How was your experience with Andrew Toledo at RBA?
Dr. Toledo has an incredible bedside manner. He really understands what his patients are experiencing emotionally and knows how difficult infertility can be. He made me feel like I was a partner in deciding what treatment options we would pursue. Because my condition turned out to be so unusual (unexplained thin uterine lining that does not respond to hormones/drug therapy and makes carrying a baby highly unlikely) I did a lot of research on my own. I would bring different possible treatments options to Dr. Toledo and we would discuss each one. He made it clear that he was willing to try anything so long as it wasn't dangerous. I also made it clear very early on that it was very important to me that he didn't "sugarcoat" my diagnosis. Dr. Toledo respected my request and always discussed matters with me as an equal - not as a superior. On top of all that, he is a very optimistic person and makes it very clear that he will not give up on you.
What's one piece of advice would you give a prospective patient of Andrew Toledo at RBA?
Keep a list of questions as they arise and bring them to your meetings with Dr. Toledo. He will answer all of them. Do your research ahead of meeting with him so you can work with him to develop a plan/protocol that is right for you - he is great at creating customized protocols based on your specific needs as a patient. And be your advocate. At one point early on in my treatment I felt like a protocol wasn't right for me and one of the nurses was discounting my concerns. When I spoke with Dr. Toledo he listened to me, understood that I knew my body better, and worked with me to deviate the treatment so it was better suited to my body.
During treatment, were you treated like a number or a human with Andrew Toledo at RBA?
Dr. Toledo is incredibly compassionate. He always makes time to speak with you, even if you don't have an appointment with him or are only in the office for monitoring. If he isn't available in person, he will call you. He remembers all the details about not just your medical treatment but also your personal life. I have no idea how he does it - he must have tons of patients but he treats you like you are the most important patient. I have an incredibly unusual and rare issue and my treatment has not gone as planned. But Dr. Toledo has been very honest an empathetic throughout the entire process.
Describe the protocols Andrew Toledo used in your cycles at RBA and their degree of success.
I had an antagonist protocol for my IVF cycle. I was on Gonal-F, Menopur, and Ganirelix. The doses were very light and this was done because I have PCOS. Dr. Toledo listened to my concerns about the possibility of developing OHSS and monitored me closely to ensure this didn't occur. But I was also concerned about using a Lupron trigger (and not an HCG one) - I had read that eggs may not mature as much with a Lupron trigger. But a Lupron trigger is often used with PCOS patients to lessen the risk of OHSS. Dr. Toledo monitored me carefully and after 10 days of stimming allowed me to trigger with HCG. For my retrieval we had 24 eggs (15 were mature), 14 fertilized, 5 made it to day 5 blasts, and 3 tested normal in PGS. I did not have any complications during or after egg retrieval.
Unfortunately I have been unable to transfer any embryos (yet) due to my thing lining. But Dr. Toledo has worked with me to try at least 4 different frozen embryo transfer (FET) protocols to try to develop my lining. None have worked so far but he continues to work with me and present new strategies.
Describe your experience with your nurse at RBA. (Assigned nurse: Krista)
Dr. Toledo has two nurses. Both are organized and respond extremely quickly to your questions. Usually I receive a response within 10 minutes if I email and about an hour if I have to leave a voicemail. One of his nurses isn't as positive or energetic as I would like but that did not impair my experience (and since Dr. Toledo himself is so optimistic and positive this particular nurse seems to be a real contrast in personality). But my primary nurse, Krista, is phenomenal - very organized and incredibly empathetic. Also Dr. Toledo's assistant, Mellisa, is very friendly and recognizes the emotional toll that this process takes. I also found the ultrasound techs to be very nice and compassionate, especially when I was having a down day during treatment.
Describe your experience with RBA.
The staff is very friendly - much more so than any other place we visited. The receptionist staff is always smiling. The clinic is large but I never felt like a number. I felt like they respected my time and didn't make we wait at appointments. But when I needed to talk to someone they would take the time and never rush me. I had to call the billing department once or twice because there had been an error, which was annoying, but they took care of it as soon as I called.
Describe the costs associated with your care under Andrew Toledo at RBA.
IVF cycle (freeze all with genetic testing) - approx. $14,000
FET unlimited transfers until live birth - $6500
My medications were about $4000 for IVF and FET but those were not through the clinic (purchased through specialty pharmacies).
I also had a hysteroscopy performed by Dr. Toledo. It was approximately $2000 (not covered by insurance).
Describe Andrew Toledo's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RBA.
I have not made it to transfer yet. However, Dr. Toledo has strongly encouraged that if/when I do I transfer just one embryo, particularly because mine are PGS tested. I get the impression that I could push for two and he would consider it but he has not said that (and I only want to transfer one).