How was your experience with Nathaniel Zoneraich at Advanced Fertility Care of Arizona?
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.
What's one piece of advice would you give a prospective patient of Nathaniel Zoneraich at Advanced Fertility Care of Arizona?
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.
Describe the protocols Nathaniel Zoneraich used in your cycles at Advanced Fertility Care of Arizona and their degree of success.
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.
Describe your experience with your nurse at Advanced Fertility Care of Arizona. (Assigned nurse: Sandy)
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.
Describe your experience with Advanced Fertility Care of Arizona.
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.
Describe the costs associated with your care under Nathaniel Zoneraich at Advanced Fertility Care of Arizona.
Thankfully my insurance covered our IVF cycle with AFC, so our costs have been mostly limited to our deductible and out of pocket max.
Describe Nathaniel Zoneraich's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Advanced Fertility Care of Arizona.
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!