James Nodler

Dr. Nodler is smart, kind and strikes the right balance of setting realistic expectations but also providing hope. He has good attention to detail and really seems to care about his patients' outcomes. I like that he practices evidence based medicine, but this means his protocols/approach may sometimes feel less holistic (not a lot of time spent discussing supplements and other TBD ART supports). I thankfully haven't had any major disappointments to date, so can't comment on how he might adjust/personalize protocols in the event of disappointing outcomes.

Ask questions and share any concerns you have- I've found Dr. Nodler is always happy to provide more information or explain his thought process.

Dr. Nodler and his nursing staff (Amelia and Erin) have all been warm, available and encouraging to date. I like to know exactly what's going on at each step of the process and they always seem happy to answer my questions. I am also prone to negativity and Dr. Nodler and Amelia have been so kind- they are realistic but offer regular reassurance where it is due.

IUI was really managed by the nurses. I have a high AMH and was prescribed clomid only (no injectables). Monitoring was overseen by Dr. Nodler, but the actual IUI was performed by the nurses. I had a different nurse each time, and no specific point person if I had questions during the cycle (just had to call the nurse line). I didn't feel like IUI cycles were a priority for this clinic. My experience was totally different once we moved on to IVF. IVF patients are assigned a specific nurse and this makes communication much easier. Monitoring ultrasounds were done by Dr. Nolder (or the REI covering for him if he was not available). I was prescribed gonal-f (150), menopur (150) and cetrotide. I responded well to meds and my protocol did not need to be adjusted. I did a dual trigger with lurpon to avoid OHSS. We did ICSI as that is standard for my clinic (and as we used frozen donor sperm). We retrieved 16 eggs, 13 mature, 13 fertilized, 9 day 5/6 blasts, 4/9 normal CCS/PGS results. Recovery from the egg retrieval was easy and fast. Our first FET cycle is currently in process.

Amelia is smart and responsive. I do think she is a very busy person, and I sometimes felt bad asking extra questions, but she always responded to me same day. I found emailing her was sometimes easier than playing phone tag.

Houston IVF/ CCRM-Houston may be a bit more expensive than other clinics in the area but I think it is worth the costs. I have interacted with all 4 REIs and believe they are all very skilled and up-to-date physicians who care about their patients. I also think the lab is superior to many other clinics in Houston. I had better than expected outcomes (100% fertilization of mature eggs 13/13 and good blastocyst rate 9/13, 70%). I wish they paid as much detail to patients' IUI cycles as they do IVF, but understand that IUI is a much less controlled and lower cost procedure, so it makes sense that IVF cycles are prioritized. That said, if someone's goal is to conceive via IUI and to really avoid moving on to IVF, this may not be the clinic for you. To summarize: smart and personable REIs and nurses, a great lab and a comfortable and convenient physical space (I used both the med center and memorial city locations).

IUI: $1,300 per cycle (including all monitoring) IVF (PGS with FET): $20,630 (included all monitoring, CCS/PGS and first FET), NOT including medications

I personally feel very strongly about eSET and Dr. Nolder was aware of this from the beginning so multiple embryo transfer was never a conversation we had. I do believe this clinic does more multiple embryo transfers than is ideal because they are quick to honor patient wishes and I think many patients ask for multiple embryo transfer.

Dr. Nodler is really knowledgeable and really nice. Sometimes, though, I felt like he wasn’t putting the research into our case. It was “unexplained infertility” and move to IVF instead of figuring out the cause of our infertility that could maybe be fixed by diet, supplements, or lifestyle changes. He has been great though, especially since the many failures and setbacks we have had, even calling me personally after we lost our baby at 10 weeks to unknown issues.

Ask lots of questions and request all the details.

What is great about Dr. Nodler is that he is at the Houston IVF Med center location so it is more intimate, he does his own ultrasounds, and knows who you are. The Memorial City location is big and you can feel like a number over there.

We first did our blood work and scans and I had a minor septum so we did surgery on that. We then started with 3 IUIs using Letrozole, which didn’t worked. My insurance covered three which is why we did 3 but that is also normal protocol. We then moved to IVF using Menopur and Follistim. Our goal was a fresh cycle but I had over stimulation so we froze the eggs, 4. 3 tested normal during PGS and one was unknown. We then did a FET once my body got back to normal. FET 1 worked but at 10 weeks we had to terminate due to the growth of the organs outside the fetus body. It was never determined if that was genetic related. Have a long recovery from the D&C we did FET 2 which ended in a chemical pregnancy at 6 weeks. Currently waiting to start FET 3. All FETs have been the same protocol: 3 weeks birth control, lupron, estrogen patches, PIO, and progesterone suppositories.

Amelia is amazing. She returns all my calls timely and understands exactly what we are going through and is alway willing to help us out with scheduling issues or getting meds ordered timely.

Houston IVF can be big so I recommend the med center location. They have great resources so use them all - therapy, acupuncture, etc. You do have to go to the memorial city location for all big procedures.

IUIs, labs, egg retrieval and FET 1 were covered by insurance so I paid 20% until my $500 deductible. FET 2 was $4,500.

I wanted to transfer 2 the first time but he wanted one as it is statistically better and safer. It didn’t work. For the 2nd FET I again pushed for two but he wanted one so we did one. We now have two embryos left so we are finally transferring two during FET 3.

The first thing I liked about Dr Noddler is how smart he was and how informed he seemed about the most up to date information. I consider myself an intelligent woman, so I went into our relationship having concerns and things I wanted clarification on. Dr Noddler without hesitation answered all of my questions and had a very sophisticated approached to my treatment. He was also lighthearted when needed and serious when necessary. I really enjoy being his patient.

Dr Noddler and his nurse use a very black and white protocol. The patient needs to know that every step of their plan is being carefully put together for each patient's best result

Doctor Noddler always greeted me by name, remembered conversations from previous meetings and always cared about what I had to say. He never rushed me out of the office and answered every question I had without problem.

I have a very high AMH so my antagonist protocol had to be very closely monitored. The reason I switched to Houston IVF and Dr Noddler is because my previous clinic and Dr over stimulated me so badly that I ended up with severe OHSS. To the point I had to have my belly drained. This was my biggest concern when I first met with Dr Noddler, and he took my concerns very seriously. He tailored my program to stimulate me enough to get good quality eggs, but not so much to cause me an discomfort. With a perfect cocktail of drugs, I was able to produce 26 eggs, 16 fertilized, and 9 grew to 5 day blasts. out of those 9, 3 were graded 5AA the highest quality egg possible. I am currently still in treatment. I've had my 5 day blast frozen embryo transfer 4 days ago, so I can't comment if it worked, but so far this has been the best experience I could have hoped for.

There are not enough superlative adjectives to describe how amazing Amelia has been with me. I am a super type A pain in the butt and never once did I feel like she was annoyed with me. She is so knowledgeable and kind, and funny and light hearted but serious when needed. She is truly the best and I wouldn't want to do this journey without her.

The expression "you get what you pay for" is a perfect one for this clinic. It is a little bit more expensive than my previous one, but the amount of attention and personal service you get is worth every penny!

Monitoring appointments were always at 7:30am outside of working hours, so perfect

20,500$

I demanded that I have an eSET because I'm petrified of having twins. I was lucky that I fit in the perameter of those that qualify to have eSET

My egg retrieval, fertilization and blastocyst results improved with Dr Nodler. I believe that this is the result of the protocol that Dr Nodler put me on. I transferred 2 PGS embryos, and both failed to implant. In the follow up, there were no explanations of why, just many possibilities. He suggested that I do an ERA (which I am doing) or use a gestational carrier. I am hoping for a more conservation solution.

Let Dr Nodler make his recommendations and follow them. He is the expert, not us.

Dr James Nodler is attentive, caring and kind.

For simulations, Dr Nodler used the antagonist protocol. It worked well. I do not know why he chose that particular protocol. Our main issue is male factor resulting from Robertsonian Translocation 13/14. He recommended CCS to screen all 46 chromosomes for abnormalities.

My primary nurse Amelia was great and responsive, when she was in the office. When she was out of the office, it was difficult to get a response, or I got no response at all. The on call nursing staff needs to improve their communication style with the patients. They are timely in their response times; however, there responses can be short and seemingly irritated. And if you miss their call, or have a follow up question, they get upset. Since cost of treatment is out of pocket, many patients will attempt to get some procedures covered by their insurance. The billing department is very slow to respond and requires multiple follow ups to get required information.

The strengths are the doctors and their affiliation with CCRM. In every appointment in which I saw Dr Nodler he asked if I had any questions. At that point, I could ask any question I had, whether it had to do with this particular appointment or something else. Procedures are performed by any doctor within the practice. Initially I was concerned about this, but it wasn't an issue at all. The weaknesses are the on call staff, billing department and their fees which are higher than other clinics.

Egg retrieval, PGS (7 embryos), FET (1 time) = $21,000 ERA= $2,350

Due to my history of failed SET of PGS embryos, I requested to transfer 2 and he did. But he recommended I do one. I wish I had listened to him.

James Nodler is an excellent doctor. After many years of infertility, we had great success under his care. I have twins, conceived on the first round of IVF. My experience was positive; every visit and procedure went very smoothly.

Ask lots of questions. He will explain in detail anything you are unsure about.

Dr Nodler took the time to get a thorough history of my infertility journey. He made clear what results I could expect from various procedures. He spoke freely about statistics, allowing me to have a realistic understanding of my chances of success.

Dr Nodler explained all our options and we all (Dr Nodler, my husband and myself) felt comfortable with an IVF cycle. Ultrasounds were done to assess my uterus, ovaries and eggs. Blood work was done to screen for other potential issues that would prevent conceiving. We were able to proceed with no issues.

Weakness: somewhat hard to reach via phone- lots of transferring or leaving messages for a call back. Strengths: blood work in house was very convenient, nice and clean facility and short wait times. Lobby staff was always friendly.

We did chromosomal testing on the embryos. We elected to transfer 2 embryos, understanding that chromasomally normal embryos would have a higher chance of implementing with no issues to follow. We understood that our chances of twins would be higher.

We are still currently in the process of treatments as we recently had a failed IUI and are now starting our IVF treatment. So far, everything has gone smoothly and we have been well-informed on the process of IUI/IVF.

Always be open, honest and ask as many questions as you can. He is very professional and personable and takes the time to answer all of your questions.

Dr. Nodler took the time to explain the process and go over our test results in detail so we knew what what was going on and what to expect for the future.

Only weakness I could see is that it's really hard to get a hold of a person, you have to always leave a message. They do respond back typically within a few hours so the wait time isn't too long.

My insurance covered three rounds of IUI and one round of IVF. Currently do not know the final cost of IVF.