all of my procedures are preemptive...when I would as questions, Dr. Uzelac often seemed annoyed or even defensive...We retrieved 7 eggs, 7 mature, 7 fert (all ICSI) and 4 day 5 blasts. Only 1 PGT Normal...each time I would go in for a scan I felt like I was fighting for details about how my follicles were progressing, how many there were, if this was an expected/unexpected outcome etc...
The office [Marin Fertility] was clearly at capacity with patients and I often felt rushed and even at times pressured to move forward with decisions that may have kept the office "on schedule" but likely weren't right for my body....My pharmacy would blame marin fertility and vice versa but at the end of the day there were several instances where I had to scramble or pay out of pocket because no one at the clinic communicated to me that my trigger shot was rejected by insurance and wasn't being delivered, among other hiccups...
How was your experience with Peter Uzelac at Marin Fertility?
Dr. Uzelac was compelling and informative at the initial consult and I felt like we would be in good hands. However, my case is somewhat unique - I'm 27, with an unexplained AMH of 0.4, normal FSH and average initial AFC of 15. Moreover, I'm in a committed relationship and able to make embryos, but not actively trying to conceive to "test" the embryos so all of my procedures are preemptive.
During my first cycle - I felt like I was constantly seeking information and trying to understand my treatment plan. It felt important to know the why behind my dosages, days of stim etc. but getting thoughtful detail out of Dr. Uzelac was like pulling teeth. As the process progressed, each time I would go in for a scan I felt like I was fighting for details about how my follicles were progressing, how many there were, if this was an expected/unexpected outcome etc.
Most upsetting, when I would as questions, Dr. Uzelac often seemed annoyed or even defensive. By my second round it was more of the later which was a massive red flag for me. There are a lot of unknowns in fertility, but you deserve a doctor who is willing to have an active dialogue with you about your specific case and not fall back on repetitive statements like "we just won't know" or "there just aren't explanations" etc.
Particularly after I had my second round, which was somewhat different in protocol and very different in outcome, I felt like I couldn't get Dr. Uzelac to dialogue with me at all about learnings, findings or what we might do for round 3. It was at this point that I knew I needed to find a doctor who would be committed to this level of care. And let me tell you - it exists! It is not normal for your Dr. to get defensive when you ask questions or want to understand the reasoning behind your particular treatment plan. IVF/egg freezing is a tremendous emotional and financial investment and you have the right to decide who you want on that journey with you. If you are someone who has a nuanced situation and likes to ask questions - I'd recommend going elsewhere.
What's one piece of advice would you give a prospective patient of Peter Uzelac at Marin Fertility?
Trust your gut. I gave feedback to the head nurse after my first round with the clinic and truthfully, it didn't change much.
Ask tough questions in your evaluation phase and see if you resonate with the way he responds.
During treatment, were you treated like a number or a human with Peter Uzelac at Marin Fertility?
The office was clearly at capacity with patients and I often felt rushed and even at times pressured to move forward with decisions that may have kept the office "on schedule" but likely weren't right for my body.
Describe the protocols Peter Uzelac used in your cycles at Marin Fertility and their degree of success.
I didn't get a ton of explanation on the "why" behind my first protocol except that I was young and likely quantity would be a bigger issue than quality. During the 1st round I started with an AFC of 10 & stimmed for 12 days (225 Gonal F/150 Menopur/10 mg Provera/+Cetrotide/Pregnal trigger). We retrieved 11 eggs, 8 mature (4 ICSI, 4 Norm) - 8 fertilized & 6 went on to become 5 blasts. Only 2 were PGT normal and subsequently frozen. Clearly my biggest drop-off came from egg quality revealed by PGT testing.
For round 2, Dr. Uzelac reasoned that my body responded well enough to stims and perhaps a larger dose would help with quantity. I primed with Estrace & had a cyst on one ovary which Dr.Uzelac was not worried about and cleared right before we started. However, I started w/ an AFC of 7 - which was lower than both my AFC off 15 at my initial consult and my AFC of 10 during the last round. Here's where I wish I would have been louder. I felt in my gut that I should skip this month due to the cyst and the lowered AFC - I felt that Dr.Uzelac pressured me to move forward and I didn't feel comfortable pushing back. I stimmed for 10 days (300 Gonal F/150 Menopur/10 mg Provera/+Cetrotide/Ovadril). I only used Ovadril because we couldn't work out how to get a trigger shot through my insurance after working with the clinic for month -this was frustrating but I will add that context to the clinic review. We retrieved 7 eggs, 7 mature, 7 fert (all ICSI) and 4 day 5 blasts. Only 1 PGT Normal.
One last thing - I had several tests done as a part of this process - not just embryo testing but also genetic screening, hormone testing, infectious diseases etc and had to repeatedly ask to receive a copy of the results. I Actually never received a paper copy of a detailed embryo report with the quality ranking etc and had to schedule time with Dr. Uzelac to hear the results over the phone and write them down.
Describe your experience with the nursing staff at Marin Fertility.
The nurses were all extremely kind individuals whom I enjoyed being around and being in the care of while in the office. However, I repeatedly had issues getting the medication I needed by the time in the treatment that it would be used. During my first round my trigger shot was never delivered because my pharmacy rejected the order via insurance and the clinic never ordered an alternative, moreover, I ended up stimming longer than planned and ran out of medication.
I know both of those things sound like something that I, as the patient, would catch but this was my first time being a patient and I put all of my trust in Dr. Uzelac and the nursing staff to communicate to me if there was anything I'd need to do on my end. I ended up paying for several last minute medications out of pocket because my pharmacy couldn't stock them in time.
Additionally, when I flagged the fact that I didn't have a trigger (happened both rounds) a nurse was going to give me an "extra" trigger shot they had on hand at the clinic until I opened the package to see that the medication had been mostly used and was likely expired. Had I waited to open that medication until I went home I would have been without a trigger shot at 2 in the morning.
Describe your experience with Marin Fertility.
Dr. Uzelac commitment to running every appointment
Accepted my fertility benefit, Progyny
Organization/coordination with insurance and making sure that the burden of logistics doesn't fall on the patient
Dr. Uselaz's bedside manner and openness to questions
General communication - appointment times, when to expect what, who to contact after hours, copies of your testing/results
Describe the costs associated with your care under Peter Uzelac at Marin Fertility.
I am fortunate to have a fertility benefit via Progyny, which covered everything after I'd paid $2.5k out of pocket.
What specific things went wrong at Marin Fertility?
- Failed to call in prescriptions to pharmacy
- Failed to call with results
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at Marin Fertility.
During both rounds I had tremendous issues getting the necessary medication. My pharmacy would blame marin fertility and vice versa but at the end of the day there were several instances where I had to scramble or pay out of pocket because no one at the clinic communicated to me that my trigger shot was rejected by insurance and wasn't being delivered, among other hiccups. It was such a horrible thing to stress about while I was already in the thick of this process.
I also felt in the dark during my IVF ultrasounds and would literally have to ask repeatedly about the status and size of my follicles. Once, when prompting Dr. Uzelac for answers about how best to think about planning for a family of 3 with my existing outcomes, he seriously suggested the best way for me to find out the quality of my embryos would be to try to conceive with them today. So tone deaf to the fact that the entire reason I'm doing IVF/embryo freezing is to not conceive today.