Samantha Pfeifer

I had a pretty negative experience with Dr. Pfeifer and her office through two consultations and ultrasound exam. I did not go through the egg retrieval with her and will probably choose other doctors. TLDR: Dr. Pfeifer made some quite condescending and potentially racist comment during our first consultation. During the second in-person consultation and ultrasound, the nurse of her office had extremely unfriendly attitude. Background: I’m in my mid 30s and started exploring egg preservations earlier this year. I completed two cycles with another fertility clinic. One of the two cycles did not yield a good number of eggs, but I understand the volatility is hard to predict and manage. The reason I went to Weill Cornell and Dr. Pfeifer is that I would like to try IVF with sperm donor in a few years, so I thought a more established hospital is worth exploring. I made the appointment with Dr. Pfeifer through her office. It was about a month and half wait and first appointment is an online consultation. First Appointment (online consultation): Two minutes before the scheduled time, Dr. Pfeifer's assistant called me and said that Dr. Pfeifer was still with a patient and will be a few minutes late. I told her it’s okay. She was 45 minutes late. I didn’t really mind that because it’s an online session. She asked about the protocols my previous doctor used, the results, etc. Nothing I’ve got to complain there. She was professional and to-the-point. The weird comment came when she asked about why I’m pursuing egg preservation. I told her that I’m single and may consider conceiving a baby using sperm donor in a few years. She said that’s common and her office (or Weill Cornell) has a whole support system for this including teaching classes, phycology support etc. She then said: “In your case, it is advised to choose a sperm donor that have similar physical characteristics with you”. I was a bit surprised by that advice and asked: ”Is that for the purpose of having a baby looking like myself?” She then said: “Yes, and for example, when you take the baby to the playground and call her, you would not be considered nanny...well food for thought.” I was shocked by the “nanny” comment but was a bit lost at the moment. I didn’t say anything about it and concluded the online consultation and agreed to an in-person appointment one week after that. After the initial consultation, I felt uncomfortable with her comments of choosing sperm donor and “nanny”. I think the comment is inappropriate to say the least. It’s only about the nanny part, but more about how to choose the sperm donor part. It is very strange for a doctor to advise prioritizing physical appearance over other more important issues (e.g. screening for genetic disease) when it comes to choosing sperm donor. With this, I was debating whether to cancel the in-person appointment. In the end, I decided to give it a second go and maybe it was not a hostile comment. But looking back, that is a huge red flag of the patient care and I should have canceled the appointment. Second Appointment (in person) The second appointment was in her office in Tribeca Weill Cornell location. It’s a very nicely maintained medical office and the front desk is very friendly. The appointment was at 10:15am. I arrived at 10am and was called into the check room at 10:30am. In the check room, the nurse asked me whether I need to go to the bathroom. I said, if I need to wait longer, I probably need to use the bath room since I’ve been here for a while. The nurse said :”well your appointment is at 10:15, it’s only 10:30 now, it’s been only 15 min wait.” A comment completely uncalled for. I wasn’t complaining about the wait but the response from the nurse definitely sounds defensive to me. I used the bathroom and got ready. The doctor arrived at the check room at 11:05am, 50 minutes late, again. Dr. Pfeifer asked a few quick questions and performed the CT/GC Cultures and Ultrasound. Nothing went wrong there and we didn’t really talk much. I couldn’t tell whether the previous comment was just a misspoken error or indeed racist. However, during the ultrasound, the nurse was standing behind the doctor, rather than by my bedside. I was feeling a little awkward as she was facing my opened legs and they asked: ”what’s the problem?” I told them in my prior ultra sounds, the nurses normally stand by my bedside not behind the doctor. Dr. Pfeifer said: “She needs to be there so that she can pass me the device I need.” I said that’s okay then. After that exchange, the doctor continued the test but the nurse was throwing devices on the table and making a lot of noises with the trash bin and on her way out with the door. She was clearly demonstrating that she was upset. I know that this is not me over-interpreting the situation because the doctor actually paused for a few seconds after the nurses left the room and said sorry, and then continued the conversation. I don’t know whether there is a protocol or not where nurses should be for ultrasounds, but when a patient feels awkward that someone other than the doctor is standing in front of their spread legs, I don't think the nurse should give an attitude. After they told me the reason, I agreed to proceed with where the nurse was standing. The negative attitude of the nurse is rude and extremely unprofessional. Communication and billing I was sent to Dr. Pfeifer’s assistant after the ultrasound to discuss logistics. It’s the same person who helped making the appointment. She is friendly and explained to me the cost and that even though I did two cycles elsewhere before, I still need to attend the teaching classes before starting a new cycle with Dr. Pfeifer, which I understand. The costs are slightly higher than the other clinic I went to, but acceptable given the overall better facilities of Weill Cornell. By that point, I was very conflicted whether I even want to proceed with Dr. Pfeifer, so I specifically asked the assistant that if I should first pay for the consultation first in the case I don’t proceed with the egg preservation. The assistant said, nothing to be paid and send me away. A week later, I received two bills from Dr. Pfeifer’s office for ~$1300 in total, without any prior communication or receipt outlying what’s included in the charge. I have no problem paying for the consultation I had with Dr. Pfeifer, but I do not understand why the costs of the consultation was not communicated to me before and after the appointment, when I specifically asked about that. The overall experience makes me feel that Dr. Pfeifer and her team does not really care about their patients. The potential racist comment is also concerning. I think for egg preservation and IVF process, the patient care is particularly important. Dr. Pfeifer and her office don't seem to be able to provide a minimum level of professionalism, respect and care to their patients.

If the doctor sees my comment, I would like to know whether she also makes the same suggestion of sperm donor to all patients, or only to patients of minority ethnicity groups I also hope she encourages her nurses to be more caring towards patients and know that the patients are not medically trained, it's not their job to know the in and outs of all protocols of how a fertility clinic runs.

I received two bills with total amount of $1300 for the two consultations. The communication problem with the billing was stated in my overall review. When I asked about the consultation cost, the assistant told me no need to pay for anything and I received the bill a week later without any explanation of what's included. The egg preservation cost is $8500 for the monitoring and checking, not including the medication and anesthesia. It's higher than the previous cycles I went through, but not significantly higher

Dr. Pfeifer gave me the impression that she is on top of all the latest research, which was very important to me. I appreciated going to a doctor who made evidence-based decisions and explained all the options to me. When an initial ultrasound before starting IVF discovered a cyst on my ovary, she provided me adequate information about the pros and cons of surgical removal of the cyst. She was not always easy to reach in a timely way for follow-up, including after the surgery that I decided to go through with, after the egg retrieval, and after the embryo transfer. I needed to be proactive in making appointments to talk with her about how things were going and what would be the next steps. But once I had the chance to speak with her, I left the appointments feeling satisfied with the plan.

I would recommend writing down all your questions ahead of time, bring something to write with, and document all the answers that she provides to your questions. I referred back to my notes a lot which helped me remember some of the finer details about why something went wrong or what we are doing to change course in treatment to try to get it right.

I was on a protocol taking Gonal F, Menopur, and Ganirelix injections for 11 days before a Pregnyl trigger shot for egg retrieval the next day. This was my first and only IVF cycle and I was pleased with the results: 10 mature eggs, 10 fertilized, 6 embryos.

Monitoring was in the mornings from 6:30am-9:30am which worked out fine with my full-time work schedule. On weekdays, I would go to the Tribeca office and on weekends the Upper East Side office. Each had drastically different environments. Tribeca was quiet and spacious and wait times were low. After the ultrasound you could go straight in for bloodwork. At the Upper East Side location, it felt like a factory and you would be called in separately for ultrasound and bloodwork. There was a kiosk that was supposed to make checking in faster but it hardly ever worked. At Upper East Side, my doctor was never there so I would see whoever was rotating through at the time.

I paid out of pocket $1,168 for infertility testing (e.g., HSG, sperm analysis, bloodwork, consultations). My insurance covered the laparoscopy. For the IVF cycle, insurance covered a portion and we paid about $16,000 out of pocket (e.g., medications, PGA, embryo storage fee, ultrasounds, etc.)

Given my age, my doctor suggested single embryo transfer. I trusted this choice and did not ask about multiple embryo transfer.

I think Dr. Pfeifer is very knowledgeable and trustworthy. I was concerned that there wasn't more investigation into what could be going wrong considering I had what appeared to be a pretty successful cycle producing seven 5-day embryos but sadly all failing to implant. I asked for additional testing like ERA or immunity and Dr. Pfeifer did not think it was necessary.

Be your own advocate. This is a busy facility and they are juggling a lot of patients. I've had to contact Dr. Pfeifer's assistant numerous times after a failed transfer and she can be hard to get a hold of which is frustrating when you are going through this process. If something doesn't feel right speak up.

My protocol was 300 Gonal F + 150 Menopur with Antagonist/Dual trigger. I triggered after 8 days and we retrieved 22 eggs, 14 mature, 13 fertilized and 7 made it to day 5. We transferred all 7 over the course of 4 cycles and all failed to implant. I did not do PGS testing because it's not a guarantee and Dr. Pfeifer agreed. Not sure if that was a contributor to the failed transfers but I know that even tested embryos can fail to implant. We transferred 1 embryo fresh and 2 embryos during each frozen cycle.

My insurance covered the bulk of it but after I exhausted by allotted 10K for meds I was coming out of pocket so I'd say I paid $1500 in total for each cycle

With fresh transfer Dr. Pfeifer said we'd only transfer one. Subsequent frozen cycles we transferred two since they were not PGS tested

I was very happy with Dr. Pfeiffer until for one cycle, when we were setting up the IUI appointment she said “remind me for next cycle that you ovulate early” and it just showed me she did not have faith that this cycle would work. I already felt like it was a waste of time. At my consultation, one of the recommendations was laparoscopy and when I went in to try that as an option, she said if I was open to IVF then that would be the better option. However, when she discussed the IUI, I felt like she just felt that IVF was going to be what I did and was dismissive of other options. I thought she was a great doctor, and very thoughtful and compassionate, but I did feel like what she truly believed was not what she wanted me to do. It was as though I was rushing through the IUI’s so that I could be eligible for IVF. Also, there was only one cycle of the 4 cycles I was there that I saw her throughout the entire process. I really wanted her to be my doctor but she was often out of the office.

Be mindful that she is not always available and you will need to see other doctors quite often

First cycle was clomid 50mg only but no timed intercourse or IUI. My husband had a viral infection and Dr. Pfeiffer was not sure if his sperm would be okay to use for the IUI. Second cycle was clomid 50mg again with an IUI (this is the cycle I saw Dr. Pfeiffer throughout). Third cycle was clomid 50mg with an IUI. My follicles were very small and I was already surging when I was told to go in for my IUI the next day. Fourth cycle was clomid 100mg with timed intercourse because the IUI was not scheduled on time. The two follicles were small (13-14) and I was again already surging when I was to schedule the IUI the following day. All four cycles resulted in negative pregnancy tests.

All costs were paid by my insurance except some medication and copays. I paid for Clomid, Sperm wash, and IUI through insurance.

N/a

Dr Pfeifer is wonderful - she truly connects with her patients, has a good balance of optimism and realism, she is patient and listens. She cares - whenever I run into her outside of the office, she remembers me and stops to have a real conversation.

You are in extremely good hands. There will be a rollercoaster of emotional highs and lows but Dr. Pfeifer will do everything possible to support you and try to get you to a successful outcome.

I transferred embryos from another clinic to Dr. Pfeifer in order to do a FET. All we needed to do was build up my lining; however, my body refused to respond to the estrogen. So we tried various methods of getting estrogen into my body - patches, pills, suppositories - until one worked. We didn't build much of a lining but Dr. Pfeifer thought it was worth then trying a transfer (I have a bunch of embryos) - and I ended up getting pregnant with that transfer.

FET cycle was about $5,000.

Doctors in general seem to view success as a single embryo transfer that results in a pregnancy due to the risks associated with being pregnant with multiples.

Dr. Pfeifer is extremely knowledgeable about current research, and will explain results of different studies and the stance of the ASRM on different points. She is an excellent communicator, very patient, and appropriately optimistic, which helps when you are feeling pessimistic. She has a philosophy of giving anything reasonable a try for a few months before moving on to a new plan, which worked well with my desire to avoid invasive interventions if possible but helped me not waste too much time. Whenever there were bumps in the road (adverse reactions to a new drug or injection, etc) she changed course appropriately, and was available by phone to check in or squeeze me in for a visit first thing in the morning. I felt like she took all of my concerns seriously, and she monitored me very carefully during IVF. Overall she is an excellent, compassionate, and careful doctor and I would recommend her to anyone.

She will not always do all procedures, and there were one or two times where things she said made me think she'd be doing a procedure or be the doctor I'd see for a visit and then it ended up being one of the other doctors.

5 unsuccessful IUIs: 3 with clomid, one with letrozole that gave me an adverse reaction, and one with a higher dose of clomid that then caused me to have ovarian cysts so we stopped using that drug. Before any IUIs, she removed a uterine polyp she found. Then after those didn't work, my husband had a varicocele repair (minor male factor). She was then ok with us trying on our own for 3 months. After that the plan was to do 3 more IUIs, but we never did the third one because at that point I'd had negative reactions to both clomid and letrozole. IVF: low dose of follistim, menopur, and ganirelix. Lupron and hCG trigger. 33 eggs retrieved, many (I think 23) embryos produced using ICSI, one transferred, and 7 of good enough quality to freeze at day 5 or 6.

For IUIs I would have to make an appointment. There was sometimes a wait but never too long. For IVF it was during monitoring hours, and the wait time was very variable. Sometimes the appointments available were a little earlier or later than I would have liked but it was never too difficult. The upper east side location, where I'd have to go on weekends, was more crowded and had more of a feeling of a huge line.

For us, each IUI was somewhere around $500-700 out of pocket. All IVF costs, including drugs and ICSI, for us were about $18,500. There were some other incidental costs along the way probably totaling around $1000 - I think $600 for a final test before IVF, some sperm tests, and copays for visits and a surgery.

I felt very comfortable just transferring one embryo.

Dr. Pfeifer always had a positive attitude and disposition. She explained what she was looking for and what she found. With tough news she was always the one to personally call whether from the office or her personal phone. Her attention to detail with my personal life made it lovely to connect with her at each visit.

Know that you get the facts along with a person who genuinely cares about your success. Dr. Pfeifer is easy to talk with, ask questions and she volunteers information.

When we first started together I had already been diagnosed with PCOS. The treatment was timed intercourse with Clomid, which we did 2 cycles and then moved to Clomid with IUI for 2 cycles and 1 with Letrozole. After 3 failed IUIs, Dr. Pfeifer moved us quickly to an IVF protocol controlling the start date with BC then started with Follistim (started with 150, reduced to 125, and fluctuated based on BW), added in Menopur and Cetrotide on day 5 of the shots. Trigger used was Lupron and HCG. We got 4 embryos from this cycle, 12 eggs retrieved, fertilization rate not ideal. We did a day 5 fresh transfer with 1 embryo and froze the other 3. The fresh transfer didn’t take, so we moved to transfer 1 frozen, this also didn’t work. Based on the results from IVF round 1 and the transfers, the recommendation was to try and bank more embryos, Dr. Pfeifer moved us to an increased dose of Gonal-F 225 adding in Menopur and Cetrotide on day 4, Lupron and HCG trigger on day 9. We got 26 eggs, 14 mature but 0 fertilizer and I had OHS. We regrouped after I recovered and decided to transfer both of my remaining embryos via a programmed cycle (using estrogen patches and adding progesterone shots). I did get pregnant with one baby from this cycle, but lost the baby at 8 weeks after hearing the heart beat at 7weeks. We took a 4 month break after that and started again with a cycle ( 75 Gonal and menopur at the same time, adding Cetrotide on day 5) Trigger on day 10 with Lupron and HCG. We got 10 eggs, 4 mature one day 5 embryo which we genetically tested. Recommend for testing came from the miscarriage and the lack of fertilization in the previous cycles. The embryo was not recommended for transfer.

It was a combination of efficiency and a ton of women just waiting. Some days you would have a scheduled time, other was “just come between 7-830”. Weekend at the uptown office were always packed. Earlier the better!

At first , I had no coverage and monitoring appointments ran about $450 each time. My husbands insurance added some coverage during our rounds which helped but everything, especially the medicine and retrieval were expensive.

Dr. Pfeifer cares so much for her patients that she overall preferred to transfer single embryos. We spoke several times about risks with multiples and weighed the options very carefully before putting my 2 embryos back.

Dr. Pfeifer was/is excellent. She was compassionate and caring and very knowledgeable--but still blunt enough so that you know to expect realistically. She keeps up-to-date with emerging studies surrounding IVF and doesn't just jump on the bandwagon of extras unless she truly thinks they could help. I love that she takes your thoughts and opinions and concerns but at the end of the day she is the doctor and I can trust her to make the best decisions for my protocols.

Feel free to ask questions. If you aren't getting helpful enough information from the nurses, you can call Dr. Pfeifer's assistant for an appointment with her. I have never walked away from a consultation wondering what to do or what was going on.

For us, our infertility was male factor with no issues on my side. Because of this, and my risk of OHSS, Dr. Pfeifer took a more conservative approach to the stim meds. I never did more than 150 units of follistim per day, and then I also had menopur and cetrotide. And then progesterone in oil going into transfer. They retrieved 13 eggs, 9 mature, 8 fertilized. By Day 3, they were concerned none would make it to day 5 in the lab so we transferred fresh at day 3. Neither took. I had 2 embryos make it to freeze. The first transfer was positive but ended in miscarriage. Second transfer was positive but ended as a chemical pregnancy. We will be going for a 2nd egg retrieval in 2019 and I know she is going to up the meds a bit to try to get more eggs. We will do a day 5 fresh transfer (my decision, not the doctor's) and then PGS test the rest of the embryos that make it to freeze.

Not a cattle call. It was a well-oiled machine. You walk in, sign in, and then sit down until they call you back. Honestly, I was almost always out of there within 20 minutes. The only time I wasn't was when my veins were not cooperating and it would take a couple people to find a vein.

IVF with ICSI including fresh transfer was just under $12,000. Medications were about $6,000-8,000. Hotel for 3 weeks was about $6,000. FETs were about $4,000 plus medication and hotel.

Dr. Pfeifer is very smart about it. She prefers to transfer just one, but will allow 2 if you really want. She moreso bases it on age and circumstances. I'm under 35 so I only transfer 1. At 35, 2 would be okay. I'm not sure, but I believe she does not recommend more than 2.

Dr. Pfiefer is compassionate and a good communicator and she’s made adjustments to my protocols to improve my cycles. My obgyn recommended that I see Dr. Reichman or Dr. Pfeiffer for IVF. Dr. Reichman had better reviews but his assistant never called me back, so I ended up seeing Dr. Pfeifer. At 40 years old, my AMH was 2.29 and my FSH was 7.18, so we thought it would be ok to start with 3 IUI. My first two IUIs were unsuccessful. Dr. Pfeifer then found a small fibroid which she removed surgically. I thought this might be preventing me from getting pregnant so we tried 2 more IUIs which were unsuccessful before moving on to IVF. I’ve done 3 ivf cycles using the antagonist protocol, with adjustments and significant improvement with each cycle. For IVF#1, I had 5 follicles and 7 eggs retrieved, 7 mature, 5 fertilized, but there was fragmentation with most of the embryos. For IVF#2 (four months after IVF#1), I had 9 follicles and 7 eggs retrieved, 5 mature, 4 fertilized but the quality was much better – no fragmentation. For IVF#3 (seven months after IVF#1), I had 9 follicles and 16 eggs were retrieved, 13 mature, 12 fertilized and 6 made it to blastocyst. Two were transferred on day 5. Four were PGS tested: 2 normal and 1 mosaic. So far I have had a favorable experience with Dr. Pfeifer. At some point, I asked Dr. Pfeifer if DHEA supplementation could help and she was neutral on it, she said the research isn’t conclusive but it if I wanted to it wouldn’t hurt. I ended up doing my own research and taking DHEA as well as other supplements and my cycles have improved the longer I have been taking the supplements, although I'm not sure if it is the DHEA or something else. I am personally doing a lot to try to improve egg quality, as far as diet, exercise, supplements, acupuncture, yoga, meditation and herbs and educating myself about avoiding fertility harming toxins, and having emotional support of close friends (who have gone through IVF) and family. My second and third cycles were also a lot easier for me mentally since I had been through it before and knew what to expect and was much more adept at administering the medication.

Dr. Pfeifer is a great doctor and you are in good hands. My advice is more in general about IVF: Be sure to have a lot of support from friends and family. Take time to nurture yourself, and educate yourself about IVF so you know what questions to ask. Take the time to educate yourself on what diet, exercise, lifestyle and supplement changes you can implement to improve egg quality because there is a lot you can do. "The Infertility Cure" and "It Starts With The Egg" are good resources. The CCRM fertility supplement list is also helpful.

IVF#1: For my first round of IVF, my protocol was 325 to 400 iu Gonal-F for the first 5 days, then 250iu Gonal F, 150iu Menopur and 1 vial Cetrotide for the next 5 days, and HCG trigger on day 11. I only developed 5 follicles, mostly on my left side, which was not as good a response as we thought I’d have. However, Dr. Chung did my retrieval and we were able to get 7 eggs. All 7 eggs were mature, 5 fertilized and we transferred 4 embryos on day 3 by Dr. Schattman. Dr. Pfeifer said that most of the embryos had fragmentation, so it would be best to transfer them on day 3 since it didn’t look like they’d survive to day five. The four that were transferred were one 10 cell, and three 8 cell. One of them was grade 1.5 (which is the highest) and the other 3 were grade 3 which are “so-so” quality. The cycle failed and I spoke to Dr. Pfeifer about what we could do to improve the next cycle. She said it was remarkable that all of my eggs were mature, even though I had some follicles under size 10 and 11 and that she’d trigger me earlier next time, with a lead follicle between the size of 16 to 17, since my eggs appear to mature at a smaller follicle size. She said she also would have me start Menopur sooner. She explained that they aim to have 90% of the eggs be mature. She said this could help with the egg quality because if you are triggered too late the quality could decline. Later on in my research, I learned that there are studies proving that older women usually do much better when they are triggered at a smaller follicle size. IVF#2: I started taking micronized DHEA (25mg 3x a day) along with other supplements 2 to 3 months before my 2nd IVF. I also saw a fertility acupuncturist 1 to 2x a week who prescribed me custom herbs to take before and after ovulation, did yoga regularly, and I tried to cut down on exposure to bpa/phthalates/fragrances, the use of household plastics and plastic food containers/water bottles. I had a better response for IVF #2. My protocol was 300iu Gonal-F and 150iu Menopur daily, with Cetrotide added mid-cycle. When I triggered, I had 9 follicles (6 on the right and 3 on the left) – which was 4 more than I had with IVF #1. On the morning of my trigger my follicles on the right were size 17.8, 16.8, 16.6, 15, 14, 11.4, and on the left they were size 15.3, 14 and 14 and my E2 was 1944. However, only 7 eggs were retrieved by Dr. Kang. 5 of the eggs were mature and 4 fertilized but they didn’t have the fragmentation that embryos had during my first cycle. All four were transferred on Day 3 and Dr. Pfeifer did my transfer. We were hopeful, since all 4 embryos were graded 1.5, which is the highest grade, but I didn’t get pregnant. I met with Dr. Pfeifer and I asked her a lot of questions, such as should I be tested for natural killer cells, should we test for dna fragmentation, are there any other tests I should do and should I try an ultrasound guided transfer. She said she didn’t believe in natural killer cells and didn’t think any other tests were needed. She said she didn’t think an ultrasound guided transfer would make a difference, but we could do it next time. Also, she said she was happy with how my second cycle went and would keep my protocol the same, except she would have me use the Estrogen patch before my next cycle. IVF#3: I had my 3rd cycle of IVF two months after my second cycle and it was the best so far. The number of eggs retrieved doubled, and the number of fertilized eggs tripled compared to my previous cycle. My protocol was the same as IVF#2 except I took the estrogen patch 6 days before I started stims, changing it every other day. My AFC on day 1 of my period was 12, with 6 follicles on the left and 6 on the right. After 10 days of stims, the morning of my trigger I had 9 follicles, 4 on the right (size 16.3, 16.2, 14.5, 12.5) and 5 on the left (size 17.6, 16.8, 15.2, 17.5, 14.6). My lining was 11-12 and E2 was 2440. I was triggered with 5,000 HCG. Dr. Kligman did my retrieval and 16 eggs were retrieved, 13 were mature and 12 fertilized. This was amazing considering I never had more than 7 eggs retrieved or 4 eggs fertilize. Dr. Pfeifer was surprised with the results since my response was significantly better with virtually the same protocol. This was the first time I had enough eggs to push to day 5. On day 5, I transferred 2 blastocysts grade 3AB and 2.5AB via a fresh ultrasound guided transfer by Dr. Chung, with a visiting doctor from Taiwan present. On day 6, I was told I had four extra blasts which were PGS tested. Two weeks later I was told that 2 were normal and one was mosaic, and I had the option of knowing the genders. Unfortunately, the fresh transfer was not successful but I am feeling hopeful after my recent follow up appointment with Dr. Pfeifer. She said she expects a 60% success rate for each frozen embryo and would recommend a single embryo transfer, and she is encouraging me to do a number of tests that should improve my chances for success. I did a lot of research on questions to ask and tests to do after a failed IVF cycle. I asked if I should do a saline sonogram (to check for fibroids), hysteroscopy, endometrial biopsy/scratch, endometrial receptivity array, and be tested for an infection or blood clotting disorders. Dr. Pfeifer said I should do an saline sonogram (between day 6 and day 10 of my cycle) and depending on the results, we would or would not do a hysteroscopy. She discussed the endometrial biopsy/scratch and endometrial receptivity array and said that it could possibly aid in implantation. However, since I had irregular cycles in the past, I would need to do a mock cycle with estrogen and progesterone prior to doing this test, so I'd have to wait another month before I could do this test since I need to start taking the estrogen on day 2 of my period. She didn't think I was not getting pregnant because of an infection since my white blood cell counts are normal, but she agreed to have my blood tested for clotting issues. She was so pleased with my improvement in more than doubling the number of eggs retrieved and the significant improvement in egg quality that she took notes as I shared with her what I did differently. I told her that I continued with acupuncture and yoga which I strongly believe contributed to stress reduction, and that my husband also made positive changes in lifestyle and also took supplements which I found supportive. I shared with her a very long list of supplements that I had been taking after the first failed cycle, including 500mg of Ubiquinol, 100mg of Pycnogenol, 75mg of DHEA and several others. I stopped taking certain supplements during stims and in the two week wait. I continued to try to avoid exposure to bpa and other toxins. I started doing more cardio and meditation, changed my diet to include more protein and good fats and less carbs and less gluten when possible. I also incorporated more warm, cooked foods, especially vegetables and bone broths. I tried to keep my carb intake under 40% but it realistically ended up in the range of 35% to 45%. I cut out caffeine except for chocolate. I had dark chocolate frequently and I cut down on alcohol except for a few glasses of wine on a few occasions socially. Dr. Pfeifer believes that diet, exercise and sleep are all very important to one's overall health and she encouraged me to keep doing what I am doing.

A well oiled machine. At the Tribeca office, I usually arrived between 7:45am and 8:10am and I never waited more than 15 minutes. Usually it was 5 minutes or less. At the York Ave. office, I usually arrived around 7 to 7:30 and the wait was also minimal. I learned my lesson that if you arrive after 8am at York Ave. you may need to wait a long time.

4 rounds of IUI plus 2 rounds of IVF totaled $48,000. I paid about $13,000 out of pocket after $35,000 in fertility benefits/insurance was used ($25,000 for treatment and $10,000 for medication). Note that fertility medication for the first round of IVF cost approximately $11,500 with insurance covering the first $10,000. When you use insurance, the prices of the drugs are somehow inflated. For the second round of IVF, I purchased the same amount of fertility medication, but since I was paying out of pocket, it only cost around $4,000 instead of $11,500. I do not have the total costs for the third IVF cycle yet.

For a 40 year old woman, she would recommend transferring up to 4 embryos for a fresh day 3 transfer (untested), up to 2 on a day 5 fresh transfer (untested), and 1 PGS-tested normal embryo for a frozen transfer.

Dr. Pfeifer has a very direct approach to explaining things with good bedside manners. There were times where I felt she could do better in explaining the whole picture or long term impact of my treatments. For example, when she mentioned harvesting more eggs sooner rather than later, I didn't realize the long term impact and timing of all the IVF cycles

Be prepared with questions but also asking about the timing of each treatment plan.

1. Both IUI used Clomid and HCG shot - negative pregnancy results 2. IVF Cycle 1 & 2 use the same protocol except cycle 2 had 1 day less on hormones Gonal-F - Total 900IU - 4 pens: 450mg for 4/5 days then decrease as close to retreival Centrotide - 6 Kits Menopur - 10 vials Chorionix Gonad (HCG shot) 3. IVF Cycle 1 resulted in 2 frozen transfers (1 embryo at a time), both transfer took Progesterone vaginal inserts - both transfer resulted in negative pregnancy 4. IVF Cycle 2 was a Day 3 fresh transfer so took Progesterone oil. Transferred 3 embryos, pregnant with 2 and miscarried at 8 weeks

There was a set time for monitoring and bloodwork. You learn quickly what times to go in and to avoid due to "morning traffic". It was fine and the timing was ok that I got to work on time.

My out of pockets cost for 2017 was $14,366. Healthcare benefits was exhausted since last IVF. Medications ~$5,000 out of pocket IVF Fees ~10,000 out of pocket (last IVF I paid $5000 out of pocket as benefits were exhausted) PGS Fees ~2,000-5,000 (depending on number of embryos tested) 1st IVF, I paid for 7 embryos to be tested and did not have any tested on 2nd round Hospital Fees ~1,000 (paid twice for each egg retrieval Other Dr Visits/Lab Work ~2,000 out of pocket after insurance

Because I have never been pregnant before, my hormones levels and reserve was good, my doctor suggested to transfer 1 embryo at a time. Looking back, I would have transferred 2 (because that is all I had at the time). I ended doing a fresh transfer with 3 embryos in my 2nd IVF cycle.

Dr. Pfeifer was kind in how she explained my results and what we'd try next. After a few losses when trying naturally she seemed to be in my corner and wanted to see me pregnant. She didn't perform my IUI but saw me for my ultrasounds (except for weekend monitoring.)

She had me take 100 mgs of clomid on cycle days 4-8, trigger shot on day 12 and IUI on day 13. I will take progesterone suppositories day 17 until negative pregnancy test (or continue on progesterone if pregnant.) Currently waiting for the results.

My insurance covers most testing and the IUI. I've paid $30 copays for some visits and for some of the drugs. I think I also paid for the trigger shot.

Dr. Pfeifer was always very positive and encouraging in regards to treatments, medications, etc. The clinic was always very busy, so her time during morning monitoring appointments was rather limited, so those appointments were quick and to the point. When an issue did arise with one of her nurses, she was nice enough to offer that we should contact her directly.

Be patient and make sure you have questions ready when you do meet with her.

She diagnosed me as a having a "smidge of PCOS" as well as unexplained infertility. I did appreciate she taking all precautions before going through with any treatments (in my case there was some suspicion that my uterus bicornuate uterus so she recommended I go through an MRI to confirm. Also when I reported feeling extremely emotional when she prescribed clomid she switched me over to letrozole, which worked much better. She listed to my life situation and recommended an altered plan to proceed with IVF while my life (work and school responsibilities) got sorted out. My only kind of negative comment about the treatment strategy would be her lack of enthusiasm towards supplements. After doing some additional research I asked her thoughts on adding CoQ10, she was very unenthusiastic and said it couldn't hurt, but she also said that the vitamin/supplement industry is a multi-million dollar industry, etc. when I inquired about vitamin E and melatonin. I was a little taken aback, but respect her feelings.

Luckily all of our IUI's were covered by my insurance. We did not proceed with IVF due to the issues we encountered, so we don't know what that would have cost us out of pocket.

Dr. Pfeifer gave me every confidence that she was dialed in to what I needed for my personal treatment success and I'm very glad I chose her to guide me through this process. I would definitely recommend her to anyone looking to have a great working relationship with their doctor and be treated as an individual, even within a very large practice.

Understand that despite the fact that Dr. Pfeifer is very personally invested in her patients, it is still up to you to be your own advocate as a patient, especially in a large practice like Cornell--ask questions, follow up with your nursing team and question things that just don't seem 'right' until you feel comfortable.

Gonal-F, Menopur and Cetrotide with an HcG trigger-- close monitoring to guard against the onset of OHSS.

The monitoring hours are very efficient, although the later you come, the longer you will wait-- so if you wanted to be seen quickly, it required that you come earlier. Even during peak times, the longest I was in the clinic during monitoring was probably half an hour.

I have insurance coverage for infertility procedures, so I only paid my insurance deductible and, in some cases, co-payments, as well as PGS testing fees and embryo storage fees.

Initially I came to Dr. Pfeifer after a referral from Dr. Peter Schlegel during treatment for male infertility. I was an out-of-town patient which made communication and remote testing complicated at times. That said, Dr. Pfeifer had at one point provided me her cell number and has since allowed me to text her- though I try to respect her privacy and do so sparingly. I did, however, find this to be especially helpful at times when I needed something urgent, or in the event I was unable to get through to her via e-mail or get through to one of the nurses or on-call physicians (weekends, nights, etc.) The shear fact that she trusted me with giving me her cell number shows how much she cared for me as her patient. We had success after a frozen blastocyst transfer in June of this year, after a failed fresh 3-day transfer in March (2nd IVF cycle), and failed TESE/initial IVF cycle with a frozen embryo transfer. Dr. Pfeifer is always very approachable with questions, but at times, it seems she struggles to keep up with her large patient load as it can take multiple attempts to get a hold of her. That said, she is always more than willing to help and listen when you do! It requires a lot of patience and persistence, but worth it when you do get through to her.

Persistence is key when getting through to her directly. Due to the high volume nature of the clinic, you really have to be your own advocate as everyone is vying for time with her. Being in high demand is not a bad problem to have, but wish that Cornell would hire more physicians to lower the patient to provider ratio.

The first IVF cycle, we used injectables (Follistim, Ganirelix, and Menopur). The second cycle we were able to use what we learned from a failed frozen cycle to modify my protocol to produce better results. During IVF round 2, we went with a lower initial dose and continued that dose for a majority of the time, which while it sounds counter-intuitive, produced almost double the number of eggs retrieved (16). It was somewhat discouraging to find out that only half of the eggs were "mature", but we had two 8 and 7 cell embryos transferred and another which made it to Day 5/6 to freeze, which ended up being the one that worked.

Pretty painless at Tribeca office. Usually in and out in 30 mins. There was one day I waited over an hour for bloodwork, but I think this was due to a snowstorm that had impacted morning monitoring the day prior.

IVF w/ ICSI is about $13,000 + cost of medications which for me was about $2-3,000

In our case, she would have liked to have performed a day 5 transfer in March (IVF cycle #2), but wanted to wait and make the final decision once she saw what the embryos looked like on day 3. In the end, she ended up transferring two moderate quality embryos not knowing if the other six, slower developing embryos, would make it to Day 5. Only 1 of 6 was of good enough quality to freeze, so in hindsight was the right decision. Those two failed to implant, but we did an FET with our day 5 frozen embryo in June and that proved to be the lucky one!

So far my experiences have been very positive. Dr. Pfeifer takes the time to answer the questions I have and comes across as caring and thoughtful. She strikes a good balance of being honest and nurturing.

Be prepared with questions if you have them and if you are concerned about something, speak up.

I haven't yet started my IVF cycle but the protocol the Dr. is recommending is 225-400 FSH plus Menopur with Ganirelix.

I am just starting IVF but I think the cost for IVF with PGS testing and meds without insurance is around 25K; our insurance will cover 10K for treatment and 4K for meds.

Based on our discussions and the fact that we are doing PGS testing, the current recommendation is to transfer one embryo.

Dr. Pfeifer was easy to work with and clear in her communications. I wouldn't say she is the most compassionate doctor - but I don't think you can expect that from most fertility clinics. She answered questions directly when I had the chance to ask them. The day of my egg retrieval even though she was not the doctor in the OR she called me to check in and let me know things had gone well. When I didn't answer the phone (napping) she took the time to call my husband which I really appreciated.

Write your questions down and ask them as she is doing the monitoring exams. Know as much as you can before you go in so you can play a more active role in deciding your treatment path.

We had unexplained infertility which is so vague and annoying that its even a "diagnosis". I did the HSG scan, blood work, genetic testing and my husband did seamen analysis - all came back good. We then did two rounds on clomid, with IUIs - one with trigger shot - and one round of letrezol with IUI. All were unsuccessful. I went for daily monitoring and blood during all three cycles. When we moved to IVF I had more ultrasounds, and then moved to injectables: Gonal F, Menapur, Gonarelex with a trigger shot. I also took some antibiotics. We opted for ICSI, and the embryos were transferred day 3.

I think each monitoring session was abut $40 and each IUI was about $70. The retrieval and transfer for IVF was about $12,000, the meds were covered by insurance (about $10,000) except for $750 that I paid out of pocket.

She was open to what we wanted and supported our decision to transfer two.

Dr. Pfeifer is very personable and knowledgeable, and is also a straight talker. She's also funny and warm, and made me feel like a person, not a number. However, it's difficult to get ahold of her on the phone, which can be frustrating.

Ask all your questions during your appointments, because you'll most likely speak to your nurse when you call, who will then have to call you back once she speaks to the doctor.

I had one unmedicated IUI, two medicated IUIs (with chlomid and an ovulation trigger), and then IVF using Follistim, Menopur, Ganirelyx, estrogen patches and progesterone.

For the most part, it's an efficient system at the Tribeca office. There were some mornings when it would take a long time, but there was always a reason - they were short-staffed or the computers had gone down. If I had an appointment (which I recommend, even for monitoring hours), I was always seen quickly with no issues.

Each IUI cycle cost about $4k, for all the appointments, blood work, ultrasounds and medications. For IVF, the full cost was about $12k.

I felt that I was "told" how many embryos were being transferred, as opposed to having the option to disagree. This was my biggest issue with Weill Cornell.

Dr. Pfeifer established a plan for my treatment and explained it well. She was realistic yet encouraging. When my body responded in unexpected ways and we had to change the plan, she clearly communicated why. I trust her very much.

Go see her!

First I was on estrodial and progesterone for a few months in an attempt to restart ovulation naturally. Then I tried clomid, but that didn't produce ovulation. Since I wasn't responding, we canceled that cycle and I took medicine to bring on a bleed so we could start again with the next cycle. Then I started taking the nightly hormone injections, and finally my hormone levels started to rise and my follicle started to grow. I went to the clinic every other day to keep an eye on its growth. When the time was right, I gave myself the trigger shot injection. Then we did an IUI.

Because I was classified as infertile, almost all of my costs were covered by insurance. I purchased donor sperm myself.

Samantha Pfeifer was very polite, cheerful and had great bedside manners. Our meetings with her were precise; she had answers to all our questions; she never dismissed any of our concerns as silly or stupid. She constantly evaluated my health, and my fertility journey to modify the approach so as to achieve success in an optimum number of cycles.

Keep faith in the process and trust Dr Pfeifer's knowledge, expertise regarding the fertility treatment.

I met Dr Pfeifer in 2016, and the first thing she wanted me to focus on reducing my pre-diabetic numbers to normal. I was suggested to go for additional help from a endocrinologist. Then in 2017, Dr Pfeifer discovered I had uterine polyps and asked me to go for a surgery. In 2018, I had my egg retrieval after my insulin numbers were stabilized and then in October 2018, I had my egg transfer. To sum up, Dr Pfeifer in the two years that I have known her, tried to remove every possible hurdle that would have prevented me from having a successful IVF cycle.

I could go in for monitoring in the mornings. The process was efficient. All I had to do was check in at the front office, and I would be called within 10 minutes. Cornell had also issued a card, which we could swipe to check in, and that was super easy.

The costs included all the monitoring done with bloodwork and ultrasounds, one cycle of IUI, egg retrieval procedure, PGD/PGS testing, ICSI, Embryo transfer.

Dr Pfeifer was very clear,because of my age, she would like to transfer a single embryo only. We agreed with this approach and are happy with the result

We went to a different clinic for our first child and wanted to try a different place for our second. Dr. Pfeifer sat with us at our initial consult and went through all of the medical records and discussed them. She was impressed with my knowledge of treatment and therefore didn't dumb things down for me. She was friendly and warm, but also had a plan of action that she was ready to put into motion immediately. I saw her at every monitoring appointment, and I always felt like she knew exactly what was going on with me. She also performed my tests and was really good about going over results.

If you've been to a previous doctor at a different clinic, make sure you bring your medical records with you. Don't be afraid to ask questions.

Because I had success at my old clinic with IUI, Dr. Pfeifer recommended that we try three cycles of IUI with medication and trigger shot before discussing IVF. She ran the IUI cycle concurrently with some tests I needed to have (a saline sonogram, AMH levels, day 4 bloods). I took 100 mg of Clomid from days 4-8, then went in for a saline sonogram (not the normal course of action in an IUI, but they had to make sure my uterus was clear of scar tissue from my previous c-section) on Day 10. At Day 10 they noted that my follicles were large, but my lining had some catching up to do. I went back in for monitoring on day 11, they drew blood, saw my lining had grown a bit more and my follicles had gotten bigger. I was called that day and directed to take an Ovidrel trigger shot on the evening of day 11. I had an IUI on the morning of day 13. Two weeks later, I had beta blood levels drawn and got a positive. Dr. Pfeifer had me come in for two ultrasounds - one to confirm an intrauterine pregnancy at 5 weeks, and another to confirm viability (fetal heartbeat) around 7 weeks.

Infertility testing and IUI is covered by my insurance, with Weill Cornell accepts. All money owed is because of deductibles/co-pays.

I feel fortunate to have worked with Dr. Pfeifer. Her professionalism and bedside manner is unmatched! She is understanding and really wants the very best for her patients. I do wish it was easier to get in touch with her. During tough times, it is helpful to have that level of understanding.

Be patient. This is a long journey and may have positive and negative outcomes.

I went through 3 different protocols: 1st & 2nd- Gonal F/Follistim; Menopur; Ganirelix 1st resulted in pregnancy 2nd resulted in more eggs. the first transfer, no pregnancy 3rd still had 2 frozen embryos and implanted both... no pregnancy again.

There were definitely a lot of patients during monitoring hours... but I understand. We're all there for the same purpose.

Roughly $10k-$15k out of pocket for both cycles. This is because my insurance covered a portion of it.

she was great- she was easy to talk to and was a good listener. she had a great energy about her and just pleasant to deal with. i sincerely felt she cared about me. and, i felt that she was experienced to make the right decisions. i would recommend her to anyone.

just be prepared to find a good OB as early as 8 weeks as unfortunately, she does not do deliveries!!

Tribeca office was great- the York Ave office was a painful line. i think there is a window in June or July where they don't do IVF so it becomes packed with women squeezing in the last IVF before the doctor's and nurses go on vacation, i think...

Dr.Pfeifer did every ultrasound during IVF and my egg retrieval. While she has 100s of patients, I always felt like her only one. She explained everything in detail and always made me feel educated and comfortable every step of the process.

Monitoring hours were very convenient and you can go to any location.

I have 0 fertility insurance

We discussed all the pros and cons of single or multiple embryo transfers and she made sure we had all our questions answered and help us make informed decisions

Dr. Pfeifer sticks to facts and research in giving you information to make decisions. Perhaps she leans more on experience in developing treatment plans as she is a professional with many years under her belt, but she doesn’t leave it to the inexperienced patient to make decisions based on “feeling”. I also appreciated that she was very knowledgeable about how fertility medication may affect people with an autoimmune disease I have. I already knew this information but asked anyway and was impressed that she could state specific studies that were done on this and their findings.

Do your research on the process BEFORE going to see her so that you can spend time asking deeper questions. I was a little bit green and regret wasting time asking about basics that I should have researched before. She has a lot of knowledge so go prepared to dig into it.

I only saw Dr. Pfeifer for a consultation. I intend to go through an egg freezing cycle however the clinic closed temporarily because of Covid-19 before I got the chance to.

Only had a consultation (~300?) with bloodwork.

She is an outstanding physician - she clearly explained our diagnosis and set up a treatment plan which worked after the second attempt. Very knowledgeable and experienced. Excellent bedside manner. Travels a lot for conference so was frequently out of the office.

Give it 3-4 attempts and then move on to another lab like CCRM if it doesn't work

Estrogen patch priming followed by Antagonist protocol

About 15K per cycle

She was not a strong proponent of PGS testing so is not opposed to multiple embryo transfer of untested embryos for age > 35