Dr. Balmir is kind and puts your mind at ease in appointments, but I never once saw her in person. I had two virtual appointments and never met her when I went in for monitoring or IUIs. I never heard from her when treatments failed or in response to MyChart messages...Above all, be prepared to do a lot of your own research, self-advocacy, and follow-up. I asked for increases in my medication dosages, to add progesterone, to have my thyroid rechecked after a dose adjustment, and to be monitored earlier in my cycle because of when I was getting positive OPKs
Ask to be put on the IVF waitlist [at Jones Institute] immediately. Even if you never end up needing IVF, at least you won’t find out about a months long waitlist once you’re already ready to start. Above all, be prepared to do a lot of your own research, self-advocacy, and follow-up...I often had to remind them of what medication I was on, and my mid-cycle ultrasounds were scheduled on a different day each cycle
How was your experience with Fabiola Balmir at Jones Institute at West Penn Allegheny?
Dr. Balmir is kind and puts your mind at ease in appointments, but I never once saw her in person. I had two virtual appointments and never met her when I went in for monitoring or IUIs. I never heard from her when treatments failed or in response to MyChart messages. She led me to believe that we would do 3-4 IUIs in our first consult, and I learned only later, when I told a nurse I wanted to move onto IVF, that there was a 6-12 month waitlist. I felt misled and like a detailed care plan hadn’t been made for me. I told her in our last video visit that we would be moving to another clinic for IVF, and she told me she’d do everything in her power to get me pregnant before then. My very next IUI was cancelled because the clinic did not monitor me closely enough and I ovulated before my mid cycle ultrasound.
She does take the time you need with her in appointments, but (and probably because of this) she is always extremely late. She was over 30 minutes late for both of my appointments.
What's one piece of advice would you give a prospective patient of Fabiola Balmir at Jones Institute at West Penn Allegheny?
Be prepared for her to be late to appointments and for it to be difficult to contact her. Ask her up front about all of your options, and what the wait times are to begin those options. Ask to be put on the IVF waitlist immediately. Even if you never end up needing IVF, at least you won’t find out about a months long waitlist once you’re already ready to start.
Above all, be prepared to do a lot of your own research, self-advocacy, and follow-up. I asked for increases in my medication dosages, to add progesterone, to have my thyroid rechecked after a dose adjustment, and to be monitored earlier in my cycle because of when I was getting positive OPKs. Each time I was told “oh yes, we can do that” - but no one was making these adjustments or recommendations for me.
During treatment, were you treated like a number or a human with Fabiola Balmir at Jones Institute at West Penn Allegheny?
Dr. Balmir has great bedside manner, and my husband and I felt really confident in her plan for us (3-4 IUIs) after our first appointment. However, once we got started with IUIs, I quickly began to feel like a number. Each month when I called with a negative pregnancy test, the nurses were straight to business getting me schedule - there was no acknowledgement of the emotional toll of the failures. I often had to remind them of what medication I was on, and my mid-cycle ultrasounds were scheduled on a different day each cycle. It didn’t seem there was any thought as to how the last cycle had gone. On occasions when I needed to communicate with Dr. Balmir, I was unable to. I could not reach her by phone or MyChart, and was told to make a follow up appointment when I wanted to ask her a question (minimum of 3 weeks wait time).
Describe the protocols Fabiola Balmir used in your cycles at Jones Institute at West Penn Allegheny and their degree of success.
I did 3 medicated IUIs with letrozole for 5 days, beginning on cycle day 3 (first two cycles were 5 mcg; 3rd cycle 7.5 mcg; I took 5 days of 7.5 mcg for a 4th cycle that was canceled). On my first 2 cycles I had 2 mature follicles, in the 3rd I had 3. In the 4th the mid cycle ultrasound was too late and I had already ovulated. I also has Ovidrel (trigger shot) for the first 3.
In my first cycle only, they brought me in for a baseline US and bloodwork. I never again had bloodwork until what should have been my 4th IUI, because the ultrasound tech saw that it looked like I had already ovulated.
They only brought me in for one mid-cycle ultrasound, ranging between days 11 and 14 (never on the same day) and although my follicle sizes and uterine lining measurements were different each time, I was always told to trigger that night.
None of my IUIs were successful, and I’m now in the TWW after my canceled IUI (I was told to have timed intercourse instead).
Describe your experience with the nursing staff at Jones Institute at West Penn Allegheny.
I very rarely spoke to the same nurse, and never felt that any of them knew me.
There were numerous occasions in which they conveyed a different care plan to me than what Dr. Balmir and I had discussed, and I had to correct information (for example, she wanted me on letrozole; they tried to start me on clomid. She wanted a day 12 ultrasound, they tried to schedule it for day 14).
Each month when I called to tell them I’d had a negative pregnancy test, they jumped right into scheduling without asking how I was doing, offering any condolences or encouragement. It never felt like they were invested in my journey or really knew where I was in the process.
The nurse who called with my ultrasound results most recently told me in a very chipper tone that I had one collapsed follicle and bloodwork showed I had ovulated, so Dr. Balmir wanted me to have timed intercourse that night. I had to ask her if this meant my IUI was canceled, and she said “yes, we would have had to do it today!” She offered no apology or empathy over this.
Describe your experience with Jones Institute at West Penn Allegheny.
They had good availability for morning monitoring during the week.
A huge limitation is that this clinic does not do monitoring on weekends (at least for IUI, which has been my only experience), so if the best day for your mid cycle ultrasound falls on a weekend, you’re out of luck. It seems that they schedule your appointments based on their convenience rather than what will optimize the chances of your treatment working.
It is impossible to get anyone on the phone - you always have to leave a message and wait for a call back.
As of the time of this review, they have a 6-12 non to wait list to begin IVF, even if you are an established patient, and they are not upfront about this. They have limited OR time and few embryologists, which I was told is the reason for the outrageously long waitlist.
Describe the costs associated with your care under Fabiola Balmir at Jones Institute at West Penn Allegheny.
I was lucky to have insurance coverage. I paid about $95 in coinsurance for meds, and about the same for the IUI.
What specific things went wrong at Jones Institute at West Penn Allegheny?
- Failed to order appropriate test
- Failed to send your chart to another clinic
- Canceled a cycle due to clinic error
Describe the specific things that went wrong at Jones Institute at West Penn Allegheny.
During my first appointment, Dr. Balmir told me she wanted me on a letrozole protocol and had concerns about me being on clomid based on my medical history. She also wanted me to have a day 12 ultrasound. When I spoke with a nurse about starting my first IUI, she had clomid in my chart and a day 14 ultrasound. I had to push back multiple times to get her to confirm with Dr. Balmir.
After my first failed IUI, I sent a message through MyChart stating that I wanted to move on to IVF if the second failed. I received a response from a nurse informing me that there was a 6-12 month wait list - no apology or explanation offered. I asked to speak to my doctor, and she stopped responding.
What should have been my 4th IUI was canceled because they do not do monitoring on the weekends. I called on a Sunday morning to notify them of a positive ovulation test. Instead of bringing me in for an ultrasound, they kept my appointment for the next day. 5 hours after my ultrasound I was told that it was too late to do the IUI, that we would have had to do it that day. Had they adjusted my plan of care based on the information I provided about the OPK (as they asked me to), my IUI would not have been cancelled and I would have had another opportunity for this less invasive procedure to work prior to moving to another clinic for IVF.
1
Clinic
Jones Institute at West Penn Allegheny
Pittsburgh