Shady Grove Fertility WMA

Dr. Reh was just the person we needed on our team during our fertility journey. My husband and I were diagnosed with unexplained infertility and Dr. Reh was so direct and clear with information and options, yet also positive and optimistic. Her team is amazing and I always felt like I was able to get into contact with the right person when I needed. She listened to me, validated me, and gave me options when options were available - I felt like I had space and respect to make decisions that were best for my husband and I. I appreciated her direct nature and honesty throughout the entire process. During monitoring appointments, I didn't always see her, but a) I loved the team so much that it didn't matter who I saw and b) if I ever needed to see her directly or speak with her, it was easy to do! Currently 37 weeks with a little boy thanks to Dr. Reh, her team, and IVF!

She is willing to consider all options!

For IUI cycles, Dr. Reh prescribed Letrozole with a trigger shot. All 4 IUI cycles resulted in at least 1-3 appropriately sized follicles. None were successful. For egg retrieval, I followed a "standard" protocol and had a successful retrieval with 19 eggs, 13 mature, 11 fertilized, 6 day-5 embryos, 4 PGT-A normal.

I was an out of pocket patient. An IUI cost about $2,000 per cycle with medications. I paid for the Shared Risk Program with PGTA testing - this cost about $26,000. Medications for egg retrieval were about $4,000. Overall, I paid about $40,000 throughout treatments.

Dr Malik is a very methodical, practical doctor. She approaches things with a level head vs. being emotional and lays out multiple paths that you can consider (including the risks and benefits of each). I had a few other fertility specialists that I knew in other states that I got second opinions from, and she always welcomed that other feedback/insight and never felt overly protective of doing things "her way" if I felt strongly about doing something else. When our IVF egg retrieval went poorly (we retrieved eggs but discovered poor egg quality and did not get to the blastocyst stage), she came prepared with a new treatment plan for us to adjust with this new data. Ultimately IVF is a long process and each new test / result is a new data point to customize in the future. I felt like Dr. Malik was in it for the long haul with us. We did get spontaneously pregnant after our failed IVF cycle and Dr. Malik made sure to be the one to do our ultrasound at 7 weeks. She also made sure to be our doctor on days where I needed certain procedures done since she knew my chart the best. Overall, I felt like she was very invested in our journey and I trusted her. Even though we got spontaneously pregnant, I would have felt comfortable going forward with another IVF cycle with Dr. Malik despite the first one not going well because I felt like she had a customized plan as a next step. Would definitely recommend her to others.

Do your own research and ask questions - Dr. Malik will lay out all the facts but for us she relied on us to make the final decision on how to move forward. This allows the patients to have control over the situation but I think it's good to understand a bit on your own before going into appointments.

I can't compare costs to other clinics but their financial team gave me a full breakdown prior to every treatment / procedure so I was 100% clear on what my costs would be

Dr. Nair was not very thorough or compassionate, and our visits with her felt so harried and lacking in clarity. During our post-initial testing visit where she gave us our diagnoses and outlined next steps, it was very rushed. Each time we tried to ask questions she ushered us along, stating "We only have 30 minutes today". Thirty minutes to provide us each with a new medical diagnosis and discuss options and next steps was simply not enough time. She hardly went into any detail about our diagnoses, didn't listen to our concerns, and, again, didn't allow for questions given the time constraints. As a medical provider myself, I couldn't believe that a physician would provide patients a new medical diagnosis without going into much detail about what that meant for them. She didn't even leave us with written handouts or links for us to read and understand better. At one point when I asked a question, she replied that we didn't have time for questions today, but that if I had questions to schedule a follow-up visit. So I went ahead and scheduled a follow-up visit (which seemed absurd that I even needed to do so just to be able to ask questions), and when the consult started she couldn't have come off as being more annoyed that she was having to meet with a patient again simply to answer questions. She came off as very cold during this consult and gave awkwardly short, non-detailed answers to my questions. At one point during the consult, she appeared to be looking down at her phone as I was talking. It felt extremely dismissive and lacking in compassion. Dr. Nair seems like she has taken on WAY too many patients than she can manage. My husband and I decided to switch care under a different physician at the clinic, and we felt so much better taken care of after that.

If you're not okay with having extremely limited contact with your healthcare provider, then consider switching to a different fertility doctor.

Tests, procedures, and medications covered by my insurance with co-pay required

She was nice, but we only interacted with her twice during seven months of treatment, once at the consult, and once in a video appointment after our first few rounds of treatment failed. She was very optimistic, which when everything failed made us feel like the optimism was unrealistic.

Insist on a frank and realistic explanation of your chances of success.

We did seven Clomid cycles, adding Gonal F after the first few failed, but it did not help the number of follicles. In six of the cycles we did IUIs, all failed.

My insurance covered half of most costs. It added up to thousands of dollars out of pocket. Our treatment failed, but we’re still getting bills for $100 here and $130 there, and those will continue for months as they work through it with our insurance. The bills are depressing reminders of the failed treatment.

Dr. Reh is very professional and sensitive to how emotionally fraught infertility treatment can be. She always treated us and our decisions with respect. She was understanding when we initially sought treatment at another clinic for financial reasons and also understood that finances affected other decisions like opting out of PGT-A testing. I also appreciate that from the beginning she emphasized that my behavior or diet or supplement regimen was not contributing to my infertility. I was confident that she was trying the treatment that had the highest odds of success.

Don’t expect to be able to reach her directly. I have heard that other doctors in the practice are more accessible. She would call to give important results but otherwise all communication is through her nurse.

Lupron stop protocol yielded 1 abnormal embryo, antagonist with estrogen patch protocol yielded 1 embryo and miscarriage, micro lupron flare yielded 2 embryos and miscarriage. The goal with each was to increase my low number of mature eggs but changes in protocol did not yield a different outcome, despite trying different trigger times/types.

22,500 for shared risk plus cost of medication

eSET is preferred but two embryos transferred due to multiple failed cycles.

At this time I have only met with Dr. Reh once for my consultation. She made recommendations but also allowed me to make my own informed decision. Due to having endometriosis and one blocked tube IVF is the preferred treatment. My insurance does not cover IVF so I decided to begin with IUI for a few cycles. Dr. Reh moved forward with my desired treatment. Following initial ultrasound she reported to her staff that I would have to take birth control for one month prior to proceeding. I just started Clomid cycle with Gonal f injection

Have all documents in order to present to her so that she can review them with you in the room. If she has questions she can ask. Make notes of your questions and ask them at the end...once she is finished talking

Initial ultrasound, one month of birth control, Clomid (5 days) and Gonal f injection plus trigger shot, IUI. I am currently still taking the Clomid

Kaiser insurance: thus far $377 for Rx, $450 for IUI, $30 office visit

It was explained that single embryo is preferred. I am not at this stage yet so we will see what happens in the future

Dr. Reh was honest in her assessments, if not a little conservative in her estimates of our chances of conceiving. She seemed up to date on the latest literature. She answered all of our questions. She made adjustments to my treatment as we went in response to how I was progressing. Overall, I was very pleased with my experience.

Dr. Reh was not especially warm, but she was extremely knowledgeable and competent.

Gonal-F (225 IUs) and Menopur (75 IUs) evenings; Cetrotide in the mornings; Lupron trigger; 27 eggs released; 21 mature eggs; 12 embryos; 7 day-5 or day-6 blastocysts; 2 chromosomally normal blastocytsts; 1 male child

We did the shared risk program (guaranteed live birth or most of the fee is refunded). I believe that was $28,500 (due to my age). Meds on top of that for one cycle were ~$4,000.

Dr. Reh preferred single embryo transfer and we agreed

Dr. Reh seemed competent and was friendly and good to talk to. I did feel at times like she was obligated to try to sell extra services. However, this is only based on one in-person meeting, one phone call, and one voicemail. Most of my interaction were with other staff at shady grove, which were not always as positive.

Try to get more time and check in more with Dr. Reh herself— she seemed like she knew what she was doing, but it got lost in translation being relayed through multiple layers of staff.

I did three unmedicated IUI which resulted in negatives. (One of these was monitored, with a trigger and prometrium after iui, but I’m not sure Dr. Reh had anything to do with that protocol choice— it seemed to come from the nurse.) the next planned steps were/are a medicated iui and then she suggested an IVF cycle with PGD.

With 50% coverage on my insurance, the cost for appointments was $105-$135. (However, when the insurance snafu happened, I became aware that the self-pay option was actually about 5-6 times that amount.

I was worried that Shady Grove would try and push us into treatments that I wasn’t comfortable with/we couldn’t afford. Dr Reh listed to our concerns and took time to explain the pros and cons of each treatment option. She was also honest about questions we had that she couldn’t answer. We never felt guilted, pushed, or pressured into making a decision.

I would say have know that she will be honest with you and have faith in the decisions you make together. At least in our experience, we met with Dr Reh to lay out a treatment regime but then went through the rest of it under the care of clinicians at other facilities that were closer to work, so we didn’t get to see her as regularly as we did in the beginning. We asked a lot of questions of Dr Reh in the beginning so that we fully understood our path forward and that helped us navigate through treatment. This was important as the treatment can feel very factory-ish and the other medical personnel you’re dealing with may not have the time or insight to answer questions specific to your treatment.

We had insurance that covered 50%, and they had an excellent financial counselor (Grace). We knew the cost of treatments before proceeding with them, so we were able to make informed decisions.

Dr. Reh is friendly and to the point. She does not dilly dally. She provided optimism in my fertility journey. I trusted her in my care. I had also heard excellent things about her from other patients/my personal friends.

She will do whatever it takes to get you pregnant and I would trust her advice even if you think it will never happen.

I underwent 3 cycles of IUI. First with clomid, the following 2 cycles were w/ letrozole. I also used vaginal progesterone and estrogen. The 1st 2 cycles failed. Then prior to initiating a 3rd cycle, my thyroid studies were abnormal so I was referred to an endocrinologist and started on levothyroxine. My 3rd IUI was successful. I am now 8 weeks pregnant and hopeful this will be a successful pregnancy.

$1800 for each IUI cycle and everything done within that cycle (ultrasounds, blood work). I had to pay out of pocket for medications/whatever my insurance didn't cover. Seemed like reasonable pricing.

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I am 38 years old and was referred to Dr. Reh by my OBGYN . I had been thinking about egg freezing for about a year and had a lot of doubts about the whole process. I was very fortunate to become Dr. Reh’s patient. She sat with me and explained the process, my initial test results as well as the options I had. The protocol she created for me worked perfectly. I did not have any side effects from the medication and was able to get more eggs than the initial estimate from my pre-evaluation exam. I went through two cycles and both times Dr Reh performed a painless egg retrieval. I was fully recovered next day. She was very supportive during Corona 19 outbreak. I am very happy with the care and results I got. I highly recommend Dr. Reh!

It’s a long process that can get difficult but you are in really good hands!

The protocol was perfect for me. I had no side effects and was happy with the results.

I only paid for the program I signed for.

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While I have not yet officially gone through IVF, I have just started my cycle and Dr Reh has been so helpful in clearly answering all of our questions. What I like about Dr. Reh is she's real: this may not work, and we were able to have a candid conversation about that.

Nothing - she's great!

I've not yet started my protocol, but will provide an update when I do!

$30k - includes PGS testing, all meds, and two cycles, frozen transfer

Not applicable for me - I was not eligible for multiple embryo transfer due to a medical condition.

Dr. Nair has a great bedside manner and truly takes her time in getting to know you and your partner. She focuses on your health and ways that are beneficial in your journey to conceive. I’m so thankful for her.

Dr. Nair is knowledgeable and tells you the blunt truth about the best treatment option.

We just started our next cycle with donor eggs. Currently just on birth control. Awaiting the next steps.

Since we are using donor eggs the cost is not covered by insurance. However, Shady Grove does have excellent programs to help.

Prayerfully we will get to that step sometime this year.

Dr Reh is smart, honest, and compassionate. It was always a great experience, even when the results were not what was desired. She was always prompt. When we got bad news and she was unable to reach us, she took the time to squeeze in a 10 minute call between appointments to quickly address next steps (we also scheduled a follow up call).

Come prepared with questions and feel free to ask her to explain things. Even drawing a picture can help understand things.

We went straight to IVF because of my age (42). I took a lower dose of medication because my bloodwork was good, however due to a low egg count, I was put on an aggressive protocol for IVF 2.

We did the multi cycle plan, which was approximately $23,500 plus medication.

I thought Dr Reh was helpful when we spoke to her and answered our questions. She listened to our concerns and didn’t push us into things we weren’t ready for. She was realistic with us and told us what to expect. I would see her again but hopefully I won’t need to.

To go see her and listen to her advice.

It was never really clear. I felt like I’d check out and be told we owed. Since I paid then they never sent bills.

She indifferent about my options. She present the risk of each procedure but didn't' seem to have a strong opinion on what option would get me my baby. She would do whatever I wanted which is great to a point.

Just proceed with caution. She is nice and all but she doesn't seem to out of the box to try something new or give you an example of what worked for her other patients that might work for your situation. Do your homework and come with questions..

After my IVF fail, I realized I wasn't on the most aggressive protocol which I thought she would put me on after my failed medicated IUI. Again, you are your own advocated.

Everything had a cost to it... so expect at that.

My main doctor only wanted to transfer 2 but the actually doctor doing the transfer did 3 which I agreed to since they quality fo the embryos weren't great If I didn't transfer the third one , it would most likely died.

My best day with Dr. Reh was when she personally did my heartbeat ultrasound with the pregnancy that resulted in my son. Up until that point we'd had three and a half years of struggle and disappointment and losses. I started to feel like I was a bad bet. But she never gave up and had a new avenue to pursue whenever one was closed off.

Shady Grove tends to run its patients on a need-to-know basis—you only find out what's next when you get there. I'd recommend asking a lot of questions if that's what you need, or if you are a more live-in-the-moment kind of person, this style might really work for you.

After my second miscarriage, Dr. Reh recommended an endometrial biopsy, which revealed I had an E. coli infection in my uterus, which was treated quickly with antibiotics. The protocol that eventually worked for embryo transfer included an injectable blood thinner, a low dose of a steroid to suppress my immune system a little bit, and progesterone suppositories.

Each IUI cost $1,700, which included monitoring and the procedure. The package for two rounds of IVF, including egg retrievals and unlimited embryo transfers, was a bit over $25,000. The shared risk program for donor embryos was about $16,000, which included six embryo transfers and a full refund if none result in a live birth. For each round of IVF, I spent about $7,000-8,000 on medications. Medications for IUI were less; the most expensive was the progesterone suppositories. Medications for embryo transfers were in the middle; for one of my transfers we did a "natural" cycle that nevertheless included Menopur, which I think is about $700 for a five-dose box.

Dr. Reh strongly prefers transferring only one embryo. She repeatedly expressed that she was trying to get me pregnant with exactly one baby.

I wanted to see a different provider in Shady Grove Fertility, but it would have added two more months of waiting for my initial consult so I agreed to proceed with Dr. Reh. During 6 months of treatment, I saw her only three times (initial consult, one monitoring ultrasound, and follow-up consult). The rest of the communication with Dr. was done through the nurse. I did not feel I got sufficient explanations of why specific treatment was chosen based on my situation (e.g. natural vs. medicated IUI, choice of specific protocol). I felt part of the problem was that she did not review my records before the appointment, so she did to have any specific suggestions on my treatment during our conversations. I was receiving written recommendations on my treatment only after my appointment with Dr. Reh which made it more difficult to ask questions. She also did not seem caring.

Try to do your own research on possible treatments and make a list of questions that you may have about it before the appointments.

I did two IUIs using clomid, ovidrel and progesteron. I did not receive any rationale for why these medications were chosen for my cycle. I tolerated them well, and my response was also good, but both cycles failed.

Costs through our insurance: Initial consult $200 First IUI cycle $1200 Second IUI cycle $800 (had fewer monitoring appointments), plus meds.

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Dr. Reh was direct and kind at the same time. She listened to my concerns when our suppression meds failed, and adjusted course so that our next attempt at a transfer was successful. When my husband and I asked to do the fertilization process in a limited manner, Dr. Reh agreed with our requests, even though it would not be the most efficient route.

Know what you want, and what you are okay with in terms of treatment. Dr. Reh will do her best to work with you to customize your treatment protocol.

We did an egg retrieval, single egg insemination, fresh transfer, and egg freeze. Several months later we did a limited egg thaw and fertilization, with fresh embryo transfer and embryo cryopreservation.

After insurance our egg thaw and transfer cycle was around $5,000. Meds were approximately a total of $200

Was only offered a single embryo transfer based on age and infertility factors.

Going through fertility treatments is hard and I was hoping we would have our first baby on the first try. We did get pregnant from our IUI but miscarried. Dr. Malik advised me on doing IVF FETs as I was already 38 when I first met her. We did 2 rounds of embryo preservation and I am so grateful for that advise. We have a 2.5 year old toddler and are currently pregnant with twins from our FET procedures. I am grateful for having all my options explained to me so we could make the best decision for our growing family.

Just have patience, it takes a while to understand the long process of trying to get to the point of being pregnant. Also, don't give up hope. It's a numbers game and you have to keep trying until your successful with a baby.

Our FET treatments included doing progesterone shots, estrogen pills, lovonox blood thinner shots and prenatal vitamins and maintaining my thyroid at a .2 tsh level. I have PCOS and hypothyroid.

They had monitoring hours and the appts were in the mornings and very easy for me to get to. They worked with my schedule.

We had fertility benefits from our health insurance so I am not sure of the costs.

I believe it is SGF policy to only do eSET due to risk to me as an advanced maternal aged woman.

To say Dr. Reh is a wonderful provider would be an understatement. She is outstanding and provided a warm and successful experience from beginning to end. Because of Dr. Reh, we now have a beautiful daughter. All credit goes to her and her team. From our very first visit with Dr. Reh, my husband and I knew we could trust her. She directed us to begin our journey with medicated/timed cycles. We tried four cycles of Letrozole. After that treatment did not result in pregnancy, we moved to IVF. Dr. Reh explained thoroughly explained the IVF process and our individualized odds of success. We were incredibly confident in her treatment plan. We underwent one egg retrieval cycle which resulted in three PGT-normal embryos. I let my body rest for a few months after the egg retrieval and transferred one embryo, which resulted in a success pregnancy and birth. Dr. Reh personally called me the morning of the egg retrieval to wish me luck and was present for my "graduation" appointment at Shady Grove before I moved to my OBGYN. She was also my provider for several of my monitoring appointments. If I choose to move forward with a second embryo transfer, I will make sure Dr. Reh is my provider. She is outstanding and the absolute best Shady Grove has to offer.

Shady Grove is a large institution and you may not always see Dr. Reh at your appointments. Trust the process. She is still overseeing your treatment and is always available via her staff.

I do not ovulate regularly, so I started with Letrozole and medicated/timed cycles. I completed four cycles of varying dosages. While I did ovulate each time, I did not become pregnant. When I moved to IVF, I used an antagonist protocol (Gonal, Menopur and Cetrotide) for my stimulation cycle. I produced 22 eggs. ICSI was used resulting in three PGT-normal embryos. One embryo was transferred which then gave us a successful pregnancy and a healthy baby girl.

We took advantage of the Shared Risk program. Treatment and medications totaled $30,000.

Dr. Malik was an amazing listener and really cared about our results. I saw several NP's for my bloodwork/ultrasound appointments but she was checking in and I knew always reviewing my results. She performed the actual implantation procedure and was always patient to answer my questions. I would highly recommend her!!

Trust her and her team, it seems so overwhelming but you're in good hands and they always give bite sized information to take it day by day.

We first tried an IUI since we're relatively young and healthy and have unexplained infertility. Rather than continue to try IUI's, we opted to try IVF as insurance didn't pay for any of it, we wanted to put the money towards the better option (percentage of success wise). We did one cycle of IVF, and our first fresh transfer was a success. We are so grateful!

Mornings were always busy to be expected, wished they had some later options but it is what it is.

The cost of the actual IVF were laid out clearly, one thing that wasn't were the meds. We had nothing covered by insurance so while it was estimated we'd pay 5K for meds, it was more like 8K because of increased dosage and refills. Good to know- just over estimate if you're paying out of pocket.

Dr. Malik strongly recommended we only try one embryo for now since it was our first try, and she was right- it stuck! Grateful to be pregnant with one :)

Dr Rey was wonderful, she connected with me at important moments, made sure I had time and space to ask questions, and she always made me feel like she was familiar with the details of my fertility journey.

She has a very calm demeanor but don't take that as a lack of enthusiasm or investment in helping you have a baby.

Started with a standard egg retrieval process with injectable medications. Resulted in 3 day-5 embryos, which were then biopsied for PGT A & PGT M. Only 1 embryo was cleared for transfer. I was hoping for more than 1 viable embryo so Dr Rey counseled me on options and we decided to do a 2nd round of egg retrieval – she upped my medication levels this time, resulting in 6 or 7 embryos that were then sent for genetic testing. Of those, we got 4 viable embryos! Once we had 5 embryos we decided to move forward with a medicated frozen embryo transfer. During the medication lead up to the transfer my uterine lining was not thickening up to an ideal number – I discussed with Dr Rey and since my lining was naturally thin, I opted to move forward with the embryo transfer. I got a positive pregnancy test but had a miscarriage at week 6. I was pretty devastated and doubting myself – thinking I had done something wrong. When talking to Dr. Rey she was honest with me that even she was a bit surprised that I miscarried with a genetically viable embryo, but she explained that PGT testing isn't 100% guaranteed due to what cells are tested in the blastocyst stage. We decided that for my next embryo transfer we would try an unmedicated cycle before transfer since I had been able to get pregnant previously. (I pursued IVF because I had to terminate two wanted pregnancies due to fatal genetic issues, my husband and I are carriers of the same genetic disease) The natural cycle worked better and my uterine lining got thicker than the previous cycle – my embryo transfer went smoothly and I'm now 9 weeks pregnant.

My fertility care was covered by my employer so I had minimal exposure to costs. I will say that Shady Grove offered financial consultations and plans.

Dr Rey explained that they typically transfer a single embryo because of the risks associated with twins, especially for someone at my age (37). She also recommended 1 embryo since I had been able to get pregnant naturally in the past and my focus in IVF was pre-implantation genetic testing.

I could not have asked for a better doctor. Fertility treatment is always challenging, but Dr. Reh made the process easier. She was extremely patient and excellent at making sure to address all of our concerns.

Follow the process and be patient because fertility treatment takes time (after all, one cycle is a minimum of 28 days).

She increased our letrizole dosage to help increase chances for pregnancy by having multiple eggs produced at once. She was always careful not to over stimulate. We also tried chlomid upon our own request and desire to try other ovulation stimulating medication. And finally she was a pro at our IVF. She carefully adjusted the medication for optimal results (maximizing the number of developed eggs at the same time) and we had resounding success.

My insurance only covered initial diagnostic treatment. The fertility treatment itself was out-of-pocket, though the clinic did give information on financial resources if needed.

We did PGT-A testing and therefore only did a single embryo transfer.

Dr. Reh was able to personalize her approach to help get me pregnant. She reviewed the results each month and adjusted medications as needed. She was friendly and knowledgeable and I felt confident in trusting her opinion. I had a great experience with her and I have recommended her to others struggling with fertility.

Dr. Reh has years of experience helping others get pregnant. She knows how to guide her patients to a healthy, safe pregnancy. I personally have recommended her to friends/colleagues and encourage prospective patients to meet with her as well.

I took letrozole to induce ovulation because I do not a regular cycle (due to PCOS). I also took a trigger shot each month followed by progesterone pills. I completed this process for 4 months before getting pregnant. Each month the amount of letrozole that I took increased slightly to help with my egg development and it adjusted at that level to ensure that the chance of multiples were reduced.

Same day lab work cost about $50-$75 with insurance per cycle. My medications (letrozole/trigger shot) were about $75-$100 per cycle with insurance. I also had a co-payment of $35 for visits.

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