Kate Devine

Dr. Divine, from the beginning, has been honest and candid about my fertility options. Given that I am over 40, she shared the scary statistics without making them feel daunting. Instead, she highlighted all possible options including ones I had never considered (e.g., using donor eggs if mine are not viable). Although she has a direct communication style (think: straight, no chaser), I found her candor to be refreshing. You definitely know where you stand, both with her, and your fertility options. After every appointment, I was clear on what to do next. She has been thorough, rigorous and quick minded I implicitly trust that she will do everything possible to ensure that I have the best possible options during this journey. Given that I struggle financially and, like many, juggle other life stresses, it is a relief to have a doctor and medical team who don’t add unnecessary stress due to lack of bedside manner, incompetence, etc. Overall, I am pleased with Dr. Divine and I look forward to having her continue to guide me through this process!

Ask as many questions as you would like. She is patient and thorough! She’s extremely knowledgeable! She will also guide you to nurses for questions they can address.

Dr. Divine definitely has a direct communication style but I have never felt like a number. During my appointments with her, she was always patient enough to answer my questions, and I tend to have a great deal of questions. :) She also provides advice that seems to come from a place of care and concern. I felt more “connected” with her after the first meeting. That also might have been because I was overwhelmed about the process.

I am on round one of IVF with donor sperm. My protocol includes birth control pills and IVF “shots” to include the trigger shot. I have had to increase my Vitamin D. I also elected for PGA testing. Going straight to IVF instead of IUI made the most sense for my age (42)

I started with Sheila and ended up with Kelsey when Sheila left SGF. Both were very knowledgeable about the process and allowed for extra discussions about it. I’ve asked them both at different times to walk me through a notional timeline. They literally walked through each step very slowly and deliberately. I felt like I was not alone when we talk through the process. They were also very reassuring. I have appreciated working with them both

SGF is huge so it is ideal to have questions prepped in advance before making a phone call or laying a visit. Some appointments move very quickly. I would say that if you need to slow them down, advocate for yourself and slow the conversation down. It’s your money, your baby and your experience!

23,500 for the two round bundle deal. 5,000 for PGS testing, 5,076 for medication. Also approx 2,000 for donor sperm. This is all out of pocket for me unfortunately. No insurance coverage outside of the initial visits

No comments on this actually. She mentioned preferring single and it makes sense to me.

Dr. Devine is very knowledgeable in her field of practice. It is clear that she wants results and hold herself to high standards. She is direct and no-nonsense while still offering hope and I really appreciate this quality in a doctor. Because of these strengths I found it really disappointing that I had almost no contact with her. I had much more contact with the nurse assigned to me-Sheila Ormond who is a phenomenal nurse and support to me during my cycles. When I walked in for my first IUI cycle I was dismayed to see a woman I had never met. I asked her where my doctor was and she said that Dr. Devine would not be performing my IUI. I really wanted to see Dr. Devine and get her real time insights on my cycle. Same thing during my 2nd IUI cycle. Doctor Devine was nowhere in sight. I was assigned a Physicians Assistant who did the IUI. During my 2nd cycle I ran into some complications --my trigger shot did not work! I was sure of it and I needed to speak to Dr. Devine desperately. The nurses did not seem concerned by my pleas to speak with her. They told me that they would handle it and that I should speak to her through them. At that point I reminded them that I am a self-pay patient and I deserved to speak with my doctor. After several hours, she called and we talked at length and she was able to devise a new plan of action. Again, I respect Dr. Devine and her expertise and it is this respect that I have for her that leaves me wanting more contact with her, especially during a complicated cycle.

Have all of your questions written down in advance. She does a great job answering them but you must offer them. If not, she keeps it short and sweet. Also feel free to contribute your thoughts and ideas, after all you are an expert on your own body. She is willing to work with patients when devising treatment plans.

I feel that Dr. Devine treats me like a human being. When she was forced to cancel my first IUI cycle due to over-stimulation she called me personally to tell me and to go over next steps. Since I was paying completely out of pocket she was able to work with me to do my next IUI at no cost, even the meds were provided for me. I really appreciated this gesture.

1st cancelled IUI cycle protocol: Clomid 100 mg CD 2-7, Gonal -F 75 CD7-9, trigger, vaginal prometrium 200 mg twice a day. Result: cancelled due to overstim 2nd IUI Cycle: Femera CD 2-7, Menopur CD 7-8, HCG trigger,Estrace due to thin lining, prometrium 200 mg twice a day. Result BFN 3rd Cycle: Femera CD 2-7, Menopur CD 7-8, HCG trigger (trigger failed), 2nd trigger novarel administered intramuscular, Estrace due to thin lining on femera, prometrium 200 mg twice a day. Result TBD I was started out on a high dose protocol due to an elevated day 3FSH, I overstimmed and I also had strange visual side effects with the clomid so I was switched to femera. Not sure why I was switched to menopur but my nurse said something about it being helpful to my lining? (not sure whether that is coming from any real wisdom or if it was a way to get me to stop asking questions) I was switched to novarel trigger during my 3rd cycle because I did not respond to the Ovidrel.

Sheila Ormond is a sweet, and helpful Nurse. She answers my questions and lets me know when she cannot and when she cannot she always follows up with Dr Devine in order to get me an answer.

I love that the clinic has 7 am monitoring hours. I am able to make these appointments while being only minimally late for work. I also like that you can be in and out in the morning without long forms to fill or people to meet with during monitoring. The staff keeps the flow of patients moving quickly. The clinic is closed at 4 and for an hour midday for lunch (12-1) I think given its high capacity functioning and sheer number of patients, it should be open for scheduling and calls during the lunch hour. It should also close at 5 (6 even). Other than the morning monitoring hours, the rest of the day's schedule isn't very convenient.

base IUI fee $1800 Meds: $500

Dr. Devine is not warm and fuzzy, as noted above. But she is really really good at setting expectations and I appreciate that. I went to her to preserve my fertility because I had a difficult time getting and being pregnant with my first child. That evolved into me actually trying to get pregnant with a second child - this has not happened yet and we've moved onto getting a gestational carrier and will be working with Shady Grove to do this. We decided it would be a good idea to create embryos right away after having our first child (in part because my insurance actually covered it and I had the time). I got amazing results from the one IVF cycle that I did at Shady Grove: 28 eggs retrieved, 24 were mature, 21 fertilized, 16 made it to day 5 embryos and were frozen, and 8 were genetically normal (2 of the 16 were re-biopsed because they didn't get conclusive results and one was normal and the other was not). That was awesome. However, during the IVF cycle, we discovered that I had "Asherman's Syndrome" still or again - I had it before my first child was born but thought it was treated. It either wasn't totally treated or it recurred from a c-section. We then discovered that even when the scars sticking the sides of the uterus were cleared I still seem to have an abnormally thin lining that tends to collect fluid during treatments that raise my estrogen level - there seems to be a trade-off between thickening the lining and increasing the fluid. Neither of these things is good for implantation. Ugh. I've now had 3 more hysteroscopies since doing IVF (I had 3 prior to having my first child)and done 2 questionable transfers of genetically normal embryos to suboptimal lining conditions at Shady Grove (under the theory that I got pregnant before with a very thin lining - 4mm). My lining does not make it out of the 4mm range. We've now called it quits on the transfers and we are officially moving onto a gestational carrier, as noted above. Dr. Devine actually thought I should go straight to a GC the first time I met with her based on the trauma of my first pregnancy (di-tri triplets, multi-fetal pregnancy reduction, debilitating nausea, intrauterine growth restriction, c-section at 36 weeks and 3 pound 11 ounce baby). But I insisted on trying again to get pregnant. I am calling it quits because it's been 4 years of infertility taking over my life, more than 5 different fertility doctors (not to mention the other ob/gyns and MFMs involved), 2 miscarriages, 2 partial ovarian torsions, 1 botched D&C, 1 multi-fetal pregnancy reduction, 1 c-section, 1 amazing baby with scary terrible pregnancy, 6 hysteroscopies, 2 unsuccessful frozen embryo transfers, and countless random doctors and nurses telling me that my uterus doesn't look good on ultrasound. I can honestly say that the least stressful part of this whole experience was actually my IVF cycle at Shady Grove. That was a total nothing. Worked out great. Can't ask for better results.

If you want someone warm and fuzzy, I would not go to Dr. Devine. If you want someone who will be straight with you, Dr. Devine is amazing. I must tell you that because of how Shady Grove works, you end up seeing whoever is there that day so I didn't always see Dr. Devine. She will call you to follow up but sometimes it's not at a convenient time for you so you end up relying on what other doctors and nurses are saying. This is not a problem with Dr. Devine; this is more just about how the Shady Grove practice works. Everything is high quality, but you don't get your hand held by one person. You have A LOT of access to your nurse, but not as much access to your doctor.

It is so hard to review doctors when you are still in the process of being treated by them and don't know what will result! Things I like about Dr. Devine: she always takes the time to talk to you extensively about results (good and bad) and about the prognosis. She is really, really good at setting expectations (low ones in my situation). She is the first doctor who said I might need a gestational carrier and I was actually able to hear that. HOWEVER, Shady Grove is kind of run like a factory, but I think there are totally upsides to that depending on what you are being treated for. So I do sometimes feel like a number there. It's not a warm and fuzzy place. But I'm in a spot with my fertility issues where I don't really need warm and fuzzy right now. I just need the care to be good and I do think Shady Grove has an excellent lab. One thing to watch for is that you have a ton of access to nurses and other ancillary staff at Shady Grove but it can be hard to schedule time to actually talk to your doctor. On the other hand, I don't really need to talk to my doctor all of the time now anyway. I am not having any medical emergencies, etc. Mixed feelings. But yes, when I talk to Dr. Devine, she treats me very much like a human.

I actually don't remember the specifics of the drugs I took for my one IVF cycle with Dr. Devine. She was concerned about over-stimulating me (I have PCOS and am very responsive to fertility drugs and have had partial ovarian torsion twice). She managed to maximize the number of mature eggs while not over-stimulating me which was great. The rationale for doing IVF was to preserve my fertility since I was 36, my insurance covered it, and I had a hard time conceiving my first child due to Asherman's Syndrome. It's now totally awesome that we have the embryos because we are pursuing a gestational carrier. Okay, here's the complicated thing that happened while I saw Dr. Devine: I wanted to get a hysteroscopy from my old doctor in San Francisco because he had already performed 2 hysteroscopies. I went to him in December of 2016. On hysteroscopy, he thought my uterus looked pretty good and put me on an estrogen therapy protocol. Every single time I went in to have my lining checked at Shady Grove during the estrogen therapy protocol, the lining was still really thin and my California doctor thought I should keep taking the estrogen. Dr. Devine didn't think the estrogen therapy was working. I went with the California doctor's advice because he had helped me in the past and I had had a successful pregnancy. Dr. Devine might be right that it wasn't working. I don't really know. Anyway, I did the estrogen therapy for 3 months. Then I did two unsuccessful frozen embryo transfers. Both cycles were really confusing because my lining didn't look great (still thin and fluid-filled), I was in the process of moving to New York City and was doing outside monitoring and seeing random clinicians for the measurements/assessments of my uterine lining. I would take a picture on my phone of the image of my uterus and send it to Dr. Devine's nurse because outside monitoring does not actually send the images (just a written report). I don't even know what to say about that experience. Outside monitoring is just a really really terrible experience if you have a uterine lining problem. It was terrible but not because of anything Dr. Devine did. She was very clear about the likelihood of success with these transfers not being great (as mentioned above, she is very good about setting expectations - and in my case, setting them low). This all prompted me to actually get another doctor in New York City. This New York doctor partnered really well with Dr. Devine and that was great. They knew, liked, and respected each other and I felt like I was in much better hands once that occurred. I really wish someone at Shady Grove had encouraged me to actually see a doctor in New York sooner (and not just do outside monitoring). I only got another doctor because I took the initiative. The nurse at Shady Grove made it seem like it was no big deal to do outside monitoring and let me tell you it really really was for me. It was expensive, time-consuming, and frustrating.

I would say that the nurses are highly variable. I had a few nurses who were absolutely amazing (Sheila Ormond, most notably). They are so responsive and compassionate and because of how the practice is run you end up interacting with them a lot and they really know and understand your situation. However, it's uneven - I randomly had a nurse for a few weeks during a time when I was doing outside monitoring who was unresponsive and had no idea what was going on with my case. She got re-assigned (perhaps after I complained, though I'm not sure). I now have a gestational carrier coordinator who seems great. But yeah, I would say it's variable. The nice thing about a "factory" place is that because of the sheer volume of nurses, you can probably complain and get re-assigned easily to someone really good.

I'm repeating myself. Shady Grove is a "factory" and there are pluses and minuses to this. I think the doctors, nurses, and other staff there really know what they are doing and you get great care overall. Everything is convenient and efficient. However, if you want your hand held by a specific doctor, this is not the place to go. I am happy with Shady Grove because I did a successful cycle of IVF there and I feel like they have adapted well to my evolving situation (moving to New York, involving another doctor, moving onto a gestational carrier).

They weren't too bad. My insurance actually covered a round of IVF so that was minimal cost. We also had a physician discount of 20% (my husband is a physician) on other procedures. The thing that was really expensive was actually the outside monitoring that I did in New York City. So be prepared for that. Shady Grove is really good about preparing you for the costs of things in general. But I was not prepared for the cost of outside monitoring.

Dr. Devine is a huge advocate of eSET. I'm sure there are specific situations where she would be okay with a multiple embryo transfer. But not for me!

I was under Dr. Devine's care for over a year. At every step she would lay out the plan then we would talk it through. After a surprisingly unsuccessful first IVF, we regrouped and she presented a new plan. When that plan didn't work, I asked if she would ask other SGF doctors what they thought. I thought I was being a little pushy and that she might have felt that I was losing confidence in her. I wasn't, I just wanted a little additional reassurance. She did exactly as I asked and called me to discuss their thoughts as well as her own. When she presented her own opinion, I felt even more confident because she had the input of her colleagues. She was very responsive and supportive, but struck the right balance as my doctor. Even after two failed cycles, she said, "we will keep going and we will get this to work." When I had a successful third cycle that produced 2 genetically normal embryos, I asked for her guidance in whether or not to do another cycle. She gave me really helpful advice and I decided to do another cycle to produce more embryos. I was glad that I did. One of the things I liked most about Dr. Devine is that when I was frustrated, she was frustrated and when I was successful, she felt successful. We worked as a team and I have a high degree of trust in Dr. Devine and the entire practice.

Dr. Devine is direct but nice. She isn't a hand holder, so when she gives you information, think carefully about what questions you need to ask to feel comfortable. She has all the information for you, but you need to be proactive in sharing it and also expressing how you are feeling about the process. Don't be afraid to speak up. I felt that Dr. Devine was most effective in the times that I was struggling, nervous, or unhappy. If you ask for help and guidance, she will absolutely provide it, but she is cautious to not assume what you need from her.

Dr. Devine expressed empathy and spoke clearly to me- she would explain the medical terminology then break it down into more digestible language. She ALWAYS called me back same day and sometimes on weekends. She would occasionally just check in and the one time I needed some reassurance from her, she told me to come in right away. She was responsive and caring, but without being overly emotional or warm. She struck the right balance as my doctor.

Cycle 1- standard protocol, Menopur and Gonal F, Lupron trigger (suggested because my test results were very good). This cycle produced 1 embryo that did not implant. Cycle 2- Lupron microdose flare- suggested for poor responders. Still not a great response, only 1 embryo that did not transfer. Cycle 3- high dose Menopur, Gonal F, and HCG trigger. Worked much better and produced 2 PGS normal embryos, unfortunately, I developed OHSS. Cycle 4- same protocol as #3, slightly lower HCG. Great results. 4 PGS normal embryos.

Alison Loffredo was the best nurse of the three and I also dealt with her during my OHSS so it was a bit more complicated. She explained the test results well - what my results were and what the normal range was. While I had the OHSS, she was extremely responsive and checked in with me often.

I really only have good things to say. The practice runs like a well oiled machine. They are efficient and effective.

In all of the monitoring appointments for four cycle, I only had one time where I had to wait for a while and it was on a weekend at 9am, when patient load is heavy. This part is well run.

I was able to squeeze insurance coverage for 3 cycles and paid for one out of pocket ($15,500 for IVF with ICSI and a FET).

Yes, Dr. Devine was very clear that only 1 embryo was appropriate for me given my age. I agreed.

I do feel that Dr. Devine is a good person. I just felt like there were maybe so many patients that I couldn't get the individualized care that I was hoping for. I had to be my own advocate. The first round of IUI was a fire drill. I came in for day 12 monitoring as scheduled and we realized we needed to quick give myself the trigger shot and come back for IUI the next morning. For the second cycle, I was asked to come in on day 12 again. I requested to come in on day 9 since it seemed I ovulate sooner than most people. They said okay and on day 9 I was ready for my trigger shot and were able to follow the typical schedule better by having a day between the trigger and the IUI. In addition, I also felt I had to be the one to ask questions about "is this the right medication for me?" The first round I took Clomid which produced multiple follicles, but thinned my lining. The second round the nurse did not mention anything would be different and I had to say that I did not want to do the exact same thing as it did not work well the first time. Dr. Devine may have already been thinking she would change the medicine too but this was not communicated to me and I had to make that request. The third round of IUI, I had to request again to come in even earlier. The plan was to give additional shots to help follicle growth if needed. I was asked to come in on day 8. Since previously I was ready to ovulate on day 9, I had to request to come in on day 6 so that we had time to give the shots if needed. It seemed like common sense to me (and all the monitoring was included in our price), but it felt like I was not be treated individually based on my previous responses to the medications and IUI. I felt frustrated a lot of times that I needed to be the one to raise questions and change the course rather than the experts helping guide me through the best course for me.

Ask questions and request frequent communication with Dr. Devine. She eventually responded well to this and had better communication with us towards the end of our 3 months.

We did not directly speak with Dr. Devine for about 2 months when starting the IUI process. We were assigned a nurse coordinator who would handle our questions and act as a liaison. I would come in frequently for monitoring and be seen by different technicians and nurses each time. There were many women lined up outside the clinic each morning waiting to be cycled through for blood work and ultrasounds. There were times when I just wanted to speak with the doctor directly because I didn't feel the nurse our technicians really knew me individually. I will say though that by the third cycle of IUI, Dr. Devine did a better job of calling me directly to discuss the results and options.

As previously mentioned, my first round of IUI was using Clomid. It produced multiple follicles but it thinned my lining and resulted in a negative pregnancy test. There was a standard protocol for all rounds of IUI, which was ultrasound on day 3, medication day 3-8, and monitoring day 12, with usually IUI day 14. Because I seemed to ovulate early, I had to request to come in earlier than the protocol recommended. I also eventually (3rd IUI cycle) had to begin medication on day 2. For my second cycle I was switched to Letrozole. For my third cycle, I continued with the same dose of Letrozole, but gave myself FSH injections multiple times while being monitored each day. Both the second and third cycles of IUI resulted in only one follicle for ovulation and both resulted in a negative pregnancy test.

We originally had a nurse coordinator, Allison, who responded to emails but never checked in on me after procedure or test results on her own. She eventually moved to another clinic and was no longer our coordinator, but she never emailed to tell us so much. We found out from Dr. Devine after the fact. Our new nurse was the same way in that she never reached out to check on me on her own. During our third cycle, it was over a weekend, and I didn't know what to do as far as refill the FSH medication again or not. It is expensive and I didn't want to do it if not necessary but I would absolutely do it if it would help. I was told, I could do it if I wanted to. There was no one to talk to since it was the weekend and it was so incredible stressful. I spoke with one nurse who was on call and she was very comforting but didn't have a great answer for me either. The whole day was filled with waiting for a phone call about the results of my monitoring that morning and stressing over whether or not to refill the prescriptions before the pharmacy closed. I emailed both Allison and Jennifer hoping for some guidance. I understand that they do not work on the weekend and so that's why I didn't hear back, but I also never heard from anyone on Monday or ever after that just to check in and see how it all turned out. Or just to say I'm sorry that was so stressful and we'll be in touch with next steps.

They are a clean facility with friendly front desk staff. They can get you in and out in the morning which is nice when you're trying to get to work. The weakness is that you don't particularly feel connected to anyone and when you have questions you may not have access to someone who can answer them. There is a MD on call, however you will be charged if you use them and its not an emergency.

$1800 for each IUI cycle + $50-150 for medications

I know that Dr. Devine preferred single embryo transfer to reduce the risk of multiples and the complications that can occur with multiple births (prematurity, CLD, etc.)