How was your experience with Martha Noel at UCSF?
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.
What's one piece of advice would you give a prospective patient of Martha Noel at UCSF?
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.
During treatment, were you treated like a number or a human with Martha Noel at UCSF?
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!
Describe the protocols Martha Noel used in your cycles at UCSF and their degree of success.
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.
Describe your experience with your nurse at UCSF. (Assigned nurse: Olga Salamanca)
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.
Describe your experience with UCSF.
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.
Describe the costs associated with your care under Martha Noel at UCSF.
$27,000 for cycles
$10,700 for medication
Describe Martha Noel's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at UCSF.
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.