Jeffrey Nelson

We didn't know much about fertility treatment when we began our fertility journey. Upon consultation, we were told that we should have started our treatment years ago, which was discouraging considering we had just gotten married and there was nothing we could do about that. We began with all diagnostics to make sure that everything in my body was working as it should, which was Dr. Nelson's suggestion. We were never told that anything wasn't "good." HRC Pasadena in general had many miscommunications and directions given to us that were not clear, from both the medical assistant assigned to our case to the financial coordinator. As we began our treatments with Dr. Nelson, which was close to our home and convenient, he began conservatively. We appreciated this because I came in believing, and was under the impression even after all the labs, that I was fertile Myrtle. We were NEVER told that my AMH was under 1 when we began trying to get pregnant. It wasn't until we were out of funds in 2017 where we were just paying our OBGYN to do IUIs that we consulted with another fertility doctor who went over our labs from 2015 and said that she would have started with IVF immediately back in 2015 to retrieve the eggs I had! I have been so so so so so disappointed in the fact that 2 years and over $50,000 have been spent without us knowing the proper information. We have taken time off to build up our financials so we can try retrievals once again AND here we are in 2019 now with nothing. I'm SO angry, upset, resentful and frustrated that my bloodwork and personal lab results were withheld and not given to me clearly in 2015 when I was 34 as they would have changed our plan and how we proceed. I also know now that if someone says something to you like, "you should have started your fertility journey years ago," they are NOT the person you should trust to guide you on your way to making a baby.

Don't expect a physician to objectively explain your lab work or the process. Get educated and ask for all of your information and labs to be printed for you so you can get educated on your own.

Dr. Nelson wanted to start with bloodwork and diagnostics to make sure that my body was functioning properly. He suggested we start with an ICI, which was very conservative and in hindsight, we have no idea why he would start there if he knew that my AMH was below 1. We asked about using Clomid, which he didn't offer immediately. Going into our first insemination, we did use Clomid, per our own request, and we did request an IUI. After the first insemination, he thought the Clomid was pointless and he didn't suggest any other meds except the HCG trigger shot. We continued with 3 more IUIs using HCG trigger shots, none of them resulting in pregnancy. It was after our 4th insemination that the nurse practitioner, who we'd just met, said, "you should just do IVF." At that point we were done with this office and never received a call or follow up from Dr. Nelson.

Each time we did a round of IUI, it was $2000 for the procedure + the cost of meds + the cost of sperm = $3500-$4000 each round of IUI.

We never go to this point with Dr. Nelson.

Dr. Nelson is good at what he does. I liked him a lot, and if I do this again I would choose him again. His team is great at keeping in constant contact and answering questions. They are also genuinely excited to see you make progress in this crazy process.

I'm sorry you need fertility treatments. HRC is a peaceful place to go deal with hell and Dr Nelson a steady guide through.

For egg retrieval we did one cycle. Treatment was 375 ml(?) follistim and 1 vial menapour. This resulted in 25 eggs, so the planned trigger was changed to a lupron trigger (unknown dose) to prevent OHSS. I did not get OHSS but it was still rough. By collection, follicles are about marble sized and stretching the uterus a lot. Currently in the beginning of the FET cycle.

Full IVF cycle, plus genetic testing (generic and specific) and freezing for a year $18k. Drugs is another 4-5k. Not finished yet, so not totally sure of final tally there.

Dr Nelson is open to transferring two embryos at a time since we are open to the possibility of twins. No more because the risk of high multiples is to great and the chance of pregnancy not increased enough.

Dr Nelson is a great doctor and very kind throughout the process. I found that sometimes I had to do some research and bring it to him vs. him proactively recommending protocols. The area of improvement is largely with the admin staff - the financial team certainly has much room for improvement as messaging is inconsistent and they do not have the detail orientation and follow through that I would prefer when spending this amount of money.

Do your homework and go in with questions. He will listen and address your questions.

I underwent 3 unsuccessful IUIs, followed by 3 egg retrievals. My first transfer was a fresh transfer that resulted in a successful pregnancy but ultimately went into pre-term labor at 5 months which resulted in the loss of our daughter. In our subsequent transfers - we did the endometrial biopsy, hysteroscopy and proceeded with FETs, the current cycle is a long cycle using Depot Lupron for 2 doses rather than the daily Lupron shot.

Each FET cycle is $3800, Embryo storage is $750, meds per cycle are $500-$1500 per cycle, Egg Retrieval was $10,000

Each transfer has been 2 embryos implanted each time

Upon first meeting Dr. Nelson he was a soft spoken doctor yet presented himself very honestly. Being novice in the IVF world I felt my husband and I were very fortunate cross paths with him. Not knowing a lot about IVF, I truly was unaware of what this journey would take. Dr. Nelson sat down with my husband and I discussed everything that was presented in our case he approached the good the and and ugly. He explained some factors that he could see through testing yet kept reminding us the IVF is no guarantee and it can be a long process. Even though he presented the reality of what could come he was compassionate and brought hope to the issue and assured us he would work through all issues. I was diagnosed with a cyst that all my previous doctors had missed which unfortunately lead to me losing one of my ovaries further compromising the opportunity of having a child due to limited egg availability. Dr. Nelson presented his finding and then made sure I was referred to one of the highest ranked surgeon's in the area in hope I might be able to save my ovary (which was not the case in the end). Dr. Nelson's attention to care and keeping our future goals in mind throughout his treatment and our care. Finding the specialist to treatment my cyst was not the only time Dr. Nelson went lengths to try to help us. During my second year of treatment and after 3 failed transfers, Dr Nelson suggested doing a procedure that would be working with a doctor at Yale University to determine if I had something else going on in the tissue. He truly was vested in a positive outcome! Being that Dr. Nelson was softer spoken, he still made you feel hope even when you felt all things were lost. Going through many transfers that failed, each time he would take the time and speak with us and answer all questions without making us feel his time was limited or he had another patient.

Be patient even if you do not get the results you want in the beginning. That was the most trying part for my husband and I. IVF is truly a journey where patience grows and grace is extended to yourself and team around you.

My IVF journey started not using Lupron in the beginning yet after the first failed transfer it was quickly added. My journey began with a retrieval intended to freeze thr embryos at day 3. The retrieval cycle began with taking Birth control for a few weeks after my period, then I would begin stimulation drugs (Gonal F, Menupur) for a couple weeks and then 36 hours before the retrieval I took Pregnl. During the stimulation cycle I would have blood draws to monitor my levels and ultrasounds to monitor the follicle growth/development. The decision on what stipulation drugs prescribed was decided by Dr. Nelson based on what my case presented. During the transfers, each one after the begin after being on birth control was a 3-week Lupron cycle (daily injections) and then at the last week of Lupron the dosage would be stepped down and Estradiol would begin. Ultrasounds and blood work would be taken to monitor estrogen and progesterone levels. As we got closer to the transfer date (I believe 2.5 weeks prior) progesterone dosing was started. My first 2 transfer cycles I was on oral and vaginal progesterone dosing and intramuscular injection after the transfer due to low levels of progesterone. Upon transfer 3-5 I was changed to micro dosage of vaginal progesterone which was slowing increased (25mg in the beginning) through the transfer date to 200mg along with IM injections of progesterone oil. This protocol was actually determined through the testing with Yale University and Dr. Nelson.

An IVF complete cycle with retrieval and frozen transfer to include ICSI and assisted hatching was approximately $18,000 which include a year of freezing of embryos. The medication was approximately ($5,000 for the egg stimulation cycle and $3500 for the transfer cycle).

Dr. Nelson allowed my husband and I to determine how many embryos we transferred. He gave us medical opinion and discussed the potential risks of transferring multiple embroyos. Dr. Nelson did select the embroyos to be transferred however would always as if we had a preference of which embroyos we wanted, yet we deferred that decision as we respected his medical decision.

Dr. Nelson has a warm and approachable bedside manor. He is very thorough and in our first appointments asked a lot of questions and had me do all the necessary tests to rule out specific fertility issues. I appreciated that during each ultrasound to check my ovaries he would show me the screen and explain what was going on. He monitored me closely every step of the way during the clomid cycle and I completely trusted his opinion and expertise on next steps.

Ask a lot of questions if you don’t fully understand the process. While he does explain everything it’s a lot to take in and make sure you get all of the info you and your partner need.

We did two separate rounds of clomid, tested for ovulation, at positive ovulation administered an HCG shot, did timed intercourse, and waited the 2-weeks to take a pregnancy test. When both of these rounds were negative pregnancy he had me come in more frequently for ultrasounds to check the progress during the cycle. By doing this we found the ovulation test was positive a full week before I was actually ovulating. I appreciated Dr. Nelson monitoring more closely and switching gears when finding I wasn’t reacting normally to ovulation testing.

Insurance doesn’t cover fertility treatments. Every appointment was for an ultrasound so each appointment cost $320. All of the medications associated with a clomid cycle are also not covered by insurance and generally cost about $500. We have only done times intercourse so I’m not sure what the cost for IUI is but I know it’s in the 1,000s.

Dr. Nelson comes across as genuine and kind. He has wonderful bedside manner and has always answered my questions with compassion and care. He seems very confident in what he does yet he has a calming presence at the same time (doesn't seem arrogant or stuck-up). Only downside is that I haven't gotten to see him as often as I would have liked as he has been traveling. IUI #1 was done by him, but baseline and followup ultrasounds have been done by nurses in his absence. Same thing has been happening with round #2. He also doesn't answer emails personally, you have to wait for the nurse or someone else from the team to talk to him, and then they relay the message. I would prefer if it was actually a bit more of a doctor/patient direct exchange.

Make sure you write down questions and bring to consults where he will be so that you can ask the doctor directly when he is in the room rather than have to wait for others to relay messages back and forth.

It is $2100 for IUI (includes ultrasounds, sperm washing, blood work if/when needed). It was about $450 for initial blood-work for STI and genetic testing which was sent to outside lab.

Very respectful & patient. He always treats me like our situation matters & we never feel rushed. He answers questions thoroughly & at a level we can understand. I would definitely recommend him to others.

Write down list of questions so you get everything answered. I would bring a pen & paper with me to jot down notes of things he’d mention, but that’s just the OCD in me.

I saw him numerous times for different stages so all of my protocols were different. I ended up finding an amazing research center that he referred me to & I also have twins using a surrogate. My surrogate loves him too that she referred other people to him as well

I had different costs for different procedures. That is one negative about the clinic. Sometimes I feel like the costs changed week to week as if it wasn’t set in stone. Sometimes I felt like they were guessing & I over paid once.

N/a

I really like Dr. Nelson and would go back to him again. He’s warm and engaging and I felt very secure in going through this process with him. He explained things well and gave me a good idea of what to expect.

Start ASAP because some months are busier than others. I was lucky and got in right away when I called to make a consultation, but I think I just had lucky timing.

Because my hormone levels were good and I initially had a good number of follicles (I’m 41), I think we just did a more standard plan for egg harvesting. But then I only got 4 eggs, so he changes the regimen a bit and then I got 7 the next time.

It’s a package that includes visits, ultrasounds, and blood draws. And the retrieval costs.

N/a

I think the biggest weakness is the number of patients Dr. Neslon treats now. When we first started seeing him it seemed it was easier to make appointments and their was more flexibility and availability. 2 years ago it seemed as if it was harder to book an appointment. That being said, he will go out of his way to book Saturday appointments if needed for the best treatment plan for your body.

He his knowledgable about infertility and comes with years of experience.

We had male infertility. We used ICSI with IVF with a fresh transfer the first time. With the second transfer we did a frozen transfer. We used typical IVF treatment and adjusted medicines based upon my levels since infertility was not female related. We have used 2 eggs every time because of my age and the high number of embryos created.

All of the cycle treatment appointments were under the IVF or embryo transfer bills. There was no seperate bills if needing extra appointment.

Yes, we were educated about the number used and the reasoning. We also, were informed that if something happened to one of the 2 embryos during unfreezing they would unfreeze another 2 and transfer 3 in that case or however many survived. That they would rather transfer 2 then just one. Again, BC i have a high number of embryos.

My doctor is very knowledgeable and I trusted that he knew the best course of action. He explains things thoroughly and in a way to help me understand. This might be my issue more than his but during ultrasounds I tend to not ask questions and I think later I should have asked. He doesn't necessarily give you more information than you need to know. Ask questions and he will explain what he sees and what is going on very clearly. He makes me feel comfortable and I feel he is capable.

Ask questions and gather as much information as you can. Getting a hold of him to talk to him directly is hard. All communication is done through his support staff.

My husband and I have unexplained infertility and sometimes anovulation. Because we are both on the younger side he elected to have us try IUI with Clomid. I started clomid on about day 3 of my cycle and then I took OPK and if I saw a kit change I came in for them to asses. If I didn't see a change then they would trigger shot me. They gave me the shot even with the kit change to ensure that I would ovulate. Then I came in within the next day or two and had one IUI done (sperm wash included). We used my husband's fresh sperm. The following day I would have a second IUI and sperm wash. From there they placed me on progesterone for two weeks just as a precaution (I didn't have progesterone level issues). I did 3 rounds of IUI just like this and all 3 times had negative results.

Each of my IUI were about $2,500 which included ultrasounds, medications (clomid, trigger shot, progesterone), and back to back IUI sessions with sperm wash. During my last IUI they had me pay per day rather than the package since that was slightly cheaper.

N/A. We haven't done that option yet.

Dr. Nelson has great bed side manners; he is very calm and collective. He likes to take his time to review your case and answer whatever questions you may have. He is compassionate and available to his patient's needs. I felt comfortable being his patient.

Ask questions; do not hesitate to say or voice your opinion/concerns.

During my first cycle, which was a fresh transfer after a 5-day egg retrieval I resulted in my first pregnancy; however, I felt that my body was too exhausted to take on a pregnancy after being through so much hormones and treatment. It would have progressed to my knowledge if we froze the embryos and did a Frozen Embryo Transfer vs. a fresh one. On my second cycle, we did a FET with injections [estrogen and progesterone injections] along with baby aspirin and levothyroxine. This cycle did result in a pregnancy, however at 6 weeks into the pregnancy resulted in another miscarriage.

Combination of both IVF cycles we paid about 25K [$25,000]

My RE transferred 2 embryos per cycle; I asked what his preference was whether 1 or 2 he suggested 2 since I am young and have no fertility issues.

He was well informed about my history and treaded gently, but directly about the sensitive nature of infertility. I liked his individualistic and holistic approach. He explained things thoroughly. I think the o lu weakness was punctuality in making the appointments. My husband and I chalked that up to him trying to be as thorough and present with each patient. He always asked us if we had more questions and was very patient with us. We never felt rushed. I’m assuming he provides the same level of care to all of his patients.

Be flexible with your schedule. He might not always meet you at your appointment time.

I believe he used the agonist protocol. Higher dosage than typical. 150 Menopur, 375 Gonal F and Cetrotide. Higher dosage because of my age, I believe. I produced 10 eggs among the which 4 matured. Three were fertilized. But none made it past day 7.

About 9000 retrieval and fresh transfer, 550 for analgesia, 1500 for ICSI About 6000 for medication

Dr Nelson is a very nice man who has a ton of experience. He was recommended highly by two other medical professionals. My issue is that his staff are a mess and if he hasn't seen fit to fix that, that is a severe flaw on his part. When there was a huge mistake made with my protocol, he did not take any time to explain potential effects to ease my mind. I was just left hanging, completely scared and seemingly alone.

Triple check all instructions given. Be very proactive and over communicate. You are your only advocate.

My list of medications for the first cycle: Gonal-F Menopur Cetrotide Progesterone Lozenges MethylPrednisolone Chorionic Gonadotropin Estradiol Doxycycline Aspirin

It was around $13k for the retrieval process. Even if you had insurance, you had to put that amount down prior to the cycle. You would be reimbursed for anything that ended up being covered by insurance. Medication was separate. They recommended Freedom Pharmacy, but did not give any tips or suggestions on the best way to maximize your insurance benefit. My meds were $7k through insurance, which ate up most of my benefit. If I had paid cash, it would have cost less and left me more insurance benefit for clinic costs.

He did not discuss preferences with me

From the moment my husband and I met Dr. Nelson at the clinic’s open house, we knew that we wanted him to be our Dr. He has been completely honest and forthcoming in all matters, yet is always kind and empathetic. I have never felt that any of my questions or concerns were dismissed. He is very personable and easy-going and during every appt. and procedure I never doubted that I was in good hands. Despite all of our setbacks he always tells us not to give up hope! Even when I’ve been frustrated and felt like I was ready to give up, he remained positive and encouraged me, and my husband, to keep trying.

Remain positive and trust the process. Dr. Nelson will explore all avenues and help you and your partner find the path that is right for you.

For my IUI’s I took Clomid and then the HCG trigger shot. The Clomid made me very emotional. I cried constantly and at the smallest thing. For my IVF I took Ganirelix, Endometrin, Menopur, Progesterone, Methylprednisolone, Estradiol, Pregnyl HCG and Follistim. I was able to produce a significant number of viable eggs using this protocol. The side effects included severe bloating, pain at injection site, cramping, backache, full and sore breasts, headaches, fatigue, nausea and an uncontrollable roller coaster of emotions.

My IUI’s were approx. $2500 each, plus medication costs. My IVF was approx. $10,500 plus an additional approx. $6000 for medications.

Given my age and our previous failed IUI cycles, my Dr. was willing to transfer 2 embryos. We talked extensively about the risks of multiples, for both mother and babies. He was very upfront and honest with us regarding our concerns. We all (Dr. Nelson, myself and my husband) agreed that our best chance in conceiving would be to take a more aggressive approach and transfer 2 embryos.

Dr Nelson is a kind man, very positive and warm In his interactions. He decided to go with the same protocol as my previous doctor since that had worked for us. I don't know that he's fully up on what all the newest evidence is but I felt that he was doing everything he could for me.

Be aware you may have to wait for a long time for your appointments.

Same protocol as my previous doctor. Bcps, gonal-f, menopur, cetrotide. I had a poorer response this time wth not as many eggs and so he upped the dosage a ton, which helped somewhat.

Very expensive. They charged 500 per sonogram and do a sonogram at the start of each cycle. There are lots of "extras" at hrc so so far 1 egg retrieval and 2 frozen transfers were around 20000

We wanted eSet. He seemed more inclined to push multiples, even asking one more time immediately before transfer.

He was extremely frank, which I appreciated. At my first appointment we discussed my husband and my medical history and what attempts we had been making to this point to conceive. Dr Nelson listened to us and then very clearly stated how we would proceed. It was kinda like "oh, you want to have a baby, here's how we're going to do it." No bs, no voodoo.

If you want to discuss how your vegan diet or meditation practices are impacting your fertility he's probably not the guy for you.

We started with a series of diagnostic tests. Blood work and sperm samples, etc. Once everything checked out ok the plan was to have an HSG and the following cycle to start with IUI - because of my relative young age and no obvious problems. We agreed that we could afford to do the shots vs. Chlomid, which seemed to have better results as well. I got pregnant naturally after the HSG so I didn't proceed with the original treatment plan.

Blood work was more expensive there. I think it was $30/ visit. Much cheaper to go to labcorp. Our first visit was a couple hundred bucks.

A bit scatter brained it seemed? During our second appointment, he forgot who I was even though we'd had an hour long initial consultation one month ago. At the very least, please review the chart. However, did come across as a nice guy. The only thing I will fault him for is that my initial ultrasound showed very low potential for egg retrieval. That month was a bit low, maybe because of stress or sickness. Since this is my first time, I didn't know any better and trusted the doctor when he said this was not the best indicator. FALSE!!! It can happen that results are better than expected but I suspect that percentage is exceedingly low. Had I known, I would have put off the egg retrieval to a following cycle where I would have better results. I blame the doctor for suggesting we proceed when initial results showed poor probability, implying that they wanted business more than they cared about me

The pill initially then menopur and follistim. Follow on doctors were surprised by my dosage implying he knew I was low and was trying to stimulate aggressively. Otherwise, a quite typical 10 day stimulation, 12 day retrieval.

Egg retrieval was approximately 6000 and drug protocol was approximately another 6000

He is very knowledgable and experienced. My husband and I felt comfortable in his care. He wasn't pushy when we requested to try clomid treatments for almost a year before taking another measures. He also made sure that both my husband and I had all tests done to make sure there wasn't an "obvious" reason for our infertility.

Be prepared to carve out a large chunk of time for your normal schedule once you start treatments... the average wait time in the clinic seems a bit long.

Sorry, I cannot remember the exact treatment and strategies.

I cannot be certain how much we spent but something I'm unhappy with is they offered an upfront plan where you paid 5K extra to get a second chance at the IVF process if it wasn't successful the first time. We were successful so it was a loss of 5K. Way too much of a gamble.

I was a bit hesitant to transfer 2-embryos but Dr. Nelson said given my age since I had never successfully gotten pregnant the chances for multiples was low. If I had known more about 5-day blasts and how "strong" they were I probably would have only transferred one. I became pregnant with twin boys.

He was a kind and knowledgable doctor. However, I did feel like the visit was a bit rushed. I would have appreciated learning more about options aside from IVF and IUI. More attention to medical options on trying to conceive naturally by addressing diet and or medications or hormones that would support the effort in trying to conceive naturally.

Be prepared with questions beforehand. Do your research and have them written down before you arrive for the appointment.

Luckily I was given a coupon from my OBGYN to be able to visit HRC for my first consultation for free.