Spring Fertility San Francisco

I cannot recommend Dr. Klatsky highly enough! He never gave up on our case even when there were multiple setbacks. He remained optimistic that we would have success even when we started to doubt it. He was patient and empathetic throughout our treatment. He was open to changing protocols based on prior outcomes. It felt like he was as invested in our success as we were.

Trust him. He is up to date on current recommendations and treatment plans. There were times when I wanted to try an add-on treatment if things weren't working but after we looked at the research together we decided against it. He was open to a discussion but was clear about the limitations of small studies and why he advised against these (cost, no clear difference in outcomes, etc.). In the end, the research based treatment protocol worked for us, we just needed to be patient and trust his instinct and years of experience.

Standard egg retrieval protocol (cannot recall specifics) For our embryo transfers we tried multiple protocols: 1. Frozen transfer, modified natural cycle with Letrozole 2. Frozen transfer with estrogen patches and Lupron 3. Fresh transfer after egg retrieval cycle 4. Frozen transfer with Letrozole + vaginal progesterone 5. Frozen transfer with Letrozole + vaginal progesterone 6. Frozen transfer w/ Estrogen patches, Cetrotide, and progesterone in oil

He felt strongly about eSET

I appreciated Dr Tan's no-nonsense, action- and solution-oriented approach. Many online reviews complain that they saw Dr Tran a limited amount of time and instead mostly saw his team or NPs throughout their treatment. But Dr Tran was there for the most important parts - consultation and determining your protocol, egg retrieval, transfer procedures, and if you're lucky - your ultrasounds, and that mattered most to me. His team is well coordinated and the visits were always on time and super time-efficient. Dr Tran is clearly one of the best - the procedures were always quick, flawless and painless. He managed my expectations perfectly. We changed my protocol after the 1st and 2nd retrieval to ensure optimal results in the 3rd one. His approach is focused on data and sharing statistics, and that suited me - it normalized and grounded what could otherwise be an emotional rollercoaster of a journey.

Trust the process and Dr Tran's knowledge and experience. Sometimes you may not have all the details and that's ok.

We tried aygestin priming first, mid-lutheal second, and lastly - demi-halt which resulted in the most amount of viable eggs retrieved. We ended up with a total of 4 PGS-tested normal embryos. I just completed my 1st trimester of pregnancy after a single frozen embryo transfer.

Dr. Pasternak is a great doctor and I had a very positive experience with her during my egg freezing process. She is very personable and always made me feel comfortable and was very gentle. She has great bedside manners and would always take the time to explain things to me and address any questions or concerns I had. She would never rush my appointments or visits with her and she always continued to finding ways to improve and tweak each retrieval I had based on historical data and past cycles. I would highly recommend her and would love to see her in the future if I need any future treatments.

Don't hesitate to ask any and all questions or express any concerns you have. Dr. Pasternak is always willing to listen and address questions, etc. and will do so in a thorough and not rushed manner.

Dr. Pasternak would tweak each retrieval based off of the past one to try and improve and get better results. This was done through trying new meds, timing the process differently, etc. I very much appreciated Dr. Pasternak using the data and learning from each past retrieval of mine to get better results for future ones.

I underwent four egg retrievals and one embryo transfer under the care of Dr. Pasternak. I felt Dr. Pasternak was engaged and attentive before and during each retrieval. For example, after the first retrieval, I found that a specific medication made me excessively sleepy and irritated. With this information, she changed medications for the second retrieval, which I responded better to. Although appointment times were short, and I felt I had to come prepared with questions in hand, she always answered my questions swiftly and clearly. After each retrieval, Dr. Pasternak phoned us to discuss results and next options, and I always looked forward to hearing her thought process and recommendations.

If you would like to speak to her between appointments, call your care team and let them know you would like to speak with her or ask her a specific question.

I underwent 4 retrievals. The first protocol used was an antagonist protocol with estrogen priming. Because I did not respond well to the protocol (yielding 4 follicles and 1 embryo), for the next 3 procedures, Dr. Pasternak switched me to a mini-IVF protocol with progesterone priming (each also yielding 1 embryo).

Dr. Pasternak advocated for a single embryo transfer

My experience was wonderful. Dr. Pasternak has a great bedside manner, kept things light (even when they could be heavy) and was clear about what to expect. She was very helpful in making our upfront decision to pursue IVF instead of IUI. She let us know she would support either one but just have us candid facts about odds. And she helped us by always keeping our goals in kind - one more child as soon as possible. She was competent and empathetic and I felt supported and like we were being cheered on the whole time. That means a lot when you’re putting so much work into and have such high hopes.

Take advantage of the fact that she will give you candid advice. And ask questions - these clinics are busy and they can’t know how much to explain, but Dr. Pasternak always answered all my questions to the fullest. Always ask.

We did IVF right away. We did the egg retrieval, and protocol was normal. We did genetic testing of embryos due to to age, and thankful we did because 6 of our 7 embryos were abnormal. They helped us navigate that process with their genetic counseling partner and helped contextualize their feedback. We adjusted the timing of the protocol to make sure we had an understanding of what to expect. We had just one embryo, and she suggested we go forward with it - we only wanted one more child, it only takes one embryo, and she said she saw no reason I wouldn’t have the best odds to be successful (versus doing another round of egg retrieval). We discussed what options there were if it didn’t work. Ultimately, we moved forward, and I am currently 20 weeks pregnant.

Monitoring needed to jags leeches timing by its nature, but they are open seven days a week and they always gave as much advanced notice as possible for ease of scheduling. I always wanted early mornings and they always could accommodate.

Dr. Klatsky is very passionate about fertility preservation and helping individuals and couples achieve their family building goals. I was a very interesting case for him as I have a genetic mutation on Fragile X that impacts my fertility and that was a big surprise for all of us. We've been working to create an insurance policy for me should I experience early menopause. Initially I was very frustrated and felt sold to, but have now come to like having Dr. Klatsky as my doctor. I realize he just really believes in the work he does, but do recommend that you help ensure he knows if you are just looking for information instead of treatment in your first consult.

He is very knowledgable and cares about making sure you achieve your plans. That said, if you are not sure about whether you want to do treatment, make sure you say that up front in a consult since he may assume you came and are planning procedures.

First retrieval - July 2019: did high stimulation protocol. I had 6 follicles so we debated doing high stim (a more typical cycle) vs low stim. He decided to go for high stim. Unfortunately, we ended up with nothing. 11 eggs retrieved, 5 were mature, 4 fertilized, 3 made it to day 3, 1 made it to embryo, did genetic testing and it was not genetically viable. 2nd retrieval - March 2020: Did low stim protocol. Primed with estrogen and then used Gonal-F and Menopur for about 2 weeks at a lower dose than before. Got 6 eggs. 5 were mature. 4 fertilized, all 4 made it to embryo stage. Did genetic testing and 3 viable embryos as a result. We were really happy with this outcome, given my number of follicles.

1st embryo preservation round: ~$25,000 including medications for one round (paid for meds through Spring) 2nd round: Low stim round: ~$13,000 and then paid for meds separately (maybe another $3,000 to Alto Pharmacy)

N/A

I like Dr. Tran because he seems very knowledgeable and data driven. I only have one complaint which is that he does not seem able to give recommendations on specific treatment protocols. I have very very low amh for my age, and at the beginning of my treatment, I didn't know if I should be trying to do multiple retrievals to get more eggs before trying a transfer. I asked what people in my situation normally do and he seemed hesitant to provide any detail and a comparison point for me. In addition, I've done 3 min stim cycles (oral medication + injections), the first two with clomid and the 3rd with letrizole because I wanted to do a fresh transfer with the last one. The first two went very well. The last failed in that my follicles did not grow. Although it's a small sample size, I would think we should want to go back to clomid and then try a FET. He wasn't able to provide much guidance for me. In that situation, I would have wanted advice. However, I think for liability reasons, they cannot "recommend" particular treatments protocols or fresh/frozen transfers so I'm not sure if this is something I can truly fault him for.

Be sure that you want a more scientific doctor as opposed to a warm and friendly doctor.

I've done three retrievals with Dr Tran. All three were min-stim cycles meaning 5 days with clomid or letrizole and then another 4-8 days with gonal f and menopur (150 units gonal f, 75 menopur). The first went very well- clomid seemed to work well for me and from an initial scan where only 2-4 follicles were visible, I had 6 eggs retrieved, 4 mature, 1 almost mature=3 frozen day 3 embryos; 2 ok quality, 1 good quality. That took 11 days total until trigger; 5 days of clomid and 6 days of stims. The 2nd cycle similar thing happened- I had EIGHT follicles as of day 8 of the cycle! But unfortunately at retrieval, the doctor said 2 follicles on the left prematurely ovulated and they couldn't retrieve them. So we only retrieved 5 eggs, only 3 mature and 1 almost mature. Crazy enough, the 1 that was almost mature did mature and ended up becoming a Morula (stage between day 3 and blastocyst) and I had one other good quality day 3 embryo (both frozen). That took 9 days total until trigger, 5 of clomid, 4 days stims. The 3rd was a disaster. I decided I wanted to try and fresh transfer so we switched to letrizole for the first 5 days. At day 5, I had a measly 3 follicles, one at 10mm, the other two small. Day 8, had more 6, but the largest one had only grown one mm. Day 11, I had 8 follicles but the biggest ones weren't growing. He made me go for another 3 days so in total, I did 5 days on letrizole and NINE days on stims. We ended up cancelling which I was happy about and to be honest, I was a little frustrated that they let me go that long bc it ended up doubling the cost of my medication that cycle. After that, I knew logically I should go back to using clomid. So am going to do a 4th cycle, freeze only, and then do a FET after that. Dr Tran didn't necessarily push me that way but to me, it seemed obvious (even if the sample size was small).

First cycle cost $13,049, 2nd cost $13,165, third cost $4,854 (was just medication and monitoring appts because it was cancelled). The first two costs are generally related to contracted rates between my insurance and Spring. A portion of that is out of pocket related to medication or certain procedures that are out of network. I expect the fourth cycle to be around $13k total.

No comments. I am doing day 3 embryos because I have so few so we will be transferring 2.

So far, we've only had the opportunity to do a virtual consultation with Dr. Tran and it went well. He asked us a few questions, and took the time to get familiar with information we had sent in earlier. We liked his no-nonsense straight to the point style. He is respectful, but direct, and lays out options in a very matter of fact way which we appreciated.

If you're looking for a doctor who will be emotionally supportive, I'm not sure he's the best fit for you, but we've also only had a consult and have not experienced working with him fully. However, if you appreciate getting right to it, I think he's the one!

I've recently had an HSG test done elsewhere and tubes are open, and both our counts for egg and sperm are better than average for our age, so Dr. Tran mentioned the possibility of the tubes perhaps not functioning (not the same as being open), potential poor egg quality, or potentially something on the male end. So we are going all in with a plan to start with a new panel of bloodwork, get genetic testing done for both of us, and then proceed with IVF, including ICSI, PGS/PGD, and potentially a Saline Sonogram somewhere in this.

The team there was super helpful in providing a breakdown of numbers and the various packages they have. For our full bundle, the estimated costs are about $18,000 not including medication and bloodwork.

n/a yet.

Dr. Klatsky is warm and meets each patient where they are. E.g., early on I wanted to leave most things up to him, but as we progressed I got more involved in the data. He is warm and compassionate, and has a quirky sense of humor.

Come armed with knowledge, or as you are - he will be candid and forthright.

Mid-luteal cycle start for my second cycle as I responded poorly at the first retrieval.

It’s all covered by my company’s insurance.

N/A; haven’t transferred yet

Dr Minjarez is a great Dr, she is very understanding and friendly and you know she is rooting for you. She has an excellent bedside manner. Most of her feedback is data and statistically based, and sometimes I just wanted her gut are a heartfelt point of view. She has a wealth of knowledge and is willing to try new things and hear you out.

Make sure you have a list of all your questions beforehand, she is very busy so you never know the next time you will have a one on one opportunity again. After that, there is a lot of going through nurses.

Mini-stim due to diminished ovarian reserve. Hope to get high quality over quantity

Costs were withing the same amount as other clinics, slightly more than a hospitol

This is all based on your personal situation; your age, egg quality, egg reserve, your financial situation. She would never have a blanket approach to all patients

As others have mentioned, Dr. Trans communication style is to keep things very short and to the point. Usually, I prefer this style, but through the confusing and daunting IVF process, Dr. Trans explanations are a bit too fast and simplistic for me. The lack of detail/explanation causes confusion, and makes me feel that he's ready to rush on to the next patient.

Dr. Tran is highly skilled, and extremely involved/immersed in what's going on. He's laser focused on delivering results, and for that reason he's crazy busy. Make the most of your time with him and other doctors by having list of questions ready before every appointment, and get questions answered during your appointment. With regards to treatment, he can be stubborn about his viewpoint/methods. But as long as you can show him that you respect his expertise, stay relax and talk through your concerns, he is open to compromise and/or break from the normal protocol.

3 retrievals followed by FET. Drugs: GonalF and menopur, Cetrotide, Leuprolide, and novarel. The retrievals: 1st: 9 eggs/5 embryos 2nd: 14 eggs/5 embryos 3rd: 21 eggs/ 10 embryos * all embryos are day 3

Package deal for 3 retreivals and 1 FET.

Due to my age and likely poor egg quality, Dr. Tran advises transferring multiple eggs (ie 5+ per transfer).

I'm a physician assistant so I've met a lot of physicians, I can honestly say Dr. Tran is the smartest physician I've ever met. He's an absolute genius, kind of the "mad scientist" type. He's not afraid to think outside the box and try new things to get you the best result. His bedside manner can be a little blunt/robotic, but you can tell his way of showing he cares is giving 110% to get you pregnant. I've had two other fertility doctors before him, but from now on I'm only trusting Tran!

His bedside manner comes off a little cold at first, his way of showing he cares is to go above and beyond trying new things to get you pregnant!

I had two cycles cancelled a different clinic before going to Tran. I have severe migraine with aura, and was told I could no longer safely have any estrogen-increasing drugs due to the risk of stroke. Tran crafted a new plan to manage my stroke risk- no birth control priming, start injections mid-cycle, and high dose letrozole during stimulation. My estrogen actually went down during stims! It worked great, no stroke and 11 blasts from one cycle (afc 12.)

An embryo freezing cycle was $13,500 pls meds, I think it went up $1,000 this year. A FET is about $4,750.

I am under 35 so an basically required to do eSET at Spring. I think after 3 failed transfers or over 35 they do multiple.

Dr. Tran first assessed my case in the summer of 2019. He was the second doctor to assess me for IVF. I was 37, I am BRCA1 positive, and I was told I have a diminished ovarian reserve. This was the conclusion at UCSF, which dr. Tran confirmed. Both dr. Tran and the other clinic were not optimistic about my chances of getting embryos, however, dr. Tran was VERY good at explaining that I would need several rounds of IVF if I had a hope of freezing my eggs, what the costs of that would be, and how we might manage things going forward. We decided to go ahead with one round of egg retrieval, and move forward depending on the result. Unbelievably enough, the first round was successful beyond all our plans & expectations, with 12 eggs retrieved during the first cycle alone. We understood that we are in a whole different ballgame, and given that there is no problem harvesting my eggs, we can actually have the luxury of filtering our embryos for the deleterious BRCA1 gene mutation. This result is life changing. We went ahead with further two rounds of egg retrieval and embryo freezing. We managed to get enough eggs to produce 10 day 6 blastocysts. Out of those, 5 were free of BRCA1. Hooray! We went ahead and implanted our first embryo 2 months ago. Knock on wood, things went very well. I am 38, and this is my first pregnancy. I am over the moon! The result speaks for itself. The experience, though by no means physically pleasant, was as efficient, easy and painless as it could possibly be. There was no time when I didn't know what the next step was. All decisions were pretty clear, at each fork in the road, I knew what my options were. The clinic was easy to reach. They were always on top of things, nobody was ever confused (clearly they have a great system of patient records). All appointments were fast and on time. I am really really pleased with how things went, would recommend Dr. Tran to my best friend 100 times, if they ever had trouble conceiving.

Don't expect a warm bedside manner, but expect excellent results.

Total costs for 3 rounds of IVF, genetic testing, egg freezing and one implantation were close to $60,000. Nothing was covered by insurance.

I absolutely loved Dr. Tran. He was super straightforward, answered all my questions and beyond, and performed all procedures skillfully. He was also very respectful of me and my partner at every opportunity. It is a pretty rare situation that I leave a serious conversation with a doctor feeling pretty good about everything - even if the answer isn't necessarily what i wanted - but somehow he managed to make that happen.

I spend a lot of my time dealing with healthcare advocacy for others, so Dr. Tran's bluntness was a big positive. But if that's not working for you, I would highly recommend Dr. Harris, who I think was my favorite for bedside manner out of all the doctors at Spring that I saw in brief.

I had failed multiple IUI cycles elsewhere already. Based on my ethnicity and a combination of PCOS and unexplained infertility, and with some other considerations (like limited sperm vials to work with) I was recommended an antagonist protocol for a freeze-all cycle and FET. We opted for PGS just because we could. We ended up having to adjust medications downwards because I was responding too well. Got more of everything than estimated - eggs, fertilized #, day 3, day 5/6. FET was a letrozole-assisted cycle and succeeded on the first try.

18k for stimulation/retrieval including icsi and pgs. around 4k for medications. 4500-5000 for FET. then $950 for saline sono and $450 for the last appointment to confirm pregnancy before graduating to my regular OB.

He had a VERY, very, very, very strong preference for eSET due to my age and PGS-tested AA grade embryos.

The proof is in the pudding. I'm a 42-year old woman, using my own eggs and husband's sperm, and am currently 20-weeks pregnant after a single embryo transfer! Dr. Tran is matter-of-fact and VERY data-based meaning he doesn't waste time with frivolous treatment without proven efficacy. After two failed transfers in LA, my doctor there had me going down rabbit holes. Not so with Dr. Tran! He reads all of the studies so you don't have to. At the same time Dr. Tran really, really cares about your outcomes. I have video of Dr. Tran in our first ultrasound, grinning from ear-to-ear. As we're all first laying eyes on our baby to be, Dr. Tran is ecstatically exclaiming "you've got a one good one!"

Don't be afraid to ask questions and be open to data-based answers. Like I said, he's not going to waste your time with un-substantiated rabbit holes.

The one key decision, which was different from my past (unsuccessful) transfers with my 1st doctor: unmedicated transfer cycle, using my own body's natural cycle to guide transfer timing. I believe that made all the difference in my outcome! That meant that the stuff I had to do before my other (unsuccessful) transfers - endometrial scratch, ERA testing, daily injections with progesterone treatments - were not necessary.

We chose eSET because of my risk factors: age and two previous ectopic pregnancies. That was absolutely the right thought process and decision!

Dr. Tran is an intelligent, competent doctor, but there's a lack of emotional IQ to balance his intellectual IQ. Infertility is an emotional journey, and we look to our doctors for support. Many times during my care I felt like he didn't have enough capacity for me, and he was taking on too many patients. In the worst of times, I felt abandoned by him as my doctor. He is present at appointments, but his time is rushed. Appointments have become difficult to schedule due to his split time between Redwood City and SF offices, and I have even had major procedures rescheduled last minute to accommodate his busy schedule.

Get to know your nurse, because Dr. Tran will not be available to you beyond your appointments. Be direct in your questions. Don't let yourself get rushed, or brushed off - speak up for yourself. You may need to ask questions multiple times to get the answer you need. Find a good therapist to help with the emotional stuff - you will need it.

I found Dr. Tran to be very conservative in his approach vs. other docs, which may be due to his background at UCSF (teaching hospital). He will not perform an ERA, or other new procedures, unless they have tons of data back them up. He won't order blood-tests or recommend aggressive treatments unless absolutely necessary. He isn't super proactive - which may be partially due to his lack of time. If you're looking for a doc that will be extremely thorough, and give you all the bells and whistles, he many not be the doc for you.

We had some insurance coverage, but about $46-50k for retrieval, $6k for transfer, $800 for meds

I wasn't given an option - single embryo transfers only

What I mostly appreciated about Dr. Tran was his willingness to listen and adjust the treatment as new information came in and we wanted a change in direction. I think there's a lot of ego in this field and his flexibility was refreshing. He is very keep on the mid-luteal protocol. At the beginning he was reluctant to share what approach he'd take, stating that he doesn't care what the protocol is called, but whether it is appropriate for us, but ultimately took the approach he seems to be known for. We experienced a setback with unusually high drop in embryos in the lab (b/n D3 and D5/6). He was upfront about how unexpected that result was and presented a solution, without throwing the stats based on my age in my face, which I appreciated. Ultimately, we didn't get to an embryo transfer with him. He very candidly shared his opinion that our embryos had a better chance in my uterus, which is what we came to realize, and showed that he had our interest at heart. This is not where the clinic makes money, so he won my full trust with this recommendation.

Be prepared with a list of questions to get the most out of your visits with Dr. Tran. We had most of our monitoring visits with him personally, but they're routine in nature and quick, so I found myself following up with the nurses with follow-up questions I didn't get to or didn't think of during the visits.

We had to IVF cycles with mid-luteal protocol, with moderate to low doses. I had 8-9 follicles at baseline, and given that there wasn't much potential beyond that, it was important for me to not get overly medicated (some other fertility doctors we consulted with in our research mentioned "aggressive" protocol, which was a big turnoff). Dr. Tran took a moderate approach and adjusted down given my good response in the first cycle. The meds were 225 IU Gonal-F and 150 IU Menopur. Great response initially - of 8 follicles we retrieved 8 mature eggs, 7 fertilized with ICSI. Second time less so - of 9 follicles, we retrieved 4 and only 2 mature eggs which were fertilized. "0" embryos at Day 5/6, however, and the whole reason we did IVF was the genetic test at D5/6 so we can minimize the risk miscarriage. The mid-luteal protocol didn't allow for a Day 3 transfer. Seems like our embryos can't make it beyond that in lab environment.

We went through insurance as we had some coverage (with a lifetime max). Still unsure of the total out-of-pocket costs for either cycle due to the messy billing. Dealing with the billing department at Spring was the most stressful and painful experience, an unwelcome one too given how taxing the IVF process already is. Inquires required multiple follow-ups before Spring would respond (sometimes 2-3 weeks later). They simple didn't address/ignored some direct questions. Last but not least, they said they'd do the billing in a certain way for our second cycle, but didn't do so despite the agreement we had reached on that. Super frustrating experience, and I am still entangled in this two months after treatment.

eSET was the considered approach but we didn't have a single embryo for transfer.

Dr. Klatsky is optimistic but also realistic. He’ll explain everything in detail if you ask him to. I came prepared with a list of questions at the consultation and he answered all of them with patience. My ultrasound appointments were smooth, I appreciated his positivity.

Come prepared with questions! You’re your own advocate.

We did an IUI cycle with letrozole and trigger shot. I asked for letrozole over clomid because I had researched that it had fewer side effects.

Each IUI is about $1600. Letrozole and trigger shot about $100ish.

Dr. Minjarez clearly cares about her patients. She takes the time to hear about your fertility journey in your own words, but has also clearly taken the time to review the information you provide in your intake forms. I think she takes all steps necessary to achieve pregnancy.

Ask questions. And ask what she would ask if she were in your shoes. Know that the fertility journey is not linear.

I had a saline sonogram to look for scarring in the uterus. Then had a hysteroscopy to remove the scarring. And now am on estrogen, and then will the provera toward the end of the estrogen.

Saline sonogram was around $700. Hysteroscopy with anesthesia was around $3500. Initial office consult was around $350.

Dr. Minjarez has a strong preference on eSET, due to all of the risks for mom and babies if there are multiples.

Dr. Minjarez took time to thoroughly explain different parts of the process and answer any of our questions. We've had some delays getting started, and she's been helpful and responsive. She does a good job of balancing clear, direct communication with kindness and the feeling like she's rooting for us.

Make sure you think through your questions ahead of time -- it really benefit us to have done our research so we could make the most of our time with Dr. Minjarez. Appointments can be brief, but her team is always very responsive via email if things come up afterward.

We haven't started stimulation yet, because my follicles weren't ready. But the plan is to stimulate with FSH and Menopur.

saline sonogram: $950 ovarian stimulation and monitoring, retrieval of oocytes, embryology lab services (including ICSI, PGS/PGD): $18,375 medication package: $4,400 future frozen embryo transfer (monitoring + thawing, transfer): $5,250 embryo cryopreservation after 6 months: $650

This facility transfers only one embryo at a time.

At the beginning there was some miscommunication, but when I expressed my concern Dr. Harris was apologetic and made up for the initial misunderstanding. He truly wants to see his patients succeed and does what he can to that end. He was always sure to ask at each visit how things are going, whether you have experienced any side effects, etc. He explains the options clearly, and is thorough in describing the treatment plan.

Dr. Harris is openly optimistic and enthusiastic, and the result is that you can get swept into the optimism and expect more from your treatment than it can realistically deliver. The result is that a failure can hit harder than it might have otherwise. I'm ultimately happy with our choice of doctor, but just be realistic with yourself,

We used Clomid with an Ovidrel trigger shot followed by IUI three times. We have just started our first IVF cycle with Dr. Harris. Given our severe male factor infertility, he originally suggested we skip IUI and go directly to IVF, but that was not financially feasible for us at the time so we attempted IUI anyway despite the probable negative outcome. The first IUI cycle I had some spotting pre-period, which is unusual for me, and a positive pregnancy test long after the Ovidrel should have dissipated so we suspect the possibility of a chemical pregnancy. Dr. Harris was thorough with his description of the different approaches we could take with IVF and explained clearly why he felt the approach we went with was best for us. We're using birth control for 2 weeks followed by injectables for egg retrieval at the end of the month.

The self-pay cost for IUI is $1600 and it's $18,375 for IVF. With insurance, we paid ~$600 for the first two IUI cycles and nothing for the second as we'd hit our max out of pocket. IVF is going to cost around $3000 and most of that is the out-of-network surgical center. I don't yet know what additional there will be on top of that for the genetic testing, anesthesiologist, etc.

We didn't discuss this as I had decided in advance that I wanted to do single embryo transfer.

I have only ever seen Dr. Tram in person once, at my initial consult. My IUIs were done by different doctors, and all other information has been conveyed through nurses and my patient coordinator. However I feel like I’m getting the care I need, and if I move on to IVF, I believe I will see him more.

His primary focus is IVF, so if you are starting with IUI, you might not see him for many of your appointments. However he will still be involved in your care, and it’s easy to get answers to questions via your patient coordinator.

I am early 30s with good stats, and his strategy was 3 unmedicated IUIs, then (if no pregnancy) 3 medicated IUIs, then potentially move on to IVF. I have had three unsuccessful IUIs. I am now going to have an HSG test. I elected not to have one before beginning initial treatment, but now that I have had 3 unsuccessful IUIs, Dr. Tran thinks I should do one before beginning the more involved and expensive process of medicated IUIs. Depending on the results of the HSG test, I will either move on to the planned medicated cycles, or look at IVF.

Monitoring ultrasounds—$400 IUI— Around $800

From a scientific and IVF protocol I completely trust Dr. Tran and his decisions. He is very accurate in his assessments and his protocol is always adjusted and designed to fit my individual needs. He is straightforward and sets realistic expectations which is exactly what you need in this process so you are not giving an unrealistic sense of hope; with this approach it can lack a little bit of warmth in his messages but in the end you leave his office with a real sense of understanding for the future.

Be patient with the process and trust Dr. Trans decisions as he shares the same desired outcome.

I did two retrievals using Lupron, Gonal-F, Menopur, Cetrotide and Novarel. Both retrievals resulted in a desirable amount of eggs; my particular problem is in growing the embryos to day 5. The number of embroys drastically dropped during this time. First retrieval results in 2 embryos that both came back normal after genetic testing. The second retrieval resulted in 1 embryo that came back abnormal. I then did a FET immediately following the second retrieval that resulted in a healthy pregnancy. I did a second transfer Sept 2019 with the remaining embryo from first retrieval that did not result in a pregnancy. I am currently undergoing preparation for another retrieval.

The first two retrievals and transfer were covered by insurance. Second transfer was around $6,000 and current retrieval will be around $25,000

I agree with Dr. Tran's approach of eSET as I highly risk adverse to having multiple babies at my age.

I trusted that he was well educated and believe that he made decision in our treatment that he thought would result in the best outcome. I felt that he set our expectations for success once we moved on to IVF too high. Sometimes I would have to push him to make changes to my course of treatment after multiple failures because he did not believe changes were needed. I'm not a fan doing the same thing over and over and expecting a different outcome.

If a doctor with a really good bedside manner is important to you, chose one of the other doctors at this clinic. Dr. Tran can be a little "cold", but that was not something that bothered me.

IUI cycle - $1,500 plus cost of meds IVF retrieval + PGS - $17,500 plus cost of meds Frozene Embryo Transfer - $4,500 plus cost of meds

Dr. Tran was very adamant about not transferring more than one embryo.

Dr. Tran is seriously smart and on the cutting edge. Creative yet evidence-based and doesn’t recommend a bunch of things you don’t need. He is a scientist and straightforward but compassionate, and has some good deadpan humor! He does explain things quickly so write down and bring your questions and don’t hesitate to send up a follow up question. I most appreciate that Dr. Tran is willing to keep working with poor prognosis patients—some clinics want to move on to donor eggs to boost their numbers but not the case here. We were initially devastated after our first two cycles led to no transferable embryos likely due to poor egg quality and me being a poor responder to meds. At that point he recommended proceeding with minimal stimulation ivf which worked really well for us and ended up giving us a better blast yield per cycle and ultimately leading to success for us. Not all clinics do mini IVF so I was grateful Spring offers this as other clinics would have either proceeded with full stim (high expense for low yield) or pushed donor eggs.

Write down your questions and don’t hesitate to send the team a follow up question!

1 letrozole flare 1 mid-luteal start 3 mini IVF with clomid and gonalF/menopur

Pricing is transparent and up front. Comparable to other clinics in the area. Mini IVF cycles can be packaged which makes the cost about 50% of a regular IVF cycle

They recommend eSET for PGS tested