Aspire Fertility/ RMA of Texas

The clinic overall is very pleasant, everyone is welcoming and as a nervous, anxious patient they do help change your mindset to a positive outlook but their weakness would be to slow down a bit, and give details on specific guidelines.

Dr. Arredondo is a very welcoming individual and does find his ways to keep you calm (as I'm an anxious person) but I dont like how on the go he is. Sometimes a bit more detail during this time would be much more comforting.

Erika was very passionate as I was a wreck this go around, but the organization needed a lot of work. I had to call for a few things because I was explained at the time of the visit.

Dr. Arredondo will make you feel comforted, welcomed and I. good hands. He does Express the risks and importance of the procedure/risks involved. Only thing I have been unhappy about is how on demand he is needed, maybe a bit more detail would ease the questions all not answered. And I know timing cant be determine, but he hasn't performed any of my transfers so for the second I would have preferred him as I had no rapport with the one scheduled.

Ask if you could have a bit more detail beforehand and get answers from him directly and not the nurses.

I did an embryo transfer, meds scheduled at specific amounts and times. Now since it had been awhile since I have done so, I was not explained protocol properly which I believe had a bit to do with the negative result in my own opinion.

I was doing a embryo transfer this go around but it was about $5000 or so unlike the first time $25,000+

My first IVF I was much younger and did multiple which resulted in being blessed with My BabyBoy. And the second time a few months ago, he explained only 1 could be used. I extremely did not want that, but he mention the risks if possible twins. And since I still feel at age, I tried to stick to thinking positive. But I could not shake the single transfer decision, and I regret not making it a point that I would prefer that method or go elsewhere.

Strengths: clean, friendly staff, nurses, and personable, knowledgeable, good and updated equipment Weaknesses: Bad location, rush patients in and out sometimes, didn't like the retrieval and transfer area (too open for all patients to see each other) and didn't have success here with not a lot of feedback after our cycle failed.

He took the time to contact you back by email or phone when I had questions, and would explain what he saw or was looking at during the check up appointments once on medications. However, many things he did push off to the nurses to explain more. We live 3 hours away from the clinic (closest one to us) and at the time it was difficult to take an afternoon or day off of work to go to appointments and only be there 20 minutes. There were several times my husband and I thought this is it? We felt rushed in and out and then like we had too many questions on our list to ask. But this was our first time to go through IVF and as much money as we had to pay out of pocket, we wanted to spend time talking with the doctor, the expert in his field, not just the nurse.

Pretty good job of explaining things by email or phone. Overall, she was good, but would have liked the doctor to explain more and her less.

Strengths were he spent a lot of time in our first consultation with us. He was a good communicator for the most part, but we did feel at times we had to pull things out, like he didn't want to tell us everything. Knowing now that IVF isn't a guarantee for pregnancy, we just wanted more reassurance that I was doing everything as right as I could do leading up to, during and after the whole process. Weaknesses were the follow up post failed transfer, which we had to do over the phone, because we didn't get the answers we were looking for. He suggested we do IVF again, or use donor eggs but couldn't pinpoint why my transfer failed. Side note, I have one son who I conceived naturally, had healthy pregnancy, and delivery, so hearing this did not sit well with us. This is when we felt we wanted to switch doctors.

Don't be afraid to ask questions, and be pushy about them if need to, because these clinics assume you know it all and don't offer extra help if you need it.

I was on agonist cycle and a slow dose, lowest dosage being my first one I guess.

Total paid for the IVF cycle : $15,553 (this did not include my first appointment ($325 for ultrasound, etc)

He had preference for SET and said I would be lucky to get more.

I visited both the medical center and Stone Oak location based on the day of the appointment. I wish it was more consistent on which doctor I saw for each appointment, but they were all very nice.

Dr. Browne would personally call me to check on me during the injectable stimulation process and also called to give me the results of the PGS testing. Although we didn't have any viable embryos for transfer, she was delicate and understood my frustration and pain. She was also candid and honest in providing me reasons why our IVF cycle may not have been successful and what we could do different with the next cycle.

No weaknesses. Kristina and the rest of the staff were great communicators and compassionate and informative.

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.

Setting up appointments can be tough in the beginning. It wasn't until after I was on a timed schedule that it got easier for me. Also, the other location at Stone Oak was difficult at times. I had more billing issues there than anything else.

The office itself sometimes made me feel like a number, but most interactions with Dr. Browne I felt like a human. There was one IUI where I was in a gown waiting for her to come and do the procedure for almost an hour...that time I felt like a number.

Overall everyone was really nice and answered all of my questions throughout the process.

I was referred to Dr. Browne by a friend and I'm so thankful I for that. It was the first step in the process that led me to where I'm at today. She took the time to walk me through all of my available options. She was kind, didn't try to rush me, and answered all of my questions. She has a great bedside manner and was encouraging when needed. My reasons for switching doctors didn't have anything to do with Dr.Browne personally.

Call right now and make an appointment, you may have to wait a couple weeks to get seen!

My insurance covered 6 IUIs (lifetime), so given IVF isn't covered and I wasn't ready that was the route we chose. She thought there was a chance I had endometriosis, but didn't think it was necessary to address at the time. My husband had slight motility issues, but again nothing dramatic that needed to be addressed. We could have done timed intercourse with Clomid but chose to go straight to IUIs given we'd already had one miscarriage and we weren't getting any younger! IUI #1: 50mg Clomid for 5 days, trigger shot, insemination at 36 hours post trigger. Failed cycle confirmed via blood test. IUI #2: 50mg Clomid for 5 days, trigger shot, insemination at 36 hours post trigger. Failed cycle confirmed via blood test. IUI #3: 5mg Femara for 5 days, trigger shot, insemination at 36 hours post trigger. Failed cycle confirmed after negative HPT and period starting. IUI #4: 5mg Femara for 6 days, 2 Menopur injections, trigger shot, endometrial scratch, insemination at 24 hours post trigger. Failed cycle confirmed after negative HPT and period starting.

My insurance covered most of the IUIs, but had it not I think it would've been around $1200-$1500 per cycle.

N/A

Nurses are great with communication, recommendation sticking with one or two nurses if the other isn’t there. One weakness I think would be to communication between the staff, sticking with one nurse is best so there familiar with your issues and treatment.

Doctor Balthazar is so kind and has a great bed side manner. Very encouraging and positive through our whole experience. Through our whole process she’s was very straight forward with expectations.

While in Amy’s care she alway went above and beyond for our first cycle. Responds to emails with in 24 hours or less. Very compassionate and listens when there is an issue with medication or even insurance. For our second cycle Rebecca is our nurse and she is also very good with communicating about our care and makes sure all our questions are answered.

While in doctor Balthazar’s care she gave us complete honest care. I never felt like we were being steered in the wrong direction, she gave us a lot of hope but at the same time let us know what we may be expecting. Our cycle did end in a chemical pregnancy, when we went in for a follow up her compassionate care ment a lot to us. With our outcome from our last and from my lab result she did not give us any false hope for a future cycle with my eggs. She answered all our questions for a future cycle and other options we can look into to built a family and still experience the possibility of pregnancy.

Expect wonderful care

I already started with diminished ovarian reserves so we started out with 4 shots twic daily, at the end prior to retrieval doctor Balthazar adjust and increase of injection doses. At egg retrieval we only got to eggs as we expect, both fertilized and did a three day transfer ending in a chemical pregnancy.

Diagnostic’s, fresh ivf cycle cost,medication cost, acupuncture

With our cycle we did a two embryo transfer due to endometriosis and low ovarian reserves.

Email seems to be the best way to reach the coordinator. Trying to reach anyone by phone is difficult. I believe sometimes they take longer than I feel they should to return calls. (I do understand that I am not their only patient and that I can sometimes be a little impatient) The staff are all very friendly and helpful!

Dr. Balthazar always makes you feel comfortable and remembers things that you have asked or said previously. She makes you feel like she truly cares.

Lisa is awesome! She makes sure that she explains everything to us when a new medication is prescribed or when a medication is to be taken. She gives us a schedule for the process and goes over it with us to ensure that we understand everything. She shows compassion and is very easy to talk to.

Dr. Balthazar is kind and shows excitement and empathy where and when needed. Dr. Balthazar gives me a lot of hope when it comes to treatments and options. She explains every step of the process when she is performing procedures, such as with my HSG test, she explained what she was doing, why she was doing it and what she saw. I was a bit nervous about the HSG test but with Dr. Balthazar explaining everything I was much more at ease. My wife and I have never felt uncomfortable with Dr. Balthazar, she does not treat us any differently than I feel she would treat a heterosexual couple. Choosing Dr. Balthazar as our RE was the best decision that we have made for our TTC journey.

Trust her! She is very good at what she does.

We went in for a consultation, had a uterine ultrasound performed so that she could be introduced to my uterus and ovaries. Because I have PCOS and my periods are not regular she prescribed me medroxyprogestrone 10 mg twice daily for 5 days to force my period to start. Once my cycle started I came in on day 3-4 to have the HSG test done. She wanted to verify that my uterus was good and that my Fallopian tubes are open. I was instructed to call back once I began my cycle again so that we could began the first IUI cycle. I started my period on my own that month but much sooner than expected, we had not chosen a donor by that time and did not want to rush that process so my wife and I opted to hold off until the following month so that we could get that taken care of. Once again, my cycle did not start when it should have so I was prescribed the same medication as before after a negative pregnancy test was acquired. Once the medicine was complete and my period came we went in for base line testing where an ultrasound was performed to verify that I was in the proper stage to move forward. Dr. Balthazar prescribed me 5 mg of letrozole to be taken at night for 5 nights and scheduled a follow up ultrasound. On the day of the follow up ultrasound she verified that with the help of the letrozole I had one follicle that would be mature enough to move forward with. Dr. Balthazar prescribed me a trigger shot of Ovidrel to be given by my wife at 9:30pm on Wednesday night and IUI was scheduled for 9:30am Friday morning. That was on August 31st. On September 17th I went back in for blood work to see if the procedure resulted in a pregnancy. Unfortunately it did not, but my wife and I were aware of the chances that it would not work.

I was told that I would have to pay my co pay plus additional cost not covered by insurance each visit. The first 2 appointments I paid my copay plus $96, the first visit and then my copay plus $256 the second visit. Once I received my EOB from the insurance company it showed that I should have only paid the copay. My wife and I figured that they had us pay additional amounts that most insurance companies do not cover. The additional amounts were put back onto our account as a credit. So far we have only had to pay the copay.

I think my clinic does a great job of making you feel valued. I never feel like a number when I'm there. They call me by my name and they give all the time I need to have my questions answered. They are all very patient and kind. They never make me feel like I'm asking a dumb question or too many questions. They know my history and I don't have to remind them at any point. Their one weakness in my opinion is that they do not let you know if you will be seeing another doctor that isn't your doctor. They assumed I knew it was my doctor's day off (had go in for a scan during a timed intercourse cycle), and I didn't know I wasn't seeing my doctor until the other doctor walked into my room to do the scan.

She always knew everything going on with me. I never had to re-explain my situation or my history as I had with my OB. She always took as much time as I needed to answer my questions and explain everything in depth to me. I never felt like she was rushing to get me to leave. You can tell she cares about you as an individual.

The entire staff is very patient and kind. From the intake staff to the billing. Everyone explains everything fully and takes the time to make sure you understand it all. My specific nurse is new to me as we won’t start our IVF until May but from what I’ve asked so far she has been very ready and willing to talk with me and answer my questions. I’m looking forward to having her through this cycle.

Dr. Balthazar is friendly and kind. You can tell that she really does want to help you grow your family. She does give you all the options and she is honest with you about your chances with each of them. She is smart and experienced, so she’s seen a lot of cases and knows what to do with each of them. She is compassionate as well. When I had my third loss she let my husband and I sit in her office and cry and ask all the questions we had. She never rushed us out or said she needed to go. She just listened and answered. She just makes you feel like you’ve got the champ in your corner that you need in a time like this.

To ask anything you want to know. Don’t walk away wishing you had asked one more thing. And know that she will be honest with her answers.

When we came to Dr. Balthazar we had recently had our second miscarriage with no live births. After testing she found I had MTHFR gene mutation, and a high egg count. She addresses the MTHFR with a prescribed prenatal with folate and a baby aspirin a day. She choose a timed intercourse cycle with Clomid (25mg the first round and 50mg the second) with an Ovidrel trigger shot each time. She said because of my high egg count the signal from my brain to my eggs may be causing my eggs to go too soon or too late causing them to not be timed correctly and thus the miscarriages. With Clomid we could help one to mature at the correct pace and the trigger shot would tell that egg exactly when to go and that would help address that issue. The first month with this cycle we received a negative pregnancy test. The second cycle we received a positive pregnancy test but my HCG didn’t rise as needed and we lost the pregnancy.

I completed all of my fertility testing at this office, which estimated $2000 out of pocket. I also completed two timed intercourse cycles which totaled about $1300 with medications. I have IVF with PGS & an FET scheduled for this summer which will be approximately $26,000 total, with no insurance coverage.

Strengths: Schedulers and billing staff are communicative, timely, and so nice. Good hours for working people Weaknesses: Sometimes it hard to get a scheduler on the phone for that initial consult- I played phone tag . But if you leave a message they return it. Once you are an established patient it is much easier.

Dr. Balthazar takes her time with us. She listens and answers all questions. She is warm and humorous and definitely puts thought into her patients’ care even when they are not directly in front of her.

Amy is very communicative WHEN it is important and/or when she is at the office. Sometimes I would wonder if she got my email but now she acknowledges them and let’s me know that she is not in the office . She sometimes says that she will send in a ( non urgent) script right away, but that doesn’t happen as soon as she made it sound . Over all she is a million times more helpful than the nursing staff at our last clinic.

Again- Dr. B is warm, humorous, upbeat and able to answer all questions. She explained the protocol she game me and why she selected it based on my diagnosis of DOR. I responded poorly to the first cycle and was oversupressed. The second cycle, I had cysts and was still suppressed from the birth control . Third cycle, everything cleared up and we are attempting an egg retrieval.

Go in with a list of questions. She loves it!

Cycle 1 Estrogen priming 10-12 days 2 weeks BCP Stims: 75 Menopur 150 follistim Letrozole 2.5 Dexamethason Micro dose Lupron 10 units 2/day Omnitrope Pregnyll Cycle 2 - cancelled Cycle 3 - same stims but no estrogen priming or BCP

IVF with ICSI, hatching and PGS $19,000

We have not really discussed this yet- decided to discuss when we see what grade of embryos we are working with.

Some of the staff are very friendly. Amanda C. is very nice and understanding. So is Brianna. The rest of the staff mainly treats you as a number. They perform these tasks on a daily basis and have gone through them thousands of times. It was my FIRST time, and no one took the time to be patient or inform me of all the steps in the process. I was very disappointed and feel cheated.

THEY FAILED TO INFORM ME I WAS A CARRIER FOR A GENETIC DISORDER. The quality of staff reflects the standards of the doctors running the facility. That’s where their problems begin. I felt very rushed through the entire process, like everyone else knew what was going on, but since this was my first time discovering that my husband and I had fertility issues, no one really took the time to really explain the process at each visit. On several visits my husband or I were cut off by Dr. B when we were asking questions or explaining something. By the time we actually got to performing the IUI, I had already had an uncomfortable feeling, but since I had nothing to compare it to, I tried to push it out of my mind. On the day of my IUI, as you can imagine, I was very nervous. The procedure went well enough, and the MA told me to lay there for 10 minutes to allow the sperm to enter the fallopian tubes. I tried to cover my eyes and I didn’t pay attention to the time because she put an alarm and it would let me know when to get up. I heard the beep and I thought it was early, but I got up and started getting dressed. I was almost finished when I heard another beep and looked at the wall, it flashed 3 minutes and was counting backwards! Apparently, it had a warning bell at 5 min and 7 min. I got scared and went back to lay down on the table, then the 10 min alarm sounded off, and I finally got up. I wish someone had informed me about this, but as with the rest of my experience it had been rushed and there was little attention to detail. I left the room and went to check-out, everything had already been paid for, but I wanted to get a copy of all my lab work to show my PCP. I took the copy and went to my car and looked it over quickly. Right on the first page, there it was, “Carrier For Cystic Fibrosis and CFTR-Related Disorders.” I got a sinking feeling in the pit of my stomach. I was in my car, so I called the office right away on my way home. Perhaps I was misreading the results. I was transferred to the nurse, but she didn’t answer and so I left a message at around 10 in the morning. I finally got home and I emailed a few people in the office to see if any of them would respond. Dr. B didn’t call me back until after 1 pm. Over 3 hours of hell. I was a wreck. Why had no one told me about my carrier status, why had my husband not been asked to get tested as well?? Why did I have to find out about this on the DAY OF MY IUI. The risk of both of us being carriers was very very low, but the risk was still there. I felt like it was going to be a failed attempt due to all the stress right away, and it eventually was. All Dr. B could say was she was sorry and that the Genetic Counselor was supposed to call me 3 months ago when they had the results. Apparently, they tried to call “me” 3 times, but that was incorrect. They had my husband’s phone number because he was the first one to have an appointment at the office. My husband did receive a call and he told me about it, but we had an appointment with the doctor in a few days, so I didn’t think much of it. Dr. B would tell me about whatever they were calling about. WRONG. Why did she tell me about my low Vit D and not the carrier status? All I can think of was she didn’t want to spend the time talking about it because it would have been an extensive conversation. She had treated me nicely through the process, but was not thorough, and that’s what you’re getting with this facility. There were several instances where I felt like I was just being pushed through the system. From the gaps of information and lack of attention to detail. My IUI was not successful and as we all know, stress is a huge factor. They CREATED the stress I endured after the procedure. I refused to go back to get my blood test because I got my period. It was a very painful situation to go through, and I truly believe that I’m not the only one that his happens to, I was just unfortunate to find out. I had my first meeting today with my new fertility specialist, and she had informed me that starting the clomiphene on day 6 really didn’t do anything to improve my chances. So, when I asked the MA to inform me about the repercussions, and her stating that ‘it’s fine’ was very misleading. I did ask for my money back because I felt like it was all a waste. Of course, they only gave me back the 160 dollars for the blood test and nothing else. This place would probably be an acceptable place to go if you have experience with infertility or have already been through the process. If you’re new to it though, you will leave with many gaps in knowledge. I would never go back, nor would I recommend this facility to anyone.

She was very short with me and did not give me the full information about procedures. I feel that her attitude and attention to detail is reflected by the standard the Dr. Balthazar sets. She had me starting clomiphene on the wrong day and brushed it off without providing sufficient detail about what the repercussions were. Her only answer to my question was "It's fine."

She failed to inform me of key information through out my experience. She was abrupt and cut me and my husband off multiple times when we were in the process of asking questions or explaining something. She failed to inform me of my carrier status of a genetic disorder and I believe she did no mention it because she didn't want to have an extensive conversation about the results. She never asked to test my husband, she never brought it up once. I discovered the medical error of omission upon receiving a copy of my laboratory results from the staff.

Take your time. Explain everything. Go through all the options for that particular person. It would have been nice if you would have told me what the reasons are for having a low AMH. And you mentioned that my egg reserve, although low, was still 'good' because I am only 34 yo. That is not entirely the truth, is it? Because there are conditions where the egg quality can reflect the egg reserve. This was never explained to me, therefore I had to go and spend more money on someone else who would.

She never mentioned a particular protocol. The treatment she utilized was oral FSH stimulation through the use of Clomiphene, 100mg daily for 5 days, starting on day 5 of the cycle. Her staff did not start me until day 6 of the cycle though. Three ultrasounds, beginning, middle, after IUI. IUI with frozen sperm after Ovidrel injection.

$1200 for the IUI without the cost of medication or frozen sperm.

I have none.

Strengths-friendly organized clean warm inviting. The only thing I can say was in the beginning they did not explain much to us and we would leave wondering what was next. I understand it’s a process but maybe they should somehow explain that everything will be done in steps and explained as we go. Otherwise I love this clinic, staff and drs. I never felt uncomfortable here and I loved the whole experience.

Going to this clinic they always knew our story and were always on top of where we were in the process. They are honest and made us feel like they want the best for us. Always felt comfortable.

One thing I greatly appreciated was response time. They always promptly returned emails or phone calls. They always knew what was next and even helped me obtain medication I was not prepared to pay for. Great staff!

Dr was always very enthusiastic when she spoke to us. She was always positive but never gave us false hope. She always explained every step of the process. She always made me feel like she knew me personally and was hoping for the best for us. Very friendly. Best dr I’ve ever encountered.

Trust in the process and the doctors orders. She will do what’s best and not any less. Asking questions is ok. She will will be honest.

I’m in a same sex relationship. Our choice was for me to carry using my wife’s embryos. We used donor sperm. My wife had a fibroid that had to be removed first in March 2017. The fibroid was blocking one of her ovaries. Once removed the ovary was visible and not so high up. She started estradiol and CoQ10 to help her egg quality since her AMH was low; that was started in June. Dr said the CoQ10 would help with egg quality and the longer she was on it the better. She then started birth control to control her cycle in July. Fertility meds started in August were Lupron, Follistim and Menopur. That was for about 11 days before egg retrieval. We retrieved 3 mature eggs and only one made it to day five for freezing. I started birth control in September and Lupron injections. I started Estrace in October and my baseline showed that my lining was too thick I believe it was at a 18-19. So we canceled the protocol. I restarted birth control in Nov this time without the Lupron. I did start the Estrace again and continued with progesterone injections, Endometrin doxycycline and Medrol. However in the beginning of Nov I went in to have a hysteroscopy with Dr Balthazar since my lining was so thick and I have heavy cycles. She removed polyps that lined my uterus. Having this done my lining looked a lot better. However the day of the transfer it was still very thick at about 17 or around there. Dr Balthazar advised since we’ve done everything we could do we would move forward with the transfer. Transfer day was Dec 4th and I tested negative Dec 14th. We have a follow up next week.

The reciprocal ivf cycle cost was $15,950. Mental health counseling was about $150. Medications costs about $7,000.

If we would have had more than one embryo to transfer we would have chosen two.

In my opinion, RMA at Stone Oak is the best fertility clinic in San Antonio, based on my experience and talking with other women about their experiences. They are very organized, well-educated, and run a successful clinic. They will be able to answer your questions and give you an honest assessment of potential issues and solutions. With that said, I feel like lately they are very focused on increasing their volume of patients. They have started running advertisements on television for their clinic and promoting INVOcell. The positive in this is that INVOcell is less expensive and less invasive than other forms of IVF so if you are a candidate, that is great news. But again, it feels like it's becoming more of a competition for largest volume of patients at the clinic.

Dr. Balthazar is a very warm, friendly and enthusiastic doctor. She will call you and your partner by name - and actually knows it, not just from a chart. She knew our case well, indicated that she thought about our case often, and even walked us through her thought process for each procedure. She has a warm, energetic and upbeat bedside manner and is willing to answer any question you have of her. She is also very good at responding to emails.

I think Erica generally supports Dr. Arredondo, but she continued to support us when we switched to Dr. Balthazar. Erica was a good communicator and answered our questions during our first procedure. Her communication, management and follow through of our case and protocols steadily declined with each procedure. By the end, I felt like I was managing my own case. Guess she assumed we knew what we were doing, which should never be the case. The fact that we were working with Dr. Balthazar may have also been an issue.

We initially worked with Dr. Arredondo at RMA-Stone Oak, but had interactions with Dr. Balthazar during some of our visits. After a few procedures with Dr. Arredondo, I asked to be switched to Dr. Balthazar as our main doctor to interact with because she had a much more friendly and positive bedside manner. All the doctors at the RMA clinic discuss all of their cases, so it was our preference to interact with Dr. Balthazar more than other doctors there. Dr. Balthazar brings a lot of energy to your case. While being realistic with outcomes (she doesn't promise it will work), she is very upbeat and a huge cheerleader for you. She'll let you know if something doesn't look right and explains why she is suggesting a certain protocol. She will know you and your partner by name and does a great job communicating in person and over email.

Some people may find Dr. Balthazar's energy overwhelming. She can be loud. However, she is extremely knowledgeable and friendly and will be a champion for you. I highly recommend her.

We went through three rounds of frozen embryo transfer. I do remember that after our first unsuccessful round, my husband and I saw a news report on ERA testing, which determines an individual's implantation window. We brought it up with Dr. Balthazar at the time and we discussed it. It was a very new test at the time. After discussing it, however, it was determined to not do ERA testing because the protocol recommended was different than the first round. After our failed second frozen embryo transfer, it was decided we should go through the ERA testing. We did the ERA test and it turns out my implantation window was different than when we had been transferring in the past. The third frozen embryo attempt failed as well, so I don't know if the ERA test would have worked in round 2 or not. However, I know that ERA testing is being used quite a bit now at RMA. My understanding is that doctors don't want patients to go through every single test out there because a lot of the tests may not be needed. Doctors seem to have a process in place for most cases: Try protocol 1 and that works on x% of people. If it doesn't work for you, try protocol 2 and that works for another x% of people. If that doesn't work, try the next protocol...and so on. This is just my observation and from talking to other women going through infertility treatments.

I went through a lot of procedures with RMA. With each new procedure there was a "discount" that was applied. Once or twice, when I ran out of medication and needed a very small amount to finish my protocol, they were able to provide me with the medication.

RMA promotes a single birth as the best possible outcome. They will show you statistics of issues with mom and baby for multiple births. However, at the end of the day, they say that they act as a coach and you as the patient have the final say in how many embryos are transferred. But, I think they limit it to 2 embryos transferred at one time.

I think RMA at Stone Oak is the best place to go for treatment in San Antonio. It has it's pros and cons, but overall the staff is very knowledgeable, friendly and doctors know what they are doing there. Staff is willing to work with you on scheduling as appropriate. The facilities are generally nice and clean. The hours of operation are generally about 7 to 4 or 4:30, so if early morning appointments work for you, this clinic is a good fit. They don't work late in the evenings. RMA also has a Facebook page, which is generally helpful in getting information out about the clinic, staff and events.

Dr. Arredondo is very intelligent and runs the RMA clinic. My husband and I saw him for over 2 years, and I don't believe he knows our names. Our faces maybe, but not names. He has a very neutral, removed bedside manner. I always felt like I had to spit out a question, before he high-tailed it out of the room. With that said, the man is smart and knows what he's doing. However, right now I feel like he is more focused on increasing the number of clients vs. quality and successful care of his current clients.

Our nurse was Erica Salgado and overall, she was okay at her job. Erica was great at answering questions in person and demonstrating how to use medications and do injections. She also generally had a good, empathetic nature about her. However, she was not very organized. On numerous occasions, I had to reach out to her to ask questions or move to the next step. She often times didn't respond directly, rather another nurse or doctor would follow-up. I felt like I managed my case and Erica was just a coordinator.

Dr. Arredondo runs the RMA clinic and is very knowledgeable on infertility. However, his bedside manner is often lacking. He is very stoic and somewhat removed from the emotional side of infertility. My husband and I saw Dr. Arredondo off and on for 2 years and I don't think he knew our names. He may have known our faces and case, but not our names. At least he never addressed us by our names. My perception is that Dr. Arredondo is more concerned about obtaining new clients and trying cutting edge technology vs. focusing on quality care of current and recurring clients.

If you want a lot of interaction with your doctor, a positive bedside manner and to make a personal connection with your doctor, I would not recommend Dr. Arredondo. If you want one of the brightest and creative minds in dealing with infertility and don't mind the issues listed above, Dr. Arredondo is a great choice.

I was diagnosed with diminished ovarian reserve. The first round of egg retrieval was very drug heavy with large dosages to see how my body reacted. This resulted in 2 embryos. We did the genetic testing and only one was viable.

Monitoring appointments were pretty quick, easy and painless. They work with you and your schedule to get you in and out as needed.

I went through 4 rounds of IVF at RMA. The first round was the most expensive and likely cost around $25,000 all in. Each procedure after that was significantly discounted.

Dr. Arredondo's vision of success is ONE healthy child at a time. He is not a proponent of multiple embryo transfers and will show clients the health impact on a mother and fetus for twins and triplets. Under certain circumstances, I'm sure he would allow transferring 2 embryos. However, I doubt he would ever allow more than that.

Overall, I am very happy with the clinic. The staff always made me feel like more than just a number. They knew my name and always greeted me with a smile. I did have a few problems with the insurance coordinator. I had 2 insurance plans, one through my employer and one through my husband's employer. I had to fight multiple times with them to ensure that the claims were processed through the correct insurance. I would suggest to any new patient to make sure you are familiar with your insurance plan. Ask questions. Make sure someone explains things to you. Ask more questions. Do not be afraid to be your own advocate.

Dr. Balthazar truly went above and beyond to make me feel like she truly cared about me and wanted my treatment to succeed. She made the effort to get to know me and to make sure that I felt comfortable with every aspect of my treatment.

My nurse was just as amazing as Dr. Balthazar. She got my schedules to me on time, she was always proactive regarding my prescriptions and my insurance. She explained the injections and answered any questions I had. She also made me feel like she truly cared about me.

I liked Dr. Balthazar from the moment I met her. She is smart, caring and truly makes you feel like she cares about you. I had just about given up hope of ever getting pregnant and she gave me that hope back. She was honest and explained all aspects of the treatment protocol, including any changes that were made. If I had any questions, I was able to email her directly. When I had my chemical pregnancy, she was the one who gave me hope and convinced me to keep trying. When I got pregnant during my 3rd FET and my first beta came back at only 18, she was honest about the chances of a successful pregnancy. During those first few scary weeks of not knowing if I would miscarry, she was with me every step of the way. She had the perfect balance of being honest and giving me hope.

Don't be afraid to ask questions. She will take the time to answer them and to explain anything you don't understand.

I was always advised that single embryo transfer was the best option for me.

The clinic was very organized and in the know. When we were expressing concern about our financial situation and initially only being approved for under half the cost of IVF, ($6500) Dr Browne and colleague offered to us an option that would keep $6000 of the cost in house—with no interest and time to pay the clinic in full. By this Time it had been a few more months, I had undergone the hysteroscopy and we applied again for a loan with same company and we were denied completely. My husband also was having a difficult time at work (car sales) and we were having a very difficult time financially. I applied for a credit card to help us with IVF before his troubles started at work, but we had to start using it for groceries and paying bills instead. We seemed to be hitting road block after roadblock.

Dr Browne spoke to us plainly and honestly. She wanted to truly help and have her plan of treatment -which was also IVF. She provided explanation and when we expressed concern about expenses, she provided options. Even that she wanted to start a program that could assist those like us needing it. We were asked if we were interested in speaking to one of the administrators about this option.

We didn’t get too far to really get to know the nurses. However, while at the clinic, I felt they were organized, aware of what was going on and were attentive to our needs

For all reasons stated in previous question. Dr Browne truly cared and wanted to help as much as she could. She listened to our concerns about the financial responsibility and provided options. I was actually referred to Dr Browne by a friend of a friend and was bery happy with the referral

No real advice would need to be given. Dr Browne is a great Dr. Just fill Recommendations would be given

We didn’t get to start a whole lot with Dr Browne. I did go through my second hysteroscopy. Had a $3500 insurance deductible and had 6 months to pay this off with the surgery center. And denied a loan for IVF. Financially, we were unable to move forward.

I do not recall the actual breakdown of costs. We didn’t really get to that point.

No comments

I have nothing but good things to say about RMA. Dr. Brown, the nurses and staff were always friendly, informative, and compassionate. The only reason I switched clinics was to find a clinic that offered ivf at a more affordable price for our budget. Otherwise, I was very impressed with RMA overall.

Dr. Brown took the time to talk with me, explained my options.and realistic results. She took the time to understand my specific situation.

Rma at medical center was very friendly, personable and seemed like they really cared about the patients. They were very organized and informative as well.

I really liked Dr. Brown. She has a great bedside manner, explained my options, and her recommendations. She spent plenty of time explaining what the next steps in my fertility journey we're. She also understood my financial concerns and concerns that my husband had as well.

I really do not have any advice for any new patients, except that the procedures can be kinda pricey, so do your research for financial resources, but Dr. Brown, and the clinic are amazing!

I remember that the clinic does not use injectables. She recommended at least 2 more rounds of IUI with an increased dosage of clomid, from 50mg to 100mg. I only produced 1 follicle, and the IUI was not successful for me, but it was a good try, and much more affordable than going straight to ivf for us.

A cycle of IUI including ultrasounds and labwork was 1300.00, not including meds. Clomid is very inexpensive though. The ivf procedure was I think around 8-10,000, not including meds, which can range from 2,000-4,000.

RMA is so organized, and does a great job at patient care. We were not expecting this because of our sub-par experience with a previous doctor. The team of doctors and nurses are wonderful and brilliant people.

The first conversation I had with Dr.Arredondo was after a year of discouraging failed treatment with a previous doctor. His passion for patient care was evident from the start, and every appointment with him and his staff would confirm that over our course of the treatment. My husband and I felt known, and our journey felt cared for so thoroughly.

I still email her from time to time, and it's been over a year since I "graduated" from RMA. She answered my (many) emails quickly and thoroughly. She was so so so kind, and made my husband and I feel truly cared for and cheered for. We are forever thankful for Erica!

Dr.Arredondo helped us to see our infertility in a broad spectrum and as needing a long term plan. He reviewed our labs with us thoroughly and patiently. My husband and I are both major question-askers, liking to know every detail, so this was very important to us. He was compassionate toward us from the get go, and was able to explain technical medical procedures to us in a way that was very clear. There was never a moment we doubted or distrusted him.

Never leave without being clear and comfortable with everything discussed. He is ready to answer anything you are wondering or confused about.

Freeze all IVF cycle with ICSI. Embryo PGS and FET 3 months later. Menopur, follistim, ganirellix, lupron all used for egg retrieval. Switched to lupron trigger rather than hcg because of OHSS risk. 29 eggs retrieved, which resulted in 11 embryos for PGS. 9 healthy embryos frozen after PGS. We did genetic testing (PGS) but declined to know the embryo genders. Mild OHSS did occur, and was treated with 10 days lupron and lengthier dose of BC after the retrieval. Estrodial and progesterone (oil injection) used for successful FET of 1 embryo. Continued daily progesterone through week 13, but switched from injection to suppository at week 8.

We paid $19,000 through Winn Fertility for our IVF package. This included IVF cycle, genetic testing, my medicine, one FET, embryo freezing fee for a year, and all appointments within the cycle. Other appointments were billed to our insurance.

We chose to do PGS so that eSET had higher chance of success.

They are very friendly and welcoming and warm. The nurses remember you and ask how you are, even if you are like me, not a very outgoing friendly person.

I received the best treatment from Dr. Balthazar out of all the doctors I actually saw and all the others I spoke to on the phone. She was the only woman, I don't know if that had anything to do with it. She was more positive & upbeat than any other doctor, by far!

Amy was pretty good. When she wasn't out of the office, she got back to me right away and answered the majority of my questions.

I can't say enough good things. She was so positive & upbeat. After 2 failed cycles at another clinic in NYC, with no resulting viable eggs and several consultations with other doctors, I had very lottle hope left. Dr. Balthazar believed from the beginning that we could get blasts, even after seeing my previous results. She said there was no reason to believe otherwise & she was right! I got the most eggs I had ever gotten (4- which was great for my diagnosis). She wasn't focused on how few follicles I had, unlike the other doctors. She was focused on the quality of the 4 I had. And we got all 4 & all 4 were mature & all 4 fertilized. Every step of the way was an amazing accomplishment. She was always smiling & saying we were going to succeed. No other doctors that I saw were so positive and nice.

To not waste time with anyone else and go straight to her!

I don't know the name of the protocol, but it is their diminished ovarian reserve protocol. I think I started with estrogen priming, I know I used birth control after that. I then used Menopur, Follistim and Lupron. Growth Hormone was added later. It was a long protocol, and it worked!

It was a little over $13,000 for the entire cycle, including anesthesia, ICSI, retrieval, transfer and a follow up ultrasound or two. Then they started billing insurance for follow ups and I paid my co-pay.

Everyone at RMA is extremely kind and caring. Employers always ensure that you have the absolute best care. The facility is extremely clean and is in the best of condition! RMA has a comfort feel that isn't found elsewhere. RMA sets the bar for excellent fertility care.

My husband & I have been trying to conceive for a total of about 5 years, and the road to starting that family has not been easy. Dr. Balthazar from the start was an extraordinary RE. Our first fresh IVF round took and we were pregnant! Unfortunately at my 8 week sonogram Dr. Balthazar had concerns of our pregnancy being a cornual ectopic. Dr. Balthazar went above and beyond to find the top specialists in San Antonio to give their expertise opinions. When each of them concluded her worst fears, Dr. Balthazar set me up with a world renown surgeon to preform a laparoscopic robotic surgery to remove our pregnancy. Dr. Balthazar was beside me every step of the way. Dr. Balthazar visited me in my room prior to my procedure, explained what was going to happen and why. Dr. Balthazar sat in the surgical room with me, and promised they me they wouldn't take the one thing we had prayed so hard for, without being 100% sure that scans were accurate and termination was in fact the right course of action. After the procedure Dr. Balthazar went with the surgeon to talk to my family and explain how the procedure went. After the procedure she followed up with me extremely closely and showed genuine concern for me as not only as a human being, but as a woman. Upon my first set of testings after the removal of our cornual pregnancy, Dr. Balthazar showed as much as enthusiasm as we had to try to get us that BFP! And after both our FET'S ended in negative betas, & our final embryo was used Dr. Balthazar gave me her sincerest of pep talks. Dr. Balthazar is an extraordinary RE, whom saved my life and has given me a fighting chance at motherhood. There are no words that will ever be able to describe my gratitude for Dr. Balthazar and her staff, I have always felt like my husband and I are their number one priority.

Amy is an amazing nurse & fertility coach. If I ever have any questions or concerns, Amy is more than willing to help in any way that she can. Amy is an excellent nurse with outstanding bedside manner and excellent patient care.

Dr. Balthazar is an amazing RE. She has a wonderful bedside manner, prestigious professional input in all protocols, quick to answer any questions or concerns, open to patients desires, and she always puts you as her number one priority. Dr. Balthazar always makes me feel like I am more to her than a patient. She is always so open to understanding your life outside of reproductive medicine. My husband is a frequent international traveler throughout the year, and she always makes sure to find ways to include him in scans, meetings, or appointments. She is always concerned of how I am handling things without him here, especially after the cornual pregnancy and each of our failed FET'S. Dr. Balthazar has become so much more to me than just my RE, she has grown to hold such a special place in my heart. I trust her and know without a doubt she will help get us to where we need to be to get that BFP!!

The one piece of advice I would give to any future fertility patient (regardless of the doctor) is to go in with questions. Do not rely on Google to answer them.

For my fresh cycle Dr. Balthazar placed me on Lupron, Follistim , Menopur, and PIO (I can't remember if I was on Esterase or not). Baseline scans showed 12 follicles. My IVF cycle resulted in 12 eggs retrieved, 11 mature, 11 fertilized, 9 made it to day 3, and 3 made it to day 5 expanding BB blastocysts. For my FET 1 I was on Lupron, Esterase, Doxycycline, Medrol, and PIO. For FET2 I was on Esterase, Doxycycline, Medrol, and PIO. Due to my husbands international travel we used a frozen sample from him. Throughout it all I have taken 2000IU of Vitamin D3 and a prenatal. Prior to egg retrieval I was placed on CoQ10 600mg.

Roughly $30,000 for everything. Insurance did not cover any testings, cycle or prescriptions.

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The staff are friendly. They dont keep you waiting too long to see the doctors. A weakness is that it is very difficult to get hold of the doctor to speak with her or get a message to her. And to get a response.

I found Dr Brown, down to earth and genuine and the fact that she had had her own experiences with infertility and shared this with me made me feel at ease. I found her examinations of infertility to be very thorough and she discussed the results and explained our options which made me feel less stressed. She answered everything we asked very patiently.

I found some of the nurses in the financial department to be not very clear at communicating clearly about the costs expected from me. I found some nurses not very enthusiastic or clear in communicating certain procedures I was to experience. On the other hand I found the lead nurses to be very effiecient and aware of where I was in the phases of my treatment and they kept in contact with me.

She had her own story. (with infertility). She shows compassion and empathy.She took the time to explain the results from the testing and she explained what the next steps would be. I felt positive after my experience with her. She was helpful and provided referrals for my husband and his issue.

A lot of your questions will be answered and you will feel less stressed.

She explained that I would receive a complete blood history diagnosis for my egg reserves and hormone levels and any other health issues that I may not know of. She said this is a standard protocol. The next strategy was a call from the clinic to come in for an examination procedure and to get my tubes checked to see if their was a blockage. The next strategy is, I was called in to for a procedure to get my uterus checked. (This was administered by Dr Arrendando in the same clinic.) The results were positive.

Extemely high.

Ihave no comments on this as I have not experienced this.

My recommendation is for there to be a paitient portal to view cycle plans, ask questions, see lab results or communicate with anyone on the staff

They knew my name, held my hand, made it personal at every interaction. From the nurses and doctors to all the office staff, I was more than just another case.

Beyond compare!!!The epitome of exceptional care and dedication. They were thorough, empathetic and informative every step of the way

Clear communicator, intelligent, empathetic, knowledgeable and genuine. He was a man first, and wanted to know about every aspect of my worklife, social life and health. I knew that I could reach out to him if I needed anything or felt I had substandard care. Luckily, that never happened. He spoke to my husband and I in a very direct and professional manner, addressing concerns about our infertility. Hemade a plan, stuck to it and the result was pregnancy.

Trust the process!!!! It may be long, but if you trust in it, the results speak for themselves.

Stimulation was lupron, menopur ganirelix and lupron trigger. 30 eggs retrieved, 20 fertilized, 6 made it to day 5 for biopsy. Fet was long lupron cycle, estrace and endometrin. Transferred 1 and positive bloodtest 2 weeks later

Convenient and very organized. Always have time slots available for me to fit into my morning

I have had a rocky road with the billing and insurance process, not at the fault of the clinic, but with the insurance paying claims timely. Up front costs were reasonable and paid automatically from my hsa. Claims had to be reevaluated with the insurance to hit the correct fertility coverage, and the clinic constantly worked with me.

We switched because they only do FET. We wanted to try fresh. It made us nervous because sometimes you may not have any to freeze but you could have transferred a day 3...while at RMA you couldn’t. Knowing nothing about how I would atom or my egg quality etc, we wanted to at least have the option of a fresh cycle. In retrospect, the only cycles that ever got positive pregnancy tests were FET. So maybe they’re on to something.

She was very caring and patient and as this was our first real experience in seeking fertility treatment, she explained everything very clearly on a medical level and a layman level. My husband and I both appreciated that. She wanted to reallly get to the root of the problem and she was encouraging and positive.

They were organized and compassionate. They were working hard but kind and had time to answer any questions or track down the doctor or paperwork needed. They all work well as a team and it seemed a good work environment for them too.

Aimee Brown is patient and understanding. She is knowledgeable and professional. I have a uterine anomaly and she was professional in discovering this while also being realistic about how that has been affecting our chances. She had a clear plan moving forward.

Be patient with the process. She is worth the time.

She was considering doing surgery to fix my uterus shape but my particular shape cannot be fixed with surgery. We did our entire work up with her and because we felt restricted (by insurance ) on time, we transferred to a different clinic that would do fresh transfers; RMA only does frozen.

I don’t remember. I’m sorry.

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The clinic is small and cozy. It is well decorated and relaxing and there was never more than one other person in the waiting room in all my visits. Also I never waited more than 5 minutes for an appointment and the doctor was never double-booked for an appointment time (unlike other clinics in town we tried). The clinic staff is also well organized and easy to deal with in case of insurance issues or other admin questions.

I always felt like a human, the practice seemed relatively small, never a long wait or crowded waiting room, and the doctors, nurses, and staff were always warm and friendly and answered any questions I had quickly and thoroughly.

I had one primary nurse who took care of my case and scheduling, she was very organized and good at explaining all the steps. She was also very thorough at our IVF class where we discussed my calendar and medications. Also, the rest of the staff including the other nurses and those who took blood and helped out with my retrieval and transfer were great. They make you feel welcome and I remember during my transfer having nearly all the nurses who worked with me while I was being treated in the room keeping my company and wishing me well.

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.

The clinic is clean, modern, and a one stop shop. You can get everything you need taken care of in one place. I didn't have to leave to go anywhere else for bloodwork, the Hysterosalpingogram, or anything else. Everyone you encounter is friendly and there to help you, even if you are not under their care specifically. The wall of baby footprints from successful fertility treatments at RMA sent a wave of hope over my husband and I. The chalkboard wall where you can write why you are there is wonderfully inspirational to people who are struggling for something as "simple" as having a baby.

Dr. Balthazar understood that our desire was to start a family. She made us feel like our case was a priority to her. At our initial appointment, we got answers and the prescriptions we needed. There wasn't any hassle to it, and she didn't seem the least bit inconvenienced. She took her time explaining everything to us and never made us feel like anything was wrong with us because we couldn't get pregnant on our own.

Every single nurse is quite possibly the friendliest person you've ever met. They all have impeccable bedside manner. They are kind and compassionate and not the slightest bit judgmental as you proceed through what can be a very embarassing and personal time in your life.

Dr. Balthazar explains everything in a way that people who aren't physicians can understand. She helps to create a plan with you and your spouse that suits your needs, your desired outcomes, and what you are comfortable with in terms of invasive fertility treatments. She also will express her concerns openly, but in a gentle and caring manner. For us, her concern was the possibility of having multiples. She did everything in her power to make sure we were able to get pregnant with the singleton that we so wanted.

If you are searching for a doctor who is compassionate and who is going to guide you through this tough patch with grace and humor, Dr. Balthazar is the fertility doctor for you.

Since I have PCOS, Dr. Balthazar had to find a way to make me ovulate. She took a look at my ovaries via an internal sonogram and showed my husband and I my "classic" case of PCOS. Since I am still young, she didn't feel like Clomid would be effective. The side effects can be harsch and she didn't think it would be worth it. After having my Hysterosalpingogram to see that my fallopian tubes were open and functioning (as well as my husband having his sperm checked to ensure that he was not part of the issue) and a variety of blood tests, she prescribed a 5 day long dose of Letrozole. She explained possible side effects but I chose to take the drug at night, before I went to sleep, to avoid any nausea. I had absolutely no side effects from taking the drug. I went back to the clinic about 10 days later for my second internal sonogram and the drug had worked. I had 4 potential eggs that could "win out" and be ovulated that month. This was good news and bad news for Dr. Balthazar. She brought me back in about 4 days later to check via internal sonogram to make sure it would be safe to try to conceive. Fortunately, only 2 follicles had finished maturing and would be ovulated. She had me use an at home ovulation kit to determine the exact day that my husband and I would need. This was also a money saving factor- my insurance did not cover any treatments. About 2 weeks later, an at home pregnancy test (also to save money) revealed that I was pregnant after only one round of Letrozole. Again, since I am only in my 20's and to save money, Dr. Balthazar had me follow up with my own OB-GYN since those visits would be covered by insurance. I was sad to no longer be working with her, but my husband I look forward to seeing her again when we want to have a second child.

We spent $700 total for the Hysterosalpingogram, blood work, sperm analysis, 3 internal sonograms, and 3 separate appointments where we were seen by Dr. Balthazar each time.