Martha Noel

Strengths: Dr. Noel is thoughtful about her recommendations and fertility plan. She also takes the time to explain and answer questions. She’s responsive over email. Weaknesses: Dr. Noel hasn’t been as always to access since the email system got updated. Now you can only email the care team and a nurse usually responds. At least the responses are within the day.

Dr. Noel is compassionate and thoughtful about each patient’s case. UCSF is structured to rotate doctors and nurses for each visit. Even though you won’t have that much contact with Dr. Noel, she is making the final decisions and recommendations for you.

Dr. Noel is thoughtful about my case and take the time to explain everything simply, draw diagrams, provide important details and answer all of my questions. She is also realistic and kind at the same time.

We started conservatively with progesterone treatments, then moved to IUI (4 rounds) then IVF when previous methods were unsuccessful. Dr. Noel was measured and didn’t try to pressure me into IVF vs other doctors I had consulted. So far no pregnancy but Dr. Noel mentioned it could take a few tries due to age and lower egg count.

Care coordinator: Thuy - she is very responsive and helpful with getting all of the paperwork and necessary appointments set up. Very organized. Main nurse: Olga - she is very organized and is the main point of contact for updates. Very efficient and explains processes well. Can sometimes be curt but don’t think she means it negatively. General nursing team: all wonderful, well-informed, professional and kind.

Strengths: wide range of time slots, both early morning and weekends. Very professional staff, punctual and high quality of care. Weaknesses: hard to get into the system initially but go above and beyond once you’re a patient.

IUI costs $3-5k depending on monitoring and insurance coverage. IVF costs about $20-30k depending on specific procedures performed/elected.

The approach is meant to optimize for saving the embryos that I can produce due to lower egg count. So day of transfer and # transferred depends on how many eggs and embryos in that cycle.

Overall I feel very positiely towards Dr. Noel. My treatment with her was interrupted because she went out on maternity leave for a few months, and the few other doctors I saw in her absence really did not compare. Her approachability and ability to explain what's going on in a kind, clear way are great. I wish she were more accessible (I was never allowed to email her and had to always go through her assistant, which I felt led to needless delays and games of telephone and misinformation), but that was my biggest complaint.

Beware her scheduling assistant. Nice, but not exactly competent. If receiving panicked emergency calls about forms not being in order right before your first IUI will upset you (as it did me), you might be best off avoiding Dr. Noel because you're stuck with the coordinator she has.

When I actually got to see or talk to Dr. Noel, I very much felt treated like a human. I think she has a great bedside manner, and is exactly the right amount of direct and clear but also gentle and supportive. She seems to know her stuff, and I liked working with her. Her scheduling coordinator was unfortunately a big impediment, mixing up appointments, getting the wrong information, being slow to reply, and acted as a strong buffer / blockage between us and Dr. Noel, which put a big negative on the experience.

Letrozol + ovidrel -- we increased the letrozol in the 3rd and 4th IUIs resulting in 2 mature eggs instead of one. no success with IUI

Olga was good. After a rough start initially (lacking some bedside manner / awareness of our case's history), I came to really like her and found her quite accessible and helpful.

It seems fairly difficult to get access to your doctor at this clinic, and you never see your doctor for the actual IUIs, and rarely for the ultrasounds checking follicle counts during IUI process. I'm very confident in the lab and the state of the art medical procedures, instruments, and capabilities at this office, and that was enough for me to want to be and remain a patient there. The main weakness was a real lack of access to the doctor (it's strange to me that it was not possible to send an email to the doctor - it's not like I was expecting to get her cell number or her address, sheesh), and the extent to which the scheduling person really controls things. I assume that's very hit or miss, and in the case of Dr. Noel's person, it's a big MISS. Really too bad because I think she's excellent, but I'd consider choosing a different doctor to avoid the scheduling nightmares and unreliable ability to track documents and checklists.

The IUI cost changed during my second cycle (described earlier) and during my 3rd/4th I was on new insurance that covered my treatment so I only had $20 copays. Unfortunately I dont remember more except that I believe initially IUIs were about $900 out of pocket, and skyrocketed to $2700 or $3000 (which I never paid because I protested them raising the price when I was literally already in the middle of treatment).

for our age at least (early 30s), UCSF seems pretty adament about eSET only, no multiples transfer

Dr. Noel is amazing and confident in her recommendations. She is warm and understanding of the emotion that goes with infertility. She has wonderful bedside manner and truly listens to all questions and concerns. She is never rushed and is responsive to emails and calls. She directed every aspect of my treatments even if she wasn’t the doctor to perform them based on my cycle. She also adjusted my treatments when I didn’t tolerate the hormones well. She is amazing and the reason I’m expecting my daughter. I can’t recommend her enough! UCSF is the best hospital with the best doctors and Dr. Noel is an example of that. She’s wonderful.

Fertility treatments are not easy but with the right doctor you will get positive results.

My care was thoughtful and specific to my needs. My first chemically controlled cycle for transfer of a PGS embryonwas rough (I did not tolerate the hormones well) and resulted in implantation but not proper growth. To prepare for my second transfer, we discussed at length the benefits and risks of a natural cycle and created a protocol that was easier on my body. Dr. Noel was my point person for everything even if I was seen for procedures by other doctors in the practice. She is compassionate, kind and smart. She was responsive and answered every crazy question I could dream up. At no point did I feel unheard or uneasy about the treatment plan. I can’t recommend Dr. Noel enough. She’s wonderful and because of her caring and compassion, I am 39 weeks pregnant with my daughter.

I had a natural conception and no issues with my first child. When I had a miscarriage with my second pregnancy and trouble conceiving thereafter, I wasn’t convinced I needed to see a fertility specialist. I met with Dr. Noel unconvinced I had true fertility problems and based on my prior natural conception, she recommended I do Clomid with IUI’s. We tried 3 with no luck. Thereafter we stepped up the fertility to an egg retrieval and PGS testing as egg quality was the suspicion. The PGS was telling and I ended up with 3 normal and good quality embryos. I did a medicated cycle to prepare for my first transfer. I took a drug that is used for treatment of prostate cancer that suppresses the ovaries. I then had to do progesterone injections. The medication was very hard on my body but resulted in a positive pregnancy. The embryo didn’t show proper growth and resulted in a miscarriage with manual uterine aspiration. In discussing my second transfer, I advised Dr. Noel that the medications were very difficult on my body and she suggested we do a natural cycle. We did and it resulted in a positive test and healthy pregnancy. I used estrogen suppositories to boost the pregnancy which were easy to use. Dr. Noel followed my progress through delivery and was so kind. She was as excited that I was pregnant as I was!

Dr. Noel’s team was wonderful and compassionate. They were also responsive and organized. They walked me through the process for each step so I was confident in My medications and use.

The clinic is the best of the best. They are organized and open daily to accommodate for all cycles. I saw many different doctors for various treatments based on my cycle and they were all wonderful. UCSF is the best hospital around and the clinic is representative of that.

For the IUI’s and harvest and 2 transfers, we spent approxsintelt $20,000.

I only wanted one additional child so we planned to only transfer one embryo at a time.

She is extremely approachable, easy to talk to, is not judgmental at all about "stupid" questions (just to say there isn't anything I would be embarrassed or hesitant to ask her), she's thorough and very reasonable, she does the serious talks with kindness and gives straightforward answers, but she also is personable and will laugh with you about all of the ridiculous moments that inevitably happen throughout this process. She will talk short game and long game, and when she (very appropriately) raised the possibility we might need to resort to donor eggs and I was not emotionally prepared to talk about it, she respected that. But I know that if we got closer to that point, she would approach it again kindly (as she should). I trust her to tell me the truth in a way and at the time that I'm ready.

Nothing specific to Dr. Noel, only general advice about entering this process or seeing any doctor, like make a list of questions and be sure to write down the answers they give because you can't remember everything, things like that.

Dr. Noel has been extraordinarily kind and patient while we asked questions, sometimes over and over; she remembers us in detail every time we see her and it feels like we're also friends; she says things like, "I was thinking about you guys the other day, and I think we should try X" or "I asked for a colleagues advice..." just showing that she knows our case inside and out and is really thinking about whats best for us rather than following a formula or a standard treatment procedure without tailoring it to us. She emails with us directly and understands that since we live two hours away sometimes it's nice to have discussion appointments over the phone. She gives us our options AND her honest, professional opinion. She is honest when our cycle doesn't go as well as she hoped (or we hoped), and we talk about why and she helps us set reasonable expectations for moving forward, while continuing to be hopeful and find options for us. I can't say enough good things about her. And her team!

I am 30 with DOR (very very low AMH and AFC 10). We did three IVF retrieval cycles, one of which we cancelled before the retrieval, all to freeze embryos. Cycle 1: Estrace for mild supression, stims of 300 IU Follistim, 150 IU Menopur, adding Ganirelix. Trigger was Pregnyl with Follistim co-trigger. 4 follicles at time of retrieval, 3 eggs retrieved, 1 mature, it fertilized with ICSI, and was frozen on day 3. (Yield: 1 embryo) Cycle 2: half dose Estrace, start with Clomid (100 mg), 300 IU Follistim, 150 IU Menopur- canceled cycle before retrieval. (Yield: 0 embryos) Cycle 3: Lupron strting 6 days after ovulation, stims of 300 IU Follistim, 150 IU Menopur, and omnitrope. Trigger was Novarel with Follistim co-trigger. 5 follicles at time of retrieval, 5 eggs retrieved, 4 mature, 3 fertilized with ICSI, 2 looked great and were frozen on day 3, while 1 was poorer quality and so was grown to dat 5 to see how it went then it didn't make it. (Yield: 2 embryos) We did not do PGS and so are very nervous about the egg quality, and 3 embryos doesn't give much "wiggle room" for failed transfers, miscarriage, aneuploidy, etc., especially since we would love 2 kids. We're hoping for one more IVF cycle to get a total of 5 embryos is possible.

Olga is amazing too! We've been so lucky. She often gets an email from me then picks up the phone to call me to chat about my question. She likes to plan my cycle in detail ahead of time (just like me!), she's very kind and personably, like Dr. Noel, good at the serious stuff but is also quick to laugh with you. She commiserates in a totally appropriate way, and I always feel like she is on top of things and totally has my back.

They run very on time, I'm usually in and out very quickly for the regular ultrasound check; the staff is all very nice and professional; the office is always clean; I don't think they allow babies and children in the waiting room which is nice. I felt like they did their best to find programs to help up pay for treatment, since my insurance doesn't cover anything. It's never enough of course, but I can tell they really tried and did find us some options, especially for medication include a $100 coupon for one of the pharmacies. I wish they had a payment plan rather than having to pay up front, but I expect that that is a pretty standard policy. Overall I've been exceptionally happy with UCSF.

$27,000 for cycles $10,700 for medication

We will only be transferring 1 embryo at a time, for two reasons. 1) we have very very few, we can't mess around with them. 2) I'm fairly young and my uterus looks good, so we should have a higher implantation rate.

Dr Noel was informative and direct while being really sensitive and gentle. She gave us information and success probability of all our options and let us decide what felt best for us. We ultimately decided to go with an egg donor because I was not up for numerous more stims and retrievals.

I think she’s an excellent option, I don’t think there’s anything specific for her. As with any RE- have specific questions written down, to make sure everything gets answered

Dr Noel was very patient with us. I was really emotional and stressed out during our appointment as she took extra time with us and really listened to our concerns. I felt like she was easy to talk to and easy to connect with.

We haven’t started yet

So far she has been excellent with communication, really quick to respond to emails and phone calls. She has been efficient and concise.

The clinic is new and beautiful, really peaceful environment. We feel comfortable there. Everyone runs on time, so we haven’t had to sit and wait for appointments. Parking is easy but the location is a bit out of the way for us.

UCSF has a program to discount costs if your insurance does not have fertility coverage, which is one of the reasons we chose to use them. I think our costs for OVF including meds will end up being around 20k

We’ll be using donor eggs so eSET is required

I'm just starting my visits with Dr. Noel and will begin a medicated cycle next month but so far she's been really great explaining everything in a clear, concise, and straightforward manner. All of my appointments except one have been with Dr. Noel and the one time I saw her nurse was for a minor follow-up appointment. The only negative thing I've experienced thus far is having to wait for my appointment when she's behind schedule. When she is running late she's very apologetic.

She appreciates when you're armed with information about your cycle and specific questions you have.

Even if Dr. Noel is behind schedule she still takes the time to explain next steps and answer any questions I may have.

All of the clinic staff have been very friendly and welcoming. The one negative thing about the clinic is that they don't seem to enforce the no children at the clinic policy they have listed on their waitlist. I understand that things come up but it can be very hard to sit in a waiting room, waiting to meet with your doctor to discuss struggles of conceiving, and having babies/young children around. It can also take several days and persistent calling to reach someone from the finance team.

Unfortunately our insurance doesn't cover any fertility costs so we're paying out of pocket. I haven't started a medicated cycle yet so I'm not sure how much that will cost but when paying out of pocket follow-up visits are $119, a transvaginal ultrasound is $243, and I believe an SA is $80.

I could not have asked for a better doctor! She's the perfect combination of being realistic but still having an emotional/personal touch in everything that she does. She has made this process as seamless as it possibly could be.

You are in great hands and trust her expertise.

We came to Dr. Noel to get a second opinion. We had previously been to a private practice and had no idea if they were incentivized to tell us to do IVF. She walked us through everything and made us feel super comfortable. She never gave false promises but also didn't just state the facts and move on.

I started on Lupron and then used Menopur and Gonal F. I was very happy with the results and produced more eggs than expected. We also had more make it to day 5 than expected.

Nursing staff was excellent. The women at the front desk could not have been nicer and everyone we worked with was great. Even if when they were quiet, they were extremely respectful.

The clinic runs very efficiently. The entire staff is nice, courteous, and respectful. If there is any downside, I would say it's runs like a machine since there are so many patients but the benefit is that there is a process for everything and that it runs as smoothly as possible.

Treatment & Retrieval is about $15k, Genetic testing is about another $4k

We are genetically testing ours so it will be a single embryo transfer.