Fertility Centers of Illinois

We've been patients of Dr. Hirshfeld's for just about a year now, after a long and difficult history of infertility. When we became patients of hers and her team, we were assured that we would be kept in the know and that direction would be personalized to our situation. Dr. H-C blew our expectations away. We are now 11 1/2 weeks into our first pregnancy (ever!) and could not be more delighted with the help that Dr. Hirshfeld provided to get us here!

Read up about Dr. Hirshfeld-Cytron on the FCI homepage and get to know and understand her a bit better, too. Realizing how much she wanted me to reach my goals really helped ease my mind about being seen as a patient/person and not as a number (which had been my experience at other clinics in the past).

Dr. Hirshfeld's first egg retrieval with us (in August of 2022), had me taking human growth hormone for the first time. We were informed that this medication can help with egg quality, I believe, and it did. We retrieved (7) eggs (I think) and (2) made it to the PGT testing; (1) to frozen status. In October of 2022, we did another egg retrieval with Dr. Hirshfeld, to similar success. In December of 2022, we did our first frozen embryo transfer, on a medicated cycle (our choice, since we had more control over the scheduling and timeline). It was unsuccessful, so in May of 2023, we did a natural cycle to prepare for our next frozen embryo transfer, which WAS successful.

Our only issue is an ongoing one with our insurance. No fault of the clinic; the insurance confirmed coverage and is now reneging on that confirmation.

I am 41 and overweight with only (3) frozen embryos so, based on the stats shared with us, the directive was to transfer one at a time to mitigate the risk of pregnancy complications and to increase the likelihood of a successful pregnancy and live birth.

It is clear that Dr. Kaplan is extremely intelligent but he is more of a salesman than he is a physician. In our initial consultation, he raved about how 'easy' our case was and was so bold as to promise it would not take much to get us pregnant. Unfortunately, in doing so he ignored blatant indicators in both my labs and imaging that I had PCOS. I was put on a generic protocol. Even when the protocol failed and we looked for reasons and potential causes he continued to ignore the notes in every single one of my ultrasounds on the condition of my ovaries.

Dr. Kaplan is not the right physician if the cause of your infertility is still unclear and if you want a protocol that is customized to your unique diagnosis. He does not do much in terms of work up and pushes hard for IVF as the first course of treatment even if underlying issues are still unclear. As a result, the protocol you're initially put on will not be tailored to you. If you feel strongly about using Dr. Kaplan (he is very nice and very warm) I can't stress enough how important it will be to advocate for yourself to do research on testing before starting your protocols. Despite the fact that he agreed with me (wholeheartedly) I had to ask for an ERA with only 1 embryo to transfer, I had to as for PGT testing, I had to ask for ICSI despite my husband's poor morphology. He has a cookie-cutter template and if you want a unique approach you will have to do the research and present it to him.

When we came to Dr. Kaplan we believed our issue was MFI (poor morphology, good counts, and motility). We moved directly into two medicated IUIs. I am a hyper responder and got 3 follicles each cycle with just 5mg of Letrozole (he is not a Clomid fan). After both failed we moved to IVF. I did 21 days of birth control, 225 gonalF, and 75 menopur with an antagonist protocol. We did a Lupron trigger because my estrogen climbed very high and my retrieval yielded 40+ eggs. Only 14 were mature, 11 fertilized, 6 embryos and just 1 tested PGT normal. I believe this protocol was far too aggressive for a hyper responder like myself.

Dr. Rapisarda's demeanor is professional, calm, and warm. He is very inquisitive and has an investigative approach to diagnosing and treating infertility. When he discovered that I had an isthmocele ( a c-section scar defect) he referred me to a surgeon. He let us know our treatment options, including an Endometrial Receptivity Test which assesses the best time to implant an embryo.

Come with a list of questions and he will be happy to answer them.

He performed a saline ultrasound to diagnosis an isthmocele. He then referred me to a surgeon to determine if an isthmocele repair was necessary or not. He performed an ERA at his office to assess the best day for an embryo transfer. For my FET and ERA, I was put on a protocol of estrogen pills 3x a day and a daily progesterone shot. After it was discovered that there was fluid in my uterus from the estrogen, he changed the protocol so that one of the estrogen pills was taken internally.

We're still waiting for our final bill. Our insurance paid for the first ERA.

I understand that I'm not the ideal patient. I have had 2 natural pregnancies and losses and advanced maternal age with diminished ovarian reserves. However, Dr. Kaplan remained positive for me and optimistic during my cycles. But also remained very honest. I appreciate the fact that Dr. Kaplan performs all his own retrievals and transfers with his team of embryologists in Highland Park. So the retrieval and transfer dates are set each month. So you can plan your life around those set dates. Dr. Kaplan is also creative in his treatments. He changed the protocol for my 2nd cycle to improve my #'s. He is creative and adjusts the medications depending on my response. Prior to my 2nd cycle, my blood tests showed that I was not ready to proceed with stimulation. I expressed that I was disappointed but he told me to return in a couple days to test again. My numbers improved slightly and he allowed me to proceed with IVF. I really appreciated that he just didn't cancel me and have me wait another month but was understanding and compassionate to give me a 2nd chance.

You won't be able to see Dr. Kaplan often or hear from him directly, but you can trust his IVF coordination nurse Ilynne. Trust that he is reviewing your labwork and providing the best treatment even if you don't hear from him. If you have questions and need answers, be persistent with the nurses and they will communicate with Dr. Kaplan for you.

1st cycle: Priming: Endometrin 3 times a day for 4 weeks prior to stimulation. Estrace pill once a day. Stimulation: 1) Follistim 450. 2) Menopur 150. 3) Microdose Leuprolide. 4) HCG. 5) Ovidrel trigger shot Retrieval: 10 eggs, 6 fertilized, 2 blastocyst sent for PGS testing. Both embryos returned as aneuploid. 2nd cycle: Priming: Endometrin 3 times a day and Estrace pill 1 times a day. Stimulation: Clomid for 12 days during stimulation. 1) Follistim 450. 2) Menopur 150. 3) HCG 4) Ganirelix 5) Ovidrel trigger shot Retrieval: 6 eggs. 3 fertilized. 3 blastocysts sent for PGS testing. All 3 returned as aneuploid. Awaiting to commence 3rd cycle. I also took the following OTC supplements: Prenatal Coq10 Ovasitol Probiotic Omega Fish Oil Vitamin D Magnesium/Calcium Melatonin Acupuncture and Yoga

For each cycle not covered by Insurance: Biopsy of embryo for genetic testing $2600, Freezing $1200, Thawing $200. Genetic Lab testing $2500. HCG Shots $700-800 Insurance Out of Pocket: $3k each year. 4 cycles retrievals covered by insurance. Vitamins/Acupuncture/Yoga out of pocket. $2k

I believe that Dr. Hirshfeld is well informed and I trusted her care. I wouldn't characterize her as a "warm" person, but rather she is straight to the point which for me was totally fine. I appreciated her direct answers, but I could see how some other women might need a warmer experience especially during such a trying moment in their lives.

If you are looking for a no-nonsense, fact based experience that gets results and don't need someone who is warm and fuzzy to deliver the good and bad news, Dr. Hirshfeld is a good option.

I had diminished ovarian reserve and my husband had some motility issues. Dr. Hirshfeld prescribed some vitamins including Vitamin D and CoQ10 for each of us. I was prescribed Letrozole for 5 days, then after an ultrasound confirming I had a viable follicle I used the Ovidrel trigger shot and then took Prometrium every evening following. We had one unsuccessful IUI, but we got pregnant on the second try. I used Prometrium every evening until I was 9 weeks. I am now 16 weeks pregnant.

My insurance is pretty good so much of my costs were covered. I think I only paid for the ultrasounds and the prescriptions. All in all, with two rounds of IUI I think we spent around $500. After the first unsuccessful IUI I did more research on IVF and that would have been considerably more, in the range of $5K-$8K, due mostly to the prescription drugs.

Perhaps my opinion is schewed by the fact that both my wife and have each worked with Dr. Hirshfeld to try to get pregnant, and we have not yet gotten a healthy embryo to implant, but I often felt like I was a lower priority than my wife because my probability of producing healthy eggs was lower. This would manifest in time spent focused on my options during a consultation and how quickly she recommended moving on to only my wife attempting egg retrieval. However, at a recent appoint in the last 6 months, I felt like she started to "click" with us a bit better and really understood that my wife and I are both going through the fertility treatments as patients who might both conceive and not just a carrier and supporter. We have been seeing Dr. H for nearly 3 years and will stick with her through the remaining pursuit to have a baby. Despite some of the concerns I had about her interest in my fertility options (as opposed to my wife's), I trust her judgement and appreciate her compassionate approach to the ups and downs of the last couple of years. She also always took the time to explain the processes in great detail, in terms we could understand, was honest about the percentages of success for most procedures and took the time to answer questions.

Make sure she understands your family dynamic and that you ask questions if you feel unsure that all options have been explored or offered.

I started an egg retrieval cycle following standard diagnostic tests and consultation. IUI was not an option because of a blocked tube. My bloodwork and ultrasounds revealed that my estrogen levels were very low and only 1 follicle per ovary reacted to the drugs. Per this info, Dr. H said we could not go through with the egg retrieval. We are now working to use an egg donor, and I have completed a new round of ultrasounds and bloodwork to prep for this process. I am now on birth control pills to regulate my cycle while determine the egg donor and associated paperwork.

We are lucky that we have insurance that covers some of the costs associated with fertility, but only to a point and for so many attempts. I feel that the cost most glaring was tied to the storage of sperm and/or embryos. That was a significant cost for us during this process and it is not covered by insurance. This is especially difficult to get a large bill like that following an egg retrieval that results in abnormal embryos that need to be destroyed (or used in research). Long-term storage of embryos or sperm seems reasonable, but short-term storage while viability is determined seems unfair.

No comments as it is not relevant to my treatment to date.

I enjoyed meeting with Dr. Rapisarda. He was thorough and answered all of my questions. I don't know if this is typical, but unless you have a consult, it's as if you have no access to the Doctor. That I do not like. Unlike other healthcare providers, there's no option to message the Doctor via the portal. I don't like that I have to schedule a separate consultation if I have a question for the doctor. Again, I'm not sure if this is the standard procedure for fertility clinics, but it's a challenging set up.

Again, my frustrations aren't with Dr. Rapisarda, however expect to have little to no interaction with him.

My first round of egg freezing didn't produce a lot of eggs. They wanted to do a more aggressive approach for round two, but after my second consult I never spoke to Dr. Rapisarda, everything was through the nurses and clinic staff.

There are different buckets of costs. First, there's a cost for your consult(s). Then you have a cost for monitoring appointments. (Note, if you don't get a period you'll need to go in more often for them to know when your cycle is occurring.) Then you have medication costs. Then procedural costs. Then freezing costs.

NA

I came to Dr. Hirshfeld-Cytron after a terrible experience with another doctor that resulted in no viable embryos and a poor bedside manner. Dr. Hirshfeld-Cytron was 1) willing to try a different / more aggressive protocol, 2) was willing to meet with me as many times as I needed to discuss my progress and answer my insane questions, and 3) was attentive to how I was progressing, having me come in more often for bloodwork and ultrasounds as needed (sometimes multiple days in a row) and adjusted my doses as needed. I think that in our video conferences she could come off distracted as she is typing at the same time, but I think she's being diligent / organized in writing notes. I would say that she was realistic in her communication with me, IVF isn't a guarantee, but was willing to be creative. Overall, I was happy with the care of the entire FCI team, they all work together.

I would say that she can come off as distracted but really she's very attentive and is writing copious notes. She's willing to monitor on a daily basis if needed and adjust as necessary, I'd say that's not typical for most IVF Doctors. She's willing to share information, just ask for an appointment, this is a very busy clinic. She'll be creative if warranted, my first round of IVF yielded no embryos so she treated me like "one of her over 40 patients" versus my actual age of mid/late 30s. She tailored my protocol as necessary.

10 days of stims Lupron 20 units daily for 10 days (started 2 days prior to the rest of medication) Clomiphene 100 mg for 5 days Gonal F 300 IU (ramped up and down based on US and Bloodwork) Menopur 150 IU Omnitrope 0.3ML

It was communicated up front based on our insurance. When checking in online for appointments, I would advise patients not to immediately pay costs other than the copay through that portal because it's sometimes wrong. Ask for the detailed invoice before paying.

Single fresh transfer given my poor first round results. She thought a fresh transfer the most likely to yield good results.

Really knowledgeable, patient and clear. Very good at setting expectations and walking us through the data. Data coupled with personal preference and needs guided all treatment decisions. I never felt like any question was annoying.

She is not effusive but she cares deeply. She is super smart and knows statistics by heart. She is experienced and trustworthy

IUI w clomid, follistim and ovidrel x 3 Now prepping for IVF w frozen transfer/ natural cycle. Priming w estrogen patches and next cycle will be stimulating meds and retrieval

Insurance covered most of our treatment minus 15% coninsurance

She is the ideal balance of science-backed guidance + empathy. I always felt like I was in very good hands with her. She also was open to offering alternative treatments suggestions to assist / enhance the IVF process -- such as Chinese acupuncture. She is highly respected as a fertility doctor in Chicago for her knowledge and expertise -- I trust her and highly recommend her to friends who are looking for pursue fertility treatments.

Stay open, come with questions, know that you're in great hands with her. <3

She gave us the facts of single versus multiple, and there was very little "steering" as to what she would recommend until I asked her point-blank. Given my age and the increased risk for miscarriage and complications, my husband and I opted to move forward with a single embryo transfer.

Dr. Kaplan is very straight forward but also still has a decent bedside manner. At the same time, I feel like he didn’t just tell us what we wanted to hear. He recommend IVF right away which was refreshing after going through 4 IUIs at a former clinic. I later learned that the chances of success for this with our issues were very low so I appreciated being advised to go directly to IVF. We froze multiple embryos from one egg retrieval and I now have 2 daughters after 2 transfers.

Expect to receive honest feedback about your circumstances and be prepared to try a course of treatment you might not have anticipated.

I have PCOS and my husband has slight MFI so we went straight to IVF. I retrieved 55 eggs, 46 were mature, 31 fertilized and we froze 21 embryos. We did two frozen transfers and both were successful.

Most of the cost was covered by my insurance.

Dr. Hirshfeld is not warm and fuzzy and that's completely okay with me, I don't need that. But what I don't need is someone with horrible bedside manner. She was not empathetic to my/ my husband's concerns, questions, and situation. Maybe she favors patients who seem to be in a favorable age range (from the reviews I'm seeing) and simply feels annoyed with those patients who don't yield good results for her. My husband and I constantly felt like we were bothering her with simple questions and tried to stay on her good side after being scolded by her. When calmly expressing a bit of frustration about admin fails, without hearing us out, she actually said, "If this is too much for you, we can stop this right now and you can come back when you're ready." We were shocked wondering where this unprofessional outburst came from considering she had encouraged us to let us know if we ever had any concerns. This is literally the only thing we ever mentioned to her bc it had gotten so frustrating. She spoke to us like we are her children, threatening to take away her IVF services. This was only the tip of the iceberg. Even after this, we proceeded on with a few more cycles with her until I decided finally to pull the plug and switch to a different clinic altogether, knowing if you switch doctors at the same clinic, they all talk and it's just awkward.

She might be better for you if you're someone who has been through IVF a few rounds already and know what the expect and advocate for certain procedures. She is not a doctor who thinks outside of the box or adjusts protocol based on learnings from the last cycle. So you're just sending money down the drain repeating the same cycle or sometimes having to cancel them. During the middle of my second stim cycle for IVF, the nurse told me that we may have to cancel this cycle and I asked why. She said bc my follicles weren't getting big enough. As a last ditch effort, I did some online research to find out that other women have proactive conversations with their doctor to plan for an IUI in the off chance of these circumstances. So at the 11th hour, I asked if this could be done with us so as not to waste those 2-3 follicles that were of the right size. My request was granted though yielded negative. This was infuriating to say the least. Even if she felt there was low chance for success, I want a doctor who has that conversation with me. Then we went into another Egg Retrieval (with the same protocol) and got no eggs. No change to meds. In our follow up consult, she then suggested we look at donor eggs. At this point, I was beyond frustrated with her lack of creativity, general passivity and bad behavior. "For some patients, it's like a 50 meter dash, they get pregnant right away. And for others, it's a long haul." she said. I think honestly she just didn't want to deal with long haulers. With hesitation (due to my ticking DOR), I took the plunge and switched clinics and to a doctor who took me on more thoughtfully. She had me on different medications (each cycle, learning from the prior one), and developed a plan for me to bank 3 PGT-A tested embryos in trying for 1 baby before transferring again. She strongly recommended the comprehensive Mock cycle whereas Hirshfeld didn't advise me either way on this decision. This new doctor got me pregnant in less time that it took Hirshfeld to scold me and prematurely suggest donor eggs.

Dr. Alvarez's strengths include being honest yet empathetic to his patients. He was my second opinion after failing 3 rounds of IVF with my first RE. I appreciated that he stated that he would do everything in his power to get us a baby using our own embryo but also stated that I realistically needed to consider using donor eggs too if things don't work out. He made that statement after knowing my history of DOR and poor egg quality (among other issues). I know a lot of women who do not appreciate donor eggs being brought up on consultation, but that made me trust him even more. He was honest with me and giving me realistic expectations, but at the same time gave me hope that he could successfully get us our own genetically normal embryos (which he did). Another strength is his communication. He personally would call me with updates on certain important parts of each process, something my first RE never once did. If I missed his call, he would try calling me back a few times in the day (one time he called me 4 times in one day) to ensure that he gave me an update and to make sure all of my questions were answered. Another strength is his up-to-date knowledge and best practices in all things RE. He graduated from his fellowship a few years ago and is up to date on all the of the latest best-evidence research on how to achieve your goals of creating a family. I firmly believe that his recent training contributed to our success. He is also just a very sweet and kind human being. My husband and I loved every interaction with him... he's just so sweet and positive! I honestly have no weaknesses to describe of him.

Trust his process. IVF in general is a long, arduous journey, but he truly has your best interest at heart. My first embryo transfer failed, and we were all so perplexed because I had such a high chance of success given all of the testing we had done prior to the transfer (ERA, Receptiva, HSG, saline sonogram, etc). But Dr. Alvarez explained that these transfers sometimes fail and we will never know why. When I asked him what we were going to do differently for the next transfer, he said he didn't want to do anything different... that everything was perfect last time. That was a very hard answer to hear and to come to terms with, but we trusted him. We did the exact same protocol for our second transfer and it worked! I'm currently over 13 weeks pregnant. In all, trust his judgment. He truly wants the very best for you.

Before switching to Dr. Alvarez, my previous RE had maxed me out on Follistim (450/day) and Menopur (150/day), Omnitrope priming, and had me on Ovasital and CoQ10. He did on micro flare protocol too. All of these methods failed to produce any genetically normal embryos. When I switched to Dr. Alvarez, he did a gentler approach with these medications and put me on low doses. My Follistim was 100 twice a day (once in the morning and once at night), Menopur 75/day, and he added I believe 5 days of Clomid. Before starting a cycle, he would also put me on birth control pills for 10-14 days. Then I would prime with estrogen and omnitrope before starting the stim medications. I had major success with Dr. Alvarez's method, as I think my follicles responded better to a slower, gentler stimulation to gradually grow my follicles/eggs rather than being blasted with the highest doses of everything. Dr. Alvarez was able to get me a total of 3 genetically normal embryos... something we never imagined would happen!

Our costs were minimal because we bought a BCBS marketplace plan for myself. After we paid $8,000 out of pocket, we didn't have to pay for anything else other than genetic testing (total of $1000) and freezing and storage ($750). So we paid a total of $9,750 for the entire year. We met that deductible within 3 months via medications and two retrievals.

Things with Dr. Alvarez started out well. We had an initial consult during which he was empathetic, patient, and detailed in explaining what next steps would be given that my diagnosis of diminished ovarian reserve probably came as a shock at my age. We then ordered some testing and he walked me through the results and my options in a follow up conversation in a thoughtful and sensible way, making sure I had no questions. That's where the good experience ended. Separately, in the nursing section, I provide detail on what happened over the next five weeks with his nurse. Working with her for over a month, I couldn't get the requisite attention from her to even successfully order the prescriptions necessary to accomplish the egg retrieval, and missed two opportunities for egg freezing cycles in the process. At this point, I decided to loop in Dr. Alvarez. In a telehealth appointment, I explained to him everything that had happened with Rebecca, his nurse, and told him it had been 5 weeks just trying to get medications ordered and I was losing faith in their ability to oversee a complicated and time sensitive process. He had emphasized that time was of the essence for me to do this freezing procedure and so I asked for his help in giving Rebecca more supervision and making sure we were able to proceed. Although I made it clear that I felt my experience with her went beyond the typical complicated insurance dance of fertility treatment, which I was familiar with and knew what to expect, he did not seem willing to accept that Rebecca had done anything wrong. He excused Rebecca's inattention to detail and lack of responsiveness by explaining that they have many patients to balance and that insurance can be complicated so hiccups are to be expected. He explained Rebecca's perspective to me, which was that everything had been lined up and ready to go for weeks and she didn't know why I was saying that there was a problem. I encouraged him to look at the messages we had traded back and forth, which he has access to, as well as the record of the prescriptions she'd called in for me and what she hadn't called in, to see that her version of events was clearly not supported by the facts. He continued to resist any implication that the delays in my treatment were somehow Rebecca's or his fault, or that any mistakes had been made so far, although he did admit that he was concerned that at one point she had lied to me about having done a task I asked her to do, which she had not done. I began to feel like his priority was in protecting himself and Rebecca, not providing quality care to me particularly in light of the time sensitive nature of my diagnosis. During this appointment I also asked him a medical question about what could have caused my diagnosis. He at first gave me a very confident answer, however, moments later, he interrupted my response to that answer and said that he was just now looking at some medical articles online that indicated that actually maybe the answer was more nuanced than what he'd said moments before. I was a bit unnerved that he would answer so confidently if he wanted to do some research, instead of simply saying that he needed to look into it and get back to me. My problems with Rebecca continued for another two weeks after I looped in Dr. Alvarez, and I describe those further details below in the nurse section. If Dr. Alvarez did discuss with her and intervene, it did not have any obvious impact on Rebecca's ability to run things to ground effectively, and he never followed up with me to see if we were ready for a cycle or if things had improved. After 7 weeks of Dr. Alvarez and Rebecca and two missed opportunities for cycles, I decided to switch to Dr. Kaplan in the same practice. His nurses got me completely squared away within 36 hours of my first appointment with him, and I started my cycle just a week later. I only mention that to underscore the point that what I experienced with Dr. Alvarez and Rebecca was truly not typical and went beyond the normal insurance dance with infertility treatment. The whole experience made me feel like an inconvenience to them, not like a patient.

Go to Dr. Kaplan instead.

I never proceeded with a cycle with Dr. Alvarez because the simple process of ordering prescriptions was never able to be completed.

Miscommunications over treatment with Dr. Hirshfeld played a significant role in my negative experience with FCI. My husband and I had two initial meetings over zoom with Dr H to discuss egg/ embryo freezing/ transfer options. I found Dr H very polite but somewhat indirect. She explained that my TSH was high (3.19) and my AMH was low (0.5) but that was pretty standard for women my age. She showed me numerous charts and graphs about the decline of fertility over time for women in their late 30’s (I’m 38). She explained that to get the optimal number of viable eggs, with my low AMH, we are looking at multiple cycles. Nothing in those conversations ever seemed prohibitive. She did tell me numerous times that low AMH would make the process harder but if the cycle fails, the plan would be to continue with additional months of stimulation and retrieval. I did not want to pursue IUI because of the low success rate, so for my first round we opted for an IVF cycle to retrieve eggs, fertilize, conduct genetic testing, and transfer. I was given Follistim 225u, Menopur 225u, Dexamethasone 0.5mg and 250 mcg of Ganirelix beginning day 5. I triggered on day 12 with HCG. I grew 4 follicles on my right (17.4m, 26.6m, 22.1m, 16.6m) and 3 follicles on my left (18.3m, 10.7m, 9.5m). The results from the retrieval were 3 oocytes: 2 did not mature and 1 did not fertilize. I was not surprised when the cycle did not yield any viable embryos as this was predicted and my assumption was that we would just continue additional rounds of treatment. In fact, the day after I learned of the results, Dr H called me and said, “don’t worry because there are at least 4 additional aggressive protocols we can try.” A few weeks later my husband and I had a meeting with her to discuss next steps and this is where my confusion with Dr. H begins. During this conversation, Dr. H said I was resistant to the medication and my response was low- even though in our initial conversation she correctly predicted I would only yield 3-5 eggs based on age/ AMH. She stated that the dosage of medications I was given was the maximum for women with “poor reserve” and that if treatment goes the same way this next round, IVF is not a good option and we should consider donor eggs. When I asked why her assessment seemed in conflict with the charts, that she took care to show me in our previous meetings that outlined the necessity for numerous cycles, she said those numbers no longer apply to me because I couldn’t create a single embryo. She declared although my AMH is 0.5 I have the eggs of a 44-year-old woman. When I asked her why the medication was not adjusted at all during the cycle to account for any of these obstacles, she stated again I was on the maximum dose of all medications. (I later learned that I was not on the maximum doses, but it was a refrain Dr H would continue to tell me throughout the second IVF cycle). Needless to say, these contradictions shattered my confidence in the process. This should have been the most delicate conversation and instead I walked away totally demoralized, confused, and feeling like I was being “blamed” for the outcome. Additionally, the suggestion of donor eggs after one failed IVF cycle felt completely premature. For my second IVF round I was put on estrogen priming then MD Lupron 20 units in the AM and PM, 225 unit of Follistim SQ, 225 units of Menopur SQ and 0.3 ml of the Omnitrope SQ for 4 days. Around day 4 Follistim was increased to 300, then 375 and eventually 425 for days 13 and 14 (see previous statement about being on max doses). I also received bi-weekly acupuncture. Ultimately, I only grew 2 follicles on the left (18.2m and 17.7m) and 2 follicles on the right (21.0m and 12.8m). During a blood draw towards the end of the cycle, a random nurse looked at my chart and suggested I switch to IUI to save the expense of the retrieval. Days later, this recommendation was echoed by Dr H in a zoom appointment. She said we could go forward with IVF if I wanted to, but the response would likely be the same. With such a banal recommendation, I knew I could no longer continue with FCI for my treatments. I agreed to the IUI in order to quickly bring the cycle to an end. The IUI ultimately failed. In addition to this failure of communication, I was never given a diagnosis for my fertility issues other than DOR. I later found, by requesting my full medical records, that the ultrasound techs documented on numerous occasions “Nabothian cysts” and “known myomas” which was never disclosed to me. This seems like something important a doctor might discuss with their patient, regardless of its impact or importance. I think the moral of my story here is that if you are like me- in your late 30’s with a somewhat unsophisticated understanding of fertility, any conversations about plan, treatment, or options must be had with the utmost care and consideration. It’s not enough to say a doctor just doesn’t have a good “bedside manner” and its’ certainly never ok for patients to walk away confused, demoralized or feeling blamed for their infertility. It is also unacceptable to rely on the category of “unexplained infertility” when other possible barriers have not even been discussed. My case appears to be one with significant complications. But based on this experience, I don’t believe FCI is a sophisticated clinic that can address my issues. I certainly didn’t feel appropriately educated about or confident in my treatment plan. The only hope I have is the possibility of obtaining a second opinion from a doctor who might be better suited to address my specific needs.

This doctor may not be the best fit if you are a woman who has fertility issues that require close monitoring or if you need a personalized treatment plan.

2020: Complete Workup, Bloodwork, Self-Pay Appts w DR H, Self-Pay Natera genetics testing. TOTAL: $2,430.95. 2021: Loan for meds to meet out of pocket insurance max, acupuncture, specialty pharmacy for meds not covered by insurance. TOTAL: $10,758. Estimated total billed to insurance: around $50k

Dr Sipe can be considered a nice, caring, friendly, knowledgeable fertility doctor. Many patients believe he's amazing and dedicated to helping them become pregnant. However, this doctor didn't show that same dedication, compassion, hope, and heart for wanting to help me become pregnant. It's hard to ever meet or have an appt with Dr Sipe unless you have surgery or a procedure scheduled, especially during the Covid years. Dr Sipe acted like it was an inconvenience to have a phone call. He doesn't accept email either from patients even though the company newsletter encouraged emailing your doctor. I did have a couple Zoom video calls that included nice conversations with the doctor, but I do not feel this platform is the same kind of connection as an in-person or phone call consult. I didn't feel as much compassion was given towards myself and my file in the same way as other content patients. Dr Sipe chose to not listen to comments about issues with how the office staff communicated and handled paperwork with some of the patients, which I believe he should have stepped up to assist his staff to manage. One positive mention is that I felt cared for and safe having surgery done by Dr Sipe. The nurse anesthetist Dan did a great job administering anesthesia also. One great day of care can't replace or make up for the many days of various communication and paperwork issues that occurred with some of his staff on my file. Dr Sipe should have some respect of his patients' honest truths, as several of my file's issues and the treatment of some staff towards me were presented to Dr Sipe and dismissed.

My advice for prospective patients of Dr Sipe is to only have a consult if you have a healthy body in general. Write down all your questions in advance of your consult because he’s very hard to reach, as you’ll mostly be having communication with his nurses and office staff. During the consult, make sure to find out exactly the type of other doctor appointments and prerequisites required (ex: a primary care physical, mammogram, or missing shots) from the doctor in order for him to allow you to do the fertility treatments and when appts need to be completed. Write this info down. Otherwise, his staff do not provide a worksheet of medical prereqs needed and this will take precious months of your time. Advise the doctor the qualities you need as far as dedication and caring toward your goals, and not the goals that influence the office pregnancy stats. Encourage this doctor to not play the wait-and-see game when it comes to deciding on IUI or IVF protocols / plans. Be prepared to do extra outside office work for his staff on your own time, especially if you're having records transfered there because the office staff misplaces records and signed docs often.

I had the hysteroscopy surgery in summer to remove uterus polyps. Then we moved towards an IUI due to low egg reserve. It wasn't until the winter months when my body was ready for the IUI due to a few setbacks, so the initial protocol was changed. The IUI protocol changed into doing Follistim injections for several nights plus oral Letrizole for five days instead of doing Estrogen priming first. This plan didn't work and the cycle was canceled, so now I am focused on Estrogen priming first.

I had to pay approx. $2400 total to FCI over the course of the year for blood labs and ultrasounds, using insurance. I paid Labcorp, which bills separately for genetics testing, the cost of $331 for the blood draw done at FCI. Then I paid $1700 to FCI plus $546 anesthesia costs to Lakeshore Anesthesia for my hysteroscopy, with my PPO plan. Since I met my deductible by the time of the IUI cycle, I didn’t have to pay for the Follistim injectable meds. However, if I had attempted the IUI four months earlier Walgreens Alliance were going to charge $2600 for the first two Follistim vials shipped and then remainder vials shipping would be free since the deductible would have then been met. My cycle was canceled halfway thru, but my insurance would have paid for IUI costs since I met the deductible.

Dr. Hirshfeld took the time to listen to my story and address my concerns. She provided facts and research while answering my questions. She adjusted my treatment plan after failed attempts. She was clear and precise.

Be prepared with questions; as she can not help you if she doesn’t know your concerns.

I began my journey a few years ago with the hopes of preserving my eggs for future use. I went through hormone shots to increase the number of follicles. And now have 6 eggs in freezer. About a year ago I went back to start my journey to motherhood. At that time my bloodwork came back that my thyroid levels were to high so was put on medicine. She then did the saline ultrasound and told me I had polyps within my uterus. I would then have surgical procedure to have them done. I was given a vaginal pill to thin my lining the morning of the procedure within 1 hr I was having every side effect I could related to that drug. They took me back flush my iv to clear the drug and then put me under. Before the surgery I was told it would be 15mins but 4hrs later i was able to go home. (partially cause of all the allergic reaction). Originally they said they would scrap the fee polyps but when I woke up I was told there were way more then they thought so they performed a full D&C. A few months later I decided to pick a sperm donor and start the iui process. The 4 trials I always took clomid the first 2 were same dosage the 3rd time she up’d the dosage and the 4th she added a hormone shot.

IUI treatments monthly roughly cost me $1500 out of pocket after insurance.

He is very busy and not very accessible; most communication is done through the nurses. But otherwise we had no complaints about working with Dr. Sipe. He was warm, funny, and direct, which was what we wanted. He was never pushy or judgmental, just laid out the options and the odds and left it to us to make the decisions.

Take notes during your consult because he goes over things pretty fast and the clinic doesn’t provide a lot of written summaries.

I’m not sure what this question is asking. First we tried IUI 2 or 3 times in early 2015, then changed to egg retrieval and fresh embryo transfer. My protocol included intramuscular injections of progesterone. That led to a single live birth. We tried a frozen embryo transfer in early 2020 with the progesterone IM injections, as week as pills, patches and suppositories. Although my lining ended up at 10 mm, which was good, and everything looked good with the embryo after thawing, sadly this transfer resulted in a negative pregnancy test.

The first round of IVF was covered by my insurance so our total costs including drugs ended up being about $6000. The frozen embryo transfer in 2020 wasn’t covered by insurance. They charged us $2575, not including drugs or out-of-state monitoring.

The doctor initially told us in 2015 that they’d recommend transferring two embryos, on the day of, Dr.Sipe switched to recommending a single transfer. When we did the frozen transfer in 2020, he again recommended transfer of one.

I loved working with Dr. Sipe because he has a great personality, doesn’t sugar coat things and tells you his honest opinion, and gives you information to help guide you to make a decision. He doesn’t push you one way or another.

Be your own advocate and ask questions when needed.

I went through 3 IUI cycles with clomid and they were unsuccessful. He gave me the option of doing another IUI with a 10% chance of success or IVF with 50% chance of success. I chose to go with IVF and had a failed fresh transfer and have no embryos left. He is changing protocol for our next retrieval and we will be getting started as soon as the covid restrictions are lifted. The clinic has kept us very informed as far as what their plans are with covid going on.

Costs seemed the same as other clinics from the other ladies I have talked to. I have had no problems with the billing department.

Dr. Sipe felt that with my age and other factors, the risk of multiples was not worth the benefit of transferring more than one embryo. I agreed with his assessment.

Dr. Kaplan explains everything very thoroughly. He also has a calming presence to him that helped me feel comfortable. I appreciated how he took my input into account. I had started my cycle before Shelter in Place went into affect. Dr. Kaplan called me and we talked - for a long time - about options (keep going or stop cycle) and he allowed me to feel empowered. Sadly my embryo did not take, and again he took his time talking and checking in. I felt very cared for and in the end felt a lot better about what happened.

Take your time and ask all the questions. You are not inconveniencing him, so don't rush things.

For my IVF I used shots and medication. I had progesterone shots that I needed help with due to having to put them in my bum. The stomach shots weren't bad. It was all based on my personal information.

I was able to setup a payment plan for the egg retrievals and IVF. Medication for egg freezing was paid out of pocket, but I got a group deal. IVF medication was covered by insurance and the clinic helped me facilitate getting those.

We only did one embryo, but I am going to ask about doing two next time to increase my chances.

Dr. Hirshfeld-Cytron has been very straightforward in her communication with us. She made time for us during our first consultation to ask any questions and she honestly laid out potential plans for treatment, as well as expectations. She doesn't over promise, but is very truthful in what to expect from treatment cycles. She may not come off as the warmest doctor at first, but she is very caring. She always has clear communication every step of the way so I've never felt in the dark or unsure about next steps. Everything has been laid out for us in exact terms. She has performed the majority of my procedures and I've always felt like I was in good hands with her. I left my first consult feeling like she was the right choice and haven't changed my opinion of her in four years. She has been sympathetic to our losses, and has celebrated in our success. We have done an IUI, egg retrievals, PGS testing, hysteroscopy and embryo transfers with her. I've felt safe and empowered in her care. I would recommend her to anyone.

I would say to prepare to receive honest answers and information from her, even if it isn't always easy to hear.

I have had an IUI cycle using Clomid and a trigger shot. This cycle resulted in a miscarriage due to abnormal chromosomes. We moved on to IVF with PGS testing. I had an egg retrieval using Follistim, Menopur, Ganorelix, and Dexamethasone. We retrieved 18 eggs, five made it to day 5, and two were normal after testing. We transferred one and did progesterone shots, but lost the pregnancy around 7-8 weeks for unknown reasons. We transferred the second embryo and had a successful pregnancy. We are trying again and did a second egg retrieval using the same protocol. We retrieved 17 eggs, six made it to day 5, and 2 were normal. We had ICSI done for all of our retrievals. Our transfer is now on hold due to COVID-19.

Our most recent egg retrieval, ICSI, prescriptions was about $10,000 out of pocket even with good insurance that has a fertility benefit. Our genetic testing was about $5,000.

Because we did PGS testing on our embryos, our clinic will only transfer one embryo since it would not increase the odds to do more than that. Dr. Hirshfeld-Cytron also went over the risks of multiples.

Dr. Hirshfeld is compassionate, personable, and an effective communicator. But most importantly to me, I felt that out of all the doctors I consulted with before beginning IVF, she was the most professional and practiced using the most up to date and evidence based practices. She was always willing to provide education when I had questions, and made recommendations that were direct and appeared to be based on current science and good sense. I always felt I could trust her guidance - a really important thing in this confusing, emotionally trying process.

Come ready with your own research and questions! She will take you seriously and the more you bring to the table, the more you will get out of the process. Dr. Hirshfeld isn’t likely to automatically recommend every additional test and intervention under the sun, but will point you in the right direction about what would be helpful for your situation, and what may not.

One thing I really appreciated Dr Hirshfeld recommending was to have a laparoscopy for endometriosis AFTER my egg retrieval. This both minimized the potential impact of the lap on my ovaries/fertility, and meant the lap would be done right before my frozen transfer - maximizing the benefit of the lap for implantation.

Egg retrieval - $9800 FET - $3500 Cryopreservation - $1525 Embryo biopsy - $2600

I specifically sought a clinic that used eSET for younger women (as I was) - this was one of the reasons I was drawn to FCI and Dr. Hirshfeld over other clinics in the area.

We met after to follow up with results and to get an idea of what the next step would be, she would check kept an eye on the treatment and followed up in between to reassure us and answer our questions.

The treatment and all the tests can be overwhelming, along with the time it can take can but be hopeful

We did 2 IUI’s and the second one ended up being a chemical pregnancy. She told us we could go for IVF as it had a better chance, but our insurance needed us to complete 6 IUI’s so we did 4 more and got 3 negative pregnancies and 1 more chemical. when we finally went for IVF she strongly suggested us to do a genetic testing which we hesitated at first but went with it. Out 32 eggs we got 3 embryos and only 1 was viable for a transfer the other 2 had chromosomal abnormalities, I’m so glad we went with her recommendation and got the test done. We got the healthy embryo transferred and now I have a beautiful boy all thanks to her. I would choose her as my doctor if I need to go back again.

Dr. Rapisarda was very kind and compassionate. He listened, but he did not give me enough details on my treatment. On my first IVF cycle, the dr. nor the nurses showed me how to do my injectable meds. I had multiple cancelled FET's due to thin lining, and not one time did I receive a call from the doctor. Only from the nurse, who always gave me the feeling that I was bothering her. We tried ~5 separate times for an FET and the doctor barely made any changes to my protocal that clearly was not working.

Be your own best advocate. Document everything.

Monitoring was a well-oiled machine, but sometimes long wait times. There were at least 30 people waiting for monitoring each time I went.

My insurance covered most costs. Out of pocket for ERA test, genetic testing, embryo storage

I wish I had gotten to meet with him more frequently, but I always felt extremely confident he knew what he was doing and was putting me on the best possible course of treatment to ensure success. My only complaint would be the limited windows of time he was available each month for procedures, causing longer wait times (~2 months) between cycles than I would have liked. I wish this schedule had been slightly more flexible, but realize this is how they are able to treat so many patients.

If there’s anything you want to ask or make sure he knows about you, be upfront so you can use the time with him most efficiently.

Used ganirelix and menopur for retrieval cycle and Luprolide (sp?) for the trigger shot. Due to number of eggs retrieved, froze all embryos rather than doing transfer right away to increase chances of success. Used Estradiol tablets for the first frozen transfer, then after that didn’t work, switched to patches for the second frozen transfer, which worked.

The only part of my treatment not covered by insurance was a $300 admin fee, and I was able to appeal to get this covered under my insurance plan.

Because of my age (31), no prior history of issues or known risk factors, and the fact that a pregnancy with multiples is considered risky, Dr. Kaplan recommended transferring only 1 for at least the first two cycles.