Lorna Marshall

Dr. Marshall is kind, funny, calm, and reassuring. She clearly has a lot of experience and I trust that she knows what she's doing. Sometimes this can be a double edged sword, as she assumes I also know the details of a procedure/protocol, but she is always happy to answer questions. I appreciate her work towards trying to get insurance coverage for fertility treatment in the state of Washington!

Don't be afraid to advocate for yourself. Dr. Marshall said the same - we should feel comfortable calling and asking questions whenever we want.

For IUI with PCOS - first 3 rounds were with Letrozole and trigger. Round 4 and 5 included additional Gonal-F.

IUI with ultrasounds, approximately 1,000-1,200 per cycle IVF - 23,500 + 3-6,000 meds, 1,000 testing, 4,000 PGT-A testing

The clinic strongly feels that one embryo per transfer is the way to go. At my age, I have no issue with that but would likely feel differently if trying to conceive later in life.

She was compassionate and optimistic about results. She offered alternatives when they did not meet our expectations. She is very knowledgeable and does share everything she can. I do wish I saw her more frequently, she did not perform my IUIs.

I would recommend more time with patient, although I know this is hard given how many people seek treatments. I often felt when I was meeting with other doctors they did not have the full context (although I am sure they did) and weekend appointments because of timing made it so I was seeing other people.

I cannot remeber.

They were high, $30K.

NA

Dr. Marshall is straight forward and easy to understand. She clearly has incredible experience in the fertility world. Any frustrations we had with the process were simply because it can be a frustrating process, not anything related to Dr. Marshall.

Be patient. The process can be slow and involves a lot of waiting. But you are in good hands.

My first retrieval resulted in very poor fertilization rates. For my second retrieval we switched to an antagonistic protocol and had amazing results. For my first two transfers we did a typical medicated cycle, both of which failed. For the third transfer we did a "kitchen sink" natural FET. That transfer resulted in my twins.

My first two transfers were eSET. When those failed we asked about transferring two embryos and Dr. Marshall was supportive given our situation and the fact that I was young and healthy.

Dr. Marshall seems to be very well practiced in her field. I have 100% trust in her knowledge of fertility treatment. She was present for most of my procedures and often entertained my questions. After my hysteroscopy she told my husband about the results, because I was still coming out of anesthesia, but she would have never followed up with me if I hadn't asked. After our failed embryo transfer, when we were finally able to meet up to discuss what happened - she couldn't remember a lot of the details of my cycle (how many embryos did we get? did I have a positive HCG?, etc) and clearly hadn't refreshed herself prior to the meeting. Which was disappointing. After such a loss (chemical pregnancy of your one and only embryo), I was hoping for answers but since she didn't appear to know me from the next infertile woman so it felt like a waste of time.

She's very knowledge but not that personable - she lays out the facts but she doesn't pressure you to go one way or the other. She is one of the harder doctors to get appointments with - prepare yourself for a lot of 'hurry up and wait'.

I was diagnosed with low ovarian reserve (AMH ) and probable poor egg quality, other than that I don't know why the meds and doses were chosen. my IVF regimen was as follows: 3 weeks of BCP suppression check/blood work Follistim 450 IU and miniHCG 20u for 12 days. Meanwhile reporting to the clinic day 5 (ultra sound - 9 follicles), day 7 (US - 12 follicles), day 9 (US - 14 follicles), day 11 (13 follicles), and day 12 (12 follicles). Started Ganerelix on day 9. On day 12 max follicle size was 18.6 so HCG Trigger shot was scheduled for that night with retrieval the next morning. Egg retrieval in the morning, 10 eggs retrieved, 7 of those were mature. Day one report - 5 fertilized. Day 5 - 1 blastocyst and two more still growing. Day 6 - 2 blastocysts, both biopsied and frozen PGS report a four days later (we were told it would take 2 weeks) - 1 chromosomal normal blastocyst About a week after the retrieval I had a hysteroscopy and removal of some polyps found during the Saline Sonogram. Then I took a month and a half break (continuing birth control pills) to allow healing. For the FET, I did 2 weeks of lupron at 10u (some overlap with the BCP). A suppression check and blood work prior to starting Estrogen patches. The patches started at two every other day for a week then increased to 3 patches every other day for a few days then up to 4 patches every other day. Lupron had been reduced to 5 units every day. My first lining check was not thick enough so I continued with 4 patches. Still continuing with Lupron. Finally my lining was thick enough (it took 5 weeks instead of the 4 that was initially outlined). Progesterone was to start 6 days prior to transfer, but I forgot to start the progesterone so the cycle got cancelled. For the next cycle to prepare for the frozen embryo transfer, we repeated the BCP and lupron portion of the meds but I reacted negatively to the estrogen patches (rashes) so we switched to delestrogen injections. The delestrogen injection worked much better and my lining was ready pretty quickly. 6 days prior to the transfer I started progestrone injections and stopped the lupron. 10 days later I had my first beta HCG which was 150ish and my follow hcg test had declining levels so I had to repeat it again and the number was even lower so I was told to stop the delestrogen and progesterone.

IVF with ICSI and PGS $22,000. Meds for IVF were about $4,000. FET about $800. Meds for FET about $1200.

Lorna Marshall thoroughly reviewed our chart and was happy to help us with IUI because she knew we were not ready for IVF. When we wanted to be more aggressive she adjusted our protocol and added inhectables. She was always understanding of our situation and showed compassion while at the same time being straight forward with our situation.

I can’t think of any advice to give specifically related to Lorna Marshall.

I was prescribed Letrozole 5mg daily days 2-6. This was a little earlier than typically prescribed because my cycles are a little shorter than average. My ultrasound on day 8 showed 3 mature follicles. I triggered that day and did the IUI next day. The second IUI with PNW Fertility we added follistim (75iu) on day 7 in attempts to be more aggressive. My ultrasound was day 8 and showed 3 mature follicles. I triggered day 8 and IUI was day 9.

Consultation $295-375 Ultrasound $185 Venipuncture $25 Hormone testing $79-85 each Injection $40 Insemination $275 Sperm wash & prep $270

N/A

Very nice and very informative. I wish I could have seen her more often and felt like she was really working to try to make things happen for me. I didn’t feel like she remembered me whenever I saw her.

Ask a lot of questions. She is thorough with her answers.

Started with no meds and IUI, then moved to letrozole for 3 cycles, then moved to letrozole and follistim, all with IUIs. No positive results. Discussed embryo donation, egg donation, and ivf and pros and cons with each.

$330 per IUI. Ultrasounds and doctor visits cheaper.

When meeting with Dr. Marshall I felt very confident in her knowledge. She has a gentle disposition and is able to clearly explain the process and procedures she recommended. I went to her after having a bad experience at another clinic and upon meeting her she put my mind at ease.

Expect to not see her at every visit.

Dr. Marshall's first treatment plan was to have me try Metformin as she explained that it sometimes helps patients with PCOS get pregnant naturally. My body didn't react well to the Metformin so she then had me start on Clomid with IUI. Her reason was that there is a better chance in conceiving with IUI versus naturally as the timing is exactly right. After 7 cycles of Clomid (and 6 IUIs) she recommended that we move forward with IVF.

Each IUI cycle (including meds, ultrasounds, IUI procedure, and lab work) cost about $1,100 out of pocket - my insurance does not cover infertility medications or treatments. I was told that I can expect IVF to cost between $20,000 - $25,000.

I was told that my clinic likes to transfer single embryos; however, if we would like to transfer two we have that option. They would not transfer more than two.

It's great so far. Honestly, I'm just getting started after seeing my regular OB-GYN for about a year before seeking additional expertise. My first visit was great, I felt like we had a gameplan and well taken care of. UPDATE: The gameplan played out exactly as she predicted, after one failed cycle (I ovulated, but did not get a positive pregnancy test), I got pregnant on the second cycle and am currently 16 weeks along and everything looks good so far (hoping I didn't jinx it by counting it as "1 live birth" on a previous question).

Come prepared with lots of information.

Started taking metformin (500 mg/day for first week, then bumped up to 1000 mg) Taking 5mg of Letrazole on days 3-7 (I was already doing this with previous OB) Ultrasound on day 13 with injection of 10,000 USP units/vial to induce ovulation

$295 for office visit/comprehensive exam $185 for pelvic ultrasound $135 for pregnyl shot through MRD pharmacy

not applicable as of now