Caroline Juneau

My husband and I went to Audubon after a year of unsuccessfully trying to conceive on our own. We had a consultation to discuss future options with Dr. Juneau, and I felt so much more hopeful even after just talking to her. She has been so patient with me and my crazy questions and seems personally invested in our journey. She can somehow make me still feel positive after receiving not so great news. We’re in the middle of prepping for a third egg retrieval, and before we began each treatment, Dr. Juneau sat with me and my husband and helped us decide what was best for us. And she doesn’t stop thinking about your treatment when you leave the clinic. I’ve received multiple calls from her after leaving saying “I’ve thought about this more, and instead of doing X, I think we should do Y...”. I can’t imagine a more compassionate and caring RE.

Ask questions. Since Dr. Juneau is living and breathing infertility treatment every day, sometimes she forgets to explain (or assumes you know) next steps or reasons for why she prescribes certain things.

We started infertility treatment with an “unexplained infertility” diagnosis. IUI - Letrozole for 5 days followed by follistim (don’t recall the dosage...maybe 75 units), with an HCG trigger shot. Had 4 follicles but no pregnancy. IVF retrieval 1 - 150 units menopur, 225 units gonal-F. Cetrotide last 4 days of stims. Lupron trigger (my estrogen was over 5000 so she didn’t want to give me an HCG trigger because she was worried about OHSS risks). Retrieved 16 eggs (she had trouble getting eggs from my left ovary which was hardened), only 6 mature, 5 fertilized, 1 good quality day 5 embryo (PGS normal). IVF retrieval #2 - added omega-3, folic acid, CoQ10 vitamins to improve egg quality since it was identified as an issue. 150 units menopur, 225 units gonal-F. Cetrotide last 3 days of stims. Dual trigger of Lupron + small dose of HCG (2500). My estrogen was still very high again, but Dr. Juneau added HCG trigger to try to improve egg maturity. 26 eggs retrieved, 20 mature, 15 fertilized. I ended up with 2 fair quality day 5 embryos (one PGS normal) and 2 poor quality day 6 embryos (both PGS normal). I had very mild OHSS. IVF retrieval #3 - I’m currently on day 5 of stims under the same protocol as retrieval #2.

The following represents their IVF costs: Procedures and physician fees - $1400 (monitoring, oocyte retrieval, embryo transfer, injection teaching, etc.) Anesthesia fee - $500 Lab fee - $3,825 (oocyte ID, sperm prep, culture and fertilization, ICSI, assisted hatching, crypto preservation, prep for transfer, 1 year embryo storage) Facility fee - $3600 Medications between $2000-$5000 PGS testing - $4750 (up to 8 embryos; additional $300/embryo above 8)

Dr. Juneau has said that the typical practice is to transfer one good or fair quality embryo at a time. For poorer quality embryos, or if there has been an issue with embryos implanting, they may transfer two.

Juneau was amazing. From her being honest and open to what could or couldn’t happen. To getting us the treatment we needed to hopefully be able to conceive. She went above and beyond to make my husband and I feel comfortable. She had a great personality and just made us feel good at every visit even when we knew things weren’t going as expected.

Even when you’re sad be prepared to laugh and smile with Dr Juneau. She is great at opening her heart and making every situation good or bad better.

During our first round of IUI, Juneau did just oral meds. We did I believe 3 days and I came back to see follicle development before triggering for IUI. We had like 1 or 2 viable for the transfer. For the second IUI, we did injections. Just the normal maybe 5 days I went in every 2 days to check follicle development. We trigged with I believe 3 that time. On our last round we did a lot more injections as my body was not responding as quickly to the meds to mature follicles. In the end we had 4 on one ovary and 1 on the other before we triggered. Still then with as many as we had no luck in getting pregnant.

We spent at least 15,000 with the 3 IUIs plus ultrasounds and bloodwork procedures when going to fertility. Not counting the funds for when I got pregnant to do ultrasounds, bloodwork and genetic testing another 3,000 at least.

None she was amazing.

She’s a bubbly, friendly person. We felt comfortable with her instantly. If I had a question I was able to contact her through the portal or by leaving a message with the front desk. I always received a response that same day. She talked me through each ultrasound, explaining what she was doing and seeing. She calls me personally with lab results (this HUGE for me as a patient).

Be honest and don’t be afraid to ask a question.

After bloodwork she had be start Letrozole to stimulate follicles. She felt that this drug was safer for PCOS than Clomid as far as side effects. I went for follow up ultrasounds after to monitor my progress. I responded very well and a trigger shot and IUI were scheduled. Unfortunately, it was not successful, but she explained to us before hand the success rate. We were all hopeful but also not surprised when it didn’t work. I’m grateful that she was willing to try for us when our other doctor refused and would only do IVF.

There are different levels to each treatment and the clinic gives VERY detailed printouts explaining each part of the procedure, the cost associated with it, where the money goes, and financing options available. For our IUI we paid $1,200 and it included baseline and follow up ultrasounds, semen collection, washing, and count, also lab work and office visits associated with the procedure. The trigger shot was $80 (not covered by my insurance). I opted to do the pregnancy test at a local Labcorp to avoid missing more work (we travel 3 hours to get to Dr. Juneau for visits). We will soon be starting IVF and they have gone over cost with us for that as well. Again, it is broken down on a printout detailing each step and the cost associated with it. The total estimated cost was around $14,500 plus optional genetic screening for ~$4,000.

Dr. Juneau is Intelligent, trustworthy, and compassionate. She is extremely kind and makes the patient feel like family. She explains every detail of both the IUI and IVF process. She is very detailed and doesn’t miss a beat. She has been a true blessing. She was with me every step of my infertility process. She made my husband and I feel like family. She is extremely thorough. She knows her stuff! She personally performed my ectopic surgery- even though it took place at a hospital and not the clinic. This was so reassuring during such a scary time. After my ectopic, Dr. Juneau presented my husband and me with all of our possible options. We decided to move forward with IVF/ICSI/PGS and transfer using a frozen embryo rather than fresh. We only transferred one and it worked! We are excited to say we are expecting our first miracle and rainbow baby in December (2018). Dr. Juneau monitored me every week prior to the transfer and after until we reached 10 weeks. We “graduated” and I began seeing my regular OB. The week of my first visit with my OB, Dr. Juneau messaged me to check on us! She didn’t have to do that- but that is th kind of doctor that she is. Leaving Dr. Juneau was bittersweet. Although we were sad to no longer be under her care- we knew it meant things were progressing as they should for a healthy pregnancy! I would recommend, and do, Dr. Juneau to anyone experiencing infertility. She is truly a light in such a dark time!

Trust her! She welcomes questions and concerns and always listens. She gives recommended actions- trust her advice. Infertility is such a difficult time and there are so many decisions that need to be made- trust her and allow her to help take some of thher decision making off of your plate.

HSG- checked to make sure tubes were clear before beginning IUI. They were. 1st: IUI with clomid- transvaginal monitoring and bloodwork .... BFN 2nd: IUI with injectables- transvaginal monitoring and bloodwork... BFP, low HCG to start, but began to double appropriately. Resulted in ectopic, with emergency ectopic surgery and left tube removal. Dr. Juneau performed my entire procedure and checked my right tube as well. IVF- Gonal, Menapur, Cetrotide.... transvaginal monitoring and bloodwork, 15 retrieved, 11 mature and inseminated, 8 fertilized, (3) 5 day blasts (frozen after biopsy sent off for PGS testing). PGS: 2 normal and 1 abnormal. Used birth control to control cycle, started Estrace and PIO (progesterone in oil injections). Monitored often. Transfered 1 embryo when the timing was right- BFP! Dr. Juneau personally monitored the pregnancy until week 10 ( which is when I got off of PIO). Baby due 12/29/18!

About 5,000 for IUI About 24,000 for IVF All process fees stated above included my labs and monitoring, medication. My insurance doesn’t cover- so this was out of pocket fees.

Dr. Juneau recommends transferring 1 embryo. If for some reason the 1 didn’t take- she believes in having a discussion about the possibility to try (2) for the 2nd transfer. Not promised.

A pretty good doctor very nice explained most of the details always responded and answered questions. Wanted to jump to surgery right away after I had just undergone surgery less than a year prior to me seeing her.

You will not be disappointment and try to come with a list of questions so u can have them answered right away.

First visit was a consultation, then I went in for a SIS I opted out of the hsg which would have been the next test. On day 3 of my cycle I went in for a baseline ultrasound then I went in for a day 11 ultrasound after taking letrazole for 5 days my eggs weren't quite ready so I went in again on day 13 they were ready so I triggered at 9 15 that night and my iui was scheduled for 36 hours later. Then after the iui I went into the office for a hcg test which came out negative

250 for consult 350 for sis 525 for hsg 1250 for medicated iui monitoring which included all the ultrasounds, and bloodwork 120 for letrazole and 83 for trigger shot I had to pay everything out of pocket because my insurance does not cover fertility

Dr. Juneau has always shown me compassion and empathy. I can tell she really cares for her patients and wants the best outcome for each one. She has a sweet disposition and is always so kind and gentle. Every detail was explained along the way and I always feel like I am in good hands. She is very honest, forth coming, and does not sugar-coat anything. I Would highly recommend her to anyone.

She looks very young and is very soft spoken, but she is very knowledgeable about her profession.

Antagonist protocol for DOR. 9 days of 300u Gonal F/150u Menopur. Cetrotide on day 6-9. 10,000u Hcg trigger on day 10. Expected 6 follicles. Stimmed 8. Retrieved 7.

I had some insurance coverage but have since maxed out of lifetime benefits. For prescriptions. $11,000 out of pocket.

My insurance only allows single embryo transfer. But we never made it that far.

Caroline Juneau is very thorough and makes us feel very hopeful for our journey. After our first iui we were informed that my husbands count was to low for anything except for IVF. We were told that there was a small chance for us to ever conceive naturally. She made us feel very hopeful through the whole process as she explained what we needed to expect at where to go next.

Write down questions to ask because you will likely not think about them when Dr. Juneau gives you the amount of information she gives!

Dr. Juneau said that she always prefers a single embryo transfer due to less chance of multiples and therefore less chance for problems during pregnancy