How was your experience with Daniel Levine at Hudson Valley Fertility?
Dr. Levine is very compassionate, explanatory, friendly, and has a great great bedside manner. He makes himself available for many of the appointments personally. He doesn't sugar coat the odds. He does ample testing to cover all bases. He, personally, has performed most of my IUI's (a few were done by his P.A.), all of my saline sonograms, hysteroscopies/D&C's, ERA, and my IVF retrieval/transfer. If you don't want to be passed between many different doctors, this is the place. He adjusts treatments frequently based on lab work and ultrasounds. His lab had phenomenal results for us using ICSI and growing out my poor aging eggs to blastocyst stage for PGS testing. If I had to pick a few downsides, I'd say it's that they barely have a donor egg/embryo program and the little that is available seems much more expensive than other places.
What's one piece of advice would you give a prospective patient of Daniel Levine at Hudson Valley Fertility?
Ask lots of questions. Take notes after each appointment. Speak up if you're uncomfortable or don't understand any procedure.
During treatment, were you treated like a number or a human with Daniel Levine at Hudson Valley Fertility?
Most of the staff were extremely friendly and knew us by name. Very supportive during breaking bad news.
Describe the protocols Daniel Levine used in your cycles at Hudson Valley Fertility and their degree of success.
I have PCOS so I always had a decent amount of follicles/eggs during IUI cycles and IVF. I am also AMA. Dr Levine was always careful to balance meds and not overstimulate. Our very first IUI cycle (many years ago) was cancelled due to fast response to meds and far too many follicles to procede with IUI.
All of my meds for IUI were either Follistim alone (150-225iu per day), or a combination of either Letrozole 5mg (or Clomid 100mg) and Follistim together. For IUI we occasionally used 250mcg Ganarellix for a few days to hold off ovulation and let follicles catch up with others. For every IUI we used 250mg Ovidrel as the trigger. Every cycle we used progesterone suppositories during the luteal phase.
For our one IVF cycle, we used 225iu of monopur for 11 days and 225iu of Follistim/Gonal F concurrently for 11 days. For 5 of the 11 days, we also used Ganarellix 250iu. We used a half dose trigger of 5,000iu of Pregnyl to lessen the risk of OHSS since my estrogen was high (over 5,000) and I had approx 27 follicles. We used cabergoline after retrieval to avoid OHSS also.
On day 14 we had 22 eggs retrieved. 15 were mature and 2 more were able to be matured in the lab for a total of 17. All 17 fertilized with ICSI. At day 3 we still had 17 embryos. (9 grade 1; 5 grade 2; and 3 grade 3). By day 5 we had 3 AA blastocysts that were biopsied for PGS and then frozen. At day 6 we had 3 more blastocysts (grade BB) that were biopsied for PGS and then frozen. The other 11 embryos were either low quality C blasts or deteriorated and stop growing.
We had 1 PGS normal blast and 1 inconclusive blast from the testing. The other 4 had monosomies, trisomies, or multiple chromosomal errors.
7 months later we transferred both blastocysts. The 7 month delay was from me needing a few procedures on my uterus and also having 2 transfers cancelled due to lining issues and unexpected bleeding.
For lining prep and during and after transfer we ultimately used BCP, Lupron, Estrace orally, Estrace vaginally, estrogen patches, delestrogen injections, progesterone vaginally, progesterone in oil injections, Lovenox, Medrol, and doxycycline. We also used Valium the day of transfer.
1 of our 2 embryos stuck but stopped growing near 5 to 6 weeks. A heavy bleed following shortly after, but I ultimately ended up needing a hysteroscopy/D&C near 10 weeks for a retained gestational sack.
Describe your experience with the nursing staff.
The nursing staff were all extremely friendly and compassionate. Their phlebotomist was excellent and gets blood on the first poke 99% of the time.
Describe your experience with Hudson Valley Fertility.
I think I've gone thru the strengths already fairly well. One more huge strength is their working with many insurance companies. In addition, they often were able to get many things covered that my insurance claimed were not covered. Also, if they happen to have any sample meds or donated meds around, they'll give you what they can.
So I believe some of the weaknesses would be the phone system and return phone calls. I believe a human answering the phone initially for every call would be better than an answering machine routing calls. I also believe there should be an option to speak to a nurse or be put on hold for a nurse (instead of message and call backs eventually).
I also think they could use improvement for medication instructions for injections, med storage, and instructions for time of day for meds. Being sent to a generic web site for instructions that aren't the exact meds or exact needle delivery system wasn't very helpful. A good printed instruction sheet and FAQ for meds frequently used would have been better. I googled things far too often to figure out what I was doing.
Even with these few negatives, the positives of Dr Levine's office FAR outweigh the negatives.
Describe the costs associated with your care under Daniel Levine at Hudson Valley Fertility.
Costs were broken up into a million different costs also billed thru insurance. So it's difficult to say what total costs would have been for cash pay. Many options were ala cart and could have been chosen or not depending on your preferences and needs.
Describe Daniel Levine's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Hudson Valley Fertility.
Dr Levine runs a very tight ethical ship however he uses common sense and weighs the odds and uses his experience to make sounds decisions with number of embryos transferred. Before we knew how many embryos I would get (remember I'm advanced maternal age) he was leaning towards transferring a couple (2-4) day 3 embryos. When we had 17 day 3 embryos we decided to grow out to day 5 and go along with my husband and my desire to PGS test. When we had 1 PGS normal and 1 inconclusive blastocyst, Dr Levine was supportive of our choice to transfer 2 back in.
What specific things went wrong at Hudson Valley Fertility?
- Failed to call with results