Aspire Fertility (formerly RMA of Texas)

Summary: Dr. Crawford has poor bedside manner when dealing with emotional patients. My OGBYN referred me to Dr. Crawford. When first researching her, I didn't like her strong social media presence and the fact that she talked about patients (without mentioning their names) on social media. I also lived over an hour away from her office, so it would be a pain to make the trip often; however, my OGBYN loved her so I decided to give her a try. My first consultation was OK. During one point in the consultation I got upset (Infertility is emotional people, but I'm preaching to the choir, you all know this.). Dr. Crawford just kept talking and didn't stop to address my emotions. This should have been my first red flag. However, I let it go with the thought that maybe she thought if she just kept talking I would be able to pull myself together and we could move forward. I came back for my second appointment for my husband to do a semen analysis (SA). Once his SA was complete, Dr. Crawford would be able to go over next steps with us. During my previous visit, I mentioned to Dr. Crawford, my fertility coach, and other staff how uncomfortable my husband would be giving the SA. Even leading up to our appointment, I spoke back and forth with office staff on the possibility of him doing it at home and bringing his sample in. Ultimately, he decided to do the analysis in the office because we were concerned with the 1 hour time frame that we had to get the sample to the lab (remember, we live 1 hour away) . The day of our appointment, they placed my husband in a room right by the nurses desk and the waiting room. He could hear every word the nurses said, every person who checked in at the desk, and even when they called me back to our consultation room. Why would they have not taken notes about how uncomfortable I told him he would be and placed him in the room furthest away from everyone? Instead, they placed him in the least private of all the SA rooms. Unfortunately, he was not able to provide a SA. We then waited on Dr. Crawford for our consultation. We were greeted by a nurse who said Dr. Crawford would not be able to see us today because my husband had not been able to provide a SA. I immediately start crying. First, We had driven an hour, how can she not just come into the room and talk to us and explain possible options (option 1: if his SA came back good. option 2: if it came back bad). Second, I'm her patient too, not just him. Come talk to me and my husband about what's going on with me and the blood work results from the last appointment. Because I got upset, the nurse went to get Dr. Crawford. As soon as she entered the room Dr. Crawford was on the defense. Instead of giving me a chance to talk and explain my concerns, she immediately started explain why it was unethical for her to treat us without his SA. Unfortunately, I tried to talk over her in order for me to express my concerns. Her response: "I feel like you are personally attacking me." UMMM.... WHAT?!? She then proceeded to say "It's unethical for me to f***ing take your money without his SA." So now she has refused to see us, said I was attacking her, and she cursed. I should have trusted my gut from my first consultation when she ignored me when I got upset and kept talking. Based on her reaction to my emotions at my second appointment, she clearly needs more work in how to properly deal with patient emotions. I needed a hug, a "it's going to be OK, here are next steps," not cursing and refusal to see me.

Don't try to confront her, she'll curse and say you are personally attacking her.

$40 copay based on my insurance

He explained things in an understandable manner. I didn’t leave with questions of his explanations. I did however feel post failed transfer that there was things that should have been explained better which could have told us more information - having now done more research of my own.

Do your own in-depth research and ask questions

We were self pay as this clinic didn’t accept our insurance. It was approximately 14,000 out of pocket not including medication

I only had 1 to transfer

Dr. Kelley is very warm and explains every detail thoroughly. She definitely was honest with my protocol and setbacks and made me feel comfortable along the way. My only "weakness" for her is that you don't get to see her for every monitoring appointment along the way and other doctors in the practice are not nearly as thorough and understanding as she is.

My advice with any doctor would be do some research before-hand, so that you have a list of questions to ask. Dr. Kelley will answer all of them and put your mind at ease.

I have low AMH (1.5) and my husband has low sperm count, motility, and shape. Therefore, IVF was our best option. For my first retrieval, I did a Lupron lead in + Microgestin birth control. There was a mix up on how long I was supposed to take BC, so I had to push my cycle out a month. Then when we started back, I had two lead follicles at my baseline, so we had to continue Lupron for a few days. Then I started a Gonal-F (300 daily) and Menopur (150 daily) protocol for about 10-12 days. Dr. Kelley retrieved 7 eggs but only 2 were mature and produced 1 emryo that made it to Day 6 blast and tested PGS Normal. For the second cycle, Dr. Kelley suggested we add a couple of days on stims to give the eggs more time to mature and we also added Omnitrope (25 units daily) to help with egg quality. This time we got 7 follicles, 5 were mature and 3 made it to blast. We got 1 PGS normal embryo, 1 low mosaic, and 1 abornormal.

Monitoring was between 7-9 am. That worked well with my schedule because I could go in before work. I generally had to wait, which was annoying. The other negative I had was that I rarely saw my doctor, as each of the three doctors rotated on a schedule. I think this is a miss. One of the three doctors, Dr. Skillern, definitely made you feel like a number at the deli counter and I had to stop her from leaving before I could ask her questions.

I use Progyny insurance, so I'm unsure of the out of pocket costs. I did have Aspire quote me on an additional cycle if we needed to do a third egg retrieval. I don't have itemized costs yet, but the total for an egg retrieval cycle with all monitoring, genetic testing, assisted hatching, anesthesia, ICSI, and cryopreservation for a year was $17,999. Meds are an additional $5-6k.

Dr. Kelley and the other two physicians at Aspire lead with eSET. I agree with this approach.

Dr. Crawford's strengths are her ability to take a very complicated, and overwhelming process and break it down into simpler terms to help you visualize and understand it. She is patient and super positive. Always open to additional questions and even encourages them. So far, no weaknesses, but we're still very early in the process.

If you're a potential for IVF treatment, have a consultation. She'll shoot you straight, explain things thoroughly and have a very direct approach on the path forward for your family. You'll leave with all the question marks in your mind answered.

Cycle Management Fee IVF Class Mock Transfer Monitoring Appointments: Office Visits, Labs, and Ultrasounds Monitoring Labs Include: Estradiol, Progesterone, and BETA-HCG Anesthesia Fees Egg Retrieval Egg Identification Sperm Preparation Intracytoplasmic Sperm Injection (ICSI) Culture of Embryos Assisted Hatching (If Necessary) Embryo Blast Embryo Sampling PGS (includes unlimited testing for 1 year) Embryo Cryopreservation (includes 1 year of storage) Embryo Thawing Embryo Transfer Preparation Embryo Transfer Emotional Wellness Session First Pregnancy Test Must be completed within 12 months of commencement Menopur 75 IU 22 Follistim AQ 300 IU 1 Follisitim AQ 900 IU 3 Pregnyl 10,000 IU 1 Leuprolide Acetate 2 Week Kit 1

IVF treatment was above average in cost

Her recommendation is eSET.

Dr Skillern is brilliant. She does not sugar coat things, but she shows compassion. She is relatable, trustworthy, honest. She was available on nearly every visit. She set realistic expectations and gave us a game plan for each cycle .. making modifications to get better results each time.

She’s a professional. She is busy, but she treats your case as though it is important. She gets excited when good things happen for you and is genuinely sad when things don’t go as planned. She is wonderful.

Many tests to determine reasons for infertility. 4 egg retrieval’s. Genetic testing on embryos. Biopsy of my uterus to determine correct day of implant. 2 embryos implanted. 3 frozen embryos.

RMA is on the expensive side... but worth every penny.

Dr Skillern really promotes single embryo transfer. Pre-consultation I always envisioned implanting more than one embryo. After listening to her reasons, I agree with her decision to implant one at a time.

Dr. Mak is brilliant. Had I listened to her originally I would have been further along in this process. I trust her completely and appreciate her dedication to my case. Not only does she personally respond to e-mails she checks up on you during appointments. She never makes us feel uncomfortable and throughly explains everything. It’s also nice that I get to personally see her for my visits rather than being pawned off because she’s a really busy doctor.

Be ready to hear the truth and accept it. She has great bedside manner but everything she is telling you is fact and it’s better to absorb than to run from it.

I haven’t had any cycles yet, but we are in the prep phase. We had a minor set back during the mock transfer that is all cleaned up now. I did 3 months on Lupron and now we are ready to start invocell ivf.

My invocell is going to be $8600. My past treatments (mock transfer and saline ultrasound) were under $400.

None. Dr. Mak explained the risks I could face with doing a multiple transfer and I accept that a single is my best route.

She was candid about me having fibroids but completely focused on getting us to move forward with IUI or IVF. She never provided any other alternatives and was just matter of fact in saying that I had "unexplained infertility" -- which was most definitely not the case after a second opinion. She's a second rate doctor that should find another profession.

Go somewhere else and don't waste your time with her!! She's awful!!

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Initially just copays. But ended up having to pay out of pocket because they fraudulently coded my consultation as "infertility". All I went to them for was diagnostics!!! She never did ANY procedures or treatments on me.

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We thought everything was being check with our blood draws and come to find out she never tested our husband's testosterone levels. We found this out after 2 retrievals and couldn't believe this wasn't done before hand. We wasted two potential cycles and hard earned money as insurance didn't cover IVF. Extremely disappointed.

I would seek several other opinions before choosing your doctor.

$30,000+ for 2 retrievals

My husband and I both felt very comfortable with Dr Arredondo from the initial consultation throughout our years of treatment. His passion and knowledge was very evident!! We loved how easy it was to just sit and ask questions...and felt like his questions to us were not just clinical but really covered emotional, financial, relational topics as well! Because his main office is in San Antonio, we did not see him at every appointment but we had equally great interactions with other doctors in his practice!

If it is important to you to see the same doctor at every appointment, you may want to travel to San Antonio to see Dr. Arredondo or choose another doctor at RMA who is always in Austin! We also fell in love with Dr. Skillern, who did our embryo transfer and who will do our next transfer as well!

With our embryo transfer, we wanted to try a natural cycle because I had taken many medications in previous fertility attempts. He and his staff were supportive in our wishes but also advised and encouraged when to deviate from our original plan, such as the need for progesterone after the transfer!

IVF $15,000 Embryo Transfer/meds $6,000

Got pregnant on our 1st round of IVF with RMA under her care. She was fantastic and I highly recommend. She always set expectations and was in every appointment besides blood draws. Loved her!

She will be very frank with you and not sugar coat. She does not talk to much about the future and talks about today and the next step. I'm a huge planner, so it took me awhile to adjust to this, but with infertility it was the best for me. You can't plan to far ahead with this. You need to be in the moment and think about today and the next appointment and what needs to be done between then.

I was fortunate enough to have insurance that covered IVF. I only had to pay 20% after my deductible was met. I did pay for CCS services and that was $2,500 I think cash payment of IVF ranged from 10k-25k

Dr. Skillern is not the most touchy-feely, but she is very honest and pretty easy to talk to. She was completely up-front with us from the get-go, and seemed to communicate with myself and my husband as equals. Also, did every appointment except for blood draws, and was always willing to answer a call or email if I had questions.

I used the antagonist protocol, with a couple weeks of birth control pills before starting stims. Because of my large follicle count, and risk of OHSS, we planned a freeze-all cycle from the beginning. I started off with relatively conservative dosage amounts of Menopur and Follistim and did reduce as we moved forward. Also, since we did a freeze-all, I triggered with Luperon instead of HCG. I started with 24 eggs retrieved, 20 were mature, and 17 fertilized with ICSI. After six days, I had six remaining embryos for transfer. I was able to transfer my next cycle, after a hysteroscopy to double-check my uterus. Because of the grades of my embryos, we transferred one and it was successful.

Unfortunately I did not have insurance coverage for IVF. The clinic offers a service that provided a "bundle price" for the procedure plus medications that was lower than the "list price." For all meds, plus IVF, plus a frozen transfer I paid roughly $16,000. The clinic does a good job billing what they can to insurance and they helped me out writing care summaries and letters to insurance to get me a couple claims covered that were originally denied.

She is very blunt. I do appreciate this but prefer more compassion than I got from her. She did not do both of my egg retrieval’s which I didn’t appreciate. She set realistic expectations on how many eggs I should expect and viable embryos after testing. I haven’t done the transfer yet so can’t review that process.

Don’t expect warm and fuzzies. She is to the point and you won’t have a ton of interaction with her.

She prescribed - Lupron 10 ml while taking birth control pill then I moved on to Follistim 300 IU, menopur , omnitrope 50 ml. Then Pregnyl shot.

Full IVF $17,000 after slight discount Egg retrieval $11,000. Testing covered under insurance since we are CF carriers.

She will only do a single embryo transfer. I don’t have many viable embryos so I am ok with this method. If I had more and wasn’t doing PGD and PGS testing I may feel different.

She has excellent bedside manner, for instance I had my hsg done and found out my left tube had hydrosalpinx. Dr. Crawford explained what that meant and gave me percentages on me getting pregnant naturally, went over the risk of not removing that tube and gave excellent analogies to help my husband and I understand. She is just amazing all around

I would listen to her podcast As A Woman she discusses great topics and when you go in you know some of the lingo and what to expect

Dr. Skillern was great, but at times I felt she was rushed or didn't take time to reassure me in the midst of concerns. She did everything right though, and I'm pregnant now. Compared to experiences I've heard at other clinics, she is a lot more on top of potential complications and preventing them. I didn't mind her blunt personality.

Be patient and trust her.

My protocols seemed to be fairly standard. They do use birth control to start your cycle at the best time for them to manage office visits, but that actually helped my cycles to go by the book.

Covered under work benefits

Be sure to come prepared with any questions you have in advance. The baseline examinations are very quick. If you have questions during a procedure, be sure to let them know you have questions and they need to be answered.

Dr. Skillern is not chatty and no nonsense. There is no time for banter. Come prepared.

16 eggs produced, 9 fertilized, 2 made to embryo stage, 1 was normal Lupron = 20 units for 10 days / 10 units during stimulation phase Follistim = 150 IU for 11 days Menopur = 150 IU for 11 days Omnitrope = 25 IU for 11 days I had a failed cycle before where the embryo was not normal. Omnitrope was added to the protocol and not covered by insurance.

I have insurance so that changes things but the self pay price with genetic testing is about $20,000 + medication

Doctor has strong preference for eSET

Dr. Crawford is the exact right combination of sweet and compassionate and direct and knowledgeable. We have been with her for a long time after a bad first experience with another doctor. She is very accepting of us as a same Sex couple and me as a person. She advocates for her patients and I trust her.

Tell her everything, all your fears and doubts.

We did both clomid pills and injectable and femara. It takes a lot of medicine to make my body ovulate so tried both pills and injectables.

Dr.Crawford is hands down the best for such a sensitive procedure. She gave me her contact information and she made me feel so well taken care of. She explained everything down to my age and the affect it may have and what all the testing does to help. She makes me hopeful that i will Accomplish my IVF goals

Listen and relax, Dr. Crawford makes you feel at home. So i wouldn’t freak out unless she ultimately Does. Put your complete trust in her 🙂

Haven’t started my procedure yet. I’m waiting on blood results and this covid-19 to end

I’m still worried about cost. It’s quite pricey and My insurance doesn’t cover it. I’m trying to find the money to cover it

As of now, I have only gone through the diagnosis and decision making process with Dr. Kelley and will be starting treatment soon. Dr. Kelley had to deliver very unexpected news to me and handled it with great care. I had no experience with fertility issues and she was very helpful in explaining my status and my options and was very understanding on where I was emotionally. Additionally, Dr. Kelley was awesome at responding to me and my emails filled with additional questions and/or concerns.

I felt very comfortable, relaxed with her. I have diminished ovarian reserve and she was very clear about the expectations. Each time, I felt very well-guided, and that there were no surprises ahead. Plus, she is just a very pleasant and nice person.

I have Stork Fertility so the cycle was covered through insurance.

She is straight forward. She explains and she tells you what is best but still allows you to make the choice. She was always avilable or someone on the team was to answer any questions I had. I would recommend Dr Skillern. However my first transfer did result in pregnancy. I felt horrible and questioned myself but after meeting with the Dr she made me feel its not my fault and even put her own personal story out there.

She will be honest and straight forward.

Dr. Kelley listened to the difficulties we were going through. She evaluated my old records and paid attention to the details. She discussed what treatment options were available and the risks/benefits of each and success rate of each. We felt like we had a clear plan and knew what to expect. Luckily for us, it only took one cycle of Femara for us to become pregnant and have our healthy daughter!

Femara 5 mg Day 3-7, with ultrasound monitoring, and then HCG trigger shot and timed intercourse.

Dr. Failor is a great doctor. She is empathetic and informative and relays information very well. She is easy to contact and talk to and explains each step of the procedures and plans very well. The only negative is that the clinic is often busy so some of my appointments were very quick.

ASK QUESTIONS!

With my GYN I tried clomid, and when I came to Dr. Failor she had stated after testing that IVF seemed to be my highest percentage of conceiving. First we had to have surgery for uterine polyps, then we began IVF. My dosage was low as she thought we would be successful on a low dose (due to being 26 with no sign of anovulation or dimished ovarian reserve). For my egg retrieval I was on Gonal F, Menopur, and ganirelix. We retrieved 26 eggs, 19 fertilized, and 10 made it to day 5 blastocyst. We were about to start prepping for my FET however due to coronavirus this has been postponed.

$15,000

I feel she spoke to us with care but once we started asking the hard questions she would go around give an upfront answer. I want to know what the risks are completely upfront instead of being misleading. She is very sweet and very intelligent. I think she is afraid of destroying our dreams by giving us hope that might not be there.

Ask her the hard questions and ask for the hard straight up answers in return.

We are actually in the beginning stages where we are about to make a payment. Due to the payment being over 16,000 without meds, and my insurance not covering anything we have to wait a little longer. But we are suppose to do an egg retrieval, sperm donor and then a gestational carrier

$80 for our co pay every time we needed to see her. Then they quoted us over $16,000 for a basic IVF cycle with no meds and no sperm. We do not qualify for insurance benefits.

She’s is recommending we only transfer one but is okay with transferring multiple embryos. We are good with her suggestions

She was such a delight to be around she always had a smile on her face when she would come into the room. She expressed disappointment in negative results with me. I always feel like she is on me side cheering me on. Looking for the best treatment for me.

Let your guard down, and trust the process. It takes time to find the right treatment plan for each patient.

I had used clomid with my obgyn and it resulted me becoming pregnant. I went back after having my daughter and did clomid for 5 more cycles each time I'd ovulate but success of pregnancy. I moved on to RMA and was put on femara for my cycle ovidrel to trigger a couple of nights or night before my husband and I'd go in for our iuis. Eventually we kept that same protocol and added in gonal f in. It was femara gonal f then ovidrel go in for iuis. Each time I'd make about 2 to 3 follicles. Once I had 4.

I really do not know what the actual cost were because my insurance covered my iuis and if I had not meet my deductible I could use my insurance card.

When we talked about ivf I was told I would be given a single embryo transfer because twins would be considered high risk and the only way theyd do multiple ones would be if they were growing slower than they were suppose to at day 3 or 5 transfer.

Dr. Browne was honest and open with me about the process and the chance for success. The only thing I wish was different is I didn't always see her for my checkups during the STIM process and she wasn't the one that did my retrieval.

Be very honest about your fears and if you have any known risk factors (i.e. overweight, smoking, etc.).

I did IVF premium with PGS testing. I chose to have PGS testing because I wanted to make sure we transferred an embryo without any of the tested genetic defects. At the time, there was no known egg quality problems so we were more concerned with quantity. It included daily nightly STIM injections with Follistim 150u and Menopur 150u for 7 days. I added Ganiralex the last 3 days in the morning. Then I did the Pregnyl trigger shot. I had a positive beta test and was scheduled for egg retrieval the next day. This yielded 13 eggs, 12 were mature, 6 fertilized. On day 1 and 3 I still had 6 embryos. By day 5 I only had 1 embryo to send for genetic testing. The results came back a week later and it was not viable for transfer. The embryo was mosaic for Turner's syndrome.

IVF premium using Capex MD was $22,085.19. I had to finance it through lending club.

Dr. Browne said that if we did PGS testing we could only do single embryo transfer. We didn't when make it to that though.