RMA of Colorado - Conceptions Reproductive Associates

From the minute I walked in he made me feel comfortable. They did every test they could to figure out I couldn't get pregnant. Then I had my surgery to remove A polyp in my uterus. I was so scared but when he came in the room all my fears were gone. And I was pregnant two weeks later with my beautiful almost three old. I cried when I left them to go to my obgyn

Know what you want from them

I went in they did many test to determine if my tubes were blocked they did find I had pcos. When doing a test they found a polyp blocking my tubes I had them removed and got pregnant right away

Less than 1,000

Dr. Bush was prompt and efficient. When we first met with Dr. Bush we had already gone through 3.5 years of trying on our own and a year of Clomid and other measures with my OBGYN. Dr. Bush reviewed all of our screenings and tests before our initial consultation so we felt like our time wasn’t wasted. He was very clinical and frankly quite blunt but we actually appreciated that approach. We weren’t looking for someone to beat around the bush at this point. Dr. Bush was very confident that despite a diagnosis of unexplained infertility he would get us a baby of our own. He was very proud of his clinic. The initial impression definitely came off a touch cocky, honestly. But we were glad to know we were with a doctor who was very confident in his practice. In our consultation appointment, I came with a full list of questions and he actually took the page from me and went down and specifically answered every single question. We felt very confident in his ability to treat our case. We felt like he genuinely wanted us to be successful.

Don’t be turned off by his clinical nature. Despite a blunt delivery, he truly cares about his patients’ success.

Dr. Bush recommended going straight to IVF. Due to insurance and financial matters, we opted to try IUI first. We did three rounds of IUI. I honestly don’t remember our IUI procedure other than doing a trigger shot 24 hours before the IUI. We moved on to IVF after 3 unsuccessful IUIs. IVF protocol started with birth control. Due to my chronic hypertension, I can’t birth control pills so I requested an alternative option. I was able to use NuvaRing instead of the pill prior to egg retrieval and transfer. I did 9 days of stimulation prior to egg retrieval. I took Menopur, Omnitrope, and Gonal-F every day. I was also taking synthroid and vitamin because some test results showed I had low thyroid and vitamin d levels. I took a trigger shot before egg retrieval. They retrieved 18 eggs, 10 were mature, and 5 were successfully fertilized using ICSI. By day 5 only 3 were ready for freezing. We did PGT-A testing and 2 came back normal. After retrieval I had a trial embryo transfer and hysteroscopy. The TET went very well but the hysteroscopy showed that I had several uterine polyps that would have to be removed before transfer. I chose to have this done with my OBGYN because of insurance/financial reasons. After polyps were removed we were cleared for transfer. Then COVID-19 happened and our clinic was forced to shut down which canceled our transfer. We were able to get rescheduled 2 months later when the clinic reopened. I did a normal transfer protocol plus omnitrope. I asked about intralipid infusions but Dr. Bush said he didn’t think it was necessary. I heeded his recommendation here and we did not do the infusions. I did do acupuncture for three weeks leading up to transfer, immediately before and after transfer and for three weeks following transfer. Our embryo went through thawing and assisted hatching before transfer. Our transfer was successful and I gave birth to our healthy baby boy in February 2021!

I was able to make all of my monitoring appointments at the beginning of our egg retrieval calendar. All of the monitoring appointments had to be in the morning and I was able to get them scheduled before work which was helpful. I was in and out within 15 minutes and the ultrasound tech and phlebotomist were the sweetest!

Initial consultation: $450 Three IUI procedures: $3,600 One round of IVF cash pay: $17,388.50 This included monitoring, egg retrieval, ICSI fertilization, freezing, thawing, assisted hatching, and first transfer. IVF coordination of care: $986.50 Anesthesia for egg retrieval: $400 IVF meds: $4,122 PHT-A testing: $1,500 Transfer meds: $1,353.54 Polyp removal surgery: $200 I don’t remember costs of acupuncture but I think it was around $2,000 for all sessions.

We agreed with Dr. Bush’s recommendation of transferring one embryo because he and his team showed pretty convincingly how their high rate of pregnancy could lead to a high rate of multiples. And we definitely were not trying for multiples.

Dr. O is highly skilled and extremely knowledgeable. She is very straight-forward and to-the-point. She is up on her research, able to cite the latest studies when giving her plan for the best course of action. She’s not warm and fuzzy though, at all. When I had a miscarriage she didn’t call or email to reach out, we didn’t hear anything from her until our follow-up almost a month later. I appreciate her honesty, but in the world of infertility a little compassion goes a long ways. I don’t think she’s mean or rude, nothing like that, but she just feels cold.

She’s from New York. She has the brusque abruptness that I’ve heard New Yorkers often have lol. She’s a great doctor though, knows her stuff and gets things done efficiently.

During the IVF cycle, I had an antagonist protocol with omnitrope. I did 1 vial menopur and 300 gonal-f pretty consistently. I had a lab draw and ultrasound on days 2 and 6, then daily on cycle days 7-13. 19 eggs were retrieved, 16 fertilized, 11 made it to day 5 for PGS testing and freeze, 8 embryos passed the testing. Dr. O saw on hysteeosalpingogram that my tubes were hyrdrosalpinxed and they were removed, then I had a frozen embryo transfer 2 months later. It resulted in a negative pregnancy test. We had another transfer a couple months later that was positive, and I miscarried at 6 weeks for unknown reason. Repeated hysteroscopy and some blood work, and ready to try another transfer in 2 months

A full IVF cycle including all lab work, ultrasounds, retrieval, embryo testing, and 1 frozen transfer was around $19,000. Each subsequent frozen transfer is $5,000

Dr. O strongly believes in a single transfer. She is open to a 2-embryo transfer in my case now with so many failed attempts, but still STRONGLY prefers a single transfer approach

Dr.Greene made my husband and I feel very comfortable. He is warm and thorough while remaining open about what outcomes could potentially be. He also explains why he is changing protocol and is able to discuss what did not work after a failed cycle. We both really appreciated the way that he approached our failed IVF cycle and he was able to talk about it and share the disappointment with us while remaining hopeful.

Dr. Greene is very knowledgeable and approachable. He will answer any questions and is always available via email.

I have PCOS and prior to egg retrieval my Menopur to encourage egg growth as we were hoping for them to develop more and were nearing 2 weeks on medications. We ended up going in for retrieval shortly thereafter because he did not want me to have OHSS. I felt like he really monitored me progression to keep me healthy while getting the best results. I was also taking Cetrotide to prevent ovulation.

For IVF with genetic testing and more that 10 eggs retrieved we payed around $26,000. We did not transfer any embryos as the eggs fertilized but did not make it past day 2 due to an egg quality issue.

Dr.Greene prefers to transfer one embryo but is open to transferring two depending on the situation. He is not willing to transfer more than two due to health risks.

We initially chose Dr. Grindler based on her nutritional and environmental approach to infertility. As I imagine it is with every couple, it was a hard struggle to accept infertility was our reality. As someone who doesn’t even like to take Advil, I was facing a battle against my values knowing I would have many rounds of medications and injections. Dr. Grindler shared numerous articles and research on diet and lifestyle recommendations that made the whole process a little easier to swallow. While we only physically saw Dr. Grindler a handful of times over the course of our treatment, each visit she came prepared with all lab results and a plan of action for moving forward. She explained in detail our results and was readily available for any questions we may have. We were diagnosed with mild diminished ovarian reserve and a slight male factor, Dr. Grindler recommended IVF as our best course of action however, respected that we wanted to try IUI before taking the plunge into the scary and overwhelming world of IVF. While our two rounds of IUI were unsuccessful, Dr. Grindler treated us with the upmost care and respect and never made us feel that our chosen path to treatment was wasteful. While I communicated with nurses daily, I knew Dr. Grindler’s expertise and extensive knowledge was at the backbone of our treatment and played a high role in our successful egg retrieval.

Put your trust in their hands - Conceptions is highly regarded and has the best live birth rates in the country. Their facility, practice and doctors are ahead of the game, paving the path to success.

Prior to starting treatment, various diagnostic testing is preformed to ensure the best course of treatment: Pap Smear, Ovarian Reserve Testing, Vitamin D, Thryoid, Infectious Disease, HSG and Semen Analysis. We were assigned the Antagonist protocol, Conceptions uses a three phase treatment cycle for IVF and requires you and your partner take an IVF class prior to retrieval. Here they explain the full IVF process and show you how to administer medication. This class was SO helpful and relived a lot of anxiety I had for administering injections. My overall experience was so much better than I expected – I had truly expected the worse out of IVF however, I the class helped me to overcome my fear of administering injections, I ended up giving myself all shots with the exception of the Trigger. I even found that the egg retrieval wasn’t as painful as I had expected, recovery was quick and I was back to work the next day. We had a great outcome, we started with 26 eggs being retrieved, 16 of which fertilized. We ended up sending 8 embryos off for genetic testing, 5 of which came back as viable embryos to transfer. Phase 1 is IVF Stimulation and Embryo Development. During this phase, I was placed on birth control for a couple weeks followed by 1.5 weeks of twice daily home injections and daily blood and ultrasound visits. I had two trigger shots once my ovaries had reached their peak in stimulation and egg retrieval followed. Conceptions uses ICSI for the insemination technique and freezes all viable embryos. Their You’ll learn the number of eggs retrieved the same day of your retrieval, their Embryology Lab calls you the next morning with the number that fertilized overnight and a second phone call a few days later confirming how many embryos developed. Embryos are then sent off for genetic testing, which takes about two weeks to get results back. Phase 2 they call the “Wash Month”, which allows hormone levels to return back to normal and ovaries to recover from stimulation. I was placed back on birth control for a few weeks and had three uterine procedures: Hysteroscopy (this I found to be the most painful of everything related to IVF), Trial Embryo Transfer and Doppler Ultrasound (all done on the same visit). This phase is where you’ll learn the genetic screening results confirming the final number of viable embryos, if you had testing preformed. Phase 3 is the Frozen Embryo Transfer, which takes 6-8 weeks. I’m currently at this stage, which unfortunately got put on hold due to COVID-19.

Round of IUI: Around $600 IVF with Chromosome Assessment: $18,375 Medication for Stimulation for Egg Retrieval: $4,740.15 Anesthesia for Egg Retrieval: $400 Medication for Transfer: TBD (Anticipating $2,260)

Conceptions recommends transferring one embryo at a time for the best outcome as well as the health and safety of the baby and mother. However, they do not prohibit multiple embryo transfers if that is what the patient prefers. They explain the risks involved with transferring multiple embryos and that there is a chance for the embryos to divide resulting in triplets or even quadruplets.

He was straight forward, yet took the time to explain all the ins and outs, acronyms, processes, possibilities with us. He knows his areas of strength and has intelligently filled his team with people who can support patients in other ways. He isn't just after the nest numbers (though his numbers are very good) because he sincerely wants the best for his patients. He is very good at what he does and is able to tackle tough situations and conversations with ease.

Be ready. Know that you are in for an in depth conversation, very specific to your body and it's needs. Come with knowledge of the process and common IVF acronyms. It will help expedite the consultation and provide opportunity for you to ask questions.

Tried IUI with estradiol, letrozole and luteal HCG because we hadn't tried IUI yet and infertility was unexplained. When that didn't work (twice), we began egg retrieval stimulation using follistem, menopur and saizen (saizen due to suspected poor egg quality). We froze all embryos for PGD since we didn't know why I couldn't get pregnant, nor why I miscarried. Around retrieval time, I also took doxycycline, nexium and a novarel trigger. The trigger was a half dose due to my high estradiol results. I needed ganirilex injections as I was very close to ovarian hyperstimulation. The next month, I started birth control pills to calm my own hormones and allow doc to control them with meds. For the transfer, I was on lupron, estradiol, and progesterone in oil with medrol right around transfer. After being diagnosed with ashermans and having multiple surgeries to resect the scar tissue, I was on hormone therapy using estradiol 2 mg pills twice a day and del estrogen injections to rebuild the lining. We tried a couple different protocols, using Viagra or Cialis with pentoxy to help encourage uterine lining growth. The final successful cycle involved Viagra, estradiol 2mg, pentoxy, del estrogen and HCG (new study released Dec 2017). I used acupuncture during all if my treatments and it was an integral part of our success and highly recommended by Dr. Bush.

In seven years, one egg retrieval, four transfers and four surgeries, and lots of medication, we spent around $50,000. All things considered, very reasonable.

He was open to our decision but encouraged us to transfer one at a time when we asked him what he would do if he were in our position.

He was very helpful and encouraging. Honest approach and matching to patients real life needs without pushing hai own opinions. I was going through divorce and I needed to save my eggs, and he listened to my needs and goals without judging me unlike CRM Dr.Sarah Barton who said I have low quality eggs in front of my husband and who was going through depression which made the situation even worse. Fertility doctors please don’t do that! Please treat patient as human not as money! Dr.Bush was able to understand what I’m going through and accepted my choice which was to “save my eggs first before I reach 41 years old”. Women should have right to make decision by themselves. I have only one ovary, so it made sense for me to do egg freezing and get as many eggs out as possible instead of doing whole IVF cycle with just one or two eggs.

Do your homework first, be well prepared. Ask Dr.Bush the options you have. Take some time to reconsider the options, and make the choice that you agree with!

I could tell every cycle they were using different strategies and really monitoring the follicles growth. They were manipulating the growth of my follicles by increasing and decreasing the injections unlike Dr.Sarah Barton from CRM who never cared to even manipulate my doses and give me the same dosage of injections until the end.

It was costly, but they never canceled the cycle due to delayed payment. We had great trust developed and I did 6 egg freezing cycles in a row. Sometimes paperwork were not fast enough but still nobody stopped me and choose to trust that I will pay.

I don’t have experience on this procedure yet.

If you’re looking for a doctor who will fight hard and have a “whatever it takes” attitude to be flexible to regiments/protocols for you, he is not it. One size fits all for Dr Bush, he is skilled, and will give it a try as long as you don’t hurt the clinics numbers . If you require customization beyond the basics that should get you pregnant- you won’t get it from him. From my very first consultation with him, I was discouraged but moved forward because of the clinic’s track record (which I now am a bit unsure about because they do not report to SARTS).. I told myself his blunt communication was honesty, and even though the consultation me feeling discouraged I told myself compared to to other consultations that I had with other doctors who had been more encouraging perhaps he was the real deal for not trying to “sell” to me. What I didn’t realize is he was really just showing me from the very beginning that his true focus is who might fit in the clinics successful statistics or not. I wish I would have listened to my intuition in my first consultation which was bleak and had the tone of “why havent you had success” instead of “we’re going to do what is needed to help you”. He had me do a work up to see if he would even “accept” me. After the consultation, I was only able to communicate with him directly two more times on transfer days. I emailed him once and got a response from his nurse that he communicates through them only. Strengths: Transfer skills and monitoring Weaknesses: Everything else. Zero flexibility to your needs, he is not willing to try different protocols, accept embryos from any other facility you may transfer from, take a closer look or customize to you -the problem is going to be “you”- it’s never going to be anything else. Bottom line- He has a well ran machine and formula I’ll give him that - but if you don’t fit his set formula he will just tell you that quote unquote: “you just fit in the percentage that’s not successful” at their clinic and emphasize their clinic numbers that ARE successful. Which will make you feel more horrible as a failure. Emphasizing clinic success rates as an answer at the time of someone’s failure and need to know what they can do to be successful is inconsiderate and arrogant. It was a VERY low point for me. I read he did this in others reviews and it should have been another red flag to me. But I hoped I would be on the other side of his clinic’s questionable statistics to not have to deal with that. I can’t emphasize enough that he only cares about the clinic’s numbers. If you fit the formula, he can bring you success. **If you need customization to get success - he will not be willing to customize for you.** With this doctor you either fit in his preset formula…. or you don’t. That’s it.

Take a look at other reviews and see that there are stark differences in initial consultations. Some will say how positive he was and reassuring that he could help him. Others like mine are the complete opposite. If you don’t get a decent positive tone of wanting to help you in your consultation- run. Don’t take it as honesty and move forward like I did. Because what that tone is telling you - is that he doesn’t think you may fit into their set formula of protocols and ideal patient candidates. And if you don’t fit, he is not going to be flexible or customize anything for you- so you’re wasting your time. Stop and find another doctor at that point.

I did two rounds and protocols were pretty much the same regardless of results. Rationale was never given for the protocols. We got 1 embryo from the first round and 0 embryos from the second round before I moved forward to donor eggs.

He allowed me to transfer two pgs tested embryos in my donor egg round, which resulted in a chemical pregnancy.

When another clinic was unprofessional & left a feeling of “in it for the money” I found Dr Chiang. She’s been absolutely amazing & so supportive of all the hiccups in our case & the poor timing of covid. We’re close now to having our first transfer with a donor embryo.

Trust her judgment & know she’s in it for you & your family.

Because of my age, I have poor egg reserves, so the option was always a donor egg regime with my husband’s sperm. Then covid hit and everything kind of fell apart. Once we were able to go back she felt a donor embryo would be the better option as we just wanted a baby, period. So now we’re in the process of the mock transfer & getting ready to start hormone therapy. We’ve already reserved our embryo & she’s just waiting for the day like us 😊

$13,200 for a donor embryo transfer. Plus additional services if needed & medications.

The option is usually one but I would’ve preferred two as that is what he & I wanted but weren’t allowed that option.

We personally had a great experience with Dr Bush. He is very confident in his abilities and we had success twice over with him. You don’t have much interaction with your doctors but the interactions we did have with him were pleasant and professional and he has a good sense of humor.

Do not expect to see him every appointment. Have trust in the nursing staff and don’t be afraid to advocate for yourself if you think something is wrong

Due to my age, he had me do testosterone gel prior to starting my round of IVF. He also had me use HGH in combination with all of the other hormones in the antagonist protocol and with both transfers (second transfer was to my wife). We were able to get 3 normal embryos and after two transfers 2 healthy babies.

As a lesbian couple when talking to people they we all very accepting and I never felt judged. However… all of the forms are so heteronormative. Please fix that!!

About 7K oop for retrieval and transfer and 2k oop for second transfer

They had us meet with a therapist to talk about using donor material and talking about that with our children. Otherwise they handled everything with Cryogam well.

My husband and I have had nothing short of an amazing experience with Dr. Bush and his team at Conceptions. We are 3 for 3 with our frozen embryo transfers and have 3 amazing children that we can't imagine living without. We are about to move forward on transferring our 4th and final embryo and trust that this cycle will be as successful as the first 3. Dr. Bush is intelligent, kind and is truly an expert in his field. We live in Tampa, Florida and chose Conceptions in Colorado because none of the doctors we interviewed compared to Dr. Bush. He is thorough, straight-forward and detail oriented. We have zero complaints. If you choose Conceptions, you will not be disappointed.

Trust him and do what he suggests, you will not be disappointed. He is direct, but also compassionate.

We only had singles transferred. Dr. Bush was confident that a single would be successful and it was. This was important to us because we did not want multiples.

As stated earlier, Dr O stonewalled me when I tried to go around tests I felt were unnecessary. I thought genetic testing was optional but she made it seem like she wouldnt work with us if we didnt do it. When she required me to go for an additional consult with a maternal fetal medicine doctor she did not provide a referral just said to "find someone in my network." I wanted a referral because I did not totally understand the purpose of the consult and wanted someone they had worked with previously so they would be familiar with the request.

I think Dr O has been doing this so long she's set in her ways and probably headed towards retirement. I wouldnt recommend her.

I was not given specifics or explained much of anything. It felt very robotic.

23,000

Dr Grob seems like a smart, capable doctor who is keen on getting results and being on the forefront of this field. However, my experience with her has been very disappointing in terms of feeling supported and catered to as an individual. She does not seem to like to be questioned and does not offer much information, either upfront or when directly asked. If you are not fully prepared for a consult with everything you want to know, it is very difficult to get satisfactory answers or information afterwards via email, and you will be asked to set up another (paid) consult. As a person who struggles with anxiety and likes to know the ins and outs of what is happening to my body, I found her less-is-best approach to explaining her reasoning on protocols to be very frustrating and stressful. In my experience, it also seems like Dr Grob might err on the side of throwing the kitchen sink at this process, medication-wise. With only my age as a clear factor, my first stim protocol started at the highest level of medications (according to general consensus of information including the FertilityIQ education pages) but to Dr Grob this was what she deemed standard, and despite a retrieval of MANY eggs, her second stim protocol employed yet an even higher dosage of medications. For the FET phase, a fully-medicated protocol- with every single medication you can possibly use for it- was the only one she offered, with no indication that there was any other way to do it. My concerns about the safety/necessity/efficacy of these protocols were repeatedly dismissed in a way that unfortunately eroded some of the vital trust, adding a lot more stress to this process. There was little that she offered in our consults to make me feel as if I was getting treatment tailored to me as an individual, or using the information gleaned from all the tests and procedures to determine the best way to proceed. It feels very one-size-fits-all and with her direct, very scripted manner, it definitely does not lend itself to feeling like you are working as a team with your doctor. I have no doubt that she can generally get good results, but the way in which it is undertaken leaves me feeling like I'm a statistic she's hoping to add to her success column. If you do not need reassurance or support and are happy to place complete faith in your doctor without requiring much information, Dr Grob might be great for you. Likewise, if you are willing to do your own research, prepare thoroughly for consults, and fiercely advocate for yourself, you might also get good results working with her, albeit in a more DIY manner. If you fall somewhere in between, then you might find what is already a very emotional, stressful experience exacerbated by your own doctor.

Inform yourself on medications, protocols etc so you can fully discuss any concerns or thoughts you might have, as not much detail may be offered by Dr Grob. Be prepared to advocate for yourself if you are not feeling aligned on things- and instead of much reasoning, you may well get told the doctor version of "Because I said so".

For all retrieval cycles, we used a protocol involving Menopur and Gonal-F, with Ganirelix added in and a HCG trigger with Lupron shots. Omnitrope was used as an adjuvant to hopefully help egg quality, and estradiol was employed for priming. With a high number of eggs retrieved each time, this protocol succeeded on that front, which seemed like the main objective- quality, on the other hand, did not seem to have much evidence for ways in which it could be improved, so the only change suggested was to add CoQ10 supplements (which require at least three months to have any potential effect; it would've been good, given my age factor, to have been told that at the very beginning of the process).

Our insurance included a fertility coverage with a lifetime max- this fortunately also covered medication as "pharmacy" , so these did not contribute to the lifetime max. After our max was reached- with the insurance out of pocket of $6700- we also did a cycle retrieval package rate that was around $10k. Genetic testing was additional and charged for additional embryos over a certain amount plus shipping fees, and cyro-storage for embryos is charged at around $65/month. Frozen transfer is charged as a separate entity.

Dr Grob advocates for single embryo transfer; it was presented as a given due to my age and the higher risks.

Dr. Chiang is excellent and I really can't say enough good things about her. She is kind and compassionate. She listens well and makes you feel so personally cared for. She is smart, confident and practices evidence based medicine. I really appreciated how she explained studies and statistics to us.

Know what questions you want to ask because she will answer all your questions and give you valuable feedback. Know what your family building goals are and what you are willing or not willing to do to get there, because she will often ask you what you want to do/are willing to do next.

For IUI we used clomid, but I had a hyper-response to this resulting in a cancelled IUI cycle when I had too many follicles. We then switched to letrozole. Overall, we did 1 IUI with clomid, 1 cancelled IUI on clomid and 2 IUIs on letrozole. For IVF we did a down-regulation on lupron followed by estrogen pills/suppositories and progesterone IM shots.

~$35k

Dr Greene is compassionate and has walked in my shoes with his own experiences and knew what to say and what not to say to make me feel comfortable and confident in him. When our recent transfer failed he expressed and emphasized how it was not my fault which gave me peace.

During consults or follow ups have an agenda to follow so you make sure you cover all concerns abs questions. I am fairly comfortable with our Dr. But I always seem to freeze up during consultations and lose my voice. An agenda helped keep me on track without becoming too emotional.

• ERA, SHG, HSG , TET tests prior to transfer Protocol: • Birth control pills the cycle prior to FET - down regulation ▪︎ Lupron injections for 4 weeks – this and birth control work as my down regulation cycle. This combo will shut down (suppress) my ovaries and allows my clinic to control my cycle. ▪︎ Omnitrope injections for 10 days - we added this to my protocol with Sunny due to implantation failure in previous cycles. This drug can help your uterine receptivity become more favorable for an embryo. Essentially this is the welcome party drug for our embryo. ▪︎ Progesterone in oil injections begin 6 days prior to FET and continue through 12 weeks of pregnancy – helps prepare the lining of the uterus and helps maintain a healthy level during pregnancy ▪︎ Estrace pills vaginally twice a day – helps build the endometrium lining nice and thick ▪︎ Vivelle (a.k.a estrogen patches) 1 patch, increased to 4 patches then decreased to 2 - helps build lining ▪︎ Baby aspirin – improves blood flow to implantation site ▪︎ Intralipid Infusion 1 week prior to fet and aging at 7 weeks pregnant Next fet cycle we will repeat an shg and do a microbiome test

Roughly around $40,000

He strongly advises against multiple embryo transfer because of his success and even after our very recent failed cycle with him he advised against increasing embryos

Dr. Grindler was very straightforward at our initial visit and went over our desired family size and the results I already had from diagnostic testing done by my ob/gyn. I had some questions before starting IVF and we were able to schedule a virtual visit with her to go over everything. I had some problems with my trial embryo transfer and despite my bringing up my concerns, Dr. Grindler mostly brushed them off and was confident that I would not have any problems. Unfortunately my first embryo transfer had to be cancelled at the last minute (literally while I was on the procedure table) due to the same problem. After that Dr. Grindler took steps to address the issue and made sure it would not be a problem the next time around and the next embryo transfer went very smoothly and was successful.

Communicate any questions or concerns you are having and if you are concerned about something make sure it is addressed. Also grab one of her cards at some point - at the end of my appointments with her she would always tell me to email her if I had any questions, but I didn't have her email address until I grabbed one of her business cards off the front desk at one of my last appointments! (Also I could have just asked her for her email address!)

I think I got a version of the standard starting stimulation protocol used at Conceptions for my egg retrieval. I used injectable menopur in the mornings and gonal-f in the evenings and added in ganirelix when my follicles were getting large. I used a lupron only trigger for my egg retrieval because they were worried about OHSS. The egg retrieval was successful and we had 4 euploid embryos at the end. I did 2 (mostly) unmedicated/natural FET cycles (the first one was cancelled at the last minute). I went in for a lot of monitoring to check my lining and follicles and when I was ready to ovulate on my own I triggered with pregnyl and used progesterone suppositories. So far the second FET cycle has been successful. I will stop taking the progesterone suppositories soon, when I am 10 weeks pregnant. We graduated from Conceptions after our 9 week ultrasound showed that everything looked normal with the pregnancy so far.

Our IVF self-pay package was $17,875 (included egg retrieval, ICSI, PGS testing of up to 5 embryos, pre-FET diagnostic testing, and 1 FET cycle). We also paid an additional $1400 for testing additional embryos. Anesthesia for the egg retrieval was $400; IVF medications were about $3600; and FET medications (for 2 unmedicated/'natural' cycles) were about $1200. The embryo storage fee at Conceptions is currently $62.50 per month.

We preferred to transfer only one embryo. I think we were told that if we really wanted to we could convince Dr. Grindler to transfer 2 embryos.

Due to the Covid pandemic, 90% of all our appointments were via telehealth appointments, but he made sure they were warm and inviting and friendly. Even with a technological setback where we couldn't get volume to work, he called in on our landline to speak with us while presenting the slides on the computer. The only time we got to see him in person was during our embryo transfer which was amazing, and made us wish we could've been in the same room with him throughout the entire process. He was genuinely excited for us, took time to explain, to encourage, to include. Everything was well communicated, he made it a point to tell us what we were looking at on the screen, made sure to pause the process (where possible) so my husband could get pictures of our little embryo being shown to us, get videos of the nurse bringing the loaded catheter in, everything that would help us remember and honor our journey. Since you have to have a full bladder for the procedure, I was naturally a little uncomfortable and he cracked a joke that made us all laugh. I warned him that he was in a danger zone for making me laugh and if he kept it up, I might accidentally pee on him. He laughed even more and said that "I fully believe laughter is good for the soul. If laughing gets you this baby and gets me soaked, I'm fully willing to take that one for you!"

Ask him anything. I have a crazy good immune system and hardly ever get sick and, although I "knew" the answer, I needed his professional reassurance that it wasn't my own body working against me for the failed natural conception or IUIs. He took so much time and explained how my immune system was such a good thing in this case and went into the process of immune issues that would cause problems just so that I would have peace of mind.

Egg retrieval: Menopur 75 units subcutaneously daily as directed (for 15 days, I think) Gonal-f RFF Inject 75- 450iu subcutaneously daily as directed (don't remember the length of time) Ganirelix Acetate 250 mcg, Inject subcutaneously daily as directed Leuprolide - Inject 4mg (0.8ml) subcutaneously at the appropriate time as directed for trigger and repeat the same dose 12 hours later Chorionic Gonadotropin (HCG), 1000- 10000iu IM as directed for trigger For the FET cycle: Birth control pills for 24 days. Active pills only, no placebo. Lupron for 27 days, 10 units. On Day 1 of the cycle: baby Aspirin (81 mg), Metformin, Vitamin D, and prenatal vitamin throughout the first 3 trimesters, stopping at the advice of my OBGYN. Pregnyl 10000 units, Inject 5000 units IM for trigger before transfer Estrace 2 mg tablet, altered between dosages and whether orally or vaginally until desired hormone level was reached Vivelle-Dot 0.1 mg patches, Applied anywhere from 2-4 patches for the first trimester per doctor's orders Progesterone in Sesame Oil 50 mg, Inject 1.5 ml intramuscular for first trimester, slowly weaning off per doctor's orders I'm sure I'm missing something, but that's as close as I can recall at the moment!

I've never kept detailed track of what cost what, but I know the initial IVF protocol that includes PGT-A screening, ICSI, and frozen embryo transfer (FET): is $17,875 Anesthesia: ~$400 Medications over our entire cycles probably ~$3000-5000 Acupuncture for transfer day - $100 Embryo storage fee: $62.50 a month When speaking with the clinic's pharmacy, they recommended a program that could potentially help with payments based on income levels and went above and beyond to do everything they could to help keep costs as low as possible.

We were given the option for a multiple embryo transfer, but we would have to "plead our case" and do a good job with logical reasonings behind why we though it would be a good option, etc. before Dr. Greene would approve it for us. We didn't wish to do more than one embryo since we didn't know how my body would respond to a pregnancy, so kind of N/A for us

Dr. Bush, from the outset, gave us hope and optimism that parenthood could be achieved. While it took a while, he ultimately made that dream come true and we are forever indebted to him for it. We met with him a handful of times through the journey -- but were lucky enough to have his expertise for the egg retrieval and all three transfers. When faced with setbacks or disappointment, Dr. Bush welcomed us for WTF conversations and adjusted the plan to produce better results. We absolutely would recommend him to anyone wanting to achieve the ultimate goal of parenthood. Dr. Bush made it happen.

Don't be taken aback by Dr. Bush's demeanor in the meetings in his office. He is direct, confident and generally not "warm and fuzzy". BUT he is brilliant and you are hiring someone to make you a parent, not become your best friend. Once I reminded myself of that, my expectations of our interactions were adjusted and I came to appreciate his approach, confidence and care.

PCOS diagnosis- Agonist protocol for IVF following three failed rounds of IUI. Egg retrieval resulted in 18 eggs, 12 fertilized, 8 made it to day 6-7. Of those 8, 6 tested genetically normal and were frozen. First transfer- resulted in positive pregnancy test and graduation from clinic. However, miscarriage at 12 weeks occurred. Second transfer- adjusted protocol to include intralipid infusion. Resulted in a negative pregnancy test. ERA cycle- resulted in normal results but helpful for diagnostic puroposes and for me getting focused and centered as the patient. Third transfer- addition of blood thinner, additional growth hormone, and hydroxychloroquine. Transferred two tested embryos, both stuck. Positive pregnancy test resulting in the healthy birth of boy/girl twins.

We spent about $50k to achieve our highest goal of becoming parents. We ended up with twins, and even if it had been only one baby, we know it was worth every penny.

Dr. Bush was clear that multiple embryo transfers were off the table until all other options had been exhausted. First two transfers were eSET. Third transfer utilized two embryos to increase the chance of success, and resulted in fraternal twins. Dr. Bush was clear with us about the potential risks of a multiple embryo transfer and we ultimately let him decide on transfer day if one or two would be used. We are thrilled with the result.

Dr. O’Shaughnessy is very honest. I like that. It may not be for everyone, but I’m a patient here because I want to be a mom. Her honestly and directness is refreshing and I appreciate it. She truly wants her patients to succeed.

Be ready for her to give it to you straight and listen to her. She knows what she’s doing and wants you to succeed the first time.

So far, I’ve done quite a bit of testing. Bloodwork, sonograms and uterine testing. I’m now on a birth control pill. I will soon take progesterone and lupron prior to my transfer.

With the donor cycle, it’s been around 25k. We were told at a previous clinic that it would be closer to 60k, which would have been out of reach for us.

With my age in consideration, we are only doing a single transfer, which is what the clinic suggests.

Dr. Grindler comes off as very smart, educated and competent. I think those are her strengths. She is also quite thorough and provides info in a calm and objective manner. What she lacks in warmth, she makes up for in comprehensiveness. I never left her office without fully understanding a diagnosis, procedure, or with any open questions.

A little warmth goes a long way. This process is so emotional for a newcomer to infertility. Initially, maybe acknowledge that fear, trepidation and nervousness about the process before delving into the specifics of the consultation.

Dr. Grindler did bloodwork and ultrasound to determine my baseline strategy. She took my age and health factors into consideration. I have Hashimoto's so she was looking for specific thyroid factors in the bloodwork. After that came back, she then suggested we do an HSG to determine if my anatomy was a factor in my infertility. The HSG showed a blocked tube, so essentially she gave me the option of IUI or IVF. My chances of conceiving naturally she determined were about 1-2% a month, given my age and hydrosalpinx. She gave the IUI a 10% chance of success and IVF a 70-75% chance of success. She agreed that IVF would be the best bang for our buck, so we started right away. She had me do more blood work and determined that I would prime with estrogen. on Cycle Day 2, we started with injections: 4 vials Menopur & 0.7 cc of Omnitrope AM and 300 IU Gonal-F PM. We slowly increased the Gonal-F throughout the cycle from 300 to 375 and then finally to 450. On cycle day 8, I started with Cetrotide and continued with the protocol until we triggered on Day 12. Overall I came away with 12 follicles. We retrieved 9 eggs, 5 were mature and 5 fertilized. Of those 5 embryos, 4 made it to blastocyst on day 5 and day 6, respectively. We biopsied all 4 and sent them to Natera for PGS testing. 3 came back abnormal with trisomy 16, 21 and deletion of chromosome 7. One came back PGS "normal" with an 85% confidence on chromosome 13. That embryo is currently frozen. Because of the confidence, Dr. Grindler agreed with my decision to do a second retrieval cycle to try to get more healthier embryos to potentially transfer. She is changing my second retrieval to prime with Estrogen, Cetrotide and Omnitrope and will start my Gonal-F at 450 IU from the start. She will also have my take the Omnitrope for longer. Unfortunately, my insurance company denied my second cycle and wants me to transfer my 85% confidence embryo first before they approve a second cycle. That is currently where I am with my protocol.

I believe my insurance has covered about $38k to date. I have a $55k lifetime fertility benefit. Out of pocket I have paid just under $10k for medications not covered and the PGS genetic testing that is not covered.

Dr. Grindler said that the clinic does practice multiple embryo transfer and that the decision to do that is up to the patient. Dr. Grindler is very good at managing expectations to just focus on the step at hand. Because so much of this process is beyond control and results driven, she doesn't like to get ahead in the process of planning next steps. She redirected conversations about transfer back to the retrieval process. She knows that patients can get ahead of themselves and therefore their expectations can be shattered. She is very good about having patients temper their expectations and focus on the present task. As such, we never had an in depth conversation about multiple embryo transfer other than what I stated above.

As mentioned previously, Dr. O'Shaughnessy is very blunt and also very smart. That side of her is much appreciated. What's not appreciated is her lack of bedside manner and what seems to be lack of understanding. I went into the appointment very excited and with a list of questions. Her immediate personality turned me away from wanting to ask any of those questions. In fact, when I did ask some questions, she made me feel as though my question was dumb, hence why I didn't continue asking questions and therefore, didn't feel like I got everything I needed out of the consultation when I was looking for a fresh start.

Despite the lack of bedside manner, don't hesitate to be you, and get your answers—you deserve it and if Dr. O'Shaughnessy isn't for you, then move on.

I have only gone in for my first consultation and I am currently finishing up diagnostic testing. She has wanted to test my blood levels of many different tests as well as run an HSG test on me. My previously sonohysterogram showed a focal adhesion or polyp, she reviewed the test itself (ultrasound video), and immediately said "that has to be removed". I went in for the HSG and the HSG test showed that everything was normal—no adhesions or polyps.

Unfortunately too early to tell. So far, I've had $40 copays with my insurance for 1. ultrasound and 2. HSG test

Dr. Bush was great in the initial consultation, he made me hand my husband feel optimistic about our potential to get pregnant. We were nervously excited about the process and were disappointed that after that meeting we would not see or speak with Dr. Bush again until the egg retrieval. It is also requires an act of congress to even speak with Dr. Bush even if requested. Although I know he's a great doctor, his success rates can speak for themselves, it was a bit of a disappointment to not be working with him as much as we had thought.

Make sure to do your homework before each appointment so that you know what to ask because getting answers after the fact is a challenge.

I was on the Antagonist/Saizen protocol and I do not know why.

Monitoring appointments went very smoothly.

Coordination of Care Fee = $990 PESA = $18,600 Natera = $1,500 Anesthesia = $400 Embryo Storage = $400 IVF Medications = $10,000

Dr. Bush strongly suggests eSET due to the riskiness of multiple birth pregnancies.

I only met Dr Bush in person at the time of egg retrieval. But it was very clear that he was personally directing the day to day management of my cycle. He is meticulous. I never felt like I was being pushed off to a nurse or secretary.

He’s not super warm and fuzzy from what I understand, so if this is something you need then he’s not for you. But he works miracles and I know he will help me have my baby.

Started with Birth control and added growth hormone after. Then did antagonist protocol (menopur/follistim/ganerelix). Daily blood and US once I arrived in CO. Trigger with lupron and pregnyl and ovidrel.

Initial consult was 175$. IVF cycle with PGS was about 16K. Nurse coordination fee around 1000. Plane tickets to Denver and back 250$ 8 nights hotel 900$ (they had discount agreements). Rental car 300$. Transfer of donor sperm vial from old clinic to new clinic 750$.

Have not transferred yet. Waiting for PGS results.

She was very blunt and to the point, did not sugar coat anything and was a little cold coming off. However I did appreciate that as it is the kind of info I would rather have opposed to having someone beat around the bush.

Don’t be offended by her confidence and strait forwardness.

Estrogen priming cycle before start. High dose menopur 2 vials in the am with omnitrope 0.7ml for 9 days and high dose gonal f 450 in the pm. Cetrotide toward the end. Stimmed for 14 days total 7 follicles at my last us 8 eggs retrieved 7 mature 3 fertilized 2 look good still on day 3.

I was lucky enough to have bits and pieces covered by insurance, but even with that we paid a lot more then we had thought. I do feel like dealing with insurance coverage and getting credits was a bit difficult to figure out as we had several credits and I had to specifically ask and remind people about them.

As far as I remember dr didn’t have a strong opinion either way. But we will only do 1 frozen when the time comes.

Dr. Bush exhibited a great balance of compassion and intelligence. Once under his care I had a renewed hope that we would successfully conceive. He made me feel like our case was a priority and he was very adamant that the staff working with us treated us in the same manner. All of the tweaks that he made to our protocol were thoughtful and made sense.

Dr. Bush has vast experience in fertility. He talks fast and often explains things at a high level. If you have any questions at all about what he's explaining or why he wants you to do a certain test or take a certain medication be sure to ask him to elaborate further and in simpler terms if necessary. He is a Dr. that uses a more scientific approach rather than a holistic one.

Before scheduling my embryo transfer Dr. Bush performed a hysteroscopy and saw that there was a build of scar tissue in my uterus. He performed surgery to remove that scar tissue and then used estrogen to thicken my uterine lining for a couple of months prior to transfer. He also used Viagra to raise the volume of blood flow to the uterus. It was very important to him that my uterus lining was thick enough to allow for successful implantation

IVF is expensive but they do take most insurances. If you don't have insurance coverage one IVF cycle will be 25-35K depending on your specific protocol.

Dr. Bush will only allow up to two embryos to be transferred at one time. Typically, only one is recommended but in some cases they will support implantation of two depending on the case. In my situation we transferred two embryos and had one healthy implantation.