Spencer Richlin

Dr. Richlin loves his job and loves helping people. I like that he's very open and honest. He's extremely positive, which is nice, even though when I first started I was totally depressed and in shock that I was having trouble getting pregnant at all (I have unexplained infertility, so wasn't expecting that) and I didn't always cheer up from it, but being on the other side (my son is now 2.5), I appreciate his attitude. Whenever I would do my own "research," I would get so nervous about potential side effects or negative outcomes, and Dr. Richlin would always discuss them, and he was ALWAYS right about what to expect and the true likeliness that something bad would happen. I didn't tend to experience a lot of side effects from anything (even pregnancy), so others may have had different experiences, but that's what happened with me.

Get ready to get used to talking about all those intimate details and explore your reproductive system (did I mention I was traumatized at first? I had never seen a transvaginal ultrasound before...nor did I prefer male doctors)--he makes it totally normal and comfortable, and I really appreciate that. And he is just so positive, so let it lift you up in what can be a really stressful time!

Antagonist protocol: Follistim 150iu + Menopur 75iu, Ganirelix .25mg I was put on very low doses and ended up being a high responder: 22 eggs retrieved, I think 21 were mature, almost all fertilized, but many arrested between days 3 and 5, so possible egg quality issue--the cycle resulted in 4 embryos. We did not do PGS. First fresh transfer was eSet with negative pregnancy test. Next month did FET with two embryos and my son was born from that cycle :) About a year after that we transferred our last remaining embryo, which resulted in a miscarriage--HCG levels were not rising appropriately, I think it was the 5 week ultrasound that showed a strong heartbeat, but unfortunately the following week ultrasound showed a miscarriage. I'm looking to begin a new cycle in a few months, but I don't know what protocol he will put me on this time.

It was well-run. The early morning hours were never a problem to get to, and I've seen them when I was an online/working-from-home student and working full time. If you can't make the morning hours, I hear they can fit you in during the day, but still might not be convenient depending on your work. Infertility is just not that convenient, though...

Most was covered through CT fertility mandate (covers diagnosis and 2 cycles), but I was unclear about what counted as a cycle (both egg retrieval AND frozen transfer do...I know that now), so I ran out of coverage pretty quickly. Was also on a different insurance for a little while that didn't provide as much coverage.

I believe their goal is to use eSET as much as possible. For my situation--30yo with unexplained infertility/no big red flags--it made sense to do for our first transfer. After a negative result, and judging by my embryo grades (very average), they decided to put two in. Yes, they explained the risks.

As mentioned in my previous post, Dr. Richlin is very relatable which was/is extremely important to me during this process. Along with being relatable, he takes the time to thoroughly explain each part of the treatment cycle, statistics based on age/treatments etc, suggestions and his recommendations. He using PowerPoint slides to visually review and dumbs everything down to make it easy to understand which helps limit the stress in an already stressful situation. During procedures and testing/ultrasounds Dr. Richlin’s disposition is calm and he eases the situation through conversation, questions. I’ve had a very positive experience with Dr. Richlin. While I’m not yet at the end of my journey, I am confident I am in the right hands and my outcome will be positive in the near future.

Be patient & even keeled. While the start of fertility treatment can be terrifying, it can also be very exciting. Don’t think that the first round of treatment will automatically work, however it’s important to stay positive and optimistic. Try to remember that the best things in life take time and your hard work and efforts will eventually payoff- emotionally, try not to get too high or too low-and most importantly never give up!

3 Rounds of IUI Rounds 1 & 2 letrozole for 5 days (2.5 mg , 2 tablets daily) Bloodwork and Ultrasound-2-4 mature follicles both rounds Trigger Shot, ovadrel Sperm retrieval and washing (2 consecutive days) Sperm implantation (2 consecutive days) estrace and progesterone meds Negative pregnancy tests Round 3 letrozole for 5 days (2.5 mg , 2 tablets) Menopur injections 4 days (half vial) Bloodwork and Ultrasound - 3-4 mature follicles Trigger Shot, ovadrel Sperm retrieval and washing (2 consecutive days) Sperm implantation (2 consecutive days) estrace and progesterone meds Negative pregnancy test IVF put on hold because of Covid-19

Rounds 1-2 of IUI(oral meds)= $3,500 each Round 3 of IUI (oral/injectable meds)= $6,000 * meds are billed separately so I’m not sure why there is a price difference between the two. IVF= 17k *not including meds

My doctor is highly against a multiple embryo transfer for a few reasons: my age, the risk caused by a pregnancy of multiples, and my diagnosis (unknown infertility).

Dr. Richlin is fantastic. He knows his stuff as well as he cares about his patients. I worked with him for 2 years prior to our first RMA baby and we have been at it again for the last 14 months. When my husband and I first met with him, we were eager and optimistic. Dr. Richlin connected with my husband (as well as me) and made us both feel comfortable being in the unfamiliar office, with unfamiliar technology (the vaginal ultrasound wand is no joke!). As we progressed through diagnostic procedures without unveiling answers, I got more frustrated, but Dr. Richlin stayed with me, motivating me and explaining what "unexplained" means. He also gave insight into what we were finding and helped us understand our options. After the required (by insurance) 3 IUI's, we headed into IVF. When we had no embryos on day 5 after our first retrieval, Dr. Richlin called me in shock. Hearing the surprise in his voice made me feel better. I was not a number, I was a future success story, but he was as frustrated as me by our roadblock. After another failed retrieval, he took our chart to "case review" to get his colleague's opinions. I love that he was humble enough to do this and that the others cared enough to help. What is better than 1 amazing brain? 5 of them! We kept tweaking the protocol and ended up with something that worked. When it was time for us to come back for baby #2, he welcomed us with open arms as though we'd never left. When I more recently had a miscarriage, he followed up via phone and email to see how I was doing. Knowing I have his support and that he is walking with me on my journey makes it so much easier to walk back through those doors.

Don't be afraid to ask questions! He will gladly take the time to explain something to you, or work through a scenario with you. He is a great listener and wants to know your concerns.

3 IUI's - standard protocol 1st retrieval - standard protocol, nothing made it to day 5. PROTOCOL: 1/15/15 - baseline ultrasound and bloodwork; 1/17/15 - Dexamethasone 1/2 tablet in AM, Gonal F 300 + Menopur 75 at night; 1/20/15 - ultrasound and bloodwork; 1/21/15 - dexamethasone continues, start Doxycycline 2x daily, Gonal F 300 + Menopur 75 x2 + Ganirelix; 1/22/15 - Ultrasound and bloodwork; 1/24 - ultrasound and bloodwork, 1/25 - ultrasound and bloodwork, last dexamethasone, HCG trigger, Gonal F 300 last time; 1/26/15 - bloodwork; 1/27/15 - retrieval 2nd retrieval - Luteal Estrace/Antagonist. 2 blasts on day 5 (very very low quality) (untested); PROTOCOL: 3/2/15 - bloodwork; 3/2/15 - start estrace 2mg twice daily, start baby aspirin; 3/12/15 0 ultrasound and bloodwork; 3/14/15 - Gonal F 300 + Menopur 75 at night; 3/14/15 - start dexamethasone 0.5mg 1/2 dab orally every am until taking HCG; 3/15/15 - last dose of estrace; 3/17/15 - ultrasound and bloodwork; 3/19 (or around then) start ganirelix (.25 prefilled syringe) and possibly started menopur; take HCG 10,000 units or Ovidrel 250 (mcg) 36 hrs before retrieval; The night of the retrieval take Medrol 16mg for 5 days, also start Doxycycline 100mg 2x/daily for 5 days. Start Estrace 2mg 2x/daily after retrieval and begin Crinone 90mg the morning after retrieval (prep for fresh transfer) 1st transfer (FRESH) resulted in a negative pregnancy test (PROTOCOL - see above) 3rd retrieval - IVF with Luteal Estrace/Antagonist - resulted in 1 embryo on day 6 (untested); PROTOCOL: 4/27/15 bloodwork; 4/27/15 start estrace 2mg 2x daily, start baby Aspirin; 5/11/15 - ultrasound and bloodwork; 5/12/15 - Gonal F 300 + Menopur 150 every evening also Dexamethasone 0.5mg, 1/2 tablet orally every morning until HCG; 5/13/15 - last dose of Estrace; 5/15/15 - ultrasound and bloodwork; 5/17/15 (or around then) - begin Ganirelix and likely Menopur; HCG 10,000 units 36 hrs before retrieval 4th retrieval - Luteal Estrace/Antagonist - resulted in 1 embryo on day 6 (untested) 2nd transfer (frozen, used 2 blasts) resulted in a positive pregnancy test. One fetus was lost at week 7, other is a precious 2 year old :) Used estrace valerate to support my estrogen numbers. --break due to pregnancy and nursing-- 5th retrieval - did luteal phase priming - resulted in 4 high quality embryos on day 5. None were tested. (at this point, I've been on NeoQ10 for almost 5 years, otherwise the result was a surprise) PROTOCOL: 2/19/18 - bloodwork to confirm ovulation; 2/19/18 - start estrace 2mg orally twice daily, start taking baby aspirin; 3/5/18 - return for ultrasound and bloodwork; 3/6/18 - Gonal F 300iu + Menopur 150iu every evening; 3/7/18 - last dose of estrace; 3/9 - ultrasound and bloodwork; 3/11/18 (or around then) started ganirelix and may have increased menopur 3rd transfer (frozen, using 2 blasts)- used estradiol valerate and copied the protocol from transfer #2 - negative pregnancy test. PROTOCOL: 4/10/18 Start Estradiol Valerate (0.2ml (4 mg) injections. One injection every 3 to 4 days so that you are doing them 2x a week. Start baby aspirin daily. 4/20/18 - REturn to office for bloodwork and ultrasound. 4/21/18 - Start Progesterone 50mg (one cc) IM @ 12pm alternating every other day with Crinone one vaginal insert 2x daily. Continue Estradiol Valerate at the same dose and schedule. 4/26/18 - Transfer day. Use Crinone, one insert vaginally in the morning. 5/4/18 - Pregnancy blood test 4th transfer (frozen, using 2 blasts) - used estradiol valerate and copied protocol from transfer #2 - positive pregnancy test, week 6 demise of both pregnancies. I had a heterotopic pregnancy/miscarriage, resulting in a ruptured right tube and a D&C. PROTOCOL: 8/9/18 Start Estradiol Valerate (0.2ml (4 mg) injections. One injection every 3 to 4 days so that you are doing them 2x a week. Start baby aspirin daily. 8/22/18 - REturn to office for bloodwork and ultrasound. 8/25/18 - Start Progesterone 50mg (one cc) IM @ 12pm alternating every other day with Crinone one vaginal insert 2x daily. Continue Estradiol Valerate at the same dose and schedule. 8/30/18 - Transfer day. Use Crinone, one insert vaginally in the morning. 9/7/18 - Pregnancy blood test 6th retrieval - this was rushed due to squeezing it in before the end of our insurance cycle, we didn't want to "leave money on the table" - resulted in no embryos on Day 3 - quite a shock to have none * I also do acupuncture 2x a week when in cycle, whether it be a retrieval cycle or a transfer cycle. I do laser acupuncture before and after the transfer. ** I take a prenatal, DHA supplement, NeoQ10 and folic acid regularly

Morning monitoring is not awesome, but the waiting room is well-stocked with coffee, tea, TV and on the weekends, bagels. It is first come, first served, but we sit waiting for our name to be called in a very comfortable place. Once your name is called, you go do bloodwork and from there they take you to an exam room. About 15% of the time, the exam rooms are all full and you go back to the waiting room and have your name called again for the exam room. The exam rooms are pleasantly decorated in peaceful tones, but are otherwise exam rooms. The primary facility (where I go) was opened in 2015, so it still feels fresh, clean and new.

We are very fortunate to have had many of our procedures covered by insurance. I believe we paid a total of about $30,000 out of pocket for our first child ($20,000 was covered by insurance). We've now paid approximately $10,000 (in deductibles) for our second go-round.

Yes. I did not know what to do and felt very comfortable asking him to make that decision. Transfer #1 - fresh transfer, 2 embryos very low quality - it wasn't discussed too much. I think the doctors knew there was a slim chance either would work. Transfer #2 - I was mentally exhausted and questioning whether I should even do the transfer. I wanted to only transfer 1 and possibly have the second for a second baby, but I also barely had it in me to go through one transfer cycle. Dr. Richlin talked to me about the consequences of transferring 2, and then said he thought I should do 2 based on my mental state. I needed to get on with things (we were talking egg donor if it didn't work). My husband and I discussed the possibility of having twins and we were excited about it. I was 35 at the time. Transfer #3 - I was 37 and we discussed it, but transferring 2 seemed like the right thing to do. Transfer #4 - There was a brief discussion, but we were comfortable transferring 2. **After the miscarriages from transfer #4, we will now get any embryos tested and only transfer 1.

Dr. Ritchlin always a has such a positive attitude. It is very clear that his end goal is to get us pregnant. It is evident that he is passionate about our goals and is our biggest cheerleader. He wants success for us and that is evident.

Make sure to ask questions specific to outcomes so that he can further explain the rationale and reasonings.

We first started in April 2018 with clomid and timed intercourse. That did not work. We then went into doing 2 cycles of IUI which neither worked. It was our choice to proceed with an IVF cycle instead of waiting one more round of IUI. IVF started in August with stims and a retrieval followed by 3 frozen transfers: September, October, December. We are currently prepping for our second IVF cycle.

I have always had a super short wait period for bloodwork and morning monitoring. I have never waited more than 5-7 minutes.

So far, we have paid roughly $25,000 - $30,000 for our cycles and medications. This also includes roughly $1,000 for acupuncture appointments, $175 mental health appointment and the rest is what insurance did not cover.

Dr. Ritchlin shared the concerns about doing multiple embryo transfers and we agreed that single embryo transfers were the best option for our cycles.

He is very helpful and caring. He gives good detailed explainations of everything that is going on, but in a simplified condensed manner that really brings the most important things to light while allievating fears.

Ask which office he is currently rotating at to ensure you can see more of him!

Did a birth control start into a Lupron microflair protocol with gonal f and Menopur and a hsg trigger. This was due to my age factor. Next protocol will be similar but with an estrace priming due to low number of mature eggs in last round.

Morning monitoring was from 7-8am and this generally worked out well. As long as you got there near 8 they would still see you. There was a wait at times for bloodwork depending on how many people there were but it was usually fairly quick to be seen.

Insurance was denied so out of pocket Opportunity Plan was $20,000 for PGS and one round of IVF with 10 days of medications included. We paid for one additional day of meds for $500. Diagnostics and genetics testing were covered under insurance since we got our max out of pocket.

Dr. Richlin is an amazing doctor. He’s kind, caring, gentle, professional, helpful, and wonderful to work with. He asks you personal questions to get to know you and tells you personal information about himself as well. He makes you feel totally comfortable and humanizes the doctor/patient relationship. He likewise makes what could be a stressful or uncomfortable experience, the opposite. Initially I saw a different doctor at RMA but after meeting with Dr. Richlin and having him do a few of my exams and my first IUI (even though I was technically seeing another doctor), I switched to his care as soon as I could. That's how nice, helpful, compassionate, and competent he is. He always makes you feel at ease and calm, as well.

You'll feel comfortable in a situation that could otherwise be uncomfortable.

Cycle 1: Clomid 50 mg; injectable ovulation trigger; 2 IUI's on back-to-back days; progesterone supplements Cycle 2: Clomid 100 mg; injectable ovulation trigger; 2 IUI's on back-to-back days; progesterone supplements

Insurance covered my IUI's so I only had to pay co-pays for visits and medications. Maybe $10 for progesterone and climid. $150 and then $75 for the ovulation trigger injection (based on my own insurance deductible) For 4 IUI's (2/cycle and I did 2 cycles), which included numerous morning monitoring visits and blood tests, it was only a few hundred dollars.

He was very understanding and put us at ease. He explained to us step by step and was able to tell us what will happen next and what he suggested. He did factor in our opinions. When we were paying out of pocket for the treatments (insurance didn't cover anything) and had 4 failed timed intercourse (letrozole medicine, ovidrel shot) cycles, we were hesitant to continue with another round of timed intercourse. He sat down with us and weighed our options, doing another round of timed intercourse vs jumping into ivf cycle. The only thing I was hesitant about, was when we initially came to meet him, prior to any treatment, he seemed way more optimistic than he should've I felt. He said you should have no problem getting pregnant based on my levels. And it's been almost 9 months later and.... no success with anything. It's certainly not his fault what So ever, just wish he didn't give me that false hope in the beginning of treatment. But overall, he's been cheering us on, and helping us along the way with any details.

Understand he isn't G-d. He isn't guaranteeing a pregnancy, so don't be too hopeful (no way near his fault). He is there to guide us professionally and maximize our opportunity to get pregnant.

I had to pay for everything out of pocket, which every cycle with a timed intercourse was 2000 dollars. Prior to that I had several tests done which in itself was closer to 3000. Medicine was also not included.

As of 2017, in CT, it is a law they are no longer allowed to implant more than one embryo during each time, unless there is a certain circumstance (e.g. above 35 yrs old)

My experience with Dr. Richlin was very positive. The first time I met with him, I met with him on my own and he was very reassuring and helpful. Each staff member that I encountered was friendly and welcoming and made sure I was comfortable. Questions were always answered promptly if I was unable to get in contact with someone right away.

He is very reassuring, almost to the point that I felt there was no way my treatments wouldn't work. Unfortunately, I have not gotten pregnant yet and felt very disappointed each time, which is to be expected. The advice I would give is to remember that nothing is guaranteed, a doctor can't possibly know for sure if something will work for you so...I would say be cautiously optimistic.

Dr. Richlin recommended I try timed intercourse with Clomid. The first dose of clomid was too little and follicles did not grow large enough for the trigger shot. He gave me a higher dose of clomid immediately, which did the trick as my follicles were large enough for a trigger shot. I gave myself the trigger shot as directed, ovulated, and had timed intercourse as directed. I went in for a blood test about two weeks later and it was negative. I then began my next cycle with the larger dose of Clomid and did the whole thing all over again the same way with the same results. For the third round it was recommended that I switch to letrozole, but I declined to go for another round because there was some factors in my life that caused me to need to put things on hold.

My insurance covered everything.

N/A

Dr Richlin was, from the beginning, extremely open, honest, compassionate, and took a deep interest in our situation. Unfortunately, our first pregnancy ended in a loss due to chromosomal issues. Dr. Richlin called me personally to extend his sympathies and stress that he and the team were there for us whenever we were ready to move forward. He never hesitates to check in, answer questions, go into more detail, and make sure that we're comfortable with where we are and the next steps. He takes the time to point out everything he's looking at during ultrasounds and explain what he sees. He's so thorough and caring in everything he does.

He's chatty! I like that, because I'm chatty as well, but if you're looking for a doctor who just presents the facts with nothing else, Dr. Richlin isn't the one for you. But if you want a doctor who is more than willing to go into tiny details and talk about anything with you, he's the one!

I have annovulatory PCOS, but no other fertility issues, so we started with Femara and a trigger shot for ovulation induction and a timed intercourse cycle. Our first cycle was successful in that we conceived, but we lost that pregnancy at 15 weeks due to chromosomal abnormalities. Our second cycle we followed the same protocol and were successful as well. We are awaiting genetic testing on this pregnancy. Usually patients start with Clomid, but due to my history of depression as well as the risks of non-ideal cercival mucus and uterine linings, plus the slightly higher risk of multiples, I asked if Femara would be an option. He was immediately on board. I liked that he was willing to brainstorm different possibilities with me.

Ovulation induction was covered under our regular health benefits, with the exception of the trigger shot which came out of our fertility benefits. We had very few out of pocket costs other than the prescriptions and some copays for office visits.

Dr. Richlin is a friendly and knowledgeable physician. However, he explains procedures very quickly and does not respond to emails in a timely manner. While he is my assigned physician he did not complete my IUIs and there is a strong possibility that another physician will complete my IVF.

Since Dr. Richlin works at RMA be prepared to feel like a cog in the fertility machine.

I had two medicated IUI that did not result in a pregnancy. My first round of IVF medications resulted in a poor ovarian response. While he was encouraging me to complete the round of IVF I decided to cancel.

Insurance covered 75% of the cost. I was overly charged for certain fees that my insurance covered. I had to wait several weeks to get reimbursed.

Dr. Richin didn't explain any negative aspects to multiple embryo transfer to me.

Dr. Richlin was beyond compassionate and thorough when I was going through the chemical pregnancy and the miscarriage. He monitored me daily through ultrasounds and bloodwork and kept me in the loop with everything happening. I couldn’t have asked for a better doctor to get me through one of the most difficult things.

Relax and let him do his job-he’s extremely smart and you can trust everything he says.

As a practice, they don’t like to transfer more than one embryo because it is very unhealthy for the patient and baby (orbabies). Multiples put the patient in many categories for risks. Dr. Richlin always shows us statistics and comparisons when we ask about putting more than one embryo in.

He was a very caring, approachable doctor, but I only saw him 2 or 3 times max. He did not perform the IUI even though he was my assigned doctor at the clinic. He recommended that I try another IUi, however my husband and I ended up moving out of state.

My diagnosis was unexplained, besides going on thyroid medication (thyroid was slightly elevated). He recommended trying an IUI. I went on birth control, then started clomid, after taking clomid my lining was thick enough and my progesterone wasn’t high enough. They put me on more medication, but came back with a negative pregnancy test. He recommended we try again, but like I said before we ended up moving.

Never discussed

He is a very warm physician who takes the time to explain the science behind the procedures. He seems to care about you as a human being and is rooting for your success. When we did not initially get the results we were hoping for, Dr. Richlin met with us several times to talk about altering protocol. He renewed our optimism.

Bring all of your questions with you - he will take the time to answer them!

I had normal numbers, so we did a standard antagonistic cycle with low to moderate dosages. HCG as trigger. Now, I am using a down regulation stimulation (just started with lupron).

No complaints. Very efficient.

19,950 for one ivf cycle

I haven't start my first cycle yet. But I have been in the clinic couple of times now for other procedures. I trust him and like his style. He is Honest and very genuine. I believe I am in good hands and can't wait to the end of the tunnel.

Do not be afraid of ask questions. Sometimes I feel like I wasn't getting answers but was also my anxiety taking the best of me.

My insurance is paying most of it. I am paying for first cycle with PGS testing about $8,000 - if this doesn't work - would need the same plus donor sperm and medicines for another cycle.