Shady Grove Fertility WMA

My husband and I found Dr. Widra to be compassionate, but also frank. He didn't sugarcoat anything, but I certainly never found him cold. When trying for my first, we went through a number of retrievals and transfers and I appreciated feeling "known" despite being at a very large clinic that has a reputation for being a factory. I am detail oriented and Dr. Widra always took the time to answer my questions, whether in person or on the phone. While much of my communication was with my nurse, if there was difficult or sensitive information to deliver, he always called me himself and I never felt rushed off the phone. We ended up doing PGS testing and when I became pregnant, Dr. Widra told me to call him if I ever had any questions. We were indeed told at one point in my pregnancy that we should consider an amnio to rule out chromosomal abnormalities. At this point it had been a few months since I saw Dr. Widra, but I called him and he returned my call within hours. We went back to Dr. Widra when we were ready to try for our second, and unfortunately we did not have success. After two cycles, he recommended we move on to donor egg. While we weren't (aren't) ready to do that, I appreciated his honesty about how he views our situation.

That he may not be the warmest upon first impression, but you should not take his frankness for a lack of compassion.

I began with fairly low doses of menopur and bravelle, 75 and 150, respectively. But that cycle did not produce many follicles. In my subsequent cycles, I was using higher doses -- around 150 menopur and 300 bravelle. I did two antagonist protocols: bcp followed by stims, with cetrotide added when the follicles got to a certain size. While these yielded a decent number of eggs, Dr. Widra thought we might be able to get more with estrogen priming, so we did that for my last cycle when trying for my first. When trying for my second, we started with estrogen priming since that had yielded the most eggs when I was trying for my first. However, that did not result in many eggs, so Dr. Widra proposed a micro-dose Lupron protocol.

I found monitoring appointments pretty easy because there were multiple locations I could go. There were often multiple women waiting, but that didn't negatively impact my experience. I knew that the earlier I went, the less time I would have to wait. Very occasionally, I would be taken to a room and then had to wait for 10-15 minutes, but usually once I was taken to a room, I was seen within a few minutes.

I was part of shared risk, both times. That meant I paid an upfront fee (~25,000) that covered up to 6 cycles and I got my money back if it didn't work.

Dr. Widra had a strong preference for eSET given that we were exclusively transferring 5 day embryos. I appreciated this approach, given that it is safer for both women and babies.

I believe that all the doctors at SGF are required to follow strict guidelines so there is not a lot of experimentation that I've seen so far but I have a fairly straightforward case. Dr. Osborn has always been friendly, considerate and willing to answer any questions that I've had. She has been the one to share good and bad news with me and will always contact me if I've requested to hear from her. She is realistic and clear with what she expects from treatment.

She is much more willing to share and elaborate if you ask questions. She doesn't talk just to talk so be prepared with what you want to know.

Antagonist protocol for retrieval which resulted in less embryos than I expected but exactly what SGF predicted for me.

I had insurance coverage so I do not know the total amount of each procedure.

eSET is recommended.

Dr. Osborne's bedside manner isn't great, but it's not the worst I've ever seen. Fertility clinics seem to be extremely nervous about getting a patient's hopes up, which means they are so neutral that they veer into actually withholding information, and being obtuse. I found Dr. Osborne to be this way. For example, I couldn't get a straight answer from her about nutrition/supplements to before/during egg freezing. Overall I sometimes felt like I was talking to a customer service or sales rep instead of a doctor - she just was unable to be personable.

Come prepared with all your questions, and don't be afraid to press further if you don't get a full answer to a question, or one that you understand.

Age: 38, AFC: 18, AMH: 1.58. Doctor expected ~13 eggs per cycle, of which ~9 would be mature. First cycle was way less successful than expected, so they used the same protocol but increased the dosage significantly. Then 3rd cycle they used a different protocol. First 2 cycles: birth control, then antagonist protocol (Gonal-F, Menopur, Cetrotide, Leuprolide trigger). 3rd cycle, no birth control, estrogen priming instead, then same antagonist protocol, except HCG instead of Leuprolide trigger. 1st cycle: 5 eggs retrieved, 3 mature 2nd cycle: 12 eggs retrieved, 8 mature 3rd cycle: 14 eggs retrieved, 9 mature

$12,500 for an egg freezing cycle: 20 mature eggs or 4 cycles, whichever came first. For 3 cycle, I paid the pharmacy ~$15K. SGF also tried to bill me for blood tests and a consultation with the doctor in between cycles. I was nickel and dimed.

As a single woman I was nervous about judgment from the doctor and there was none of that. She takes the individual circumstance and recommends treatment based on that, without judgement. I only see or talk to Dr. Osborn periodically and most communication is with the nurses.

Have a lot of questions prepared in advance. She is very patient about answering them but might not provide all the information YOU want unless you ask.

As I am a single woman, without any known fertility issues, she started me with two unmedicated IUI cycles. These were unsuccessful so then we talked and I said I wanted to be more aggressive so the next cycle I went did Clomid, Follistim, trigger, and Progesterone. This was also unsuccessful but will try another cycle with the same protocol.

Unmedicated/unmonitored IUI was $295 Medicated IUI with monitoring, blood work, IUI is $1800 - not including medications

Dr. Osborn was recommended to me from a friend doing IVF. I was not in the same situation as a patient, but I found her care and compassion to be top notch. This is such an emotional process and so expensive-- it is imperative to have a doctor who you can trust, who is there to answer all your questions, and who can provide the kind and supportive bedside manner one absolutely requires in the fertility treatment experience.

I would recommend going to Sibley for your screenings so you have a chance to interact with Dr. Osborn more frequently. I chose to go to a closer Shady Grove center, which I would have done differently in hindsight. I would also make sure you ask to have Dr. Osborn do your retrieval procedure if possible.

I was pretty run of the mill in terms of treatment course. The medicines and dosages were pretty par for the course of friends of mine who have gone through retrieval for IVF. I was happy to see i responded well to the medicines and would up using a sub-cutaneous trigger shot. I wound up having my retrieval a few days earlier than expected, too.

I chose to go to a clinic for monitoring closer to my house. Scheduling was easy and on the weekend, it was no problem getting into the K Street clinic.

The cost options and plans were clearly laid out and discussed with me anytime I had questions. I did not have insurance coverage so I paid directly and was able to handle payment in one installment.

Very good listener. Friendly and warm bedside manner. Super flexible in scheduling me around other constraints. Good communicator - provided easy to understand explanations and was super responsive. Following my miscarriage from a naturally conceived pregnancy, she was able to get on the phone with my ob and have the tissue tested the same day without much notice. She was super easy to work with and I'll go back to see her again when we're ready for baby #3.

With Shady Grove's system, you can go anywhere for monitoring (which is awesome in terms of the flexibility it enables). That said, I'd try to see Dr. Osborn as much as you can which will help you build a relationship with her and get instant answers to questions and next steps.

I responded very well to an antagonist protocol which is what we used for both of my retrieval cycles with good success.

I always scheduled for 1st thing in the morning and was almost always in and out for monitoring and other appointments in under 15 mins.

We did PGS so we knew what we were putting back. Given that, Dr. Osborn only recommended transferring a single embryo which is what we wanted. No difference there in opinions on best way to proceed.

Eric is a smart doctor. And you'll see him for your until consultation to devise a treatment plan. But he's not a warm and fuzzy doctor. Neither is he's hands on, nor especially client interfaceing until things don't go as initially as planned. We barely saw him over the course of our three IUIs. He did not perform any of the monitoring appointments or procedures. Due to the clinic's large size, those tasks were performed by whichever doctor was available at the time. However, once we moved onto IVF cycles - we saw Dr. Widra more frequently. Still however, the procedures were completed by available daily doctors (not Widra). We finally got to experience Dr. Widra in a more hands-on and compassionate way after I began to experience unexplainable RPL of chromosomally normal embryos/fetuses. He took the time to meet with my husband and me as often as we felt we needed to come in and consult with him, and have him reassure us. He was not initially responsive to the additional testing I wanted to have done (Leiden V) or putting me on additional medications. But after the second miscarriage, he was amenable and willing to accommodate my requests. Through these difficult times he has been thoughtful, caring and respectful.

Make sure he's the right personality fit for you. If you're looking for someone who will be overly supportive and involved in every way (complete every procedure, call you directly with monitoring appointment information, hand holding) that's not how he or the clinic operates. But if you're comfortable with a more formal manner, direct, thoughtful and respectful manner - then he'll be a good fit.

Diagnosed with PCOS and unexplained fertility issues. Completed 3 rounds of IUI with Clomid and ovidrel. Resulted in good egg stimulation for all three cycles but only one chemical pregnancy. He was not open to changing protocol as I requested to include metformin and femerra. Moved onto IVF. Egg stimulation and retrieval: Cetrotide 250mcg Gonadotropin FSH ( Gonal F 450 iu pen x 3) and 75 IU FSH&LH ( Menopur 75 iu vials x 15) Lupron 2 week kit with 1ml luerlock syringe, 27 g ½ “ needle - “Trigger” subcutaneous. Zithromax 1 gram - taken evening before egg retrieval Resulted in 18 eggs retrieved. 8 made it to 5-day blocyst; 5 remained after PGD testing. Froze all embryos. #1 IVF and FET Round: Birth Control Pills Prenatal Vitamins: 1 daily Del Estrogen injection (40 mg/ml; 1 vial has 5 ml; 6 mg = 0.15 ml): 0.15 ml IM every third evening Progesterone in Oil injection (50 mg/ml): 1 ml IM every night Resulted in pregnancy; SPL/miscarriage at 6 weeks; misoprostol abortion. Diagnosed as carrier of Liden V. Round #2 IVF and FET: Lovenox injections 40mg daily Prenatal Vitamins: 1 daily Del Estrogen injection (40 mg/ml; 1 vial has 5 ml; 6 mg = 0.15 ml): 0.15 ml IM every third evening Progesterone in Oil injection (50 mg/ml): 1 ml IM every night Resulted in pregnancy; SPL/miscarriage at 6 weeks; d&c abortion. Fetal tissue chromosomally normal. Diagnosed with PCOS and unexplained fertility issues. Completed 3 rounds of IUI with Clomid and ovidrel. Resulted in good egg stimulation for all three cycles but only one chemical pregnancy. He was not open to changing protocol as I requested to include metformin and femerra. Moved onto IVF. Egg stimulation and retrieval: Cetrotide 250mcg Gonadotropin FSH ( Gonal F 450 iu pen x 3) and 75 IU FSH&LH ( Menopur 75 iu vials x 15) Lupron 2 week kit with 1ml luerlock syringe, 27 g ½ “ needle - “Trigger” subcutaneous. Zithromax 1 gram - taken evening before egg retrieval Resulted in 18 eggs retrieved. 8 made it to 5-day blocyst; 5 remained after PGD testing. Froze all embryos. #1 IVF and FET Round: Birth Control Pills Prenatal Vitamins: 1 daily Del Estrogen injection (40 mg/ml; 1 vial has 5 ml; 6 mg = 0.15 ml): 0.15 ml IM every third evening Progesterone in Oil injection (50 mg/ml): 1 ml IM every night Resulted in pregnancy; SPL/miscarriage at 6 weeks; misoprostol abortion. Diagnosed carrier Liden V. Diagnosed with PCOS and unexplained fertility issues. Completed 3 rounds of IUI with Clomid and ovidrel. Resulted in good egg stimulation for all three cycles but only one chemical pregnancy. He was not open to changing protocol as I requested to include metformin and femerra. Moved onto IVF. Egg stimulation and retrieval: Cetrotide 250mcg Gonadotropin FSH ( Gonal F 450 iu pen x 3) and 75 IU FSH&LH ( Menopur 75 iu vials x 15) Lupron 2 week kit with 1ml luerlock syringe, 27 g ½ “ needle - “Trigger” subcutaneous. Zithromax 1 gram - taken evening before egg retrieval Resulted in 18 eggs retrieved. 8 made it to 5-day blocyst; 5 remained after PGD testing. Froze all embryos. #1 IVF and FET Round: Birth Control Pills Prenatal Vitamins: 1 daily Del Estrogen injection (40 mg/ml; 1 vial has 5 ml; 6 mg = 0.15 ml): 0.15 ml IM every third evening Progesterone in Oil injection (50 mg/ml): 1 ml IM every night Resulted in pregnancy; SPL/miscarriage at 6 weeks; misoprostol abortion. Diagnosed as carrier of Liden V. Round #2 IVF and FET: Lovenox injections 40mg daily Prenatal Vitamins: 1 daily Del Estrogen injection (40 mg/ml; 1 vial has 5 ml; 6 mg = 0.15 ml): 0.15 ml IM every third evening Progesterone in Oil injection (50 mg/ml): 1 ml IM every night Resulted in pregnancy; SPL/miscarriage at 6 weeks; d&c; fetal tissue chromosomally normal. Round #3 IVF and FET: Metformin 3 pills daily w/ meals Lexapro 10mg daily Lovenox injections 40mg daily Prenatal Vitamins: 1 daily Del Estrogen injection (40 mg/ml; 1 vial has 5 ml; 6 mg = 0.15 ml): 0.15 ml IM every third evening Progesterone in Oil injection (50 mg/ml): 1 ml IM every night Result: TBD

Year 1: For 3 IUIs + shared risk IVF package + out of pocket meds + medical deductibles = ~$50,000

At first I was frustrated at my doctor's unwillingness to implant multiple embryos. But after he explained the potential risks and long term effects of the babies (developmental issues, under weight, early term, etc) I began to understand and agree with eSET.

Dr. Osborn is a very good doctor and one of the best in this field. I think that personality-wise, she might be a bit shy and is respectful of your privacy so she is not as nosy about your preferences as other REs might be. But you just need to be very well informed and go into your appointments with her with a lot of questions because she is patient and will answer every last one of them honestly and truthfully. She is forthcoming about why Shady Grove recommends some things (for business/cost reasons vs. strictly medical outcome reasons).

Make sure you are well informed, read the latest findings and studies (i.e., about Ubiquinol/CoQ10 studies) and ask about their applicability to your situation. Shady Grove is a busy practice and Dr. Osborn is not going to spend time with you providing endless amounts of information if she does not think you are interested. But if you ask her specific questions about the latest research, about your situation, etc., she will take the time to answer honestly and thoroughly.

4 fresh IVF cycles with own oocytes, ICSI and assisted hatching. After a failed cycle, Dr. Osborn adjusted the medications and protocol to encourage more eggs to be developed for retrieval. Adjustment in medications led to successful outcome.

With insurance, IVF with ICSI and assisted hatching was $3500 out of pocket. Medications were approx. $500. After employer dropped IVF coverage from health insurance, IVF with ICSI and assisted hatching was $10,500 and medications were approx. $4,000.

Dr. Osborn actually recommended multiple embryo transfer because of my age but I requested eSET twice because that was what I wanted. On one cycle, where the embryo transfer was not a 5-day blastocyst but 5-day morulas, I agreed with multiple embryo transfer recommendation.

I found her to be very warm and caring. We wanted a lot of detail and she was happy to provide it. She had an analysis of our results and expected outcome using different treatments. We were going to go forward with IVF with her but ended up with a spontaneous pregnancy before we shifted to IVF.

3 rounds of IUI with no success, spontaneous twin pregnancy ending in miscarriage. Decision to move on to IVF but had another spontaneous pregnancy prior to starting.

My insurance covered everything so no comments other than having several billing errors that were cleared up with a phone call.

Dr. Osborn met with us to understand who we are, our background, etc. She met with us again to review genetics study tesults and explain everthing. She came in to see me during most of my visits, and she followed up after my daughter was born.

Use her!!! She is terrific!

I followed a traditional course of treatment with clomid, IUI, then IVF.

Dr. Humm is an excellent REI. She took the time to answer me and my partner's questions. She walked us through the process, gave us candid feedback and shared her perspective, and helped us make educated decisions. I highly recommend Dr. Humm.

Come prepared with questions.

I had an appointment and would wait for my name to be called in the waiting room.

Dr. Humm recommended single embryo transfer.

Dr. Bromer was very informative and willing to work with us despite challenges we had run into with previous clinics. I had been told I was simply a poor responder to medication, Dr. Bromer was convinced with the right treatment I could respond and he was right!

He’s very willing to both give his expertise but accept what you’d like to do as well.

I did one IVF cycle with a fresh transfer with Dr. Bromer. I had poor results in previous retrievals so he monitored my medications very closely and took a different protocol than previous doctors.

I was fortunate enough to have my husband’s insurance cover the entire procedure aside from the PGT-A embryo testing which was $3,400.

He seemed open to either, we chose a single.