Nevada Fertility Institute

I never met her throughout the entire course of treatment. Instead, her NP was the only person I ever saw. Yet, I was told Dr. Duke was overseeing my ultrasounds, even though she’d never met me in person. I never even saw her in passing in the office any time I went there for treatment.

Don’t go here. Fertility treatments are hard enough. But there is a huge lack in communication and transparency that makes it very difficult to work with Dr. Duke. I never even met the woman during my care so how can I put faith in her being a capable doctor with a plan to meet my specific needs.

IUI included birth control Norethinidrone 5mg for a few days at the start of my period, then clomid 200 mg for 5 days. Then HCG trigger shot. Insemination. Then Endometrin and E2 afterward to support the pregnancy.

It was 2000 for IUI not including medication. It was probably about another 350 for the meds. My insurance covered a lot of the pills. The HCG trigger was the most expensive. I think it was around 250. The rest were like 20 to 30 bucks each. The Clomid might have been a little more.

I don’t know because we never got that far. I moved clinics after the first IUI.

Dr. Duke is an incredibly compassionate and skilled doctor. We've had two tele-medicine calls with her and she has performed 3 IUI's for us so far. Whenever I've met with her she has been patient and understanding as I ask question after question. The one thing that is a little hard about Dr. Duke is she is incredibly optimistic. After our first meeting and before we started IUI, I left our meeting feeling like we would 100% get pregnant from IUI. I know she didn't say it was that certain, but she was so confident with our numbers and age. There has also been some confusion about statistics and IUI. She told us our first IUI had a 20% chance of success and each consecutive IUI chances would increase by 20%. So, our second IUI would have a 40% chance and our 3rd 60% chance. I later understood that isn't exactly what she meant by those stats and learned in reality the chance is only 20% tops each time and doing multiple IUI's helps in those stats, but doesn't effect my body. I learned this clarification from a nurse in our first IUI cycle and it was deeply upsetting to me. Now that I know the stats, I was able to go in to our next IUI cycle with eyes wide open. All in all, Dr. Duke is a caring, patient, and friendly doctor who treats me like an individual and human. I just wish our expectations weren't set quite so high and that I could meet with her more often.

Write down your questions and don't be afraid to ask them even if you think they are silly. Also, don't rely on Dr. Duke to know how much your treatment will cost. Definitely speak with the office manager about that. We were told our IUI was covered and didn't realize till midway through the cycle that coverage did not include medication, which cost us about $1,500 per cycle.

Dr. Duke has had me take supplements since before we started IUI: COQ10, myo-Inositol, and a prenatal vitamin. For the IUI's I took Clomid, follistim, and sometimes estrace. I also took progesterone after each IUI cycle. Lastly, I did an ovidril trigger shot. Each cycle I have had quite a lot of eggs and a risk of multiples as a result of these medication and my possible PCOS. My first cycle I had OHSS. My last two cycles I did not have OHSS because Dr. Duke adjusted my medication, which I appreciated.

My IUI was covered by insurance. But, I had to pay for medications and co-pays out of pocket. This ended up being about $1,500 per cycle

I did IUI, not a transfer. She warned me thoroughly about the dangers of multiples and we had to specifically agree that we understood the risks before proceeding. We have spoken to her about IVF and she prefers transferring a single embryo, but is open to no more than two embryos.

Dr duke is super nice and she does explain things to you only if you ask. The telemedicine appts always seem rushed. I have only met with her in person at the egg retrieval, and frozen embryo transfer

Make sure you do things for you. If you want something done ask because they might not give you that option

I respond well to medicine so egg retrieval was pretty basic. However I did get OHSS from it. Frozen embryo transfers start out with letrozole then gonal, cetrotide, and trigger shot. endometrin suppositories are used instead of the shot

$15000 for IVF without meds- does include 1 frozen transfer 4500 each frozen transfer without meds- can also include a mock cycle if need. But once you use your mock cycle it’s still $4500 $600 for yearly embryo storage options

She lets you choose which I think is great. She gives you the option 1 or 2 but tells you the risks and complications, but it’s essentially up to you as long as you know the risks

I’ve seen Dr duke over the years for various rounds of treatment. I switched to her after negative experiences with other clinics. As she’s gotten busier you do see her personally less but when you do see her she is still caring and thorough

The clinic is busy and sometimes you’ll have to follow up on communication but I’ve had this issue at every clinic I’ve been to in town

I’ve had many cycles with various drs and am still ttc so it gets fuzzy, but the only dr who actually kept searching to find more and to look into my unique case has been Dr. Duke. She’s the one who found majority of my issues and then treated for those to help me conceive. We did IVF with immunotherapy such as intralipids and adding blood thinners due to conditions I have

I was an insurance patient but usually had no issues with billing

Dr. Duke typically advocates for a single embryo transfer which I’m all for. Since embryos have the potential to split I prefer to transfer one at a time

Dr. Duke was helpful with our initial diagnosis and felt hopeful that we would conceive with IUI. She puts a lot of the decisions in your hands which sounds great but was not helpful. Her major downside is communication. Out of all the times that I had questions about what treatment was going to entail, how we needed to adjust my meds, or what decision I should make regarding cancelling a cycle, I only spoke with her twice. Almost all communication was through a nurse. And when we were hoping to speak with her shortly after a failed cycle to reassess plans, it was over a month long wait for a telehealth appointment.

She's a great doctor, but her office staff and communication leave a lot to be desired.

Cycle 1 was IUI with clomid. I did not respond well to the lowest dose of clomid and was on it for a second week at triple the dose. It resulted in two 18-20mm follicles. The cycle did not end in pregnancy. Cycle 2 was another IUI but with letrozole. I did not respond to the letrozole at all. We added in 75iu of follistim and 37.5units of menopur. I ended up with 2 15mm follicles that I ovulated prior to being able to complete an IUI. The cycle did not end in pregnancy. Egg Retrieval Cycle: 2 weeks of estrogen priming, doxycycline, Gonal-f 400IU, Menopur 150IU. At my second ultrasound I only had 5 small follicles and was given the choice to convert to an IUI, cancel the cycle, or continue. I was called at 7pm and asked to make a decision within the hour without speaking to Dr. Duke. I was concerned about using birth control to prime/time a cycle and so estrogen was suggested instead.

Monitoring for the most part was quick and simple. My first appointment I waited for over an hour just for blood work. I was assured that was not normal.

Traditional IVF cycle was 15k Mini-IVF was $7500

Dr. Duke preferred single embryo transfers. I lost twins at 24 weeks so this was fine with me.

Dr. Duke is incredibly knowledgeable and took all of our history into account without relying solely on it to decide her course of action. She did the testing she needed to make the best decision she could for us, which resulted in finally getting a positive pregnancy test. She was thorough, kind, and patient with us. I will recommend her to everyone.

Fertility treatments are hard, but Dr. Duke is amazing at what she does. You won’t see Dr. every time you go in the office, but you don’t need to. You’ll be well taken care of.

Due to my age and the number of IVFs and failed embryo transfers we suffered before coming to Dr. Duke, we did three mini IVFs with Dr. Duke. We didn’t get a lot of eggs, but they were good enough to get three embryos to pass genetic testing. After 4 previous IVFs with another doctor and 4 failed embryo transfers that lost 7 embryos, Dr. Duke finally got one to take and we are forever grateful.

Hope was amazing. Very kind and thorough and answered all of my questions.

I really don’t see any weaknesses. She is a smarty, honest, and educated woman. You can tell she cares about you more than other docotors. We are looking forward to success with her! Our last doctor didn’t recommend IUI before IVF, and they also didn’t tell Is IUI was covered by our insurance...our first appointment with Dr.Duke she was open and honest and hopeful, her positive attitude and sincere care for us was so refreshing!

Enjoy her positive attitude!

She diagnosed me with PCOS. So we started with IUI treatment. She put me on clomid and provera. I had regular ultrasounds to monitor follicle growth. Then I started I injections of follostim to help grow follicles to a good size.

Other than medications and co-pays the IUI was covered by insurance. 40$ co pay every visit and about 700-800$ in medication.

Dr Duke is very knowledgeable and helps me understand things that I may be unsure of. She explains treatments and procedures thoroughly and is always there if I have questions which I often do. She makes eye contact with me and on numerous occasions has held my hand and hugged me to put me at ease after a procedure. Dr Duke also went out of her way to cover the cost of my polyp removal when my insurance would not cover it. Not many doctor would do that, this is why I have been going to Dr Duke now for 3+ yrs. I believe in her and I know I will one day have a positive pregnancy result and ultimately give birth to a healthy baby.

Don’t give up on yourself, because Dr Duke will not give up on you.

Dr Duke had prescribed estradiol medication along with clomid and hcg trigger shots to help my ovulation process. I only have 3-4 eggs to work with and these medications helped my eggs to mature . I also took crinone twice daily to help prep my uterus for pregnancy.

My office fee was $30 a visit and bloodwork copay as well. Fertility medication was paid by me

Dr. Duke is very compassionate and candid. She presented our options thoroughly and left the decision to us. We would have liked more detail on the process and what to expect, as well as our treatment plan. We didn’t receive a full explanation as to what our IVF protocol would be and the reasoning.

Ask lots of questions.

She recommended transferring two embryos before we even started IVF and encouraged it even when we expressed concern about transferring more than one. We have not decided how many we will transfer if we get this far.

I felt that I didn't know everything about the prospects for pregnancy for my wife and feel like we got vague and unrealistic responses to our questions about success factors. I didn't know what questions to ask at the time and though I expressed a need for details, only the questions I asked were answered, but the likelihood of success in our case seems glossed over given what I now believe I know about it.

Education! Have a web site and materials that teach. Verify with patients that they have reviewed the materials and understand the costs and potential for success.

I was given clomed as was my wife. My sperm was tested and though apparently low in count they were of good quality. My wife was also tested for various conditions prior to treatment. All of these were very expensive.

Quoted about $20k per cycle for IVF, about $2k for IUI

She told me the next steps but as a person who did not do all the research I had to figure out what the terms meant that she had used She remembered my spouse and my names She was very kind and compassionate

The doctor is great and once you get used to the way the office is run in will be easier Don't give up and or become frustrated if the office does not answer the phone or it's hard to get thru

So because of Thanksgiving we had timed intercourse which to us seemed a waste and we were only given a $300 discount The next cycle we skipped because of Christmas The following cycle we did IUI and were so surprised to get a positive test,the numbers were not good and the pregnancy was over before it started. The next cycle Dr Duke changed some things up...trigger injection site, days till IUI etc and no pregnancy We are going to do our 3rd cycle soon

Each IUI cycle is $1300 We did timed intercourse and were only given a $300 discount

I did have questions from time to time that weren't answered before leaving and that required me to call and ask for clarification. My medication was switched with no explanation from the doctor and the communication for this came from my nurse, this was the only hiccup I ran into and it was easily fixed and discussed just after the fact. Dr. Duke was always optimistic and kind when working with my husband and I. She takes time to speak to you about concerns and risks and she speaks to you like you are knowledgeable and allows you to ask questions without being frustrated in you asking.

Just ask questions. If you are unsure about what is happening or why, ask. You can discuss multiple options with her and she will give you her honest opinion. Don't be afraid to discuss treatment options she is open to many and very knowledgeable.

I started with letrozole 7.5 mg CD 3-7 and started estrace 2mg twice a day starting on CD 9. We were initially prescribed a different trigger but it changed the night of the trigger to preglyn 10,000. Endometrin 100mg twice a day starts two days after IUI

Our IUI with monitoring was $1,300. Our medication cost another $500 and we are still being billed for some bloodwork through our insurance.

Dr. Cindy Duke was amazing! She answered all our questions, no matter how small or large the questions were. She explained everything to me and she truly wanted the best result for us, and found every possible way for us! She didn't give up on us.

Beside that she is amazing, nothing.

She is a strong believer of single embryo transfer because she wants the best chance and opportunity for both the embryo and the mother to be.

Dr Cindy Duke explained everything word for word and went into detail to make sure we understand what we were going to do, how the medicine would work and what to expect. She went above and beyond. We had 4 IUI’s and now she recommends IVF

Ask all the questions because she is willing and ready to answer them all until you understand them

I’ve done so many from just clomid to follistim menupor lovenox and endometrin. To follistim menupor lovenox endometrin Estradiol melatonin baby aspirin.

IUI $1300 Medicated IUI $1800

Doesn’t apply for us

Bedside manner is great, she is so nice and left me feeling hopeful! I wish she would call between visits. When we would go into the office it was always a great visit, but when we leave and post-visits, I always felt lost in steps to take next.

Don’t talk to nurses, talk to Dr. Cindy Duke instead.

We are dealing with male factor infertility. My husband started taking clomid and his counts went up a little. My husband then started taking HCG shots with clomid and blood work went well. We have been on it for two months (hcg) and hope to be pregnant in a couple months. Still no positive pregnancy tests, but my husbands numbers have improved.

$100 every time we went in. $25 clomid a month and $365 HCG a month.

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Dr Duke does care about her patients and makes sure she lets you know what to expect. My last Dr was all about the payment but Dr Duke understood the journey of infertility. She is hands on and very detailed with the treatments.

She is amazing! I hope you enjoy her like I have

We only went through a IVF consult so far. I am needing to do the SIS testing and the go from there.

They do offer military discounts for the IVF procedure and the medications.

I asked how many she would implant and she said 2 would be the maximum for my age.

She is very direct with possible issues but has great bedside manner. She even provided her personal cell phone number when I ended up in the er with an ectopic pregnancy. Very personable and caring!

Make a list of all the questions you have and go over them there with her.

Iui was 1300.00 and meds were 1000.00 and blood tests after deductible with insurance were about 2000.00 hsg was about 400.00 and sis about 300.00

I have only done iui. Ivf is next.

Dr. Duke always explained the treatment, the reason, and the science behind it. i never felt I had many questions, as she always answered them before I had a chance to ask. At times, she would often give information that I did not know I wanted to know. I always felt like she had all the time in the world for us, even though we know she is a very busy professional. During times of setbacks, she was empathetic and compassionate about the experience, and optimistic moving forward.

Take notes during your appointment so you can process everything after.

Egg Retrieval: We used Gonal, Menopur, and eventually Centrotide during stimulation. I was frequently monitored so that the timing would be accurate and optimal. I triggered with Lupron and Pregnyl. Due to my blood work and high number of follicles, adding Lupron to the trigger was to help avoid OHSS I believe. FET: Our first attempt at an FET was a fully medicated cycle. As I followed OHSS protocol after the retrieval, this was to avoid it again. I was frequently monitored. Unfortunately, my lining did not grow, and that cycle was cancelled. I used Lupron for supression, and then Estraidol tablets, patches, and injectable estradoil to stimulate lining growth. Our second attempt at an FET was a medicated natural cycle. I took letrozole for 5 days, then used Gonal to stimulate, grow follicles, and grow my lining. My lining did not reach 8 mm before my progesterone naturally spiked. Dr. Duke decided to cancel that cycle as well due to not being able to verify the timing. While this was not the desired outcome, we potentially and likely would have not had a successful cycle. Our third attempt was cancelled before we got started as my estrogen was too high and needed more time to drop below an optimal threshold. Our fourth FET was ultimately successful. We followed the same protocol, except we added in Centrotide earlier than previous cycles. My lining reached 8mm, we triggered, and transferred one embryo. Our BETA was positive after this FET.

The clinic did a great job coordinating with our insurance as much as possible.

We chose to transfer one tested embryo. We were consulted on the statistics of transferring two embryos, the impact that twins can have on the body, and the potential risk to mother and baby.

My husband and I first met with fertility specialists in 2015 in Colorado; during that time, every step we took was in the backwards direction. We continued to receive bad news and nothing was working for us so we had stopped trying. When we first met with Dr. Cindy Duke at Nevada Fertility Institute (NFI), we had very little confidence in my ability to get pregnant and stay pregnant. As a matter of fact, I had recently spoken with my GYN about an early hysterectomy so I could finally put the fertility matters behind me, but she referred us to NFI instead for further evaluation before she would consider the hysterectomy for me. At our first meeting with NFI we filled out paperwork, health history, wrote down our goals of being parents, had some blood drawn and then met directly with Dr. Duke to discuss our options available through her clinic. Personally, we knew that using an egg donor would be best for us because of our failed attempts with my eggs in the past. Once we made that decision, it was a brisk talk through the necessary testing which would identify for her any lingering issues within my body. My husband and I left the meeting with somewhat of a renewed hope in our hearts and minds, again thinking that we actually had a chance at being parents. After just a few weeks of private discussion in our house and within our family, we all decided to move forward as soon as possible (I'm mid-30s and we all know there are extra risks as an "older" mom-to-be.) The egg donor process moved quickly and efficiently; we were able to discuss a small set of parameters and come to a decision within about a week. Once the egg was received in the office, my husband provided his sample, and it was just a matter of a few days when we received the call with our embryo count. I couldn't believe it! We successfully had embryos to work with and a healthy body cleared for transfer. One of the best things to know about Dr. Duke and NFI is that they don't really leave anything up to chance. The science is down to an art form and once we were on the medication schedule and lined up for the trial round, it was up to us to simply stick to the routine. Follow the directions, take the injections, show up for the blood work & ultrasounds. Honestly, compared to our last experience in Colorado, this felt seamless. We knew we had the entire team helping us through every single aspect of the IVF process; we felt supported and encouraged. It is now December 2020 and we are 18 weeks pregnant. Our first attempt at frozen embryo transfer resulted in one successful pregnancy, with no complications. We remained in the care of Dr. Duke and NFI until Week 12, graduated and then sent on our way to grow this baby under normal OB supervision and circumstances. As a woman who's been receiving Abnormal test results for nearly two decades, I feel like our time at NFI was like being under a canopy of Magic. I feel like hearing the words Normal and Pregnancy in the same sentence are all I need to continue to be happy. It is only with the care and attention that we received from Dr. Duke and the entire team at NFI that our dreams to be parents were made into reality, and we look forward to seeing the whole team again when it's time for us to transfer our second embryo.

Follow the directions and trust her knowledge.

Everything was listed on a medication schedule for me, per day! All prescriptions were called directly to the pharmacy and plenty of refills were provided.

From start to finish, with the egg donor included, we've spent approximately $28,000 while under the care of Dr. Duke / NFI.

We all agreed a single embryo transfer was going to be best for us. There was no further discussion about it.