Geisinger Medical Center Fertility Center

My experience with Dr. Zoma has been great. He has answered an absolute onslaught of questions from me with ease. You can tell he's extremely knowledgeable, and he does stick to the most evidence based, up to date practices. Which should be reassuring to anyone seeking treatment.

This is the same advice I would give anyone seeing any fertility specialist; read as much as you can about your specific reproductive issue/the procedures you're looking to undergo and come ready with a list of questions. The whole process is extremely overwhelming and it's easy to get lost and forget things. It's also helpful if you can bring a support person as a second set of ears.

Dr. Zoma recommended we jump straight to IVF, as with my occluded fallopian tube and endometriosis, other fertility treatments would likely be unsuccessful. We completed our first round of egg retrieval on the short protocol with gonal F, menopur, cetrotide and lupron trigger. We also discovered that I'm a poor responder to medication despite having a normal AMH for my age. (My left ovary is smaller and has fewer antral follicles likely from two endometriosis laparoscopic lysis of adhesions previously). We ended up doubling doses of both medications halfway through. Triggered on day 13, retrieved 12 eggs, 8 were mature, all 8 fertilized, and 2 became blastocysts that were thankfully PGT-A normal. My husband and I decided we wanted to bank embryos given that I'm close to 35, so we elected to do another egg retrieval. Because I was alarmed at my slow follicle growth and 25% blast rate, Dr. Zoma said we could try the long protocol. For my second egg retrieval I primed with estrogen only birth control, and cross tapered with approximately 8 days of microdosing lupron. Then immediately started on the double dose of gonal F and menopur, and stayed on the lupron as my GrNH agonist and triggered with HcG. We again retrieved 12 eggs, 8 were mature, 6 fertilized, and unfortunately all embryos arrested during development, and we ended up with 0 blastocysts. Dr. Zoma sat with me while I cried, and reassured me that this wasn't my fault, that all cycles are different, and that the long protocol clearly just wasn't for me. We made a plan to go back to the short protocol on the maximum dose of medication and are hoping for greater success. Dr. Zoma also performed my HSG and hysteroscopy to remove a polyp following my second miscarriage.

My insurance covers most medication and fertility treatments, thankfully. The financial counselor is very sweet and easy to speak to.

Dr. Zoma again follows the best evidence-based protocols. If you do not elect to have your embryo's PGT-A tested, he will transfer 2 embryos. However, if your embryos are PGT-A normal, he will only transfer 1. That is because the rate of miscarriage for chromosomally healthy embryos is far less, and the rate of embryo splitting (creating identical twins) is far greater in IVF than in the general population. IVF pregnancies are already considered high risk for multiple reasons, and creating a multiples pregnancy on purpose is unsafe. The goal is one healthy, full-term baby.

Dr. Zoma was very blunt and straight forward. He does not allow enough time for questions, unless you are persistent. He often wouldn't even sit during the visit to discuss results or options. He would stand with the door open to review results and provide instruction. We worked with a separate fertility clinic for the male portion of our IVF journey and he would not return their calls to discuss our case.

Be your own advocate; my insurance dictated that I had to use this clinic. If presented a different option I would go with another clinic. Otherwise you need to be your own advocate; politely ask questions and do your research.

After our initial workup it was determined that I was a routine patient; meaning no issues on paper with my fertility. I have never been pregnant, our issues were male factor that could not be handled at this fertility clinic. My stims cycle was pretty routine from my understanding; Gonal F, Menopur for stimulation, added Cetrotide on day 6, then Lupron trigger. This occurred with both cycles; retrieval 1 resulted in 7 mature oocytes, cycle 2 resulted in 11 mature oocytes.

This has been very up in the air; my meds had copays which was less than $2,000. I have IVF coverage with my insurance; with this clinic a lot of my visits are still pending with insurance.

Yes, we were advised that if we completed PGT-A Testing a single embryo would be transferred, if we opted out of this 2 embryo's could be transferred. This was based on my age, previous attempts at IVF, which in our case this is our first.

Dr Zoma is very to the point and not very emotional. If you’re looking for someone to hold your hand throughout this process, Dr Zoma is not the doctor for you. But he is very professional and good at his job. At times, he can hard to understand due to strong accent.

Write down questions beforehand because it can be overwhelming. Make sure your needs are heard and make your goals known. Do not be intimidated.

After my diagnosis, I did one round of a Clomid which was not successful followed by two rounds of Femera which also were not successful. We underwent 3 cycles of IUI with these medications. I recently did one round of Gonal F injections which I did not respond to. I’ve been plagued by ovarian cysts and multiple abnormal cycles.

My insurance does not cover fertility treatments and I have received multiple bills. So far I’ve paid around $1000 which does not include medication costs.

He has a different cultural background so there is a bit of cultural difference but he explained everything very well and kept me fully updated every step of the way. He definitely wants the best outcome for his patients.

Just realize that he is not a warm fuzzy doctor but that is likely due to cultural differences.

Diagnosed with a large ovarian cyst at my first scan. Hoping it would go away he monitored it for several months before scheduling a cystectomy. Cystectomy performed and was clear at my scan a month after surgery. Next month started Follistim and Menopur, then added Ganirelex on day 8. Retrieval on day 15 with planned freezing for PGT-A testing and eventual frozen transfer. 18 eggs retrieved, 17 fertilized, 12 made it to blast, 6 PGT-A tested normal. FET on hold for now due to COVID.

My treatment was mostly covered by my insurance. I had to pay around 1700.00 for medications, my 500.00 medical deductible per year, 150.00 for scans, 1000.00 for donor sperm and 3200.00 for PGT-A testing on 12 embryos.

Because I had PGT-A testing and no known fertility issues other than age my doctor advised against transferring more than one embryo.

Dr. Zoma was always in a hurry to move me through the appointment and had poor bedside manner. When you would ask him questions he would get irritated like I was a bother. He was not sincere or comforting when speaking with. Also when it came to procedures and ultrasounds he was very rough and unpleasant

If you have another fertility clinic in mind, use them!

I did Clomid with timed intercourse which only resulted in 1 follicle in 1 out of 3 cycles. That cycle failed. I then was on Letrozole for 3 cycles and only 1 cycle yielded a follicle. That cycle failed

My insurance covered most of my timed intercourse and oral medicated cycles. When it came to IVF they wanted $18,000 for 1 cycle. That was when we knew we couldn't afford Geisinger anymore and moved to a more affordable clinic with alot more knowledge and compassion

Again, Dr Zoma is a very knowledgeable person in his field. He made sure to explain every aspect of what was going on. Has a great bedside manner and is easily approachable with any questions that you may have. He makes you feel comfortable and eases your nerves when you meet him.

Just listen carefully. He does have a slight accent that can be difficult to understand if you aren’t paying close attention.

So far Dr Zoma has has only done my test to see if my tubes were blocked, one of my baseline ultrasounds, and my IVF consultation. He always explains everything thoroughly prior to whatever procedure he is doing, as well as during the procedure itself.

Unsure as most of this process for me has been covered by my insurance. That could change for IVF though

He will do two embryos for transfer if we didn’t have genetic testing done prior to. If we had that elective testing done, they would only do one transfer.

Dr. Zoma sees me every visit and always takes the time to explain if I have any questions. He has even done my ultrasounds if the tech is busy that moment. He makes sure to ask if I understand how to give my injections every cycle. He explained everything in length in the beginning and continues to do so.

If you don't understand what he says ever... ask :)

WE have done timed intercourse for a full 4 cycles. I started with clomid and hcg injections, since im anovulatory with PCOS. I did one full cycle with clomid. I did take clomid for 2 cycles though. The first there was a mass in my uterus that was found for my mid cycle scan tha tneeded to be removed by Dr. Zoma. The second was a full cycle that ended in a cyst. He then changed my medication to Femara to see if we would have better results and less complications. I have completed 2 rounds and I am in my 3rd round of femara and hcg injections. Currently in my two week wait.

The costs are all reasonable and everything was discussed with a financial advisor before anything was done

Dr. Zoma was sometimes very personable, very nice, and communicated well with us at our appointments. At other appointments I felt like he wasjust there because it was his job. It was a hit or miss.

I’m not sure

My first treatment dr zoma wanted to try was IUI. We wanted to go the less expensive route first. After doing the insemination, dr zoma told us that my husbands sperm analysis showed that his sperm was not very mobile, meaning that the chances of iui working was slim. I felt very discouraged. We went back two weeks later after getting a negative pregnancy test. Dr zoma told us that he personally felt we would be wasting our time and money doing more iuis based on my husbands sperm analysis. He recommended we go straight to IVF w/ ICSI. We agreed and moved forward with the IVF process. Dr zoma recommended we do a fresh transfer with our IVF and freeze the remaining embryos. We transferred two day 5 embryos and it resulted in a negative pregnancy. We had 4 remaining embryos to freeze so we went back a few months later and did a frozen embryo transfer. We transferred two embryos and that resulted in a single pregnancy. Our son was born in may 2016 and is now a happy healthy 2 year old. We went back in June 2018 to use our remaining two frozen embryos. I followed the same protocol as my first FET but this time it did not work and my beta was negative.

Ivf package was $9,997 out of pocket. Cost had to be paid up front before any treatment was done. Medication was a separate cost that we had to pay for.

He's really caring and works with u and makes sure u understand stand how things work and if u have thoughts and ideas he listens only thing that would be a negative would be he's not big on FMLA paperwork when I had my chemical pregnancy after the ivf he was very understanding and caring but would not sign papers or give me any pain meds I was informed everyone experiences it different otherwise I am very happy with him

Don't take offense to what he says he only tells you things if he thinks it will help /or hurt ur chances and some times the truth hurts but he's not mean about it he's just trying to help u , and he has an accent so u may have to concentrate a little sometimes on what he says but overall he's the best I've seen in my years of trying

I'm not really sure on this part I would say compared to the YouTube videos I would say it was the standard meds and procedures but it was over a year ago

Normally my insurance covered most of the things leading up to the procedure but but as far as it and the meds we paid a little over $13,000 it was 9,000 something for the procedure and 3,000plus for the meds plus anything that I ended up needing a refill

Dr. Zoma has a thick accent but I could understand him. He explained all my options throughly and was honest where he needed to be. He always addressed my concerns. I felt like I was a person and not just a number in his office. When a procedure failed he was honest as what he thought would be the next best option.

Dont be afraid to ask questions. He will be honest with you too so be prepared to hear what he may say.

First IUI with Clomid was with husbands sperm who has low sperm count. He wasnt hopeful it would work but it is what I wanted to try. It failed. After that we tried IVF with ICSI. I dont recall meds I was on. I know we retrieved 21 eggs, 17 fertilized and 2 were injected as fresh. The others never made it to freeze. We didnt do genetic testing so we had no answers but doctor thought that there was some incompatibility with egg and sperm. Got pregnant naturally 2 months after IVF and it ended in miscarriage at 9 weeks. So we pondered IUI with donor sperm since it appeared to be a compatibility issue. My IUI cycles were with clomid and injectable for triggering. First IUI with donor sperm failed and the second worked. I know have a 3 year old.

Insurance paid for ultrasounds but I paid for medications and the Dr. Office gave coupons when they had them and the IUI and IVF we paid for.

They always said 2 and I agreed

Dr. Zoma is a cheerful, jovial, and at times, an abrupt provider. He provides evidence-based practice, and there is no doubt in my mind that his experience paired with him "sticking to science" is his greatest asset. He will take the time to answer questions you may have, but it is important to make sure you ask them, because he might not offer a lot of information otherwise. He was a terrific doctor, and I would not have wanted my care from anyone else.

Ask questions if you have them, he doesn't mind answering them and will take the time with you---but really only if you ask for it.

They have an excellent financial person, Denise that lays out the payment plan. Costs about 10K with meds for one cycle of IVF. THey don't do package deals (like some places do where you get refunded if you don't get pregs etc). They have a cap for things like IUI if those aren't covered, so you always know how much out of pocket expense you might have.

Dr. Daggs was very straight forward in her approach and wasted none of my time. Her and my time were precious and were treated as such. My first appointment with her turned out to be my pre-op. The next time I saw her was in the OR. I saw her maybe 2 more times before I became pregnant. When she heard of this, she wrote a note to the office nurses in capital letters JULIA M IS PREGNANT! She celebrated with me and I owe it all to her that we conceived our precious daughter.

Trust that you are in the best hands. She will not steer you wrong. She may do some things the same as former doctors but there will be things you’ve never heard of. Go with it, trust the process. She’s amazing!

These are the medications I was taking the month we conceived. Again, I had laparoscopic surgery in February 2014 to open a blocked Fallopian tube and to diagnose and treat endometriosis. Medications: Letrozole 25 mg day 2; metformin 500 mg, twice daily; vitamin b6 500 mg timed release once daily; fertile cm one capsule three times daily; Mucinex 600 mg timed release day 11 thru peak plus 1; 5-HTP twice daily; Omega Avail twice daily; prenatal vitamin 3 capsules once daily; vitamin d 3 5000 iu once daily. I began the HCG 2000 units via injection peak plus 3 and continued on peak plus 5,7,9.

The only thing I had to pay out of pocket was from my laparoscopic surgery. She opened a blocked Fallopian tube and my insurance would not cover that as it is considered infertility. Everything else was covered under PCOS, endometriosis, and recurrent pregnancy loss.

Dr. Daggs and Holy Spirit Hospital does not and will not use IVF or IUI. Their approach is all natural and customized to each patient. About 90% of my treatment was covered under insurance as it was not coded as infertility but an actual medical diagnosis (PCOS, endometriosis, recurrent miscarriage).

He forgets that he is dealing with real people that have real feelings. He doesn’t take the time to explain things fully so you understand. I have to research on my own to figure out what I need to ask him to be informed of anything. Poor bed side manor and no sense of humor. Not personable at all.

Go elsewhere

IUI eith femara and HCG trigger shot since my eggs don’t come to maturity on their own. I also kept creating ovarian cysts but he couldn’t explain why.

Between 300-400 each cycle plus medicines

Due to his accent, it is difficult to understand sometimes. After my second transfer failed he made changes to the protocol. I wish all test and protocol changes that could be done happened after the first failed transfer. Every time you go in, he does meet with you and talk about everything. I did wish he had more bed side manner

Have someone else go with you to take notes Incase you don’t understand

Egg retrieval- different stimulants Frozen embryos Transfer- vagina suppositories and oral medication Beta test after 10 days

It was through my insurance. I had three trials paid for.

The first round he was ok with one embryo. The second round I felt he pushed multiple embryos and I did not feel comfortable with that. He did respect my wishes.

Dr. Zoma is clearly very educated in his field, but in my opinion, lacks compassion and empathy in a field that is full of emotional ups and downs for patients and their partners. After three failed rounds of Clomid/Provera and timed intercourse, I needed to pause my treatment for personal reasons. During my last appointment to establish an interim plan until I was ready to come back, Dr. Zoma was cold and seemed bothered that I needed to take a break from treatment. He spoke directly to my husband about my ovaries, my period, etc. I did not feel heard.

If you are a person who expects compassion and a warm bedside manner, perhaps look elsewhere for treatment. He can be difficult to understand, so take notes and listen closely.

Everything was covered by my insurance.

Every time I’ve gone to see Dr Gell she truly has been amazing. Going to a fertility clinic is overwhelming. I had come from an OBGYN who told me there was a good chance I would never get pregnant. So naturally when I first went to see Dr.Gell I was terrified. As a young woman you never think getting pregnant is going to be a struggle. She sat down and looked over all the testing I had and told me. “You can get pregnant we just need to teach your body how”. After hearing this a sudden relief came over me. Of course during all this we had our ups and downs but she has always been very straight forward with me. Not only is she my Dr but she is like my friend. Following an ultrasound where we were prepared to trigger shot she saw that my follicles had not grown enough in order to proceed. Naturally I was upset and felt like nothing was going to work. She sat in the room as I cried and comforted me told me there were other things we could try and not to be discouraged she had a plan. Following a few more failed cycles I had stopped trying for awhile. Started a new relationship, got married and tried to conceive for about a year with no success. We made an appointment with Dr .Gell and it was as if I never stopped treatment with her. She started repeating all the testing and we made a plan! Then we found out that along with my fertility issues my husband is dealing with a low sperm motility count. Of course this was a hit to gut but Dr Gell contacted us explained the results fully and told me the realistic percentages of success over the next few courses of treatment. We devised a plan and started to work through it. We were prepared to do some more testing and possibly start a oral medication routine when COVID-19 hit. Due to this we had to delay everything but every time I have sent a message to her I get a prompt reply and explanation to my questions. She is really the best Dr I have ever been treated by.

Breath! It’s scary it’s overwhelming but keep breathing. When it feels like your world is caving in just know Dr Gell is going to do everything she can to rebuild your confidence in yourself and give you the future family you deserve.

I’m on metformin 1500 mg daily. I have done Clomid I believe 5 times. Following dosages of clomid I did ultrasounds and it was found that the follicles had not grown enough for us to proceed with a trigger shot and timed intercourse. I have taken provera to bring on cycles to give me some sort of cycle regularity. More recently IUI and IVF have been discussed which hopefully we will respond to positively.

Medications range from 5$-1000+ when IUI was previously discussed I know the medications were close to 800. IUI starts around 400$ IVF as per the clinic starts around 15,000$

N/A

Strengths include being completely honest about a patient's chances of conceiving. Dr. Gell always takes time to answer all my questions, no matter how silly I feel asking them. No judgement, just honest answers to my concerns.

Be patient! You well learn all the details you need to know at the right time.

We first tired 3 attempts of IUI since my insurance covered 3 lifetime attempts. The sperm counts were not in range for a successful IUI, but we tried it anyway because it was covered by insurance. I feel my doctor always took financials into consideration, trying and recommending what is least expensive and least invasive first. My first retrieval cycle included folistim, menopur, and ganirelix. This resulted in 10 eggs retrieved, 9 able to inject by ICSI, 4 fertilized, and only 1 blastocyst making it to day 5, but it was chromosomally abnormal. 2nd retrieval cycle included a change of meds to folistim and leuprolide. This resulted in 13 eggs retrieved, 11 able to inject by ICSI, 9 fertilized, 6 made it to day 5 blastocysts. Of the 6, 4 were normal euploid blastocyst, when was abnormal, and one was a low-level mosaic. to prepare for a frozen embryo transfer, the first thawed embryo did not hold together, so we lost one. A second embryo was thawed and transferred, however this resulted in a biochemical pregnancy.

$15,203 was the cost for one full cycle, retrieva and transfer. Genetic testing was an extra fee.

Are doctor explained that to limit risks, it is preferred to now only transfer one embryo. We elected to complete genetic testing so that we knew a chromosomally normal embryo would be selected to prevent risks of miscarriage. If genetic testing is used, our doctor explained that they will only transfer one euploid embryo.

I always feel like I am more than a diagnosis (even though we are stamped with “unexplained infertility”) with Dr. Gell. She is optimistic but straight-forward. I feel confident in her expertise and support during this process.

Trust in Dr. Gell’s guidance!

Dr. Gell prescribed three-four rounds of Clomid with a trigger shot. I am on round two currently. To diagnose, I was administered a femvue surgery. It determined I had clear tubes but low ovarian reserve (AMH). I was diagnosed with “unexplained infertility” after 1 1/2 years of trying. If the Clomid and trigger shots don’t work in the next two cycles, we are moving forward with IUI. From there, we will decide if IVF is the next step for us.

The costs/co-pay were reasonable under my insurance. The medicine itself was affordable thanks to Dr. Gell’s office working around my requests and allowing me to use a mail-order specialty pharmacy instead of a local one.

N/A

Dr Gell was always friendly when I saw her for my ultrasounds and procedures. You could tell the office if very busy as she was in and out of the exam room pretty quickly. Most of the time I interacted with her nurse.

Have a list of questions and don’t be afraid To ask for clarification if you don’t understand something. Don’t be afraid to ask her to repeat something is she going thru it too quickly.

3 times intercourse with Clomid and HCG trigger- all unsuccessful 4-IUI with Clomid and HCG trigger All unsuccessful My 4th IUI I changed to Femara bc I was experiencing terrible eye floaters. She said she had never heard of that being an issue, but it really bothered me. I wish I would have been offered injections after the 2nd Failed IUI, instead they kept me on the Oral medication (none of which worked).

500 insurance deductible Each IUI was $350 out of pocket plus $100 HCG shot IVF Frozen transfer costs $1500 embryo fee plus $350/embryo for PGS testing

I am Currently going thru my first IVF cycle and it seems that’s Dr Gell prefers single transfer, especially if PGS testing.

Dr. Gell is very kind and knowledgeable. She made me feel better during a tough situation. She was very thorough and never made me feel rushed during any visits. She took time to answer all of my questions.

As with any doctor, it’s important to do your research and advocate for yourself. The visits were more beneficial after I did my research and knew what to expect.

Levothyroxine, birth control pill for 3 weeks to suppress ovulation, Lupron daily (with labs 1-2x/week to determine dosage), follistim, and Hcg to prep for retrieval. Transfer was cancelled due to OHSS. FET prep included birth control, estradiol, Lupron, and prometrium intravaginally.

My medications cost around $1,500. My insurance covered just about all of the medical care I received.

Dr. Gell recommended doing 2 embryos per transfer for me.

Dr Gell laid each step out and was always up front with me and our options. There was no sugar coating. That is not what I needed. I needed information that my previous doctor could not give me. She is honest and really wants to see her patients have a successful pregnancy.

Be open and accepting to the honesty that comes with infertility.

We started with Chlomid but was monitored to see how my body responded. This was after my husband and I both had testing done to see where our fertility issues were. It was with me. We did two rounds of chlomid with no luck. My lining was thining due to the chlomid. We switched to another from (I forget the name) my body responded well the first time and took a trigger shot to ovulate but did not get pregnant. Tried same oral pills again and on the next ultra sound found cysts and waited for my next cycle. Cycle came, tried again. Still no eggs. We have now moved on to injectables. Currently going through treatment to see if I have any more eggs remaining.

I found Dr Gell because it was the only doctor our insurance would cover treatment with. Besides co-pays, we have had not extra cost in office. We have not attempted our IUI yet due to cost.

N/a

Dr. Gell is a knowledgeable and compassionate doctor who cares for her patients personally and professionally. She believes strongly that her treatment plan and course of action will succeed and does her best to transfer this hope to her patients. Nevertheless, she is not reluctant to offer a new treatment when others fail.

Started with IVF with ICSI. Protocol was birth control pills, followed by Folstim, Menopur, and Ganirelix. Ultrasound and bloodwork used to monitor progress. Triggered with Ovidrel. Husband was treated at the same time with Clomid and Anastrozole for infertility by a different specialist. This protocol resulted in 11 eggs retrieved, 8 fertilized with 2 used for third day transfer and one blast frozen. This resulted in positive pregnancy test and eventual miscarriage. Second protocol four months later started with Lupron and then added Folstim, triggered with Ovidrel. This resulted in 8 eggs, 4 fertilized, but none survived to blast for PGS. Third protocol for frozen transfer was Lupron and progesterone injections. Transfer did not result in positive pregnancy test.

Typical IVF cycle runs $9300-9800 before medication and billable office hours and testing.

She is a understanding dr who is always trying to help her patients. She kind, caring,genuine, and honest! Always willing to sit down and discuss any of your concerns or fears! I feel extremely confident and comfortable with her as my ob and fertility dr! When she had to tell me after my you that it didn’t work she was very calm, collected, and soft. She asked me if I was ok seeing the hurt on my face, and she seemed upset as well. I truly believe she is an amazing person who can be as honest as she can with you, yet being caring at the same time. This is hard to find and I recommend her to a lot of people!

Make sure you ask questions. She is not a mind reader and will answer them if she can and if not she will call around and ask others to see if she can get you an answer.

We started with just trying to conceive with clomid but that was not working so she switched me to femara and that seemed to help the follicles grow but when I used the trigger shot I’m not sure if an egg released and we did that 2xs but I was not getting a possitive. So she did femara, follistem and the trigger for iui. I got another bfn. After that she asked that I conseder ivf. I have not been able to get the money for it as of yet.

Dr Gell is a warm, caring doctor with an excellent bedside manner. She is honest and straight to the point without being insensitive. My only complaint is that I wish she focused more on testing and diagnosing the problem rather than just treatment. She also doesn't run standard CD3 blood tests (LH, FSH, AMH, E2) as part of her initial testing like most REs do. I actually had to go to my OB/GYN to get the tests done because she said she thought they were unnecessary (I disagree). I just don't understand diagnosing someone with unexplained infertility without performing simple blood tests which could provide some insight into the problem. After 3+ years of trying without a positive pregnancy test or an answer as to why, I don't feel like I should have to push for additional testing or information that's readily available. I don't feel comfortable moving on to expensive, invasive, treatments if there's more testing that can be done first. She's a great doctor but like with any doctor, I think it's important to do your own research and advocate for yourself. There is no exception here.

Do your own research and push for CD3 blood tests. There is no harm in educating yourself!

My first treatment plan was timed intercourse with Clomid. I did two cycles of this before moving on to IUI. She does not do ultrasounds during TI cycles but she does check your progesterone to see if you've ovulated. My second treatment plan was IUI, Clomid, and Novarel hCG trigger. I did 3 cycles of this without success. I had two ultrasounds during each cycle to monitor my follicles. She had me administer the trigger shot once my follicles reached around 18mm. IUIs followed 36 hours after the hCG trigger shot. She did not check my progesterone during IUI cycles. After 5 failed medicated cycles, she recommended I move on to IVF. She did not bring up injectable hormones or suggest that as an option. She said I responded well to Clomid and if that (IUI) didn't work then it was unlikely that it was going to. She said IVF will give us our best chances. She also said I could opt to do a laparoscopy to check for Endometriosis and/or scarring before moving on to IVF. She said she didn't think it was necessary but it was ultimately up to me. I decided to do the laparoscopy and she found some mild endo and was able to remove it during the procedure. Afterwards, she recommended that we try naturally for 6-12 months and if I'm still not pregnant then we should to IVF.

Consultations are ~$400-600 if your insurance doesn't cover it. I believe it's on a sliding scale. IUIs cycles are ~$1200, out of pocket. The IUI itself is ~$375 which is what I paid since my insurance covered the ultrasounds and medications but not treatments. IVF is around $11,000, out of pocket. Medications are around $3,000 -$5,000.

N/A

We could not be happier with Dr. Gell. She made sure that we understood every single piece of treatment and really listened to our concerns. When Clomid wasn't working, she changed treatment by adding metformin and starting the process to do an IUI. Fortunately, we were able to get pregnant on an "off" cycle prior to starting the IUI.

Be an advocate for yourself, but listen to what Dr. Gell offers, as well.

Clomid, starting at 50mg. No ovulation Clomid, 100mg. No ovulation Clomid, 150mg. No ovluation. Clomid 150mg plus metformin. No ovulation. Clomid 200mg plus metformin. Ovulation but low progesterone level. Continued metformin while preparing for IUI. Got pregnant on natural cycle after 3 months on metformin.

Clomid, out of pocket, not covered by insurance. Approximately 25-50$ per cycle. Metformim, covered my insurance. $0 per month. IUI with medications - $3,000 (estimate) IVF with medications - $10,000 ((estimate) Office visits - $25 per visit HSG - $0 after insurance Ultrasounds - $0 after insurance Bloodwork - roughly $125/month after insurance stopped covering due to "infertile" diagnosis