How was your experience with Hey-Joo Kang at Weill Cornell Medical College?
Dr. Kang has been great thus far - I appreciated that she did not immediately push us to IVF and instead took a more pragmatic approach of trying IUI. She did my first IUI, and then the 2nd cycle I asked to do a double IUI, both of which were performed by nurse practitioners.
One thing I will say is I feel like the timing of the IUIs may not have been ideal. First cycle was only 22 hours post trigger (which seemed early), and 2nd cycle had IUIs at 26 & 51 hours (2nd seemed really late). I would prefer they teach you how to administer the trigger shot at home on your own so you can get the timing closer to 36 hours (my IUIs were all in the morning about 9:30-11). We're still awaiting results of 2nd cycle, but if it didn't work I'm going to push for that.
What's one piece of advice would you give a prospective patient of Hey-Joo Kang at Weill Cornell Medical College?
The clinic is busy and they talk fast. Be prepared with questions for each visit with her, or you can call & talk to her assistant (Diana) or the nursing staff. Especially when it's your first cycle I feel like you need to do this or you may wish later on you'd done things differently (it's expensive you want to maximize your odds of success each round).
During treatment, were you treated like a number or a human with Hey-Joo Kang at Weill Cornell Medical College?
Based upon the process thus far, we are happy we chose Dr. Kang. She has a nice demeanor, and is very easy to talk to but also professional & clinical. I've been fortunate to see her for all my monitoring ultrasounds at CRM except one (which was with an RE fellow). Given the volume of patients they have at the clinic, she is good with remembering our specifics and has been helpful in keeping our spirits up during what can be an emotional, difficult process.
Describe the protocols Hey-Joo Kang used in your cycles at Weill Cornell Medical College and their degree of success.
First cycle, I went in for baseline bloodwork & ultrasound on Day 2, then took 100 mg Clomid/day for Days 2-6, monitoring bloodwork & ultrasound Days 12, 13 & 15, and trigger shot on Day 15 with IUI next morning (22 hours after trigger; 2.25 hours post collection). Had 3 mature follicles (16, 20, & 21) on day of trigger. Did not work and Dr. Kang said afterward that clomid had resulted in thinning of the uterine lining (endometrial stripe was 6.8 when triggered), so we would try letrozole/femara next round.
Second cycle did baseline bloodwork & ultrasound on Day 4, with 5 mg letrozole/day for Days 4-8, monitoring bloodwork & ultrasound Days 11 & 15, and trigger shot on Day 15 with double IUI next 2 mornings (26 hours after trigger, 1.5 hours post collection, & 51 hours after trigger, 2 hours post collection). Had only 2 mature follicles (21 & 14) on letrozole but better uterine lining (9.4), but given my age if this cycle doesn't work she recommended going back to clomid to increase our odds with more follicles.
Describe your experience with the nursing staff.
Thus far in my treatment at CRM, I have not felt like I had one particular assigned nurse or clinical coordinator. Would be really helpful for them to establish a single point of contact up front for clinical questions/issues, and in particular if you could communicate with them more directly via email, secure message etc. Sometimes you are not in a workspace conducive to being on the phone talking about your treatment, and at those times having an alternate method by which to communicate with their staff would be invaluable.
Describe your experience with Weill Cornell Medical College.
Weill Cornell has a large volume of patients, and it's not cheap. But hopefully you get top notch treatment and that will make it all worthwhile. For daily monitoring, come as early as you can (ideally before 7 AM) to get in & out more quickly. Also, it seems in 2019 they have enhanced their financial collection efforts - I had not even invoiced yet for coinsurance from my 1st cycle and they were asking me to pay the balance prior to starting my 2nd cycle.
Describe the costs associated with your care under Hey-Joo Kang at Weill Cornell Medical College.
Our insurance has a $30K lifetime max for infertility treatment so I've been tracking costs of everything really carefully. Would recommend putting it in a spreadsheet right away because there will be A LOT of insurance claims and it can get very confusing. Here's how it breaks down thus far (total for both husband & myself):
o Diagnosis (physician consult, bloodwork/ultrasound, semen analysis & HSG test) = Billed charges ~$5,700; after discounts our insurance paid ~ $3,200; our cost sharing (deductible & coinsurance) ~ $900.
o Genetic Testing (through Mt. Sinai Genomics/Sema4) = Billed charges ~$20,500; after discounts our insurance paid ~ $1,400; our cost sharing ~ $500
** I think the billing staff at CRM said if the genetic testing was not covered by insurance it would only cost a few hundred dollars each, so was completely shocked by the enormous amount billed to our insurance. Wish they would have told us about that in advance (and fortunately our insurance confirmed genetic testing would not go toward our $30K lifetime maximum).**
o IUI cycle #1 (medical) = Billed charges ~$4,600; after discounts our insurance paid ~ $3,300; our cost sharing ~ $300;
o IUI cycle #1 (Rx-clomid & ovidrel) = after discounts our insurance paid ~ $70; our cost sharing ~ $130
o IUI cycle #2 (medical-estimate) = Billed charges ~$4,700; after discounts our insurance paid ~ $3,500; our cost sharing ~ $400;
o IUI cycle #2 (Rx-letrozole & ovidrel) = after discounts our insurance paid ~ $50; our cost sharing ~ $120
Describe Hey-Joo Kang's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Weill Cornell Medical College.
N/A - have not discussed since we are only doing IUI so far.
What specific things went wrong at Weill Cornell Medical College?
- Failed to call in prescriptions to pharmacy
- Provided conflicting information
Describe the specific things that went wrong at Weill Cornell Medical College.
For my 1st cycle it was a bit of a scramble to get the trigger shot (ovidrel) in time. CRM's prior authorization team did not submit the request to my Rx insurance when they should have, and it resulted in me having to spend a lot of time on the phone with CVS Caremark mail order specialty pharmacy trying to ensure I could get it in time from them or someplace else & pay out of pocket. At the end of the day it worked out (and absolute worst case you could pay for script in-house at CRM) but it was a lot of stress that could have been avoided if they acted in a more timely fashion. Just be sure to keep on top of them, and call Dr. Kang's assistant, Diana, if you run into a problem.