How was your experience with Mark Hornstein at Brigham & Women's Hospital?
Dr. Hornstein is an excellent communicator. He seems aware of the power differential between patient and doctor, and actively mitigates it during consultation by listening actively within the time constraints of the visit. By the time I became his patient, it was clear that I likely had endometriosis that previous doctors failed to take seriously as a reason for both my infertility and severe pain. My goals closely aligned with his, which likely made him a good fit for my case (single embryo transfer, plenty of cool down time between failed transfers, aggressive pain management of my endometriosis during the process).
I came to him in crisis and feeling hopeless. He validated all of my anger and frustration, and my sens that "something just wasn't right." He had me in the OR within 6 weeks to remove endometriosis and we were on to infertility treatment from there, quickly moving to IVF. His approach is wholly evidence-based, which I appreciated greatly. Dr. Hornstein never did any of my infertility procedures because you get who is on the schedule. But there was never a moment that he wasn't up to speed on my care. I had a lot of setbacks: return of endometriosis, two canceled transfers, two failed cycles, some complications post second retrieval. It was a long road from the start of my care to the MFM hand off once I finally got pregnant (2 years, 4 months), but there was never a moment where I doubted his clinical judgement. I have no regrets about choosing him, and would feel the same way had I not ultimately been successful (my husband agrees).
I hesitate to write this because it may identify who I am as a patient, but it's very important. As a woman with a significant physical disability, Dr. Hornstein never once questioned my ability to be a mom. Other doctors had, in ways that were unfounded and not evidence-based. He cared about my disability when it was relevant, and didn't when it wasn't. It's hard to put into words how refreshing that is, as OB/GYN care is particularly challenging due to my disability. He always took the extra time needed for pelvic exams and procedures (HSG, SIS), and collaborated with my physician who cared for my disabling condition when necessary. I would not hesitate to recommend him to any woman with a mobility-limiting disability.
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
Come in with your questions ready, trust his judgement, be patient with the process.
During treatment, were you treated like a number or a human with Mark Hornstein at Brigham & Women's Hospital?
Dr. Hornstein always took the time I needed even when his schedule was booked, and always answered every question. Pelvic exams are difficult for me due to physical disability, and I have had previous terrible experiences with gynecologists as a result. He is the most accommodating doctor I have ever seen in a specialty unrelated to my disability. I continue to see him for endometriosis management.
Describe the protocols Mark Hornstein used in your cycles at Brigham & Women's Hospital and their degree of success.
I do not remember specifics, but I do remember his approach changed with each failed cycle or canceled transfer. We were constantly balancing increased endometriosis pain while during ovarian stimulation. So his approach to stimming was a bit conservative with me. However, we were very much in alignment, going for quality over quantity. I stimmed with GonalF for my first retrieval and got quite a few low quality embryos. He adjusted the approach for the second retrieval, adding in Menopur, resulting in better quality embryos, and my pregnancy.
Describe your experience with your nurse at Brigham & Women's Hospital.
I do feel that his nurse at the time was a weak link in the process. There were some communication issues there, but I soon figured out how best to work with her. I would not let the nursing staff dissuade me from using this doctor.
Describe your experience with Brigham & Women's Hospital.
You have a choice of where to do your monitoring if you can't come into Boston, but it's still a time consuming process. I often did monitoring in Foxborough and once at Chestnut Hill. The wait times for monitoring can be very long at BWH Boston. Be prepared to wait, and there will often be children in the ultrasound waiting room, especially on weekends. The clinic itself is often running behind schedule, but they are good at letting you know where you are in line. You really could do so much worse than BWH, though. And living in Central MA I have.
Describe your experience with your monitoring appointments at Brigham & Women's Hospital.
Very busy at BWH Boston on the weekends. There will be children in the waiting room, so prepare yourself if that is a concern.
I did weekday monitoring at Foxborough, and once at Chestnut Hill. Foxborough was, for the most part, a well-oiled machine. But, factor in time for traffic if you are taking 495. The courier service that picks up the blood for analysis at the main hospital is always on time and if you miss the window you are out of luck. No exceptions. As a patient driving in from central MA I often had to just judge by traffic whether I could beat the courier at Foxborough or if I just needed to drive into Boston.
Describe the costs associated with your care under Mark Hornstein at Brigham & Women's Hospital.
We have a state mandate in Massachusetts that requires private insurance to cover a maximum of six fresh cycles of IVF. IUIs, drugs, and infertility testing are also covered. My daughter is a $200k kid. I paid, maybe $2,000 of that once you figure in copays for office visits, surgery and meds.
If you don't live in Massachusetts, my advice is to get here now. No one should have to go broke to have a kid. You're supposed to go broke after you have the kid. ;-)
Describe Mark Hornstein's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Brigham & Women's Hospital.
I opted for elective single embryo transfer because of my physical disability. We were in agreement about that. As the process dragged on and treatment wore me down, at one point I suggested trying two. He was gentle in his reminders of why I chose eSET and I agreed. I did not push back on this.
What specific things went wrong at Brigham & Women's Hospital?
Describe the specific things that went wrong at Brigham & Women's Hospital.
My husband received a diagnosis of male factor infertility during our time at this clinic. Somehow, our insurance company knew this before we did, and it resulted in an awkward conversation with the insurance coordinator while we were scrambling to figure out why insurance was no longer covering IUI ("uh... it looks like your husband is infertile, too?"). I don't know where exactly the ball was dropped, but it happens (and you should expect this to happen at least once with infertility treatment. There's just so many aspects of care to juggle). I was pretty upset with my doctor, but appreciated his apology.