Julierut Tantibhedhyangkul

Dr. Tan was informative and caring. She took the time to listen to and address all of our questions and concerns. Even though we saw various other doctors and nurses for procedures and monitoring, I felt good knowing that Dr. Tan was ultimately making the decisions about my care. I will say we did usually have a long wait once we arrived for appointments, but that’s because she takes the time to address all her patients’ concerns during each visit. I never minded sitting in the waiting room because I knew I’d be getting the same personal attention once we were called back. I would recommend her, hands down, to a friend going through infertility. She listened to me when other doctors didn’t, and I am eternally grateful for that.

Prepare a list of questions before your appointment and make notes during your consultation. Be prepared to wait to see her, but know it will absolutely be worth it.

We were diagnosed with unexplained infertility. My first medicated cycle, I did Clomid and she ordered bloodwork to gauge my response. I responded well, so we moved onto IUI with Clomid plus Ovidrel trigger. We did two rounds of that, monitored with ultrasound. My lining was on the thin side, and I had bad hot flashes from Clomid so then I switched to Letrozole. We did two more IUIs with Letrozole plus Ovidrel trigger, and monitoring via ultrasound. I had negative pregnancy tests for all of these. At that point, we met with Dr. Tan and my husband and I were ready to move on to IVF. For IVF, I took birth control pills for 3 weeks then had a suppression check (bloodwork and ultrasound). Everything looked good and I was cleared to stop birth control and start stims 4 days after my last BCP. I used Gonal F for stims and added in Ganirelix around day 4 or 5. I got bloodwork and ultrasound monitoring every 2-3 days to adjust meds as needed. My doses were low because I had a higher AMH. I did 8 days of stims then was told to trigger. Based on my bloodwork, I did a combination Lupron plus HCG trigger. I had bloodwork done the morning after trigger to be sure everything looked good. My retrieval was the following day, and I was cleared for a fresh transfer (we did not opt for any PGT). The day after retrieval, I started progesterone suppositories, doxycycline, and Medrol. I took the doxycycline for 5 days and Medrol for 4 days. I had a day 5 transfer of one embryo. We froze two day 5 embryos and one day 6 embryo. (Initially I had 11 eggs. Nine were mature. 8 fertilized. They used ICSI on all mature eggs. I had 7 mature and 1 immature fertilize). Four days after my transfer, I started Vivelle Dot patches. I did those for about 2 weeks, changing patches every 3 days. I got a positive beta HCG on 15 days post 5 day transfer, so continued progesterone suppositories until 10 weeks of pregnancy.

We were fortunate to have insurance coverage. But we did have to meet our deductible before it kicked in. I think each IUI cycle (monitoring, IUI, sperm wash and prep) was around $1000 before insurance kicked in. For IVF, they gave a packet upfront with costs. The package was $11,600. That included the retrieval, one transfer, embryology lab, and one year of embryo storage (basically everything but medications and monitoring). For monitoring, they offer a self pay package. It was around $825 total for 5 ultrasound, bloodwork, and nurse consult appointments. Medications were dependent on where you get them and what you needed. If you wanted to freeze a back-up sperm sample ahead of time, that was $710. Infectious disease lab work was $304. Genetic carrier screening was $500. Both infectious disease and genetic carrier screening were required prior to starting IVF. A hysteroscopy, if needed, was $450. If you’d had an HSG, SIS, or hysteroscopy within the last year, you were not required to get the hysteroscopy before IVF. After the first year, embryo storage is $577 per year.

We were comfortable with eSET. Given our ages and situation, we would not have wanted to transfer more than one embryo because the risk of twins was too high. Our clinic’s goal is one healthy baby, and we were on board with that.

Dr. Tan was incredibly respectful and compassionate. She really listened to my concerns and I felt that I was in good hands. We initially saw Dr. Tan after trying to get pregnant for a year with no luck. She ordered several blood tests for me and a semen analysis for my husband. Turns out we had severe male factor infertility, so she immediately referred us to a urologist. The urologist found that my husband had a grade 3 varicocele, which was the likely cause for his low sperm motility. My husband had a surgery to remove it, and three months later he had a second semen analysis. The test showed improvement, but he only had about 1.2 million motile sperm. I was sure that we would have to do IVF. However, Dr. Tan recommended that we try IUI a few times before moving forward with IVF even though his numbers were not ideal. She said that ivf is a lot of money and can be very invasive, so if we could get pregnant through iui, that would be preferable. She agreed that we could use my natural cycle since I was ovulating regularly (I had used a clear blue monitor for about 9 months). She said that we could move forward with IVF if IUI did not work, and that I could begin preparing for ivf while doing a couple cycles of iui. She was up front that we only had a 10-15% chance of getting pregnant with iui, assuming his post-wash motile sperm count was over one million. We were really fortunate that we got pregnant on our first IUI cycle (his post-wash count ended up being 3.8 million). I really couldn't believe it. After I got a positive pregnancy test, she ordered blood work to confirm the pregnancy. Now we are going in for an ultrasound in just a couple weeks. I was really happy that she did not make me take medication, as I know a few people whose doctors prescribed Clomid even when they were ovulating pretty regularly to slightly increase the chance of pregnancy. I was also happy that she considered our finances and well-being, even though ivf is more profitable for the clinic.

She's fantastic. Use mychart if you are trying to talk to her--she normally reasponds the same day.

None

The IUI procedure was about $670. The blood work, after insurance, and the semen analyses were about $250.

Dr. Tan initially set a very comprehensive plan but when it came to the details or having the opportunity to check in with her we were always pushed to a nurse practitioner in her office even after miscarriage. It always felt like there was a disconnect in communication which meant a missed opportunity to course correct.

There’s a very good chance that no matter what path you take she will recommend IVF in every instance even if you have gotten pregnant with IUI before or you were new to infertility. You have to do all of your own homework to understand all of your options

The out-of-pocket pricing plan was very reasonable

Dr. Tan was direct and clear in every plan to help us become pregnant. She wrote detailed directions and would reexplain procedures or why she was choosing what she was for treatment. She was available to email through my chart, although her nurse responded for her. She performed my HSG as well as first IUI, which unfortunately failed. She would re-evaluate my plan to help me become pregnant and why that course would be taken. I do have to say, you truly need to advocate for yourself if you would like a different treatment plan.

Be positive and realistic. If you have questions ask and ask again if you are not understanding. Be your own advocate.

Dr. Tan performed routine blood work, pelvic ultrasound and transvaginal ultrasound as a baseline to gather why I could not conceive. An HSG was performed after 3 failed Clomid cycles. I had my first IUI and began Letrozole as planned for all IUI’s.

I had to a $40 copay everytime I saw Dr. Tan whether it was consultation appointment or follow up appointment under my old insurance. Under my new insurance I have a $20 copay. Clomid was around $30 dollars and Letrzoloze was $9. My blood work, pelvic ultrasound, and transvaginal ultrasound were covered under insurance. My HSG after insurance coverage was $1,393. My first IUI was $201 and husbands sperm washing around $450. IUI was $659 out of pocket and need to be paid before IUI performed.

Not applicable

She is very easy to talk to which makes it easier to open up to her about any concerns, she makes sure that her patients are fully aware of the treatment plan and even asks opinions on if this is the correct course they want to try. other providers I have seen have made sure that I knew the plan but never made me feel like I could have a say in how it goes.

Be prepared for a lot of options to be given to you so you can do your research on which you think is best for you

Since I was going in as a single parent using donor sperm she wanted first to make sure I was able to ovulate so we did one natural cycle with just using the opks then when that one didn't take she started me on 50 mg of Clomid to help a jump start on ovulation, currently I have done 2 cycles with that but no pregnancy yet, so I had to come in to get a scan to see what is going on and that is when she discovered I have an ovarian cyst so we put off the iui and I will be having a follow up scan to find out where we go from here.

$35 consult fee, each iui $200 (CCF employee discount), $10 Clomid 5 pills, $40 OPK test kits, $200 U/S

She stated that if I decide to do IVF the choice would be mine to make not hers.

Dr. Tan is a very kind and knowledgeable doctor. She is compassionate and truly cares about her patients. She always explains each detail of the plan for that month and answers all questions. De. Tan often calls me personally to discuss cycle details or the plan for that cycle. When things do not go as planned she always explains what the next step will be and we come uo with a new plan, if needed together. Dr. Tan is always cognizant of her words and is always very soothing when things do not go as planned. Dr. Tan is open and willing to offer suggestions and try different methods if one method has not worked. Dr. Tan is always gentle during painful procedures and talks me through it. I have had a fantastic experience with Dr. Tan and although I am not yet pregnant, I have confidence and trust in her as a doctor.

I would advise that the patient goes in with an open mind and be as open and honest about their situation as possible. Dr. Tan is very LGBTQ friendly.

I have PCOS so I when I started my fertility journey in 2016 I was prescribed Metformin in an attempt to lower my sugar and reduce insulin levels as a measure to assist in ovulation. I also had an HSG to ensure that my tubes were not blocked. My first cycle I took Letrozole and it gave me very severe headaches and I didn't ovulate that cycle. The next cycle I tired 50 mg of Clomid and did ovulate,l on that cycle but we did not inseminate as it was a trial run. The clomid was increased to 100 mg and I did not ovulate that cycle although I got a positive opk. I did inseminzte that cycle, but dis not fall pregnant because i did not ovulate. At that point it was determined that opks did not work for me and my dose of clomid was increased to 150 mg and we did a follicular ultrasound in CD, I took the Clomid CD 3-7 and had an ultrasound on CD 10. Unfortunately, that cycle I ovulated too soon and could not inseminate. I did 2 more cycles on the same dose with very close monitoring and I had confirmed ovulation but did not become pregnant. I took a break for a few months and then in the Summer of 2017 we decided to do a cycle of Clomid along with the Follistim pen. This cycle did not work and I did not grow eggs. We decided to take a break and then in September I began having very heavy, irregular bleeding and had a biopsy, but all results were negative. My wife and I are planning to begin again and discuss IVF.

I have paid out of pocket for some services, but my insurance pays for some of the services such as my follicular ultrasounds. I have to pay out of pocket for all medications and IUI. IUI is $300. The cost of medication varies per cycle. Looking into IVF the costs are around $15,000 with medications.

We have not discussed this as of yet.

Dr Tan was kind, caring and understood how difficult fertility treatments were for me and my husband. She was supportive and made herself available for questions and concerns through the entire process. I only wish I had more money to get the results I’m still praying for. One more child....

Ask as many questions as you have. She is always willing to discuss options that you are comfortable with.

IUI’s without success then moved onto IVF’s. Standard protocol worked the best for me retrieving my own eggs even though previous testing would have not recommended this as a first option. We discovered this through other protocols that either did not create enlightenment eggs maturing at the same time or when I ovulated before my HCG injection on other protocols.

They scheduled more than one appt at a time with ultrasound, often ran over and behind schedule. Often made me much later to work then planned. They tried to offer early am appts but often still took awhile to have ultrasound and then wait again to speak to the nurse for results and next steps.

$15,000-$20,000 each IVF cycle and that did not include all costs for meds and monitoring.

Most of the time they allowed me to transfer 2 at a time based on age and number of viable embryos. The lab chose them and all eggs transferred were rated A.

Dr. Tan, while great when I was going through diagnosis and fibroid removal surgery, left me hanging after surgery. There was no discussion about when to contact again after surgery or if there were even other steps I could take.

Write down your questions and bring someone to help you remember the answers.

She had my husband go for semen analysis and was scheduled for an HSG, but they weren’t able to complete it because of my cervix position so I got sent for a transvaginal ultrasound then later an MRI to confirm the fibroids. From there we tried three rounds of clomid, and were unsuccessful. I then underwent fibroid removal surgery and just last cycle we’re we cleared to start trying again. I’m not sure what, if anything is next.

All I remember is we paid over $1000 out of pocket for the fibroid removal surgery.

She’s very detail orientated while explaining what is going on. I had an HSG done with her and she tried everything possible to get the dye to flow through. I love that she’s compassionate to my circumstances and wants to help

The process takes time. Just be patient

She prepared me well for my procedures. I had the HSG done twice. The first time was pretty tough and it was thought that was why the results were what we had. She medicated me more the second time to try and relax me and make me as comfortable as possible

Overall I think that she is a good doctor, but when it come to taken vitamins and other supplements I wish she give more insite. I do like that we only move as fast as I want to go, there are sometimes I wish she were a littlest more pushy on when to move forward. The benefit of going through any doc with Cleveland clinic is at anytime you can message them with issues and concerns.

Fertility oral meds until you ovulate, as period changes your dose may change. Then an HSG to see the movement in and out of tubes.

She was wonderful. She makes a very stressful process manageable and provides her patients with encouragement and compassion. She is thorough in her explanation of circumstances and always positive about our outlook.

Be prepared for anything.

The ultrasounds and bloodwork panels and our visits cost a total of $2,500 over a six month period.

Dr. Tan explained everything clearly and made us feel comfortable and cared for. She was knowledgeable and kind. When I had an ectopic pregnancy she dropped her schedule and immediately scheduled surgery which she performed. She personally called to let us know an IVF cycle resulted in a negative test and was available for questions.

She’s awesome! No advice here!

11-12,000 for a complete cycle

It may be too early to fully ealuate but I can tell you that I have worked with her nurses and students more than her. During all the interactions I did have she was vague and lacked compassion.

Don't be afraid to ask all questions.

She ordered tests that my previous physician had not, like the AMH SCREENING.

$300 out of pocket for blood work and Dr. Time.