How was your experience with Ryan Steward at Houston Fertility Institute?
My obgyn gave me two options in The Woodlands. Dr. Steward or Dr. Griffith. In doing research, I chose Dr. Steward because he was younger, native Texan, trained at Duke , had personal experience with multiple miscarriages with his wife (At the time of the appt I had three miscarriages in a row and was desperate for answers) and had a kind, empathetic face. I just had a second d and c three days prior to my appt with him, so I was very fragile at that time. At our first meeting he set out an exact plan for us to complete at our pace and never pressured us to rush through the work up. Everything he hypothesized was happening with us came true. He said this is not a sperm issue, no need to even do a sperm test, we have gotten pregnant three times on the first try on our own, sperm could not be involved. And of course I forced my husband to do the SA and it came back with off the chart stellar numbers. He hypothesized I may have some lackadaisical hormones and mild "garden variety ovulatory dysfunction" which does not fit in any type of diagnosis and because of that, I ovulate late and can't ramp up the hormone supply needed with pregnancy. Since my AMH levels were great (5) and age was 33, we could build my entire family at the age of 33 with PGS tested embryos and give ample hormone support as well as aspirin and lovenox to prevent miscarriage with a frozen embryo cycle. Well all the testing was normal including sperm, uterus, etc and my hormones were exactly as he said. We elected to proceed with IVF instead of an assisted monitoring cycle so we could build our family NOW and take off any pressure to have more kids in a rapid succession later. As he predicted, I did not need a ton of medication due to the great AMH at 5. with embryo retrieval we got 13 total. 12 mature. 12 fertilized. 8 have been sent to PGS testing as day 6 blastocysts and we are currently waiting on these results. The process has gone exactly as he said it would. He nailed the medications. I did not have ANY left over. I did NOT hyper stimulate. I feel like we got the most "bang for our buck" with the 8 embryos for pgs testing (the max amount allowed without paying extra) and spent 4k on meds without wasting/having leftovers. He has been blunt with delivery but so kind and warm and most importantly has been 100% accurate thus far. I am in the medical field and it's VERY difficult for me to be the patient and I have surrendered and trust him with every decision here on out. no questions asked. I highly recommend him!
What's one piece of advice would you give a prospective patient of Ryan Steward at Houston Fertility Institute?
He knows his stuff. If you bring research he will review it with you and weigh in. He does listen and consider what you have to say but without a doubt every question I had, or concern I had, his knowledge prevailed and he was right. Be prepared for very cut and dry black and white approach. He is warm with more visits and he does have a great bedside manner. I felt I was in extremely competent hands with someone who is very confident in his skills.
During treatment, were you treated like a number or a human with Ryan Steward at Houston Fertility Institute?
Whenever I was in Dr. Stewards presence, I felt like a person. He remembered specific stories we have shared or remembered to ask about recent vacations. When I was going through the actual monitoring appts at the clinic without interaction with him, I Felt more like a number
Describe the protocols Ryan Steward used in your cycles at Houston Fertility Institute and their degree of success.
After suffering 3 miscarriages in 2017 and the work up was done from oct 2017-dec 2017 and was essentially negative and no causes found for miscarriages, I was presented with three options. 1) do what he have been doing and call when pregnant for hormone support 2)assisted cycle with Timed intercourse to really nail ovulation time and with climid maybe producing more than 1 follicle with more options for sperm to find egg and also use hormonal support with progerstone or do 3)IVF with PGS testing and build our entire family at 33 years old. He said he would leave it to us. We ultimately decided to skip to IVF as 2017 was a long hard year with three losses and we were ready to be parents and surrender a little bit of control bc what he had been doing had not yet produced a live birth. So in january after a much needed vacation, I downregulated with birth control for 2 weeks, stimulated with Gonal F 150 and Menopur 150 for 10 days (with ceteotride for ovulation prevention added in when my follicles got to 13). He stated I did not need many meds as I have a garden variety ovulatory dysfunction in the pcos family but not severe enough to be pcos with an AMH of 5. He nailed the medications. I did not have any left over so there was no money wasted. I only had two monitoring appts week one and two appts week 2, so 4 total and it was not a disruption to my life or full time work schedule. I got 13 retrieved, 12 mature, 12 fertilized, 8 made it to 6day blastocyst and we have sent those for PGS and waiting on results. I consider this very successful at this point.
Describe your experience with your nurse at Houston Fertility Institute. (Assigned nurse: Jennice)
Jennice was super intelligent. She gave us a one on one IV injections class. Always called me in addition to sending messages to my portal and was caring and compassionate at appts. I had a few other ladies do some random monitoring on me during cycle and Jennice was by far the best.
Describe your experience with Houston Fertility Institute.
HFI strengths: VOLUME. They do this so much they know their stuff and have seen it all and can handle it all. Their embryologist communication was excellent post retrieval. they do retrievals on weekends. I was so pleased that they did not accelerate my cycle or downregulate my cycle to make it more convenient for them.
Weaknesses: you do not get one on one time with your doctor at every monitoring appt unless you have some particularly unusual case. So get comfortable with nurses giving you answers and not doctors. Get the first AM appt at the woodlands office or else you will be waiting for a while. they use the portal a lot so get used to it. You may not have your doctor for every procedure. I had a hysteroscopy with another doctor but she truly was wonderful so I did not mind. I also wanted to keep on a schedule and not wait until my doctor had an available operating slot, so I am sure I Could have had him if I wanted to. They have call doctors for weekends so you may not have your retrieval with your exact doctor.
Describe the costs associated with your care under Ryan Steward at Houston Fertility Institute.
workup, including hysteroscopy, was billed under Recurrent pregnancy loss and was covered under insurance without any out of pocket cost, except for Sperm analysis which was 100$
doctor fee/cycle monitoring 6900$
anesthesia for retrieval 250$
surgery center cost for retrieval 2800$
pgs testing and other lab fees 7,750$
have not ordered medications for transfer yet but I think about 1,000$
FIRST transfer is included in the original costs. subsequent transfers of frozen embryos will be around 2,000$
Describe Ryan Steward's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Houston Fertility Institute.
Dr. Steward only recommended FET after PGS testing for me given that our goal was to not have any more miscarriages (we already had 3).