RMA of Philadelphia

Dr. Gutman is very patient, caring and experienced. While you can tell she is very busy with many patients, the appointments never felt rushed. If questions aren't asked, she won't got into much detail. However when questions are asked, she will tell you what she is was thinking. Overall I would say her methods are on the traditional/conservative side. While I appreciate her not pushing any products or treatments that don't have proven success rates, I do wish we would explore more out of the box options. Overall, I feel a sense of trust working with Dr. Gutman and feel like she truly cares about my outcome.

If you have a question, ask it. Don't assume. She doesn't give much detail if you don't ask for it. If you want to try something new, you need to start that conversation as well.

I have been through 2 IVF cycles with Dr. Gutman. The first cycle we used BC for a week prior to starting stims. We then followed the agonist protocol with an aggressive med list. We did 300 follistim iu and 75iu menopur for twelve nights. About a week into stims, we realized I wasn't responding to the meds as we would expect for someone my age. I was producing fewer eggs than normal. The word "cancel" was tossed around once or twice, however we went through with the retrieval. 8 follicles were retrieved, 6 were mature, 4 fertilized and made it to day 5, however only 1 was able to transferred. That round ended in a negative beta. We took a month off, and then started another round of stims. This time instead of BC, we primed with estrogen ( we thought the BC may have suppressed me too much). We then did the same agonist protocol with the same dosages. We stimmed another twelve nights and all monitoring appointments showed more follicles than the first round. However, retrieval yielded only 7 follicles, and none fertilized. We haven't done another IVF cycle since then. We have done 4 IUI's with follistim and follistim/clomid. The first IUI resulted in a chemical pregnancy. The other three ended in negative betas. Each IUI showed at least 3 mature follicles.

Early morning monitoring appointments were hit or miss. Some days I would be in and out very quickly, other days I would be there for almost an hour. I would say they were usually on the quicker side for the most part, however there were still a handful of times that took way longer than needed. The days that did take long however, once I got into the monitoring room, I did not feel rushed out.

My insurance covered monitoring and bloodwork for IUI cycles. Nothing was covered for IVF. RMA prices are high and they don't offer any bundled packages which is the main reason I am holding back on moving forward with another cycle. If they offered better more affordable options, I would have started another retrieval already because I do feel comfortable and trust them. They did offer a tiny discount however with my next cycle being my third round, I was hoping for a deeper discount than offered.

We never had the option to transfer more than one embryo. However for our IUI with injections, Dr. Gutman was ok with proceeding with 3 or 4 mature follicles.

Strengths and weaknesses Dr. Schlaff was knowledgeable, compassionate, warm, and direct. He made several small adjustments during my cycle that I truly believe made a difference in our outcome, such as delaying our retrieval by two days to allow for more follicles to mature (resulting in a couple more eggs being retrieved than would have otherwise) and also delaying our FET because I had fluid in my uterus. He adjusted medications to reduce the fluid down to almost none by transfer day. I found him to be an excellent communicator and felt from the beginning that no matter the outcome, we would have been satisfied that we gave it one last try under his care. I would wholeheartedly recommend Dr. Schlaff to anyone and can think of no weaknesses whatsoever.

Do not hesitate to meet with him if you are thinking about undergoing fertility treatment.

self-pay: 18K for single IVF cycle with PGS and ERA biopsy, including meds, though some meds were covered by insurance

Dr. Gutman is brusk and and no-nonsense, but she is also incredibly intelligent and honest, which makes her very trustworthy. The way she casually talks about the procedure puts you at ease and makes you realize that she has done this a hundred times and knows what she is doing. Her treatments are kind of drawn out, however that's because she requires constant consultations and re-evaluations to make sure that you are completely safe and avoid any potential risks during the treatment. She's funny and I never once felt judged or uncomfortable with her. Once visit, I told her I was on my way to a baby shower and she said, "Well, if you need me to write you a doctor's note, I will absolutely do that." She understands how hard the journey is but doesn't dwell on it and always pushes forward.

Trust the process. She is not a terribly warm individual, especially when you first meet her, but that's because she is still evaluating what the absolute best options are for you. Every time you talk to her, you will be reminded as to why you are in her care. She's great if you like someone who is straight and to the point - no sugarcoating bad news. It might be a long treatment, but she will be invested the entire time and is open to suggestions if you feel as though you'd like to try a different treatment which I appreciated!

After our initial consult, she scheduled me for an MRI of the pituitary, which showed a small tumor, meaning that I would very likely not respond to oral medications and advised we go straight to injectables. I began 75iu of Menopur for three days, then after my blood and ultrasound, continued for three more days. I was then bumped up to 150 iu after my estrogen was still <100. I had bloods and ultrasound every 3 days throughout the entire process. I triggered with Ovidrel after day 14 of Menopur and my IUI was performed 32 hours later. I received my period prior to the pregnancy test. Our second IUI followed the same protocol, with 16 days of stims before trigger. This time, she started me at 75IU, but shortly bumped me back up to 150iu, as my estogren dropped after the first three injections. The second IUI resulted in a positive HCG test, but the level was 34 and quickly dropped to 6. I got my period shortly after. Our next IUI baseline is scheduled for this week and will likely follow the same protocol.

The out of pocket IUI package was $1800 and included everything but medication for a full cycle. I paid an additional $1800 for Menopur and $200 for ovidrel. We have no insurance coverage for fertility treatments, monitoring or medication. Total was about $3300 per IUI. We completed two unsuccessful cycles and are beginning our third.

Not applicable for our treament

Dr. Castelbaum is a very smart man. He is not an alarmist - he only gives you the information you need, and I think that’s to keep you for over analyzing or overthinking. I do, though, prefer to have more knowledge than I may need, so this has bothered me from time to time. When in his care, you need to have the mindset that he’s a professional and you need to trust him. Sometimes this can be hard for me, but I have seen many people have great success with him, so I do trust him.

Ask for more information when you need it.

I was put on the antagonist protocol. He never explained the logic for this protocol. This yielded 14 eggs and resulted in 10 frozen embryos. We transferred 1 embryo each time. First transfer resulted in a negative test and the second resulted in a miscarriage.

The cost of an IUI cycle was approximately $1,000 and for an egg retrieval and transfer, it cost just over $10,000.

I appreciate his conservative approach because the thought of carrying multiples worries me due to the increased health risks for myself and potential babies.

At first I was frustrated with communication, then we all realized they'd just switched over to a new email system. Dr. Castelbaum will answer emails the same day, often within a couple of hours, and once I could reach out that way I became very comfortable with care at RMA. Our situation was a really difficult and emotional one, but Dr. Castelbaum was really wonderful about being compassionate and giving us all the information and time we needed to make a decision we were comfortable with but that also gave us the best chance of having a child. Using an egg donor was a huge step, but once I was used to the idea, I was really glad we decided to do so. We got pregnant on our first cycle, currently 12 weeks.

Never be afraid to ask questions of Dr. C or of the nurses. They are happy to answer and you will feel more comfortable. They are all there to guide you through this process, and understanding what is going on and why helps a lot. There were many times when Dr. C supplied answers to questions I didn't even know to ask or before I could ask them.

We were given about a 20% chance of success with our own eggs after testing, vs 60% with a donor. As we were paying out of pocket, we knew we couldn't afford to try over and over, and we had to decide which was more important to us: the genetic relationship but with a much reduced chance of success, or having a much better chance of having a child with a donor egg. In retrospect, given the stress inherent in IVF with the hormone shots and whatnot, I'm really glad we went with a donor to limit all of that. Out of our 6 eggs, 3 became viable embryos, which is fantastic. We've only done one single embryo transfer cycle, and are now 12 weeks along.

I don't want to talk about exact numbers, but I will say that we consulted with another practice and RMA Philadelphia's pricing was much more reasonable. All pricing was done as packages. Since we were new to the process, we had a lot of questions, and the financing department understood the medical side of what was provided and were able to answer all of our questions.

Dr. Castelbaum strongly preferred SET given our circumstances.

When i first met with dr Lange she thoroughly reviewed my records from previous doctors and cycles and explained how we would approach treatment with her and what to expect. Once I went through an egg retrieval and then frozen transfer which resulted in a chemical, she recommended further testing as far as a miscarriage panel and ERA biopsy. I also recommended some further tests like natural killer cells and she agreed and wrote for it. Once we reviewed all results she took a different approach this time around which i am currently in the process of getting ready for a transfer. We made adjustments like synthroid for my borderline tsh, also started me on letrozole for a month to suppress my system for my endometriosis, along with testing my pituitary by ct scan due to elevated prolactin levels and started me on a medication for hyperprolactinemia, and I will get intralipid infusions for elevated NO cells . And will adjust my progesterone injections from the results of my era. To say the least I think that is very thorough and shows she is trying to everything she can to make this cycle work.

You are in good hands with a genuine and kind hearted physician that truly cares about her patients and developes a plan that works for you and if you have any questions or recommendations in your care she will take it into consideration and help as much as possible.

Unfortunately I don’t have results yet because I am getting ready for another transfer which I discussed earlier the different protocols she is currently using in my care.

Not sure

She recommended single but was willing to do multiple due to recurrent miscarriages but explained the risks

Dr. Gutman is very knowledgeable, compassionate and has a great sense of humor. During our first consultation and workup she was completely upfront and honest with what my test results revealed and the potential difficulties that could lie ahead. However, she was always very empathetic and made it known that she was confident in her abilities and was going to work very hard to achieve my desired results. I felt very comfortable in her presence and confident in the treatment decisions that she made throughout my care. She understood how crazy the back and forth almost daily visits at times for monitoring could be and did her best to take my life/work schedule into consideration. I don't know that I could have had a better experience. She truly made this very stressful process go much smoother than I ever anticipated. I am blessed to have found such an amazing fertility Dr.

Dr. Gutmann is straight forward when it comes to describing your care, potential issues, all of your potential options. She doesn't sugar coat the facts, but she also lets you know she is here to help and fight with you through the entire process. My percentages for a successful pregnancy were extremely low and she was up front with that, but also had a thorough game plan in place to beat those odds. She is determined and very skilled at what she does.

My first cycle began with Clomid and Ovedril leading to my IUI. My second cycle we used Letrozole to regulate my ovulation and Ovedril prior to the IUI. Throughout both cycles there was constant blood work and ultrasound monitoring to track my ovulation.

With each visit I had a $30 copay. All other treatment was covered except the cost of my donor sperm. I had to pay out of pocket for two rounds of donor sperm which ran around $2000.

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We've been using RMA and Dr. C since 2014 and if you are seeking fertility treatments, you are also seeking expertise, compassion, and facts. In total, we've completed one IUI, one egg retrieval procedure, and five frozen embryo transfers. We had two births, one miscarriage, one unsuccessful transfer, and are currently expecting our third. It's a rollercoaster and Dr. C has always been informative and never gives false hope. Our first transfer was successful, but after a failed transfer and a miscarriage, we regrouped with Dr. C to discuss options for the remaining embryos because it was getting expensive and emotionally taxing. Dr. C provided us with the research, facts, and risks with genetic testing the remaining embryos and ultimately left the decision up to us. After we decided to move forward with testing, Dr. C supported it and it resulted in another birth and we are currently pregnant. He often talks about how enjoys his ongoing relationships with his patients, we are repeat customers over five years and despite our various journey with each transfer, Dr. C has guided us with the information we needed to make the best choice for us. He might appear too direct for some, but when you are making life decisions that are emotionally and financially taxing, you want truth, not someone pushing you in one direction or another, or providing a false sense of what might be.

Dr. C is a mix of kindness, quirky, and direct. Don't be put off by his directness and appreciate the quirky.

I had unexplained infertility until our first consult with Dr. C. As soon as he did an ultrasound he diagnosed me with Endometriosis and we made the decision to try IVF. We proceeded with an egg stimulus process and egg retrieval. He suggested I wait one full cycle for my body to recover from the retrieval before doing our first transfer. Although I was excited to do our first transfer, I realized my body needed time to recuperate and heeded Dr. C's advice. A year after the birth of our son, we returned to RMA and the next two transfers were unsuccessful (one negative, one miscarriage) and Dr. C suggested genetic testing for the remaining embryos. We moved forward with genetic testing with resulted in two (out of the five remaining) viable embryos. The next transfer resulted in a successful pregnancy and birth. We returned to RMA this January to use our final remaining embryo. During my mock transfer, the doctor saw a fibroid in my uterus. Dr. C suggested I have it removed prior to our last embryo transfer, as he wanted to remove any risk of the transfer not working. Again, although I was excited to do our last transfer, we heeded his advice again, and are now pregnant with that embryo.

We were full pay out of pocket.

From the beginning, Dr. C advised against multiple embryo transfer because of the risks associated.

Dr. Gutman seems to be a no-nonsense doctor. While my partner and I have been having fertility problems she said our outlook is optimistic. I don’t think she would have said this if she didn’t believe it. We went to her for a second opinion and she discussed different ways she would change our current fertility regimen. This was helpful in that we were able to discuss these suggestions with our primary fertility doctor. Dr. Gutman also offered us the single best piece of advice we have received in our fertility journey. After 2 years, multiple IUIs, a cycle of IVF we were unsure of how to proceed on this journey. Dr. Gutman stated that whatever we decide we should be able to look back and be comfortable with the decisions we made. In this painstaking, emotional journey those words ring very true as we proceed in trying to make our family.

No non-sense, not the warmest person but very knowledgeable and willing to try different regimens.

Having one failed IVF cycle Dr. Gutman stated that If I did more IVF treatment cycles she would add Menopur in addition to Follistim. Also, having had one chemical pregnancy she suggested doing a hysteroscopy and ERA testing.

I thought I would be eligible for a clinical trial which would cut my expenses but Dr. Gutman quickly informed me that I would not be eligible. Other than that, they did set up an appointment for us to speak with the financial team which we have not followed up with because at this point we only went to Dr. Gutman for a second opinion.

She would elect for in the future doing PGS testing and then transfer one embryo. She said, ultimately it would be our decision on transferring one or two embryos.

I felt like Dr Castelbaum has a very high opinion of himself and his clinic. He spent a lot of time talking about how his clinic did well when inspected by the FDA. This seemed like a strange thing to talk about during our consult with some difficult news. I felt like he was pressuring us to use a donor egg without asking how we felt about it. He really dumped a lot of difficult information on us at once without much compassion. He suggested we have a cry and beer at home before coming back and talking with him again. If felt very strange and like we were taking up space in his office is we weren’t totally on board with his plan after 5 minutes of discussion. He was very blunt and said “you’re a complicated case” immediately after we entered the room. He prescribed Clomid and did not offer to monitor or follow up with me. I had a very bad drug reaction and spoke with a nurse who said she spoke with the doctor and told me there was nothing they could do and I should see my general doctor. When I called a week later seeking guidance after I got my period, I spoke with a nurse who said she would talk to the doctor and get bs m to me and they never did. I’m so glad we went elsewhere!

Don’t expect a great deal of compassion. He is very blunt.

He prescribed clomid but had me start on day 6, which another doctor confirmed didn’t do anything. I had terrible side effects (tingling in limbs and panic attacks) and they did nothing to help me or advise me after I called reporting the side effects.

The HSG test costs seemed high. Other costs were for office visits.

Dr. Castelbaum genuinely cares about the patients he works with. He was warm, friendly, and funny when appropriate. He treated me and my partner with the utmost respect and dignity. He worked extensively to help us with the situation we had, and constantly expressed empathy and compassion for our specific case. I absolutely love being a patient of his and wish all doctors had the knowledge and kindness he freely displays.

Take him over any other doctor, he is truly one of a kind.

We did a fairly aggressive antagonist protocol with Gonal-F and Menopur then Cetrotide. I responded extremely well to the protocol. At retrieval I had 25 eggs, with 23 being mature. 16 fertilized with ICSI and 8 embryos made it to day 5 for PGS biopsy and freezing. I did not respond well to the oral/vaginal estrogen, so we performed a mini-stim protocol for the FET. I did 10 days of follistim 75IU injections, with PIO starting a few days before transfer. Unfortunately the transfer resulted in a negative pregnancy test. I am hoping to generate more embryos before prepping for a new FET.

I had insurance coverage so the total cost of meds plus treatment was under $5000 total.

RMA's policy is to transfer a single embryo unless it has been shown to be absolutely necessary to try multiples.

I honestly can't think of a single weakness when it comes to Dr. Castelbaum. He is knowledgeable, compassionate, thorough, and kind. No two people are the same and he knows that and it shows in how he interacts with each of his patients. My husband and I brought embryos with us to Dr. Castelbaum from another facility. He was up front in telling us that he wanted his embryologist to review them because every clinic has their own guidelines for freezing and storing embryos and he wouldn't know what we had until they could look at them for themselves. After the first transfer with him from those embryos it resulted in a successful pregnancy where I gave birth to a healthy baby girl. Upon returning to the office two years later we did 4 additional transfers. The first 2 were with our remaining embryos we had brought with us from the other facility. From those, we had 1 early miscarriage (blighted ovum) and 1 chemical pregnancy. We then did another round of injections for egg retrieval. First transfer from this round was a chemical pregnancy. Second transfer was successful and I'm currently 10 weeks, 3 days pregnant and was discharged to my OB a week ago. It's so easy to blame doctors for a failed embryo transfer. My failed transfers were devastating to me; but I also remember how shocked and upset Dr. Castelbaum was for us. We did not do genetic testing although it was recommended to us to reduce the risk of miscarriage. Even though we chose not to, we were never judged for it. I almost gave up after the third failed transfer. Emotionally, I didn't know if I could keep going. Mentally, I knew I wasn't ready to give up. I'll never forget what Dr. Castelbaum said to me on my last appointment: "I know you were ready to jump ship and I understand why. But I'm so glad you didn't. It takes a lot of courage to do what you did. I'm glad I got to be a part of this and am so happy for you." These words will stick with me the rest of my life and I still tear up thinking about it. I could never thank him enough for all he's done for me and my husband.

Please realize Doctors are human. They can't give guaranteed results and they aren't perfect. Dr. Castelbaum loves what he does and it shows. If you want someone that will give you the brutal truth, yet deliver it in a compassionate way and someone who will truly fight for you Dr. Castelbaum is the guy to see.

I had insurance coverage for almost all of my treatments.

Dr. Castelbaum is a strong believer in only transferring one embryo. I was hesitant to agree but after he gave us the facts, I understood why and I knew he had my best interest in mind.

Dr. Freedman did exactly what he set out to do. His role was to help me get pregnant with a healthy baby. We got pregnant with our first transfer (under his care) with a PGS normal Male embryo. He followed our progress daily and called personally to congratulate us! He made sure our questions were answered the same day we asked. You can't ask for much more.

Trust in what he believes...his experience in this process speaks volumes.

My protocol was metformin and estrace daily. We added gonal-f and menopur with a lupron trigger. At age 39, we retrieved 35 eggs, 30 were mature. I ended up with 6 5AA embryos, sent for PGS. After PGS we had 3 normal males and 2 mosaic males. We got pregnant on the first transfer of a 5AA PGS normal male.

We had insurance (at the time) with a $6500 deductible. The deductible was met quickly,.then 80 percent was covered. For a full cycle, including monitoring, recurrent loss blood panel, karyotype testing and PGS testing, we paid about $5000 out of pocket.

He believes in PGS testing with one common goal, which is helping each mom have a healthy pregnancy with a healthy baby. He doesn't transfer multiple embryos if PGS tested.

I saw Dr. Gutmann primarily for our diagnostic work up as we then moved out of state. The clinic has you complete a through form outlining your medical history and history trying to conceive. During my initial appointment with her, Dr. Gutmann reviewed my answers with me and asked follow up questions when needed. My husband had to participate by phone and she answered his questions as well as mine. She explained the benefit of getting a HSG completed. I ended up getting my HSG done by her a few weeks later. I was very nervous and found the procedure to be painful She was kind and compassionate throughout.

She will be direct and very scientific about what your chances are of conceiving.

I saw Dr. Gutmann for diagnostic workup.

My diagnostic tests were covered by my insurance.

NA

Dr. Castelbaum was very positive and kept my spirits up during the low points of fertility treatments. He seemed confident that he would help get me pregnant and he did. There were some roadblocks that we had to get through but he always found the solution. He misdiagnosed me with unexplained infertility at first. During IVF, hydrosalpinx was found on my one fallopian tube. He quickly set up surgery to remove the tube and assured me that my chances of IVF success would be the same after my unilateral salpingectomy. Even though the diagnostic test missed the hydrosalpinx, I still felt confident with his care. It took longer than anticipated but the end result was a pregnancy. I'm currently 31 weeks and am forever grateful for his care.

Ask a lot of questions! He doesn't mind answering them

With my insurance, IUIs we're covered. I paid a $40 copay each visit. And I paid for the medicine out of pocket. I don't recall the medicine prices. For IVF, we paid all out of pocket. We did the RMA assure plan which costs in total with meds about $30,000

He suggested one embryo transfer at a time because of my age.

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).

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.

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 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.

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.

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

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.

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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.