Pacific Fertility Center (Prelude Network clinic)

Dr. Herbert is direct and to the pony. This may not be for everyone. I personally really liked it. He was also very compassionate and caring. He also thought outside of the box, learned from my first canceled cycle and was successful the second time. Where other doctors would have stopped he kept going and tried.

To be honest and to know that he will try his absolute best for you.

below were drugs for my first cycle where I had a positive pregnancy, second cycle was the same minus the Letrozole. Both cycles we did extended stim an additional 7 days for a total of 20 days bc of my endometriosis. Medication SIG Quantity Refill Substitution Lupron MD (1:10 dilution) 50 mcg/0.1mL - Vial 1:10 Dilution (1mg/0.2mL), final conc 50 mcg/0.1 mL) Dispense 4 mL vial. Sig: Take 10 units BID as directed. 1 1 DAW Syringe 1/2 cc (U100) Insulin - - - - As directed. 22 1 DAW Follistim AQ Cartridge 300 IU - Injection As directed. 8 1 DAW Menopur w/ Q-cap vial adapters 75 IU - Vial As directed. 13 1 DAW Syringe 3cc 20g 1.5 in - - - - As directed. 14 1 DAW Needle 27g or 29g 0.5 in - - - - As directed. 12 1 DAW Needle 25g 1.5 in - - - - As directed. 2 1 DAW Sharps Container - - - - As directed. 1 0 DAW Letrozole 2.5 mg - Tablets 2 tab po on CD3 - 7 10 1

With drugs a cycle was about $15,000 but that did not include genetic testing.

We did multiple embryo transfer for both. He let me make a decision I was comfortable with.

As a patient, I always felt that Dr. Li was there for me. We could schedule a phone call with her anytime we wanted to discuss something important, and the most difficult times, when i had the miscarriages she always took time to talk to us. She respected that i wanted to have a little time until i would feel better but at the time she would talk to her I felt the comfort that she knew what i was going thru and she cared for me. We would talk about what happened, and we would do other test like Endometrial Receptivity Array and other blood test to check Immune system issue etc. I always felt so much better after talking to Dr Li. After the transfer of my last embryo and an unsuccessful pregnancy, we had to think what to do. For my surprise, my company announced that our insurance plan added the Infertility treatment but unfortunately PFC is not in the insurance list clinics. The last call that we had with Dr. Li i was in tears and Dr Li said that my dream is the first priority that she will support me and understood that i have to choose another clinic because of the insurance coverage. Dr. Li is an amazing professional but also a wonderful human being. We always had her support and compassion in the years of our journey at PFC.

Dr. Li has lots of knowledge about the infertility issues. Make sure to schedule the appointments either in person or via phone. Make a list of all your questions because she will answer all of them.

I had 4 embryos - day 5 blastocyst and the protocol used was : 1. Ultrasound and blood test on the 2nd or 3rd day of the cycle 2. Start Delestrogene shots -every 2 or 3 days -0.2 ml 3. after 10 days ultrasound and blood test 4. Start Progesterone - Ethyl oleate 1 ml - 5 days prior to Embryo transfer 5. Emnbryo transfer after 5 days of Progesterone shots 6. Continue shots of progesterone every day, and delestrogene 2 x week 7 . after 9 days, blood test HCG Beta 8. if positive continue with progesterone and delestrogene until reach week 9

I went thru the following procedures: 1. Egg retrieval : Medication around $4000 , each ultrasound $255 , each blood test $150 , hcg test $135 2. frozen Egg donor - total $21000 each embryo transfer : $2900 Embryo Transfer 950.00 US Guidance for Embryo Transfer 315.00 Assisted Hatching 685.00 Prep Embryos 575.00 Thaw Embryos 375.00 Progesterone - $360 3 vials Delestrogene - $230 each vial each ultrasound $255 , each blood test $150 , hcg test $135

I hear a lot of debates regarding to eSET and multiple, but my reaction about just do a eSET was positive, since the goal of the treatment is to have a health baby and a health mom, which for me it's sufficient to approve the eSET

Dr. Ryan was excellent. Although her fist impression on the phone was not the best, in person she explained everything clearly. She proceeded to be very caring, very thorough and I trust her immensely. I would highly recommend her. Communication with the nurses was also easy over email and the online portal kept everything very organized. At times fertility treatment can be overwhelming but the staff, nurses and doctors all make it as easy as it can be.

Although she may not make small talk, she is always there to answer questions and never rushes you.

I was diagnosed with annovulation a and possible PCOS. I had tried letrozole for several months prior to seeing Dr. Ryan (with my ob/gyn). We tried IUI with letrozole twice without any success. I then had a very successful egg retrieval (34) and had the eggs tested and then frozen (20). We then did the first transfer with only a brief chemical pregnancy, but the second time it worked and I'm now 10 Weeks pregnant.

I don't remember this off hand but it is all clear on the website. It was straightforward.

During an egg retrieval cycle, you see one of the doctors that's available when you go into the office. You are going almost daily if not daily for a week when your eggs are growing and I think I saw a different dr each day for the sonogram. I liked all but one. Her bedside manner was nonexistent and I think she laughed at one of my questions in a scoffing manner. I already felt like an alien growing eggs and full of hormone shots so I didn't need this dr I had never met acting that way. I gave that feedback during my "exit interview" after my eggs were frozen. They seemed genuinely interested in knowing how I felt about my interaction with that dr. Everyone else was great. I can't rem if Dr Givens or another dr harvested my eggs. I had such great results and felt so comfortable overall there that it didn't matter. I've met with her twice recently to discuss next steps (turning my frozen eggs into embryos and implantation to become pregnant) and she is open to answering any and all questions I have and new information I may have read up on that she hasn't heard about yet...things are happening quickly in this field.

Ask a lot of questions and do your research. For the egg retrieval portion, it's pretty straightforward and takes up a month of your life. I've found that it's better to talk to as many people as possible when moving forward with the rest of the IVF process. There are many more moving parts and things to know.

The drugs I took were Follistim, Menopur, Ganirelix and HCG. I ended up going for a couple more days to let the eggs get even bigger so I needed more Menopur which I was able to pick up at the office (PFC). They keep drugs on hand for this last minute purpose as the rest comes in the mail ahead of your cycle. I ended up with 28 eggs retrieved and 22 were frozen. Given my age at the time of 39.5, I would have to think her protocol worked well.

I think my total fees for egg retrieval in 2014 was $12,000. That included all of my drugs. I think the finance person grossly underestimated how much my drugs would be. The dr. Also added more at the end to let my eggs "cook" a bit more. On their price sheet in 2014, they list X-Cycle Fee as $8,345. They say this includes 4 of each of the following---office visits, ultrasounds, Estradiol as well as one of each of the following---anesthesia, egg retrieval, facility, lab, cryo preservation & one yr of storage ($600). Blood testing, ultrasound and at least one office visit were covered by my insurance as they will not cover fertility treatments, but do pay for "diagnostic procedures and tests provided in connection with infertility evaluation. Office visits and consultation used to diagnose infertility."

Please refer to my previous response

Ask questions and probe, don't hesitate to call or email with follow-ups.

My first cycle was a fresh donor egg cycle requring 3 Rx of shots. In the second and 3rd cycle she recomended Prometrium via vaginal inserts, which i did not care fir and requested shots fir the 3rd round. She urged me to continue w/Prometrium vaginally due to the potentcy and proximity to the uterus it is applied. I took her suggestion hesitantly, however the 3rd round was a success, so worth it.

I believe the total with drugs was approx $18k

Again, mentioning his affability, he is very likable and an easy communicator. After a successful round of ivf with ccs, I had three frozen chromosomally normal eggs. We implanted one, I became pregnant, but no heartbeat at 7 weeks - having a dnc at week 8 - a few months later I implanted the next one, similar outcome. At this point, I had had 5 miscarriages, 7 pregnancies in 4 years.....with one naturally conceived easy live birth so I knew that I could carry to term. I had every blood test under the sun, always normal. I kept asking dr. herbert, 'is there anything that you can think of that would be causing these miscarriages?',...'should we check for anything else before we implant my last frozen egg?', His answer was fair for sure, 'could be anything, we never really know..let's do a medicated implantation this time' (more costly and time consuming for me) Before implanting my last egg, I sought a second option with ucsf, within one hour of meeting me they did a sonogram of my uterus and determined that I had a significant amount of scar tissue in my uterus due to all the pregnancies and dnc's over the last few years. Since I always miscarried around week 8, they determined that this was the most likely cause, the embryo simply couldn't grow any bigger. On one hand I was relieved that I finally had a potential answer for all my recurrent miscarriages, but on the other hand I was astonished that I had seen almost every doctor at PFC (pacific fertility center) over the course of two years and not one of them thought to investigate my uterine cavity. During my sonogram at ucsf, she pointed out all the scar tissue on the screen, it's white and very easy to see even with my untrained eye. A hysteroscopy was performed at ucsf a few weeks after the initial diganosis and a post-op sonogram revealed virtually no scar tissue, again very easy to see the difference with my untrained eye. It seems that an easy routine test in the form of a thorough sonogram could have prevented so much heartbreak, let alone time and money.

Be your own advocate

basic IVF, 12 days on meds, I responded well to meds and 17 eggs were retrieved. I should mention I was 41 at the time and exceeds all stats etc.

I think 25K for IVF plus meds plus another 3K to natera for genetics testing, implant 3K each times 2

He has been in the field a long time and seems to know his stuff. I wish he would have been better at talking me through things and showing a bit more compassion throughout the process. Compared to other doctors, I think he did a good job during the ultrasounds. He didn't rush through them like many of the other doctors I saw and he was sure to show me each follicle and tell me how it was doing - this I really appreciated.

Don't go into it expecting him to cushion the blow. He is up front and realistic which can be good, but also hard for someone who may be emotional and having a hard time.

I wasn't given much explanation for the protocol used. I now now (only since I have been to another doctor) that he used the long protocol. I took estrogen pills before my cycle and then went on to menopur, follistim and ganirelix for about 9 days. My menopur was 150/night and follistim was around 350/night. He didn't explain there were different options so I assumed this was the only one. During my cycle he also upped my dosage and it wasn't clear why he did that.

my insurance didn't cover anything besides the initial visit so I paid for all ultrasounds as well as the procedure cost, Anastasia, and meds.

I liked Dr. Herbert in general, he was kind and friendly enough. But I would say the warmest/most compassionate doctor in the practice is Schrioc. He proably has the best bedside manner/warmth. Over the course of the many years I was at PFC, I had appointments with all of the doctors, as they cover for each other for u/s and all the way to retrievals and transfers. Dr. Herbert would get on the phone and answer questions and was responsive. It's looking back that I'm not sure he was as creative with treating my infertility. I had 3 retrievals and many transfers there - and don't think there were very many changes to my protocol. That being said, when I asked for some things, for example, for them to let all of my embryos "have a chance" and grow them out and freeze them, even if they were low quality, he let me. He let me transfer them too. Those "bad" embryos at least got me pregnant, though I did miscarry. My current clinic would not have frozen or transferred those low quality embryos. The fact that Dr. Herbert did and I got pregnant, gave me hope to continue - as that was my first pregnancy ever. Had my 1st round of IVF not produced a pregnancy at all, I think we would have quit. So bottom line, I found him more open to listening to my wishes, in that sense and letting me decide. I think that was a good thing. On the other hand, I did bring up a concern with transferring fresh embryos when I am an endometrios patient (a disease that flares up with hormones). He wasn't very open to exploring this and we continued to transfer my best embryos in fresh transfers. My current clinic said they would not have done this with me, full of stim meds. In fact, the trend overall now, is to mostly do FETs. I always wonder if we wasted by best embryos at PFC doing those fresh transfers. I wish he would have taken more time to consider what I was saying.

I think if you are not successful with a protocal or a doctor, ask them to change things. They should learn from the data they have on your cycles. I would also ask them for their success rates with people similar to you. PFC is a big enough clinic now that nothing should be completely new to them. If it is - I would find another clinic. You don't want to be any clinic's guinea pig.

Too long ago and too many to remember specifically. I know I used Follistim, Menopur, Cetrotide. My FETs were (mostly) unmedicated. I got 15 eggs on two rounds, 17 on another. So not a lot of variance there. We tended to have about an 80% fertilization rate. My embryos didn't do well between day 3 and 5 in the lab, so for my 2nd and 3rd round we froze on day 3. I had a few pregnancies, and all ended in m/c - some early and one 2nd trimester. No living children to date.

In 2010, I think IUIs were roughly $2,000 plus meds. For our second & third ERs we did a plan that allowed you to do two ERs if you didn't get pregnant, at a slight discount. That was in the mid-$20,000 range - drugs, monitoring and additional transfers were all in addition to that.

Isabelle Ryan has a very direct, succinct, blunt manner. That didn’t bother me at first, but at a later stage in my care I realized that many crisply communicated statements really glossed over important nuances, and areas of uncertainty. Our meetings were always very quick, and I left thinking I had gotten all the information I needed, but it’s hard to know what you don’t know. As a small example, I was a first-time patient, and it was never communicated to me that at PFC my doctor likely wouldn’t be performing my retrieval surgery. I now know this is very common, but this shouldn’t be communicated to a patient the first time in the middle of a stimulation cycle. Most importantly, I feel she handled my case poorly from a medical standpoint, and made critical errors which, subsequent doctors pointed out, introduced unnecessary risk. She and her care team overlooked disturbing symptoms that I had and, in retrospect, gave me a treatment which was dangerous rather than helpful. This aspect of my case would not apply to most patients, but I think it speaks to a lax attitude about complications, and an unwillingness to take the time to think beyond the obvious norms. Finally, she was coordinating care with an outside specialist, and the communication about the status of this coordination was bad -- I realized months later that the tests from the outside specialist had actually given me the opposite results that Dr. Ryan had used in her assumptions and care.

I probably would see a different doctor unless you are ready to go home and independently fact check what you hear, and almost act as your own secondary doctor.

Before cycling she had my husband and I do prophylactic antibiotics (zithromax and cipro). First cycle (which ended in a cycle cancellation with no retrieval): 3 weeks birth control pills, started 200 IU Follistim & 75 IU Menopur, this was increased but not sure to what levels. Never triggered because cycle was canceled for poor response. Second cycle: Removed IUD; no birth control pills. Estrace priming before cycle start (4 mg daily). At baseline ultrasound start micro-dose lupron (10 units, twice per day); then starting dose 300 IU Follistim and 150 IU Menopur. Trigger 10,000 IU hCG. Resulted in 19 eggs retrieved.

Not sure how much we paid for the first canceled cycle. Second cycle where we did a retrieval was about $12,000, though they gave us a $1,500 discount because of issues in our first cycle, and because we were self-pay patients. This did NOT include all of the lab tests and drugs, which added several thousand dollars, or the $1500 to Natera which is the outside reference lab used for PGS testing.

Recommended eSET with PGS, but did not do a transfer at PFC so it wasn’t a lengthy discussion.

Dr. Chenette came highly recommended to me, so I had high hopes. In our initial meeting, he reassured us that our situation was common and there were lots of avenues we could go down to increase our chances of getting pregnant. I did want to try to be as "natural" as possible and not take drastic measures unless we had to, and I'm not sure that was totally respected. His team made a mistake putting together my schedule for when to take the Clomid, so the first time it didn't work. The second time was a slam dunk, so we were lucky enough not to have to take more extreme measures. The nurse assigned to our case was absolutely fantastic, but other than that I'd say Dr Chenette was just ok, and the rest of the staff was quite frustrating to work with. Our information was not passed correctly from one team member to the next and I found myself having to repeat myself in the same appointment and in one appointment after another.

Get a feel for the whole staff you'd be working with, not just Dr. Chenette.

I did feel certain Dr. Ryan was on my team through the process. She was supportive and kind and professional. I didn't want to hear the news she was ultimately able to convince me of (that my lack of success was "120% due to egg quality") so I think I continued too long with attempting each method of treatment. Not sure what else she could have done to get through to me, but I do wish I hadn't put my body through so many medicated IUIs, for example.

Really listen and ask questions to make sure you aren't just hearing what you want to hear. She will help you make a plan.

My treatments were so long ago ... I don't remember specifics. I did 10+ IUI. #7 resulted in a pregnancy that was not viable. 1 IVF and 1 cancelled IVF.

I've blocked out the specifics - the costs were high.

I do remember she was very helpful on advising the number to transfer. I understood the pros and cons.

i would say that she was blunt, but i didn't mind blunt. some people might be put off by her somewhat cold bedside manner but i didn't mind. she was very thorough in describing the processes involved in IVF and i appreciated that. my only complaint was her failure to warn me of all the risks with the ectopic pregnancy. perhaps she thought i knew how dangerous they are, but i did not. i had no idea.

If you want Dr. Ryan to be very thorough in how much information she gives you, ask for it, and i think she will oblige.

I felt respected. I fellt she had enough time for me. I never felt rushed. She answered all my questions earnestly and revealed when she diden't know something. I the clinic is extremely well organized.

Ask questions

I have low ovarian reserve and she wanted to used the highest dose of medictaion for stimulation because of my age. She felt it was our best shot. My cycle is currently postponed due to COVID.

21,000 for the IVF cycle

She does not typically do multiple embryo transfer due to the risks associated with twins. I support this completely.

Dr Li is very kind and smart - I felt like I was in trustworthy and knowledgable hands. She doesn't rush conversations - and makes herself available whenever needed. She's very approachable - I didn't feel uncomfortable asking any questions.

Be prepared to be given a lot of data - which is obviously important. But also make sure you fully understand the process. And ask lots of questions - Dr. Li is more than happy to answer any and all.

My treatment was pretty standard- it was my first retrieval.

$16k for monitoring, retrieval, testing, and storage. About another $1k for consultations and bloodwork.

I had read that she was not the most warm of doctors. But I really appreciate information, and I know she had the latest facts and was very up front with my husband and I on what to expect and I appreciate that.

Be willing to hear the hard truth, this is not a doctor that will sugar coat it for you.

She advised starting with IVF, but due to financial my husband and I did IUI to start with Letrozole. She adjusted my dosage as we went. Then we switched to IVF, with 300 Folistim and 150 menopur, I just had a canceled cycle due to poor responding (3 folicles- 1 mature), so we did another IUI. I am currently in 2ww

Ultrasounds cost $330 iui cost $495 IVF round without medications about 19,000

Dr. Schriock is very knowledgeable and helped make a timeline and game plan for upcoming procedures. The office is kind and friendly. I’m still have treatment ongoing at the office and hopefully will lead to pregnancy soon

Do your research. Lots of info and details will come from meetings so it’s best to be prepared

I have PCOS and was encouraged to see how the IUI process goes while also getting a sample from my husband and being able to see how those counts were. It’s was a good way to test the waters and the medications without a lot of risk.

First appointment was approx $300. During IUI each ultrasound is approx $325 total IUI was $3500 or so. The facility is “out of network” for all coverage except 2 very rare providers.

Eset is encouraged “for the health of the baby”

He is straightforward and still compassionate, reviews our file before every appointment so he is up to date. Sometimes I wish I could get more answers or even speculation out of him, or more ideas of alternative things we could try.

We were ok with it, but he does push IVF and donor eggs quickly, so push back if you're not ready.

IVF with genetic testing full cycle (stims w ICSI + transfer) is around $25k IUI around $2k, but i'm not sure about these numbers

promotes eSET, and i am good with that

Dr. Li thoroughly answered any questions I had. She is not intimidating and is very patient. She is very kind and I felt she is very empathetic. Also, she smiles but is not overly professional like some doctors I've encountered.

Not sure

Unsure

Appointments were not made to be very convenient

$2000 for IUI, $25,000 to $30,000 approx for egg retrieval. $3,500 approx for each frozen embryo transfer. All approximations based on memory.

I believe the facility's policy is based on age and they are strict on one embryo per cycle because of the health risk involved with multiples.

She is candid, no-nonsense, not super warm-and-fuzzy but very competent and was genuinely happy with the positive outcome. Some PFC physicians I liked more and some I liked less, but it was the overall competence of the center that was important to me.

I went in with very good numbers and was doing IVF because it was the straightest route to pregnancy as a single woman. My cycle involved Follistim, Menpur, Ganirelix, and a bit of Lupron late in the cycle. It was a straight-forward stimulation and retrieval. Upon embryo transfer I was on progesterone and HCG.

Roughly $22,000

Dr Givens was direct and clear on my prognosis from the beginning. She was on time for my appointments. She answered my many, many questions, and she explained my treatment well. My previous answer covers everything else.

I would give them advice to anyone looking at any RE. Be specific about their success rates for your type of case.

I don't remember.

She strongly preferred transferring 1 embryo. So did I so we didn't discuss it much.

Dr Schriock was a good doctor and I would recommend him. In general he was very willing to answer questions and explain information. He is kind and caring. Fertility treatment is stressful and time sensitive, and I definitely have some small quibbles with the overall Pacific Fertility Center process, particularly with the handoff to non-primary doctors late in the process, although I do understand why they need to rotate doctors on call on weekends etc. However overall I would definitely recommend Dr Schriock and PFC.

Make sure to proactively set up telephone consults if you need anything explained during the process rather than expecting detailed responses via email (which is primarily used for urgent/transactional communication only).

As I said before Dr Li was warm, efficient and candid. She explained why we would proceed with an IUI as a first step after a number of failed Clomid only cycles with my gynecologist. She answered all our questions and I learned a lot from her.

Do your research on possible treatments before your appointment so you can ask more informed questions.

We used approximately $2500 of our Carrot fertility benefit for our IUI, including genetic testing and initial bloodwork. Each ultrasound was about $330.

Open minded, kind and professional are qualities I would ascrbe to Dr Herbert. He was recommended to us by a very happy former patient and her faith in him was borne out. We were very happy with him. It was gratifying that he was willing to use a new procedure that limited or most injections and relies instead on vaginal suppositories and oral meds to prep me as the recipient of the donor egg. This was an approach that has been very successful in the UK and I wanted to try it and avoid all the injections. It worked! Herbert had no ego around holding on to his own approach but did his own research and went forward with me in this novel approach with great success.

If you are using a donor egg ask him about approaching it using suppositories vs injections!!!

See previous comments and implant one embryo only.

I don’t recall in detail. It’s been a while!

Strengths: laying out all treatment options. Being available for additional consultations when we wanted them Weaknesses: very quickly jumped to egg donation (which was at odds with what other providers recommended)

He is candid and is not afraid to give you information you may not want to hear, so it's important to bring your own positive attitude about treatment potential

First tried an agonist for IVF cycle #1 The tried antagonist (with growth hormone and supplements) for IVF cycle #2

Per cycle was around $16490 (medications separate)

Strongly prefer multiple embryo transfer

He was professional but warm, knowledgeable but not condescending. Confident and calm. We are still in progress with our treatment but I would recommend him. He made himself available for scheduled calls to go over questions we had. He sets all those around him at ease. He conducts his own ultrasounds personally.

Be yourself. Come prepared with whatever questions you might have because he will answer the openly. Bring as much of your family history As you can.

We are mid-treatment, so I can’t go into great detail here

We are mid treatment so I can’t fully say.

Not yet.