How was your experience with Robin Fogle at ACRM?
Dr. Fogle is knowledgeable and doesn't rush through the appointments like other doctors I've had. She asks questions, is direct, eloquent and uses clear language while giving enough information in a non-condescending way. We are patients that do research and come up with multiple questions; she has addressed them with patience. However, she didn't inform us about the risk of not obtaining a result upon sending the products of conception for genetic testing, and in my opinion, represented that there wasn't a male factor in our journey, when it was found later that there was upon doing further testing. I believe we should've been warned that a test was missing that could show more later if we decided or needed to do it. For a long time, we assumed that we only had one issue and didn't work on improving the male factor. Dr. Fogle has an approachable personality. I would recommend her and for the time being intend to continue treatment with her.
What's one piece of advice would you give a prospective patient of Robin Fogle at ACRM?
Ask enough questions and be your own advocate. Dr. Fogle will listen and take your opinion into consideration.
During treatment, were you treated like a number or a human with Robin Fogle at ACRM?
Dr. Fogle took the time to answer questions and explain things to us as we are informed patients. She also repeatedly reminded me that our prognosis wasn't as bad as I thought. She also performed a D&C after our miscarriage and was kind when I woke up from the procedure.
Describe the protocols Robin Fogle used in your cycles at ACRM and their degree of success.
We did two medicated cycles with Clomid under Dr. Fogle's treatment and one IUI (actually performed by Dr. Hasty in ACRM). Looking back, the IUI should've perhaps been cancelled because husband was traveling on the more ideal day but she took in consideration our opinion and we didn't want to "waste a cycle." These treatments resulted in negative pregnancy tests.
Dr. Fogle also performed a HSG and HSC (actually performed by Dr. Keenan).
Upon getting pregnant naturally, Dr. Fogle performed ultrasounds and adjusted my synthroid dose from 75 MCG to 88 MCG after I asked for my TSH to be checked again. She also adjusted my progesterone dose upon my request. Unfortunately, that pregnancy ended in a miscarriage. After our second miscarriage (first under her care), she recommended a number of tests including karyotypes, glucose tolerance test, SCSA, and more.
Dr. Fogle has reviewed the supplements I am taking (Vitamin D, DHEA, Coq10, Fish Oil, Dim Detox, L'arginine, Magnesium, Acai Berry) and adjusted some doses. She is also recommending a mini-stims IVF cycle with ICSI. We plan to start this next month.
Describe your experience with your nurse at ACRM. (Assigned nurse: Megan Barbrow and Suzanne Lloyd)
Megan and Suzanne are two nurses at ACRM and both are good communicators. Megan is a bit more responsive. Both nurses seem knowledgeable and answered emails and questions on an ongoing basis. The nursing staff is overall good and responsive but can sometimes take long to call with results.
Our patient care coordinator is Vanessa Otamendi. She is really nice and very responsive as well. Some members of the staff taking care of blood work and other jobs besides communicating with the patients could use better bedside manner.
Describe your experience with ACRM.
The clinic is organized, clean, and offers various locations for convenience of the patients. The nurses are good and responsive and the doctors are knowledgeable. The patient coordinators do a good job at knowing your cycle and when to schedule the different tests and appointments.
The admin and finance staff could be better though. The OR at ACRM is top notch! I would definitely recommend them, from the nurses to the people doing follow ups. They were compassionate and clearly cared about the patients.
Describe the costs associated with your care under Robin Fogle at ACRM.
We've paid out of pocket for fertility treatments since our insurance doesn't cover them. Diagnostic tests are covered. We believe that 1 appointment wasn't coded right as we were still discussing options and it was coded as IVF appointment because Dr. Fogle did provide the protocol she would suggest. However, we were still in a diagnostic stage. ACRM isn't particularly affordable but such is the cost of medicine in the US.
Describe Robin Fogle's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at ACRM.
Dr. Fogle and her clinic (ACRM) have a clear policy to only transfer 1 embryo.
What specific things went wrong at ACRM?
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at ACRM.
We were specifically told by Dr. Fogle and Dr. Hasty that the genetic test post D&C would give us answers about what went wrong with the pregnancy. We were never told that the results could be inconclusive. We first found out about this option, when the nurse notified us that there had been maternal contamination and Natera would run again the sample. Needless to say, we didn't get any answers from the genetic testing post D&C.
We were told by a nurse that a level of 8 is OK for progesterone although everything seems to indicate that lower than 15 is a problem. Not entirely sure if this is contradicting or inaccurate information.
My TSH wasn't checked again to adjust my synthroid dose, until I asked during a second ultrasound while I was pregnant when the baby was already measuring behind. We were later told that although the number hadn't dropped enough, this wasn't the cause of the miscarriage or that the level didn't matter much. Finally, post-miscarriage the level has gotten under control. I would've prefer if they stressed the importance of the thyroid level being a certain number a little more.
I wish they were more proactive in their recommendations. We were told that my husband's sperm was perfect with "slightly lower motility than needed" but that it wasn't an issue and we shouldn't concern with it, only to find out after our 2nd miscarriage, that he has a DNA fragmentation issue. I wish that they told us in advance after the 1st miscarriage and during the initial testing that there was another test for the sperm, even if not recommended at the time, but for months we relied on their advice focusing only in my fertility with lifestyle changes, acupuncture, etc. without knowing that he could've been making improvements as well. I believe it is important for doctors to qualify their statements. Saying there is no male factor knowing that there are further tests out there (SCSA) to determine something as important as the quality/DNA fragmentation is to me failing to disclose key information.