How was your experience with Shala Salem at Pacific Reproductive Center?
Good communicator and friendly. (A nurse practitioner actually did the iui procedure the second time and she was great, too.) Honest about success rates, but still hopeful and encouraging. Felt somewhat patient led in our treatments though, according to research I had done. Wondering how a less informed patient would get treated. Or perhaps because our tests came back with good results, it was more up in the air with what would work and what we could try, rather than tackling specific problems. Things like nutrition and supplements were only brought up if I mentioned them. She agreed with everything I was doing, but again, wondering about a different patient who didn’t do as much research. Not sure if she just didn’t think I’d need to be doing all the healthy things I am or what. She did say that not all of her patients want her opinion about nutrition, so maybe she has learned to gage how willing patients are to change their lifestyle. Our only hindrance in conceiving is that, while my husband’s sperm count is great and mobility is great, his overall volume was a little low. We tried 4 iui’s, which kind of have us equal chances to get pregnant at that point with people who have a normal volume, because they “wash“ the sperm and only insert the “best.” The count for the iui was higher each time than if we had needed to use donor sperm. With the last 2, we really seemed to find the right dosage of letrozole to produce two follicles, while having a great, thick uterine lining. However, none of the iui’s worked, so we have an appt to discuss ivf as the next step.
What's one piece of advice would you give a prospective patient of Shala Salem at Pacific Reproductive Center?
Do all the research you can and read It Starts with the Egg. Dr. Shala will answer any questions and won’t rush you, but it’s best to be self-informed as much as possible.
During treatment, were you treated like a number or a human with Shala Salem at Pacific Reproductive Center?
Very personable and listened to us. Always available to answer questions. She’s kind and straight forward.
Describe the protocols Shala Salem used in your cycles at Pacific Reproductive Center and their degree of success.
The first iui, we tried clomid because my husband’s coworker had success on clomid, though Dr. Shala had wanted to try letrozole first. Though I do not have any apparent issues ovulating or producing eggs, the idea is to hopefully produce at least 2 or more follicles to give us more chances to conceive. Each person responds differently to medication though, so it was a matter of trial and error to see what would work. She was perfectly fine to try clomid instead. In addition, I had read about women taking progesterone to also increase their chances to conceive, so this is something I brought up myself and Dr. Shala has no problem prescribing suppositories, which I would start using at night, the day after the iui, for two weeks until we tested. Though I do not have a luteal phase defect or some kind of progesterone deficiency, it was nice to know I was using these to help increase my chances and get my body prepared for pregnancy. There was always an appt once my cycle has started to ultrasound my uterus and check it’s “readiness.” Then I’d start taking the prescription. The first time being with clomid. A second appt was required shortly before ovulation to check my uterine lining and follicles. The first iui, my lining was at its thinnest, barely thick enough for the green light to do the iui. Then we’d do a trigger shot on the instructed morning. The trigger shot was used to time the iui, but also had some hcg in it to help the body prepare for pregnancy. The morning following the trigger shot, we did the iui procedure, with my husband producing the sperm at the location, an hour before the procedure. It was the same process all four times. The second iui, we switched to letrozole and my lining was thicker, but still only one follicle. The third iui, I took a doubled dose of letrozole and had two follicles ready, with a thick lining of 10mm. The 4th iui, we did the same doubled dosage and I had two follicles again; my lining was at 9mm. We were instructed that we could also have intercourse later on that day, to further increase our chances, which we did for all. Unfortunately, none of the iui’s worked, and we had not consulted about ivf yet, so we are basically missing out on this month with getting started with ivf. Part of me wishes we had consulted sooner, so that I could already be taking shots and starting the process, but we really wanted the iui to work (less money!) so perhaps it’s good to take a break?
Describe your experience with the nursing staff.
Everyone is kind and helpful. They’re knowledgeable as well and can answer any questions. Sometimes they do get backed up with appointments, but even when they feel rushed, they’d still take the time with you that was needed. I never felt rushed myself. My only issue overall is how I felt self-led in what was going on with the research I had done, so I’m still not sure what the experience would be like for someone less prepared. Again though, every single person offered to answer questions and you can always call in to ask as well. Sometimes information is repeated, too, because they’re all used to doing the same thing and going through the motions.
Describe your experience with Pacific Reproductive Center.
They only do certain things on certain days. Like, consultations are only Mon Wed and Fri. I went to the Corona location, but they only do iui’s there on those same three days, so food one iui, we had to drive out to their Irvine location. They are not open on the weekend, so I have no idea what would’ve happened if I were set to ovulate on a weekend date. They can get backed up and I’ve waited two hours past my appt time before, but I don’t work so I just deal with it. It’s not always like that. For initial testing, I had to get bloodwork done at Quest and do the HSG test at a different site, so not everything is done in house at this facility. They did the sperm wash and iui’s on site though. Had I gotten a positive pregnancy test, they said I would’ve needed to come in for a blood test, so I wonder if sometimes they can do certain bloodwork. I’m curious to find out what they can and cannot do during an ivf process.
Describe the costs associated with your care under Shala Salem at Pacific Reproductive Center.
It’s all dependent on what a person’s insurance covers. My insurance only covers diagnostic testing, not treatment. Each iui, with all the medications, appointments and procedures probably ended up being $1500 each time. They claim to have a special, thorough semen analysis test that they do on site, which is $125 each time, regardless of insurance. It’s the same for doing the “wash” prior to an iui. Some people come to this clinic just to get the semen analysis done and then the results are sent to whatever fertility place or regular doctor they’re actually going to.
Describe Shala Salem's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Pacific Reproductive Center.
We have not discussed this with our doctor yet. I personally am not sure yet if I’d like to do more than one at a time anyway.