UCSF

I had a large number of tests ordered to try to get to the bottom of my recurrent pregnancy loss. However, a few tests that were supposed to be ordered were left off of the lab request. And in one case the wrong test was ordered (the name sounded similar to the correct test). If I didn't know exactly what tests I was supposed to be getting, I wouldn't have been able to catch all of this and correct it.

1) I had a progesterone blood test to confirm ovulation and came back as 0 (did not ovulate) when I know I had. I demanded they run it again and it came back 26 (did ovulate) 2) I've had to call/email to get results of tests and/or inquire about my next protocol 3) I've had to call/email multiple times to get Rx's phoned in

See above

For each of my three betas, the lab results were released in the morning in the online portal (10-11am). I would call the clinic multiple times to try and speak to a nurse or doctor about the results, but wouldn't hear back until 4-6pm in the evening. This was very frustrating for me. There were a couple of times that I was billed extra costs unexpectedly, which I think was more about my not being able to meet with the financial counselors ahead of time than any sort of shady business practices. I also had one nurse who had terrible communication skills. I was switched to progesterone in ethyl oleate after getting pregnant because I became allergic to the sesame oil, and I still haven't been able to get reimbursed because I was "self pay" at UCSF and so they did not submit a prior authorization to my insurance. (I do not have infertility coverage but do have coverage after getting pregnant.)

Billing is a nightmare; from what I've heard it is like this at every IVF clinic. We'd often get emails at 7 pm the night before a procedure that had our bill (typically for thousands of dollars) and the bill would be due early the next morning or else they would discontinue the cycle. Often these letters included language along the lines of "you're going through a hard time and this is a lot of money. You need to sign that you understand everything in this letter. You're 100% responsible for all of the complex fine print here. If you don't understand you need to have a meeting with our billing team prior to signing." Considering we were getting complex bills with legal agreements attached to them — getting them late the night before they were due was extremely stressful. Also, we learned to read the bills carefully because often the amounts were wrong.

I think I've elaborated on what went wrong during my previous responses. But in particular there was an issue with my Day 2 embryo report results not getting communicated to me in a timely manner that caused me enormous stress during my final cycle there. This left me not knowing whether i'd be doing a Day 3 transfer the very next day, or whether my embryos would be cultured to Day 5 and sent for PGS testing. The nurse apparently couldn't get through to my cell phone and left multiple messages there all day long without trying any other avenues, such as my email or my husband's cell phone. When the nurse finally connected with me it felt like she was blaming me for the messages being delayed on my cell phone. I have no idea why my cell wasn't working properly but a nurse has to be a better problem solver than that.

Nurse case manager Shem did not order all of my medications required for my treatment I have an intolerance to Valium (suicidal ideation) which I communicated multiple times and they still ordered it for me. Shem and Dr Mok-Lin pushed for me to terminate pregnancy at 5.5 weeks due to no heartbeat on an OB scan, insisting I was much farther along, and confused my records with another patient. Clinic hasn’t responded to requests to forward records to other hospitals or release records to me.

Billing and paperwork is a nightmare there. I sent my medical history over 3 times and they never got it. You can't get a hold of the billing department to get any questions answered.

The appointment and scheduling needs work. Taking time away from work for an in office visit is already an inconvenience. I mentioned the two times when the automated voicemail said to come in when I could have had a 15-30 min phone call instead. Also there were a couple times when I was in the waiting area for 20-30 min and had to keep checking in so they'd remember to let me into see someone.

I've noted these in previous questions but: -IUIs 1-3 the nurse didn't call my RX into the pharmacy and I had to pay out of pocket to get it locally in time and insurance wouldn't reimburse IVF #1: They never called with results after monitoring appointments. Took all day to get news after egg retrieval. IVf #1: Not thrilled that most of our embryos didn't survive and they didn't bother to tell us until we were there ready and excited for our transfer IVF #1: UCSF asserts that they are supportive of Eastern medicine practices like acupuncture if the patient wants and you can make arrangements to do this at the clinic. I called days before my transfer to make arrangements for having acupuncture before and after the transfer itself. We arrived over an hour before the transfer as instructed but they just had us wait. We sat in the waiting room for an hour and had to delay the transfer because they couldn't seem to find a room to put us in. Every 20 minutes or so I would ask but they would just tell me someone was coming to get me. The nurse then came out to take me to my transfer and I explained I'd be sitting there for an hour waiting to do acupuncture and I really wanted to do that first since it was our plan, and I was paying someone for their time. She was pretty annoyed about it. It was a lot of stress during a time that should NOT have been stressful. They ended up putting us in a freezing cold sterile room with bright lights (great for acupuncture and relaxing). -IVF #2 the nurse we worked with on all our IUIs and IVF #1 tried to sign us up for IVF Orientation forgetting we'd already done it. -IVF #2 the nurse dialed in for our phone appointment. The whole point of the appointment was to review the calendar but she had forgotten to send it to me and it wasn't actually ready so she had to reschedule -IVF #2 my protocol said one thing and the voicemail they left said another regarding the trigger shot IVF #2 our final phone appointment with the doctor, he never showed up. We had to call the after-hours line and have him paged. No explanation or apology for missing the appointment (and this was the appointment where he told us we probably shouldn't move forward with anymore ART)

They didn't diagnose my uterine septum for 2 years-- they just never looked there as they identified my issues as ovarian. Huge mistake that cost me two years of pain, emotional anguish, and lots and lots of money.

I had one cycle when there was a complete breakdown in communication from the doctor to the nursing staff and a cycle was canceled. It was very disappointing.

Disappointed in the level of communication and indications of how to proceed in future.

I had lots of problems with the UCSF Fertility practice: 1. wrong dosage on prescription given (which Dr Cedars later acknowledged and apologized for) 2. wrong dates given for post-cycle testing (expensive and creating a wasted cycle) 3. failure to test if I was _already_ pregnant before prescribing me a round of fertility drugs which are absolutely not meant for pregnant women 4. mistakenly canceled appointment with Dr Cedars with my rescheduling etc etc

At one point, based on information they provided after my procedure, there was question / concern that they may have implanted the wrong (some other patient's) embryos. While this was cleared up swiftly, any doubt in this area is unacceptable. Billing and admin were a total disaster and I was over billed routinely / UCSF continually failed to submit to my insurance provider.

Already did.

Miscommunications, delays in prescriptions and insurance authorization led to cancellation of a cycle.