How was your experience with Cynthia Austin at Cleveland Clinic Fertility Center?
I did not get to see Dr. Austin very often. I think I only met with her three times. When we did meet she was very straight forward and honest. I did feel a little like she would get confused about my diagnosis or issues. Sometimes I had to remind her that we had borderline low morphology or endo. Although she is hard to get a meeting with, she personally called me after each failed cycle to discuss the next steps. She also was always very good at responding via My Chart, Cleveland Clinic's messaging system. I definitely got to know my nurses better than her, but I felt like she was available if I needed to contact her.
What's one piece of advice would you give a prospective patient of Cynthia Austin at Cleveland Clinic Fertility Center?
She is very straight forward which can be difficult to take when you are so emotional already. Still she was very understanding about all my worries and concerns and took the time to address them.
During treatment, were you treated like a number or a human with Cynthia Austin at Cleveland Clinic Fertility Center?
The staff at Cleveland Clinic Beachwood learned my name and never forgot it. From the receptionist to the doctor, everyone was very friendly and compassionate. Even at times when I was less than happy, they kept a smile on their face.
Describe the protocols Cynthia Austin used in your cycles at Cleveland Clinic Fertility Center and their degree of success.
I was diagnosed with Diminished Ovarian Reserve with an AMH of 0.131 at age 27. I also had an abnormal HSG which lead to a laproscopy where they found that my right ovary had the tube twisted around it and was atrophied. After many cycles we found that my right ovary never produced. They also found endo on my left ovary which they removed. After my surgery, I was given the option to move straight to IVF or start with IUI first. Dr. Austin was honest that I needed to move quickly considering my AMH levels, but gave me the option of IUI or IVF. Because we were paying out of pocket, we decided to try IUI with clomid first. After 3 unsuccessful rounds we moved on to IVF. My first round of IVF was an Antagonist protocol. Dr. Austin referred to it as the most aggressive protocol. I did not respond well to the meds and also had a cyst emerge so that cycle was converted to an IUI. The next 2 cycle I did mini IVF which both were canceled due to a lead follicle emerging. The last cycle I did with Austin was an micro flare lupron cycle. They retrieved 7 eggs, 6 mature, 4 fertilized but all stopped growing by day 3. Dr. Austin suggested donor eggs at this point (though she had mentioned it to me before) and I decided to pursue this route. I found an egg bank with a donor I liked that was outside of the Cleveland Clinic and Dr. Austin stopped being my primary at that point althought I still did testing there.
Describe your experience with your nurse at Cleveland Clinic Fertility Center. (Assigned nurse: Nicole)
I actually did not get assigned a primary nurse but I really liked working with Nicole and requested her for everything. She was wonderful and friendly and positive and everything you could want in a nurse.
The other nurses I worked with were also great. The ultrasound techs were proficient and quick as was the blood lab. Both secretaries at the front office were so helpful and kind.
Describe your experience with Cleveland Clinic Fertility Center.
I think the biggest strength of the Cleveland Clinic is it's cutting edge technology and labs. They were able to do all tests and labs right in office. They had on-staff people to do everything from the surgery to HSG to the blood word to embryo assessment, etc. This made getting results quick and efficient. I also think have multiple specialists on staff os great. There were several IVF specialists, male infertility specialists, etc. They also have great appointment times. I was able to do 6:30 a.m. appointments for all my scans and bloodwork which allowed me to still get to work on time daily. They also are open every day of the year except Christmas Eve and Christmas day.
Weaknesses... The biggest weakness of Cleveland Clinic was their knowledge on how much things would cost. Many patients pay out of pocket, like myself and while they did provide cost break downs they were so far from accurate it was shocking. They quote you for an IUI around $460 but after the meds, scans and bloodwork that insurance doesn't cover it was more like $3,000 each time. The billing department was unable to help you figure out what was covered by your insurance as well. I was able to get the codes but even my insurance company was unsure until after the fact about what each scan would cost.
Another weakness is the pharmacy. Barron's is the pharmacy they recommend using. It is a wonderful place with super helpful people, but they are not the cheapest. I wish I would have known that by I had trust CC with they said it was the cheapest. Overall I felt they had no idea what their procedures were really costing patients.
At times I wanted additional tests done, like vitamin D or FSH, but CC was unwilling. They were also unwilling to try estrogen priming and other procedures that sometimes work for patients with low AMH. I felt they were very rigid in their views and treatments.
The last weakness may be more personal but still... after my 4th failed IVF I decided to move on to donor eggs. I searched the 2 donor egg banks CC recommends but was unable to find any donors I liked. I searched for several weeks before eventually branching out and looking at other donor egg banks. Eventually I found a donor I loved but it brought me under the care of a different lead RE. The RE was located in California where I'd be traveling for my transfer but I still needed all my monitoring done at Cleveland Clinic. The second I was no longer under Dr. Austin's care, they stopped helping me. Dr. Austin even met with me to say she could no longer answer questions for me because she didnt want to step on toes. I completely understood this. What I didnt understand is why I could no longer use their lab for blood work or get the appointment times that I had been using for 3 years. After I switched doctors my blood work had to be done at the main lab where I would wait for an hour at times. Then the blood would have to be sent to an external lab to be processed and results would sometimes take 1 or 2 days to come in. They even sent me to a whole other branch of the Cleveland Clinic to do a procedure they had done on my twice before, but they would no longee due since Dr. Austin wasn't my primary. I was confused by this since they were still receiving my money for these appoinyments. I felt like I was just a number to them at that point. Prior to this I had not felt that way though, but I felt it needed to be mentioned.
Describe your experience with your monitoring appointments at Cleveland Clinic Fertility Center.
Quick and easy monitoring appointments at convenient times. The lab techs were proficient and quick.
Describe the costs associated with your care under Cynthia Austin at Cleveland Clinic Fertility Center.
I mentioned this in the weakness portion but...
I paid put of pocket for everything. I felt Cleveland Clinic was unaware of how much their procedures really cost their patients. They always provided estimates but were so far off it was shocking. Their billing department was unable to help me predict costs and even my own insurance company wasnt much help. They quoted IUI as costing $460 plus meds but it really cost $3000 once scans and blood work were factored in. The IVF cycles ran anywhere from 18,000-30,000, but whatever their quotes were it always cost at least a couple thousand more.
Describe Cynthia Austin's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Cleveland Clinic Fertility Center.
I never made it to transfer but Dr. Austin did mention that she prefers to only transfer 1 embryo. If we only had 2 poorer quality embryos she said she would consider transfering 2 at that point but we would need to have a discussion about the risks.