Andrew Toledo

Dr. Toledo has a wonderful bedside manner. He is friendly and personable and has been doing this a long time. It takes a long time to get into see him, but there's a reason for it. You won't be sad you waited an extra few weeks. Some of his explanations are technical, but for the most part, he explains things in terms non-medical people can understand. He will take as much time as he needs with patients for consultations - I think those are booked in one hour blocks, just so he doesn't have to get to another patient. I think we spent one hour with him in our initial consult (not including exams, bloodwork, and meeting with the nurses before and after). He answers questions patiently and is happy to take follow up calls. Once we had decided to go forward with IVF, I had questions about the drugs and injections I was prescribed, and I was able to get on the phone with him personally within a couple of days to get answers from him.

Be prepared to wait for your initial appointment, but he is worth the wait. And have a list of questions ready to go and be prepared to take notes.

We started with IUI on Femara. (I had been prescribed Clomid and timed intercourse with my OB/GYN but that had not worked, so we moved onto Femara.) Each IUI cycle also included a trigger shot 12 hours before the first insemination, and then 24 hours, there was a second insemination. The first IUI cycle was negative, so they changed the timing of my progesterone. The second attempted IUI did not make it to insemination because I did not get any follicles, so they reversed on the progesterone timing. The second and third IUI were identical in terms of medications, and both resulted in chemical pregnancies. My beta with the second IUI stalled at just below 50, and the beta with the third IUI barely made it above 10. Dr. Toledo did give us the option after the second failed IUI to start IVF, but we elected to try one more. After the third failed IUI, we were told our best option was to proceed with IVF. We had a whole lot of bloodwork done (on both me and my husband) and a meeting with a genetic counselor. Dr. Toledo suspected that we were getting "bad eggs" (resulting in the chemical pregnancies), and he therefore recommended pre-implantation genetic screening to screen for embryos with abnormal numbers of chromosomes. He also suggested ICSI to directly inject the sperm into the egg. We did our first and only retrieval in November 2013, and came away with 9 eggs, 8 fertilized, and 7 made it to day 5, at which point they froze and biopsied all of them for genetic screening. I was on Bravelle and Menopur at the lowest doses recommended (I believe 2 injections of each, each day) because I have PCOS and they were worried about overstimulating. We then stopped the medication since we would be doing a fresh transfer. We ended up with 4 genetically normal embryos, and planned to transfer one of them in January. For the transfer, I was placed on birth control to level off my hormones and then put on estrogen (patches) and progesterone (suppositories) on the first day of the transfer cycle, which I was on till the pregnancy reached 12 weeks. (They will normally wean you off these starting at 8 weeks when the placenta has taken over, but I was traveling around week 10 and was being extra cautious, so they let me stay on it till 12 weeks, when I started seeing my regular OB/GYN). The transfer took place on day 20 of my cycle, and Dr. Toledo did the transfer himself. We got a positive pregnancy test, and that baby is now almost 4.5 years old. Dr. Toledo also did an "uterine scratch test" at the beginning of the cycle, which has shown increased pregnancy rates. We did a second frozen transfer in October 2016 with the same protocol and steps as our first frozen transfer, but Dr. Toledo did do an HSG test to make sure my uterus was still in good shape (no fibroids, cysts, etc.) It was all clear, and one of his colleagues did the second transfer. That baby is now 1.5.

The IUIs cost around $1500 ($500 per insemination, plus ultrasound monitoring and meds). For IVF, we used a financing plan that totaled approximately $22,000, but included 3 fresh cycles and 3 frozen cycles (and the benefit stops after a successful pregnancy). We only ended up needing one of each, so we probably overpaid. We were told when we went back for our second transfer that they had changed the program such that we could have used the funds leftover after our first successful transfer to put toward the second transfer. Medications for the egg retrieval were probably in the neighborhood of $4,000 to $5,000, most of it being out of pocket. My husband changed insurance plans for our second transfer, which had an allowance for fertility coverage, and it cost us approximately $600 or $700 out of pocket (including meds) . I think the frozen transfer without insurance would have been around $3000.

Dr. Toledo was strongly in favor of a single embryo transfer - I was 31 and 34 at the time of both my transfers - and he did not see a reason to consider a multiple embryo transfer at my age. Given our circumstances, we also had a very good chance of one working (and those odds only increased with two), and he reminded us that twins is twice the cost at the same time (two daycare payments, two college tuitions, two of all the baby gear, etc.).

When I first met Dr. Toledo, he walked into his office and was very cheerful and gave off a wonderful positive vibe! As time went on and I completed the check list, we met with him again to discuss the next steps. He still was very optimistic and told me what protocol that he thought would work. During the stimulation process, my body was slow to respond to the medications. He never gave up and allowed me to STIM a few days longer. My results were awesome and he stopped by after he did the retrieval to tell me what a great job I did!

Go in open minded and trust his thought process on what he thinks will work out for you!

I I had to take 300 IUs of Gonal-F, 2 times a day (one in the morning, one at night). I did this for 17 days. I also gave myself 0.5 ml of Lupron daily. My husband gave my my trigger shot HCG, which wasn’t bad. I had 18 eggs, 16 embryos, and 11 embryos were frozen. 2 embryos came back genetically normal.

Their financial advisor Tay was awesome! She broke everything down and you were able to make payments.

Dr. Toledo only wants to transfer a single embryo because of my age (41).

Dr. Toledo got to know my husband and I as individuals and not just patients. He wanted to know about our stresses in life, occupations, how our journey had been. Our first appointment was an open dialogue about what we had experienced. I was certain he would push IVF from the start. Isn’t that what they do at a reproductive clinic? To our surprise, he didn’t. After several appointments and honest conversations with Dr. Toledo we have decided to pursue IVF. I’m confident he has the hope that we do.

Come prepared. Don’t feel like you are coming with too much history because you are not. Dr. Toledo will look at everything and anything you bring. I predicted that I had a thyroid problem so I pulled blood labs from three years back (non related to fertility). He listened, took a look, and was appreciative of all I had provided.

Dr Toledo immediately took a look at my thyroid levels and put me on medicine. In his opinion, I should have been on it already. My levels were in perfect range after few short weeks. He ordered another sonohysterogram. I had one done a year before with my OBGYN but he wanted to run one again. I can’t even begin to explain how easy that procedure was at RBA compared to my first. The ladies at RBA explained that that was something they do daily whereas an OBGYN might know how to do it but they don’t practice it that often. Dr. Toledo also ordered a few tests on my husband so we could have the most current information. He then sat down with us and went through everything, thoroughly explained our options, and gave us his opinion.

We qualified for the “baby guarantee” program. You and your spouse have to meet certain criteria pertaining to your health and specific tests to qualify. The initial fee for this program is 25k. The program lasts for two years or one live birth, whichever comes first. If this does not happen you get the majority of your money back. If you choose to leave the program you also get the majority of your money back. We looked at all options and financially this made the most sense. It’s a great program and we are lucky to be in it!

Dr. Toledo is the most compassionate doctor we have came across. He was very good at explaining the process and showed he truly cared as he was talking to us about our options. My husband and I had a male factor infertility and he showed us that he cared and felt bad that I had to go through the medication and shots. He really showed his fatherly side when he truly felt bad that the woman had to go through everything regarding our situation. Dr. Toledo explained things thoroughly but it was hard to keep track of the language during the infertility process. He always explained when we asked so we were glad he took the time to talk to us in detail every time.

Don't be afraid to ask your questions. You are paying a lot of money, you have the right to clarify all of the details.

First we went in for our IVF consult. We then had some factors checked out with the in house urologist. We then started the IVF Egg Retrieval Protocol. I took Lupron and Gonal F. I went in every few days for an ultra sound and some blood work. My estrogen level was out of this roof close to 6000. They found a fibroid or a Polyp so I had to do a frozen 5 day transfer as they said my uterine lining wasnt thick enough to hold the baby. I didnt have my egg retrieval until 14 days later. I also had a hysteroscopy done to remove the fibroid...which they discovered was only a polyp. That was good but also frustrating as I felt this could have been done closer to the time they discovered something was not right rather than closer to the transfer time. I had a different doctor conducting my egg retrieval, hysteroscopy and then finally had Dr. Toledo conduct my embryo transfer. I made sure it was Dr. Toledo. This is the frustrating part about an infertility clinic since there are lots of doctors on staff and their schedules and on call schedules are already set while your schedule is so unpredictable as every women is different with the protocol. Prior to the egg retrieval I had to take a baby aspirin, pre-natal vitamin, vaginal progestrone twice a day and estradiol patches every three days. All the medication put me on a very regimented schedule for 4 months! He did say if we were to do this again he would change the protocol and take out lupron and use another drug.

Initially our cost was $10,000 where insurance paid 80% of it. Then, my insurance changed and nothing was covered. We then paid $4300 out of pocket for the Hysteroscopy. We paid $5000 out of pocket for the Frozen Transfer and $270 out of pocket for my HCG, Progestrone, Estradiol levels 10 days after the transfer. We also paid $6000 out of pocket for medication. We started with Aetna PPO then had Kaiser HMO. Kaiser didn't cover anything.

Dr. Toledo mentioned since I am little in stature and for the health of the mom to be and the baby it is safer to just have one embryo transfer. My husband and I agreed.

Like I said before, he’s warm and compassionate. He is friendly and funny. He takes the times to answer questions and doesn’t make me feel rushed. When the first plan didn’t work he made a new one. He’s open to things I suggest or ask about.

Write down your questions ahead of time. Write down his answers. Know that once treatment starts you won’t see him frequently but he does look at what’s happening and have his nurse call with the recommendations and changes.

We did a cycle with follistim and ganirelix. I don’t remember dosages but do know that my dose never changed from the starting dose bc I responded well. They retrieved 19 eggs but only 8 were mature. Six fertilized with ICSI and one of the immature eggs did fertilize in the dish overnight. On day 3 the embryos looked good and they pushed me back to a day 5 transfer. On day 5 all the embryos had stalled in the day 4 stage so we transferred 2. Unfortunately, we didn’t get pregnant and the remaining 5 embryos died in the lab the day after transfer.

We had some insurance coverage so paid a deposit of about $3000 and about $2500 for meds. We also did two IUIs. We submitted one to insurance and maybe paid a couple hundred dollars out of pocket for that but I can’t remember exactly. The second one we paid for ourselves and it was probably about $2-3000

Dr. Toledo was upfront when things were not going as well as expected. He laid out a clear plan of what our next steps were and provided us with sound and logical information. He always was kind and open to discussion regarding what we were comfortable with.

He is a great doctor who cares and wants to help in any way. He is also very open to what your wants and needs are and bases his recommendations on that information.

We decided based on how many embryos were produced if we were going to genetically test them or not. If there were 3 or less embryos, we were not going to test them and take our chances. We ended up with 2 embryos so we did not test them and transferred 1 embryo in July 2018 that resulted in pregnancy and ended in a miscarriage at 8 weeks. Looking back I wished I had gone ahead with genetic testing. We are now testing the remaining embryo, not on Dr. Toledo's recommendation but because I have had 2 miscarriages consecutively and cannot fathom going through that process again.

$14000 for first egg retrieval, additional 6-8K for meds, $4k for transfer.

Dr. Toledo and my husband and I decided for eSET due to the fact we have had a previous successful pregnancy (my 2 year old) and that multiples for me could be high risk since I am a petite person and complications could be high if I had multiples. Also we discussed that we knew we wanted 1 more child, but we were not sure if we wanted a total of 3 children.

He seemed like a well vetted doctor who was current on his knowledge. He was a good listener, efficient, and concerned with the the things we mentioned as concerns. It seems like he's really honed his craft. He and his wife used the clinic themselves which helped make him relatable.

Don't wait. Modern medicine is a beautiful thing. Dr. Toledo can help you conceive.

He suggested some initial investigative work including an HSG, SIS, a semen analysis for my husband, and extensive blood work for both of us including some genetic testing. He recommended 3 rounds of IUI with femara with progesterone supplementation after ovulation. A baby aspirin per day through the first trimester. Continued metformin and thyroid hormone supplementation. Trigger shot if needed to stimulate egg release. If all that failed he would move to IVF.

Not cheap and not covered by insurance mostly.

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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.

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.

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.

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).

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).

I can't say enough nice things about Dr. Toledo. I feel so well cared for and my husband also lijrs and trusts him which is really important in the field. I feel like he genuinely wants us to succeed with every cycle. And he's never pushed me to do something that I wasn't ready to do. We started out very conservatively with my first few cycles and only moved to IVF after all other methods proved unsuccessful.

Plan ahead! He can be hard to get in to see. Usually he has a pretty long wait to get an appointment, so plan to schedule your appointment a few months before you actually want to be seen. Make notes or talking points ahead of time and try to think of questions ahead of time to get the most out of your time with him!

First few cycles were tuned intercourse with femara. Then we moved on to follistim and femara for 1 cycle with timed intercourse. The next month we planned femara + follistim again but we were going to do and IUI. I ended up over responding to the meds that cycle so I was converted to IVF and had a fresh transfer. After a negative pregnancy test that month, we are planning a real IVF cycle next month.

Dr. Toledo is very kind and does not make you feel like a number. He was also open to trying new things and did not dismiss my ideas. I liked that I always saw him and felt like I had continuity of care. My only gripe would be that he would quote prices for treatment that were half of the actual cost.

Make sure you call the billing office to confirm costs of all treatment.

I have RPL with a second trimester loss, so I was prescribed lovenox for possible clotting disorders for which there are no tests, crinone, metformin for PCOS, thyroid medication for hypothyroidism, baby aspirin, folate for MTHFR, and prednisone. He performed two hysteroscopies in which he found a septum and polyps following use of estrogen after the removal of the septum. He thought the septum might have been the reason for our 2nd trimester loss. I also did two rounds with Femara IUIs that were unsuccessful. He then recommended IVF with PGS as I have not been able to get pregnant in the last 15 months despite treatment.

For IUI it was around $550.00 for the actual insemination, but you needed at least two ultrasounds that were around $245.00 a piece. If you trigger, they require 2 back to back inseminations.

He recommends a single embryo transfer for my age and the first cycle.

I just started the egg preservation process. My first appointment was great. Dr. Toledo really took the time to explain everything to me. I had signed up for an free education seminar on egg preservation they offer. The seminar includes free AMH testing. The staff said I couldn't do this and that I would have to pay for that lab test since I was already an established patient. They only offer this free screening for non practice patients to draw in business. I spoke to the practice manager, given that insurance pays for NONE of this and I'm paying >$13,000 for all this, you would think I could take advantage of some free screening. After going back and forth they allowed it but when I went in to the office they made me feel like I was a "problem" patient. I had a slew of other lab work done and was never called with results. I had my follow up with Dr. Toledo this week. When I sat down with him he was under the assumption I was aware of my results and the conversation was a little awkward. That being said he explained everything thoroughly and discussed all my options. I had asked for a copy of my blood work which they couldn't give me right away. Someone from medical records had to follow up with me. It's my own blood work, not sure why they couldn't just give that to me.

Be prepared to take advantage of his time and knowledge. I had really done my research and had a list of questions. Take notes of what he tells you and just keep track of all documents. I think he's great but I'm feeling a little apprehensive about the business and financial side of this process. That being said I'm still in the middle of it.

$8000 deposit $ 3-5k foe hormones $labs $ office visit

I always felt like I was his most important patient. When my first IVF cycle did not result in a pregnancy I felt like he was just as disappointed as my husband and I were. He was upbeat when we needed him to be and he was warm and calming when we needed him to be.

You probably won't get in to see him as quickly as you might like, but I promise he is worth waiting to see.

I do not remember.

I don't remember

We first did a single embryo transfer at Dr. Toledo's recommendation. It didn't result in a pregnancy. The next time we transferred two at his recommendation which resulted in one baby. For our second child he recommended two again but we chose do transfer just one as we were not in a hurry and did not want multiples and that resulted in one baby.

It's important to him that patients are taken care of and feel like people not sheep. He has the best bedside manner of any doc I've ever met even beyond the fertility realm. He is available for phone calls and seeks out information if it's not available. He shares his thought process with his patients. I went through 5 IUI cycles,a fresh in vitro ICSI transfer, frozen cycle and pregnancy. I now have 3 boys ages 13,11, and 7. Two natural pregnancies after the first which was successful after an in vitro frozen cycle. My uterine lining wasn't absorbing progesterone at the same rate across the uterus and he figured that out and tested the problem. I had my first at almost 36 and my last at 42.

He is amazing!!!

What worked me in the end was his absolute dedication to the specific lab results from checking my progesterone levels even while out of town. He discovered in the end that not all of my cells were absorbing the progesterone at the same rate and therefore my uterine lining was inconsistent. He came up with this while out of town on vacation!!!! He himself called to check my levels.

My insurance covered lab work and ultrasounds and some visits to doc, not the procedures themselves. It was 13 years ago so IVF was about 10,000 per cycle.

Don't recall. I transferred 2 first cycle with no success and then 4 on a frozen cycle and had a singleton pregnancy with no complications.

Dr. Toledo is great at listening to your concerns. If you don’t feel like something is right, he will immediately address it and change protocol if needed. He throughly answers questions and will address any concerns you have honestly.

If you don’t feel something is right, address it. He is more than willing to talk to you and make protocol adjustments.

Our first IUI, we did low dose Letrozol and it did not work. Our second, we upped our Letrozol, got better follicles but never surged so we tried again. The third we did 7.5 and had great follicles but still no positive test. Currently starting IVF meds.

Iui about $1200 each, currently at $15500 for IVF not including meds

He is warm and friendly. Always includes my husband in the conversation and gives big hugs. We have had a hard journey together, we don’t know why it’s not working but we are all trying to figure it out together.

Get a good relationship with the nurses.

My egg retrieval was rough. It was the max dose you could give someone to maximize their egg retrieval outcome. I had a lower AMH and that’s why he chose this. We did frozen transfers every time using lupron, estrogen, progesterone. As the transfers were failing we kept adding more medication such a prednisone and lovenox. We tried doing a uterine biopsy to test when my implantation window was. All of these procedures and still no pregnancy

Out of pocket expenses have been about 16,000.

He only likes to implant 1 at a time

I do not feel like we often had experiences with Dr. Toledo. We saw him for an original consultation - but he did not perform any of the three IUI treatments. We met with him after the failed IUI cycles and that was our second and last time meeting with him.

Find a doctor who will be there for you and to address your concerns.

Dr. Toledo is an excellent doctor and very knowledgeable about the most current research and treatments. As someone who came to him with extensive research he was able to have a knowledgeable conversation and also communicate when he thought it was best I seek an alternate opinion with all the issues I had going on. I deeply respect him and appreciate his honesty.

Ask lots of questions and be an informed patient, he respects that in his patients. Follow your gut and if something doesn’t seem right to you then voice your opinion.

Due to endo I used Lupron Depot to suppress my cycle before a FET. Then after a chemical pregnancy got an ERA in addition to changing my protocol. Following a miscarriage and using an immune protocol discussed other options.

The first time I met Dr. Toledo, he was very straight to the point. He told me my left fallopian tube was blocked and needed to be surgically removed. He explained why this was the best option and also let me know that there was a small possibility he could need to remove the right tube as well. He understood that I did not want this to happen but agreed he could remove it if he thought it was best. Fortunately, during surgery he only needed to remove my left tube. I am currently using fertility drugs to help me ovulate and he has been aggressive about how long he wants to try this route.

Dr Toledo was not only my physician but my friend and cheerleader. He is so caring and compassionate and never gave up on us. He went the extra mile to insure he was always available for procedures. When I did finally get pregnant, Dr Toledo kept in touch and even paid us a visit in the hospital. He is truly a blessing to our family.

It may take a while to get in to see him but he is well worth the wait!

Dr Toledo was open to transferring one or two and respected our decision to only do one at a time.

I would highly not recommend this doctor. We wasted time and a lot of money and he did not catch something that was highly influential to our success rate. It is beyond me why a very standard test was not performed by him so that he could identify a major problem. Instead, he did a transfer that failed and had no plan for next steps. He did not perform a very standard test that would of helped to increase our chances of pregnancy and a full term live birth by 100%. We are very disappointed with his lack of care.

get a second opinion

There was no methodical plan. My second doctor could not make sense of his protocol.

We have been through quite a journey and Dr. Toledo has been there with us through it. He has a good bedside manner and I feel like he's invested in our success and wants to help us make our dream a reality. When one protocol doesn't work he tries to figure out something else for the best results.

Don't be afraid to ask questions. This is your journey, your time and your money. If you don't understand something don't be afraid to speak up.

$14,500 (inclusig medications and ICSI)

Dr. Toledo has great bedside manner. He takes into consideration your beliefs and values and wants to determine the best course of treatment for you. He's very thorough and thoughtful. He's always willing to explain things more if necessary and makes you comfortable at all times.

Trust his judgement. He's been doing this for 30 years. He knows what he's doing.

Daily double dosage of menopur, gonal f for 10 days for IVF. Femara for 5 days for IUIs.

My husband handles the bills. I'm unaware of the cost.

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He took the time to explain my choices to me throughly. IVF was not something we had anticipated doing and he was very understanding and sympathetic when we had to decide to go that route. He called me the day of my D&C from his cell phone to check on me and that meant a lot.

Be patient. He is very good at what he does and he has a very large patient list. Sometimes your appointment is delayed quite a bit but it's because he is making sure each patient understands what is happening.

It wasn't cheap, that's for sure. But it was worth it now that I have my child.

The infertility journey is an intense one, and walking into a clinic like RBA can feel overwhelming. Dr. Toledo humanize the process immediately, forging a connection with us over a common football team. He made us feel like we were his only patients, even though he surely had dozens at the time.

My advice is to be your own advocate no matter who your doctor might be. Don't be afraid to ask questions or ask for clarification when things sound complicated or confusing.

We were very happy with Dr. Toledo. He was caring, knowledgeable, and compassionate. He was thorough in our treatments and explained everything to us each step of the way. In instances when things didn't go how we had hoped, he always gave us the courtesy to call us and explain/give feedback/or just listen to our fears/disappointment.

Be patient with the process. Ask for lots of testing up front - especially the MTHFR test which is such a common genetic "disorder" but can be easily "cured"