Kaylen Silverberg

After decades of being told that my insanely heavy periods were not a big deal, years of trying to conceive unsuccessfully, and a recent misdiagnosis of PCOS, meeting Dr. Silverberg was like a breath of fresh air. I was originally referred to him because polyps and a mullerian anomaly was detected in a saline ultrasound. In our first visit, we went over my records, administered a transvaginal ultrasound, and determined: - I didn't have PCOS - I had a septum - My endometrium may have been one of the thickest he'd seen in his career, I probably make too much estrogen, and it's no wonder my periods are insane Bam, right out of the gate! His level of confidence in that visit and familiarity with my whacked out reproductive system was reassuring. He'd seen issues like these before, and he knows how to fix them. This felt wonderful after so many doctors being mystified in the past or claiming I must have been exaggerating symptoms. Silverberg never doubted or down-played anything I said. We worked together over the course of a couple months to get my endometrium thin enough so he could perform a laparoscopy and hysteroscopy. In addition to removing the septum and polyps, he said he would laser ("zap!") any endometriosis I had, to which I replied that I'd been told several times in the past that I don't have endo. And, of course, he found and removed several instances of Stage 1 and 2 endometriosis. He also verified that my tubes were clear, just to make sure, which was nice. He performed the hysteroscopy with way more care and precision than a previous doctor, and I would absolutely trust him again with any surgery of this nature. We then went on to try a few medicated cycles and IUIs under his care. The good: If you have an appointment with Silverberg, you see him every time. Sometimes the appointments are extremely fast, as it is with REs, but if you feel overwhelmed by information, he will take the time to slow down. After one appointment, I felt so overwhelmed that his nurses secured another meeting room and he returned to walk me through additional information. He genuinely seemed invested in my level of comfort. He's also incredibly knowledgeable, and seems to truly love what he does. He geeks out over this stuff in the best way possible. It's important that he tries to find the root cause of a patient's infertility, not just throw random treatments at it. He has great bedside manner and I always enjoyed interacting with him. The OK: I might be too cynical, but his level of confidence made me suspicious at times. He would always state that my ovaries were "beautiful" and I had a lot of eggs, and inferred that I should have a smooth time getting pregnant. I may have a lot of eggs, but my baby count is still zero, so it doesn't mean it's easy for me. This could be positive or negative depending on the style of RE you're seeking, but Silverberg's approach in rooted in science. He's not going to tell you to take a ton of supplements and herbs or eat a special diet, but he will make recommendations based on studies, science, and stats. I liked this science-based approach, but I guess I also would like to have explored additional options that help my chances, even if only incrementally.

Don't be afraid to tell him to slow down or take extra time explaining something. He will gladly do so, but you need to speak up.

50mg Clomid (5 days, starting on cycle day 3) with Ovidrel trigger shot

For anything related to my septum or polyps, it was billed to insurance and covered. My insurance does not cover fertility treatments, but there are a few good options at Texas Fertility Center like pre-paying for bloodwork that can help with some of the costs. For IUI, it was about $800 per IUI cycle without insurance, including the prescriptions (including $200 trigger shot), appointments, ultrasound monitoring, semen testing and preparation, and IUI procedure. They also have third-party financing options, which I did not use.

Silverberg prefers single embryo transfers in most cases, as stated in the IVF seminar he hosted

After our initial consultation, we weren't quite sure what to think of Dr. Silverberg. Very factual, extremely knowledgeable and blunt. Didn't seem to have much of a bedside manner. When we returned and began treatment and spent more time with him, we fell madly for him. He is one of the funniest docs around! And great bedside manner. His humor is very dry so he may not be for everyone but he is a great doctor! Everytime we mention who we see to another healthcare professional, they say "oh, he's the best in town!" which is very reassuring to hear! We see him most visits, of course weekends are hit or miss and I think one time he was away at a conference, but otherwise, we are always booked with him. When we do see another doctor or have a question after hours, they always check with him on how he wants to proceed so that they are acting on his behalf. I feel like all of the doctors at this clinic are that way.

Enjoy his dry humor!

IUI #1 - gonal F injectible with Ovidrel trigger shot. Negative. He gave us a choice at where we wanted to start and we chose the big one first. Would probably do it differently next time. IUI #2a - Medications cancelled because of cyst, natural IUI. Negative IUI #2b - Clomid. Cycle cancelled because of think uterine lining. IUI #3 - Femara. Negative. IUI #4 - Femara. Negative Decided to move on to IVF with ICSI and PGS testing because of our limited supply of donor sperm. IVF 1: - FSH/Antagonist plan with birth control pills IVF 2 - Luteal Estrace/Clomid/FSH/Antagonist protocol. In process. Going well at day 10 of stims.

Very reasonable.

He is quick paced and speaks very quickly but works well and is super knowledgeable. He slows down when asked and will review any information when asked. His wait time leaves something to be desired but otherwise he is amazing. He is caring and compassionate and I would recommend him!

I would advise a prospective patient to bring a book to the waiting room of the office but rest assured that it’s worth the wait.

Our first stimulation and egg retrieval resulted in a lower number of eggs retrieved than originally predicted. Dr Silverberg adjusted my next cycle appropriately with more estrogen injections to yield more eggs for fertilization. He also carefully monitored me to ensure that I didn’t become hyper stimulated. The second round of stimulation was also accompanied by a freeze all cycle rather than fresh which was easier on my emotions and body to have the break between the retrieval and the transfer. The research showed that freeze all is typically more successful which was true for our situation as well.

All in all (for two rounds of stimulation, 3 egg retrievals) we spent $35K but that included our medications, the embryology (through Ovation), the surgery center, and TFCs services. The costs associated with TFC directly were very reasonable (for the ultrasounds, office visits, retrevial and transfer).

Dr Silverberg strongly stuck to transferring only one embryo at a time. He said he was part of the initiative that wrote guidelines for age and transfer and that he had been responsible for too many NICU babies and exorbitant hospital bills. He felt it was a more responsible move to transfer one embryo at a time based on age factors. He said once I was >35 he would be willing to transfer 2 at a time.

He is incredibly knowledgeable and has a ton of experience with IVF. I always felt like I was receiving the best care. When I was unsure of what to try next, he offered examples of previous patients in similar situations. He always presented multiple options and clearly pointed out the advantages and disadvantages of each. He left the choice up to me and was willing to move forward with whatever treatment I felt comfortable with and without judgement. He took my worries seriously and never made me feel bad for asking questions.

Be honest and up front with any of your concerns and don't be afraid to ask questions.

My first IVF cycle used a long lupron (agonist) protocol since I had never tried injectable drugs before. I responded slowly and my medication was increased to compensate. A slightly lower than average number of eggs were retrieved and only one embryo made it to the blastocyst stage. It was tested PGS abnormal and incompatible with life. My second IVF cycle used a microdose lupron flare protocol since I am a poor/slow responder to fertility drugs and there was a question about my egg quality. I was on the maximum dose for most of the cycle and ended up with a normal number of eggs. We did not have any embryos make it to the blastocyst stage. We did not get any viable embryos using my own eggs (poor quality) so we moved on to an egg donor after 2 failed IVFs. Our donor used an antagonist protocol because that is the fastest and easiest cycle for my doctor to manage. She had donated before so my doctor used her previous cycle as a starting point. Her dosage was updated every two or three days based on her response, and we ended up with a higher than average number of eggs and PGS normal embryos.

The billing department did a great job of breaking down the cost for every part of my treatment. We paid a total of about $70,000 out of pocket (no insurance coverage) for 2 own-egg IVF cycles (~$17k and $15k), one donor egg cycle (~$33k), and one transfer cycle (~$3k). We elected to freeze all and PGS test our embryos for each cycle. We were presented with an estimate of expenses before treatment started so there were no surprise charges.

My husband and I desired an eSET and my doctor was supportive of our decision. He typically recommends eSET for PGS normal embryos and first time transfers unless there is a compelling reason to transfer more.

Dr. S is compassionate, enthusiastic, positive, and interested in your patient history. For the most part he seems focused on figuring out problems and is cautious about checking all the boxes (i.e. he insisted on an ERA biopsy to make sure we were transferring on the right day before we did a frozen embryo transfer since we only had one good PGS embryo to work with). He makes an effort to talk or meet with you right away when you get bad news. That being said, I have now had 3 failed frozen transfers and am "unexplained" with still no answers as to what is going on, even though we have done everything under the sun that has been recommended.

Don't be afraid to ask questions or ask for more information or clarification, even if he is in a hurry.

2 fresh freeze all retrieval cycles on Gonal F, Menopur and Lupron (starting with birth control and Lupron suppression). Resulted in 9 mature eggs; 2 day 6 blasts, but only 1 PGS normal embryo for 1st cycle; 8 mature eggs; 5 day 6 blasts and 2 PGS normal embryos for the 2nd cycle. 3 FETs on Crinone and Estradiol support. 1st FET = HCG of 41, chemical pregnancy. 2nd FET = BFN. 3rd FET = HCG of 28, chemical pregnancy.

Fresh retrieval freeze-all cycle with PGS testing and ICSI: approx. $16,000 Frozen embryo transfer with assisted hatching: approx. $2,600 Monitoring Ultrasounds (weekdays): $210 Monitoring Ultrasounds (weekends): $250 ERA Biopsy: $300 (plus $900 for the testing company)

Strong preference for freeze all cycles, PGS testing, and eSETs.

While I do sometimes feel like he moves through the appointments quickly and he seems to be very busy, I REALLY like Dr. Silverberg and I'm very comfortable being in his care. He has great bedside manner and with procedures that can obviously be awkward at times, its really important to me to have a doctor that I feel as much at ease as possible. Besides his personality, he's very thorough in his assessments and treatment plans and he has a lot of experience and expertise in fertility related issues.

Be patient because sometimes it seems as though he's taking the long way around but its only because he is making sure you've received all the tests and preparatory steps before moving forward.

I've had 5 IUIs that we got progressively more aggressive with. My first IUI was unmedicated. The second and third were in conjunction with Femara and my fourth and fifth cycles were with gonal-f injections and the ovidrel trigger. I also used progesterone suppositories after the IUIs on the last two cycles. I'm still trying to conceive so none of the IUIs produced a positive pregnancy test. So I have decided to move on to IVF treatment.

I don't remember exactly but I think I paid about $250 per IUI and about the same for sonograms. It was about $40 higher on weekends and holidays. Consultations were about $95.

I have not yet had an embryo transfer. I'll begin my IVF cycle in about two weeks.

Dr. Silverberg is very thorough is very real. He explains everything that is happening in the appointment, such as what he sees on the ultrasound and showing us what each thing is, he shows us how he is measuring the size of the follicles and lining of the uterus, and takes the time to answer questions. He has been to Washington, D.C. several times to advocate for infertility which shows me he is passionate about what he does and his desire to help people in this situation.

Don't be turned off by the 10 minute exam once the process of the treatment begins. He spends an hour with you at the initial consult. He welcomes questions and is easy to work with.

I don't remember the type of protocols used but for both full IVF cycles, I was on birth control for about 3 weeks, lupron for a couple of weeks, lupron and gonal-f for 10 days the first round and 12 days the second round. I triggered with ovidrel both times and was on estrogen pills for a little over a week and crinone until my progesterone numbers were high enough. We went to IVF, skipping IUI, because my husband has a history of trsticular cancer which greatly effected his numbers. I feel like that was the right call so we weren't spending so much money on countless IUIs that probably wouldn't have worked. Our first IVF resulted in 6 embryos, only one in the blast stage. We transferred two, the rest arrested, and we had one healthy baby. The second round resulted in 10 embryos, 4 reaching the blast stage. We opted to freeze all in order to allow my body to adjust from being on the meds. We did a frozen transfer about 2 weeks later of one embryo which resulted in one healthy baby.

Scheduling was easy. The doctors tend to do procedures in the morning and office appointments in the afternoons. We waited in a beautiful waiting room usually no more than 15 minutes from our appointment time. The monitoring ultrasound itself only took about 10 minutes if we didn't have questions. We always felt comfortable and like we were given every piece of information we needed.

We paid for everything except the medications at our clinic. Everything had to be paid in full at the baseline appointment. If something changed, for example an extra monitoring appointment that we weren't expecting, we were made aware and they worked with us on payment.

he is an amazing communicator and always in an upbeat mood. we knew success was just around the corner. He does tons of fertility research but doesn't have clinical personality

He's very busy - be patient. He runs late because he cares so much. pay it forward - one day you might be the patient that needs that extra 20 minutes to dry your eyes and adjust the plan. if I'm in the waiting room i don't mind waiting for you.

I'm old. I needed lots of help but I conceived with my own eggs with a poor responders protocol. We used PGS and a freeze all cycle to find normal eggs on the second go round.

Did IVF with PGS - drugs were covered with copays and some of our cycle cost (PGS) was covered with one of Dr Silverberg's fertility studies. Total cost less than $10,000

I always knew I would have fertility issues and I left my first appointment with him beyond hopeful. He listened to my long story and immediately took me for an exam. He said he would go straight to IVF if he were me (after surgery) but was willing to explore less expensive options. When two tries at IUI didn't work, he consoled me and convinced me to continue my journey when I was at my breaking point. He was so genuinely happy for me when I was finally pregnant with my now five year old. He loves his job. I cannot say enough good things about him. When I went back to him almost two years later at age 40, I was pretty sure I was going to have an only child but he told me about the donor program and explained it in such a positive light that I left the office thinking, why not? So thanks to his guidance, I have two healthy happy boys and the family I had always dreamed of but never really thought I could hope for. I am so thankful I met him. It's a very difficult journey but he is so positive that it keeps you going and your eye on the prize!

Listen to every work and take his advice, He knows exactly what he is doing. If he says to go IVF, listen. It will most likely save you time, money and heartache.

My IVF came out to about $15,000. My IVF with donor eggs was about $28,000. The later includes additional costs because the first donor did not work out

Dr. Silverberg is direct, to the point, and has a great sense of humor. He was always very warm and I appreciated all the treatments I had. I did have to cancel an egg retrieval 3 times but he described why we couldn't continue and why it was in my best interest.

If you need to be cuddled by a doctor, Silverberg isn't your guy. He's direct and to the point. I am a patient who knows the doctor knows more than I do and to stay in my lane. For the most part I just took the advice/directions without 2nd guessing or questoning him.

Somewhere from 40-50K because we also had male infertility issues and my husband had to get a PESA.

TFC highly belives in only one single embryo per transfer.

Dr. Silverberg is incredibly knowledgeable about the most up-to-date research related to infertility. He thoroughly answers any questions we have. We've be pleased with the treatment received thus far. At times we have a very long wait which it seems could be due to over-scheduling.

Come prepared with questions and don't hesitate to call back with questions. He is happy to answer them. Also, bring a book for waittimes.

Dr. Silverberg seems pretty adamant about only transferring one embryo at a time, which we are comfortable with.

Confident and encouraging, smart and kind. Highly recommend him. He met me at my lowest after many failed attempts and helped me believe my dream of a child was possible. Candid and no fluff, he shoots straight and took the time to talk me through each procedure.

Ask questions!

My first IUI I produced way too many eggs and I made the decision (with his advice) to cancel the cycle. Hardest decision ever.

My insurance covered my surgery, while I paid out of pocket for my IUI. I was on a clinical trial for the IVF and that helped with cost.

We did multiple transfer and that seemed normal for my age. I love having twins.

He’s very easy to talk to. He gives you a direct answer. He will do research with you if he’s not sure what you talking about. He also consulted my husband, which no other clinic had done, and gave him information on how he could possibly improve his sperm count. No other Dr. has done this

He’s a good genuine Dr.

Not there yet

So far only 1,000. Were in beginning stages. Trying to decide our best option for success

Only eset

Very good clinic and well-run. The only major issue was that Dr. S was chronically late - sometimes 2 hours or more.

Smart and technically savvy; talks very fast.

I had monitoring in Houston.