Because Dr. Hornstein may not be actually doing your procedure, make sure you have really discussed and agreed on important things like numbers of eggs to transfer before you get to the implantation day...The second and third rounds were far more aggressive than the first and produced many more eggs and embryos. The third round led to the most eggs and embryos and had some to freeze. I did a fresh transfer after each round of IVF. Had a successful pregnancy with a FET, which was the fourth transfer.
She [nurse at Brigham & Women's Hospital] was very responsive by email and phone...The ultrasounds monitoring appointment were started before 7am. It is first come, first served and operated pretty efficiently...It's around $8K - $12K out of pocket per IVF cycle depending on your treatment plan. That does not include meds...is a large hospital. The hours for the labs and ultrasounds were very accommodating. The parking lot across the street is reasonable, and it's also close to the T. You will often find out lab results through their patient portal hours after the tests and before they call you.
How was your experience with Mark Hornstein at Brigham & Women's Hospital?
Dr. Hornstein very patiently answered our many questions when we met with him in person. He always treated us with kindness and care. His nurse answers most of the day to day questions by email or phone .
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
Make sure you know your treatment plan and know what the next steps are. The doctors and nurses at B&W are all good at their specific roles, but the communication between them can sometimes be missing. Because Dr. Hornstein may not be actually doing your procedure, make sure you have really discussed and agreed on important things like numbers of eggs to transfer before you get to the implantation day.
During treatment, were you treated like a number or a human with Mark Hornstein at Brigham & Women's Hospital?
The office was very responsive to emails and calls. My primary nurse was very good.
Describe the protocols Mark Hornstein used in your cycles at Brigham & Women's Hospital and their degree of success.
Three rounds of Antagonist protocol. The second and third rounds were far more aggressive than the first and produced many more eggs and embryos. The third round led to the most eggs and embryos and had some to freeze. I did a fresh transfer after each round of IVF. Had a successful pregnancy with a FET, which was the fourth transfer.
Describe your experience with your nurse at Brigham & Women's Hospital.
Dr. Hornstein's primary nurse, Barbara, is awesome! She was very responsive by email and phone.
Describe your experience with Brigham & Women's Hospital.
Brigham and Women's is a large hospital. The hours for the labs and ultrasounds were very accommodating. The parking lot across the street is reasonable, and it's also close to the T. You will often find out lab results through their patient portal hours after the tests and before they call you.
Describe your experience with your monitoring appointments at Brigham & Women's Hospital.
The ultrasounds monitoring appointment were started before 7am. It is first come, first served and operated pretty efficiently.
Describe the costs associated with your care under Mark Hornstein at Brigham & Women's Hospital.
Some was covered by insurance. It's around $8K - $12K out of pocket per IVF cycle depending on your treatment plan. That does not include meds.
Describe Mark Hornstein's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Brigham & Women's Hospital.
He helped us make an informed decision based on risk and insurance coverage.
What specific things went wrong at Brigham & Women's Hospital?
I had previously been seen by his partner, but I wanted a doctor who could do both the surgery for the endometriosis and oversee fertility treatments. Dr. Hornstein was very thorough with our initial work up and let us take our time before going to IVF. Dr. Hornstein presented all of the option and let us decide. We wanted to do PGS testing and even though Brigham doesn't recommend it, Dr. Hornstein was understanding.
Brigham was usually fairly timely calling with changes to medicine, but after my retrieval, I never got a call about day 3 or day 5 embryos and then how many were sent for PGS...I loved Barbara! Brigham is incredibly busy but Barbara always took the time to answer all of my questions. I did find that if Barbara was out or if treatment occurred over a weekend, the covering nurse was often not as familiar with my case.
How was your experience with Mark Hornstein at Brigham & Women's Hospital?
I first saw Dr. Hornstein at the recommendation of a good friend who had seen him for years to manage her endometriosis. I had previously been seen by his partner, but I wanted a doctor who could do both the surgery for the endometriosis and oversee fertility treatments. Dr. Hornstein was very thorough with our initial work up and let us take our time before going to IVF. Dr. Hornstein presented all of the option and let us decide. We wanted to do PGS testing and even though Brigham doesn't recommend it, Dr. Hornstein was understanding.
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
Dr. Hornstein is incredibly busy and a lot of your care will be done by the nurses/fellows/other REs. If something urgent came up, Dr. Hornstein would call.
During treatment, were you treated like a number or a human with Mark Hornstein at Brigham & Women's Hospital?
Dr. Hornstein is incredibly busy but he always took the time to answer our questions and we had a lot! He holds one late night clinic each week and we were the last patient that day. He stayed with us for over an hour until 10 pm to make sure we had all of our questions answered and could develop a treatment plan for an IVF cycle.
Describe the protocols Mark Hornstein used in your cycles at Brigham & Women's Hospital and their degree of success.
4 cycles of clomid - 3 IUIs (one was cancelled)
Agonist protocol that was a freeze-all cycle for PGS and to prevent OHSS. Relatively low doses of stims (Follistim - 112.5) and Cetrocide. I used a dual Lupron and HCG trigger.
Describe your experience with your nurse at Brigham & Women's Hospital. (Assigned nurse: Barbara)
I loved Barbara! Brigham is incredibly busy but Barbara always took the time to answer all of my questions. I did find that if Barbara was out or if treatment occurred over a weekend, the covering nurse was often not as familiar with my case.
Describe your experience with Brigham & Women's Hospital.
Brigham is incredibly large and busy and if you want a personalized, hand-holding approach, Brigham is not the place to go. All of your ultrasounds are done by techs and you wait for the nurse to call with orders to adjust for the next day. Also, your doctor is often not the one who is available for your retrieval and transfer so you must be comfortable with a group practice and residents. One interesting thing to note is that OB admitting is at the front of the hospital and you will walk through that on your way to the clinic or for ultrasounds.
Describe your experience with your monitoring appointments at Brigham & Women's Hospital.
Monitoring hours during the week were from 6:45-7:45 and by appointment on the weekends. Even when it was crowded, they moved fairly quickly. The results of the bloodwork were available on Patient Gateway within a few hours and you would usually get a phone call that afternoon from the nurse.
Describe the costs associated with your care under Mark Hornstein at Brigham & Women's Hospital.
In Massachusetts, most fertility treatments are covered by insurance with co-pays. We did pay out of pocket for a few elective things - freezing samples, ICSI and PGS but all told it was under $10k.
What specific things went wrong at Brigham & Women's Hospital?
Lost paperwork
Failed to call with results
Lost results
Describe the specific things that went wrong at Brigham & Women's Hospital.
Brigham was usually fairly timely calling with changes to medicine, but after my retrieval, I never got a call about day 3 or day 5 embryos and then how many were sent for PGS.
[Dr. Mark Hornstein's] 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.
Be prepared to wait [at Brigham & Women's Hospital], 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...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.
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?
Lost paperwork
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.
When we did have appointments with [Dr. Hornstein], he went over everything in detail and made us feel positive about our progress. However, when I was diagnosed with severe ovarian hyper stimulation I spoke to almost every doctor in his practice, only speaking to him once when hospitalized for the week.
You definitely had to get to the ultrasound clinic [at Brigham] right when they opened, they were on a first come first serve basis and the waiting room was always full. [Dr. Hornstein's nurse] was very nice, but sometimes a little inpatient relaying the information.
How was your experience with Mark Hornstein at Brigham & Women's Hospital?
He was very thorough in his testing and in our health history for both my husband and I. We never felt rushed when we had appointments with him, however, he was very hard to get in touch with personally- we spoke mostly to his assigned nurse. I felt like he definitely explained everything to us in a way we could understand, but sometimes the process wasn't always clear to me. I will say, having had 2 prior miscarriages he allowed us to stay on as his patient past the 8 week mark until we felt comfortable being released to our regular OB/GYN, which I was very grateful for.
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
Write down everything he says, have your questions ready...and make sure you get his nurses direct line for follow up questions. He's very smart and it can sometimes be a little intimidating, but ask your questions until you feel like they were answered in a way you can understand. Also, just know you aren't always going to get him on the phone, so you need to be ok with talking to his assigned nurse.
During treatment, were you treated like a number or a human with Mark Hornstein at Brigham & Women's Hospital?
He was very hard to get a hold of personally, I was always talking to his nurse. When we did sit down with him he had to re-read his notes on our case, as though he was not familiar with it. When we did have appointments with us he went over everything in detail and made us feel positive about our progress. However, when I was diagnosed with severe ovarian hyper stimulation I spoke to almost every doctor in his practice, only speaking to him once when hospitalized for the week.
Describe your experience with your nurse at Brigham & Women's Hospital. (Assigned nurse: Barbara Appel)
I spoke to Barbara the most. I think because they see so many patients that sometimes they forget this is new to us, so they go through the information quickly. She was very nice, but sometimes a little inpatient relaying the information.
Describe your experience with your monitoring appointments at Brigham & Women's Hospital.
You definitely had to get to the ultrasound clinic right when they opened, they were on a first come first serve basis and the waiting room was always full. They opened very early so it was convenient for traffic and to get to work on time.
Dr. Hornstein is a great listener. He made me feel part of the process and the solution. He delivered information with kindness but also with the level of information I truly needed....I had had a successful IVF, then miscarriage, then D&C that left me Asherman's syndrome while at the first clinic. Dr. Hornstein was the first RE to truly listen to me and to come up with a treatment plan that worked for me. When we hit set backs, he was innovative in his approach to overcoming them. I have the utmost respect for him
I spent a lot of time talking with the nursing staff [at Brigham] and felt they were always responsive and caring...I found this clinic to be much more innovative and open to new ideas and solutions....My cycles were covered by insurance. I paid roughly $350 per cycle in meds....Dr. Hornstein is a great listener. He made me feel part of the process and the solution. He delivered information with kindness but also with the level of information I truly needed.
How was your experience with Mark Hornstein at Brigham & Women's Hospital?
I came to Dr. Hornstein after a bad experience with another local clinic. I had had a successful IVF, then miscarriage, then D&C that left me Asherman's syndrome while at the first clinic. Dr. Hornstein was the first RE to truly listen to me and to come up with a treatment plan that worked for me. When we hit set backs, he was innovative in his approach to overcoming them. I have the utmost respect for him and he truly is the reason I've got children today.
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
Make sure you ask all of the questions you have. Don't hold back. He is a great listener and he will fully answer your questions but you have to be open and share all that you are thinking of.
During treatment, were you treated like a number or a human with Mark Hornstein at Brigham & Women's Hospital?
Dr. Hornstein is a great listener. He made me feel part of the process and the solution. He delivered information with kindness but also with the level of information I truly needed.
Describe the protocols Mark Hornstein used in your cycles at Brigham & Women's Hospital and their degree of success.
It's been a number of years. I did 4 IVF cycles with Dr. Hornstein. The final one resulted in a healthy twin pregnancy. My boys were born in 2004 so it's been a while.
Describe your experience with the nursing staff at Brigham & Women's Hospital.
I was that person who was always told there's a chance that X or Y could be the problem but probably not - and it always was. I spent a lot of time talking with the nursing staff and felt they were always responsive and caring.
Describe your experience with Brigham & Women's Hospital.
I found this clinic to be much more innovative and open to new ideas and solutions.
Describe the costs associated with your care under Mark Hornstein at Brigham & Women's Hospital.
My cycles were covered by insurance. I paid roughly $350 per cycle in meds.
Describe Mark Hornstein's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Brigham & Women's Hospital.
This really didn't exist when I was undergoing my IVF cycles. We transferred a number of embryos in my final IVF that resulted in fraternal twin boys.
Lots of testing [with Dr. Hornstein]...Has a very specific protocol...BC of my age (36) and my BMI (High) only recommended single embryo. His mentality was age and BMI already made it a high-risk pregnancy for myself and baby. Possible multiples would just add to that risk for both...He listened to my needs, met with me a full hour at my initial consultation, gave realistic expectations, answered all questions thoroughly
Clinic [Brigham & Women's Hospital] was good, in the hospital, so what you'd expect. Ran pretty much on time. Sticks to IVF protocol to a T so a lot of appts. Had to meet w/ a social worker before IVF. Had to meet w/ a high risk OBGYN bc of my BMI, had to meet w/ anesthesiologist before retrieval too. Lots of appts...I spoke to a few different nurses, 1 was exceptional- Zussanah. The others seemed inpatient and annoyed at my questions
How was your experience with Mark Hornstein at Brigham & Women's Hospital?
Thorough, good at explaining details, kind, realistic, gentle. Very knowledgeable, sensitive. Made me feel that every question I asked held importance and never seemed annoyed (I ask a lot of questions)
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
He is great, if you have any questions at all, ask. He is very patient.
During treatment, were you treated like a number or a human with Mark Hornstein at Brigham & Women's Hospital?
He listened to my needs, met with me a full hour at my initial consultation, gave realistic expectations, answered all questions thoroughly
Describe the protocols Mark Hornstein used in your cycles at Brigham & Women's Hospital and their degree of success.
Lots of testing. I had 5 failed IUIs with another Doctor. Has a very specific protocol. On Day 2 of your natural cycle start OTBC for 10 days. Then have ultrasound for baseline, Then start Menopur and Gonal-f for 5 days. Monitor egg development. Take trigger shot w/Lupron. After egg retrieval Start Crinone.
Describe your experience with the nursing staff at Brigham & Women's Hospital.
I spoke to a few different nurses, 1 was exceptional- Zussanah. The others seemed inpatient and annoyed at my questions.
Describe your experience with Brigham & Women's Hospital.
Clinic was good, in the hospital, so what you'd expect. Ran pretty much on time. Sticks to IVF protocol to a T so a lot of appts. Had to meet w/ a social worker before IVF. Had to meet w/ a high risk OBGYN bc of my BMI, had to meet w/ anesthesiologist before retrieval too. Lots of appts.
Describe the costs associated with your care under Mark Hornstein at Brigham & Women's Hospital.
My insurance covered actual IVF. Had co pays every visit and every time blood was drawn, ultrasound.
Describe Mark Hornstein's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Brigham & Women's Hospital.
BC of my age (36) and my BMI (High) only recommended single embryo. His mentality was age and BMI already made it a high-risk pregnancy for myself and baby. Possible multiples would just add to that risk for both
Mark was a wonderful, caring person who connected with us. He walked us through everything, made sure we understood everything, and changed his course when the first cycle didn't work. Again, he visited us after the girls were born while still in the hospital...He was very easy to talk to and ask questions. We had time in his office to just talk....Lots of shots and I know that I didn't produce as many eggs as we wanted. We used ICSI the second time and that worked.
I was happy with our clinic [Brigham]. I didn't know any better though so it was comfortable for me. I did donate a better squeezy ball for blood draws because it was so hard to get blood from my arm!...[Nurse] She would leave me the best voicemails. They were always so thoughtful and too long to fit on one call!...Most of my procedures were covered but some were subject to my deductible. All the ultra sounds and stress tests after were subject to my deductible.
How was your experience with Mark Hornstein at Brigham & Women's Hospital?
Mark was a wonderful, caring person who connected with us. He walked us through everything, made sure we understood everything, and changed his course when the first cycle didn't work. Again, he visited us after the girls were born while still in the hospital.
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
Trust him. Go for two! It sounds scary but twins are the best!
During treatment, were you treated like a number or a human with Mark Hornstein at Brigham & Women's Hospital?
He was very easy to talk to and ask questions. We had time in his office to just talk. He visited me while in the hospital once the girls were born to meet them.
Describe the protocols Mark Hornstein used in your cycles at Brigham & Women's Hospital and their degree of success.
I don't remember everything. Lots of shots and I know that I didn't produce as many eggs as we wanted. We used ICSI the second time and that worked.
Describe your experience with your nurse at Brigham & Women's Hospital.
She would leave me the best voicemails. They were always so thoughtful and too long to fit on one call!
Describe your experience with Brigham & Women's Hospital.
I was happy with our clinic. I didn't know any better though so it was comfortable for me. I did donate a better squeezy ball for blood draws because it was so hard to get blood from my arm!
Describe the costs associated with your care under Mark Hornstein at Brigham & Women's Hospital.
Most of my procedures were covered but some were subject to my deductible. All the ultra sounds and stress tests after were subject to my deductible.
Describe Mark Hornstein's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Brigham & Women's Hospital.
I am a twin so there was no worry about having twins for me, so I was thrilled that the insurance covered two and we did that. I love being a twin mom!
Very knowledgeable about my issues- he [Dr. Hornstein] performed my lap and follow [up] care. Have not [yet] started ivf[.] He took time to explain everything i did not feel rush[ed]. He is very open to work with my other fertility doctor since i live overseas[.] His nurses [at Brigham & Women's] were nice- was not always the same person each time i went. Come ready to ask questions he will take time to explain everything.
Very knowledgeable about my issues- he [Dr. Hornstein] performed my lap and follow [up] care. Have not [yet] started ivf[.] He took time to explain everything i did not feel rush[ed]. He is very open to work with my other fertility doctor since i live overseas[.] His nurses [at Brigham & Women's] were nice- was not always the same person each time i went. Come ready to ask questions he will take time to explain everything.
How was your experience with Mark Hornstein at Brigham & Women's Hospital?
Strenght- very knowledgable about my issues- he peformed my lap and follow uo care. Have not yey started ivf
He took time to explain everything i did not feel rush. He is very open to work with my other fertility doctor since i live overseas
His nurses were nice- was not always the same person each time i went.
What's one piece of advice would you give a prospective patient of Mark Hornstein at Brigham & Women's Hospital?
Come ready to ask questions he will take time to explain everything
Describe your experience with the nursing staff at Brigham & Women's Hospital.
