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.

Dr. Nelson has done a great job spending time to explain my test results and what they mean and make himself available to answer questions.

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 interacted with a nursing team over the phone that was really helpful with setting appointments, getting my lab work ordered and updating me on test results that I couldn't see online or didn't understand. I also worked with a second nursing team at my appointments who were always really helpful.

There is a team of providers all working together, so you are likely to see different doctors for different visits. The benefit of this is they can usually get me into clinic when I need to but the challenge is getting used to interacting with different groups of people.

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.

Dr. Nelson is very generous with his time, considerate of your questions, and realistic about expectations. In all our conversations I feel listened to and supported in this difficult journey.

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

The nursing staff is mostly very helpful, responsive, at times there have been some scheduling conflicts and changes but overall if I had a question they would respond in an appropriate time manner to help me answer it.

We are very lucky to have some fertility coverage through my insurance with Kaiser, so the process of medicated IUI cycles has been very affordable for us. The downsides are you see different nurses, doctors, and that they are only open normal business hours. I know some clinics do monitoring ultrasounds very early which would be great because you have to miss work frequently for these apts due to the hours they are open. If we didn't have the insurance coverage we do through t hem, I think I would already have considered other options/clinics/ maybe have moved on to IVF.

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.

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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.

Extremely gentle bedside manner. Always very concerned about my well being.

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.

Overall the nursing staff is pleasant and professional.

Kaiser Oakland has struggled to maintain the staffing (nurses and doctors) necessary for the clinic. I was initially referred to the Fremont clinic as the Oakland one was not accepting new patients and had to wait several months before being transferred to Oakland. They also do not perform IUIs on Sundays.

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.