Silvina Bocca

My initial consultation appointment with Dr. Bocca was in August 2018. Before meeting Dr. Bocca, I had felt discouraged. My husband and I have been trying to conceive for 4 years (now going on 5 years) with a history of an ectopic pregnancy that resulted in emergency surgery which later resulted in losing my right fallopian tube. We had also had a biochemical pregnancy while I was on Clomid prescribed by my OBGYN. I was on Clomid for 3 months. After those 3 months, we finally made the decision to schedule an appointment with Dr. Bocca. At the consultation, Dr. Bocca was very friendly, professional, and explained everything in detail. She answered all of our questions and concerns. She explained the lab tests that she was ordering and what results she would be looking for in those tests. She had changed my fertility medication from Clomid to Letrozole and explained in detail that the Letrozole would encourage a thicker uterine lining. She explained that Letrozole would be a better option because of my fibroid history. She also addressed a plan of action on getting a sperm analysis for my husband to rule out male factor infertility. Dr. Bocca recommended IUI for our next plan of action. She gave clear written instructions on the steps for my next upcoming ovulation cycle i.e. making appointments, taking medications, trigger injections. After leaving that first consultation appointment with Dr. Bocca, I felt encouraged and hopeful which I hadn't felt that way in years. My husband and I decided to do our first round with timed intercourse which resulted in a negative pregnancy. After that we proceeded with Dr. Bocca's recommendation of IUI. We have done 2 IUIs so far. My second IUI resulted in another biochemical pregnancy. After my failed IUIs, I had another appointment with Dr.Bocca to discuss the next plan of action. During that appointment, she was very compassionate and was aware that I was feeling grief. She explained to me my blood work results that was done days prior to the appointment. She had explained that it would be beneficial to have a Hysteroscopy to investigate the uterus, fallopian tubes, and ovaries. Along with the Hysteroscopy, she recommended that IVF is our next plan of action. While that was tough news to hear, she delivered that information in a compassionate and gentle manner. She made sure to take the time to answer any of my questions or concerns during that appointment. I am currently scheduled for the Hysteroscopy for next week.

I would tell the prospective patient of Dr. Bocca to trust the process. It may be a long road ahead, but under her care you will get the answers that you have been searching for. Always ask questions, share your concerns, and remain hopeful. This is Dr. Bocca's profession and she will leave no rock unturned.

She had changed my fertility medication from Clomid to Letrozole and explained in detail that the Letrozole would encourage a thicker uterine lining. She explained that Letrozole would be a better option because of my fibroid history. She also addressed a plan of action on getting a sperm analysis for my husband to rule out male factor infertility. Dr. Bocca recommended IUI for our next plan of action. She gave clear written instructions on the steps for my next upcoming ovulation cycle. I was instructed to call on cycle day 1 to make an appointment for an ultrasound around cycle day 10. I was also prescribed Letrozole 5mg and to take on cycle day 3 through cycle day 7. On cycle day 10, I would go in for an ultrasound to look at the thickness of the uterine lining and to look at the size of the follicles. If the uterine lining and follicles weren't measuring at certain size , the office would schedule another ultrasound two days later to look at the progress. After the ultrasound, if the uterine lining was thick enough and the follicle growth was at the recommended size; They gave me very clear written timed instructions with the "trigger" Injection which was Ovidrel 0.5mg. She explained that this would trigger the ovaries to release the follicles. Then, I would scheduled an appointment for the IUI. The IUI was performed quickly and easily.During the IUI, the doctor would explain every step that was occurring. After the IUI was performed, I was instructed to lay flat for fifteen minutes after the IUI. Afterwards, I was given clear written instructions to start taking Progesterone 50 mg suppositories at bedtime for 14 days due to low levels of progesterone and the date to take an at home pregnancy test. If the pregnancy test was negative, I was instructed to stop taking the Progesterone. If the pregnancy test was positive, I was to call the office to schedule a BETA lab (Blood work to confirm pregnancy). Sadly, after my second IUI, I had a biochemical pregnancy. After my failed IUIs, I had another appointment with Dr.Bocca to discuss the next plan of action. During that appointment, she was very compassionate and was aware that I was feeling grief. She explained to me my blood work results that was done days prior to the appointment. She had explained that it would be beneficial to have a Hysteroscopy to investigate the uterus, fallopian tubes, and ovaries. Along with the Hysteroscopy, she recommended that IVF is our next plan of action. While that was tough news to hear, she delivered that information in a compassionate and gentle manner. She made sure to take the time to answer any of my questions or concerns during that appointment. I am currently scheduled for the Hysteroscopy for next week.

The test that were associated with my care included: Basic semen analysis-$110.00 Day 3 bloodwork (FSH,LH,E2)-$250.00 in house, **Labcorp-$380.00 Cycle Day Ultrasound-$190.00 (done several times, insurance has been covering some costs of the ultrasounds). Intrauterine Insemination (IUI) with Sperm wash-$255.00 (IUI), $240.00 (sperm wash) **Have done this twice** Semen/Sperm Cryopreservation- $450.00 with $35.00 process with IUI preparation. Medications: Ovidrel Injection-$ 175.00 **Have filled prescription 3 times** Progeresterone suppositories (14 day supply) - $20.00 **Have filled prescription 3 times** Letrozole 5mg (cycle day 3-cycle 7)-$20.00 **Have filled prescription 3 times** An estimation of my current costs are between $3,000.00 to $4,000.00 as of 2/12/2019.

Dr. Bocca clearly loves what she does. I appreciate how much care she put into taking over my file after I stopped going to another doctor. She carefully reviewed my file and articulated next steps in a way that both my husband and I felt comfortable with. We are diagnosed with male factor infertility and we both felt that with our other doctor, my husband was cut completely out of the discussion but doctor Bocca is great about including both of us.

Come with questions and a notepad. She's great!

We did five donor sperm IUI cycles with another doctor. Three natural and two with letrozole and trigger shot, and progesterone. After Dr Bocca took over my file, she thought it'd be helpful to do a hysteroscopy. In that procedure, she found and removed a few uterine polyps, we will be pursuing a sixth IUI cycle with letrozole and gonal f, trigger shot and progesterone.

$250 per IUI, plus the cost if the sperm and medication. I've gotten quotes for IVF with ICSI at $12,000ish.

N/A.

Dr. Bocca has been helpful providing guidance regarding my diagnosis and recommendations for treatment. She has also been honest about the success of certain treatments. I was a little deterred from seeing her again as during our second conversation she initially only recommended an egg donor due to my diagnosis, but after another face-to-face appointment where my spouse was also present, she discussed the diagnosis a little further and what other options might be available.

I would definitely schedule regular appointments with her (perhaps monthly) to check-in and determine next steps for treatment. Ask questions and educate yourself on the options that she presents.

We wanted to try an initial protocol to try to conceive through timed intercourse as the least aggressive/invasive option. She recommend ovulation induction with a trigger shot and progesterone suppositories. The medication that we used for induction was gonal-f, which is an injectable. We are currently on our second month of treatment. If this cycle is not successful, she has recommended that we attempt IVF on the next few months to determine the quality of my eggs.

Two months of injections with timed intercourse have cost us over $4000.

Dr Bocca is very intelligent and knows her stuff. She has a way of being compassionate yet very direct in communication. I have always felt like she has my interest at heart. I’ve lost two babies to miscarriage in this process so there have been times where she is quick to diagnose. I think it shows her knowledge and sometimes it’s helpful to spend more time. However she is always willing to do whatever I need to do to make things easier to process.

In the beginning she is difficult to see because she is so popular. Probably one of the hardest to get an appointment with. But she is very knowledgeable about many things when it comes to endometriosis.

For my retrieval process I started with Lupron due to having endometriosis. I overstimulated this cycle and they canceled a fresh transfer due to being hospitalized. I think that was a good move because I was sick for a very long time. For frozen transfer I used patches/pills and IM progesterone. The first cycle we transferred 2 blasts and had successful twin pregnancy. We did lose one baby in the first trimester. Second frozen transfer was completed this month with success and literally completed a DNC this morning to complete the miscarriage. We have now decided to do genetic testing as a result of this due to losing to babies with viable heartbeats.

The medications were some of the most expensive. I spent 4000 on meds for first cycle. I did have insurance pick up some of price but the most helpful thing is they bill me whatever is contracted pricing. I’ve had to pay for two frozen transfers which are a couple thousand each time. However I’ve had other experiences such as OHSS they required several days in a hospital. I’ve also just recently had to have a dnc due to missed miscarriage. All these extra costs are outside the normal fertility treatment.

Our clinic was ok transferring one blast due to the high quality of embryos I had. Initially I was ok with twins and we transferred two but we did not continue that the next transfer

Dr. Bocca is patient, a great communicator and is easy to understand. She doesn’t use too much medical jargon and fully explains all procedures and possible outcomes. She always takes the time to answer all my questions and concerns.

Don’t be afraid to ask questions and request alternative medications (for instance, if you know of a cheaper option).

I tried IUI twice earlier this year. Each time, I started with five days of femara, cd 3-7. Day 8 I would go for an ultrasound and they would prescribe my dosage of menopur. I would do 3-5 days of shots of menopur while getting ultrasounds every few days to check my egg growth. Once they were a good size (she liked 17 or larger). When my eggs were large enough, I would take the ovidrel trigger shot. Within the next 36hrs my husband and I would go in for the IUI. I did femara and menopur because dr. Bocca said she wanted to see two large eggs at the time of IUI and I had a history of only one egg from just the femara alone.

The overall cost of IUI including medicine was close to $3000.

Dr Bocca did a good job of explaining treatments to us, and took plenty of time to talk to us. After my 11 week miscarriage, she had a nice long appointment to talk to us. Dr Bocca is compassionate and caring. However, I didn’t get a whole lot of statistics from her or numbers when it came to my chances of success with different courses of treatment. Sometimes her nurses have trouble communicating with her (as in the nurses didn’t get back to me)

Do some research on treatment options/ infertility basics before you meet with Dr Bocca or any doctor. Be sure you are your own advocate when communicating with Dr Bocca’s team- they don’t always get back to you.

We did two cycles of clomid/ letrozole with cycle day intercourse/ ultrasound/ ovidrel injection. Then we did two rounds of injectable hormones with monitoring and timed intercourse. I got pregnant the second time. All signs looked positive and things were going perfectly until I miscarried at 11 weeks due to a trisomy 14 abnormality. We then did one more cycle of injectables and iui with a chemical pregnancy. We have now moved on to ivf at another clinic that has a shared risk/ money back guarantee program and higher success rates when I comes to ivf.

My insurance covered our ultrasounds when we did timed intercouse with pills or injections. However, it did not cover any of our drugs or ultrasounds with iui. We spent roughly $1500/ month each cycle we tried

N/a

Dr. Bocca was very accessible when she was in town. She is knowledgeable and had a wonderful bedside manner. I just felt like I was going through the usual infertility routine and fell through the cracks. We completed round after round of timed intercourse with injectables. There was no change in my treatment even though we asked at the first meeting to go right to IVF at any point in the beginning if it seemed necessary. The only change was to try IUI and that was unsuccessful. Every month I just kept doing the same thing, that was not working. Then I found myself through a full calendar year with no change. It was stressful.

Do your own research and manage your calendar and meds yourself. Ask lots and lots of questions about what is next so that you are prepared and have your meds ready.

We completed round after round of timed intercourse with injectables. Twice out of the 12 months of being there, we tried IUI was was unsuccessful. Other than the IUI, every month I just kept doing the same thing, that was not working.

Since I was mostly getting blood draws and ultrasounds, the cost was ~$200-$400 a cycle. My insurance assisted some. For the monitoring patient only visits, they will not process through your insurance for you so it's $500-$600 a visit.

She has a very sunny disposition and a positive outlook. She has been my primary physician since 2009 for infertility and she has kept my hopes up when I was down. She is very focused on how I am 'feeling' and has been able to gently tell me things that I perhaps didn't want to hear. We had numerous frozen embryo failures and she told us to take a break for a few months to take the pressure off. She was also compassionate when we decided we had reached our last fresh cycle attempt.

If you want someone with glass half full, she is for you. If you are more of a glass half empty person or have trouble hearing bad news or set backs, you may want someone else.

We had minor issues for ourselves, but not enough to be guaranteed natural pregnancy. We did one cycle of IUI which failed and we decided we were better off doing full retrievals. We started on Lupron protocols which we did twice, we had one failed cycle because I was too suppressed by Lupron. They offered us our money back or to hold it for a new cycle. They put me on ganerilex instead and we went forward with three more full cycles. I also had enough frozen embroys for 8 other frozen cycles - only one took. I have 5 children now, 3 singletons and 1 set of twins. The program also got a new embroyologist recently who increased their blastocysts success rate to 60-70% survival. I have multiple blastocysts on ice. In that time Dr. Bocca stopped recommended day 3 transfers and went to day 5.

fresh cycles were 15000 all inclusive but you got a discount for repeat business. Frozen cycles were around 5000, separate ultrasounds were 300, medications were not sold by the clinic and had to be purchased at specialty pharmacies. 6 years ago IUI was 600

She originally recommended against multiple embryo transfers because I had gotten pregnant with two cycles back to back. I didn't mind twins so we started out on 2 embryos. When we failed and looked at our finances, we started doing 3 at a time. She recommended single blastocyst transfer also because of their increased twinning rates. I don't mind twins so I had 2 and 2 took. They never allowed you to put in more than 3.

She has been amazing and very thourough with our treatment plan. We are a week away from retrieval and she has given us confidence every step of the way with the treatment plan. She was also easy to set appointments with which was amazing. She also recommended a specialist for my husband which made things smooth for our family planning.

Dr Bocca truly is one of the best Dr I have seen and she is very kind, upfront, and honest about treatment plans and expectations. Come with questions because she will take the time to go through everything in detail with you.

We have male factor infertility (blockage) and IVF with ICSI is our treatment option. We are currently doing stimulation leading up to our egg retrieval. We will then be implanting 2 embryos if all goes well with the retrieving and fertilization. Our fertility issues as a couple are male only and so far I have been on the low end for stimulation drugs (follistim) as my hormone level are good. Medication seems to be working great and my dosages for stims has stayed the same since starting 4 days ago (250cc). So far we are right on track with our treatment plan and have had no surprises.

1,500 - ICSI 12,000 - IVF w/ ICSI 2,757 - medication 400 - anesthesia Initial Consultations - 260 Hydrosonogram- 1,000 Pre blood work - 300

We decided to do 2 embryos for our first round as I am young and healthy. Our doctor would never do more than 2 and that is something we would not want either.

Dr. Bocca is very nice and understanding. She seems knowledgeable. I felt like she has our best interest at heart. It's been easy to communicate with her and her staff. I found that if I call I might wait for a response but with an email I get a response within 24 hours.

Be prepared with questions (write them down). If you need to get in touch with her(her nurses) send an email using FMH (Follow My Health) portal. Don't stress about money- they work with you on payment plan.

I have PCOS and don't ovulate on my own, I also have one blocked tube. Dr. Bocca put me on Femara/Letrozole because it makes me produce more eggs than Clomid and the chances of ovulating on the side with open tube are higher. My husband has liw morphology so she recommended IUI. We tried 2 but they were unsuccessful. We're considering going straight to ivf now

My insurance didn't cover treatment: First visit - $190 Other visits -$60 Hysteroscopy $2,000 HSG -$600 IUI -$250 Sperm wash for IUI -$140

The initial visit was very knowledgeable and left us with a good feeling of where to start. There wasn't much of a breakdown surrounding cost and what we could expect in term of finances we had to do some research. Overall it was a great experience for someone who had no idea what to expect.

I recommend that you ask all the questions that you could at the initial consultation because you will not be able to have many opportunities' to do so. Come prepared with all of your questions written down so that you don't miss anything. She was very great about answering any questions or concerns.

The Process for IUI cost average $345 per insemination, $50-$100 for consultation, $100 per hormone injection per cycle, $25 for co pays, suppositories averaged $40- $50, Ultra Sounds $50- $100, blood work $0.00 included with insurance

Dr. Bocca is very knowledgeable in her job. She brings out articles, pictures, and diagrams to explain things to her patients. She only did consultations and another doctor did the procedures. This did not bother me because the two doctors always spoke with each other and knew each patient.

Be aware she does not do the procedures.

We started with IUI with letrozole. Took letrozole days 3-7 of cycle and then ultrasound day 11-14 (I think) to see if follicles growing. No blood work in between for hormone levels. Second IUI I asked to increase letrozole and dr. Bocca agreed. Same timing with ultrasound and then IUI the next day or 2 depending on your follicle growth.

We did 2 IUI’s and paid around $1200

Dr. Bocca recommended 1 transfer. The max they will do is 2. She ultimately left the choice up to us as the patient.

During my experience with Dr. Bocca I felt that she was very knowledgeable. However, I did not feel that she explained things as thoroughly as I would have liked. During my IUI the results from my husbands sample came back much lower than any other tests had. She did mention this to me during the procedure and noted that we would still have a small chance of it working. however, I got the idea that she knew it probably wasn't going to work, so I'm wondering if we even should have gone through with it or waited to find out what was going on from his end.

When she tells you something during an appointment don't feel that you need to just go with it and let them be on their way. Ask the Dr. to sit down and explain things to you thoroughly.

The IUI procedure cost close to $1,200 with everything involved.

I genuinely felt safer in my decision process knowing she was behind them. She was easy to talk to and gave great advice and didn’t make me feel like an idiot for asking hundreds of questions! She helped guide us to make decisions that worked best for us!

Be honest with her about your feelings, she won’t know unless you tell her

So we had come to a cross roads where we could go towards IVF , but she wanted us to try an ovulation induction that required a lot more medication including injectibles - follistim and ovidrel - my body reacted positively and we were able to conceive : unfortunately that pregnancy ended up in miscarriage after 10 weeks and 2 days but we had not been able to get pregnant before this so truly grateful to continue with Dr Bocca on this journey!

My insurance didn’t cover it with one job, and now it does

She was very good at explaining things. She was the first doctor that we saw when we started this whole journey so she really laid the groundwork for our whole understanding of everything. She answered all of our questions, she was prompt and through on our scheduled meetings with her.

To come to the appointment with a paper and pen because she is going to give you a lot of information.

We did 2 times intercourse treatment with Dr. Bocca and one IUI--I don't really remember the treatment protocol- I just remember her being very hopeful that the times intercourse with the trigger shot would work because we had done so well on every test prior to trying her treatment.

I believe was paid around 3000.00 for the IUI-- not including medicine

Dr bocca is one of the best doctors I've ever seen. She is very nice professional and good at what she does. Best doctor ever. She makes sure her patients are seen as mothers and fathers to be not patients.

Pick her shes the best.

She did an HSG on me found out I had hydrosalpinx and referred me to a dr ito to have surgery for the removal of the tube in order to be able to start ivf.

The testing my insurance covered but as for ivf treatments they sint cover or meds but they have payment plans with half down of full ivf

As a patient of Dr Bocca I was very hopeful of the out come of my IVF cycle. She was very knowledgeable of the process and very helpful with all my questions. Each visit with her I loved that she tried to get to know me and my family. She even notice my weight lost, which I loved. I just really felt like she cared and understood my cries every time I left the office

Advice I would give would be try to remain positive and try not to stress. You are in good hands

Due to my elevated FSH levels I receive a high dose to increase my chances of eggs. Unfortunately I didn’t produce them and had to cancel 3 cycles

All care was extremely high, my insurance covered nothing which was why I had to stop treatment

Doctor Bocca was kind and very good at explaining procedures before we actually did them. She was always very optimistic. I was diagnosed with polyps and went in to see her after several failed treatments. She was able to remove the polyps and explained every step of what she was going to do and then for post-op, she thoroughly explained the results and asked for my input on the next steps.

Learn as much as you can and be your own advocate.

IUI's were about $800 total with medications, sperm wash, ultrasound, and actual IUI.

Dr. Bocca is very thorough and responds to all messages. She answers all questions and makes sure you understand before you leave the office. If you send a email she always gets back to you within the same day. She will make timelines to better help you understand how the treatment will work. At the follicle scans she is so good about including my husband and I in explaining.

Dr. Bocca has a way of keeping my fertility reality, which is being post menopausal at 30-years-old due to cancer treatments, hopeful, but at the same time realistic which is a combo I fully appreciate as a patient.

Understand, that she is honest, and wants you to have a successful experience as much as you do.

Something to remember is science is constantly changing. In 2010, my leukemia relapsed and Dr. Bocca decided to put me on a trial to remove half of my ovary and save ovarian tissue with immature eggs to one day possibly transplant that tissue back on to my ovary for me to produce an egg. I was #13 on the study. Now they know, to get the cancer patient in remission, do fertility treatments to produce mature eggs to freeze. Science is awesome! She made the right decision for the science that was available at the time.