How was your experience with Alan Berkeley at NYU?
Dr. Berkeley was great in the initial consultation. He was also great at reviewing the probabilities of women my age being able to conceive using my own eggs. He is very knowledgeable and experienced in this field, so we trusted him completely. He knows what he's doing. The only critical feedback I would give Berkeley to date is communicating better with the patient 1) he didn't mention during the initial consultation how many rounds of ovulation induction and retrieval this might take, especially for someone in my age group. 2) Each failed cycle, we would have appreciated a sit-down face-to-face meeting rather than a follow-up phone call. Since the initial consult and the first retrieval, I haven't really met with Berkeley, other than the occasional ultrasound during morning monitoring. Depending on the schedule, I was able to see other doctors at the clinic during morning monitoring, retrievals, transfers, and other procedures. Those other doctors, during my short and limited interactions, especially Grifo and Hodes-Wertz, exhibited greater empathy and compassion, which I viewed as a plus.
What's one piece of advice would you give a prospective patient of Alan Berkeley at NYU?
Go into your initial consultation fully organized and prepared with any prior lab work, medical history, genetic testing all relevant to fertility. Also, make sure that you get clarity on exactly what blood tests and exams you'll need done or updated prior to starting any cycle; infectious disease panel, day 2-3 labs, semen analysis, mammogram, etc. Also, know that you as patient will have to be the proactive one. You'll have to make tough decisions on how many rounds of IvF you can handle, whether to transfer mosaic embryos (if that is all you have), how many transfers you're wiling to go through, and when to call it quits. I understand why NYU Fertility doesn't proactively nudge you in either direction because they are first and foremost a clinic (not a research lab). But likewise, don't expect any proactive outreachor guidance on whether to continue (unless explicitly advised otherwise) either.
During treatment, were you treated like a number or a human with Alan Berkeley at NYU?
I dealt mostly with the nurses and fellows. Some of them were very nurturing, caring, and competent. Others were less so. Depends on who I got.
Dr. Berkeley is a very matter-of-fact, analytical doctor. He gives you the straight answers and instill confidence in you that he's competent, experienced and knowledgeable. That is the primary reason why we went with Dr. Berkeley for all of our IvF rounds. His communication skills and bedside manners weren't always as consistent or strong. But we knew that going into the journey not to expect any hand holding of any kind from Dr. Berkeley.
Describe the protocols Alan Berkeley used in your cycles at NYU and their degree of success.
For the first three ovulation inductions, he prescribed 225 Follistim or Gonal F, 150 Menopur, and Ganirelex. For my trigger shot, I had to take 2 Ovidrels. For the fourth ovulation induction, I had the same protocol, except he also added clomid.
For the one frozen embryo transfer, I was on estrace, medrol, progesterone in oil injections.
Describe your experience with the nursing staff.
Nurses overall were pretty good. They communicated instructions pretty well and were generally good about returning calls. A couple nurses in particular were outstanding - they were not only competent at their jobs, but patient with listening to and answering all questions, compassionate and caring, which went above and beyond. Sandra, Nicky, and Lavina, were a few of the exceptional nurses; they were really kind, and I appreciated their compassion throughout the process.
Describe your experience with NYU.
Different parts of the clinic could get on the same page about protocols. Seems like the patient coordinator and nursing staff weren't always communicating the same things - for example, when I can start my FET cycle while waiting my PGS results - patient coordinator said no, nurses said yes - that caused confusion. Some of the preliminary lab test (infectious disease panel bloodwork) fell through the cracks so I had to re-do them. Embryology lab messed up by telling the nurse 26 eggs were retrieved when in fact only 14 eggs were retrieved (26 was the incubator number). And finance and billing weren't always the most responsive. Anesthesiology messed up one of our bills.
One thing I wished NYU Fertility could have provided is some type of counseling prior to the process and during the process. I'm not talking about psychological support - because they had that, and frankly, we found unhelpful. What I'm talking about is someone who was willing to walk us through what to expect in terms of the various decisions we would have to make, how to think through how many rounds, whether and how to make the tough decision on transferring mosaic embryos, how to manage pregnancy loss, when to call it quits, and someone we can provide feedback to directly (and not just some on-line survey after every procedure), etc. Not just what to expect from a medical perspective, but the impact IvF, FET and mosaic transfers may have emotionally, financially, etc. Someone who acts as an advocate for the patient. At this time, the nurse, patient coordinator, genetic counselor combined fill that role in limited capacities. But as patient, we had to seek that out and connect the dots ourselves. Perhaps this is a resource beyond the clinic's capacity, but that would have been helpful.
Describe your experience with your monitoring appointments at NYU.
Morning monitoring was open without appointments between 7 AM and 9 AM. For the most part, that seemed fair and reasonable. NYU was good about not having to bring you in unnecessarily. One advice to future patients is if you're going in only for blood work, see if you can move up the queue, because I often waited a long time unnecessarily just to give one vile of blood. You get mixed in with the rest of the patients waiting for ultrasounds.
Describe the costs associated with your care under Alan Berkeley at NYU.
Each IvF cycle for Phase 1 - that includes ovulation induction, morning monitoring, egg retrieval (not including Anesthesia), biopsy of up to 6 embryos (for PGS purposes), cryopreservation of embryos and transportation costs to reprogenetics lab was $15,150, out of pocket. The Phase 2 - which is the frozen embryo transfer as part of this IvF cycle was $2000 out of pocket. After our second IvF cycle, NYU began to accept our insurance, which helped with bringing down our costs. However, our insurance did not cover biopsy, shipping/handling of samples. Reprogenetics, the lab that performs the PGS tests, had their own fees, which were all out of pocket. We were charged $1000 base fee, plus $250 per embryo.
Describe Alan Berkeley's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at NYU.
I was strongly advised by Dr. Berkeley, given my age, to do PGS and aim for a single embryo transfer.
What specific things went wrong at NYU?
- Failed to call in prescriptions to pharmacy
- Failed to call with results
- Failed to order appropriate test
- Lost results
- Provided conflicting information