Rosalind Franklin Univ

I believe this clinic has done a great job of diagnosing some underlying issues. The biggest downfall is that it uses IVIG as it’s go-to treatment when immune and NK numbers are high. This puts you in a predicament of feeling like you have to spend four grand every few weeks if your not covered by insurance to keep the pregnancy viable.

I met with Dr. Kwak-Kim only two times and she was very straightforward and compassionate with my results. I have not, however, worked with her further than that but more exclusively with the nurse practitioner at the clinic.

Heather is very nice and you can tell she works hard, However at times meaningful interpretation of my test results is lacking. Also I feel that IVIG is strongly suggested frequently. (This could be due to my results as well).

Dr. Kwak-Kim provided quite in-depth testing and identified some genetic blood clotting factors that other testing did not catch. Her plan is very thorough and addresses each medical issue that I present with. I wish that I had more time to consult or hear from the doctor and not just exclusively work with the nurse practitioner.

Be prepared to have IVIG recommended as a main main part of your treatment plan. IVIG is expensive out-of-pocket if insurance doesn’t cover it which it most often does not. This has cost us a lot of stress financially feeling that we have to pay out of pocket in order to keep the pregnancy healthy. ( this is obviously based on my results ).

I am currently on Metformin Lovenox Progesterone Estrodial Levothyroxine Plaquinel Prednisone IVIG I have driven down 5 times to assess blood flow by ultrasound as well.

My insurance is covering a large portion of my visits and testing however I do have a $20 co-pay for each office visit and I am just now receiving lab bills that I have approximately add it up to around $300. Every week to every two weeks I have had to send my blood by FedEx overnight to the clinic to run my NK Assay. The shipping cost around $70 overnight. The largest cruel of cost has been with that IVIG, I had one infusion at the clinic which ran around $3500 and one infusion at home which ran approximately $4000. We are early on in our pregnancy and the cost was over one month.

The clinic is one of very few in this field. They take ins, unlike several of the others. They aren't cheap, but not outrageously priced either. They have their own lab, used by some other RIs too, that Dr. KK oversees. The staff is incredible, except for billing dept, which is meh. The u/s techs are generally foreign drs who aren't yet licensed in the US (downside is the turnaround when are licensed). The downside is given their success, they've become very busy and especially when one of the primary nurses/drs are on vacation, can be slow to respond to portal messages.

Her nurses, medical assistants, and even the receptionist knew me by first name. My protocol was tailored to my history and my labs. I regularly communicated with the nurse in charge of my case and got personal responses.

Margaret is a godsend. She knows my chart in & out. She gives me my testing schedule, checks my meds on a regular basis, analyzes my labs (with Dr. KK's input as necessary). She is incredibly caring, patient focused and supportive. She has been working for Dr. KK for many years now and knows the protocols in & out as well as Dr. KK's preferences. However, she also works closely with Dr. KK and makes sure to get her input on less routine issues.

Dr. KK is a fantastic researcher and very knowledgeable in her field. She studied under the pioneer, Dr. Alan Beer, and even worked under him in the earlier days. She is cautious (good & bad), but mostly for the purpose of preserving your overall health, not just do anything to get you a baby at the expense of your health. She doesn't do the "kitchen sink" approach, rather gives you safe & effective options, though maybe not always the most aggressive. This is enough for most, though maybe not all. She's pretty straightforward about her thoughts, she definitely doesn't sugar coat, but she won't lead you on with false promises either. She deeply cares about her patients, but not the touchy feeling type at all. She is very busy though between running the clinic, overseeing the lab, presenting research at conferences, etc. so don't expect to be getting a lot of direct attention from her, but you can definitely get her time by making an appointment with her.

She's not the dr you want if you're looking for a kitchen sink approach, but perfect if you're looking for someone who is incredibly knowledgeable, thorough, and balances your long-term health with helping you have a baby.

She doesn't do IVF or IUI, only immune protocol. She will make recommendations on your IUI/IVF cycle if you and/or your RE want her to, but otherwise she primarily starts once you are pregnant and mostly only does some bloodflow and immune checks prior to transfer. She uses a lot of prednisone, IVIG, lovenox, BA, supplements, heparin, planquil, metformin and will sometimes also use Enbrel, Humira, and a few other drugs. Doesn't use intralipids (doesn't believe in its effectiveness) or Neupogen (believes it's too risky)

The initial work-up is expensive, up to 5K if ins doesn't cover anything including labs. After that, you pay for what services you use. There's a 1 follow-up requirement per trimester. If you use portal to replace in-person/telephone follow-ups, there's a periodic charge.

Strengths - the clinic feels small and personal to me. They were always able to work with my schedule, since I was driving 4.5 hours each way to my appointments. Michelle and the staff were quick to respond to my questions via the online portal. The staff were great about sending lab orders to me via email so I could have the blood drawn locally at a lab. Weaknesses - it was sometimes difficult to talk to someone on the phone. I found that they were more responsive via the online portal than if I left a voicemail.

Dr. Kwak-Kim's office took a very personalized approach to my situation. I feel like they left no stone unturned. I feel like the staff and nurses there really get to know their patients. The front desk staff knew my name when I arrived to check in, the nurses remembered the name of my older child who would accompany me to appointments, and I feel like the NP assigned to me was very familiar with my medical history.

Michelle was the NP who followed my case. She was very thorough and did an excellent job of explaining why my medications were being adjusted. I feel like Michelle took a proactive approach to my treatment cycles and pregnancy and didn't wait until something was a problem before thinking about how to address it. She carefully considered my history and test results in making a treatment plan with Dr. Kwak-Kim. Even though I saw Michelle at every one of my appointments, I knew that Dr. Kwak-Kim was still involved in my treatment plan. The nurses who did the IVIG infusions were excellent. They were so personable, friendly, and did a great job at placing my IV lines each week. I really cannot say enough good things about Dr. Kwak-Kim, her staff and her clinic. They are miracle workers in my mind and helped us get our dream baby after 4 miscarriages and 1 chemical pregnancy in a row.

Dr. Kwak-Kim meets with patients on their first visit. The NP typically handles subsequent patient visits but keeps Dr. Kwak-Kim apprised of the situation. One example of the excellent care and responsiveness from Dr. Kwak-Kim is as follows: I was taking Lovenox injections twice daily and one of my injection sites didn't clot. After 15 hours of bleeding, I called the after-hours number on a Saturday night and spoke to an answering service person. Dr. Kwak-Kim returned the call to me herself in less than 30 minutes. She was familiar with my protocol, knew what meds I was taking, and told me how to handle the situation. She also called in blood tests that I needed to have drawn the next day. I was so impressed with her attention to detail and the personal way she handled the situation. I was worried about bothering her or her staff on a Saturday night but she assured me that I did the right thing by calling in about the injection site not clotting.

Dr. Kwak-Kim can be difficult to understand due to her accent, so be prepared to ask follow up questions and request a summary in writing.

I was on low dose aspirin, claritin, metformin, and a variety of supplements for the duration of my treatment cycles and pregnancy. During the treatment cycles, I was on Letrozole, Follistim, Ovidrel for the trigger, IVIg, prednisone, Prometrium after ovulation, and Lovenox once daily. After pregnancy was achieved, I was on progesterone support (Progesterone in oil shots and prometrium), estrogen support (estradiol tablets and patches), prednisone, IVIg infusions, and continued the low dose aspirin, claritin, metformin, and supplements. I had issues with high NK cells and inflammation levels. My blood clotting factor was also higher than normal, which had been undiagnosed by previous fertility doctors. Dr. Kwak-Kim also diagnosed with Hashimotos, which was missed by pervious doctors, as well. I feel like her tests are so thorough and her approach to treatment covers all of the bases. I felt like it was a lot of medication but each drug had a specific purpose for my particular situation. Dr. Kwak-Kim made sure that I was monitored closely, with blood work at least weekly to check thyroid and hormone levels. Adjustments were made to my medication doses every week based on the blood draw results. After a complicated pregnancy, we ended up with a perfectly healthy daughter born at 38 weeks.

The billing staff were great at billing my insurance and coding the procedures as medical rather than infertility. Many of the appointments (except for the phone appointments) were covered, the ultrasounds were covered, the administration of the IVIG infusions were covered. We did the blood work remotely so it was covered by my insurance. I had to send vials of blood via overnight mail to RFU labs for specific tests twice a month. None of that was covered by my insurance, so it ended up being around $250 twice a month for those tests. Additionally, we ran into some issues with my insurance not wanting to cover the IVIG medication. At $3000 for 30 grams, that added up quickly. Laurie was great at helping me with appeals and we were successful at getting some it covered.

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