Juan Alvarez

Things with Dr. Alvarez started out well. We had an initial consult during which he was empathetic, patient, and detailed in explaining what next steps would be given that my diagnosis of diminished ovarian reserve probably came as a shock at my age. We then ordered some testing and he walked me through the results and my options in a follow up conversation in a thoughtful and sensible way, making sure I had no questions. That's where the good experience ended. Separately, in the nursing section, I provide detail on what happened over the next five weeks with his nurse. Working with her for over a month, I couldn't get the requisite attention from her to even successfully order the prescriptions necessary to accomplish the egg retrieval, and missed two opportunities for egg freezing cycles in the process. At this point, I decided to loop in Dr. Alvarez. In a telehealth appointment, I explained to him everything that had happened with Rebecca, his nurse, and told him it had been 5 weeks just trying to get medications ordered and I was losing faith in their ability to oversee a complicated and time sensitive process. He had emphasized that time was of the essence for me to do this freezing procedure and so I asked for his help in giving Rebecca more supervision and making sure we were able to proceed. Although I made it clear that I felt my experience with her went beyond the typical complicated insurance dance of fertility treatment, which I was familiar with and knew what to expect, he did not seem willing to accept that Rebecca had done anything wrong. He excused Rebecca's inattention to detail and lack of responsiveness by explaining that they have many patients to balance and that insurance can be complicated so hiccups are to be expected. He explained Rebecca's perspective to me, which was that everything had been lined up and ready to go for weeks and she didn't know why I was saying that there was a problem. I encouraged him to look at the messages we had traded back and forth, which he has access to, as well as the record of the prescriptions she'd called in for me and what she hadn't called in, to see that her version of events was clearly not supported by the facts. He continued to resist any implication that the delays in my treatment were somehow Rebecca's or his fault, or that any mistakes had been made so far, although he did admit that he was concerned that at one point she had lied to me about having done a task I asked her to do, which she had not done. I began to feel like his priority was in protecting himself and Rebecca, not providing quality care to me particularly in light of the time sensitive nature of my diagnosis. During this appointment I also asked him a medical question about what could have caused my diagnosis. He at first gave me a very confident answer, however, moments later, he interrupted my response to that answer and said that he was just now looking at some medical articles online that indicated that actually maybe the answer was more nuanced than what he'd said moments before. I was a bit unnerved that he would answer so confidently if he wanted to do some research, instead of simply saying that he needed to look into it and get back to me. My problems with Rebecca continued for another two weeks after I looped in Dr. Alvarez, and I describe those further details below in the nurse section. If Dr. Alvarez did discuss with her and intervene, it did not have any obvious impact on Rebecca's ability to run things to ground effectively, and he never followed up with me to see if we were ready for a cycle or if things had improved. After 7 weeks of Dr. Alvarez and Rebecca and two missed opportunities for cycles, I decided to switch to Dr. Kaplan in the same practice. His nurses got me completely squared away within 36 hours of my first appointment with him, and I started my cycle just a week later. I only mention that to underscore the point that what I experienced with Dr. Alvarez and Rebecca was truly not typical and went beyond the normal insurance dance with infertility treatment. The whole experience made me feel like an inconvenience to them, not like a patient.

Go to Dr. Kaplan instead.

I never proceeded with a cycle with Dr. Alvarez because the simple process of ordering prescriptions was never able to be completed.

My husband and I saw Dr. Alvarez after struggling to conceive after 3 years. During our initial consultation he went over our detailed medical histories. He gave us a list of testing that he wanted us to complete so that he could see if there were any underlying causes. He sat with us and explained the testing and what he was looking for with each test. He was very informative and made sure to answer all of our questions that we might have had. After all the testing was completed he discussed our next steps and what would be best protocol for us. He wanted us try 3 rounds of IUI with Clomid/Ovidrel trigger shots. He thought we had good chances of conceiving with those methods. If not, we would meet with him to discuss the next steps. However, he left the practice after our first IUI and we were taken over by another doctor at the facility.

He was very knowledgeable and was able to answer any questions. He looks at all the information before moving forward with treatment.

Dr Alvarez recommended a series of tests that we get completed before moving forward with any treatment. It was requested that I get a saline sonohystrogram done to take a look at my uterus and an HSG done to verify no issues with the fallopian tubes. He then laid out a protocol for 3 IUIs with Clomid and Ovidrel trigger shots. If we didn’t have any luck, he discussed meeting again after those to discuss further treatment. Our first cycle failed, after that point we were transferred to another doctor's care seeing Dr. Alvarez left the practice. Since then we had another failed IUI with the new doctor. We have had to put things on hold due to finances and now due to Covid-19.

Our insurance for fertility care is very limited. We have coverage for initial testing only, no medication or treatment coverage. We were recommended to complete an HSG test to verify tubes had no issues. Was told that it would a covered services but it came back as not being covered so that was an extra $2,000 we had not planned. Once treatment began each IUI cycle was approximately $3,000 for bloodwork, ultrasound, medications, and the procedure itself.