Brooke Army Medical Center

My very first fertility appointment ever, Dr. Yauger mentioned follicles - I did not know what that was yet (I'd only ever heard of hair follicles), gave me zero hope of ever getting pregnant again, and said I could not do IVF. She never shows the screen for vaginal ultrasounds and only speaks to the resident and nurse while doing so and again, explains nothing. Dr. Y will often bring in a resident or student with her. A few times she has asked if that's okay, but usually does not. Sadly, though she is the highest ranking of the 3 doctors currently in the BAMC REI dept, she seems the least knowledgeable.

Do your own research!!! From speaking to several other women, patients are given cookie cutter treatment. She does not order labs to check vitamin levels (many women are deficient in several vitamins and more is needed than avg numbers for fertility). She is clueless about the treatment for the mthfr gene mutation. I've been researching my own condition for 6-7 years. Not every doctor can know every one thing, but I wish I had saved my money, spent a little extra and gone to a real fertility clinic.

For my canceled IVF cycle I did 10 lupron a.m. and p.m. 300 follistim a.m. and 3 vials of menopur p.m. Ovidrel was to be the trigger shot; however, my cycle was canceled before that. My 2 (failed) IUI'S were with Dr. Lewis, but for both I took letrozole for 5 nights and did 75 follistim for 2 days, triggered with Ovidrel.

Monitoring appts were far from convenient! For some working women it might be great, but for myself, having to beg and plead with neighbors to watch my one child at 5:20am so I could be there at 6 for labs, and wait around over 1.5 hours for an ultrasound was NOT well-timed for me. I was told that was so labs would be available by the time of ultrasound. Makes sense except most of the time, my labs were not ready yet. Pre-covid, you would rush in to REI, put your name on a FCFS list, go upstairs to get your lab drawn, then at 7:30 you would wait around to be called in order of arrival. During/post covid they are having us do 6am lab then going to REI dept for a scheduled ultrasound at 7:30/8/8:30/9....

IUI at bamc/sammc is free, covered through a grant. Tricare does not cover fertility expenses; however, IVF has a portion covered by a grant (I think the meds), so it is about $7500 which includes meds, monitoring, egg retrieval, icsi, implanting embryos, and 1 year of embryo storage at Fertility Center of San Antonio. That is also who payment is made to.

Dependent on patient's age, quality of embryo, and 3 or 5 day transfer, they will sometimes transfer 2 at the patient's discretion.

Dr. Lewis is phenomenal! It took so long to get approved to be seen by and RE and he has made my wait worth it! Each time I have walked into the clinic or seen him around the hospital walking, he greets me with a huge smile and genuine concern about my well-being. He is caring and explains each step of the process and always ends the session asking is there any other questions.

Make sure to contact him personally about your treatment, not the clinic.

After all of my testing was done, we came to the conclusion that I had Unexplained fertility as my factor. He explained the numbers and statistics from using medicated cycles with Timed intercourse as well as medicated cycles paired with and IUI. He did not mention IVF yet as IUI is the starting point for those with Unexplained fertility typically. Due to the pandemic occurring, things have been hectic, but he has still be accessible and helped with my request to do medicated timed intercourse while in clinic infertility treatments are on pause.

So far everything has been paid by my insurance since it's an MTF

I had a very positive experience and found him to be very caring. He has a great bed-side manner and is soft-spoken. If I ever encountered a setback, he was able to explain things in a way that alleviated some of my concern. The IVF process is inherently stressful so there would always be some degree of concern in my opinion. I never felt rushed in my visits with him which is somewhat unique in the realm of fertility clinics/doctors. My fresh embryo transfer was successful and he did a good job explaining every step of the process as the transfer was happening. l appreciate that I was given the option to use either progesterone suppositories or progesterone in oil injections. This made me feel like I had some choice in the whole IVF process. I also liked how during my attempts at IUI he immediately recognized that I would feel better on an alternative to Clomid. I think he has a very high emotional IQ because it seemed like he could read between the lines when I was struggling from the fertility treatments but not being forward about it (mostly because I had no reference point as to how much discomfort was normal because it varies by person and each transfer/treatment).

Write down questions ahead of time on your phone (notes section) so you don’t forget what you want to ask. Feel free to share your feelings throughout the process because he’s very kind.

We did a fresh embryo transfer with ICSI (intracytoplasmic sperm injection) due to male factor infertility. It was successful. ICSI helps the sperm make it into the egg.

I’m really glad he only transfers one embryo at a time because from my work in public education I’ve seen a lot of twins with learning disabilities from mild to severe.

It’s not that Dr. Adams isn’t nice. I just feel like she didn’t know anything about my medical history. She didn’t show me the screen during follicle checks. Never explained my labs or where she wanted the numbers to be. If this had been my first experience with fertility treatment, I would have been totally lost about what was going on.

Be ready to do your own research about treatments and labs. You must be assertive concerning your care. I also hope you have a thick skin because I think she commented on my weight at every appointment I had with her.

I did one IUI cycle with letrozole 7.5 mg daily. I had one mature follicle for insemination. Not successful. Then there were two cycles with the same protocol, but were converted to TI because of the holidays and limitations of the clinic. I then did two IUI cycles with 7.5 mg letrozole CD 5-9 and Follistim 75 units CD 10-13. One cycle still resulted in only one mature follicle and the other, two mature for insemination. Both unsuccessful. All three IUI cycles were done with Ovidrel trigger as well.

There is no cost for IUI at BAMC. Medications are included as we’ll. Only military connected patients can be seen here.

Very knowledgeable about the fertility options and what he felt was best for me He also was very blunt with what I should expect because IVF is very expensive and he allowed me to choose between IUI and IVF at the end when he said I would most likely only have 1 embryo to work with.

Write down all of your questions prior to the visit and he will be sure to answer them all before you leave.

I was on the max doses of Gonal-F, Menepur, and Lupron with trigger shot

I paid about $6,000 for IVF with ICSI, since I'm covered by Tricare and the Dr. Lewis is a military doctor.

He was willing to transfer 2 if I had them but I only had one embryo to work with.

Dr. Royster did not always show me the screen during ultrasound checks or explain what he was seeing. He didn’t explain my lab results or where he would like them to be. Dr. Royster was nice enough, but I don’t feel like he spent enough time explaining things.

Be ready to do some Google research because things will not be explained well.

Dr. Royster did many of my follicle checks for two TI cycles and three IUI cycles, though he did not perform the actual IUIs himself. He had me taking 7.5 mg letrozole CD 5-9 for the TI intercourse cycles, both unsuccessful. I did one IUI cycle with 7.5 mg letrozole CD 5-9 and two with letrozole 7.5 mg CD 5-9 and 75 units Follistim CD 10-13. All unsuccessful IUIs.

IUI is free at Brooke Army Medical Center for eligible patients and IVF is significantly reduced. Medications are included free of charge for both through a grant program.

He is the most caring infertility doctor I have encountered. He was always more than willing to answer and fully explain his answers to any questions I had. He has a way of putting your mind at ease and it is easy to trust him.

Understand that the time limit you have with him at your monitoring appointments is not his choice. Schedule a one on one and let him know you need more time to answer questions or concerns.

We used Lupron, Menopur, and Follistim for stims. Ovidrel for egg release and PIO for transfer.

Monitoring appointments are very much like a cattle call. Everyone for that day is told to be there at the same time for labs and then you sit in the waiting room to be called back 3 at a time for monitoring.

IVF was $7000 including meds, IUI is free and no charge for meds.

She thoroughly explained what is going on and always asked if I had questions. If I did she listened and answered.she made sure I understood What she told me. She spoke in understandable terms. She has a pleasant demeanor

If you don't understand let her know. She'll definitely take her time to ensure you get it

Within a certain time there was a first come first serve sign in sheet

All I paid for were costs associated with egg retrieval. Meds and everything else were covered

Extremely compassionate and caring; answered all of my questions and went above and beyond to be sure we were comfortable with the process of our treatment every step of the way. Explored options with us to help us make the best decisions for our family.

Could not recommend her more highly.

Waiting room with chairs and tv, wait usually an hour after labs were drawn to start monitoring ultrasounds. Be patient with appropriate expectations.

$7,000 for cycle and fees. Medications covered by insurance.

Knowledgeable doctor about fertility issues. She was gentle during the testing and procedure. Straightforward. Just too busy and treated you like another number not a person. Scheduled my iui too late after ovulation.

Speak up.

Clinic only does single.

He was the first REI specialist I saw so I was very worried and emotional about what he would say and find. My diagnosis was a shock and he was very empathetic and did not make me feel uncomfortable for crying. He has great bedside manner but also is very candid and knows his stuff

Dont be afraid to ask questions or be scared to cry in front of a man. He wont make you feel uncomfortable about it

This clinic charges less than most we only paid about 7k