Northeastern Reproductive Medicine (US Fertility Network clinic)

I found Dr. Brown to be competent and sympathetic for the most part, but I experienced quite a bit of shaming around my weight from her. As in, the day that my third loss in a year was confirmed, she mentioned that maybe I should take some time off to get "the best possible environment" for transferring my last embryos as everything seemed fine except I keep miscarrying. By which she meant "lose weight" because she believes that high BMI can cause implantation problems--and she's pretty blunt about that in a "that's the science" way. That same day, she told me that if my insurance was maxed out and wouldn't cover a transfer of my final remaining embryos, they'd do it anyway. So, it's a mixed bag having her as your fertility doctor. I found her generally sympathetic and likable, and she really seems personally to want me to leave their clinic with a baby, but she has the ability to hit that sore spot (whether it's justified and true or not, being told that you being fat might be why you keep losing your pregnancies is really painful). She also sometimes seemed not to remember my exact history/background and I would have to reminder her "we decided not to do that because X, Y, Z...." Honestly, I was always happy when I was seeing Dr. Murray, her partner, instead, as I felt she was just as competent, but more sympathetic.

Honestly, if they're at all heavy, I'd suggest they specifically ask for Dr. Murray instead. You'll see all three doctors anyway, but I think she's a better option personally (not clinically, where I'd say any of the three clinic docs are similar) for anyone who's sensitive about conversations about their weight.

4 rounds of IVF, all antagonist protocol (Gonal-F and Menopur stims, Cetrotide to block ovulation, Lupron+HCG trigger) with two freeze all cycles (due to PCOS and OHSS risk).

I had insurance (I've now met my lifetime max), but insurance paid: $7,800-$9,900 for each round of IVF, depending on whether it was freeze all or fresh transfer cycle and whether they did ICSI or the embryos went to blastocyst before transfer/freeze. ~$2,300 for each FET (not including monitoring (2-3 visits for ~$300/visit) or beta testing (~$500 for HCG, progesterone, and estrogen))

I advocated for eSET in my initial transfers--my doctor was open to transferring multiples because of my age, but went with my choice for two rounds before deciding to move to DET.

Dr Casson was very warm and thoughtful. NRM used to do a shared patient model, so it's possible to see one of the three doctors there. But I started to see Dr Casson more regularly during my first IVF cycle. I wasn't thrilled at the thought of a male doctor, but Dr Casson was quite personable. In hindsight, I wish Dr. Casson was *much more* aggressive with stimulation strategy, meaning I wanted to see more adjustments between protocols as well as a willingness to cancel a stimulation cycle if we're not seeing enough progress. I generated a single-digit number of follicles. (Honestly, it's hard to say if this was 100% Dr. Casson because of NRM's practice model.)

It was covered by insurance. However I got more "liberal" recommendations because I had insurance coverage versus paying cash. In hindsight, I feel angry about this.

NRM suggested Day 3 fresh transfers for every cycle. I felt this was rather wasteful after I learned more about IVF. I wonder whether NRM *truly* felt confident that Day 3 embryos would be successful three cycles in a row or if they just wanted to push ahead. In hindsight, I would have been much more cautious and conservative transferring embryos.

Dr Brown was the best with her explanations of treatments and setting my expectations. Before we started injections for egg retrieval she made it very clear to me that we would need to freeze all the embryos we created because I was likely at risk for OHSS. When we got to that day and my estrogen was sky high and I was emotional, it saved me the disappointment of not being able to try a fresh transfer. I knew what to expect and that was key for me. Dr Brown is incredibly competent and knowledgeable. Honestly the only weakness may be that she is more on the matter of fact side of treatment. I felt very supported and understood but if you're looking for someone extremely touchy feely and warm and fuzzy she may not be for you. For me she was exactly what I needed- honest and straight forward while clearly empathetic

You'll be well taken care of by Dr Brown, even when she's not directly talking with you she's making sure the treatment plan for you is the best fit

In my initial workup we found my LH to be high and my FSH to be on the lower end, much like in PCOS but I had no other signs/symptoms of it so we called it "poor ovulation" and tried 6 cycles medicated with timed intercourse that did not result in pregnancy but I ovulated quite well. We considered trying 1 IUI but given my husband's great semen analysis we all decided IVF made more sense. My protocol was an antagonist protocol. 2 weeks of birth control, a baseline US then Gonal F and Menopur for 5 days and then a follicle scan. After that scan we added ganirelix for 4 days until the next scan. After the second scan we triggered with leuprolide and very low dose HCG. We did the mixed trigger because of my high follicle count and risk for OHSS. They mentioned doing just a leuprolide trigger but decided on low dose HCG to try to maximize the number of mature eggs from the follicles. We ended up with 29 eggs, 23 mature. We split them into 2 groups for fertilization- half traditional IVF and half ICSI. Then the next day the traditional IVF eggs that did not fertilize were added to the ICSI group. Overall we ended up with 9 mature day 5 embryos to freeze.

The clinic was great at managing costs- my insurance covered diagnostics but not treatment so they made sure to bill all our initial workup and monitoring that way so it coukd be covered. They also counseled me on how to manage my PCP in order to qualify me for reduced cost medications which was incredibly helpful. The egg retrieval and first frozen transfer were $7,000 and anesthesia costs were $500. Our second frozen transfer was $2,000.

We all agreed that single embryo transfers were best for us. I am younger so our predicted success rates were pretty good, and I am also a small person and the thought of a multiple pregnancy was not worth the risk vs having multiple transfers

Dr. Murray is very thoughtful. I really appreciated the care she provided while we were at NERM. She was very thpughtful and caring when we were going through an initial loss, and was supportive/ reassuring when we decided to have my partner cardy my embryo. I remember an email she sent to me that encouraged us not to give up after a miscarriage. It was really comforting to have personal contact with a physician. It felt like we mattered to her. When I had a csncrlled cycle she called personally to tell me. Those little personal touches really mattered.

Our second transfer was really stressful. I wish the environment had been more peaceful.

First ivf: birth control , menopur 150, gonal f 150, ganatilix antagonist, trigger pregnyl and lupron. 9 days of stims: 14 eggs produced 14 eggs, 5 dsy 5 embros, 1 mc of 2 embryos. Second trandfer from this cycle resulted in a live birth Second retrival was cancelled due to premature ovulation Third retrival : 225 gonal f, 225 menopur. Ganarilix antagonist and pregnyl trigger. 11 eggs and 11 5d/6d embryos. We pgs tested and 6 came back pgs normal

First retrival was 7500 +500 anesthesia +500 meds Second retrival was cancelled and we applied that to our thrid cycle which was the same price. Meds were around 250. We had one additional transfer which cost 2500 plusmeds 300

I think the monitoring was insufficent for my second cycle which was cancelled

She is nice, easy to talk to, but also seems very competent, knowledgeable, and does a good job explaining procedures without making them sound scary. I always knew what was going to happen at every visit, and if I had questions, it was easy to get in touch with nursing staff. My expectations were that we would only get about eight eggs from freezing, but I ended up getting 16, which was a lot better than I expected. I also had no pain at all the next day, just very sleepy. I read horror stories online about egg freezing, but my experience was nothing like what I read. It was actually pretty easy and if it wasn't so expensive, I would probably go ahead and do another cycle.

Be prepared to have to see a few different people for ultrasounds and Dr. Kasson is a little rough when he does the internal U/S. He is totally professional but the technique is just rougher than women, probably because he doesn't have those body parts himself.

Don't remember.

$2,000 for the medications, $600 for anesthesia, everything else added up to ~$5,000 , so the total was around ~7,000 to freeze my eggs

N/A, didn't do this

Dr Brown was very kind and explained everything/step in detail and what the plan was. She felt pretty positive about me conceiving. She had personally called me to let me know the transfer didn't work.

To make sure you ask all questions and have a clear understanding of what would come next if the cycle didn’t work.

Started taking birth control on CD2 for 16 days. Had a uterine fibroid removed on day 17. Day 18 started stims taking 225 Gonal F and 150 Menopur mixed. That mixture was taken for 7 days. On day 8 of stims Ganirelix was added for 6 days. On stims day 13 I had to take HCG IM shot and a dose of Lupron. Stims day 14 just Lupron and stims day 16 was egg retreival. They retrieved 16 eggs of which 12 were mature and 8 fertilized with ICSI. After transfer tried Progesterone injection but wasn't able to give myself the shot so switched to suppositories.

No issues even had Dr Casson preform an ultrasound :)

costs as when I first started. Office visits, blood work and ultrasounds were covered by insurance. IUI and IVF (including meds were not covered) semen analysis $175 injection training $125 SHG $350 IUI's $400 each IVF without monitoring $7,000 plus $530 for anesthesia

Because of my age she was concerned with transferring multiple embryos but I was still at the age where it fell under their guidelines and I was able to have 2 transferred. She was very helpful in describing the risks of a successful transfer.

He is knowledgeable and takes time at his appointments to answer questions and explains things nicely so you can understand. Seems open to suggestions and what you are concerned with. Have not yet had to undergo ivf, so far just being worked up for reason we are having recurrent miscarriages. He has been open to testing both myself and my partner, explaining the process and helping us to understand what the next steps are and why.

Ask all the questions you have, wrote a list before your appointment and jot down notes. It’s overwhelming and hard to take away all the information after you leave if you don’t write it all down.

Sought his opinion after having two miscarriages after already having a healthy baby first try beforehand. Had a sonohystrogram and was tested for blood clotting issues which all came back negative, except for my AMH which was low. Diagnosed with low ovarian reserve and probably poor egg quality. Was told to try again, conceived and had a miscarriage at 9 weeks after having an ultrasound that showed a thickened nuchal translucency. Genetic testing proved it was Turner syndrome. Went through my first medicine induced miscarriage and follow ups. Have recently had carrier screening performed and found to be a carrier for Niemann pick disease type b. Husband will be having carrier screening testing done next week when we follow up. Going to talk about next step and possibility of ivf with pgs.

Haven’t been billed other than for office visit which was only $60 after insurance

Dr. Murray was very accommodating at the beginning of treatment. The clinic is 2 hours away and my initial consultation was over the phone, on a Sunday. There was miscommunication between Dr. Murray and clinic staff that resulted in a delay of my first IVF cycle and in it’s place we were asked to do another IUI in the meantime. It was not in our plan, but we went ahead with it regardless as the IVF meds could not be expedited in time to save the cycle. Over the course of the actual IVF cycle I did not see Dr. Murray again as Dr. Cason performed an HSG and Dr. Brown did my retrieval. I felt a little disjointed with so many “cooks in the kitchen” but at the same time confident in the team overall.

Be prepared to advocate for what you need. Entering into fertility treatment can be overwhelming and it helps to know as much about your options going in so as not to get overwhelmed.

BCP (10 days), Gonal f 150iu, Menopur 150iu. Ganirelix then Lupron/Pregnyl trigger. Uncomplicated retrieval, 11 eggs. 1 broken shell, all 10 fertilized (5 with ICSI, 5 unassisted). 2 embryos made it to day 5 and were transferred (both pre-blast). None made it to freeze. Pregnancy resulted, lost at 6 weeks.

IVF - SHG $350, Anesthesia Fee $530, Monitoring Fee $1000, Procedure Fee $7000. Monitoring coverage began at baseline and ended at embryo transfer. Procedure fee included injection training. Also included was 1 year of embryo storage.

I was counseled on industry recommendations through current research. Pros and cons were clearly expressed but the ultimate decision was left to us. I appreciated the guidance and conversation we had regarding single vs multiple embryo transfer.

Dr Casson met with us first to retrieve my follicles on our first cycle at his clinic. He took the time to discuss his hopes and potential outcomes. After the first round failed, he expressed his genuine sadness for us and wanted to make sure that our next experience was better. When we were deciding whether to try another round with my eggs, go for adoption or use donor eggs, he sat with us and explained our options. He not only saw us through the procedures but called me personally with updates and to wish us luck on the day of the transfer since it was on the weekend and he was going to be out of town. On our last visit to the clinic before transferring to an OB office, he made sure to see me even though I was only there for an ultrasound and blood work and gave us a graduation gift! He was everything that we had hoped for in a physician and got us to our goal of becoming a family! We have frozen embryos at the clinic and plan to return under his care when we are ready to try for our second!!!

No question is too small to ask.

For our donor egg cycle, the donor used menopur and gonal-f and I used Lupron and estrogen and progesterone. We did intramuscular shots for progesterone instead of suppositories and even though they are painful (you do get used to them when your partner is good at it) it is totally worth it to ensure that your levels maintain until your body takes over.

The cost of the IVF with my eggs was approximately 10,000 once we began the cycle. The cost for IVF with egg donation was 21,000 when all was said and done. (All included medication)

Listen to your doctors recommendation for number of embryos to transfer. Because we had beautiful 5 and 6 day embryos we only transferred 1 and got pregnant the first tome compared to having 3 day embryos before and tranferrI got 2 and getting negative results.

I'm pretty sure my husband and I would follow Dr. Casson into battle at this point. We 100% trust his medical opinion and were obviously pleased by the success of our treatment. Dr. Casson is a straight-shooter and tells it like it is - we appreciated this aspect of his personality, (although know this is not for everyone.) He was also very cognizant of the financial investment we were making in this procedure and felt like this was taken into consideration during our course of treatment. We also had great interactions with Dr. Brown and Dr. Murray on the occasions that we saw them.

Sometimes he thinks outloud - don't be alarmed by this! :)

We did a freeze-all cycle in case of OHSS. Luckily I did not experience OHSS but think the extra month was a good way to let my body recover before pregnancy. Would do this in future cycles.

~$7000 for IVF + monitoring ($1000), FET ($1000) and meds. $500 for anesthesia was billed separately by the anesthesiologist. Pre-natal care was covered 100% by insurance once pregnant, (we did not have fertility coverage through our insurance.)

Dr. Casson strongly recommended a single embryo transfer because of my age/prognosis. I was glad that he did!

I think that he is so knowledgeable that sometimes it can be overwhelming as someone who doesn't know the technical aspects. It's almost too much info. But I really like him as a person and I feel he really cares about his patients deeply

To get ready for a really difficult journey but it will be worth it. Just go with the every changing current of IVF and follow Dr. Casson's lead

Dr. Casson is going to use an antagonist protocol with Lupron trigger. Because we have to have PGD done as well our main goal is to produce as many eggs as possible and the antagonist protocol is what he believes with do this.

NRM charged us $4,750 for IVF, $1000 for embryo biopsies, $530 for anesthesia, and $6500 for PGD testing through Natera.

He recommended a single embryo transfer because a singleton is lower risk to carry to term.

I feel like I always asked the hard questions and Dr. Murray always provided a well thought-out answer. She celebrated with us when we saw the heartbeat and she was right by my side when it was no longer there. I feel like I'm a pretty demanding patient, and she's always been nothing but patient with me.

Take advantage of your one-on-one time with Dr. Murray. NRM is a small clinic, but they're very efficient so tasks that can be handled by a nurse will be handled by a nurse. You may not see Dr. Murray every time you're there, so really soak it up, ask all your questions, and get out all of your concerns when you're meeting with her.

For my IUI cycles, I was on Clomid. Both cycles had multiple follicles, but neither one resulted in a positive pregnancy test. For my IVF cycle, Dr. Murray used an Estrogen Priming protocol because I'm older and have a lower egg reserve. I feel like the cycle went very well, but my egg quality is just too poor as determined by my miscarriage and the fact that I didn't have any embryos to freeze. My only real concern with my IVF cycle was that I think the doctors could have stimmed me for an additional day to get more mature eggs out of me. This will not deter me from using NRM again, though. I'll be back.

Each meeting with my doctor costs $150. Each IUI cycle cost $400 (monitoring was done at an off-site location, I'm not sure how much this would cost at NRM). The IVF cycle was $8,000. This does not include medications, but all monitoring was covered. This included one frozen embryo transfer, however, we were unable to do this.

Dr. Murray cautioned me of the complications with twins when I transferred two embryos, but ultimately left the decision up to me.

He was honest, funny, and determined. Very caring and excited for results. He knew our financial burden and wanted to try his best to get us pregnant without IVF but also wanted to be pro active and not wast time.

Go see him. Don’t wait.

I believe he first changed my medication, and knew right away he wanted to do another surgery to clean up the endometrial wall. He wanted us to try for 6 months naturally after the surgery and then wanted us to come back if there was no pregnancy to start the IVF process. Due to financial reasons we have yet to go back.

Around 15 grand I believe

Dr. Casson has always been very positive about my diagnosis, which is helpful to keep me positive. He has a lot of experience in the field and is doing many great things in Vermont. I came to North Eastern Reproductive Medicine after going to a different clinic for 2 years and I was very happy with the switch. I felt like I had more access to the doctor, and it felt less clinical.

Dr. Casson is very knowledgeable so if you don't understand what he is talking about then don't be afraid to ask him to explain.

I am not really sure of the protocols, Dr. Casson had suggested doing a freeze all cycle to avoid ovarian hyper stimulation, which I agreed with, and am glad I did it that way. I was pretty uncomfortable after the egg retrieval and can't imagine doing a fresh cycle. When I was at a different clinic they had me on Femara and times intercourse, when I started to see Dr. Casson he switched me to Clomid as he had participated in a study that showed that women with unexplained infertility had better outcomes with Clomid during IUI's. I never had any positive outcomes on either Femara or Clomid. Dr. Casson only recommended 4 IUI's before moving on to IVF as opposed to my first clinic which would have done 6. I was fine with 4 I was ready to move on.

IUI's were $400 with blood work and ultrasounds going to my insurance. IVF was $7,000 with blood work and ultrasound going to insurance and that did not include medication. It was $2,000 for each additional transfer.

Dr. Casson recommended only transferring one for our first transfer. I only wanted one. The second time around he still recommended one, but it was not out of the question if I wanted to do two. I still only transferred one.

Dr. Brown clearly cared about our situation and wanted to help us. I wish that she had taken the time to review our prior care in better detail before automatically letting me decide to proceed with another IVF cycle. She did not rush us through our appts with her but was not there to do the retrieval or the transfer. She did call me personally with my bloodwork results which was nice.

Dr. Brown is a very nice woman who will take the time you need to discuss concerns and help make a plan that works for you.

We did an IVF cycle with my eggs (fresh) using gonal-f and menopur as well as Lupron. We retrieved 7 eggs with only 1 mature and 3 which were matured in the lab and all were fertilized with ICSI. We did a transfer on day 3 with a day 2 and a day 3 embryo. The remaining 2 embryos were left to grow to day 5 but did not survive. We received a negative bloodwork test and were left with nothing.

the IVF procedure was 10,530. We had to do preliminary assessments due to my prior IVF being a year old. I would say overall we spent approximately 12-13,000.

Dr. Brown had a candid conversation about the risks of transferring more than 1 embryo, however, given that mine were not of great quality, it was decided that two made more sense to transfer.

Dr. Murray is very patient, kind and knowledgeable. She clearly states the science and the implications for treatment in a way that is very supportive. She was always professional, and I never felt rushed during any of my visits. I would say the same of the other two doctors at the clinic.

Just relax and know that you are in really good hands.

I was given a lot of choice in how I wanted to proceed. As a forty year old woman, I tried three unmedicated IUIs, one medicated and then asked to go straight to IVF. They would have supported more IUI tries if I had wanted to go that route too, but they agreed that moving to IVF at that point was probably the best call based on the numbers. They really understood the financial considerations and constraints I had and balanced their advice with those in mind. For example, they didn't recommend testing the embryos for a few reasons: one- they knew it would be expensive for me, two- at my age they knew I was likely to have few viable embryos, three- the current research shows that the testing can produce false positives for anomalies.

Relatively affordable in comparison to other options.

They respected my strong desire not to have twins, and transferred only one embryo at a time at my request.

Strengths. Kind. Supportive. Genuinely interested in my well being. A great sense of humor. Very smart and pragmatic. His staff seemed to really like him. Weaknesses. Perhaps a bit too optimistic and hopeful in my first round. Often I had to go through the nurses to converse with him. He was very flexible and willing to accommodate my needs only to find the nurses weren’t able to do so.

He’s not fond of email but he does respond. And He his human not god so try not to blame him if it doesn’t work.

Makes time to answer questions and discuss alternative options. Warm bedside manner. Draws lots of diagrams of uteruses and ovaries. Give patients options and does not force a set one size fits all treatment plan.

Dont be afraid to call with questions and ask to speak with her, she will usually make time.

Used clomid and IUI to increase odds of unexplained infertility. Was diagnosed with endometriosis and moved on to IVF. Did two months of birth control before frozen embryo transfer to help with endometriosis. Had polyps removed from uterus. Resulted in two chemical pregnancies.

I have infertility insurance coverage. However, I wished I’d known to shop around for drug prices instead of using their default pharmacy.

Very enthusiastic about our choices to do a single embryo transfer.

Dr Casson is very giving of his time both via email and in person. He is more conservative in terms of more experimental treatments for RPL/ implantation failure which is my only consideration for those who might be interested in those types of treatments.

Ask any questions - ask for what you want. He will give you his honest opinion and not push you into anything you aren’t completely comfortable with.

I did two IUIs, one with Femara and one with a combo femara & injectibles. Had good ovarian response to both, but two miscarriages. Monitoring is good, appointments available every day of the week which is awesome.

I believe iuis were $300, my other treatment was covered with an insurance copay. I did not do ivf with this clinic

Did not do IVF but I think he prefers eSET for most patients.

He was professional, funny, kind but realistic, and explained everything thoroughly. I never felt rushed or like a nuisance with questions even though I know they’re office is extremely busy and appointments are time sensitive. He also worked with us on the payment plan, knowing financially this was a major challenge for us.

Request to work with him. He is amazing!

I think it was about 12,000 in total for 4 cycles IUI, one fresh IVF cycle, and a second transfer with frozen embryos.

He was very clear that he recommended only one embryo based in our ages, good quality embryo, etc. After cycle one failed we told him we wanted to transfer two. He still educated us about all the risks, but respected our decision.

She is incredibly intelligent. I have done a lot of research on ivf and come to her with many questions that she always answers. I trust her to help me make decisions, and she always takes my thoughts in to account. She is very positive and confident in my treatment.

Don’t hold back, make sure to share everything you are feeling.

I wish I remembered more! After all the failed transfers, I try to forgot. Two rounds of egg retrieval, 1 fresh transfer and 2 frozen. I have severe endometriosis so a frozen transfer allowed for the ability to take birth control to decrease inflammation. We used icsi for all embryos.

I paid out of pocket, our saving plus. I knew my insurance didn’t cover any of this, but went to her anyways.

We have done both, and I prefer single.

Dr. Casson has been generous with his time and patient in his explanations and plans. My partner and I have felt understood and calmed by him. This has been a long journey and it’s not over yet but we’re not willing to see another physician.

Ask all your questions, don’t hesitate.

Dr. Casson recommenced we start with IUI with donor sperm. He and his team continue to be as determined as we are to get pregnant. I was having difficulty nailing down my ovulation with predictor kits, so after two rounds of IUI we moved to IUI with clomid and a trigger shot.

My insurance does not cover anything beyond diagnostics. The out of pocket fee for IUI is $400.

I felt the entire clinic runs very smoothly and is wonderful. It is three hours away from me so only Difficult In that way. Dr. Casson takes the time to really explain things and lay out all of the options you have. I was impressed by that.

Fully think about all of the options he presents you with

I was prescribed letrozole and he completed a test with me to check my tubes. I had already had other tests done by someone else. We did I think 10 rounds of the medication and blood work to see if I ovulated. I always ovulated but still didn’t get pregnant. The next step would be IUI or IVF but I haven’t gone back. I’m seeing someone more local who wishes to do more testing during my cycles with ultrasounds.

My insurance covered the visits. I had to pay copays. It does not cover fertility treatments if I choose to go that route.

We only tried letrozole for 3 cycles, which unfortunately was not effective. We have paused on any further treatment because of the costs, as our insurance does not cover it and also my husband and I decided that we need to work on "us" and our health before giving conception another shot.

Ask questions, be open.

Started with a workup, Dr Brown asking questions about fertility history. Next bloodwork. Finally a course of action.

Our insurance covers diagnostic costs only. Any procedures that were done would need to be covered by my husband and myself.

She preformed surgery and our initial conversation. We did not see her other then that. We did speak to one of the other doctors there one more time but other then that we saw mostly the nurses. She did do wonderful with my surgery and make me feel very secure.

Clomid for iui. The amounts stayed the same each time. I wish they tried different ways after the first 3 didn’t work.

750 for iui 350 sperm retrieval