend throughout the process and not just my doctor. At my first ultrasound where we saw I was pregnant with twins, she gave me a big hug. I could tell she was genuinely excited for my husband and me.

I started on 300 IUs of Follistim and low dose hcg. This was decreased around day 3. Ganirelix was added in on day 5. I triggered on day 10 with Lupron and a higher dose of hcg.

Everythign was very easy. I was seen on time, received lab results on time and making appts was easy. I would have preferred to have spoken to only nurses that I saw in my regular office rather than nurses from other offices which happened from time to time. I was concerned that they werent as familiar with the ins and outs of my treatment and didn't always feel as comfortable.

Dr Gutmann was always realistic but hopeful. She was empathetic when we were sad and frustrated but also helped us to set realistic expectations.

THe nurses were phenomenal. They really got to know me and were extremely supportive.

Dr. Gutman was fantastic. She was very direct, which I appreciated, and she did a great job of managing my expectations. She also managed to explain complicated things clearly and in non-medical terms. I truly felt like I was in the best hands.

Trust her. She is extremely thorough but if you have questions that are unanswered, ask!

Upon initial testing, I started taking synthroid for hypothyroidism. For the first cycle, we used letrozole and waited for me to ovulate on my own which occurred very late. I also had a short luteal phase that month. In the following cycle, I used letrozole, ovidrel and progesterone to lengthen my luteal phase. I became pregnant but unfortunately that pregnancy ended in a miscarriage. Based on my testing, dr gutman felt that we should try that protocal a few more times and I became pregnant on the second cycle after my miscarriage.

I paid a copay of $40 for ultrasounds. I also had to pay a copay for medications. Nothing else.

We love that that clinic is inclusive and helps same-sex families achieve the families they desire. Location was a big plus for us with RMA--two of the offices were convenient for us when it came to blood draws, etc. Having the acupuncturist on-site was convenient as well. The facility was clean and always spotless. The staff gave very good, clear instruction about how to administer the medications and shots. They were also very helpful with suggesting rebate programs, etc., for the expensive medications. One dark spot in all the wonderfulness we experienced with Dr. Gutman and RMA came from the billing director out of the Willow Grove office. When our IVF cycle was canceled because there weren't any eggs to retrieve, the refund process was explained to us by the woman who handed billing in King of Prussia (she was wonderful). When it came time to enact the refund, her supervisor (that would be the woman in Willow Grove) got involved and was very abrupt and unfriendly with us, seemingly because either we misunderstood how we would be refunded, or because the woman in King of Prussia explained it to us incorrectly. We've always wondered if the King of Prussia woman got into trouble for either offering to give us a refund in a way that wasn't allowed, or for misleading us.

There was conversation between Dr. Gutmann and us, not just dry clinical conversation. She also genuinely seemed to be on the ride with us, wanting us to succeed. When our first cycle failed, she called with condolences and I believe she truly was heartbroken for us. She knows what her science can do for families, bringing love into this world, and I felt she was honestly disappointed when things didn't go the way we all wanted them to.

They were all very friendly, professional, and sensitive. We always felt welcomed, warmly received, and like they were interested where we were on our journey. (Part of the reason we left the first clinic we tried was because of the nursing staff. Indifference and insensitivity come to mind in thinking about them.)

Dr. Gutman was compassionate, but realistic, which we appreciated. In a good way, there was no sugarcoating. She was patient with us as we slowly accepted our need for more aggressive fertility treatments in order to have the family we imagined. All the while, she provided clear explanations about procedures and helped us understand our options.

We thought Dr. Gutman was terrific, and she will always hold a special place in our hearts for bringing us to a place where we now have the family we desired. Along the way, we appreciated her no-nonsense, upfront explanations of the way things were, step by step, good or bad. That might not work for everyone.

We were at another clinic first, but felt the care was lacking, so when we came to Dr. Gutman we had already been through the first steps of trying to overcome fertility, which was artificial insemination for us. It failed. With Dr. Gutman, we went right into egg retrieval, which was, unfortunately, not successful. We felt she was responsibly prudent with her dosages of the fertility medications, which included Bravelle and others I can't remember at this time. Something else--during initial conversations with Dr. Gutman, once we revealed we were hoping to have two children and transferring multiple embryos would be welcome, she (once again, responsibly) declined to participate such treatment, for the sake of baby's health and mom's health. As much as we really would have loved a two-for-one, we knew she was right and stuck with her and her professional opinion that we trusted.

$18,000 for the failed IVF and egg retrieval $6,000 for the medications $3,000 ICSI genetic testing for the embryos Don't remember how much the frozen egg and embryo transfer process cost

Strengths are organization and scheduling. Fertility treatment requires a huge amount of coordination of appointments, drugs, testing, and procedures. RMA, the clinic, was very organized and on top of our treatment plan. They also had appointments at convenient times and I never waited more than 15 minutes for a scheduled appointment. A weakness, if you can call it that, is that you will not see the same doctor every time you go in. This would be impossible, given that your appointments are based on your cycle and treatment milestones, so unless your doctor worked 7 days a week, it would be impossible to see him or her every time you went in. They are organized, however, so whatever doctor you see will know what you need at a particular visit. The only (unavoidable) downside is that we loved the doctor who oversaw our treatment, and who saw us most of the time, but didn't always connect with the other doctors who we only saw occasionally.

I am part of a same-sex couple, and my spouse and I wanted to use her eggs and donor sperm to conceive, and then transfer to me to carry out the pregnancy. Dr. Gutmann was open, informative, welcoming, and non-judgmental throughout this process. She understood our situation and worked with us to achieve the family we wanted.

It was good to have one point of contact for questions about the various injections, the drugs we needed, the timings, etc. She provided us both with calendars to track our drug regimen and did demonstrations of the various products we needed to use. We also were provided with comprehensive, well organized paperwork describing all the drugs and procedures in detail, so we knew what to expect and could reference them during treatment.

Dr. Gutmann has a matter-of-fact manner, which is not quite warm, but conveys her impressive intelligence and experience. She was always upfront and honest with us. She explained everything we needed to do clearly, and was always on top of our care. She was also completely willing to help us conceive in the manner we desired; we wanted to use my partner's eggs and donor sperm and I wanted to carry out the pregnancy. She was completely supportive of our wishes and was able to help us conceive as we planned.

Don't expect someone who is touchy-feely. Dr. Gutmann is matter-of-fact, but she will be honest with you, will always take the time needed to explain your treatment, and is excellent at what she does.

We did IVF, using 5-day embryo's from retrieved from my wife and inseminated me via ICSI with donor sperm from a cryobank. We then implanted the fresh embryo into me and did 12 weeks of progesterone injections. We had a normal, successful pregnancy. We froze the remaining embryos.

Our costs were minimal, as both my spouse and I had insurance that covered the vast majority of our drugs and procedures. I think we spent between $2,500-$4,000 out of pocket. But this was unique to us, due to our unusually generous coverage. RMA did a great job, however, of liaising with our insurance carriers to determine and confirm coverage.

The staff, including Dr. Castelbaum always made me feel like a priority. They always welcomed my son in the office during my 2nd cycle, even helping to watch him while I was being seen. They always knew me, my background, my family and the current status of my cycle. They worked around my schedule and always fit me in. They tried their best to make my cycles the most cost effective they could and I honestly couldn't say enough good things about any of them from reception, nurses, billing, and of course, Dr. Castelbaum.

Always knew me and my situation and current status. Very compassionate to what we were going through as patients. I wish I could remember some of their names because they were fabulous.

Dr. Castelbaum is an incredibly intelligent, capable and appreciative doctor. I want to start with that when I came back to visit with both my boys he was so genuinely touched, held each kid and truly appreciates the miracles he brings into the world. He is very straight forward with his information and also doesn't make assumption or judgments. I came from another clinic with unsuccessful IVF cycles and was referred to egg donation. I switched clinics for a 2nd opinion and Dr. Castelbaum was shocked that my previous doctor hadn't don't any type of testing on me to determine why my cycles weren't producing many eggs and why the ones retrieved were abnormal. He immediately ran some testing and did ultimately agree that egg donation was my best bet at having children while being able to experience pregnancy. He's very fact based and delivers matter-of-factly so you have to be okay with that but he also has a warm bedside manner. I loved him and would refer anyone to him. .

1st cycle -- approximately $47,000 2nd cycle -- approximately $3,500

No negative comments

At first, I felt that she really wanted to help me. After I didn't get results and my lack of insurance to cover injections, I felt like I was a less interesting patient. Also, one time she said it was because I waited too long. That was a very unfair statement. I didn't wait too long to try infertility treatment on purpose. I didn't have insurance and I had other personal issues that interfered with pursuing fertility. I still believe I can get pregnant. I am also disappointed that she didn't recommend acupuncture early on or start me on metformin

Everyone was on time, focused on my protocol and comfort, as well as communicated in a timely fashion.

She is a competent physician. She is well read, very thorough and doesn't rush. Her wait time is minimal. She explained everything thoroughly. She is good with procedures. You want 200 characters but I can't think of anything else

Be a young patient with financial resources

My cycle is fairly regular. We used medicine like cloud and letrizole to induce ovulation along with hug injection to facilitate ovulation before undergoing IUI. This was followed by topical progesterone as I had a little dip in mid cycle progesterone level. I was never told I had poor eggs. We wanted to do IVF but I couldn't afford it. All of my blood work was ok. I also had a removal of uterine polyp which was small but she wanted to make sure that there was no problem with embryos implantation

Co pays were in line with my insurance. There was one fee associated with ICI that was charged to me because I wasn't using my husbands sperm/ I had to rely on donor sperm. I complained to the clinic, they said it was an insurance issue. It really upset me. I was a single mother and this felt like discrimination and I didn't really care if is an insurance issue or not. My insurance would have paid for the injectable medication if it were given in a medical short procedure unit. They said they didn't do it that way. I was not able to get full benefit of IVF due to these hurdles. I work in healthcare. I am able to be responsible for my own care. The drug cost was out of my control and I guess it was out of their control. I decided to pursue embryos donation. RMA had slim pickings when it came to donor embryos. She didn't refer me to the competing local clinic who I found out had a much more ample supply of donor embryos

No

The clinic has flexible scheduling and is great about getting you in when you need to get there. Even my consultation appointment was made earlier because they called with a cancellation. They usually run on time and are always quick to respond to questions.

Several times Dr. Freedman has called late at night to discuss results and discuss next steps.

I wish I would see Dr. Freedman more often as well as hear from him throughout a cycle. I know he is making decisions behind the scenes, but I usually only hear about them through the nursing team. He makes small adjustments as needed, but I'm not always aware of what those changes are expected to accomplish.

Come with lots of questions and don't be afraid to advocate for yourself.

My first retrieval I did 2 weeks of birth control followed by an antagonist protocol. Part way through my Menopur dosage was raised. I stimmed for 11 days and retrieved 8 eggs, all were mature, 6 fertilized, and 2 made it to blast. Both came back mosaic. My second protocol we eliminated the birth control because Dr. Freedman thought it may have over suppressed me and we could get more eggs. Same medicine and we retrieved 13 eggs, 8 were mature, 6 fertilized, and none made it to blast. We were shocked and have no good reason why it happened. I am planning a microdose lupron protocol next month.

Currently covered by insurance

He is very adamant that single is best, especially at my age.