UT Southwestern

Strengths - it's cheaper than others (IUIs were $1050 instead of $2100 at my current clinic) Weaknesses - the amount of people involved and rotating through. At any point you would deal with Dr. Babayev, any of his 3 Fellows, any of the many nurses, have residents in the room during your procedures. There were 3 instances where I was given wrong information and I had to correct them. UTSW is a teaching hospital and it became very clear that this was an area I didn't want them learning on me... I needed to move on and get results. The Billing office is also terrible. I had to make about a dozen calls and still waiting to get issues resolved. They charge you for the cycle upfront (insurance doesn't cover).. then, it goes to insurance because apparently their system sends everything through insurance... even if insurance would cover some of the testing it doesn't matter because it's all or none. Then they sent me statements with the remainder. All of which I had already paid for upfront. Nothing was done to remedy this and I called and talked to the financial counselor, her manager, the billing department, their manager.. and still waiting on resolution. It's a horrible process.

At least 3 or 4 times I got misinformation or instructions. When I talked to Dr. Babayev about one of these instances, he told me that they process 20-25 patients a day and don't remember all of the details (basically). In this particular instance, I had talked to one of the Fellows, Dr. Babayev himself, and another Fellow that did my scan that day about my situation and timing, and she still sent me wrong instructions and then didn't follow up. A different Fellow or nurse can call you each time, so there is no consistency and that can lead to mistakes and oversights.

The nurse that I originally met and taught me how to do the injections - I believe her name was Babitha - was very nice and caring. I talked to several different nurses along the way and it honestly seemed like they were clueless. In my last round, I had to push the nurse for what was supposed to happen.... she gave me wrong instructions and kept insisting. They are unfamiliar with your particular case since it's always someone different.

Dr. Babayev is knowledgeable, however, I feel that he really limited me. Based purely on my first AMH test, he first told me that it appeared I had no eggs left, have no chance, should look into an egg donor, etc. When he finally did an ultrasound he found that was not the case at all. It was very frustrating in the meantime. Even afterwards, he decided that I have low ovarian reserve and would not be a good candidate for IVF. I have since had other opinions that are the exact opposite and my treatment has also proven so. I also wasn't crazy about Dr. Babayev recommending at least 6 IUIs. Other clinics will not do more than 3. I feel like he just keeps churning you through the process. I also feel like they don't really push for you to have a successful result. There is a goal of pregnancy with fertility and you pay a lot of money and I didn't feel any urgency with him to get us there. He is also very very conservative in his approach which can be good, but after a couple of rounds I needed something more. I felt like we would never get there with his guidance.

Push for more answers. Push for what you want.

I went through 2 IUI cycles with Dr. Babayev and team. For my 1st, he started me on 37.5 iu of menopur. This resulted in basically nothing happening and after 5 days increased my dose to 75iu. I had 1 mature follicle before trigger. For my 2nd IUI, he had me on 75 iu for 10 days and resulted in 2 mature follicles. Both resulted in negative pregnancy tests.

The IUI cycle, including monitoring ultrasounds, labs and the actual procedure (without meds) was $1050 out of pocket.

Strengths. I chose clinic b/c UTSW is a trusted facility and the online reviews were positive. Weakness, navigating the insurance and pharmacies is a full time job and clinic told me they would help but I have spent countless hours on phone with insurance and pharmacy by myself. I tried for weeks to get ahold of finance guy who never returned my call. I am not even sure if he still works there even though the front desk staff assured me that were forwarding my messages. When asking for help with all of the conflicting information from insurance, clinic told me that "it's confusing for us too". Which is unacceptable as they have helped countless patients in past. They should not be just as confused as I am. The whole process or pre-authorization for treatments and medications has been a nightmare.

My initial consultation with Samir was thorough and he made sure I understood what my options were given my specific scenario. He listened and had a good bedside manner. The only room for improvement would to see him more often during the labs and sonos. I typically only see the assisting doctors.

They were a few nurses down at times so response time was not as timely was i would have liked. I have also been going through circles with my provider and pharmacy and was told finance would help me navigate but instead the nurses have been helping. They have been somewhat helpful but when it comes to insurance there needs to be clearer guidance

Overall, Dr. Babayev has a pleasant and patient personality which helps to soothe the stress during treatments. I did somewhat feel as though I was being taken through a sales presentation during my initial consultation b/c he still wanted to talk about my odds if I used a donor egg even though I told him donor eggs were a definite no as soon as I sat down to speak with him. I had some issues with the clinic and Dr. Babayev was responsive and apologetic and assured me that things would be resolved. Also as I mentioned in one question, I don't see him often. I spoke with him during initial consult, he helped another doctor perform my IUI and finally I spoke to him after a complaint with staff. It would help to build patient confidence if Babayev at least peaked in the room to say hello during some of the scans and labs.

Advocate for yourself. If you are not interested in a treatment option they suggestion then advocate. Do not be coerced into treatments that you are not ready for. Wheter they be donor eggs are skipping IUI and moving to IVF. Of course listen to doctor but at end of day, it's your decision. And do your own reading and research so that you are not coming into the conversations with no background information.

Due to my age and AMH/FSH levels. Babayev suggested I go straight to mini-IVF. However, I started with an IUI as I originally thought IVF was not covered under my insurance. The IUI was a negative pregnancy test. Per Babayev initial recommendation, I am now doing my first treatment of mini-ivf with 100mg of clomid daily and then Menopur and Cetrotide injections. I have been on clomid for like 5 days now and will start injections tonight. Again, mini IVF was chosen b/c of my age, AMH and FSH. I also have only have about 3-4 total antral follicles during my scans.

I really can't remember itemized pricing but general pricing shared from finance was about 8k for Mini IVF and 1500-3k for meds.

I don't recall him speaking on an approach. I did ask if I would do a retrieval after first cycle and he mentioned that i would likely not produce many eggs in a cycle and his goal was to try to collect 7-8 eggs after a few cycles.

Strengths-individualized care, quick response to portal questions Weaknesses-nurse turnover, not as much hand holding like you would get at a private practice(but that was largely ok with me), they don’t do a high number of cases Things to know- reproductive endocrinology fellows perform the tracking ultrasounds, not Bukulmez. That was fine by me since most other places they are done by ultrasound techs. The fellows are board certified obgyns already so this was a bonus. Bukulmez does the transfers and retrievals and the early work up procedures

I chose Dr Bukulmez given that each patient receives personalized care and protocols. Bukulmez is extremely giving of his time during my consultations, much more so than the 2nd opinion I received prior to pursuing IVF from an outside physician

This is an academic institution so there is significant turnover of the nursing staff or the nurses are float nurses and not permanent. Bukulmez was very open that this was the case. I believe all the nurses now are permanent. They are usually extremely quick to respond to portal messages. I did have to advocate for myself sometimes so that I could speak to a fellow when it was a question above the nurses head.

Bukulmez is the chairman of the department and one of my main reasons for seeing him was that he is at the forefront of the field, individualizes his protocols, and takes the toughest cases. He does communicate at a very high, medical level. I am a physician so I liked that, but it could possibly be challenging for people not in the medical field or going through this for the first time. My only complaint is I would have liked to get more detailed updates during my IVF cycle to more fully understand what was going on. He is very responsive to the portal messaging via his nursing staff

Estrace priming followed me Antagonist protocol with follistim, menopur, cetrotide. His goal is quality over quantity and we were shooting for 8-14 quality eggs

$10k not including meds

He usually only recommends single embryo transfers in my experience. We only transferred >1 bc they were concerned we wouldn’t make it to blastocyst stage

No issues. Billing was fine. Front desk was polite. Labs were done in the office and the girls there were very patient even though it often took several stabs to draw my blood. I originally chose UT Southwestern because I thought they were on the cutting edge and might have new options for my "lost cause" case. I didn't really get that feeling though. We never tried a regular IVF cycle, as my doctor thought mini-IVF would be the better route. But that resulted in only 4 eggs total over 4 rounds of treatment. I don't feel like I got a fair chance to try and conceive. Because it was mini-IVF and required less drugs than a regular IVF cycle it cost me about $25k for 4 tries, instead of $20-$25k for one try of regular IVF. But the end result is the same. I never got to attempt a transfer because none of my eggs were viable, resulting in zero pregnancies. Had I had the money to continue I think I would have looked for a different doctor with new and different ideas. Dr. Bukulmez wasn't a bad doctor, he just didn't have that "never give up" attitude. I felt like I was climbing an uphill battle the whole way and didn't feel like he had much hope for my situation. I want a doctor who is my cheerleader and wants to make my dream come true. This just wasn't that place.

Doctor was nice. Never treated like a number. He does have a very strong accent though so you really have to pay attention. Goes through the information quickly. He always seemed rushed as a I assume there were lots of patients, but I didn't feel like a number. Not rude, just hurried.

They were great at answering questions, calling in RX's, and just overall helpful.

Dr. Bukulmez seemed to be a good doctor. Never rude or mean. But he told me up front that I had only a 17% chance of having a baby with my own eggs. He recommended mini-IVF to focus on quality of eggs and not quantity. We went 4 rounds of mini-IVF. 1st round - 2 eggs retrieved, both fertilized, neither made it to blastocyst. 2nd round - 1 egg retrieved, 1 fertilized, made it to Day 3 only. 3rd round - 0 eggs retrieved. (I was given a $1,000 credit towards my next IVF because none of the sacs contained eggs.) 4th round - 1 egg retrieved, 1 egg fertilized, made it to Day 3. I think the one thing I wish would have happened was more trying different options. I felt like we were repeating the same protocol each time and hoping to get a different result. I could have pursued it further but after 4 rounds I was out more than $25,000 and I just couldn't afford to continue. Each round was looking less and less promising. Had it been the other way around and I felt like we were making progress I may have continued with Dr. Bukulmez but that wasn't the case. Not a bad doctor, I just didn't feel like his recommendations were very specialized based on my tests or outcomes. We tried one option and that was it. I probably should have pushed more, but I didn't see him often. Usually working with assistants or nurses.

Be pushier. Ask more questions. Insist on more options.

Mini-IVF was recommended because I was over 40. It did result in fewer eggs but I don't believe it improved the quality. Over 4 rounds I had 4 eggs retrieved and none made it to blastocyst stage or were ever frozen, so I never made it to a transfer.

Mini IVF round would have run about $7,000 to completion including the transfer. I never got that far. So I paid about $4,000. Each cycle was billed as a lump sum fee that included all visits, ultrasounds and retrieval.

Advice would be to plan ahead on having extra medicine when doing an IVF, better to have extra. Don't schedule travel during a cycle and keep schedule open/flexible if possible. Emails thru my chart has been effective with getting questions answered

More specialized care, plus more monitoring and appts than previous dr.

They're organized, timely for appt, compassionate. Weaknesses-since dr is monitoring closely medications are adjusted daily. I ran out of Menpour first round of mini IVF due to no communication and planning on their end.

He's very thorough in explaining the process of mini IVF's, benefits and goals. He shows compassion and specialized care/approach for each patient. Even though UTSW is a teaching hospital, nice to know he does all surgeries and transfers.

Be sure to clear your schedule and be flexible from days 5-14 of your cycle for doctors appointments.

He wanted to do mini IVF retrievals in order to get fewer but better quality eggs. He explained that every cycle is different with some months being better than others. Results have been positive so far with 4 frozen embryos.

My insurance, BCBS of IL has been good, with all benefits met so no major charges yet in 2017

I'm not to the transfer part yet, although we have discussed implanting 2 embryos

The finance department does the minimal - it seems like they are best at taking payments. If you have insurance, they do little to assess your benefits or coordinate any required pre approvals without a lot of effort on my part to ensure all the paperwork is provided and timely.

He spoke to us with empathy and respective to our specific situation.

None of the same nurses are at the clinic compared to the day we started. This makes it difficult to rate because they have varied - some better than others.

When we first met Dr. B, one of the things he said about infertility being like other diseases and why people should look at it that way made a difference to me - showing how he looks at and approaches our situation. He is open about our chances but maintains a sense of hope that he can get us pregnant. Sometimes it’s difficult to understand him but overall we had minimal issues.

Ask questions - he is always open to our questions which is important

Single transfer recommended due to my unicornate uterus