UPMC Magee

He was able to explain items in common terms, however did not appear to always state all the steps to the process. Twice he approved for nurses to order drugs for the next step prior to testing being complete, this resulted in me paying over 1,000 in drugs that I can't use.

Make sure you know your nurses name. They are the most important.

He discontinued my metformin after having a blood sugar test, and stated I did not need it. He uses letrazole for ovulation for PCOS, as he stated that Clomid does not work well with PCOS. They have changed to a different drug for IVF, so they can control when you have your period, as they only have embryologists on certain weeks in Pittsburgh/Magee now. They used to use Ganirelex. He uses pregnyl, follistim, progesterone oil/injections for IVF.

My IUI was covered with insurance. IVF would cost 12,000 for a single cycle with ICSI.

He prefers single embryo transfer for decreased risk of miscarriage.

He was always professional and optimistic. The first RE I ever saw at 27 years old mentioned IVF at the very first visit, before running any diagnostic tests. I had met with Dr Collins several times before he even mentioned IVF. I feel as he is determined to figure out what is wrong with me before jumping to conclusions.

Be prepared and ask questions. He is fairly quiet and doesn't necessarily provide all the information upfront, so ask questions if you need clarification.

I don't ovulate regularly, and Clomid doesn't work for me. So we started with 3 cycles of Letrazol and Pregnyl, followed by timed intercourse. After that, 2 cycles of IUI with the same drugs. After taking an extended break, we are trying another ~2 cycles of IUI before moving on to IVF.

My insurance didn't cover any procedures, so I was given a "cash discount." IUI cycles were approx. $1000 each, not including drugs.

Dr.collins is not warm and fuzzy but honestly that’s what we needed. Doing any fertility treatment is draining. He came in told us what to expect and what was happening. He is very compassionate about his job and takes time to listen. I needed that and still do during this emotional roller coaster.

Just be honest and express your needs. He is there to help and guide you so go in with a list of questions.

For my iui, it was getting vaginal ultra sounds and bloodwork. He then completed the iui and if it was on a weekend we went to Pittsburgh, or during the week did the iui with him.

Insurance does not cover iui and no longer pays for my ultrasounds and blood work. Each iui cycle has cost us around 1000 dollars

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Dr. Menke is honest about your expectations, but she’s not willing to go outside the box. I presented to her research of similar patients in my situation and requested injectables in addition to Clomid. Because my hormones were normal, she’s refused to add them.

Be prepared to see her and actually speak to her only a handful of times. I think she’s thorough when she gets the chance, however I feel that she’s overwhelmed with patients and they get lost in the shuffle.

We started at 50 mg of Clomid which didn’t result in ovulation so we stair-stepped immediately to 100 mg which resulted in a positive ovulation. I took Clomid with timed intercourse for three cycles and then after fighting with the nurses to try to move on to IUI, we did two IUI cycles that failed. I seemed to be the only one who knew my protocol because I constantly got misinformation from the office staff when I’d call on CD-1.

My insurance only covers a $2,000 lifetime max for infertility. I’ve had several bills from blood work and ultrasounds that I still haven’t paid off yet.

I only met with him once in three years. He just told me to lose weight. He looked at my chart and said it could be endometriosis but he didn’t want to test for it as I have a severe reaction to some anesthesia and he did not want to risk it.

Do not get your hopes up. Be prepared to feel like you are being processed. He did not give me any insight as to why I was infertile. He wanted me to try iui and see what happened.

Dr. Sanfillipo wanted me to start weight watchers and did a full blood work up. Nothing was concluded from the blood work. He then wanted me to begin with an aggressive letrozole dosage for an iui cycle. We also did vaginal sonograms and HSG.

The cost was higher than their clinics. An iui cycle out of pocket was around $1800 with all medication and testing.

None.

My heart would like to give my Dr. one review and my head would like to give her another. It is hard for a Dr. to get to know a patient when they are rarely seen by them. In the past year I have maybe seen my Dr. 3 times. However, I have probably visited the clinic sometimes twice a week. The majority of my interactions have been with the nurses and residents. Each time I go to our clinic I am seen by a different person. This was something I did not expect. I had 3 IUI's and they were all performed by different people, to my knowledge none of them were the Doctors in the clinic. I do not have anything negative to say about the individuals I saw for my various testing and procedures other than they were not my doctor. I feel like there should be a little more consistency with who is treating the patient. I had to have a pollup removed from my uterus before I could start my IUI's. My Dr. did not perform that procedure, She made it known that her schedule did not make her available and that a different doctor would need to do it. A Dr. who I had never met until they were wheeling me into surgery. To me, that is a bit odd. Infertility is dealing with emotions, it is dealing with intimate parts of your body and I feel that you should know and trust the person handling them. Dr. Katari did come to visit me and wish me luck before my surgery, which I thought was very nice. However, it is very odd that I am in her care and rarely speak or meet with her. On a phone consultation her and I had she told me that IVF is probably a better option. When I told her that I would like to know why I cannot have children before I consider putting a financial strain on my family because we could not afford such a costly procedure she suggested I get another job so I could afford the procedure. Whether her comment was meant to be helpful or not, it was hurtful and unprofessional. I also do not feel that I have received definitive answers on medical things that were found while doing testing. I think my Dr. could be more descriptive with what they found, such as fibroids, and if they are or are not hindering my ability to carry a child. I feel that a lot of the times I was reeving half answers instead of all possible scenarios. There were days where I really appreciated my doctor and felt I was in the best hands, and there were days where I did not believe that to be true at all. Does that have to do with me thinking emotionally vs. rationally? Maybe. However, I do not know anyone on an infertility journey that is not feeling the same way.

Be your own advocate. Be your own voice with your infertility journey and what you are and are not willing or able to do. You are in good hands, however you may struggle from time to time wondering if you are.

I believe I am diagnosed with unexplained infertility. I am not too sure since I was never told my exact diagnosis. The first year there were many tests. Egg quality, egg count, sperm quality, sperm count, more internal ultrasounds than I have ever experienced in my entire life, so much bloodwork that I actually began producing scar tissue in my arm from the amount of needles. The testing was thorough and necessary. When they said be patient during this journey they were right! I feel that all the testing was done appropriately. If there were negative findings, such as fibroids, we would do another test and another. From the time I met Dr. Katari the goal was to be healthy enough to have an IUI performed. After almost a year we go to that point. We did two u-nmonitored cycles and for the third cycle it was supposed to be monitored. I appreciated that Dr. Katari was trying to save us some money by not doing all monitored cycles and she said that I was ovulating very regular so doing at home testing would be fine. The third cycle she wanted monitored to give us the best chance. My communications for the IUI procedures were with the nurses and residents only. I never saw my Dr. through any of the procedures or testing. After my second IUI failed and I was told to get ready for my 3rd I received a phone call right before I was supposed to start taking the chlomid. It was the Dr. office stating the the Dr. would not like me to do the third IUI this round because she wanted to me have another ultra sound to check my tube stability. This threw me for a loop. I was prepared for another cycle and without much explanation the plans changed from one day to the next. I had to have an ultrasound in a different department, who always had difficulty scheduling me within the correct time period my infertility Dr. needed the apt. to be. When it was time for my third and final IUI I knew that it was supposed to be monitored. When I called to start this cycle I said I was told this cycle was to be monitored and asked for them to explain to me what else needed done. I was received with the response of "this one does not need to be monitored the Dr. said you can do the at home tests". Again, this was frustrating because I am preparing to get ready for our final cycle, and the information I am receiving is different than the information the Dr. had already given me as a game plan. Again, no explanation about the change in plan. I never knew if it was a miscommunication because I am dealing so little with the Dr. or what. I did end up doing a monitored cycle for round 3 but unfortunately it still did not work.

The testing and surgery to remove the pollup was handled by my insurance. The un-monitored first IUI cycle cost approximately $400. That was for the insemination only. The second un-monitored IUI cycle cost approximately $700 because aside from the insemination I also needed blood work done one time because my at home tests were not reading correctly. The monitored cycle I did, which was my last IUI cost approximately $1,300.

Dr. Sanfillipo is always very thorough in all of my appointments. He is also very candid about any health risks that I might encounter during treatments, which I appreciate. He never makes me feel like any of my questions are stupid.

Healthy diet and weight is very important to him.

We used femara with an ovidrel shot for 4 cycles without ovulation. We then tried 1 clomid/ovidrel cycle during which I did have one small follicle and ovulation, but did not get pregnant. I am currently trying to lose weight before we try the clomid again with IUI. Dr. Sanfillipo did not recommend injectables without IVF for me due to the high number of immature follicles on each of my ovaries during my 5 cycles. I found this frustrating at times but I appreciate that safety is always his number one concern.

With my insurance, each femara cycle was roughly $150.00. My initial testing was around 500.00

Dr. Sanfilippo was not knowledgeable compared to other RE's that I have worked with. He was not compassionate or willing to take ownership of his patients. It was a very impersonal visit with him reciting what seemed like a script. He had not even reviewed my records beforehand. It was an overall terrible experience. I would never do an IVF cycle with him or his staff. I had a special request, and they were unable to make any accommodations despite the circumstances. They definitely did not show any compassion.

Go elsewhere if you can.

He gave me very generic recommendations, and did not provide specifics at our consultation because he did not even formulate a plan.

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She was very knowledgeable about infertility and was willing to explain things in an easy to understand way. She was very upfront about options and potential outcomes and tried to make you feel confident about the decisions you were making.

Go in knowing that you will have a strong support system

We had 3 IUI cycles. They all included a pregnancy blood test to confirm negative during period. These all were done using 5mg of letrozole cycle days 3-7. I was instructed to use ovulation predictor kits at home. Then a vaginal US on cycle day 12 or 13 and based on follicle size I was instructed to give the Ovidrel trigger shot and within 24-48 ours they did the insemination with a urine pregnancy test 15 days post insemination.

So far OOP for 2019 I have spent over $600. However, it might have been more if this MD was not considered in my preferred network

Dr. Sanfilippo has amazing bedside manner. He takes the time needed at EACH visit to go over everything and always makes sure he answers any questions you have. He also will go over your history at each visit to make sure HE stays caught up on changes and refreshes his memory for any specifics to you and your case. He sees hundreds and it's refreshing to know he always has YOU on his mind during your visit.

Listen to him. He knows what he's doing. Do all the tests, they ARE necessary and he will find a treatment plan suited to you and your needs. He has a positive pregnancy test as his main goal when it is yours.

First you will have a sit down consultation with him and potentially one of his partners. He will go over your previous history and what you wish to accomplish in his care. He orders a full panel of blood work depending on your case (you'll also find out your blood type!). He then ordered a sonohysterogram (SHG) to check on uterus health. From there, he ordered a Hysterosalpingogram (HSG) to check on Fallopian tubes and more detailed uterus health. After all results, he goes over them with you during a follow up and together you make a plan of treatment. He then prescribed timed intercourse with either clomid or letrozole. We would do a few treatments of that and if nothing worked, we would do some monitored cycles with ultrasounds and continue from there.

Costs are average to above average for infertility treatments. He bills appropriately, it really depends on your insurance and what is covered. This is not his fault.

From our very first visit she was very down to earth. It was like sitting there talking to a friend. She was very warm and answered all of our questions. We told her to be as blunt and up front as she can and she did exactly that. She throughly explained the testing process for me, she even came in unexpectedly when one of the tests they were doing were not going well with two of the other PA’s. She made sure I was ok and asked if I was ok to get home/back to work. She’s very considerate and very through and she makes sure you understand the process before leaving her office.

Go with an open mind and heart. She can either beat around the bush and be soft but we asked her to be brutally honest and she was- as an RE should be in my opinion.

I used clomid 100mg from cycle days 3-7. Ovulation kits starting day 9. They had me come in for an ultrasound on day 12 to see how my follicles were. If I had a surge when I tested on day 12 or before I was to come in for bloodwork. Unfortunately I didn’t have a surge the first 2 times so they did Ovidrel on day 12 or 13 and did the IUI 48 hours after that and used progesterone 100mg suppositories until my next period. My 3rd IUI they waited until cycle day 17 ( I surged later in my cycle than most women) but I still had a negative pregnancy test.

Each cycle was about 1,300. A visit with her was only 40.00 (my copay) And my preliminary testing was not covered by my insurance, which I had to pay my deductible (1,200)

Dr. Marie Menke was caring and compassionate. She was also professional, she offered hope but didn't offer false hope. She always remained professional. Dr. Menke was easy to talk to and have difficult conversations with.

I would advise them to go in with an open mind. Dr. Menke doesn't sugar coat odds, however she does give you hope.

I had various blood work and ultrasounds, including a sonohystergram in January 2018. All bloodwork and US's came back normal, providing no answers to why we are not able to conceive on our own. We decided to move forward with IUI/Clomid cycles. After each IUI I also used vaginal progesterone. During my second round of IUI I got severe headaches from the Clomid, the headaches were solid all day for over a month. For the third and fourth cycles I was switched to letrozole. After 4 failed IUI cycles, we re-evaluated and decided to move forward with IVF. After deciding to move forward with IVF we switched Dr's.

My insurance covered office appointments and some testing/diagnostics. It did not cover the IUI rounds themselves, which were $485 each.

Although we discussed moving forward with IVF with Dr. Menke, we did not discuss in details the IVF procedure.

Dr. Menke has a very pleasant bedside manner. She was very open with what her expectations were. She listened to our questions and answered appropriately. The only negative thing I can say is she was not very open when I suggested other options. I questioned possibly adding a new medication to the regime multiple times after researching success with other patients in our situation. She quickly shut it down and told us it wouldn't work.

Stand your ground. You need to sometimes be your own advocate.

I have tried Clomid unsuccessfully for many cycles with a previous doctor. Due to that, Dr. Menke decided that we should try 7.5mg of Letrozole to bring on ovulation. After roughly 4 cycles she suggested adding an Ovidrel trigger shot along with the 7.5mg of Letrozole. That cycle, I ovulated on my own without the trigger shot resulting in negative pregnancy test. We have unsuccessfully done two more cycles with 7.5mg of Letrozole alone. Dr. Menke suggests going to IUI next. I asked her to add Metformin to the regime, she refused. She stated that my levels were fine. When explaining the research I had found showing the success with women who have PCOS, she said that my case was different than those women.

Charged roughly $500 per ultrasound in a treatment cycle. Cost of Ovidrel through special pharmacy was approximately $100 without insurance.

I met her once. I know that all of my care was communicated to her through her nurse. After my first iui I never seen her again. I thought we would have had more communication face to face concerning my care so my experience with her was distant, meaning no connection. I just didn't feel like I received or was able to establish a patient and RE bond with her.

At consult let her know your expectations.

Femara CD 3-7 to induce ovulation and increase mature follicle count. Femara worked but once a follicle became mature I had to trigger because she don't want multiple mature follicles. Clomid cd 3-7produced less follicles but gave me several mature. I asked about injectables to better my chances and she declined stating that I was doing well on oral medications.

Copays collected at registration, insurance covered 80/20 after my deductible.

When I first saw the doctor she was willing to move forward. She was not giving me a run around and was willing to help. I was ready to move forward and she was with me the whole time. She explained the process were going to try with the IUI and what to expect each time. She is very easy to talk to and I don't feel rushed during my appointments. I'm hoping the second IUI will be a success!

If you are ready to move forward so is she! She is willing to help you get to where you want to be!

My treatment was insemination with my husbands semin. To inject the semin with a cathador to help the sperm arrive close to an egg. I was told to take a pregnancy test the first day of my period to make sure I was not pregnant. They would call in Clomid and take for five days. I was told to have intercourse every other day starting day 9 of my cycle. I was told to use the ovulation predictor kits day 11 and when a positve ovulation test appeared I would have an IUI the next day. After my IUI they had me use Prometrium after until 15 days past insemination. Day 15 check pregnancy and report results to the nurse. If negative stop Prometrium and your cycle should start within a few days and start the procedure all over again. She was clear as to what each medication was for and why I need to take it.

My copays to meet with Doctor Menke were $50. It didn't matter if I was there for 5 minutes or an hour. I feel she could have emailed the information one time for a five minute conversation. My blood work I never had a copayment but received bills in the mail. My IUI is covered under insurance but was billed later for I believe $247.00 but it may be all the payments for bloodwork that they didn't know for my insurance.

Dr. Wakim has years of experience helping women in our area with becoming pregnant. He is hands down the best for difficult cases as mine was (1 tube, 1 ovary, only tube blocked, diminished ovarian reserve). He was thoughtful during consultation and no nonsense during the procedures.

Ask all your questions when you are with him. You speak to the nurses for the rest of the treatment (other than during retrieval and transfer). He is blunt, tells you exactly what is going on, but not harshly. I actually prefer this.

Antagonist protocol. We were “going to squeeze out all the eggs we could” as he said. I was on an average dose of Gonal-f, and menopur. I was not on birth control prior as this doesn’t help a sleepy ovary (my ovary was in temporary POF due to a traumatic ovarian rupture from an ovarian ectopic). The dosage was adjusted after no major change in Estrogen level after 5 days. I was maxed out on both and continued to stimulate for another 10 days. We added the holding drug in at day 10. He was successful in getting my ovary to respond with this protocol. The goal was to take an aggressive approach and it worked. We had 8 eggs retrieved (again, only one ovary so this was great for us), 6 fertilized, 4 made it to day 3. Our clinic has a requirement on number of embryos to do a day 5. So we did a 3 day transfer of 2, then held our breath for our other 2. We ended up being able to freeze the remaining 2!!

They offered early morning monitoring appts which while early, worked wonderfully for anyone working long hours.

Procedure - $11000 (retrieval, transfer, scans, etc) Medications - $15000 Storage - $750

Due to my age at transfer (33), they recommended one but left it up to us. He made sure to explain why they recommend one at my age.

Dr. Collins was able to pin point what went wrong with my previous doctor. My previous doctor had not mentioned that I could have PCOS and based on my egg retrieval numbers (done with previous dr) he said there was no way I don't have it and was able to adjust the plan he originally thought we'd do to compensate for that. He's a very smart guy and maybe not the most personable (kind of quiet) but I don't care as long as you get the job done

Make sure you ask him anything you're thinking. He might not always answer your concerns outright, but if you ask him about it he definitely already has considered it (at least in his head) and can give you a good answer/plan.

I did a FET. He kept me on birth control for 2 months then we moved to gentle stimulation with estradiol. He used PIO for my progesterone as he didn't want to risk it with crinone or endometrin (not being as effective).

The transfer itself was ~$4000. Ultrasounds & Appointments came in around $1000. Medication was ~$6000

My last cycle before Dr Collins was a fresh, single embryo. I (probably/definitely) had OHSS but my previous dr had implanted anyway (at my request since it was my last day living in that state/being on that insurance). I miscarried. Dr. Collins allowed me to do 2 embryos and we were able to get one live birth

Dr. Menke is fantastic! She is attentive and compassionate. She is one of the only reasons we've stayed with the clinic. She explains things thoroughly and is also very aware of the expense of fertility treatments and does her best to minimize them.

Beware of the rest of the staff.

Dr. Menke utilized a very specific estrogen protocol to reduce fluid build up in my lining. She was very thorough in making sure we had a successful transfer

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She followed current guidelines with a preference for a more conservative approach.

He goes though everything and explains everything that needs to be done, hes never in a rush to get to the next patient and always makes dure we understand evevything. But its not just Dr. Sanfilipo but his entire staff that works together, if we have questions we cab call anytime and get an answer that same day, and we always have lots of questions. If tests need to be completed they always have room for us. The entire staff if so caring and we definitely aren't just a number in the patient world, we are there to help make our dream come true of having a baby and he is there to do everything in his power to make it happen. When we started this process i was diganosed with endometrial hyperplasia with atypia. So I had to go see the oncologist before we could move on with my fertility treatment. After treatment for my precancer and lots of biopsies I got the ok to go back to the fertility treatments but only have 6 months to try. This would be an absolute dream for us to get this grant and make our dreams come true.

Ask questions, they are there to give you the answers your looking for.

We recieved a paper with all the costs the day we went in for our fertility treatment, everything was very clear, yet, very expensive.

She was very helpful and understanding and compassionate. She respected my medical knowledge and my needing to understand things. She respected my worries and hesitations. Even though I did not get the results I wanted with those 2 IUI procedures, I would recommend her. We just moved back to State College, PA and that is why I'm not still seeing her.

Advocate for yourself and trust her.

We used IUI without injectables at this point because I am ovulating on my own and she didn't want me to hyperstimulate. My husband's count is good so she wasn't worried about that. My ovarian reserve is low so that is why we are starting these treatments early rather than trying oral medication and intercourse for longer.

It was expensive but manageable because I had good insurance as well as the amount t that UPMC will put towards your infertility care if you have it done at a UPMC hospital. It helped that I worked at the hospital where I was having treatment.

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I liked Dr. Menke’s bluntness and straightforwardness because she is also caring. I was getting frustrated with lack of success and she scheduled a phone appointment with me during a busy time for me at work. She listened and explained why our course of treatment was the best.

Don’t expect her to sugar coat! But she is so kind and caring.

We need to use donor sperm. First cycle was 50mg Clomid and IUI. I had 5 follicles but still was not successful. The next cycle was Femara but I only had one giant follicle that took forever to grow. She was able to walk me through when to test with ovulation strips since we weren’t sure when the ultrasounds should be. The next cycle I did 25 mg Clomid but only got a few slow growing follicles yet again. The final cycle she (at my insistence) put me back on 50 mg Clomid and we’re successful. We did an ovidrel trigger shot with every cycle.

We were extremely fortunate to have insurance coverage for everything except donor sperm, which was approximately $900 per cycle. Visits with Dr Menke were a $50 copay.

He is older and clearly has experience, but experience doesn’t equal showing compassion. After he diagnosed us with unexplained infertility, next steps were never discussed. It was almost like he was saying “your situation isn’t so bad, good luck and just keep trying.” It really felt like we were kicked out with nothing to look forward to and we didn’t know what to do next.

Be persistent. Be a pest. Don’t be afraid to ask TOO MANY questions.

We received full diagnostic testing through Dr. Wakim. He did explain what each test was evaluating. However after everything came back as “normal” and we were diagnosed with unexplained infertility, we were not explained what to do next. It was like we were done.

We had all of the diagnostic tests; no treatment and we paid out of pocket roughly $4,000.00