Dr Cedars was empathetic and understanding. She patiently answered our questions and walked us through each process. I felt like she had a wealth of knowledge about current fertility medicine practices. ... When it was clear we were undergoing a missed miscarriage, Dr Cedars performed the manual aspiration. When we moved over to IVF, a few things fell through the cracks.
UCSF CRH is a big place, they see a lot of patients. I didn't necessarily want to form personal relationships with the staff, but I also didn't want to be another random warm body. I felt they struck a reasonable balance in this. ... As I mentioned, my varicella immunity was low. This didn't seem to be an issue for IUI treatment as a clinical trial patient, but it was as a cash-paying IVF patient. ...
How was your experience with Marcelle Cedars at UCSF?
Dr Cedars was empathetic and understanding. She patiently answered our questions and walked us through each process. I felt like she had a wealth of knowledge about current fertility medicine practices.
What's one piece of advice would you give a prospective patient of Marcelle Cedars at UCSF?
Ask direct questions and expect direct answers.
During treatment, were you treated like a number or a human with Marcelle Cedars at UCSF?
UCSF CRH is a big place, they see a lot of patients. I didn't necessarily want to form personal relationships with the staff, but I also didn't want to be another random warm body. I felt they struck a reasonable balance in this.
Describe the protocols Marcelle Cedars used in your cycles at UCSF and their degree of success.
Six IUIs with 50mg Clomid and HCG trigger. Lupron demi-halt IVF cycle, two weeks of stimulation/superovulation with Gonal-F and Menopur, HCG trigger. ICSI and potential use of microfluidic chip (FERTILE) as part of a clinical trial -- we were blindly randomized, so I don't know if our sample went through the usual preparation or the chip process.
Describe your experience with your nurse at UCSF. (Assigned nurse: Jill Ford)
During 2016 and 2017, I took part in two clinical trials. For both, the research coordinator, Becca Wong, was my main point of contact. Becca was great throughout, easily accessible, compassionate, funny. Even during her own pregnancy, I never felt anxious or envious. When we moved on to IVF, Jill Ford and Ruthie were our main contacts. I met each of them once only, but we spoke on the phone several times and emailed a lot.
Describe your experience with UCSF.
I am very grateful to CRH. I learnt a lot from the staff. The process of going through six IUIs over two years, as a clinical trial patient, meant I paid $0 for this treatment, and received great care. It was so nice not to even think about insurance or payment during this part of our treatment.
My final round of IUI in 2017 resulted in a positive test. My blood HCG tests were low and rose slowly. For a while we were in limbo, anxious especially about an ectopic pregnancy. All throughout, Becca was available and supportive. I met with Dr Cedars at this time too, who was candid about the chances of the pregnancy going to term. When it was clear we were undergoing a missed miscarriage, Dr Cedars performed the manual aspiration.
When we moved over to IVF, a few things fell through the cracks. Becca had advised I have my OB order some blood tests, including for STDs, and immunity to several diseases. Nobody told me that my varicella (chicken pox) immunity was low and I ought to be re-vaccinated. It wasn't until Jill was running through the pre-IVF checklist that she asked me the result of these tests. (I had allowed my OB's office to share the results with UCSF CRH, so I was under the impression they'd already seen them). The two vaccines and a month "on the bench" pushed back our start date.
Also: at one point Dr Cedars mentioned we'd be eligible for a study which would cover the cost of our stimulation medications. I'd done some research and knew this was potentially a large cost. A few months went by (see above) and I asked the study's coordinator if we were enrolled. He responded that we were ineligible, and that he'd told us that several months ago. This obviously wasn't the case.
Fortunately, we were able to buy our meds from Disco Rex, the Walgreens Speciality Pharmacy in Palo Alto, for under $300 total. This was thanks to the 340B Network Pharmacy Program, as cash-paying outpatients of UCSF. Nobody mentioned this program to me at any point until I was prescribed the drugs, and it would definitely have influenced our clinic selection decision. I wish CRH made a bigger deal of it!
The only other complaint I have is a very minor one: the IVF calendar I received was ugly and a little bit confusing. It looked unprofessional, with no branding, lots of different fonts/text sizes, etc. Random reminders were scattered on various days. Other paperwork we received was also oddly-formatted or a copied copy. I feel sure UCSF has communication staff who would be able to create more professional templates.
Describe the costs associated with your care under Marcelle Cedars at UCSF.
Stimulation monitoring: $4,267
Egg retrieval $2,240
Fertilization and culture $3,365
Embryo transfer $2,810
Embryo cryopreservation (1 year) $1,753
I also paid a few hundred dollars for two ultrasounds after pregnancy was confirmed.
As a clinical trial patient, I underwent six IUIs at zero cost. I was also treated for the missed miscarriage, including the manual aspiration procedure, at no cost. There was some confusion as to the status of these treatments, at one point I made a last-minute appointment to see my OB to take over my care. I'm not sure, but I believe CRH staff pulled some strings in order to have my care covered by the study, which, obviously, I greatly appreciate.
Describe Marcelle Cedars's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at UCSF.
We only ever considered transferring a single embryo.
What specific things went wrong at UCSF?
- Lost results
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at UCSF.
As I mentioned, my varicella immunity was low. This didn't seem to be an issue for IUI treatment as a clinical trial patient, but it was as a cash-paying IVF patient.