Nathaniel Zoneraich

I love Dr. Z! He is very candid but in a gentle way, and talks to you like you are a real person, not "just" a patient. He has a great sense of humor, and calls you directly with good news and bad news, rather than having nurses deliver messages. There are 3 doctors that rotate between the clinic locations, but Dr. Zoneraich is my favorite. I saw Dr. Larsen for a few appointments and he is a close second, he is warm and kind and takes the time to explain things in detail. I saw Dr. Kummer once at a follicle check for my IVF cycle that wasn't going well, and she was pretty blunt and negative about my chances of getting cancelled, not nearly as compassionate as Dr. Zoneraich or Dr. Larsen. I just didn't jive with her as well.

Don't be afraid to ask about additional procedures or unconventional treatments. Dr. Zoneraich was fairly aggressive with my IVF protocol and willing to try things that "can't hurt, might help." But when I asked about the ERA test before transfer he said that he didn't suggest it for people until they'd had multiple failed transfers. When I decided I wanted to do it anyway (I'd had 1 failed transfer with another clinic) he was totally supportive and agreed to do it. Same thing with PGS testing - he suggested it for me but was not pushy at all when I declined. He's fairly conservative but willing to discuss alternatives and flexible with your preferences.

Because of my age (39 at the time) and previous poor response at another clinic, Dr. Zoneraich suggested a microdose Lupron flare protocol, but also wanted to add in HGH/Omnitrope in hopes that it would help with egg quality. In my previous IVF at another clinic I'd started with a decent antral count, had many follicles but few contained eggs, and was unsuccessful. My cycle with Dr. Z also started with a good antral count, but my mid-cycle follicle checks showed only 3-5 follicles growing. We discussed canceling, but Dr. Z felt we should proceed if we had at least 3, and my husband really wanted to go for it. I'm glad I listened to them, because when I came out of anesthesia they told me there were 15 eggs. I made the nurse double check because I thought she'd mixed me up with another patient! I don't know how or why they all decided to grow in the 2 days between my last scan and retrieval, but was obviously thrilled. Of the 15 retrieved, 12 were mature, 7 fertilized, and 4 made it to blast - 1 excellent and 3 good. We did the ERA test at my request and learned that I was pre-receptive by 12 hours, and planned my progesterone timing appropriately for our FET cycle. We transferred 2 embryos, which led to our first ever positive pregnancy test. Sadly our betas didn't double and we lost the pregnancy very early. Because my tests are all fine, Dr. Z and I agree that it was likely due to chromosomal abnormality due to my age, as we did not do PGS testing. However, we were all encouraged by the fact that we finally were able to achieve pregnancy. We have 2 embryos still frozen, and plan to transfer them in 2019.

My IVF coordinator/nurse Sandy is awesome. She is accessible, informative, compassionate, and stayed on top of prescriptions with my multiple pharmacies. Her IVF support nurse Bree is also very easy to get in touch with and helpful. The clinic nurses are a bit more inconsistent, and seems to be a fair amount of turnover.

Advanced Fertility Care is the 3rd clinic I've been to, and definitely my favorite. You see a doctor at every appointment, and can easily/quickly reach your doctor via phone to speak directly with them. Sherri, their embryologist, is an absolute gem. In my experience, most embryologists are very technical and not super warm, but Sherri is the perfect combination of both and talked me off the ledge multiple times. The accessibility to your team of experts at this clinic is amazing and something I didn't experience at my previous 2 clinics. I do wish they had a more consistent group of medical assistance staff - part of that is that they rotate between the 3 offices, so sometimes you'll see new faces, but they are very frequently training a new staff member. They do a great job with their injection training! My previous clinic told me to watch the videos on Freedom Pharmacy's website; these videos are great, but I would have been so much more prepared if I'd had the personalized instruction like they do here. Their cash pay rates are quite expensive, I could not afford to use AFC if I didn't have insurance, but they have been such a pleasure to work with. And while I don't have a baby in my arms yet, Dr. Z helped me achieve my first ever pregnancy, and I'm hopeful that our next transfer will be successful.

Thankfully my insurance covered our IVF cycle with AFC, so our costs have been mostly limited to our deductible and out of pocket max.

Dr. Zoneraich refers to the ASRM guidelines, and agreed with my preference to transfer 2 embryos, since I was 39 and the embryos were not PGS tested. For PGS embryos, I think he prefers single embryo transfer regardless of age group. In the "IVF packet" of paperwork given prior to your cycle, they included testimonials of a patient that had a multiple gestation and had difficulties/premature birth. They definitely want their patients informed of the risk!

I feel Dr. Z is extremely up-to-date with effective IVF protocols and does not waste your time or money with extra “fluff” that hasn’t been proven to work. As an RN myself who works in an area that encounters other women who have gone through IVF with other doctors, I really felt that Dr. Z and his protocol was very personalized and evidence-based. He did give me 3 options at the start and I initially was going to do IUI but I had 5 mature follicles and I was scared to chance the risk of multiples. I was also surprised that I had that many follicles with my diagnosis of probably early diminished ovarian reserve. I was scared that I wouldn’t produce enough follicles. When I decided to do IVF because I felt like Inhadnmore control, I was astonished to have at least 10 mature follicles for each ovary during my scan. I asked how this was possible with my low AMH but they said they would rather see me have a high AFC with an low AMH than a normal AMH and a low AFC. My AMH was 1.15 at age 34. At my egg retrieval I ended up with 24 eggs retrieved, 17 mature, 14 fertilized (conventional), 6 made it to day 6 and 3 were normal via PGS. We transferred one embryo and are blessed with a beautiful baby girl.

Have faith in the process and do everything in your power to follow the protocol exactly.

Dr. Z personally called me with my pregnancy results and would always call back within the hour if he was on call and I needed anything after hours. He outlined a very personalized plan for me that ended up turning out exactly how he predicted.

I don’t specifically remember but I know I used birth control, lupron, Menopur, Gonal-F, Pregnyl trigger, estrogen patches, PIO injections and progesterone suppositories. I also used a prenatal vitamin, aspirin 81 mg and abstained from all caffeine until my second trimester.

I had a subchorionic hemorrhage and bled every week until I was 18 weeks pregnant. Sandy was always available to discuss this and made me feel better without over-exaggerating that things would turn out ok.

Everything is cutting edge and perfectly coordinated. Even though I am an RN, the injection teaching was very helpful and the staff made sure to go over everything with me and were all always very professional. Costs were always discussed ahead of time and were never a surprise.

Insurance at the time covered $5000 of any fertility treatment and I paid around $14,000 for my IVF cycle (some of that was included in the $5k because all I did prior was Clomid and monitoring because I decided not to do IUi). My medications were around $5000.

Dr. Z encourages eSET for PGS embryos and even has a packet with a story of a patient who begged him to transfer 2 PGS embryos and she ended up with triplets and it was a rough go for her (her words) in the beginning.

I believe Dr. Zoneraich was an excellent doctor especially for me because he was very good at explaining and answering my many questions and above all he seemed responsive to me personally, I told him I would like things to be very matter of fact and clinical and always frank and technical as much as if possible and that is how he was, I could tell he still was kind and empathetic in his approach at times which really makes me think he is able to work with a patient in their own preferred way, had I wanted a more sweet compassionate hold my hand type of doctor I think he would have been but that is not how I want things medically and especially with all the miscarriages and crap leading up to going to see him I knew I would do best with some one who would help me keep it professional and avoid more emotions as much as possible for my own composure.

I would say let him know your expectations up front, as much as possible be open with him about; what you want, what you know and what you hope to learn, how you want the experience to go, how you prefer to be treated/talked to- honestly it might sound odd but basically if you want things sugar coated and or broached very carefully or just frank and more scientifically/medically direct.

Dr. Z and his staff were responsive not only to the physical clinical stuff but also my personality, I ask a lot of questions and had done, and continue to, a lot of research which I am sure can be annoying to them but they never made me feel that way, never felt rushed or as if they were being dismissive but always listened to and if any member of staff did not know an answer they worked to find out and would always follow through to make sure I was content and satisfied with their answers, and that I was taken care of in all ways.

We have retrieved eggs, from one of my sisters, and fertilized them with my spouse and frozen the embryos but I haven’t done any implantations yet, we are saving up again for that second phase.

I think they could be a little more informed about the overall procedures and protocols because there were times they had to go ask and find out answers, this is fine and they always made sure to get me answers but if there was something they could work toward it would be advisable to always be educating all the staff I would think.

They were always good about answering the phone calls or getting right back to me and getting the answers I needed/wanted. I think they could be better at their descriptions/explainations of the financials, it didn’t feel deceptive or misleading but more just like they could be more formalized and have all options planned out- just a little more organized with some of the business side of this stuff.

We spent about 3-5k going through testing to find out why we had recurrent pregnancy losses, and then just over 17k to get my sister ready for being an egg donor and then retrieving fertilizing and freezing

Dr. Z has said he would recommend one but we can discuss doing two once we get closer to that point.

Dr. Z spoke to me as a friend, not a patient. He was sincere, thorough and gave me hope during I time I needed it most. I particularly like that he called me personally to discuss a treatment question I had and not a nurse. Being 25 and unmarried, I was worried I would be negatively persuaded to choose one decision when in fact, Dr. Z gave us multiple options and explained all pros and cons of each.

Check your insurance coverage! Mine covered diagnostic testing up until I started treatment. Also, write questions down before arriving. I was often overwhelmed and lost my train of thought and forgot to ask questions while there.

Dr. Zoneraich helped me understand my diagnosis in non-medical terminology. He drew pictures to help explain and allow me to visualize what was happening. I particularly like that our discussions were in his office and only medical treatments were in an exam room because it can be overwhelming. He didn’t tell me what I had to do but gave me 3 options to go home and discuss before calling him with a decision. He was very thorough and I never felt judged being 25 and not married as I did with my first opinion doctor. Glad I sought a second opinion and glad it was with Dr. Z. We now have a friend seeking treatment options from him and will be back when we are ready for a second child ourselves! We love AFC!

I was diagnosed with Early Ovarian Failure. I had the option to induce a period with progesterone but ended up not needing it. Dr. Z gave us three treatment options to discuss. First, clomid ministim which was 5 days of clomid pills, 3 days of Gonal F injections and finally a trigger shot with times intercourse. This is the option we chose. 2nd option was IVF and the 3rd was to do nothing because we didn’t know how fast my eggs were depleting. Unfortanetly, I ovulated over Memorial Day weekend so my first treatment failed because the office was closed. However, they so kindly offered me a discount on repeating the cycle the following month since the failure was no ones fault. The second cycle gave us a happy, healthy baby girl!

The nursing staff made you feel comfortable during the process. They also call promptly with results and are the ones to let you know your pregnancy results!

The clinic was very clean. It didn’t feel like a doctors office. I have been to their Scottsdale and Mesa office. Both waiting rooms are beautiful, offering complimentary coffee and water. I only wish the front desk staff took phone calls in a private area. They openly talk to patients on the phone.

I was surprised to learn the low cost of clomid ministim compared to IVF. It was approximately $3,000 for all tests such as ultrasound and blood work once treatment started as well as the clomid, Gonal F and trigger shot.

Dr Zoneraich was very upfront about the process of IUI, and exactly why we needed to use Donor Sperm. We did not feel pressured into anything and always felt in control of our treatment. We are truly grateful for him!

He is very straight forward (which i appreciate), so just know that you aren't going to get someone who is super delicate with your feelings. Dont get me wrong though, he is still very compassionate!

He was very straight-forward yet compassionate about our situation and made us both feel at ease throughout the process.

We got lucky on our first cycle of IUI. I followed the instructions (came in for an ultraaound during my cycle, and then I believe I started Clomid on the 4th or 5th day. Took 5 days of that, had another ultrasound in which i had too many eggs. We waited over the weekend and got another ultrasound in on a Monday. My eggs had reduced to an acceptable number so the next day i gave myself the HCG trigger shot, and i was scheduled for my IUI on Thursday morning.

Everyone was extremely pleasant and helpful.

Strengths were phone based app to manage appts and tests, location near our house, friendly front desk staff, clean and well stocked waiting room. Weaknesses would be hours/locations. (Drs were split between 3 valley office locations) Also, not able to do IUI at location closest to home.

We didnt do any embryo transfers.

Dr z is amazing. He made me feel so good throughout this trying process. I am a type A planner and he was willing to talk to us through all of my questions and what ifs. He also worked with our schedules and helped us find care with other doctors that was necessary for testing. He is realistic and gives you facts that are necessary to make decisions.

To think positive thoughts and trust in the process.

He is always so happy and cheerful and answers my millions of questions with patience

My treatment included 5 days of clomid.... baby aspirin.... then the hcg trigger shot (novarel). After iui I am taking progesterone suppositories and baby aspirin

The ladies are so friendly and so helpful. I get answers right away from the portal which is a blessing. I've even used the nurse on call and she was amazing

Very clean and modern. The waiting time is usually very minimal... the offices look the same so it is nice to have consistency. The nurses even rotate offices. They give watervabd other drink choices while you wait.

I am paying 995 per iui cycle not including medications

Dr Zoneraich was a nice person and was always honest with me. Sometimes, he tend to emphasize on the worse possible outcome a little too much and this would frustrate me and make me feel less confident, but he needed to prepare me in case if it was not going to work.

He is very professional and knows what he is doing. I would recommend to future patients to stay confident in his knowledge and to not get discouraged when he exposes the possibility of having a negative outcome.

Dr Zoneraich was always smiling and happy. He was also honest all along the way. Sometimes I felt rushed as the follow-up appointments were literally 2 minutes long...

I did not emphasize too much on getting the full details of the strategies since it worked the first time.

Sandy was quick to respond to my emails. She was also patient when it came to my multiple questions and inquiries.

This clinic is well organized. It is spotless and there is minimal to no wait time. Everyone is welcoming and dedicated to their jobs. The only downside is that it was very expensive.

around 30,000$ total 16,500$ for full cycle (egg retrieval and embryo transfer with ICSI) 4,000$ genetic testing 7,000$ for drugs 2 x 2,000$ for IUI attempts

I think that Dr Z. recommended to us the eSET because he is not wanting to increase the rate of multiple births among his patients. He is conscious of the serious complications that this involves and wants to spare us this. It was a much more reasonable approach than many other fertility specialist that let their patients have 2 or 3 babies at a time...

A great doctor! I had all fertility testing done through his office. He was quick with results as he does all testing personally. He gave us our options, but did not pressure us into any treatments. I had some polyps that needed to be removed and Dr. Zoneraich did that surgery himself. I am now on my second attempt with femara so we will see what happens at the end of this cycle. I have had a great experience with this doctor and his staff so far. My only complaint is that the billing office needs some work. They have attempted to overcharge a few times. You just have to be vigilant and know what you are supposed to pay so that you can make sure it matches what they are asking for.

Be prepared to pay appointment costs up front.

Nurses were always kind and made sure I was as comfortable as I could be. I had to have one appointment with Dr. L while Dr. Z was out of town and I was so pleasantly surprised that he knew my whole history and where I was at with my treatment. Dr. Z takes the time to answer all of my questions without rushing me or my husband.

Always made sure I was comfortable. (Did I need to use the restroom, do I need water etc.)

I felt like the doctor was very smart and I trusted him completely. I wish there was more compassion in the way of financial stresses. I was very frustrated that PGS testing wasn’t brought up until after my miscarriage/egg retrieval. The packages offered weren’t nice. I thought it was weird that one of the packages you paid more for, and if nothing worked and get majority of your money back. That’s all startin The packages offered were nice. I thought it was weird that one of the packages you paid more for, and if nothing worked then you get majority of your money back. That felt to be starting off on a bad note and you think you will leave with your baby. So we chose not to do that. After we went through entire package of fresh cycles and frozen transfers nothing worked. We wished we would’ve done that plan

Know all your options. All of them. Know there is PGS testing.

I felt like everything was explained well and questions were answered. But with one miscarriage into field transfers I felt like I was just a number. I felt like they thought money was in list and just want to keep trying. We didn’t have the money for that. I was also upset that PGS testing of embryos wasn’t brought up until after a miscarriage.

I don’t remember the Protocal. It was in 2016.

Nursing staff was professional and polite. They showed compassion in the hard times and were very caring.

The billing was a little off. They seemed to have issues with getting amounts correct or charging the right thing. I would come in a week after paying a bill and I would have a leftover balance. Most recently, I’ve had a major issue with paying the yearly storage for my one remaining embryo. They would harass me for payments when I was paying every time I got a bill. It was very frustrating for them to be harassing for money when they already had over 30k from us with nothing to show for it.

We did a package that included Hey certain amount of fresh cycles and frozen transfers. We also had to pay in addiction to that for another fresh cycle to get more embryos, PGS testing and the medications. Over $35,000

Our doctor preferred single embryo transfer for all his patients. But we could only do a single embryo transfer as I have a unicornate uterus. (Half a uterus)