How was your experience with Sergio Oehninger at Jones Institute for Reproductive Medicine?
Dr. O has a long history of success in the field, and decades of experience which began working directly under the doctor who pioneered IVF in the US. He excells at giving informed, detailed comparisons between different established treatment options. Our discussions led us first to try 4 rounds of IUI, the first 3 each leading to a very early miscarriage, and the last failing to develop a viable egg. Between attempts, he was very hands-off. We had to initiate the next step on our own when some encouragement would have been helpful. When we had consultations to determine the next course of actions, he didn't always seem as familiar with our treatment history as I would have liked. After the unsuccessful IUIs, we asked again about the clinic's donor embryo program which had been briefly discussed in our first visit, and decided it was the next best step. After being matched with a frozen embryo suprisingly quickly and completing other prequisites of the program, Dr. O implanted the one embryo which survived the thaw. The first couple weeks of pregnancy progressed normally, but after some minor bleeding we were brought in for an early ultrasound and the dosage of progesterone injections was doubled as a precaution. However, there was additional bleeding and discharge a couple weeks later, and another ultrasound showed the pregnancy was lost. At that point, Dr. O was careful not to give us any false hope as we scheduled addtional follow-ups. However, he did not prepare us for the extremely unpleasant and painful side effects of the medications to induce completion of the miscarriage. That experience culminated in a 2am emergency room visit, narcotics to manage the pain, and another ultrasound the next morning when the clinic was open. After this last visit, Dr. O retired and we expect to be transferred to one of his colleagues, most of whom we met at one point or another.
What's one piece of advice would you give a prospective patient of Sergio Oehninger at Jones Institute for Reproductive Medicine?
Not applicable since he is now retired.
During treatment, were you treated like a number or a human with Sergio Oehninger at Jones Institute for Reproductive Medicine?
Dr. O was friendly and offered encouragment when the facts and odds supported it. He also kept a professional distance, but some difficult news was relayed in an abrupt manner which made it more difficult to hear.
Describe the protocols Sergio Oehninger used in your cycles at Jones Institute for Reproductive Medicine and their degree of success.
We tried 4 rounds of IUI, the first 3 each leading to a very early miscarriage, and the last failing to develop a viable egg. Since my wife has never had regular cycles, medication was needed to trigger it each time. Each time there were one or two visits to ultrasound the ovaries and measure follicles before a viable one was identified and our IUI was scheduled. Semen analysis showed slightly low count each time but good motility. Every completed IUI let to a positive home pregnancy test, followed within days by a negative test.
Due to the repeated failures of IUI, we decided that implanting a donated embryo was the next best option. After being matched with a frozen embryo suprisingly quickly and completing other prequisites of the program, Dr. O implanted the one embryo which survived the thaw. The first couple weeks of pregnancy progressed normally, but after some minor bleeding we were brought in for an early ultrasound and the dosage of progesterone injections was doubled as a precaution. However, there was additional bleeding and discharge a couple weeks later, and another ultrasound showed the pregnancy was lost. At that point, Dr. O was careful not to give us any false hope as we scheduled addtional follow-ups. However, he did not prepare us for the extremely unpleasant and painful side effects of the medications to induce completion of the miscarriage. That experience culminated in a 2am emergency room visit, narcotics to manage the pain, and another ultrasound the next morning when the clinic was open. After this last visit, Dr. O retired and we expect to be transferred to one of his colleagues, most of whom we met at one point or another.
Describe your experience with the nursing staff at Jones Institute for Reproductive Medicine.
Almost the entire nursing staff was very friendly, professional, and helpful in person. Their ability to draw blood from a patient with hard-to-find veins (my wife) varied significantly. Blood was drawn at every check-up, and I don't think they got her on the first try more than once or twice out of dozens of visits. Often it took 3 or 4 tries, and switching to less common and more painful areas.
One nurse, who unfortunately managed most of our phone and internet communication with the rest of the staff, was much less helpful than anyone else on the staff. Numerous times our messages were relayed with significant delay as well as inaccurately with regard to tone or even content. We dreaded communicating through the clinic's phone or internet "portal" for this specific reason, and feared any complaint would lead to even worse service from the same nurse. Several times I suggested switching our next treatment to different clinic, even though we were quite happy with almost everything else at this one, specifically because of this nurse and the "portal" communication system.
Managing prescriptions from local pharmacies was nightmare, due to convoluted preauthorization rules and documents to be routed back through clinic bureaucracy (combined with the fact the insurance covered almost nothing yet they kept trying to get approval). This often delays which sometimes came close to impacting treatment. However, Mandell's mail-order pharmacy (mostly for injections) was incredibly accomodating and easy to work with, aside from the unavoidable requirement to be home when the medicine was delivered.
Describe your experience with Jones Institute for Reproductive Medicine.
The clinic has been doing this longer than any other in the country. Framed photos of annual Mother's Day picnics with families the clinic has assisted are inspiring at first, but more painful to see after years without success. But the clinic also partners with Operation Hope/RESOLVE, and connecting to that organization was helpful in finding support and dealing with the heartbreak.
Many prescriptions from the clinic get routed and rerouted through a lot of unnecessary bureaucracy. As with every other medical estabilishment we've dealt with, bills and insurance decisions are incomprehensible. Payment was easy, and the clinic-provided installment billing plan for big-ticket fertility treatment was helpful (half up front, rest spread over 6 months with no interest) although there was a glitch with the automatic payment system.
Unfortunately the clinic insists on useing a "Patient Portal" system which is a gatekeeper to communication with doctors and nurses. The only effective way to communicate in real time is in person at an appointment. The "portal" system was consistenly an obstruction to communication and care. Eventually we learned what almost everything was routed through one specific nurse assigned to our doctor, and we believe much of the problem was with that individual, but the system itself was flawed in theory and practice. We are hopeful that since our doctor has now retired, we may have a different gatekeeper nurse when we begin treatment with a new doctor.
Describe the costs associated with your care under Sergio Oehninger at Jones Institute for Reproductive Medicine.
Roughly $15,000 for 4 IUI attempts, donor embryo program and transfer, medication, and associated tests.
Describe Sergio Oehninger's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Jones Institute for Reproductive Medicine.
We were very confused by apparently conflicting information about the number of frozen donated embroys available to us for implantation, and how many survived which stages of the process. This was eventually mostly cleared up, but it took several discussions with different people. However, the clinic policy of not allowing more than two embryos to be implanted was always clear.
What specific things went wrong at Jones Institute for Reproductive Medicine?
- Failed to call with results
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at Jones Institute for Reproductive Medicine.
On a couple occasions were were told to expect a call with test results by a specific time, but did not get it until the next day or until we asked.
During the embryo thaw process, we got initially got conflicting information about how many embroys survived, but this was eventually cleared up when we asked and got more detail about the different stages of the thawing and preparation process.
At 7 weeks with an implanted embryo, my wife had a suspected miscarriage in the middle of week of vacation in a foreign country. We sent a very detailed description of events and request for guidance to the clinic via the internet based patient portal system, explaining our concerns with the cost and potential outcomes of uninsured medical treatment in a foreign country with a language barrier. We got a response from the nurse through the "patient portal" system telling us to go to an emergency room with no attempt made to address our specific concerns. Because we did not feel that our situation was adequately considered but had no other way to communicate with competent staff at the clinic, we made a very difficult decision do go against this advice and wait until we returned home to address the issue with a visit to the clinic.