How was your experience with James Grifo at NYU Langone Fertility Center?
Spotting Grifo in the clinic is like spotting a celebrity. You see him once in a while in the corridors, and if you are lucky, he'll see you for 1 ultrasound out of 15. When you catch him, in your first appointment or a consultation call post PGS results, he is indeed a star. He will give you his full attention, the full truth, and will be blunt about your chances, which I appreciate, but I can see some women not being a fan of. He knows his numbers inside out, which is great, but that in itself can make you feel like another number compounding that average, that median, and keep you on your tip toes secretly hoping for the moment he will pull you aside and say "look, I followed your case day by day, I know a lot about you now, and you are not part of this statistic anymore... you are you and this is what I think!" It's not going to happen, but emotionally I'm in that phase now, as I wait for for my 2nd IVF cycle yet (I'm banking after 1 PGS-tested euploid embryo already frozen).
The retrieval is performed by the doctor in attendance that day, so if Grifo is there 1 out of 5 days, your chances of seeing him are 20%.
I just went through the embryo transfer course from Fertility IQ and am now freaking out about the performance variances across different doctors within the same clinic. Looking forward to touching base with Grifo to know his POV on this.
What's one piece of advice would you give a prospective patient of James Grifo at NYU Langone Fertility Center?
Try to take your emotions out of the equation as much as possible. Convince yourself you are making the best possible choice by enduring IVF: 1) you are maximizing your chances, 2) you are controlling the outcome (if you are doing PGS you are screening the best quality embryos in advance, and you are lowering your miscarriage chances to lower rates than mother nature), 3) you are taking an expensive, emotionally tolling, short-cut to starting a family, if time is of the essence for you.
Personally, IVF me dread every evening of treatment, but I took one day at a time, and even tried to enjoy the fact that I was taking control over my destiny (vs. years worth of trying, especially if you are retrieving a high number of eggs per cycle --imagine the monthly disappointments, or even mourning a miscarriage (which happened to be in the recent past).
Grifo is a matter-of-the-fact person, so if you are able to rationalize all the facts above, he is the doctor for you. He can be personable, funny, and charmingly smart.
During treatment, were you treated like a number or a human with James Grifo at NYU Langone Fertility Center?
You feel like a human when you are seen by the team of doctors and nurses, but once you need a follow up call with one of the doctors or nurses, the answering system is efficient, but does make you feel like just another number. They will call you back, but it's often someone you've never spoken to before. Also, sitting in a packed waiting room and having your name called among other 10 names, definitely feels like a manufacturing plant scale... The 1:1 interactions are great (with with exception of billing), but everything else around it is of inhumane scale.
Describe the protocols James Grifo used in your cycles at NYU Langone Fertility Center and their degree of success.
Gonal F, Menopur, Cetrotide and Lupron + HCG triggers. My body responded very well to drug stimulation, and all along, doses of Gonal F and Menopur were being adjusted by doctors so my follicles had time to mature appropriately. Cetrotide was taken to prevent early ovulation, and my triggers consisted of 2 days of Lupron and 1 day of HCG, at 36 and 24hrs prior to retrieval. Triggers are to be shot at specific times, so that generates a little anxiety, especially if you have to excuse yourself from a client meeting for a few minutes :(
My 1st cycle produced 20+ eggs and 2nd cycle 20+ eggs again. Quality is very different from quantity, so if you can, PGS will give you a good reality check and ensure a lower miscarriage/bad surprises rate.
I don't have final results yet as I'm still waiting on 2nd cycle results (1st one yielded 1 euploid embryo that is currently frozen).
Describe your experience with the nursing staff.
The FC NYU is a well-oiled machine. 1:1 interactions with nurses are great. And when you have to call for questions, the message service is tremendously impersonal, but efficient. Nurses will call you back in a couple of hours, and leave very unambiguous voice mails. They are great.
A few of them are more talkative and will give you invaluable tips (that should probably be part of orientation), such as: 1) if you are doing PGS, what is the best possible way to optimize timing (brith control pills); 2) if you are using the Gonal F or Follastim pens, don't throw them away if they are not completely finished as you can get a full day worth of dosage in it, or even combine it with a brand new cartridge, representing hundreds of dollars of savings in the end; 3) don't buy all drugs at once, get supplies worth a few days, because you never know how quickly your body will respond to drugs, and you might get stuck with a ton of expensive drugs you can't return.
Describe your experience with NYU Langone Fertility Center.
Not a state-of-the art clinic. Success rates, doctors, equipment were what mattered to me, but if you are looking for premium waiting rooms, 1:1 attention from your doctor during the full length of treatment, immediate responses to follow up calls, this may not be the clinic for you. The academic association of this clinic warrants a team approach, so you will have to trust the team of doctors' best practices, proven protocols, years of research and published papers. The few star doctors of the clinic will be there for you if you really need them. But you will need to be a very patient patient.
In FC NYU there are great embryologists, so if you fear your age is determining a lower quality of your eggs, you want that team looking at your embryos and performing biopsies. You also want to go for the PGS testing lab they recommend and trust their interpretation of results.
One thing I absolutely loathed about this clinic was the billing department. Staff sitting there is misinformed, inefficient, insecure, and unprofessional. Even if you consider that dealing with any insurance is a dreadful process, the billing team should be 200% better at their jobs. Every time I know I have to deal with them, my adrenaline is through the roof. FC, please reassess billing staff + provide better "client services" training and make measurable improvements ASAP!
Describe your experience with your monitoring appointments at NYU Langone Fertility Center.
Efficient well-oiled machine. Nurses are very personable despite the scale of the clinic. Well-mannered, up beat, rain or shine, as early as 7.30 on a holiday. They are GREAT!
Describe the costs associated with your care under James Grifo at NYU Langone Fertility Center.
Depends. If insurance covers, the value per IVF cycle charged is lower (about $7,500), if you are paying OOP the iVF cycle is about $10,200. Retrieval anesthesia, cryo, transfer, PGS costs, drugs are all separate. I don't have all the info yet because of insurance processing delays, but if you are doing all OOP, costs are as follow (approx. total $: 24,000)
- $15,300 retrieval + cryo + PGS
- $1,000 retrieval anesthesia
- $2,500 PGS lab testing (minimum fee, pending # of biopsied embryos)
- $5,000 drugs
Insurance scam I leaned about after many hours on the phone amidst my full time job: my Express Scripts insurance drug coverage gives me a lifetime max coverage of $4,000. If I process through insurance 1 pen of Gonal F 900 units, the cost is of $1,900. If I pay OOP, the cost is of $850 through the same pharmacy. So.... with my insurance I was hoping to cover at least 80% of the drugs I needed for 1 cylce, and with 2 pens of Gonal F (approx. 10% of the drugs I actually needed) my life time max was done!
Appalling... specially when you read Australian blogs in which women go through 10 cycles of IVF for free...
Describe James Grifo's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at NYU Langone Fertility Center.
Not discussed with Grifo yet, but my philosophy is to take as little drugs as possible, especially after the recent bombarding I did to my body, and the fact that I have no issues ovulating and a well functioning endometrium.
What specific things went wrong at NYU Langone Fertility Center?
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at NYU Langone Fertility Center.
Billing: Even if you consider that dealing with any insurance is a dreadful process, the billing team should be 200% better at their jobs. A few real life examples:
1) on day 2 of your cycle, you have to make the payment for the full treatment, already considering what your insurance will and will not cover. I got the initial information about the PGS test price during my first visit with Grifo months ago, but when I went to actually pay for the test, the billing department surprised me by saying that the lab costs were separate and could amount to almost the same price you pay for the biopsy in FC. No one ever told us that biopsy in FC and analysis in a lab are 2 separate costs, that are almost as equally costly. End result: by surprise, we spent 60% more for a test we were initially misinformed was going to cost "only" $3,600 (it's not covered by insurance).
2) on day 2 of my 2nd cycle I was the one to bring up the fact that my insurance was not going to cover my 2nd full cycle (they have a life time max that covers about 1.5 IVF cycles). The person from billing had already charged my new PGS $3,600 and forgot to check my coverage, so I had to bring it up myself. Once she started digging, she repeatedly stood up to ask for more info from her supervisors, and every time came back with a different number. A total nightmare. That day, I spent over $3,000, and all the "documentation" I got was a poorly hand-written post-it (front and back), a copy of my credit card receipt, and a verbal statement "there is no way for us to know how much your insurance has actually covered at this point, so at some point we can refund you in case you paid in excess, but I can give you this post-it with the itemized list of expenses". WHAT?!?!?!?!? I definitely expected to get better financial information from a billing department, specially since everything else in the clinic seems to be a large scale highly-functioning well-run BUSINESS. FC, please reassess billing staff + provide feedback + improvements ASAP - billing lady on 03/22/2018 at approx 9.30am.
3) on day 2 as I was making the payment for another cycle, I asked yet another billing lady for itemization of services and wanted to confirm that the price for the cryopreservation was already taken care of (specially if you are nervous you have 1 single good embryo in the freezer, you want to make sure the contractual/financial part is in good standing). Her answer "I don't have time for this now, I should not get into any details with you, look, there are other patients waiting, I'm alone here this Saturday, whereas there are 30 nurses here today. Are you going to make this $8,200 payment now on your card? We need to move on". WHAT?!?!?!??! I'm giving you almost $10,000 and you can't give me the time of day to answer a financial question? Well, she did give me another post-it I guess. I have no idea what was formalized into the system as paid or unpaid. I guess I still need to be open for surprises. FC, please reassess billing staff + provide feedback + improvements ASAP - billing lady on 03/24/2018 at approx 8.30am.