Southern California Reproductive Center

Dr. Rychlik has what seems like the experience and accreditation as an endocrinologist, but he seems to not think outside the box and wants every patient to fit his protocol. I don't feel he looks at each patient as an individual person. He was always very polite and kind but he doesn't do well responding to failure or patient concerns. There was no talk about what to do next after 4 failed transfers, it was almost as though he didn't want me as a patient anymore. Maybe it's because I would bring his success rates down? Not sure. He took no responsibility for my failures, so while even though he didn't know what was wrong with me there must be a problem and it couldn't be his protocol. The most frustrating thing was that early on in our first consult I told him is it possible that it is my uterus? He said no way that is just not likely and talked about a study of women who received uterine transplants from post menopause women and they conceived fine. In the end when we had our final failure he basically told me that he thought it was my uterus. He gave me this answer without any testing or diagnostics. Overall Rychlik is a decent man but I can't say we developed rapport so I decided to go elsewhere for a yet another opinion.

Push him to give you answers as to exactly what protocol he uses for stimulation and why. Also ask him exactly what he thinks is your infertility diagnosis and if the first transfer fails what next? See if he can provide real data to his success rates and where that proof is on the CDC website.

Stimulation was with Gonal F and lupron. Transfers were with progesterone and estrogen in form of IM, oral and suppositories. I had a DNC prior to my first transfer as a clean out. Also had an ERA when the 3rd transfer failed.

Had my monitoring don't by a local center.

For the first round all in, including the guest transfer was about 25,000. Each transfer after was about 5,000. ERA was about 1,500.

Doctor prefers single transfers.

Overall, Dr. Surrey was very great and very pleasant. He always remembered us and our situation. He would always contact us with lab results, new information or just to check in. He was very informative and always presented us with options in moving forward with procedures or testings. Financial stresses and work related challenges have been very present throughout our process. This is probably just a personal/emotional experience, but I felt as though Dr. Surrey was not mindful of our financial struggles. I understand he has an accounting department for that, but sometimes it almost seemed like we were encouraged to take the most expensive procedures/actions to move forward. However, if finances were not an issue, I probably would not feel that way.

Educate yourself as much as possible, talk to others who have gone through IVF treatments successfully and unsuccessful. Don't be afraid to ask questions.

We began with an egg retrieval, followed by a FET cycle a couple weeks later. My fiancé experienced hyper stimulation, severe bloating and swelling. Resulting in 2 taps to remove the excess fluids. The hormone injections may have been too strong for her body. We retrieved 33 eggs, made 5 embryos, 2 were mosaic. Of the 3 viable embryos, two were Day 7 and one was Day 5, which we transferred. Unfortunately our transfer was not a successful pregnancy. A couple months later we decided to do another egg retrieval and freeze. This time Dr. Surrey lowered the hormonal dosage, which prevented hyper stimulation happening again. This time we got 20 eggs and just froze them due to finances at this time.

Dr. Surrey was very neutral and didn't really encourage one way or the other. He educated us on the tradeoffs.

Dr Ghadir is a brilliant doctor, yet at times felt more like a friend which was exactly what I needed during this process. He was easy to speak to and I never hesitated to ask him to explain things to me over and over again if I needed. Upon each visit, he let me know what to expect going forward, specifically how I would be feeling mentally and physically.

Be honest with him about what you're trying to achieve, and do not be too shy or embarrassed to ask him anything!

I was prescribed medications for an egg freezing cycle, and Dr Ghadir was attentive and detail orientated when it came to adjusting my doses depending on how I was feeling and my blood/ultrasound results.

Dr. Ghadir has been an amazing doctor and guide through a very emotional experience. He’s very thorough, cares deeply about my understanding the risks and outcomes but also positive and supportive to make me feel like I am being cared for with the best In medicine and technology. He spent a lot of time helping me understand the process and has been available for any questions and concerns. I cannot recommend him more highly. After working with other doctors in the area, it is clear how important it is to have an ally when going through this experience.

Feel free to ask as many questions as you have that come up along the way. Dr. Ghadir and his team and nurses are amazing at responding and supporting you. Also communicate what your goals are for the shorter and longer term. You can’t find a better doctor to help you on your fertility journey.

I went through the egg freezing process. I am on my second round now. Dr. Ghadir has been very careful about adjusting my shots and medication as the cycle has progressed.

I had a previous experience with other ferility doctors and the experience with Dr. Shahin Ghadir is absolutely amazing. Now I feel I’m in good hands. I wish I would’ve seen him a lot early. I cannot say enough great things about Dr. Ghadir and his team! Dr. Shahin Ghadir is very competent, extremely knowledgeable and has great bedside manner, which has been such a comfort to me during this difficult, complicated and emotionally draining process. He is humble and a good listener; he cares and understands my concerns and explains diagnosis. I never felt like he was rushed to get done with my appointment. I felt important and that I mattered to him. He is honest, but also he is optimistic and offers hope. He helps me feel empowered to battle with my infertility issues. I have got unexpected good result with him while other doctors had made me hopeless. He is truly professional, smart, always kind, and compassionate doctor. He is best fit and I feel so lucky to have found him. He really took me from vulnerable place and made the experience very positive. His integrity and caring for me and others is above and beyond.

If you have a choice of clinic, save yourself some heartache and start here.

Gonal- F: 225 IU’s Menopur: 150 IU’s Omnitrope: 25 units Last days: Cetrotide & z pack I didn’t take birth control. I am diagnosed with very low ovarian reserve. I used same protocol for two egg retrievals. First time retrieved 4 eggs and formed 1 embryo and 1 passed PGS. Second time 4 eggs retrieved and Nothing passed the PGS.

Dr. Danzer really listened to all my concerns and took a complete medical history. He paid attention and I never felt rushed. I really appreciated his bedside manner. It was easier for me to get questions answered in person rather than over the phone, but I never had trouble getting an appointment.

If you feel he hasn't answered your question, ask for clarification. I think some patients don't want as much detail as I did so he starts with the simple answer, but will explain further if you ask him to.

I had started with a different doctor at the same clinic who I adored, but I wasn't getting results. After 3 retrievals we finally got 2 fertilized embryos, but then we couldn't get my uterine lining ready for the transfer. She kept trying higher levels of estrogen and progesterone but nothing worked. Finally she had me consult with Dr. Danzer and he did an ultrasound and thought I might do better without medication. So we tried a natural cycle with no injections, just some pills and vaginal suppositories of progesterone. It worked perfectly and I'm now pregnant.

I had several failed attempts at the clinic before seeing Dr. Danzer, and each of those cost money, so it was very expensive.

In my case because I only had 2 embryos, Dr. Danzer recommended we only transfer one, so if it didn't work we'd be able to try again.

Dr. Danzer is a wonderful mix between compassionate doctor and knowledgeable & experienced professional. I appreciate his delicate position as a fertility doctor, where there are no absolutes. He walks the line well between enthusiasm & sober reality of percentages. I have been recommending him to friends. I don’t see an egotistical motivation in Dr. Danzer & I appreciate that he’s rather humble & conserves his words.

Read their website info, educate yourself before & during your time in his care. He won’t have time in appointments to explain every detail of all of the ART possibilities, he’ll tell you what he recommends. If there’s something you don’t know, he does a good job of answering questions.

Taking Levothyroxine for my Thryroid to get labs in the right place months in advance. Taking Vitamin D supplement & DHEA 75mg daily. IVF recommended, but so far I can’t afford it as a student. Will keep trying to get a loan later after I’ve started a new job. Took Clomid for 5 days & 1 trigger shot, 2-3 transvaginal ultrasounds before IUI. My fiancé had a sperm wash morning of IUI. Only the 1st IUI, I understand many couples do 3-6 generally. So I’m not deterred that we had a negative result. Will keep trying & be receptive to new life.

Cost for ultrasounds, IUI & injection drug we’re reasonable for the LA area. Less than what my gynecologist quoted me.

He is professional and courteous, very straightforward and tried to show sympathy and understanding of your personal situation. He said that he wanted to get to know my personal history that led me to his practice and asked question to get to know me and my husband better. He followed up with me in a timely manner about our test results, next steps, and about what to expect from the treatment. He carries himself in an approachable way, so you are comfortable asking question and having him elaborate on any part of your treatment.

He is skilled at his work and is able to answer any questions you have in this area.

I have high egg count and my husband has a high sperm count. However we’ve experienced secondary infertility. Because of my age (40) and the amount of time we’ve been trying to conceive for, we were recommended IVF treatment

I have Progyny insurance, so have very little out of pocket cost.

I will elect for eSET because I had a high risk pregnancy in the past and because of my age.

Brilliant, clever, and truly cares about each of her patients. Her energy is contagious but she never creates a false sense of guarantee (which I appreciate). She’s direct and professional but kind. When you are sitting with her, you know she is focused on tailoring your treatment. She always called right away with results, even from her personal cell while she was on vacation. She even texted us a few times with real time updates when she knew we were really anxious. My husband and I are so thankful for Dr. Alexander. She goes above and beyond for each of her patients.

I think this goes for any doctor, but make sure you ask questions. You can see her mind is running a mile a minute to figure out the best plan for you so she doesn’t always explain every detail upfront and occasionally it was unclear what the next step was. Just ask and she’ll go through everything until you are comfortable and at ease.

For my 2 IUI’s, I took Metformin, Letrozole, Gonal F, and Estrace. I was having a poor reaction to vaginal progesterone and she was going to switch me to injections and had me come in for an early pregnancy test before making the switch. Unfortunately it was negative so we didn’t proceed and I at least got to end the failed round a few days early. I appreciate that she’s aggressive when she needs to be. For my first IVF, I took Metformin, Gonal F, Menopur, Omnitrope, Cabergoline, Doxycycline, Ganirelex, Novarel, and Lupron. She also had me on a bunch of vitamins. We then switched to Follistim for my second round.

IVF retrieval was between $20,000-$25,000, which included ICSI and PGS testing.

Dr. Alexander knew my personality well and knew I wanted to maximize the opportunity for a transfer to work. For this reason, we did an ERA before doing FET. We transferred 1 embryo.

Dr. Akopians quickly assessed my anxiety and need for control at the beginning of my IVF process. She took time to explain each detail. She wrote steps down for me so I could focus on listening but also having note to reference later. I pride myself in being organized and detail oriented so her notes were wonderful for me. She was patient with all my questions that constantly diverted the conversation. She provided me with data and additional process facts that helped educate and reassure me. She gave me a sense of comfort due to her communication, reassurance, empathy and her confidence. Her ability to make me feel at ease and confident in her abilities has been essential.

She is accessible in person if you like that type constant interaction. If you’re like me I didn’t see her in person very often but I spoke with her over phone calls which worked well with my lifestyle.

Due to the know low sperm count and motility my husband had she had him take medication to increase his quantity and motility. Due to all our infectious disease labs being expired we had to re do them. We had sperm frozen in another facility. Dr. Akopians asked us to transfer it to her facility as backup for our process. Due to our sperm ICSI was recommended and used. Due to our sperm it was recommended to use an embryo scope to reduce the amount of times the embryos are manipulated to give them a higher chance to do well. We used the embryo scope.

Consultation $275. Transvaginal US $230. Labs:Assay of Estradiol $85, FSH $85, Lh $85, assay thyroid stim hormone $85, venipuncture $30. Embryo freeze all: Cycle management fee $715, monitoring $3140, retrieval $2440. Frozen Embryo transfer: cycle management fee $715, monitoring $1590, embryo transfer $1065. Had to pay other fees for the surgery center and for the cryobank facility.

Due to our specific scenario and factors only one embryo will be transferred. Dr. Akopians made it sound like all other scenarios also only one embryo is encouraged to increase the transplant success rate. Ever couples scenario is unique.

I came from working with Dr. Surrey who had the worse bed side manner. I wanted a doctor who was going to coddle me enough but also treat me with respect during this hard time. Dr. Akopains was a lot of that and more. She is incredible, hands on, explained everything/broke everything down, incredibly kind, patient, caring, gentle but stern when necessary...I love everything about her. I was so sad to graduate.

Ask questions...she will answer it all!

IVF egg retrieval: Birth control. Followed by: Gonal F 200 units Menopur 75 units Omintrope 25 cc - for egg quality Cetrotide Trigger shot (don't recall the name) Mock ERA cycle - to up my odds for an embryo to stick during transfer. Saline ultrasound Transfer cycle: Birth control. Lupron injections. Estrace orally Endometrin Medrol Progesterone in oil 1ML

Insurance did not cover anything. I do not know the exact number but it was somewhere between $20-25k including freezing, genetic testing, procedures, medications, etc.

We did the mock ERA cycle for this reason. I did not have many embryos and we did not want to take the risk of losing any.

Carolyn Alexander really does care about her patients, about that I have no doubt. I do think though that since the clinic overall is overloaded, it reduces her ability to spend quality time with patients. Communication with her is short, to the point, and over within a matter of minutes.

Expect her to be blunt, but kind. Don't expect to get a lot of her time and expect to need to call and follow up over and over. She is supposedly one of the best in the LA area, but it's very hard to get time with her so for some, that's not ideal. She did call me one time on a Sunday which was very nice of her, so she will contact you outside of business hours, but the call with be to the point and not a second wasted before she's saying bye.

I did two medicated IUI's back to back. I was put on letrozole with a trigger shot to induce ovulation, then progesterone suppositories during my luteal phase. I'm happy with the treatment used in the IUI, my only point of upset is my progesterone was never tested, neither before the IUI's nor during or after, and months later we found out my body wasn't responding to that progesterone dose. Had they tested my progesterone we could've found that out way earlier. I did not get pregnant with either IUI.

The IUI's were roughly $800 and ultrasounds were $250. Bloodwork was in the few hundreds as well and each ultrasound and bloodwork were done multiple times a month each month. A consultation appointment with Dr. Alexander was $200 just to say "yes" we are doing IVF even though we were already decided and told the clinic we were decided. We have spent roughly $3,000 for two IUI's and no pregnancies.

We had our consultation for IVF this week so this is the only experience and insight I have on her approach. She shared that after retrieving the eggs, after doing genetic testing, after seeing how many make it to the 5-day stage etc. then we would need to decide if we want to implant one or two embryos. There were no further comments, but it did seem like it was an option she would openly discuss when that time comes.

Aside from the M.D. on his business card, it wasn't very clear to me how good / not good he is at his job. I barely saw him, which is fine if I didn't need to see him, but I felt like if I had questions about next steps they had to go through the clinic which can always mean things get lost in translation.

Be ready to do your own research.

I'm honestly not sure if he properly read my charts and tests. At first he thought my tests would be "lower" but when he got the results and read them to me on the phone he said everything was "good", but I didn't really know what that meant. There wasn't really a strategy, at least not one that was explained to me or my wife.

approximately $1,200 per IUI cycle

N/A

Dr Alexander is a wonderful doctor and person, she is very compassionate and caring, I just wish she was more aggressive. I am on the older side for fertility treatment and I went in ready to go full force ahead, however she has more of the wait and see approach. She is very knowledgable and positive, and has a wonderful bedside manner.

Go in with a list of questions, be ready to ask why/why not, and push for what you want. You are your best advocate when it comes to your treatment plan, fight for what is right for you.

IUI 1: Letrozole, trigger shot & Progesterone suppositories, switched from Clomid as my family has a history of breast cancer. Negative pregnancy test. IUI 2: Letrozole, Gonal F, trigger shot, & Progesterone suppositories - Added Gonal F to make more follicles. Negative pregnancy test. HSG IUI 3: Gonal F, Dexamethasone, trigger shot, Progesterone suppositories, 2 Sperm donor vials 24 hours apart. - Added dexamethasone for inflammation, and a second vial of sperm (one at 12 hours post trigger, second at 36 hours post trigger). Negative pregnancy test. IUI 4: Gonal F, trigger shot, Progesterone suppositories, 2 Sperm donor vials 24 hours apart. First time having symptoms but they went away after 3 days, negative pregnancy test. Implantation Blood Panel IVF Egg Retrieval: Birth control pills, Lupron, Ganarelex, Cetrotide, Gonal F, Follistim, Omnitrope, Dexamethasone, Menopur, Trigger shot. I also added Co-Q10 & DHEA to my vitamins. 29 follicles retrieved, 11 made it to day 5, 6 were cleared via genetic testing. FET 1: Lupron, Birth control pill, baby aspirin, Estrace, Progesterone in Oil, Endometrin.

When I had insurance (I was laid off in the middle of my retrieval cycle), all of my appointments were covered with my $30 copay, plus $70 lab fee for each IUI, plus $1,000 per sperm vial. My total cost for the 4 IUIs under Dr Alexander was $8700. IVF retrieval cycle: $15,400 + $6000 for medication= $21,400 FET 1: $3780 + $1500 for medication= $5280 ERA: $2785 Grand total: $38,165

No opinion.

Dr. Ghadir was very kind and easy to talk to when we were meeting - although he often seemed rushed and sometimes pushy. At first he seemed cautious and then once we had success with freezing healthy embryos he became very positive. His positive attitude is what made us feel confident to move forward but then we did not have success we felt tricked.

I would advise people to be weary of his positive attitude, to take it with a grain of salt.

Dr. Ghadir suggested I see a rheumatologist as that is what he thought was the cause of my miscarriages. If were to try again, even without Dr. Ghadir I would continue to see my rheumatolgist -- he put me on several meds including a blood thinner shot.

This is was the best of the experience. The early AM (6:30) appts saved me. If I was the first client to arrive I could be out in 15 min and not be late to work!

Towards the end of treatment Dr Ghadir started to take my insurance -- most was not covered but it did make a small difference. We spent approx. $40,000.

I asked for multiple transfer and it did not come back positive test, moving forward Dr. Ghadir said he would only do single.

Dr. Alexander is a very kind and insightful doctor who I have been seeing for much longer than either of us thought (not her fault). I have done 2 IUIs that ended in mc and 2 that have failed and I'm currently on my 5th. I ended up taking a 6 month break after my 2nd mc due to waiting for blood test results that needed time in between for accurate diagnosis. Luckily Dr. Alexander allowed me to do these tests after only 2 MCs (instead 3 which is typical RPL). Thank God she let me because turns out I have MTHFR Gene mutation and a blood clotting disorder which means I need to do blood thinning injections once I'm pregnant. I wouldn't have known any of this if Dr. Alexander didn't take the time to speak with me and let me know my options prior to potentially going through another miscarriage! Sometimes you need to ask her as many questions as you can or she won't really give you the information right up front so I've learned to ask exactly what I want to know from her and then she'll tell me. Also at the clinic there are many other doctors and she is the only one I ever see walking though the halls and she always stops by her patients just to ask how they are doing and how they are feeling. Overall I'm glad I have her as my doctor going into my second year of fertility treatment.

Always ask her your specific questions if you are confused or didnt get all the info you wanted. Sometimes she can be very vague but once you ask she'll answer & clarify.

She had me do 5 days of letrozole and none of my follicles grew. So she had me wait a couple days and then start gonal f injections. I quickly had a big follicle after only 3 days so then I did trigger shot and IUI a day later. It got me pregnant (ended in mc) so the next cycle she had me mimic it and I got pregnant again (mc) then I took a break. The last 2 IUIs I did we're the same exact protocol but they didn't work. This one I wanted to do higher dose of gonal f but she's worried I'll produce too many mature follicles. So we'll see what this one's outcome is. When you go in for scans there is a tech who does it and then she or the nurses will call you after with instructions of what to do next. They also email so it's a pretty easy streamlined process.

I have fertility insurance through my husband's work so they bill insurance but cost out of pocket seems to be pretty general.

Doctor Ghadir is an amazing doctor. He always told me the truth, but taking care of my feelings. He truly understands how delicate this process is, therefore I felt like he took care of me as if we were family. He is warm and very intelligent. He knows everyone, so he would always have a good referral for a doctor or anything that we would ask him. He would calm me down because I would get very nervous before every treatment. And he would even throw the occasional joke to make me relax when I needed it. I truly appreciate having him as a doctor. For me, he's the best doctor I've ever met.

Ask for the VIP packages and get them. They are worth every penny.

I don't remember. I'm 8 and a half month pregnant. My memory is not too good at the moment. But I'm pregnant thanks to him and his team.

Don't remember

Dr. Ghadir suggested we picked the best quality embryo to transfer this time that we got pregnant.

Dr. Ghadir was someone I could implicitly trust and count on. In a sea of emotional decisions that had to be made he was a steadfast guide who knew just how to balance a compassionate bedside manner with objective medical expertise.

I would advise any future patient of Dr. Ghadir's to be completely open and honest about their fertility goals and the mitigating factors that impact their decisions including finances so that he can make sure his treatments take your full life picture into account.

I don't really remember the exact protocols but I do remember that they were extremely effective (which is why maybe I don't remember them as I didn't need to implement many adjustments).

I don't really remember, I think all in for retrieval and 2 transfers it was between 40 & 50k?

I felt I was very educated on why single embryo transfer was a good decision for me given the high likelihood I would become pregnant and specific medical situation. I can't speak to his approach with other patients but it worked for me.

Dr. Alexander was super thorough and easy to talk to, when we were able to see her. My husband initially went in just for a semen analysis (referred by my OBGYN) and we were able to do a consultation once his results were in.. he had a 1% morph. She went through some basic questions with us and she explained our options (IUI, IVF, etc). We didn’t make a decision and she called me a couple weeks later to check in, I was midway through my cycle like day 12 and she said we should try an IUI, she prescribed me injections and they were delivered to my house... Never did any testing before or an ultrasound... Strange now in hindsight, but I had no clue standard procedure. I’m sure she just wanted to give my follicles an extra oomph. I went in after the injections for an ultrasound, but never saw Dr. Alexander for those, only a nurse and Dr. Alexander would call me after with her take on my follies + a plan. Eventually we did the trigger and scheduled an IUI 36 hours after. The IUI process was with her and she was great through it, although only saw her for the insemination. She prescribed progesterone and sent me on my way. I started my period and came in for an ultrasound with a nurse and the nurse mentioned it looked like I might have cysts. Dr. Alexander called me after and said she thought they were follicles that were big and I was going to ovulate any day... it was CD3 and I wasn’t on any medication, I normally ovulate on CD16... I got a weird feeling and decided not to continue with her and the office, it felt like my care wasn’t being considered and they were using a one size fits all procedure. Dr. Alexander was a cheerleader through the process and genuinely wants you to get pregnant, but it seems like she sees too many patients and can’t give them individualized care.

She is genuinely sweet and means every word she says to you, she’s extremely hopeful... But make sure to ask a lot of questions and be your own advocate through the process if something doesn’t feel right.

We did Gonal-F injections 75IU CD12-14, an HCG shot on CD15 and an IUI on CD17. Started progesterone suppositories CD19 at night til period started on CD28

I can’t remember fully, but I know the ultrasound and office visits were more expensive than my current RE... I want to say it was $190 per visit for a standard ultrasound and the IUI was around $500.

Dr. Rychlik made me feel like I was not intelligent, and that I was going to be emotional. After telling me on the first visit that I would need IVF, he said to me "you probably stopped listening already" and then he indicated the he would start directing the conversation to my husband. I was not crying and was paying complete attention. My husband is actually the type to have his mind start spinning, and stop paying attention. Dr. Rychlik was googling images to show me, he had nothing prepared as a presentation. He said multiple time, "that's not the picture I want. There's a graph I really like." He was not prepared. Dr. Rychlik gave me a treatment plan, IVF, after just one visit, without an HSG test, and without a semen analysis. After now seeing a different doctor and talking with a family friend who is an OBGYN, I know this is a crazy plan after just one visit.

Please do not see him.

We did not get to begin a cycle, because I was unsatisfied with his diagnosis after only an ultrasound. I did not trust him and I believe he just wanted my money.

I provided my insurance information before the appointment because they told me that they needed do talk to my insurance before the appointment. Then when I went then still didn't know if my insurance would cover the ultrasound. The Dr. called the nurse in to get me to approve the cost of the ultrasound in case my insurance wouldn't cover it. I did not end up paying because my insurance did cover it. I only went to that one appointment, so I had no other costs.

N/A

He was always very nice. Funny. Explained things when I needed. Kept me up to date on what was going on. I don't like to stress so a doctor with a sense of humor can definitely lighten the mood. I am also not the type of patient to ask a ton of questions as I put my trust in the doctor and know that this is their specialty and not mine. This is my second fertility clinic and I'm under the impression that none of them hold your hand through anything really because they have way too many patients. With that said If I needed something or had a question I would just email my nurse.

Be ready to laugh.

I dont know that their was necessarily a strategy. I am under the impression that this protocol is for everyone and not just me. So Iwouldnt say I feel special or anything. 225 of Menopur, 225 of gonal f. Take prenatal, COQ10 and DHEA.

So far Ive spent almost 18k but medications are very expensive

We havent discussed

Dr. Chang has been thorough in explaining information to us. She appears like she cares and wants to optimize our chances of getting pregnant. She communicates in a clear manner, often speaking slowly and calmly, which is appreciated given the technicalities of IVF.

I have not completed a full cycle yet, but Dr. Chang is currently preparing for IVF and has suggested a number of supplements to optimize our health. We've gone through many pre-tests and ultrasounds that have helped her give her a baseline of our health. I appreciate her having us take our time to improve our chances instead of rushing into the procedure.

Genetic screening, consultation office visits, ultrasounds, cycle day 2 labs, supplements

We started doing IVF for male factor (1 % morphology) after I had two chemical pregnancies. Dr. Alexander was extremely compassionate and thorough with testing before we started a cycle. She was confident I would get pregnant as everything on my side looked amazing. Our egg retrieval went great, with 4 PGS normal embryos. Our first transfer was delayed because she found polyps and I was scheduled for a hysteroscopy to remove them. While under she found a uterine septum and removed that as well. Then I tested slightly positive for irregular uterine cells and did a course of antibiotics. We finally started our transfer cycle only to be cancelled because my lining wasn't responding to the meds properly. We started again with a different type of estrogen priming and went ahead with our first transfer which resulted in a pregnancy. Dr. Alexander was more excited than me, as I was cautiously optimistic because I knew one beta test is not the whole picture. Our second beta came back lower than they would have liked and we did a third one which was normal. After this we waited to do an ultrasound at which point things did not look good. I was told this news during the ultrasound which was very upsetting. We had to go back several times to keep watching and I eventually started to miscarry and took drugs to help it along. Transfer 2 failed, which was shocking to everyone. We met with Dr. Alexander and she suggested an ERA and seeing a hematologist, which didn't make total sense to me. I said, why don't we do one more transfer before we do all that and she suggested another hysteroscopy before a transfer and the plan was to do a third transfer before she left for the holidays. We did the hysteroscopy where she removed a small piece of tissue but everything else looked great. We then found out that we wouldn't have time to do the transfer we talked about doing so I suggested doing the ERA while we were waiting for her to get back. We started a mock cycle on their "standard protocol" which did not work at all for me on any level. It was the same hormone protocol as the first cancelled transfer... I expressed concerns about this not working and was told it would be fine. When my lining didn't respond and this cycle was cancelled, I felt like Dr. Alexander started to lose confidence. She said the ERA was no longer necessary as she "didn't want to be chasing her tail around trying to get a good lining." It was disconcerting being told we needed a test and then a week later we didn't. She suggested trying a natural cycle which I started and when she discovered fluid in my uterus (which I believe was there from the cancelled cycle before) we were brought into her office and mid-cycle suggested surrogacy in a very odd way. Asking if I knew anyone who I would want to be my surrogate and saying she wished she could be mine. My husband and I were no where near ready for that conversation and it was very strange to have it brought up in the middle of an FET cycle. The fluid was aspirated, I had a second HSG with her associate (who called me a conundrum during that procedure) and she recommended going ahead with the third transfer. That one failed and we decided to get a second opinion at that point.

Be ready to be in the driver's seat of your fertility journey whether it's following up for results, getting medications called in and doing your research. Dr. Alexander is smart but there were things that were missed along the way and I wish we were given a more realistic idea of what to expect with the entire process.

Egg retrieval was pretty typical. FET changed from estrogen pills to many patches and Viagra, lovenox, steroids and lots of natural supplements and PIO and endometrin when it was time. Final FET was natural (waiting for me to ovulate) with a little patch support and endometrin/PIO shots, lovenox and steroids.

I think a retrieval cycle was listed as a little over $20k but once you add tests and meds its more like $30k. We spent close to $7k for everything for each transfer.

She went back and forth about whether or not to transfer one or two but ultimately agreed with our decision to transfer one at a time... she felt strongly about me not carrying twins for health reasons.