How was your experience with David L. Kulak at Genesis Fertility and Reproductive Medicine?
We were under the direct care of Dr Kulak for nearly a year. In this time we we underwent several rounds each of clomid and injectable IUIs and a few rounds of IVF, all unsuccessful attempts. We had carefully chosen Genesis primary for the following reasons: they were in-network and they were less than a mile from our house. Our cousins had gone through IVF at another clinic and had mentioned the daunting treks they went through every morning and how their doctors had poor bedside manners. We hoped for the best and were pleasantly surprised when we found that not only was Dr Kulak tremendously patient and kind, he was also very supportive throughout the process. One IVF cycle had to be cancelled and he moved mountains to clear a room so we could convert it into an IUI same day. Another time he went out of his way for us was around the point of 6 failed attempts. My husband had trouble making a sample and it caused a huge fight between us since as everyone who goes through this process knows everything is timed exactly to the minute. When we hadn't shown up for our IUI due to my husband, the doctor called to mediate (yes, no joke) and help us find another solution. Dr Kulak is young, approachable, and generally very warm. After a year at this clinic we decided to leave to get a second opinion as he didn't haven't much experience with patients with unexplained infertility but we still have positive feelings toward the clinic.
What's one piece of advice would you give a prospective patient of David L. Kulak at Genesis Fertility and Reproductive Medicine?
He comes across as spaced out because his nature is to be very calm and relaxed. Don't fret, he's a genius. And don't be afraid to ask questions- he will even send you research and statistics if you request it.
During treatment, were you treated like a number or a human with David L. Kulak at Genesis Fertility and Reproductive Medicine?
Every patient at Genesis is considered like a family member of the staff. Not only did the nurses and doctors ALWAYS remember our names, nicknames, etc., but the phlebotomist nurses always seek to find positive things to talk about with patients. This was especially helpful for me as I was deathly afraid of needles. Knowing I had a phlebotomist who was kind and trustworthy made the process that much easier.
Describe the protocols David L. Kulak used in your cycles at Genesis Fertility and Reproductive Medicine and their degree of success.
We started at Genesis after 3 months of letrozole with timed intercourse and 12 months of unprotected relations. Gensis did extensive bloodwork on both me and my husband in the beginning, as well as a sonogram and a hysterosalpingogram. We went straight to 3 injectable IUI's using Follistim and Ovidrel.
The first IUI cycle was stimmed for approximately 8 days using Follistim. Our dosage decreased overtime from 75, to 50, to 62.50 every other day. We triggered with Ovidrel 250 units on cycle day 12. The IUI was performed was on 8/17/17 using a fresh sample and we had 3 follicles, 19, 13, and 10.5. We then used 50mg progesterone bullet suppositories.
Our second IUI was stimmed for 7 days using Follistim 75 units then triggered with Ovidrel 250 units on cycle day 12. The IUI was performed was performed on 9/13/17 using a fresh sample and we had one follicle at 17. We then used 50mg progesterone bullet suppositories.
For our third IUI, the doctor tried adjusting our dosage, again using Follistim. Our dosages were 75, 87.5, and then 100. We triggered with 250 units of Ovidrel. The IUI was performed on 10/11/17 with a fresh sample and we had two follicles, one at 15.5 and one at 14. We then used 50mg progesterone bullet suppositories.
The following month while prepping for IVF we leveraged Clomid (50 units) and practiced time intercourse. We got 4 follicles, 18, 13, 9.5, and 10.5.
Our first round of Fresh Cycle IVF began on 11/15.The cycle started with 200 Follistim and consistent 75 units of Menopur. Our Follistim dosage increased every other day by 50 units of until we ended at 350. This cycle was cancelled due to generating only about just one follicle at 16 with several 10 or under. Needless to day, we converted to IUI.
After approximately 12 days of Follistim, Menopur, and Citrotide, we triggered.
Our dosage for Follistim began at 350ui, menopur 150 units. Almost every other day the doctor requested us to change our dosage. For example, 12/22 we started at 350 Follistim, on 12/24 we went down to 275, and then on 12/25 we jumped back to 300. We came in for blood work 3 times in the first week of stims and daily the week leading up to trigger. At the final scan, we generated 19 follicles, with 4 of them mature (18-21.5 size). Our retrieval produced 18 eggs and 11 fertilized. We did a 5 day freeze transfer and found out that they performed ICSI on 8 of the embryos. We put in two embryos (5AA and 5BA) and chose to froze the remaining which were 4AB, 4BA, 3BB, 3BB, and 2BB according to their grading system. Afterwards we used progesterone suppositories 200mg and took green estradiol until our blood test.
Describe your experience with your nurse at Genesis Fertility and Reproductive Medicine. (Assigned nurse: Luchia)
Overall the nursing staff at Genesis is superb. They are warm, conscientious, and professional. Luchia (IUI nurse) and Joanne (IVF lead) stood out the most for us in our time at there. Luchia stayed late to help us figure out a last minute solution for one of our almost missed IUIs. She is sweet and has a nurturing demeanor which I appreciated greatly.
Joanne was our main point of contact once we began IVF. She conducted a private course for me and my husband on a Sunday (her day off) and even stayed to answer questions we both had and walk him through mixing the injections. She is an all-star nurse!
We did have one negative experience with one of the nurses, Nelli, which we did report to the doctor. In performing the IUI procedure she "shoved" the catheter inside of me without even looking. I mentioned it hadn't felt like that in the previous IUI's and she screamed at me to shut up. It's possible it is her personality, but I have also witnessed her aggressiveness with other patients. I would recommend to any potential patients to request NOT to have her on their team to avoid the unprofessional attitude.
Describe your experience with Genesis Fertility and Reproductive Medicine.
Genesis' greatest strength is the demeanor of its staff. From the front desk to the assistant coordinators, most staff members are very pleasant, outgoing, and friendly to all. The point of contention we found with the clinic was that they had not had much experience with couples with our diagnosis of unexplained infertility. It would suit them well to hire a doctor with this expertise to best cater toward their patients needs.
Describe your experience with your monitoring appointments at Genesis Fertility and Reproductive Medicine.
Monitoring appointments are mornings 7-8 AM and are literally a scene of herded cattle. Genesis does not have enough seating room for their patients which leads several patients to sit on the floor in the hallway until their name is called. Patients are called on a first-come basis.
Describe the costs associated with your care under David L. Kulak at Genesis Fertility and Reproductive Medicine.
Since fertility treatments are covered (somewhat) by my insurance, we luckily did not have to pay an-arm-and-a-leg. We did however get large bills of 500-1,000 dollars at a time. Genesis has a rule in place that prevents any patient from going into the clinic (for even monitoring) unless their full balance is paid.
Describe David L. Kulak's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Genesis Fertility and Reproductive Medicine.
Our doctor did not consult us prior to the day of the transfer regarding the number of embryos we would transfer. When the day came around we told them we'd like to put in 2 and he strongly advised against it due to potential complications. The clinic in general only allows 1 embryo transfer at a time as they are a proponent of singleton pregnancies, which I guess is where their greatest success comes from.
What specific things went wrong at Genesis Fertility and Reproductive Medicine?
- Failed to call in prescriptions to pharmacy
- Provided conflicting information