Preston Nelson

When I first met Dr. Nelson, we had a lengthy appointment to go over all of my lab results and talk through next steps. It was a lot to absorb since I was just starting this process. He took time to answer all the questions my husband and I had at the time and really provided a lot of information. He was super attentive, thoughtful and a good listener. However, I realized later that when I left, I really wasn't sure how to move forward. He talked through all the benefits of IVF but didn't necessarily recommend that I start that immediately. Should we just keep trying? How soon should I start fertility treatments? At what point do I need to seriously consider or move to IVF, etc? I had a lot of information but really wasn't sure how to move forward. After a couple of months with no success, I expressed this frustration to him and we started putting together a plan. One of the hard parts about this process is never knowing when to start something different. I kept getting pregnant every few months, which gave me hope but the pregnancies didn't last. Once I expressed all of this to Dr. Nelson, he was really helpful in starting to put a plan together, which included beginning to take medication and then a few months later moving to IUI. Kaiser has a team of fertility doctors all working together. Every month I would put a plan together with Dr. Nelson but wouldn't see him for my visits; my baseline appointments, my check ups just before ovulation and IUI were all with other doctors. I would then have a phone appointment with Dr. Nelson around the time by period was due to talk next steps and a potential plan for the next cycle. At first the interaction with all of the other doctors was a little challenging, this is hard and emotional and it was difficult for me to share some of this with a small group of physicians, even though everyone was professional and thoughtful. After a couple of cycles, I got more comfortable with the process and the team. Since I have been unsuccessful with IUI, I'm now beginning the process of preparing for IVF. Dr. Nelson used to perform IVF and has a wealth of information to share about the process, what to expect and how my body might react to the medication. Although I have watched videos and read books about the process, his consultation has been comforting and really informative. I feel like I understand the process much better and what I might expect. Overall, Kaiser moves slowly with fertility- I was frustrated by the initial process of getting my lab work done, identifying needed tests and treatments. As a patient you have to be really proactive and articulate what you are looking for and what help you need. Once the process started moving and I got connected with Dr. Nelson, it was important to maintain regular communication and let him know what I was looking for and what questions I had. Once he was aware of what I needed, we mapped out a plan for my care and how best to move forward. Overall, I have been really happy with him.

Think about your questions ahead of time (if you can) and be upfront about your needs. He has a ton of information but none of that matters if he doesn't know what you are looking for. He is much more comfortable with phone calls than email but his schedule fills up so its good to get on his calendar regularly.

We tried three cycles of ovulation stimulation (one round of clomid and two of letrozole) with timed intercourse. When those didn't work we tried three rounds of IUI- all with letrozole. I initially wasn't ready for IUI so we tried the first process to see if we had any luck and then moved to IUI. I got pregnant my second cycle with IUI but my HCG levels were low (around 10) so I knew the pregnancy wouldn't last. I got my period 3/4 days later.

I have good health insurance coverage for Kaiser so all of my appointments and treatments were covered. I had $10 co-pays for some medications but overall very little out of pocket costs. If I move to IVF- at Kaiser or elsewhere none of those services will be covered.

Dr. Nelson is a wonderful provider, and I've felt very informed and supported by him throughout the process of IUI's and one miscarriage. He has adjusted treatment as needed, and is the right amount of realistic and hopeful.

Unfortunately, many of our contacts are on the phone and because of the nature of scheduling apts around my cycle and schedule I don't often see him for ultrasounds, IUI's.

I have regular, but anovulatory cycles. All treatment is aimed to help me ovulate. Clomid + HCG trigger + IUI x1, negative with short luteal phase Clomid + HCG trigger + IUI + Progesterone x2, negative pregnancy tests Letrozole 5 mg + HCG trigger + IUI + Progesterone, positive pregnancy test ended in miscarriage due to chromosomal abnormality Letrozole 5 mg + HCG trigger + IUI + Progesterone, negative pregnancy test Letrozole 7.5 mg + HCG trigger + IUI + Progesterone, awaiting results

Because our insurance covers medicated IUI's, co pays for each visit were $15 dollars and all medications have been between $10 and $15 as well.

N/A

In the year and a half working with Dr. Nelson and team at kaiser, we saw him once and maybe spoke on the phone three times. I would have looked for a clinic that would have given us more time to answer questions and outline options.

If you have fertility benefits through kaiser it may be worth it. For those who have no fertility benefits I would look elsewhere.

First he recommended I get an Hsg to rule out tubal blockages. When that was ruled out, we did IUI despite my husband’s poor semen analysis. He referred him to a urologist who gave him some supplement recommendations which helped but obviously not enough because after 3 failed IUIs Dr. Nelson backtracked and said we should look at IVF with Icsi.

386 for IUI, 196 for ovidrel shot, 5 for letrozole, 196 for ultrasound (two per IUI cycle).

Dr. Nelson requests calls shortly after each treatment to review how I was feeling and potential next steps. He always greets each call asking how I'm doing and if I have any questions. He ends each call confirming that I'm clear with next steps and making sure all of my questions and concerns are answered.

Be as honest as possible. He's very compassionate and non-judgmental.

We initially attempted a Clomid cycle with no IUI. Unfortunately, the medication left me with some unwanted side effects so he switched me to Letrozole for the next cycle. After a couple of Letrozole cycles with IUI, we decided to try Menopur with IUI. The Menopur did not yield greater results so we resumed Letrozole and waiting for another IUI. Dr. Nelson did recommend IVF after our first consultation but due to costs, we decided to go this route.

My husband has a good health insurance plan so costs of medications and co-pays are minimal. His insurance covers IUIs but does not cover IVF. Insurance through my employer does not cover IVF and IUI costs are higher.

Dr. Nelson was an IVF doctor but Kaiser does not offer that service at the Oakland facility so he did not make any recommendations regarding embryo transfers.