Shady Grove Fertility

Dr. Amrane did a pretty good job of explaining my specific situation and laying out possible treatments, etc. I only saw her in a couple of virtual visits (and in person once during the initial consultation, which was for egg freezing). She answered my questions and was understanding about what I was trying to accomplish. She wished me luck during the IUIs and was sympathetic when I didn't get pregnant. On the down side, she focused a lot on "what can go wrong" and it definitely gave me more stress instead of being reassured. I think she doesn't have enough experience in dealing with anxious patients.

Don't look for a super-warm bedside manner. Ask specific questions to get specific information.

I did four IUIs; the first was a natural cycle, because I was hoping to avoid chemicals, etc. She was very willing to try different things (i.e., a natural cycle) and said it's worth a shot. When the first 2 IUIs were unsuccessful, she said I should consider moving on to IVF. She did note my lower ovarian reserve, and I think that was a big reason for her suggestion. I used clomid for one cycle (which didn't end up going all the way to an IUI, because I got sick), and letrozole for another cycle. I was switched to letrozole because I may have had visual side effects from clomid, so they wanted to be on the safe side. For the IVF, I had menopur and gonal-f, and ultimately cetrotide; also, Dr. Amrane had me do a final boost of those meds before the trigger shot. I wasn't told the rationale for that... but currently I'm waiting to see how many of my fertilized eggs turn to blastocysts. I had 3 eggs fertilize.

I think IUI was approximately $1,500 a cycle. (I paid out of pocket at the time.) Ovidrel was $68. My IVF charges are still being processed, but... I was so far billed about $6,500 by Shady Grove (which includes about $3,600 for PGT testing). This does NOT include an embryo transfer - but allegedly does include the cost covered by insurance. I have also been charged, at this point, roughly $6,000 just for medications. But everything is still going through insurance, so I'm not sure how this will all shake out.

Haven't gotten that far

The doctor is genuine and listens to our concerns. He also is ready with a next plan for us so we can move forward when we are ready. He has tailored my medication each time to get better results and has been supportive when we went through a chemical pregnancy. He is good at communicating when questions arise and is very helpful at explaining terminology and gray areas of fertility. He also did our first retrieval and was very encouraging afterwards.

Be sure to ask all the questions you have as you will feel more comfortable and learn more if you approach the doctor with your concerns.

Short protocol with microdose Lupron, better outcome (9 eggs retrieved second time vs 3 first time) with adjusted dose of Lupron

Our insurance coverage was good, so we paid for PGT testing ($4500) and $20 co-pays for appointments

Dr Doyle was warm, compassionate, and nonjudgmental. He was a good listener and never made me feel rushed or pressured to make a decision. He followed up with me on a concern I expressed after hours one time too. He clearly relies heavily on his nurses and NPs to do the majority of the actual direct procedures, and he just handled consultations and approving the course of treatment. So over-all high quality provider with low quantity of actual interactions. I definitely appreciate working with him though and would recommend him to others, especially if they are going to be seen at Shady Grove Fertility.

Ask questions- he’s great at explaining things and giving answers, but he doesn’t necessarily talk a lot about things unless you ask for specifics. The nurse gives more of the details.

Ovidrel + IUI + monitoring of bloodwork & ultrasound x1 cycle resulted in 1 mature follicle, no pregnancy 5 pills of 2.5 letrozole, ovidrel + monitoring of bloodwork and IUI with donor sperm x1 cycle for PCOS - 2 mature follicles, no pregnancy 5 pills of 5 letrozole, ovidrel + monitoring of bloodwork & IUI with donor sperm x2 cycles for PCOS- resulted in 2 mature follicles and one mature follicle before IUI was scheduled Told me that with our next cycle we can do 5 pills of 7 mg letrozole for PCOS -

My insurance covered the consult with just a copay, but IUI out of pocket was ~$1600

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I wanted to see a different provider in Shady Grove Fertility, but it would have added two more months of waiting for my initial consult so I agreed to proceed with Dr. Reh. During 6 months of treatment, I saw her only three times (initial consult, one monitoring ultrasound, and follow-up consult). The rest of the communication with Dr. was done through the nurse. I did not feel I got sufficient explanations of why specific treatment was chosen based on my situation (e.g. natural vs. medicated IUI, choice of specific protocol). I felt part of the problem was that she did not review my records before the appointment, so she did to have any specific suggestions on my treatment during our conversations. I was receiving written recommendations on my treatment only after my appointment with Dr. Reh which made it more difficult to ask questions. She also did not seem caring.

Try to do your own research on possible treatments and make a list of questions that you may have about it before the appointments.

I did two IUIs using clomid, ovidrel and progesteron. I did not receive any rationale for why these medications were chosen for my cycle. I tolerated them well, and my response was also good, but both cycles failed.

Costs through our insurance: Initial consult $200 First IUI cycle $1200 Second IUI cycle $800 (had fewer monitoring appointments), plus meds.

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I would recommend Dr Nair to any close friends or relatives. She is an expert, but she is also very compassionate. She cares about her patients like her own family, not some cold numbers on the balance sheet. We had one failed transfer, but she encouraged me, adjusted the whole protocol, and was on top of each procedure. I respect her opinion and trust her judgement and professionalism. I finally got pregnant under her care after almost four years of trying. My husband and I thank her with our whole heart.

If you are looking for a down to the earth, no fluffy and compassionate doctor with great expertise, she is your doctor to go.

I was put on antibiotics to repress my immunity before transfer. She also used Lovenox to help with implantation. I think these two things finally helped me conceive.

The monitoring appointments are generally easy to schedule and on time. Occasionally it runs late.

My insurance covered main costs, but I still paid about $12,000 including treatment and medication.

I was advised to do eSET because I had a high-risk pregnancy before.

Weaknesses -- hard to get a hold of. Could be better at explaining the why of what we were doing. Strengths -- seemed very knowledgable and very experienced. I trust him because he's been doing this for 30 years and started the clinic so there's probably not a lot he hasn't seen

Don't expect to have your hand held through this process. Advocate for yourself and speak up. Ask questions (what about trying this?). He's compassionate but can be candid and blunt when appropriate.

Estrogen priming protocol with 600 IU of gonatropins. Microdose lupron 2nd cycle slightly lower doses. Microdose lupron with longer time between trigger and retrieval (37 hours vice 36) for third cycle. Lowered does of meds on third cycle to prevent OHSS. Have not gotten results on third cycle yet, but best egg yield by a factor of 3. Protocols chosen because diminished ovarian reserve. Did not respond much on EPP. Responded well on microdose lupron the first time. Second time responded very well (and possibly too well). Changed retrieval interval to improve egg maturity.

Could go in when convenient but sometimes they got backed up 30-45 minutes.

Did multi-cycle discount (2 for the price of about 1.5 cycles). Paid for it and meds out of pocket

eSET chosen because I am very skinny and have had a high risk pregnancy in the past. Also only got one PGS normal anyway from first two cycles

I liked that he took the time to explain the results fully to me during the testing. My husband also felt comfortable with him. He was positive and easy to understand and trust. I had read reviews about the clinic that you don't ever see your doctor or talk to the doctor but that is not my experience.

The testing will take awhile to time everything correctly.

The pre-screening tests were covered by my insurance (I did have to pay a few rather large co-pays). All other costs are out of pocket.

I can't answer this in full yet because I'm still undergoing treatment. She is extremely intelligent and cares for her patients, I have no doubt she's a leader in the field, but I do have some outstanding questions on how involved she was every step of the way.

Be educated and ask questions up front. Ask questions and get specific answers and talk statistics.

I don't remember the specifics.

it went through insurance, so i'm not sure of the negotiated rates.

Dr. Devine recommends SET, as does Shady Grove and we followed that guidance.

We felt well guided under our care of Dr. Moon. She is frank, to the point and is usually quite clear in her prognosis and decision-making, though we had a bit of an oddball case (says everyone dealing with infertility). I would've liked to have Dr. Moon at our retrieval and transfers but frankly, that's not how Shady Grove works and we understood that clearly before we began. I would like to see more clarity on communication with regard to the pandemic, the clinic, not necessarily Dr. Moon herself, waited a long time, gave unclear directives and made the experience much more unclear; we understand no one plans for this, but the clinic gave very little clarity on action plans for us when it all happened mid-transfer. It was really hard to deal with that uncertainty and I hope communication for Dr. Moon and others improves to reassure patients within each person's portfolio.

No direct advice; continue to give each person time on the feedback calls; we really loved after our retrieval that we didn't receive the numbers we assumed would happen and Dr. Moon took a Sunday call with us to sort through it and give us feedback on how we would approach it moving forward!

Antagonist protocol - Lupron not HCG to lessen risk of OHSS; stimmed for 11 days with Gonal-F, Menopur, and then Ganirelix/Cetrotide. 29 eggs collected, 17 mature, 7 fertilized, 4 made it to blastocyst (1AB, 3AA). Transferred 4AB embryo, pregnant but likely will be ending in a miscarriage (hcg not rising appropriately on second blood draw).

Yes, total cluster 45 min wait times for some days. Not the best way to start and there is then no point to providing monitoring appointments if it's first-come first serve open-ended whenever you want to show up!

Covered by insurance

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Dr. Moon is well educated and seems to be a numbers person. During our consult for our second IVF cycle with her for a second biological child, she ran our data from our cycle 2 years prior through a spreadsheet they had to predict likelihood for success with unexplained infertility and our age and the numbers were so-so. I pushed and asked why we only ended up with (1) blastocyst when I had 21 retrieved and 17 mature/fertilized. She responded that to her that points to male factor infertility bc the cells live off the maternal protein the initial 3 days and then once getting past 4-cells they live off the male DNA. Since we still had 10+ embryos after our Day-2 update and then only 1 come day 5/6/7, she deducts there are some MFI issues and referred us to the urologist in her practice if we wanted more information. If we had decided not to go, then we never would have learned about the Sperm DNA Fragmentation test that is available. I don't know why this test wasn't recommended after our initial 2-failed IUIs or when his semen analysis in initial work up was so-so. The results came back that 36% of his sperm had DNA fragmentation and success for frag over 30% isn't good. For our IVF cycle in 2019 to attempt for our second baby, the urologist recommended he perform a TESE procedure on my husband to get to the source of the sperm before they get fragmented in ejaculation. Again, we had 21 retrieved and 17 mature/fertilize but only 2 make it to blastocysts (day 5 & 6). They were tested and both came back abnormal. At that point, Dr. Moon and the board reviewed our case and decided we could not continue in the Shared Risk program, unless we used 50% donor sperm and 50% of my husband's. While I get they want to protect their data and pregnancy rates, this felt like a blow that they didn't have faith in our future outcomes. We want a full biological family and we know it is possible since we have our son; we'd think they would come up with ways to help overcome this DNA fragmentation. They moved our deposit for Shared Risk over to a Multi-Cycle program (2 tries) and then I don't know what we'll do if those two don't work..... After that failed cycle, I read up on whatever studies I could find and put my husband on supplements for 3-months and he was trying to work on getting his BMI down since the clinic didn't have any recommendations on what we could do to make a difference. Sadly our March 2020 IVF cycle had about 20 retrieved; 18 mature and fertilized and only 2 made it to blast again and both came back abnormal again. We have a teleconference with Dr. Moon this afternoon to talk about next steps, I guess. Curious to see what she'll say....

Don't be afraid to do your own research and schedule calls with her to get questions answered.

I don't recall the treatment protocols for my (2) IUIs, but for my (3) IVF cycles she had me on an antagonist protocol with 225 Gonal-F and (3) vials of Menopur. I am slower to respond, esp. my right side, so my 3rd cycle I was started on these higher doses and stayed pretty steady throughout cycle. Only (1) IVF cycle in 2017 was successful with producing (1) blastocyst (our son). Have a tele-consult with our Dr. this afternoon and am curious if there is another protocol we can try for our final cycle.

Shared Risk for my age was $22,500.00 Multi-Cycle (2 cycles) was $18,500.00 PGT-A Testing - $5,000.00 TESE - $5,000.00 Sperm Analysis - $50.00 Sperm DNA Fragmentation Test - $250.00

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I believe that all the doctors at SGF are required to follow strict guidelines so there is not a lot of experimentation that I've seen so far but I have a fairly straightforward case. Dr. Osborn has always been friendly, considerate and willing to answer any questions that I've had. She has been the one to share good and bad news with me and will always contact me if I've requested to hear from her. She is realistic and clear with what she expects from treatment.

She is much more willing to share and elaborate if you ask questions. She doesn't talk just to talk so be prepared with what you want to know.

Antagonist protocol for retrieval which resulted in less embryos than I expected but exactly what SGF predicted for me.

I had insurance coverage so I do not know the total amount of each procedure.

eSET is recommended.

Dr. Devine was very warm, but also straightforward. She actually listened to how my past experiences had shaped my anxiety about treatment and made adjustments to accommodate me. To the extent that was possible, she had her staff schedule my appointments for when she was on the monitoring floor and she came to my monitoring ultrasound appointments. She was warm and reassuring and made me feel confident in her decisions as a provider.

Be very honest about any of your treatment concerns with her.

My diagnosis was an anovulation due to PCOS. Dr. Device prescribed 7.5 mg letrozole taken on days 3-7 with follicle monitoring starting on day 11. When the follicle was mature, she had me do an Ovidrel trigger shot followed by timed intercourse, and then progesterone suppositories for the remainder of the cycle. She was able to successfully induce ovulation three times and I got pregnant on the third month.

My insurance covered only 50%, so every single monitoring appointment was approximately $115 out of pocket, and there are a lot of monitoring appointments.

N/A - I did not do IVF

I have not had a chance to do the prescribed treatments with Dr. Doyle yet, but it seemed clear we will not have a lot of opportunities for further interaction unless somethingdoes not go right. He is young, smart and friendly. I definitely got the feeling that he knows his stuff. He diagnosed an issue for me that others didn't. On the other hand, he was obviously touchy when pressed for additional details and further information about why a certain treatment was indicated or not. He joked about it but clearly did not like it. So if you like what he proposed, and trust him - go with it. If you have a lot of questions or disagree, he's not going to adjust to you.

Advocste for yourself with SGF and your nurses.

Did not start treatment yet. Will begin with IUIs before progressing to IVF.

Consultations were covered by insurance as was most testing (some semen analyses were out of pocket to the tube of $150 per). IUI will be abour $450 out of pocket after insurance, and simplest medications about $150 per cycle.

Clearly concerned about multiples.

She is personable. I would have liked more suggestions to increase his count. I feel like she communicates well but doesn’t give you many options for treatment. I would have liked to wait until I moved to ivf but she seems to push you in that direction

Make sure you are your own advocate. Research the different treatment options available and come to her with questions

I was on clomid 25mg. I ovulated on my own so the treatment was just a boost. It did not help because my issue is mfi

My cost was more than I expected

I would prefer multiple because we can’t afford multiple rounds. We are older and this will be our last child.

He is open, honest and willing to answer all questions. He explained the preferred course of action and what the results would be. Given our ages, he thought that we should see the varicocele surgery through the 9 month wait period to look for improvements. We chose to move forward with IVF but in the hopes that we could conceive naturally down the line.

Ask all of your questions up front about the chances of success with your treatment.

Varicocelectomy surgery to treat a varicocele causing low sperm count, motility, morphology, etc.

I thought Dr Reh was helpful when we spoke to her and answered our questions. She listened to our concerns and didn’t push us into things we weren’t ready for. She was realistic with us and told us what to expect. I would see her again but hopefully I won’t need to.

To go see her and listen to her advice.

It was never really clear. I felt like I’d check out and be told we owed. Since I paid then they never sent bills.

He is communicative, would call me personally to check in. Dr.Doyle was open to feedback and was very kind and supportive. I enjoy working with him and his team, they work well together and make sure that I have everything that I need.

If you're not sure, ask questions, he will answer them. Advocate for yourself and do your own research.

Copays and out of pocket for egg freezing.

The fact that she would leave me a voicemail with devastating news about the status of our embryos tested with PGT with no way to get in touch to learn more about why or details was HORRIBLE. She showed little compassion or care to leave news like that without talking to a patient directly. My sister's doctor (also at Shady Grove) called her day of her retrival to see how she was feeling but I got no such call from Dr. Garde.

Be prepared to have your expectation set and wait to see her. Also check and see if your insurance is covering what costs are for out of pocket meds and then filing a claim later. Insurance rates for medication were not "discounted" and my $15,000 lifetime benefit didnt cover all drugs for the first round, which was subsequently cancelled.

. We started with a protocol that included 450 iUs of GonalF daily, 150 IUs of Menopur, and then Cetrotide. That cycle resulted in a cancelled retrieval due to development of a dominant follicle. The 2nd cycle started with 10 days of birth control followed by 2 days of Lupron Injections (2x daily), 450 IUs daily of Gonal F and 150 IUs daily of Menopur. This resulted in 3 follicles with 2 eggs retrieved, 2 healthy high quality embryos, but one had genetic condition and other chromosomal issue.

eSET is doctor and insurance preference

I have 2 cancelled IVF cycles. I feel like she is not trying to figure out “why” the cycles were cancelled. She suggest the same cycles or to move along with transferring my one and only embryo. At this point, I feel like she and nurse are giving up on me.

Don’t expect to see her much in person. Most correspondence will be through her nurse. She is thorough over the phone only if you ask her tons of questions.

80% covered through insurance so not too bad

Dr O’Brien is very knowledgeable about current research and practices, sharing academic articles. She is also personally involved in her patients often making phone calls to explain results herself instead of the nurse or in addition to her.

Ask any questions you have and do not hesitate

We went right to IVF

She encouraged eSET

Dr. Reh was the best part of our experience with Shady Grove. Friendly, professional, and extremely well-informed, she consistently took time to thoroughly answer our questions about what to expect throughout the process and encouraged us through some disappointing steps. Fortunately, we are now pregnant with two babies. Navigating all the steps can be challenging, but absolutely worth it.

Ask lots of questions and take notes that you can refer to when following up with other doctors and staff to ensure nothing gets lost in translation.

She had us take all the relevant tests, starting with the female, then the male. Once she determined that we had unexplained infertility, she proceeded with genetic testing. We planned for 3 IUI attempts over 3 months, each with increasing levels of medication if they didn't work, before we would move to IVF. The first IUI was unsuccessful. Prior to the second attempt, I was prescribed Letrozole. Following the second attempt, I become pregnant with fraternal twins.

Insurance covered most of the steps until IUI, which was $1800 per round, which we paid out of pocket. We also had to pay for a genetic testing out of pocket that wasn't covered by my husband's insurance, which was $350 (I believe through a discount program)

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He gave us a realistic expectation, that it would take a few transfers to get a sticky embryo. We've had two transfers and still lost them both. One thing I struggle with is getting a thick lining and he changed up my medicine protocol unlike my previous doctor who just kept doing the same drugs and said I had a naturally thin lining. Dr. Mottla was able to get my lining at a 9. We've really enjoyed working with him.

Shady grove is a huge practice and the doctors are spread thin; however, when you are with your Doctor they give you 100 percent attention. I recommend CCing him on every email back and forth with nurses.

Efficient well oiled machine. We live in Raleigh so I would fly in and out same day and they always accommodated me. I was also able to do some monitoring at my GYNO locally and my doctors worked very nicely with them.

We paid 30,000 for a package that includes 2 retrievals, as many transfers as we want and covers some PGS testing. Some tests are partially covered by insurance or we had to pay our deductible. Our medicines are very expensive and not covered through insurance and one thing that does frustrate me is that they over prescribe.

I haven't found a doctor that is pro multiple embryo transfer. Everyone has said its too dangerous.

Overall, I like him. If someone were to go to Shady Grove, I'd recommend him. My problems are more with how the clinic is run as a whole (which as a founding doctor of the clinic, I guess means that I disagree with Dr. Sagoskin's approach in that regard.)

Write down all your questions beforehand. Do not leave until you've had them all answered. He is willing to answer, but you have to ask.

Egg retrieval treatment protocol included birth control for almost three weeks. Then we did 900 IU Gonal-F plus 150 ml of Menopur everyday for 12 days as I have a slightly higher FSH and a middle of the road AMH. The Menopur was increased to 225 in the last three or four days because my follicles needed a little extra boost to get to the desired size (they were kinda stuck around 18mm-20mm). Cetrotide was given at day 5 or 6 for the rest of the stimulation cycle to keep me from ovulating. HCG was used for the trigger, and I took an (crazy) antibiotic the day before my retrieval. (That thing was terrible and gave me the worst stomach cramps and diarrhea.) Egg retrieval resulted in 8 eggs, of which only 6 were mature. 5 eggs were fertilized, but only 2 made it to day 5. I began using Endomentrin progesterone inserts 3 times per day, the day after the retrieval through the transfer and up until the pregnancy test. I also took Estrace (Estradiol) daily. One embryo was transferred, and the other was frozen. The fresh transfer resulted in a negative pregnancy test 13 days later. The frozen embryo transfer treatment protocol: I began with birth control for two weeks, after which I began taking Estrace (Estradiol) three times per day. On day 16, after they checked my uterine lining which was 12mm, I began using 1mL of progesterone oil once every three days. I also started Endometrin inserts twice daily. On day six of injecting and inserting progesterone, I had one frozen embryo transferred that used assisted hatching. That was yesterday so I will have to update in 13 days as to the results.

The costs for diagnosis were pretty expensive, especially since some weren't covered by insurance. Many were, but most weren't. And if you lapse by three years, you have to redo everything. Semen analysis is $150/time. My husband has had to do this four times. The female diagnosis (mock embryo and HSG were...$800(?) with Shady Grove). The medication costs for egg retrieval were nearly $6000. The Shared Risk Program was $19,500.

He has told me flat out that he will not transfer more than one embryo for me. I do not know his stance on multiple embryo transfer in general, but he said that I was too thin to chance having multiples. (I'm not that thin. I'm 5'7" and weigh 140lbs.) This is one of the few issues I've had personally with Dr. Sagoskin as this wasn't even allowed a discussion.

Dr Levens spent a lot of time with my husband and I during the few consultations we had with him. He answered every question we had and was empathetic to the difficult time we were going through. I built trust for him over the process of our IVF cycle since I saw that he intervened when it was important to do so and made sure to call or email during critical times.

Dr Levens is a good doctor and wants to do best for his patients. He is open to listening if you want to try something new or tweak your protocol within the parameters of what is safe and reasonable. Make sure to advocate for yourself and speak up when you feel necessary.

We did one IVF cycle with Dr Levens. He did an antagonist protocol with the highest doses of Gonal F (450) and a medium dose of Menopur based on my AMH and FSH. He also had prior information from my first cycle we undertook at a different clinic with a different Dr (GW) and tweaked my protocol based on the outcome of my first cycle. The one thing that I asked him about and he rightly investigated was sperm factor issues. The first clinic did not follow-up on the male side after our embryos stopped growing after day 3 on the first cycle. Dr Levens recommended a sperm DNA fragmentation test for my spouse and it came back with a large percentage of fragmentation even though his standard test parameters all came back normal. The DNA fragmentation test is not a part of the standard work up for men during their fertility testing. We were coached on a number of things we could do to try and improve it. We think some of those things helped. We got better results with Dr Levens in terms of the number of 5 day blasts we ended up with vs the first clinic (4 vs 0). We have yet to achieve a viable pregnancy but I have no doubt he will do everything in his power to try and help us get there.

We purchased the shared risk program at $22k and medications are all out of pocket costing $5k each fresh cycle.

Dr Levens recommends the appropriate number of embryos for transfer based on age, embryo quality, and past cycles. He recommended a transfer of two embryos for our FET (to happen in a few months) after the first round with one embryo ended in a chemical pregnancy and I am turning 37.

He is very straightforward and clear, which I like. If you want a very gentle bedside manner, that's not really him, but he's not rough either. Somewhere in between. Very realistic, but he clearly cares too.

Be prepared and do your research. Ask lots of questions - he is happy to answer. Expect realism but not coddling.

I am in a same-sex marriage, and I'm a good candidate for IUI so the one cycle we've done so far has been natural with trigger shot. He gave me the option to go without trigger, but I wanted it. We may change protocol next time, but we'll see.

We have some coverage, so each office visit was a $40 copay. Counseling with a social worker for using 3rd party genetic material was out of network and was $300. Natural Cycle IUI is $1200 per cycle, but we were approved for the Shared Help Discount at 15% (income based), so natural cycle IUI for us is $1020. Medicated is $1800/cycle ($1530 for us). Sperm is separate. We do not have insurance coverage for IUI. HSG was covered, as was all lab work.