The Infertility Center of St. Louis

I elected to work with Dr. Silber because of my diagnosis of diminished ovarian reserve-- he is reportedly a pioneer in the area of IVF for women with this condition. Various miscellaneous errors took place when it came to coordinating my care (wrong lab work, receiving emails and labs belonging to other women), but the biggest error was being prescribed the incorrect trigger shot prior to my third egg retrieval. When Dr. Silber came into the pre-op room prior to the retrieval, he questioned why I had taken a particular injection that he prescribed. Turns out, he and the IVF coordinator had a miscommunication which resulted in me taking the wrong drug. They were able to retrieve one egg only. Then, they forgot to call me with the results and subsequently lost my chart. I called to check on the status of the fertilization results and found out that the one egg did not make it to day 3 status. Dr. Silber does not believe in fertilizing embryos to day 5 blastocysts.

Be prepared that you will likely feel like a number. Dr. Silber travels a lot so then when he is home and working, he tries to cram in all of his patients at once. I often waited hours for bloodwork and ultrasounds amongst a huge group of women who'd traveled from all over to work with him. For the amount of travel that I did to work with him myself, I would've wished for more face time with him. That would've helped me feel more trust in him as my physician (one consultation with him and with my IVF coordinator, otherwise just saw him in pre-op prior to my retrievals and transfer).

Denmark Mini IVF Protocol- follistim 150mg- cycle cancelled prior to retrieval Mini IVF Protocol used for two retrievals- 50mg clomid daily leading up to retrieval- 5 eggs retrieved first time around (2 made it to day 3 embryos), 1 egg the second time around that did not fertilize Both protocols were recommended due to my dx of diminished ovarian reserve Frozen transfer of the two day-3 embryos that we had- negative

Monitoring had to be completed between 6-8am at the hospital for all women undergoing a cycle at the same time. Dr. Silber starts all of his cycles on the scheduled dates so a large number of women are going through monitoring at the same time. The radiology techs seemed stressed by the amount of work they were expected to complete within a short duration of time.

Completed 3 egg retrievals (one cancelled prior to retrieval-- lost $1500 on that round), ICSI, and one frozen transfer for $30,000 (including cost of meds)

He recommended transferring two embryos and said that I would have a 60% chance of success due to my age (under 35)-- negative pregnancy test outcome

Dr. Silber has a pretty old school doctor demeanor in how he operates. He clearly has a passion for cutting edge technology and has a lot of expertise but at the same time can have some very strong opinions that can be off-putting or seem like possibly he is discounting something that might have scientific merit. This is what I would expect from someone who has been practicing medicine for 30+ years. He can be blunt but I was going to the clinic for the lab expertise rather than super awesome patient bedside manner. He is very willing to take difficult cases and is not screening out anyone to make his stats look better. He is not super open to certain things like acupuncture/herbs/supplements. He is confident in his lab and yet was conservative in his estimates of what we could expect as an outcome and we were pleasantly surprised with our results. I did appreciate his willingness to accommodate our conservative approach to generate as many possible embryos and not take measures that could lead to discarding one that could have been viable (for example we chose not to do PGD testing because of false positives, and not make all embryos grow out to day 5). He also very generously offered to take previously frozen eggs and fertilize them alongside a current cycle with no additional charges. We had other clinics get skittish at the idea of handling any frozen eggs they did not create.

He is pretty direct, and has some strong treatment preferences. Further discussion with him has shown he is somewhat willing to try alternatives if you have had issues with past protocols. He only does in-person consults. For FETs you are asked to have no food or drink and to hold your urine from midnight until after the procedure. I never made it through the night without having to go but still had a full enough bladder for the procedures.

We did the japanese mini-IVF protocol since in his experience this typically gives the best quality eggs for older women with age-related DOR. We only did one cycle and got 1 dominant follicle which was less than the typical 2-4. Prior to this I had been getting 2-4 during medicated IUIs at similar doses of follistim, so I'm not sure if my body didn't like this particular protocol with the clomid or if it was just what was going to happen that cycle regardless. The 1 egg retrieved did make it to day 3. In addition I had some previously frozen eggs from my 30s fertilized and almost 40% of them that made it to day 3 or day 5. With the japanese protocol there are no fresh transfers due to the ovulation induction med used (makes for poorer uterine lining). We have done 2 frozen embryo transfers (FET) with 1 embryo transferred (day 5's from my previously frozen eggs) each time and are now pregnant after the second try. We were trying to maximize the number of embryos so we liked his strategy to achieve this by foregoing PGD testing (some percentage of embryos that fail PGD actually can still be viable), freezing everything that looked great on day 3, and growing out anything that seemed less great till day 5 to freeze if it looked good enough.

There are general hours for monitoring appointments that are basically first-come first-serve, even though you call at least a week ahead and set an appointment time. The time doesn't mean anything other than they know you will show up sometime during screening hours that day. I was usually done with labs and the ultrasound in about an hour most times.

I think my mini-IVF was about 12,000 plus meds(~1800) , and that includes one FET. Additional FETs run about 5000 plus meds (~600 through 2 wks post transfer).

Dr. Silber mostly recommends 1-2 embryos per transfer. If you desire to put in more you must indicate on the procedure form that you will consider selective reduction in the event you carry more than twins.

He was never on time, wouldn't take phone calls or call me with results. I'd get mail from him that included information that was already outdated. He never discussed my labs with me or my results to troubleshoot. He just wanted to do the same protocol again and again until it worked. I finally requested my medical records and found that during my fresh transfer my progesterone was 1.7 (I've been told that over 1.5 before transfer =canceled transfer, but he went ahead with it). I only had two ultrasounds before my FET without any change in medications....it's just not an individualized plan for anyone.

RUN FAST, take a look at their outcomes on the CDC website they are below national levels by a lot.

Mini Denmark-lower medication stimulation plan. I thought we used this because I was a "healthy" and my husband had malefactor. After more research I also have fertility issues. Dr. Silber did minimal diagnostic workup.

Monitoring appointments were pretty easy.

$15,000 for the egg retrieval and TESE

He had a strong preference for day 3 embryo transfers and not doing genetic testing.

While I only got to speak directly with Dr Silber twice, the consultation and then the egg retrieval, I was thoroughly impressed with the organization he has created. Every nurse spoke highly of him, all documents sent to me that he had written were well articulated and sourced, and I truthfully felt that he without a doubt knew what he was doing. I got amazing results from his protocol with less medication than my previous clinic was going to prescribe me. I have PCOS and after going through this retrieval I am certain that I would have hyper stimulated at my previous clinic.

Don’t be afraid to ask questions, that’s why you are assigned a coordinator whose job is to assist you with any questions you have and give you updates!

We had done all our testing at another clinic before switching to Dr. Silber. So we called to set up an appointment and we were able to meet virtually about 2 weeks after that (most places are months out just for a consultation) I was shocked because after researching him and the clinic I learned her basically pioneered most fertility treatments we use today! The same day we had the consultation i was prescribed birth control as i was just finishing my period. I took BC for 6 weeks, had a period, and started taking 1 50mg of Clomid and 1 injection of Follistim each night. I started daily monitoring at St. Luke’s hospital where after the second day of injections, I would go to the hospital at 7:30am and get blood work and a vaginal ultrasound to see how my follicles were measuring and what my levels were at. We live on the west coast and decided to fly to Missouri for 10-12 days for procedure and monitoring. I was measuring well after the first appointment on a Friday, so they gave me the weekend off, and I went back in on Monday and Tuesday. Tuesday afternoon I got an email with my results (day 7 of Follistim and Clomid) and was told to do a shot of Ganirelix ASAP, then another the next morning before my blood work and ultrasound. I did 2 80unit doses of a Lupron trigger shot and my last Clomid pill along with indocin. (No more Follistim) the following morning, Wednesday, I just had blood work to make sure all was going well and took a pill of indocin that morning and evening. The following day I had my egg retrieval, also at St. Luke’s. The hospital actually has a whole unit just for IVF! We got 22 viable eggs, which is kind of crazy considering I was doing Mini- IVF where I had read you typically get a fraction of that amount. 19 were fertilized and we ended up with 9 embryos that are currently frozen until I implant in about 2 months. Dr. Silber typically has his patients wait 3 months between retrieval and transfer to let your body heal and reduce inflammation, especially for PCOS and Endo patients.

Egg retrieval, ICSI, & Embryo Freezing total: $12,750 (before insurance) +$2,300 for medications. The clinic covers the first year of embryo holding. Not sure what our total cost will be for the implantation, but from what I remember it will be about $9,000.

Dr. Silber exceeds in his knowledge of PCOS and the many benefits of mini-IVF, and he explains very thoroughly what many doctors before failed to do. He understands the pitfalls of the usual treatment pattern, and he sees every patient individually and doesn't constrain to a certain criteria - he accepts challenges confidently and he genuinely loves what he does!

If you're considering his office, don't hesitate to reach out to schedule a free consultation! They will accommodate you quickly over Zoom at no charge to discuss your case without any obligations.

We are still in the time between consultation and following through with mini-IVF but he strongly recommends this option for PCOS because I have plentiful amount of eggs for retrieval, it takes off the constraint of my eggs aging, and it reduces the cost of IVF significantly. I will require a higher dose of FSH due to my weight but that was addressed and the difference in cost estimation was explained upfront. He was very clear with his process and the strategy to retrieve and freeze and wait prior to transfer to allow my body and lining to rejuvenate and respond more favorably for the best odds.

Dr. Silber’s fee $6,500 Due 4 wks prior. Assisting Ob/Gyn fee $1,350 Due 4 wks prior. St. Luke’s Hospital fee $3,500 Due 2 wks prior. Anesthesiologist fee $400 Due 2 wks prior. Diagnostic Imaging (Radiologist) $150 Due 2 wks prior. TOTAL Treatment cost $11,900 Plus cost of medications ~$1,500-$5,000 *$500 of Dr. Silber’s fee is due at the time of scheduling. *When transfer is performed in a subsequent medicated cycle, there will be charges of approximately $1,500 for medications and $150 for radiologist. *Not included are infectious disease testing for intended parents as well as blood tests for pregnancy test after embryo transfer, specimen storage and specimen shipping. **All fees are subject to change

Dr. Silber is a straight shooter, which we very much liked. We didn't feel like he was placating us and he gave us realistic expectations once we got to our embryos and transfers. The first time around, we did a fresh transfer and he expected we would get many more eggs and therefore embryos than we did, but he was frank about the results and the quality of the embryos and exactly why he thought our chances were 50/50. When we came back to him in early 2020 to give our daughter a sibling, he said he almost wished we had done more retrievals back in 2017 because he should have known we would want to have another baby. With being 44 this time around, he was straight forward about the chances that the eggs wouldn't be good quality and was thrilled right along with us when we came up with great embryos ("amazing at 44 she makes such beautiful embryos!"). I'm sure his straight forward manner would be much harder to take if news was not good, but we appreciated his honesty. He took the time to address every question we had and even chatted with us about his chess sets around his office to take a little time to get to know us. We found him when I googled "IVF over 40" and he came up first and then over and over in the searches. He takes on cases without regard for his statistics. I'm sure he could have easily retired years ago, but he is clearly still doing this because he loves helping people have families.

Be prepared for him to be very frank with you. He will not just tell you what you want to hear. He will also have his first consult with a plan in mind and ready to go. Have an idea of any questions you might have because he will take the time to answer them all.

Denmark Mini-IVF for the fresh transfer in 2017. Birth control pills, Lupron/ganirelix, Follistim and HCG microcode, HCG trigger shot, and progesterone in oil (which continued through first trimester). 3 day transfer for the fresh transfer with any embryos beyond two to be frozen (of the six eggs we got, 4 were mature enough to be injected ICCI and we only had two that fertilized and made it to the three day transfer). From the two embryos, 1 implanted and resulted in live birth. Egg retrievals in 2020 - goal was 6 frozen embryos to give us a 50/50 shot fo getting pregnant. Mini-Stim IVF protocol - Birth control, clomid & follistim, ganirelix, HCG trigger shot. (first retrieval 5 eggs retrieved, 5 injected, 3 fertilized, 1 frozen on day 3 - continued to culture another and it didn't make it to blast stage) (second retrieval - 5 eggs retrieved, 5 injected, 5 fertilized, 2 frozen on day 3, and 3 matured to blastocyst stage). Endometrial Scratch performed prior to FBT and endometritis found (which would have just wasted the embryos because it would keep them from implanting), treated with antibiotics and transfer delayed. Another scratch prior to next transfer date and all looked good for transfer. FBT - birth control, Lupron, Estrace and vivelle dots (estrogen patch), and PIO. Estrace, vivelle dots, and PIO continued through week 14 of pregnancy. Transferred 2 blastocysts and have one baby expected in a few months!

With medications, I think the fresh transfer was around $15K. My insurance covered a lot more when we did the egg retrievals in 2020 as far as the medications. It was around $12K for the first egg retrieval in 2020, including medications, and that also included the cost of one transfer so when we transferred frozen blastocysts in 2021, there was no out of pocket cost outside of medications which were minimal. The second egg retrieval cost around $7900 + medications.

As stated multiple times here, if more than 2 embryos are to be transferred, must sign form for selective reduction in case more than twins are expected. We were told due to my age, that he would be willing to transfer as many as 3, but based on research (including Dr. Silber's) that said transferring multiple embryos doesn't increase chances of pregnancy, just chances of multiples, we chose to transfer only 2 at a time. He would be willing to transfer one at a time as well.

Dr Silber is fantastic. He is a pioneer in the infertility world and is constantly educating other physicians to help get infertile patients pregnant! I feel he knows and remembers every step of my journey (which is a lot) and continues to try and find a way to give us the family we always dreamed of. We are so lucky to have found Dr Silber. And that he is so close to us!

His consultations are free! He will do everything in his power to get you pregnant!

For my first round of mini IVF, we started with 150 iu of Follistim. On my first day of monitoring, my follicles were extremely small. Dr Silber then doubled my dose to 300 iu of Follistim. We continued monitoring with this dose for the next 8 days. I finally had 2 measurable follicles after 3 weeks of stim. For my next round, we started with 300 iu of Follistim and my body responded right on schedule! We had our retrieval the day before our "target"date .

$6,000 for Dr Silber's fees $1,350 for his assisting physician, Dr Michael DeRosa $4,000 for hospital fees $400 for anesthesia $150 for radiology $3,000+ for Follistim, Clomid, and Ganirelix

We haven't been able to do either, so it hasn't been discussed. With our first round of mini IVF, we had one egg. With our second, we had two. We never had an egg fertilize in either cycle.

I unfortunately had a fairly bad experience with Dr Silber. It started out bad during the consultation where he promised me that my case of PCOS was easy despite numerous failed cycles elsewhere. The other doctors are stupid he said and doing mini IVF will certainly fix our complicated problem. So we decided to believe him. I asked our coordinator later because this information was left out of the initial meeting when they would expect to have a scheduled transfer date since they had an easy time calculating their conveniently timed (for them) retrieval estimated date. They said that we have to wait 3 months for the uterus to heal before doing a transfer and I asked the coordinator if she would ask Dr Silber if he could reconsider that protocol for me because in my previous cycles even with Clomid, I have always been told I have beautiful linings by my ultrasound technologists. I told them I do not want to continue to proceed with the cycle if I have to wait 3 months for a transfer and they ended up conceding in writing to my request and said he did not believe in doing it fresh or one month later but will do it if that is what I want. We went ahead based on that premise and on retrieval day, he said so now you will come back in 3 months. After the retrieval was done when I was under the influence of anesthesia and my inhibitions were not the same as before the anesthesia, I said to my husband to call in the doctor because I was unhappy about that comment. I told him I felt gipped and that he said I could do it one month later and that I could show him my email that I have it in writing (this was done admittedly while ballisticly crying) because I was so upset that he was telling me this now the first time I met with him in person and on retrieval day, when I had no other option but to do the retrieval considering I had upwards of 90 follicles in my ovaries that needed to come out from this "mini cycle." He said and I quote, "You would be stupid to do that, if I did say it I meant it sarcastically and you will not have a family this way." After waiting for almost a month for Dr Silber to get back from a vacation to hear his analysis of our results and me accepting that we will wait the three months because we had no other choice - he got the coordinator to deliver the message that he no longer wants to treat us anymore and that they will arrange the shipment of our embryos to a local facility. I accepted this, feeling uncomfortable about working with him anyway and asked for the refund money for the price that included a frozen transfer in it that I would now need to pay elsewhere along with shipping (around 4k). They offered a refund of 1k. Infertility Center of St Louis charges 5k for a separate transfer which they do not advertise so if you think about it, it does not add up and that is one of the reasons why in the end we chose to transfer the embryos elsewhere. They did offer to allow in the end that the transfer to be done through the assisting physician, Dr DeRosa, but I did not feel the practice had my best interests in mind and felt uncomfortable having them handle our embryos any longer. Another couple of side notes: I do not believe in reality Dr Silber looked at our chart and previous medical history thoroughly (this is speculation). I think he saw that I have PCOS and produce a lot of eggs so he chose one of  his two mini IVF protocols, not seeing that I did similar dosages in the past with no success but he added in clomid as well to the mix. I believed when he said he was going to do mini he would be giving me less drugs based on my medical history which was sent in but I do not know if it was actually a mini for me, or what he does for every PCOS patient. This is my thoughts based on the fact that I stimulated the most amount of eggs than any of my previous 3 IVF cycles and he gave me higher doses of medication than in those cycles. I still feel scammed that he promised me that my case was easy despite lack of success in the past and that he had the magical answer for it with his perfected version of mini IVF. To me it was a waste of many months and many thousands of dollars (and more because I ended up paying for the additional transfer of embryos, storage and shipping charges to go elsewhere). I do not think that he is being malicious per se, but I do not trust that he is actually up to date on best protocols, flexible on what is best for the patient or willing to listen to their input or even willing to give a valid explanation of why this protocol is better. For example, my other RE's did not hear of ever waiting 3 months and why that would be necessary under any circumstances and he did not explain why this is necessary either.  Another example of something that happened: I was watching his online live Facebook videos less than a week after my retrieval and someone asked him how many eggs you can get with a mini IVF. He said he had a patient that just traveled in from out of town, who was young and produces a lot of eggs and she got 15 embryos (aka me). The reason I have a problem with this although he gave no actual identifying information is that it is completely inaccurate. I retrieved 25 follicles, 24 were mature and 15 fertilized. So yes, on day 1 I had 15 embryos. But on day 3 they froze 4 "beautiful embryos" which is what I actually have to work with in reality, not anywhere near 15. Most doctors (except for Dr. Silber) do not measure success based on day 3 embryos, particularly when I have had ~20 embryos on day 3 in the past. There are no guarantees on how day 3 embryos will end up developing such as in the past I would only end up with one blastocyst out of 38 eggs or 46 eggs which were retrieved at other clinics during previous cycles. The one embryo I transferred from this cycle unsurprisingly did not work. I am not writing this review to ruin his business, but as a matter of prevention to save other's money and to seek your treatment elsewhere such as in mini IVF situations considering some events that happened to me personally. He will retire sooner or later considering he is in his 70s. 

I would not go to him unless you read the above and are still interested in his care.

He said he would use a mini IVF protocol. The amount of drugs he used did not seem mini at all. I asked my other RE's and they agreed with me.

The place was really nasty and the techs too which was sad, never had this type of experience remotely like this before.

it was $10,000 for the cycle I believe, and it would be $5000 for additional FETs

Dr Silber is very knowledgeable in this field. He was able to instantly give possibilities that could be the root cause of my infertility and recommend testing that has never been discussed with me before. He is a fact kind of person amd likes to stick to the reason for the visit. He's also understanding of the struggles that come on this journey. I wish I had went to him sooner. At the retrieval as well s transfer he shares information that he has learned as well as next steps with the various scenarios that could result.

Don't wait! I wish I had sought him out sooner instead of years of other options being explored. Ask everything you can think of! He's very knowledgeable and you will get greater success being involved in your treatment plan.

Initially you are sent for testing. Once that was completed we scheduled the IVF. I was placed oom birth control to align my cycle with the times needed. I don't remember all of the mediations but a few ultrasounds were completed to monitor the follicles. The retrieval was then completed and in my case the eggs that were mature enough were paired with sperm, fertilized, and awaited day 5. Only 1 embryo made it to that stage, was frozen, and sent for testing. Once test results returned I was scheduled for a transfer a couple months later. About a week and a half after transfer I went in for blood work.

Monitoring ultrasounds were completed at the hospital which is all a part of the clinic. You have an open time frame for when to be there I believe from 6 a.m. to 8:30ish. Anytime in that time frame you can go. Patients are called first come first serve for appointments and have their own waiting room specifically for ultrasounds.

At your initial consultation you are given a breakdown of of your cycle depending on the treatment plan. Every cost from testing to medication is broken down on this plan. For the most part my plan was followed. Some medications ended up being a little cheaper than originally thought even!

Dr Silber was very direct and to the point when evaluating us and informing us on his recommendations for our fertility plan. He was enthusiastic and optimistic. when we met right before our two embryo transfers, and showed us compassion along the way.

Make sure you and your partner fully trust and are comfortable with the doctor you choose.

He only performed IVF treatments and no IUIs as he said the success rates for IUIs were far too low. He only had his patients take clomid (50mgs) leading up to egg retrieval surgeries, along with Follistim, Ganirelix and Lupron injections at various times based on your progressive test results. The medications he uses have been tried and true for him for years so he doesn’t vary different kinds of medicine with different patients.

For the initial egg retrieval (which included one frozen embryo transfer) it cost $10,400 with medications costing roughly an additional $1600. The second egg retrieval (without transfer included) cost $7500 with medication costing roughly the same as the first time. Our second (successful) FET that had not been paid for cost about $5000 with medication through the first trimester costing around $1000.

He transferred 2 embryos at a time — never any more. If you preferred to transfer only one he would have done that for you as well, but two was his standard.

Dr. Silber is a good listener and very compassionate and experienced, an example was my first consultation with him, he told me what to expect and he agreed to work with me not considering my age to use my own eggs, even after been rejected by other clinics. He is also very experienced, we had 2 cycles and a transfer and the treatment is still ongoing though. Even after our transfer resulted in a negative pregnancy, he still has not given up on me.

The best decision you will make for yourself

mini IVF, 2 cycles, produced 18 eggs which resulted in 5 embryos and we transfer 3 embryos (FET)

9 thousand plus for mini ivf for first cycle and 7 thousand plus for subsequent cycles

Not sure about the selective single embryo transfer but he does the multiple embryo transfer, for us we were not concerned about the baby gender, we just wanted a baby not the gender

He is extremely knowledgeable and understanding. We had some news at our transfer appointment that i should have had a follow up test done and he wasn’t sure if we should move forward. We chose to and wish we would have listened to his opinion. He already had another protocol ready to go.

He is older so very by the books and smart. Be prepared for a lot of information and a very straight forward answer.

IVF treatment included follistim, ganirelix, Lupron, estrogen patches, estradiol pills, progesterone shots after transfer. We completed egg retrieval and got 14 eggs, 5 mature, 4 embryos, 2 of which were watched for 5 days and didn’t make it. 2 embryos were frozen on day 3 and we had to freeze due to overstimulation from PCOS. I started progesterone shots and after getting a positive test we found out it was a chemical.

Monitoring was during certain hours, you don’t meet with Dr Silber or staff until major appointments or procedures. Scheduling all the tests were easy.

The first round of IVF, 500 deposit, 6300 due 4 weeks before, 1350 for assisting OBGYN, 3500 to the hospital, 400 for anesthesia, 150 for radiology, 2500 for medication.

He said no more than two and you have to sign consent if you want more than that. His preference was 2, higher chance of pregnancy but not as dangerous as multiples.

As a patient having a doctor get to know your husband, yourself, and then you both as a couple is refreshing. He took the time to move us from patient room once the clinical part was finished to his office for a more personal conversation. He answered every question and showed compassion the entire time. He also allowed us to learn a little about him as well. He made sure before we left we had no other questions. It was very reassuring.

Go Go Go and see what he can do for you!

We were on clomid and are currently saving for IVF. Due to our infertility factors IUI is not an option. We haven’t been able to afford a round of IVF yet.

I remember his consulation was absolutely FREE and I thought that was amazing. We only paid for the ultrasound.

He told us he bases it on the persons history and that he doesn’t always go one or the other

Dr. Silber is extremely knowledgeable in the field of infertility, and he was very good at explaining everything and the process to us. I do think there are a couple things though where he follows more of an old fashion approach (ex: freezing embryos at day 3 instead of day 5) which does work for some patients but not all. If there was something along the way that I thought should be done different (after doing my own research and communicating with other IVF patients), I would have to be my own advocate and ask that we do it (ex: growing all my embryos out to day 5, doing a uterine scratch after a failed transfer, etc). Although Dr. Silber was willing to do my wishes, I sometimes felt like I should have been given alternate options and processes instead of discovering it on my own. He is a very friendly doctor though and is willing to take on the most complicated cases.

Be your own advocate! If there is something you are wanting to try different speak up and see if he is willing to do it. He is very personable but will also be honest and upfront about your chances of success.

As a 27 year old I suffer from diminished ovarian reserve, so my best treatment option was mini IVF. For my first cycle, my protocol was Clomid for 7-8 days, Follostim every other day beginning on day 3 of meds, 1 injection of Ganirelix and then triggered with Novarel. We were able to retrieve 9 eggs, 7 were mature, 5 fertilized, and we ended up with 3 3-day embryos. For my second cycle, Dr. Silber wanted to do Denmark mini-IVF to try to produce more embryos so my meds were a little different. I don’t remember the specifics, but I did Follostim every day, micro dose Novarel every other day along with Ganirelix, and then triggered with Novarel. There were 11 eggs retrieved, 8 were mature, 7 fertilized, and we ended up with 5 blastocysts and 1 morula. We have transferred 2 3-day embryos and 2 blasts but nothing has stuck and got negative betas.

Due to Dr. Silber having a high number of patients, monitoring appointments were often crazy. Monitoring was supposed to take place between 5:45-8:30. However, if you arrived at the hospital after 7:30, you could easily expect to be there for 2-3 hours due to a long list of patients waiting to get the same monitoring done.

For our first cycle of mini-IVF we paid around $10,500 plus the cost of meds ($1,500-$2,500). The cost of the first transfer is then around $3,900. Any additional transfers are $7,900. For my second cycle of Denmark mini-IVF, we paid around $14,000 plus the cost of meds ($2,000-$4,000).

When we did our first transfer with 3-day embryos, Dr. Silber was open to a multiple embryo transfer. However, when we transferred 2 5-day blasts, he only wanted to do a single embryo transfer, but we stated that we wanted a multiple embryo transfer, so he was fine with us transferring two.

We are starting the birth control for our first IVF cycle today 9/25. So far Dr. Silber has been great. My husband and I left our first appointment with him feeling relieved and confident. He has been around for the entirety of IVF and has seen every possible situation. He gave us hope, he is blunt, and knowledgeable.

A prospective patient of Dr. Silber should be ready for a plan of action when they arrive to their first appointment. Dr. Silber welcomes you with knowledge, facts, his opinions, and his plan. We were ready and willing to pursue IVF when we arrived to our first consultation and that is the approach Dr. Silber has us taking.

Dr. Silber is having us do Denmark Mini IVF vs. doing Traditional IVF due to the fact that my husband and I are young and I still have an abundance of eggs. He feels there is no need to potentially over stimulate my ovaries whenever the mini IVF should produce a good number of good quality eggs.

Dr. Silber does not have a consultation fee. He requires you to have a trans-vag ultrasound before your first consult though. I would say the costs are average

Dr. Silber is a man of short stature but talk in wisdom and knowledge within the fertility industry. Through his experience and education he has become one of the most sought after Fertility Doctors. I personally call him the Father of Infertility, based on the research he has pioneered. Personally he’s full of life, laughter, jokes and joy. He knows how to make you smile when you want to cry. He does his best to provide you with all the details and information you’ll need during your consultation. After which you are turned over to your coordinator. The next time I’m scheduled to see Dr. Silber will be at my retrieval. This is because I’m an out of state patient. So I have to travel for every appointment which we’ve kept down to a minimal amount. He’s a strong believer in Faith and what you believe can happen, in my opinion. He’s allowing me to use my own eggs during the process and that’s my hearts joy.

Have your questions and concerns written out on piece of paper when you go in to meet with him. He’ll take the time to answer them. No question is a dumb question. Be prepared for possible changes in appointment dates because they do fluctuate. This is because other patients are being seen and based on how the medication responds to their bodies their retrieval date could change, which may affect your appointment date. Be open for change.

Based on my medical history, we started off with blood labs to make sure I didn’t have a translocation gene. Once those results came back normal we proceeded with the set protocol. THE PROTOCOL: Step 1: birth control pills for 25 days. Step 2: call doctors office with day 1 of my next cycle. Step 3: Stem Start testing was completed on day 31 (you can have this completed in your home town if you’d like, however the results have to be back to Dr. Silbers office well before close of business on the same day of testing so they can tell you when to start your medications. I opted to travel to St. Louis because I was unable to find a lab or doctors office that could complete the testing and get the results back in time. This process may require approximately a 13 days stay in St. Louis at a local hotel. Dr. Silbers office does have a relationship with local hotels that provide a discounted rate for his patients or patients of the hospital. Step 4: I began my medication protocol on day 32. This was colmid 50 mgs (1 tablet for 2 days); day 34, a Follisitm injections of 150 iu and 1 clomid 50 mgs on the 3rd day my medication protocol. On day 4 (med. protocol but process day 35) I took 1 more 50 mgs clomid table and on Day 5 (day 36) I’ll be back at the center for blood labs and ultra sounds to see how the follicles are developing. Once that process is completed I’ll be provided with additional instructions on what to do and if my retrieval will be scheduled within the next 34-36 hours. If the follicles have not developed to the desired state additional medication protocol will be established along with additional blood labs and ultrasounds until retrieval date. After retrieval we are required to stay in St. Louis for 24 hours before heading back home. We are then instructed to wait 3 months before implantation. This time period is to allow for the medication to leave the system and make sure that the lining of the uterus is back to its normal state of thickness. After the 3 months/ 3 cycles have passed then you return back to St. Luke’s Hospital in St. Louis for the implantation procedure. You will be in St. Louis for two days this time because you have to wait 24 hours after the procedure before heading home. 11 days after implantation you are required to take a pregnancy test (blood test not the standard test from the drug store or wal-mart.) Once you have the results you contact Dr. Silbers office and go from there.

For the minimal IVF procedure the cost was approximately $12,000 - 14,000.00 with me using my own eggs and my husbands specimen sample, testing and freezing for 1 year. This also include my egg freezing for one year as well. Along with the hospital charges and assisting physician (GYN).

Based upon my age and ovarian reserves Dr. Silber advised that he’d implant 2 embryos at implantation. Of course, the results could end up with twins of which we welcome and accept. His method is based upon medical history and age.

Dr Silver did not alter my protocol at all, even after multiple failed retrievals; he just encouraged me to keep doing retrievals. I feel that he allowed my lead follicles to get too big, thereby compromising the quality. I did not know this until after I had left and had my records reviewed elsewhere, when this was Brough up. I never got a call after any retrievals. I had a miscarriage at 8 weeks and a second chemical pregnancy and he never called. On a final transfer, he insisted on transferring even though the lining was 6mm. I requested a call to speak to him about this and initially was told he would call, then the nurse called me back and said he would not be calling, that he said to tell me "he does things his way and if I don't like it I can go elsewhere". This was after being his patient for two and a half years (with a break in between). I had only spoke to him once on the phone and only had two clinic visits with him. I was paying a lot of money and could not even get a ten minute call to discuss my concerns before the transfer. It was too late for me to go elsewhere. My transfer did not work. Also, I was later diagnosed with immune problems which he never tested me for.

I can not recommend this clinic. Even though he markets his clinic as good for women in their 40s and good at mini-IVF I think his protocol was still too much medications for me. For people who are very poor responders, I feel there are better clinics. I was extremely disappointed that I was not permitted to easily communicate with the doctor and discuss my care with him. I did not feel my input or concerns were taken seriously. Dr Silber said some very hurtful things to me that were unsolicited and I feel uncalled for. For example, he told my husband (when I was present, although speaking about me in the third person) that "he was scraping the bottom of the barrel" to get my eggs. It was humiliating, hurtful and degrading. I was able to go to another clinic and collect 20 embryos (still being transferred) and that was a couple years later so he wasn't even entirely correct that I had no more eggs left.

All the cycles were the same: birth control, and then started clomid daily (I believe 50 mg a day) and follistim 150 mg every other day. When they decided to trigger, they also have you take ibuprofen (or some kind of NSAID) in the 24 hours before retrieval to try to prevent early ovulation. You take clomid almost the whole time to try to prevent early ovulation

I believe it was around 7-8K including the hospital part but the prices have gone up since then

Dr Silver does not generally believe in day 5 testing and recommends day 3 transfers for most women, especially those with DOR. He will transfer up to four day 3 embryos

His main strength is that he will accept older women. A bit patronizing, but still nice. If his regular treatment works for you, then you'll be happy. The RE was really nice, and the poor financial officer was really kind though she was placed in an unenviable position. Asking to go beyond that however will not work well. First, he only meets you once. I'm really tired of doctors who do this. My last one was similar, but not nearly as bad. Silber does not appear to be up on the latest IVF news anymore. Finally, I think it is unconscionable to have people chase you down for their money. It's bad enough when you're desperate and things do not go well. I paid on time and based on the schedule. Had he not received his money, I would not be scheduled. How is it that he gets to take his time returning my reimbursement?

Honestly, find another doctor. He takes no health insurance and insists you pay out of pocket for his services. Plus, you have to argue with people about returning your money in a reasonable time. Who wants to do that?

birth control pils Clomid, Folistim 150iu Lupron I cant recall the rest.

12,000 out of pocket not including medication, also out of pocket

Dr. Silber’s strengths are his years of experience and all of the conditions he has treated and all of the peopke he has been able to help. He is also straightforward; he will tell you if it may or may not work. Dr. Silber’s weaknesses are his Clinic is in a hospital which he knows little about how the patient is treated when he is not there. The hospital also charges a lit and is not straightforward with how much they charge if you choose to use insurance for some procedures. The hospital can keep you waiting for 4 hours for an appointment and Dr. Silber does not know because his office is not in that hospital or department. Dr. Silber is very clinical and although being sensitive to my emotions after a failed procedure; he could not understand why I did not want to hear about donor eggs while still under anesthesia and expecting to use my own eggs. It is the same he says. To a woman who expects to have her own eggs that day; it is not the same and takes some time to process.

He’s very knowledgeable but very old and is more on the clinical side vs emotional side. He did not like to see me cry. See this is why we use donor eggs! OMG.

He used a low dose hormone protocol for Diminished Ovarian Reserve. It was not successful in making any eggs.

A cattle call with a long, long line.

About 16,000.00 per egg retrieval attempt.

He was well informed and explained why to transfer one egg vs more and in which situations and age of the patient. Then he asks you what you think.

He thinks he's right all the time and down plays anything you've been told by a previous Doctor, unless he shares their opinion. He's smart. Really smart. And tries new things. He thinks outside of the box. He said to us directly that he isn't worried about his stats or success rates, he does what's best for the patient and the numbers will work themselves out later if they are doing the best thing. His bedside manner is a little lacking but he has great assistants who make up where he leaves off. I'm always comforted the our assisting Doctor DeRosa.

He will be blunt and direct. Listen to him, he knows his stuff, even if it's not what you want to hear.

I did "Mini IVF" three times. Each time I started with 50mg Clomid every day, on the third day I started 150 units injections of Follistim. This continued through my daily monitoring of blood draw and ultrasounds. I would end the medications when instructed and follow with Ganirelix and Indocine tablets before retrieval. One cycle we attempted Denmark Mini. The only difference here was that I took the Follistim injections every day. The end of this cycle would have had some different medications but I did not respond well to this treatment, and the cycle was cancelled. I don't remember the plan for medications at the end of the cycle.

There was a window of time each morning to be received at the hospital. My first round I followed the instructions and called for a "scheduled time" during that window. I found out quickly that the scheduled time didn't mean anything. The best thing to do was to show up as early as humanly possible and get on the list at the door. The first day of a cycle was the busiest. All of the women in that cycle had a day one appointment. We all had ultrasound and labs. After my first day, I learned that if ultrasound was backed up it was wise to walk to the lab and see if i could get blood drawn while I waited. If the lab was backed up, I would go make sure I was on the ultrasound list and/or how far down the list I was. In the beginning, before I had learned all the tricks it could take up to three hours to be seen by both ultrasound and lab. By the end of my fourth monitoring cycle, I was in an out in under an hour. Showing up early....like thirty minutes before the monitoring time frame window opened was critical.

About $15k for the first Mini IVF cycle (I'm including the cost of my medications). This also includes the first transfer. All cycles after this were about $10k (again, including my medications) but this does not include any transfer procedures. If you end up requireing additional transfers, above the first one you pay for with the first cycle, then you are looking at around $5k.

He will only transfer two embryos at a time unless you sign a form that you will use selective reduction. I wouldn't sign the form. I never had the possibility of more than two embryos transferred at once.

Our initial consultation was delayed due to a high-risk procedure he had been called on. Once we were led to his office, we met a very funny man who takes his job seriously and personally. We discussed our medical histories, his practices and what he thought would be our best route to take in our journey to build our family. He assigned us a coordinator and from there, we had continued nearly all communication with Dr. Silber through her. When we met Dr. Silber again for our surgical consult immediately prior to our 1st egg retrieval, he was alert, concerned for our nerves (understandably a high-anxiety moment), and was easily able to put both of us at our ease. After the retrieval, Dr. Silber met with my husband (I was in the room coming out of anesthesia) to discuss the procedure and its results, the ICSI and its results, as well as our next steps for the following 48 hours. We are looking forward to seeing him again in the weeks to come.

I would suggest any prospective patient to be prepared. He will answer any and all of your questions, and you should be prepared to discuss intimate details of your infertility with a man who may resemble your Grandfather. His office may be busy, as is he, but he will treat your time together personally.

We are "ideal candidates" for Dr. Silber's Mini-IVF procedure. This is "minimal stimulation IVF" where the woman is given lower doses of Clomid, Follistim, Ganirelix, Indocin, Lupron, Gonal-f, and/or Prefera during the egg retrieval cycle. The body will still stimulate multiple eggs to mature, however the quality of the eggs is the main target and not so much a large quantity of poor eggs. Our retrieval cycles included Clomin, Follistim, Ganirelix, Indocin and Lupron. Our 1st cycle resulted in 5 mature eggs retrieved, and 2 successfully fertilized embryos. Our 2 little embys are chilling out, waiting for their sibling embryos to join them in May, and their chance at life in September.

My monitoring experience was what I would expect while in a hospital setting rather than in a clinical office setting: between certain morning hours (6am-8:30) on the days I was directed to monitor, I would write my first name only on the list and wait in the waiting room with any other waiting patients. Sometimes there were quite a few people, other times it was just me and one other person. It being a hospital, not every person in the waiting area is a patient of Dr. Silber, however the technicians are highly skilled and very adept at their careers. In our first cycle, I saw roughly 4 different ultrasound technicians who were very kind, professional and understanding. Their level of discretion is outstanding, and I felt each one respected me and my body during the entire process.

In our initial consultation, we were provided with a bill of $10,400 which covered fees for the Doctors, hospital, anesthesiologist, and diagnostic imaging for our 1st round of egg retrieval and includes 1 transfer at a later date. The cost of medication was separate, and totaled roughly $1,052 for the 1st cycle. We have signed on for a separate egg retrieval cycle, which is totaled at $7,050, not including medication which will total roughly $1,052 again. In addition to the costs of care, we do not live near the St. Louis area and so we would have also incurred hotel and transportation fees, if not for a very hospitable friend-of-a-friend who opened her family home to us during our time in the area. Also as gas prices have been on the decline in the Midwest, our transportation fees have been manageable.

We have not yet progressed enough in our journey to the transfer stage, so I cannot speak to this. As I will never be as young as I am at this moment, we agreed the more embryos we can freeze now will give us as many chances at building our family as we can have.

I was in a herd of 30 other women with the same target date as myself. I met with Dr Silber only once during the consultation and was assigned a coordinator that was supposed to facilitate the process. Aside from an inch thick packet of information they mailed to me, I was not given any other information unless I asked. The first day I was supposed to start injections I discovered the lab didn't send me a pen to do so - I immediately called Silbers answering service and the lady said she left him a message. No call back and his office insisted they never got a call from the service. The day of my egg retrieval Dr Silber saw me beforehand (13 mos after my initial consult) and had no knowledge of my personal situation. In fact he made general assumptions that based on my age I had low ovarian reserve - which was completely untrue. He then gave me trouble about waiting 13 mos to have the egg retrieval so I had to inform him that during that time I saw his reproductive endocrinologist who diagnosed and corrected a septum in my uterus that would have caused ivf failure. So unfortunately I got upset and again felt like a single cattle in a herd going into my egg retrieval. Such disappointment.

If you are a first time ivf patient please find someone who has experienced this to help you through the process. It's overwhelming and their paperwork doesn't fully explain what to expect.

I did mini ivf treatment and my protocol was 50 mg of clomid days 3-trigger shot with 150 iu of follistim 3 days. I took Ganirelix then Lupron to trigger.

Blood work and ultrasounds were at St Lukes hospital.

Mini ivf ran $10,500 plus meds

He was very forthright. He seemed very knowledgeable. He also didn't seem to want to bill for every little thing - he has a flat rate that covers whatever is necessary without adding to the charges for extras that you might need.

I would go to him first - I wish I had known about him earlier. I went to a local doctor who (after I got my medical records) transferred an embryo that the embryologist had listed as not transferrable (he got paid for that). I did have two perfect embyos that were transferred but I miscarried them. I also had a chemical pregnancy. I feel that had I went to Dr. Silber earlier, I would have been able to have a child using my own eggs because I was responding back then to the medications.

We used injections and oral medications. Dr. Silber said due to my age, he wanted to do a series of 3 "mini IVF's" to get as many eggs out as possible and freeze them as embryos prior to moving on with putting them in for pregnancy. Unfortunately, by the time I found Dr. Silber, I was no longer responding to the medication so he cancelled the cycle and told me I would need donor eggs prior to us moving forward.

Dr. Silber - $10,900, Hospital costs - $2,500, Anesthesiologist - $400 and Radiologist - $150

I don't. He said he would only transfer 2 embryos in me (he would only transfer 1 embryo in a younger person). I think that is responsible so you don't get the octomom situation.

Dr. Silber is well known in the field and has his way of doing things. You communicate with him during office consultations. Afterwards, communication is with the staff. Cycles are scheduled on specified dates with a group. This may or may not work for everyone but allows more predictability if you have a busy schedule. I wish I had a little more input in my care. Dr.Silber does not accept insurance.

Recommend asking as much as you can during the consultation. He has his way of doing things so make sure that you are fully on board with his recommendations prior to proceeding.

Mini IVF with frozen cycle. He thought fibroids was the source of my infertility and due to age recommended I do a cycle and freeze embryos prior to treatment of my fibroids.

He does grouped cycle so be prepared to wait for testing and ultrasound. It’s first come first served.

His cost is approximately $1100. There are additional costs including anesthesia and fee for his associate.

He recommends 2 embryo transfers or selective reduction if more than two embryos implant

I decided not to do the procedure with mini ivf due to the distance and time it would take. If I lived in St. Louis I would have proceeded for sure. I really trusted him and appreciated his very direct approach.

Be open to his direct approach and honesty. I felt he had a great deal of integrity.

He suggested 1 round of mini ivf and then suggested donor embryos

I dont remember - sorry bacause I didnt move forward with the treatment. He did the testing at the facility and we had the results the same day. He charged that to our insurance. I believe I paid maybe 400 out of pocket for all the testing. Not quite sure

for my age he recommended mini ivf for the highest quality eggs