Southern California Reproductive Center

I always felt like I was in good hands with Dr. Danzer! He always explained everything to me, made me feel at ease and hopeful. I never had any doubts in him. His Protocols were effective and didn't leave me feeling horrendous like some other doctors/protocols. Even though we didn't achieve the hope for results, the experience wasn't terrible.

Be aware that he is extremely busy, so his time may be limited and access impossible.

Agonist Protocol.

I would have a window between 7am and 11am, to go for blood-work and ultrasounds. Even though the waits would be of 1+ hours, it was convenient most of the time. Wasn't made to wait around once I was done with the tests, I could go home and instructions would be given to me then!

Prices in 2017 ROUND #1 SCRC Multiple charges of $340 - $510 a pop prior and post starting cycle which amounted to $2,655 just for blood, ultrasound and extra testing. IVF Round $6,295 | Roxbury Surgery (for egg retrieval) ART CENTER - ROXBURY SURGERY CENTER - IVF EMBRYOLOGY/ASSISTED FERT/EMBRYO CRYOPRESERVATION $13,240. (Medication prices not included). ROUND #2 (with transfer) IVF Round $6,051 | Roxbury Surgery (for egg retrieval) ART CENTER - ROXBURY SURGERY CENTER - IVF EMBRYOLOGY/ASSISTED FERT/EMBRYO CRYOPRESERVATION $12,590. (Medication prices not included) | HSS (HYSTEROSONOGRAM) w/saline solution $565.00 | TRANSFER OF EMBRYO $3,370. | Additional testing (bloodwork, ultrasound etc) not included in Cycle $4,785.

We only had one embryo to transfer anyway.

Dr. Ghadir was someone I could implicitly trust and count on. In a sea of emotional decisions that had to be made he was a steadfast guide who knew just how to balance a compassionate bedside manner with objective medical expertise.

I would advise any future patient of Dr. Ghadir's to be completely open and honest about their fertility goals and the mitigating factors that impact their decisions including finances so that he can make sure his treatments take your full life picture into account.

I don't really remember the exact protocols but I do remember that they were extremely effective (which is why maybe I don't remember them as I didn't need to implement many adjustments).

I don't really remember, I think all in for retrieval and 2 transfers it was between 40 & 50k?

I felt I was very educated on why single embryo transfer was a good decision for me given the high likelihood I would become pregnant and specific medical situation. I can't speak to his approach with other patients but it worked for me.

Dr. Alexander was super thorough and easy to talk to, when we were able to see her. My husband initially went in just for a semen analysis (referred by my OBGYN) and we were able to do a consultation once his results were in.. he had a 1% morph. She went through some basic questions with us and she explained our options (IUI, IVF, etc). We didn’t make a decision and she called me a couple weeks later to check in, I was midway through my cycle like day 12 and she said we should try an IUI, she prescribed me injections and they were delivered to my house... Never did any testing before or an ultrasound... Strange now in hindsight, but I had no clue standard procedure. I’m sure she just wanted to give my follicles an extra oomph. I went in after the injections for an ultrasound, but never saw Dr. Alexander for those, only a nurse and Dr. Alexander would call me after with her take on my follies + a plan. Eventually we did the trigger and scheduled an IUI 36 hours after. The IUI process was with her and she was great through it, although only saw her for the insemination. She prescribed progesterone and sent me on my way. I started my period and came in for an ultrasound with a nurse and the nurse mentioned it looked like I might have cysts. Dr. Alexander called me after and said she thought they were follicles that were big and I was going to ovulate any day... it was CD3 and I wasn’t on any medication, I normally ovulate on CD16... I got a weird feeling and decided not to continue with her and the office, it felt like my care wasn’t being considered and they were using a one size fits all procedure. Dr. Alexander was a cheerleader through the process and genuinely wants you to get pregnant, but it seems like she sees too many patients and can’t give them individualized care.

She is genuinely sweet and means every word she says to you, she’s extremely hopeful... But make sure to ask a lot of questions and be your own advocate through the process if something doesn’t feel right.

We did Gonal-F injections 75IU CD12-14, an HCG shot on CD15 and an IUI on CD17. Started progesterone suppositories CD19 at night til period started on CD28

I can’t remember fully, but I know the ultrasound and office visits were more expensive than my current RE... I want to say it was $190 per visit for a standard ultrasound and the IUI was around $500.

Dr. Chang has been thorough in explaining information to us. She appears like she cares and wants to optimize our chances of getting pregnant. She communicates in a clear manner, often speaking slowly and calmly, which is appreciated given the technicalities of IVF.

I have not completed a full cycle yet, but Dr. Chang is currently preparing for IVF and has suggested a number of supplements to optimize our health. We've gone through many pre-tests and ultrasounds that have helped her give her a baseline of our health. I appreciate her having us take our time to improve our chances instead of rushing into the procedure.

Genetic screening, consultation office visits, ultrasounds, cycle day 2 labs, supplements

We started doing IVF for male factor (1 % morphology) after I had two chemical pregnancies. Dr. Alexander was extremely compassionate and thorough with testing before we started a cycle. She was confident I would get pregnant as everything on my side looked amazing. Our egg retrieval went great, with 4 PGS normal embryos. Our first transfer was delayed because she found polyps and I was scheduled for a hysteroscopy to remove them. While under she found a uterine septum and removed that as well. Then I tested slightly positive for irregular uterine cells and did a course of antibiotics. We finally started our transfer cycle only to be cancelled because my lining wasn't responding to the meds properly. We started again with a different type of estrogen priming and went ahead with our first transfer which resulted in a pregnancy. Dr. Alexander was more excited than me, as I was cautiously optimistic because I knew one beta test is not the whole picture. Our second beta came back lower than they would have liked and we did a third one which was normal. After this we waited to do an ultrasound at which point things did not look good. I was told this news during the ultrasound which was very upsetting. We had to go back several times to keep watching and I eventually started to miscarry and took drugs to help it along. Transfer 2 failed, which was shocking to everyone. We met with Dr. Alexander and she suggested an ERA and seeing a hematologist, which didn't make total sense to me. I said, why don't we do one more transfer before we do all that and she suggested another hysteroscopy before a transfer and the plan was to do a third transfer before she left for the holidays. We did the hysteroscopy where she removed a small piece of tissue but everything else looked great. We then found out that we wouldn't have time to do the transfer we talked about doing so I suggested doing the ERA while we were waiting for her to get back. We started a mock cycle on their "standard protocol" which did not work at all for me on any level. It was the same hormone protocol as the first cancelled transfer... I expressed concerns about this not working and was told it would be fine. When my lining didn't respond and this cycle was cancelled, I felt like Dr. Alexander started to lose confidence. She said the ERA was no longer necessary as she "didn't want to be chasing her tail around trying to get a good lining." It was disconcerting being told we needed a test and then a week later we didn't. She suggested trying a natural cycle which I started and when she discovered fluid in my uterus (which I believe was there from the cancelled cycle before) we were brought into her office and mid-cycle suggested surrogacy in a very odd way. Asking if I knew anyone who I would want to be my surrogate and saying she wished she could be mine. My husband and I were no where near ready for that conversation and it was very strange to have it brought up in the middle of an FET cycle. The fluid was aspirated, I had a second HSG with her associate (who called me a conundrum during that procedure) and she recommended going ahead with the third transfer. That one failed and we decided to get a second opinion at that point.

Be ready to be in the driver's seat of your fertility journey whether it's following up for results, getting medications called in and doing your research. Dr. Alexander is smart but there were things that were missed along the way and I wish we were given a more realistic idea of what to expect with the entire process.

Egg retrieval was pretty typical. FET changed from estrogen pills to many patches and Viagra, lovenox, steroids and lots of natural supplements and PIO and endometrin when it was time. Final FET was natural (waiting for me to ovulate) with a little patch support and endometrin/PIO shots, lovenox and steroids.

I think a retrieval cycle was listed as a little over $20k but once you add tests and meds its more like $30k. We spent close to $7k for everything for each transfer.

She went back and forth about whether or not to transfer one or two but ultimately agreed with our decision to transfer one at a time... she felt strongly about me not carrying twins for health reasons.

She genuinely cares about her patients and will do anything within her ability to help you achieve your desired outcome. She pays close attention to detail and is very articulate. She will explain things as many times a you need to hear them, and give you her undivided attention.

Invest in the consult and make sure her style/approach is right for you. Because her practice has one of the best labs in the country, we decided to move forward with her office. We were told the labs were the most important part of the process, but she is also an extremely competent and supportive doctor which you don't always find in this profession.

Since we went through 3 rounds, she did try a variety of medications and approaches. She paid really close attention to my wife's response and made adjustments if/when necessary. The first round was a high dose of meds to which my wife did not respond well to. The next round, she tried a much lower dose and we were able to create one embryo even though we did not retrieve as my eggs. The final round she tried the same process and we got 8 eggs, but unfortunately no embryos. Our situation was a bit unique though because both my wife and I have fertility issues, so our chances of making an embryo together we are finding is pretty low.

About $40K for a two cycle package without the meds. The package included everything necessary to complete the cycle (blood work, ultrasounds, surgery center fees etc..)

She recommended a single embryo transfer for us, because of the inherit risk of having twins.

As I mentioned, Dr. Danzer was kind and personable, but I had very little interaction with him. I also feel that my protocol and care was standardized, not personalized. I did have great trust in Dr. Danzer, that he knew what he was doing (his history and notariety speak for themselves) and that he would obtain the best results he could for us. I was okay with a more straight-forward approach, the results were more important to me than bedside manner. However, I would have liked a bit more personal experience and reflection on our specific case.

Definitely advocate for yourself, especially with his support staff. And I would try to build as much of a relationship with Dr. Danzer as possible early on. Try to get in front of him, when you can. A couple of times, I had to request to meet with him personally, which was arranged. I think that is helpful. Also, find one friend within his team - that helped us immensely.

Dr. Danzer used a standardized protocol - birth control pills, followed by an antagonist approach of Gonal F (primary) and Menopur (secondary), with Cetrotide and trigger at time of egg retrieval. We have not moved on to the transfer cycle with him yet, so not sure of his protocol there. I felt pretty fine on the medication. The staff met with me for instruction, and offered a helpful website with videos. Because of my age, he did hit me with higher dosages. I was unsure of this, at the time, but now feel that might have been the right way to go. I ended up having to be on the meds for two extra days, for response growth. I came in for ultrasounds and blood draws every other morning. My egg retrieval went smoothly, however I did end up having slight OHSS about one week later. It cleared up the following week. We were happy with our results at first, then a bit disappointed. Retrieved 20, but less than half fertilized. We did send most off for genetic screening, but the majority were abnormal. Dr. Danzer did offer good education on our results, which I appreciated.

This was definitely not an inexpensive clinic, but I knew that going in. We were paying for the best. Both Dr. Danzer and the clinic/lab have stellar scores, no question. I was happy with the fact that the clinic did try to find us savings, where possible. I don't know that I would go so far as to say they worked with our budget, but they did try to get us some discounts.

We have not embarked on this part of the process just yet. I believe Dr. Danzer does recommend eSET, which I feel comfortable doing.

He is very knowledgeable and changes course as needed based on your response to treatment. I trusted him and felt I was getting the treatment I was expecting. I felt like he knew my case and paid attention to me beyond just the standard protocol. He also was straight forward with me regarding my options and treatment plan. He consulted other doctors in the clinic as well to get their opinions on my treatment.

Have trust in your doctor but be your own self advocate.

For retrievals I did birth control followed by menopur and follistim and added ganirelix part way through. I used an hcg trigger my first retrieval and a lupron trigger for my second retrieval. I did a transfer with birth control, Medrol, estrace, pio injections, and progesterone suppositories. I did the same for the ERA. We changed the injection time for pio for the second transfer to be exact based on the ERA.

My doctor preferred to transfer one embryo especially since they were pgd and pgs tested and we did not want to risk multiples so we selected a single embryo for each transfer.

She is genuinely warm and compassionate. She explains everything in great detail. She personally called me to give me my results after each test I have had up to date ( US readings, Blood test, Genetics, etc) I never had to chase her down or wait long for my results, Dr. Akopian was on top of it.

Don’t be afraid to ask questions. She has answers and is more then willing to educate.

N/A

I personally paid out of pocket. Insurance covers some portions. A financial advisor is present to assist in the payment options

Personable, warm and compassionate he is results driven and wants you to get pregnant as much as you do. His communication was direct but warm and he did a good job of keeping you motivated whilst being thorough with tests and exams. The challenging part is that Drs don't always understand how much the costs can escalate.

Don't get carried away with the enthusiasm, ask lots of questions and take things slowly

FET - Higher success rate Uterine Biopsy - to ensure embryo transfer date was correct after 2 failed transfers

Really easy, i would go in early before 8am and be taken within 20 mins

Dr open to transfer 2 for higher success

Dr Chang is incredibly smart and informative, but she has NO bedside manner what so ever. She was incredibly blunt, and almost rude when delivering some very upsetting news, and her protocol lacked important steps, that even someone who isn't a Dr would know. EX: when discussing doing IUI, knowing i have a blocked tube and that my home ovulation kits didn't show regular ovulation, she just told me to come in the day after a positive ovulation test for an iui. No discussion of medication, no plan to make sure I was ovulating from the non-blocked side, zero monitoring of the size of the follicle to decide when to perform the IUI. NOTHING!

Consider seeing another doctor.

Take a home ovulation kit, and come in for an iui the day after i get a positive ovulation test.

Compared to our current Dr, SCRC's pricing is far more then our current clinic.

Dr. Chang’s strengths can be summed up as compassion, communication, and expertise. She won my trust and I am so grateful she was able to add another piece to the fertility puzzle by performing my ERA and helping me understand the clinical facts behind the immune protocol best suited for me. The only drawback is that she is in Southern California and I’ve moved to Northern California, so I can no longer continue treatments with her.

Take the time to read “Is my body baby friendly” before seeing Dr. Chang. She is extremely knowledgeable and open minded regarding reproductive Immunology.

I had several ultrasounds to examine my uterine health. Dr. Chang also evaluated my hormonal health including my thyroid which no other RE had ever bothered to look at. She did my ERA and the results showed that my uterus is pre-receptive by 1 day. This means that all my previous embryo transfers were done outside my receptivity window. Because we need donor sperm due to MF, and it was determined that we would also need a donor egg, Dr. Chang recommended that I seek out IVF with a donated embryo. Her clinic doesn’t provide this service but she went the extra mile to recommend resources.

The costs were from consultations, lab and diagnostic methods, plus an on office surgical procedure. I was billed immediately after each visit and was able to pay by credit card.

In my case, I have a long history of implantation failure. Dr. Chang explained the risks and statistics behind both choices to me in a clear way, and advised me according to my diagnosis.

Dr Chang is a very effective communicator and really takes the time to make sure that all of your questions are answered. She’s extremely knowledgeable and does a lot of additional testing to make sure no stone is left unturned. I always felt 100% comfortable under her care. That being said, after 3 rounds of egg retrieval we only created one embryo. Obviously this was not the result we were hoping for but both my husband and I have fertility issues, so I’m not sure if the outcome can be attributed to her treatment plan. We are now in the midst of getting a second opinion and intend to go through another round with a different doctor to see if we can achieve a better outcome.

Interview multiple clinics to make sure that the approach and methodology is right for you. There are a lot of highly qualified doctors in Los Angeles, and depending on the circumstance there could be specific doctors better suited for your needs. I’m not sure if we made the right choice because we ended going with the first doctor we spoke with, since we felt very comfortable and confident in her approach during our first meeting. Flash forward 3 Years, we are now in the process of getting a second and third opinion because we did not get the outcome we were hoping for. Also, her fees are very expensive and there are many great doctors that charge significantly less.

She started out with a really high dose of injections during the first round to which I did not respond well to. I was on the meds for an extended period of time since my eggs weren’t growing, and they almost canceled my stim. They were able to retrieve 6 mature eggs but none of them fertilized. The next round she put me on a much lower dose of injections and I got 5 eggs but was on a shorter stim cycle and was able to make one embryo. The last round she used the same protocol, I got 8 eggs but none of them fertilized. I also tried to fertilize 4 of the eggs with donor sperm to see if we could improve our chances (since my husband has poor sperm quality) but that didn’t seem to work either.

We did the 2-cycle package which cost about $40k for everything excluding meds

For my age (34), she recommended a single since the odds of it taking are between 65-70%. She mentioned for older patients she would be more inclined to transfer 2.

Dr. Chang, was very knowledgeable, and took the time to fully access our specific situation, explain the IVF process, risks, and likely results. Going through IVF requires you to process an incredible amount of information and in a short period. This coupled with the obvious emotional and financial stakes, we naturally had a lot of questions to make sure we maximized our chances of success. So we required and she happily gave us her full attention during visits. We never felt like we were being rushed in and out of the office, as opposed to our previous doctor. Dr. Chang really focused on us achieving optimal physical health before starting our cycle. Although they extracted 11 eggs, unfortunately, we did not end up with any viable embryos. Despite the huge disappointment, I felt that Dr. Chang put us in a position to achieve the best possible results, even though ultimately unsuccessful. Which is the reason for the 8 rating instead of the 10. Though, if we decide to do another cycle, it would definitely be with Dr. Chang.

You cannot ask too many questions. And Dr. Chang gave smart, thoughtful answers, which made the entire process a lot easier.

It was almost a year ago, so I do not remember many specifics except an extremely detailed assessment of our physical state before IVF, and a comprehensive analysis and modification of our diet to optimize our fertility chances.

Approximately $20,000-$25,000

I came to SCRC not knowing what to expect. I have theee children and I assumed having a fourth was a no brainer. 9 months later still nothing. My regular OB recommended Dr. Alexander and my rheumatologist recommended another. I'm so glad I got to meet Dr. Alexander. The first visit was to go over my health status and what tests needed to be done to eval my fertility status. She also used a power point to explain all options available and also to help me figure out what course of treatment should happen next. After my consult I had a chemical pregnancy that did not want to clear my body and she checked on me weekly. She offered encouragement and also let me know that she was ready to jump in as soon as I was ready and my cycle had returned. She always finishes her phone calls or emails with "Best wishes" or "be well" and I think she might actually mean it. :) I have not conceived with her yet but I feel she will support me for as long as I continue to see her.

Come ready with questions and information about your fertility to save time.

Metformin- I have had surgery for dermoids multiple times so I think she put me in a pcos category. This drug helps with egg quality. Estrace- my lining and periods have been light either due to age or bc I have had a d and c and also retained placenta removal in the past. Coq10- help with egg quality Letrazole- I have Some cycles without ovulation Hcg injection- trigger ovulation Dexamethasone- bc i have autoimmune issues Aspirin- to build lining Folgard- not sure but I think bc a lot of people have some clotting or antibody gene or mosaic of the gene Prometrium- support potential pregnancy Prenatal vitamin

Co pay of $30 each visit. $250 for a consult but they waved it bc I she had to cance last minute.

Dr. Chang is a kind, compassionate, and extremely knowledgeable doctor who has made the IVF process feel less intimidating. She is not one to sugar coat the truth or make promises she can't keep but always maintains a positive outlook and shows great concern for you as an individual. She has taken care to ensure that both me and my husband are informed about each step of the IVF process and made herself accessible for questions and follow-up discussions. After our first FET failed Dr. Chang immediately put a plan in place to determine the reason for the failure before attempting a second transfer. She was even able to include me in a clinical trial for an ERA (Endometrial Receptivity Analysis) so that my costs for the test would be reduced. Though I'm not pregnant yet I have complete trust that Dr. Chang will do everything in her power to help me achieve a positive outcome. I truly can't recommend her enough.

Though going through IVF, or any fertility treatment in general, is a difficult and emotional experience, Dr. Chang is someone in whom you can place your trust and who will never make you question the level of care you receive.

When we first began seeing Dr. Chang, she was very throrough with her testing to determine the reasons for our infertility. I was found to have narrow Fallopian tubes and a low egg reserve, which means that natural pregnancy is possible, just very unlikely. She suggested the less aggressive route of IUI to begin with and adjusted the protocol for each round. For the first round of IUI I took Clomid and when that didn't work she had me switch to injectsble Gonal-F for the second round. The second round was unsuccessful as well so she increased the dose of Gonal-F for the third round. Though all theee rounds of IUI were unsuccessful I appreciated her adjustment of the protocol each time so we weren't simply repeating the same approach and expecting different results. After the third round of IUI failed, Dr. Chang sat us down and explained our options. Though we could continue with IUI, the expected success rate after three failed cycles in a row was lower and might be a sign that we need to try a more aggressive approach with IVF. At no point did we feel pressured into doing IVF but we understood that Dr. Chang was trying to provide us with realistic expectations and next steps that could possibly be more successful. My husband and I elected to try IVF rather than a fourth round of IUI and prior to beginning Dr. Chang had an in-depth discussion with us about what to expect. About two weeks later Dr. Chang had me start the protocol for egg retrieval. When it came time for the retrieval I had about 9 follicles but upon waking up from the procedure Dr. Chang informed me that 4 were mature enough to be retrieved. Though we initially wanted to have half of the eggs fertilized naturally and the other half fertilized with ICSI, Dr. Chang recommended fertilizing all eggs with ICSI since we had so few and she didn't want to risk the possibility of any eggs not being fertilized. I was thankful for this recommendation because all eggs were successfully fertilized. The week following the retrieval is nerve wracking as you wait for news about embryo development but Dr. Chang called me almost every day to update me about the status of our embryos. After genetic testing, we ended up only having two top-quality embryos of the initial four but Dr. Chang had told us ahead of time to expect that. Following my retrieval, which was in September, I was given about a month of recovery time prior to starting the FET protocol. I began with active birth control pills, followed by daily Lupron injections for about 10 days, after which I began the PIO injections along with oral Estrace and suppository Endometrin. My uterine lining developed nicely and was about 9mm prior to the FET. My hormone levels also looked good so we went ahead with the transfer after 5 days of PIO and all went well. Unfortunately the transfer was unsuccessful, which I could tell puzzled Dr. Chang given how good everything looked prior to the FET. Because we only had 1 embryo left she wanted to determine the reason for the failure before proceeding with another transfer. I was scheduled for a hysteroscopy to see if there were any polyps, scar tissue, or anything else in my uterus that could have prevented successful implantation. Fortunately that came back clear. Dr. Chang also recommended an ERA (Endometrial Receptivity Analsysis) to determine if 5 days of PIO was enough or if I potentially needed more (as 20-30% of women do) and was able to include me in a clinical trial that SCRC was participating in so as to reduce my costs. The ERA came back normal so Dr. Chang also recommended that I see a Rheumatologist to rule out possible auto-immune disorders that could affect implantation. So far, all test results have come back normal and I'm starting to accept the fact that the failed FET may have just been a fluke given that there's never a 100% success rate but I'm so appreciative that Dr. Chang has been so through and relentless in her search for answers. I'm confident that by the time we begin the protocol for our next FET Dr. Chang will have done everything in her power to prevent another failure.

Though I can't remember the exact costs of each procedure, here is what I do recall: Each IUI cycle cost about $1500-$2000. My stim medications were about $5000 and then the retrieval plus embryology and genetic testing cost about $17,000 (this number changes significantly depending on the 'add-one' you choose). The FET protocol was about $5,000. All in all, for three rounds of IUI and 1 round of IVF we spent close to $30,000.

Because we only had two embryos from our first retrieval cycle Dr. Chang suggested only transferring 1 for the first FET since the increase in the success rate by transferring 2 was minimal and we risked losing both on the first try. I'm so thankful we only transferred 1 since the FET failed and it would have been devastating to lose both embryos.

Wendy was our partner in a very tough journey and she took that partnership seriously, despite the volume of her practice she took the time to answer all of our questions at every juncture and truly seemed to cherish her work. When new research emerged regarding some of the treatments we had used that positioned a few of the practices in a controversial light... she did not shy away from the conversation at all and was the first in line to grapple with those choices.

IVF practices are extremely busy places and Wendy is very focused on getting folks to a successful pregnancy, depending on your specific circumstance and age that may mean that you end up with some expensive and ultimately unnecessary treatment options. Dr Chang will not force you into any of them but you do need to be informed as a patient to wade through what the best decision for you is.

I don't remember all the specifics of the injections but Dr Chang is very focused on nutrition and health as a precursor to egg health which studies have shown is a big factor.

For 2 cycles for a +40 patient with all the extra treatments it was about $45k

We did eSET as we had done PGS, in retrospect given my age and the potential inaccuracies of PGS - I regret that choice.

I am so grateful to Dr. Alexander for her incredible work with us. Her positive outlook allowed us to get through one of the most difficult times in our lives. She is extremely knowledgeable and patient focused. Her approach is tailor made to each patient. When she treats you, you feel like the sole focus of her office. She will always make time for you as a patient and will do everything to ensure a successful outcome. She is extremely sensitive to a patient's needs.

She is an amazing provider. I would recommend following all of her advice with regard to a retrieval. She is extremely responsive to a patient's need/ concerns so make sure to take an active role in your treatment process.

My first FET and retrieval were pretty standard. My second and third FET involved the use of lovenox. This was used after it was discovered that I tested positive for lupus anticoagulant. My third FET also involved the use of prednisone (a steroid) due to a discovered history of familial autoimmune conditions.

Our doctor allowed us to transfer two embryos during each FET. This was our preference and she remained supportive of our choice. She left the decision of transferring one or two up to us (due to our diagnosis). However, she was very clear that she would not transfer more than two (a pretty standard practice based on our young age)

During Clomid/IUI cycles I would only see Dr. Ghadir for the IUI, assuming he was in the office that day. I twice had other doctors do the IUI. Once I moved to IVF I saw him a lot more. He did the retrieval surgery and 2 of the 3 transfers. Since becoming pregnant I have seen him every week. I would usually only hear from him on the phone for the results of betas.

Be prepared for him to want to do the maximum number of medicated IUI cycles.

For the first medicated cycle I was put on 100 mg of Clomid. When that only produced one mature follicle I was placed on 150 mg of Clomid for the other 5 cycles I did. I usually grew 2-3 mature follicles before triggering. Once I moved to IVF I was put on Gonal-F, Menopur and Cetrotide. I started at a higher dose, and after my first monitoring appointment had the meds reduced to avoid OHSS.

Ultrasounds are $220, Blood work varies depending on what you have tested. IUI was around $250 each time. A full IVF cycle was around $10,600, which included every appointment and blood draw once you started stim meds through the first beta. FETs are about $2600, which included every appointment and blood draw once you started meds through the first beta.

Dr. Chang was very professional, but lacked compassion. Her statements seemed almost rehearsed, and I feel that she lacked interest in our personal journey. She was friendly, but it did not seem genuine. Although she did explain the risks of IUI, she failed to inform us of the very low success rate of IUI. I feel that this is a very important bit of information that may have encouraged us to re-evaluate our treatment options. Dr. Chang was only in the office on certain days of the week, which made it difficult to set up appointments. My HSS was performed by a different doctor, and I was not informed of this until I arrived for the appointment. Overall, this did not feel like a personal or tailored experience, but a scripted and routine procedure, which I was very unfamiliar with.

Ask a lot of questions, and ask for the layout of your treatment, including who will be performing the different aspects of your treatment. Ask about success rates of your procedure, and explain your expectations for your treatment.

Diagnostic blood work was performed first, in attempt to diagnose the cause of my infertility. Phone consultation to recommend IUI with Clomid due to starting treatment non-invasive and working up. 3 days of Clomid, and then more labs and ultrasound performed to see egg follicles. Ovulation test used to determine time of ovulation, and trigger shot given in the event that ovulation does not occur before IUI appointment. Ovulation test determined ovulation the night before IUI procedure. IUI performed, and home pregnancy test done 10 days later, which determined no pregnancy.

Ultrasound $220 (2 ultrasounds done), Labs for IUI $450, IUI procedure day-of about $1,000

Not applicable.

She is kind and friendly, she has a nice sense of humor. She seems like a good investigator and is open to my ideas. She was willing to refer me out to a Reproductive Immunologist, which many REs do not do, so I appreciate that. She was able to get my husband's sperm in much better condition. We were so concerned with his sperm issues that we fertilized half the eggs with his sperm and half with donor sperm and he outperformed the sperm donor! This was all because of Dr. Chang's strict orders for his diet, supplements, recommendation on frequency of ejaculation, etc. (along with his strict compliance.)

To advocate for herself. This is the same advice I'd give for most REs though. They are busy and don't have the time or attention to give to each of our cases, so find other women who have been through this and learn from their experiences.

During our initial consultation, Dr. Ghadir was running late but very apologetic. He listened and asked questions. Not long after we our consultation, he ordered lab work. Each time results came back, he personally called either myself or my husband to reveal the results. Oftentimes these phone calls were in the early evening hours. I appreciated his direct contact with us. My condition required me to have a hysteroscopy to remove uterine polyps. Dr. Ghadir came to see me both before and after performing the surgery. During my actual IVF cycle, I dealt mostly with the office staff. He did perform the retrieval and transfer. During these times his was quick and efficient. Dr. Ghadir called me to reveal my positive pregnancy test results. During the post-treatments (he asked that I have weekly ultrasounds in his office for the first 10 weeks) he was present for each and discussed what he was on the ultrasounds.

Keep a notebook to jot down questions and information you receive in the office and over the phone. This is a very fast-paced office! While his office truly is organized and on top of things, the process can seem very chaotic. Also, look into financing before beginning the process. The company they refer you to for financing has astronomical interest rates. Which just adds one more stress to an already chaotic process.

I took twice daily injections of Lupron, Menopur, and Follistem for a little under three weeks. After each ultrasound and blood draw a nurse would contact me to discuss modifications to dosages. If I recall correctly the only real changes were in the Menopur. The ultrasounds started at about 3-4 days apart and gradually became closer. The last week I was at the office on a daily basis. The day before retrieval I gave myself an injection (can't remember name) and it had to be given at an exact time of day. The nurse was very clear about the time frame I had for administration of this medication.

One cycle of IVF was approximately $15,000 paid to Southern California Reproductive Center. The drugs were about $3500 paid to an outside pharmacy. All ultrasounds and blood work done from the first injection to the pregnancy test were included in the cycle. All other (pre- and post- IVF cycle) procedures were not included They offered a package for women under a certain age (can't remember exact age) for few thousand dollars more (can't remember the exact price) that ensured you another cycle should the first not result in pregnancy. Now the catch is that if you had a miscarriage after the first round of IVF, the second cycle was null and void.

Dr. Ghadir has a warm demeanor and his confidence put me at ease. He is compassionate but very matter of the fact when it comes to discussing diagnosis and treatment options. He is highly knowledgeable and skilled in reproductive endocrinology and I did eventually get pregnant under his care. However, he was unable to complete an out of pocket hysterscopic surgery at his clinic to remove my polyp which set me back a month to begin IVF while I waited to have the surgery repeated at a hospital operating room under my health insurance plan with a regular OB who was able to complete the surgery with no issues.

Don't let your impatience to get pregnant let you make hasty decisions. I threw money away on a surgery my insurance covered because SCRC could get me at an earlier date only for the surgery to not go as planned.

IVF #1 Long Lupron protocol with Gonal-F and Menopur. I had an easy textbook cycle. 21 eggs retrieved and great fertilization rate, but by day 5 transfer day only 3 embryos had survived due to unanticipated low egg quality. Two were transferred but the cycle failed. IVF #2 Long Lupron protocol with Gonal-F and Menopur with the addition of Human Growth Hormone to give the embryos a boost. Another easy textbook cycle with 20 eggs retrieved and great fertilization rate. This time 6 embryos made it to day 5. Two were transfer using assisted hatching, and I got pregnant with a singleton.

Total costs including testing, two fresh IVF cycles with monitoring, and medications were around $40,000.

So far I'm in the earlier stages but I've been impressed. She has been thorough and detailed and quick to respond to messages. I appreciate her consistent follow-up and attention to detail. It's refreshing to have someone who seems to have a lot of compassion for what patients are going through.

I recommend her!

So far Dr. Alexander is getting me ready for a frozen embryo transfer from previously-frozen embryos and is making sure I prep correctly with correct vitamins, medications, etc. She seems to be quite cautious about getting me in the right shape to optimize the treatment.

It looks like embryo transfer and all related procedures will be about 6000.

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He is always willing to get on the phone and talk to me and my husband. Has been knowledgeable and caring throughout the entire process. We may not have gotten to the IVF stage and we hope not to, but I fully trust Dr. Ghadir and have faith that working with him will give up the best possible outcome.

Take care of yourself. Infertility can be a scary and sad diagnosis and it is easy to be too hard on yourself.

We have not gotten there yet. Only have been through testing and ultrasounds.

Most of my diagnostics were covered. I paid out of pocket for one thing that I should have run through my insurance and it has been very difficult getting and itemized bill to submit to my insurance for reimbursement