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 only saw Dr. Tan in person a few times for consultations and testing, but each time she knew who we were and was warm and friendly. We went in with a (long) list of questions and she took the time to answer every single one thoroughly. We never once left her office still wondering something or feeling as if we hadn’t been cared for thoroughly.

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.

The nursing staff varied. I was never assigned to one specific nurse, and I think that’s just the way the Cleveland Clinic runs things. When I called, I’d just get whoever was available first to return my call. Over time, we learned which nurses were good and which weren’t so great. We had a few that were phenomenal. They were caring, compassionate, informative, and responsive. I loved those ones! I also had a couple with less than stellar bedside manner. With those, I often felt blown off and had to advocate harder for the care I deserved. One in particular never seemed to get my prescriptions ordered (which was time sensitive!) so whenever I had her, I made sure to follow up until everything was taken care of.

Strengths: Being at the Cleveland Clinic, I felt I was getting the most up to date care. I know they do a lot of research and some cutting edge procedures, so I felt good about that. There were also multiple locations. We drove 45 minutes to see Dr. Tan but for procedures and monitoring, the main location was 20 minutes from our home, which was very convenient. I also felt they had a really good embryology lab. I got phone call updates every day about our embryos, and they seem to have very up to date technology. There were multiple doctors, so when we didn’t like our first doctor, we were able to switch to Dr. Tan (who we loved). Weaknesses: I wish I’d been assigned one or two specific nurses. After the fact, I realized that I think I could have requested a certain nurse when I called and they would have tried to honor the request but I was unaware of that until after my treatment was completed. Communication was sometimes difficult as a result. I feel like that is a problem at a lot of clinics though, based on talking to others in support groups. Things to know: The biggest thing I learned is to advocate for yourself. You deserve quality treatment. You deserve to be heard and have your concerns addressed thoroughly. You deserve quality care. If you feel you’re not getting it, push until you do. Dr. Tan and most of the nurses were great and this wasn’t a problem with them. With our first doctor and a couple nurses though, we had to push and be on top of things. I felt bad about it at first, but over time I realized we were paying a lot of money and going through something so difficult and we deserved good care. Don’t feel bad about making sure you get it.

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 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.

Dr. Tan and her staff always address me and my wife by name. They have always made us feel comfortable. Dr. Tan always spends ample time explaining procedures while in the office and often times personally calls me to go over our next plan. Dr. Tan even called me on a Saturday after a failed cycle to check on me. All of the staff in the office are very friendly. Dr. Tan is very flexible and open to try multiple strategies. Dr. Tan is always as gentle as possible during painful procedures and thoroughly talks me through what is happening before, during, and after.

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.

All of the nursing staff and the nurse practitioner have been wonderful, compassionate, available and understanding.

This clinic is LGBTQ friendly and has multiple locations throughout the Cleveland area. The office is easily accessible and there is a lab and pharmacy on site. I do have to drive to a different clinic location when I inseminate, because they only store donor sperm at one location. Appointment scheduling is flexible, communication is good and staff is always available through the portal and by phone. I cannot think of a single weakness about the clinic.

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 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

During my more than 24 months in Dr. Tan’s care, she only made herself available three times and never sat down to review our plan along the way. My husband and I were very candid about our desires but we were not heard.

There was not a day that went by when I interacted with the team that I didn’t have an open line of communication and a response within a few hours. They were thoughtful, fluid and detail-oriented.

There is inconsistent detail with regard to a financial plan which can definitely throw off your care plan. I never felt like I was truly collaborating with them on my care as each cycle varied. The nursing staff and supporting administration was outstanding.

The out-of-pocket pricing plan was very reasonable

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.

Dr. Tan was compassionate and made sure she took the time for you to understand the treatment.

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.

The nursing staff was great. Nothing outstanding comes to mind.

The Clevelans Clinic is GIANT with many locations. As long as you’re willing to drive (we went to Avon, Beachwood, and main campus), then it’s a great place. If you’re looking to have all services in one location, you may want to look elsewhere.

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 genuinely cares about her patients and their feelings. She’s always willing to go above to give her patients what they need to succeed in the infertility process.

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

The nursing staff are all very nice and understanding that this is a hard process. They are compassionate also. While having my testing done the nurse held my hand and asked me over and over if I was ok.

The clinic as a whole does a very good job. They normally get you into see a doctor well and will work to fit appointments in with your schedule. They are prompt in calling you back if you have any concerns

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.

Overall good, but scheduling has been confused before due to nursing staff.

Very patient friendly, I work in a hospital and from the time I walked in I was impressed. The volunteers seemed to enjoy their environment. The receptionist upstairs loved her job so much she was trying to recruit me. Very clean facility and all the people in the public eye were very nice.

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!

Dr. Tan and her partners along with the nurses were always very helpful and kind and made my husband and I feel comfortable. They were available for questions and made the process as easy as it could be

They were compassionate, caring, and helpful. They were always available for questions!

The clinic is organized and the staff are friendly and helpful. I always felt comfortable calling and asking questions and going to appointments. I always trusted their decisions and rationale and found that they were very compassionate and caring about me as a patient.

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.

Student came in first - without asking me if I was ok will ring with a student. She came in at the very end and answered a few of my questions in a very vague fashion.

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

Factual

Appointments were fairly easy to get.

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