Texas Fertility Center (US Fertility Network clinic)

Dr. Silverberg's method of communication is direct, concise, with some humor here and there. He always made sure to review my file before beginning each appointment, and was able to speak confidently about my options and next steps. At times, I had a tough time receiving his directness, which he immediately sensed and then changed tactics to make me feel more at ease. Despite several setbacks throughout the process, he always made me feel like we had extremely good chances of a live birth. He clearly has been in the field for a long time and prioritizes research, which means that he first relied on research-backed strategies, but was open to experimental approaches when those initial strategies did not work. Although I did not see him at every visit (on weekends I saw the on-call doctor and he was at conferences several times), I did see him every time he was in town, which I cannot say about my previous RE.

I would advise a prospective patient to be prepared for his direct method of communication and to come prepared with a list of questions. The appointments are quick, and I often left having forgotten specific questions I wanted to ask.

I had a previously-canceled egg retrieval cycle, so with my first cycle with Dr. Silverberg, he knew that I needed an aggressive dosing of the IVF medications. That resulted in 13 eggs retrieved, 10 eggs fertilized, but only 1 made it to blastocyst/euploid stage. I took one cycle off because I had bilateral ovarian cysts, which is common. For the second cycle, my nurse recommended we add in a new (HGH) drug called Omnitrope. In that cycle, we had 14 eggs retrieved, 11 eggs fertilized, and 4 made it to blastocyst/euploid stage. We believe that Omnitrope made the big difference on that cycle. I took the next cycle off because of ovarian cysts, again. We attempted our first transfer cycle using a traditional estrogen approach. After three weeks of estrogen tablets and injections, Silverberg canceled the cycle because my endometrium stopped growing at 5.3mm (goal is 7mm+). I took 10 days of progesterone pills to kick start my next cycle. For the next cycle, we used a Femara and Estrogen approach. Again, after three weeks of Femara tablets and Estrogen patches, Silverberg canceled the cycle because my endometrium stopped growing at 6.3mm. I took 10 days of progesterone pills to kick start my next cycle. For the third attempted transfer cycle, Silverberg went with an experimental approach of prescribing 300 units of Menopur daily. After only 10 days of injections, my endometrium reached 7.6mm, and I was prescribed the HCG trigger shot and progesterone injections to prepare for the transfer. Silverberg did the embryo transfer one week later with one thawed embryo. Ten days later, an HCG blood test confirmed that the transfer worked and we pregnant. Since then, I have seen Silverberg for two sonograms to confirm the pregnancy and monitor growth, and we have officially graduated from his care.

TFC is not within network for our insurance, so we paid everything out of pocket. We do have infertility insurance, but our insurance company decided every single claim for different reasons, most of them stemming from the excuse that the forms provided by TFC were illegible. I agree that it was often hard to read the codes and numbers written on the forms, and I sometimes left feeling like I was charged subjective amounts, with a difference of $2-400 between the same type of appointments, at times.

TFC only does single embryo transfer on its patients until you meet very specific criteria (above a certain age, etc.). We transferred one embryo and I was happy with their policy.

I completely agree that Dr. Hansard is very knowledgeable and confident and I usually feel encouraged after meeting her. At the same time the efficiency doesn't leave a whole lot of room for follow up questions on your care plan.

Be prepared. Take a notebook to jot down your appt notes, next steps and questions. Infertility care is a rollercoaster; waiting to start, the slow climb up, the free fall followed by corkscrew turns. You'll appreciate the record of follicle sizes, uterine lining, etc.

At our initial consultation Dr. Hansard reviewed my file from another doctor; I had already started some of the basic blood work and testing. She suggested a continuing the supplements I was on to assist with my egg quality and balancing my hormones and continuing with my medications. I was sent for additional bloodwork that testing my FSH, AMH, Estradiol, and LH to give a more complete picture of my ovarian reserve. Then I was sent for an xray that would look at my uterus and fallopian tubes to rule out any mechanical issues. My other half was sent for a sperm analysis that ruled out any male factor infertility. We started out with 3 IUI's with 5 mg of Femara on CD3-CD7. While waiting for our next steps consultation we asked for a 4th IUI that had the same as the previous 3. Each of those cycles resulted in 3-4 total follicles with at least 1 if not 2 dominant follicles; unfortunately no pregnancies. During our IVF consultation Dr. Hansard gave us an overview of how I would be on BCP, then follicle stimulating hormones, a ovulation inducing medication, followed by retrieval and then a frozen embryo transfer. We discussed the results of our genetic testing and our choices regarding testing potential embryos. We thought it was a very good plan but honestly, COVID changed the landscape of our finances and we opted for an additional IUI with follistm injections & an ovidrel trigger. We had better success; my lead follicle was much larger earlier in my cycle - ultimately it was a chemical pregnancy.

$350 New Patient Consult $250 Baseline & check up for follicle measuring $220 for IUI $240 for sperm wash $ 10ish for femara prescription $250.00 for 300 units of follistim $197.00 for Ovidrel $97.00 for progesterone suppositories

My doctor and clinic strongly advises against multiple embryo transfers as they are riskier.

Dr. Silverberg is the best doctor. He describes everything to you and has a wonderful, dry sense of humor which I appreciate. He is very candid, which I appreciate, and gives you the facts. At the same time, he obviously cares very much about being successful and doing the absolute best he can to give you the best chance to have a baby. I elected to hold off on my transfer because of Covid-19 and I was never made to feel that was a bad decision and his nurses discussed with me my options before I made the decision. I also appreciate how he is an advocate for his patients and is on the cutting edge of fertility technology. I am confident that he will help me decide what is best and do whatever he can to help me be successful in my hope to have a baby. Even if I don't successfully end up having a baby (I hope this won't be the case!), I would not regret choosing Dr. Silverberg as I know he has and will continue to provide me with the best chance to have a baby because he is a great doctor and I would choose him every time.

Be ready with your questions, but also don't be afraid to any any question. I asked him what I thought were probably the silliest and most ridiculous, uneducated questions I could think of and he never made me feel like I was stupid or ridiculous. Also, know that his sense of humor is very dry and matter of fact and that might feel to some people (especially those who are just starting their infertility journey) like he doesn't care. I can assure you that he cares about all of his patients and their success and it is evident in every visit you have with him or the staff. Again, I cannot say enough good things about him - I have so much respect for him as a doctor.

My husband and I went through a lot of lab work and testing before we were presented with our specific treatment options (it took about 3 months for everything to be done and results in). Once we got our results back, we were presented with a range of options from IUI to IVF with ICSI. He gave us the statistics of success with each option and my diagnosis. We decided to go with IVF with ICSI because it was the most aggressive treatment that would ensure fertilization of any eggs retrieved and with a DOR diagnosis, time is most assuredly, not, on my side. I immediately started the process to start the IVF injections, but had to wait for a month because of my hormone levels. I did the injections and had a successful egg retrieval and the number of eggs was almost exactly what was predicted based on my lab work.

It varied based on what insurance covered, different labs, how many appointments I had, etc. It's about on par with what I would have expected to pay without insurance.

I haven't completed a transfer yet, but I know Dr. Silverberg said they very, very, very rarely would transfer more than one embryo at a time, so if that is something that is important to you for any reason, you need to make sure you address that at your consultation so you are not disappointed or upset at the time of transfer.

Dr. Hansard, though incredibly busy, has taken her time with us as patients. That's invaluable. She prescribed a straight-forward plan for prenatal testing, and once all results were in, we had another consult to decide on "next steps." She has been up front and a clear communicator, while maintaining an incredibly warm demeanor. Trust her expertise immeasurably.

Trust her. Take notes while she's speaking. Don't be afraid to ask follow up questions. She will answer any questions you have.

We are a same-sex couple, so we are relying on donor sperm and IUI. Before we begin IUI, Dr. Hansard started me (as I will be carrying) with prenatal genetic testing, an ovarian reserve assessment, and a couple other blood tests (including thyroid and CMV) to understand my baseline. She recommended expanded genetic testing once we had chosen a donor. We plan to begin our first round of IUI in a couple months, so we don't have results as of right now.

To this point, my insurance coverage has been solid. I've paid out of pocket for each visit/consult ($40). Each lab visit for blood work has been approximately $25, and I've been three times. HSG was only partially covered, so I owed approximately $200 (total cost $600). This does not include the cost of donor sperm ($900/vial, recommended purchasing 4 vials).

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Dr. Hansard provided information and answered questions without rushing you through things. She went through steps to figure out why I wasn't able to get pregnant unlike my OB/GYN who told me to keep trying after two miscarriages. For surgery to remove a fibroid, she identified Stage 4 endo, removed it, and answered questions about it afterwards with a plan for my best chances.

Although some of the advice may seem contrary to what you read online, she's recommending evidence-based approaches to issues.

After surgery for removal of fibroids and stage 4 endo, she recommended to try naturally for one month, 3 IUIs, and moving on to IVF. This was based on the expectation of my endo growing back and if I didn't get pregnant right after surgery, to move on to more aggressive approaches. For my first IUI, I was on clomid but it seemed to thin my uterine lining too much so I was on femara for my last two IUIs. I had my AMH tested by a previous OB/GYN a year and a half before egg retrieval so Dr. Hansard didn't test me again. I responded poorly to the antagonist plan where my eggs were not growing quickly while doing the shots. She increased my dosage to grow more eggs but their growth slowed so that 8 eggs were retrieved, but only 3 were mature. The three fertilized but did not make it to blastocyst. She finally did the full 3 day bloodwork and found my AMH had drastically dropped from over 3 to under 1 in less than 2 years (from age 35 to 37). She put me on Coq10 and DHEA for 3 months to increase egg quality and plans to increase my dosage for the next egg retrieval.

Each IUI (2 ultrasounds, sperm wash, IUI) costs over $900. Egg retrieval including ICSI and PGS testing initially cost over $16,000 but the Ovation lab refunds you what doesn't occur (e.g. didn't get eggs to freeze, had less eggs for ICSI) and varies if you need additional ultrasounds from the clinic at $200 each. Each frozen embryo transfer is over $3000. Depending on the type of visit, some of the consultations were charged at $200 each.

The clinic provides an IVF orientation where they emphasized that SART recommends a single embryo transfer from frozen. Although I would prefer to transfer more, Dr. Hansard emphasized that the research doesn't show improved chances when there are additional risks with multiple embryo transfer.

Dr. Hansard may be a good fit for patients who want a doctor to take complete charge and not have to think about the course of treatment they're on. If you're a patient who needs to ask questions and actively participate in your health decisions, however, I strongly advise against Dr. Hansard. First, she presents some medical information as absolute certainty when it isn't. For example, while she was emphatic that a hormonal IUD would absolutely not impact egg retrieval outcome, numerous studies (and also my ob-gyn) say the research is more mixed. I didn't learn this until it was too late for me to remove my IUD; I would have much preferred to make an informed decision based on a more nuanced presentation of the information. Second, she reacts extremely defensively and unprofessionally to even the smallest questions about treatment. For example, she told me that the hormone-stimulating medications she'd placed me on would not exacerbate my endometriosis. I asked "are you sure?" (really, that's all I said) and she responded very angrily that she "did not go to twelve years of medical school to not be sure," and that she took this question to mean that I was "challenging her education level." (Later, I received a second opinion on this question from a leading endometriosis/fertility doctor in Houston, who said that the meds Dr. Hansard had given me could, in fact, make endometriosis worse.) Before I chose Dr. Hansard as my doctor, I wrote her to say that I was a patient who needed to ask questions and do my own research as a way of coping with my health anxiety and because of my career background as a journalist/researcher. During the confrontation I just described, I reminded her of this email--I'd been very upfront about my needs as a patient, and had tried to make sure we'd be a good fit. She responded: "well, there are questions and then there are questions." She and her staff frequently provided me with contradictory information about my treatment plan, and then totally reversed course at the very last minute because either she or her nurse misread an email I'd written about my health history: The day before I was to start my birth control pills - after months of Dr. Hansard telling me that I didn't need to monitor my ovulation cycle - her nurse asked me if I had a family history of blood clots (something, of course, that they could have asked when they were developing my treatment plan). I told the nurse that my father had had a blood clot in his leg, but that I wasn't sure if it constituted a history or not and that I would check. He said his blood clot was injury-related, and didn't constitute a family history (he's a neurologist, so would know). I wrote the nurse this exact information the very next morning. Dr. Hansard changed the treatment plan anyways.... and suddenly it was a course of treatment that DID depend on my ovulation cycle, and that we were basically just guessing on. On my last visit with Dr. Hansard, during the fight I mentioned above, I told her that the treatment reversal had really shaken me up .She responded that she'd changed course because of my family's history of blood clots. I reminded her of my emails to the nurse. She looked back through my chart, seeming to read the emails, and then - instead of apologizing - said, "you should never bring up a family history of blood clots if you don't have one." Somehow, she managed to blame me for a misread email. Ultimately, a few days before my egg retrieval surgery, the nurses called to tell me that Dr. Hansard had decided to go on a last-minute vacation. The doctor that performed my surgery, Natalie Burger, was much kinder and actually came back to the outpatient facility after I learned that my surgery had essentially failed (four eggs when we'd expected at least eight...) and took time to answer my questions and explain things to me, something Dr. Hansard never did.

A lot of ob-gyns say she's the best in town.... there are other good fertility doctors in Austin and other parts of the country, though, so I would pay serious attention to your instincts and go with someone else if you're not getting a good vibe from her, and know that you need a doctor who will really talk through things with you and field your questions without taking offense.

I don't remember, unfortunately. It's been 18 months.

Roughly $11,000 for egg retrieval treatment + $4000 for first few years of storage.

After our initial consultation, we weren't quite sure what to think of Dr. Silverberg. Very factual, extremely knowledgeable and blunt. Didn't seem to have much of a bedside manner. When we returned and began treatment and spent more time with him, we fell madly for him. He is one of the funniest docs around! And great bedside manner. His humor is very dry so he may not be for everyone but he is a great doctor! Everytime we mention who we see to another healthcare professional, they say "oh, he's the best in town!" which is very reassuring to hear! We see him most visits, of course weekends are hit or miss and I think one time he was away at a conference, but otherwise, we are always booked with him. When we do see another doctor or have a question after hours, they always check with him on how he wants to proceed so that they are acting on his behalf. I feel like all of the doctors at this clinic are that way.

Enjoy his dry humor!

IUI #1 - gonal F injectible with Ovidrel trigger shot. Negative. He gave us a choice at where we wanted to start and we chose the big one first. Would probably do it differently next time. IUI #2a - Medications cancelled because of cyst, natural IUI. Negative IUI #2b - Clomid. Cycle cancelled because of think uterine lining. IUI #3 - Femara. Negative. IUI #4 - Femara. Negative Decided to move on to IVF with ICSI and PGS testing because of our limited supply of donor sperm. IVF 1: - FSH/Antagonist plan with birth control pills IVF 2 - Luteal Estrace/Clomid/FSH/Antagonist protocol. In process. Going well at day 10 of stims.

Very reasonable.

Dr Vaughn cares about his patients and is a very kind man. I trusted him deeply. It actually hurts to say negative things about him because I did really trust him and like him. I wish that Dr Vaughn would have considered other transfer protocols for me. I wish that I had left the clinic before transferring our third embryo using the same transfer protocol that failed twice before.

If the transfer protocol isnt' working for you, switch clinics.

The first egg retrieval was $12k plus $8k in meds The second egg retrieval was $12k plus $6.7k in meds Each transfer was about $3k

From the first visit Dr. Vaughn outlined the exact probabilities and led us towards the best option for our circumstances. We did not take his advice and he remained completely supportive - though in the end he was right about what was best and we just wasted our own time and money in the middle! Dr.Vaughn cares about the patient as well as the outcome they're seeking. I dealt with a lot of shame and guilt for feeling like things weren't working as they should in my body and he gently but firmly would correct me on that every time I made a small comment. He's incredible. Also, we have a healthy happy baby and are super grateful.

Listen and really consider his advice and the statistics of each option for you.

I wish I remembered more specifics I'll just note for those who might be in a similar situation I do not get a period so we were dealing with a lot of complexity trying to figure out the timing of ovulation and Dr.Vaughn navigated all of that.

He as very specific that eSET was what he considered best practice and it wasn't something he seemed open to being a choice. I didn't push here though just took him at his word as he'd been solid on so many other things.

I was hesitant about a male fertility doctor - I want to get saying that out of the way. I went into our consult after having a miscarriage wanting the highest chance of success getting pregnant again. Dr. Vaughn supported me going straight into IVF. At every appointment he was there and he was always present in our conversations and patient with answering as many questions as I had, which was always a lot. I never felt rushed. He performed my egg retrieval, hysteroscopy, ERA and transfers. It was such a comfort to see a friendly face going into those surgeries and feeling like I was in the most capable of hands. He personally called with results over the weekends and stayed on the phone answering all of my questions, again never rushing me. I felt able to push back and question his decisions and he was always patient explaining why he was recommending a particular direction but ultimately respecting my perspective and decisions. Dr. Vaughn felt like an invested coach every step of the way. When I got pregnant and was told I no longer needed to see him I cried because I didn’t want to leave him as my doctor. Yes, he is an older gentleman. Once you get past that you’ll see how amazing and dedicated he is. I could not recommend him enough and feel so lucky we found him. I’ll always be grateful to him for helping us start our family.

For stims we used gonal f, menopur and lupron. I did PGT-A testing, ICSI and frozen egg transfers. I did a HSG, hysteroscopy, ERA and Receptiva testing.

I paid out of pocket - in total around $40k.

They prefer single transfer

Pros: + Very science/facts-based. Dr. Silverberg backed up his recommendations with research. I always felt like we were in good hands because he was up to date on the latest practices. Also very well networked in the IVF community and knows the cutting edge of new practices. + Very to the point. Some people like this, others don't. We loved it and felt that he was efficient, concise, yet thorough in all our interactions. That being said, he's also warm and funny, so you never feel like you're speaking to a cold clinician. + He will give it to you straight, but be open to your preferences and perspective. He explained my condition to me, gave me statistics, recommended a course of action and then let me decide. Every step of the way, he provided a recommendation but was very open with my preferences and incorporated them into the protocol. Cons - Dr. Silverberg is a busy man and frequently lectures all over the world. We wasn't available at all screening appointments or retrievals, but kept up with my case remotely. No protocol adjdustments were made unless he signed off on it, so his schedule didn't impact us.

I referred my sister to Dr. Silverberg - that's how much I trust him. Run, don't walk to TFC/Dr. Silverberg if you are thinking of getting IVF!

I was diagnosed with low ovarian reserve, so Dr. Silverberg recommended the micro-dose lupron flare protocol. Several days of lupron leading up to the cycle. In cycle, lupron, follistim (350), and omnitrope (HGH) in the morning. Follistim (150), menopur (150), and lupron in the evening. I did 3 cycles with Dr. Silverberg and he adjusted my protocol each time.

Each cycle was around $10K (including PGS testing), but we had fertility insurance, so my out of pocket cost was relatively low.

We had PGS tested embryos, so Dr. Silverberg suggested a single embryo transfer to give the embryo the best shot.

Dr. Hansard listened to what I wanted to achieve and did everything she could to make it happen. She's honest and objective without being harsh. She was non-judgmental and supportive of my decision to become a single mother by choice.

Dr. Hansard is a data-driven person. Though she knows there's a bit of luck involved in fertility treatments, she's going to let the numbers and your body's response guide her practice. She will do her absolute best to balance your desired outcome with what's a realistic outcome.

Due to my age and below-average fertility numbers, Dr. Hansard recommended a high dosage. I wanted to do three rounds of embryo banking before moving to transfers. For supplements: 800mg Coq10, 25mg DHEA + 2,000iu Vitamin D. For IVF meds: 300 Follistim, 300 Menopur, Ganirelix, + HCG trigger. For first trigger, I did 5,000 and we retrieved fewer eggs than expected. For the second two rounds, she upped it to 10,000, and we retrieved the expected number or higher both times.

The billing is extremely straight-forward and detailed. Prior to every round, I received a packet with a detailed list of anticipated exams/procedures and the cost of each. I knew exactly how much I would be expected to pay and when. If an exam or procedure wasn't used, then I was promptly refunded that amount.

When I first met with Dr. Hansard, I was thrilled by her confidence that she knew what the problem was and I wouldn't need IVF. I moved quickly into surgery, which went well, but was very freaked out when she expressed much less confidence after the surgery. However, she seemed to be right on the money, as two cycles later I was pregnant! She is very no-nonsense and keeps appointments short, which I struggled with some as a person who likes very warm care and to do my own research and talk everything through, but she was also compassionate.

Dr. Hansard performed surgery to correct an arcuate uterus and remove suspected (now confirmed) endo. After a natural cycle, I had one cycle with 5mg letrozole, which was successful. I had had four previous medicated cycles with an OBGYN (Clomid or letrozole + HCG shot, including one IUI) that were unsuccessful.

The surgery cost my OOP max for the year. Had I done an IUI without insurance, each sonogram would cost $224 and the sperm wash + IUI would have been $440. The estimate for IVF, frozen transfer, meds not included was about $20,000. $7,000 of that was ICSI, biopsy, and PGS.

The clinic is very busy and it took awhile to get a consult with her. She was recommended by my OBGYN doctor. She spent time taking our medical history and explaining IVF. We didn't feel rushed during our consults and I could always call if I had a follow up questions. Our egg retrieval happened during COVID, but she worked through the crisis and maintained quality care during this procedure. She took the precautions to keep all of us safe during the procedure.

She seems to care about her patients. Even if the procedure doesn't go well, she talks about additional options to create a family.

Egg retrieval. Menopur 150, Follistim 300 evening for 5 days. I believe Ganirelex in the morning for 5 days in addition to Menopur 150 and Follistim 300. The last few days Menopur decreased to 75. I think Ovidrel for the trigger shot. My body responded better than predicted for the medication.

Ugh....NOTHING was covered through insurance. We paid for consults, diagnostic blood work, specialized tests, sonograms, medication, surgery center, lab testing, anesthetist's fees and egg retrieval. I also saw an acupuncturist 6 weeks before the procedure. Acupuncture appointments stopped because of COVID so I didn't get it before or after the egg retrieval. We paid around $18,000 but got back $6000 because we had no embryos.

She highly suggests single embryo transfer because it is safest for mom and baby.

If I could rate Dr. Silverberg a 1000, I would. He is an amazing physician and a great person. He has gone above and beyond our expectations and continues to exceed them. He is responsive to calls and texts to his personal phone, seven days a week, and on holidays. When my husband was facing some problems, he took the time, during his busy surgery schedule, to go out to the car (thanks, COVID), and talk with him. He is very direct and blunt, but there is a compassionate heart in there too!

He is very direct and blunt. Sometimes, he uses humor to lighten the mood, and his sense of humor is sarcastic. (I tend to be similar, so I enjoyed it). He is not a doctor that is going to paint a picture of unicorns and rainbows, but he is extremely good at what he does.

We used high dose protocols due to being diagnosed with DOR. We started with a microdose lupron flare, and only had two follicles. We converted to an IUI. Next cycle was Clomid/Cetrotide with HGH. We retrieved two eggs, one mature, one not. The most recent cycle was MLF again but adding HGH. He retrieved three eggs.

We were charged for ultrasound visits ($220 each). The surgery costs were ~$1300 to the Dr and $1300 to the surgery center. The anesthesia was $450. Lab fees were about $5k (without PGS). Drugs were about $5k through a pharmacy he partners with, which provides a slight discount to his patients. He offers a 25% military discount, along with the lab offering a 20% military discount, which helps tremendously.

I trust Dr Vaughn completely. He has been at this for so long and I fully trust his expertise. He can be blunt but also warm. He has talked me off the ledge more than one and told me to be kind in the way I speak about my body.

Don’t be afraid to ask a lot of questions. And yes he has an insanely firm handshake! But it doesn’t bother me!

I saw him for IVF and so far 2 eSETs. In 2016 I had my egg retrieval and he was helpful in monitoring my progress and we got 21 eggs which turned into 9 embryos. In 2016 he transferred a frozen embryo using Crinone. That failed and he suggested (but didn’t push) an ERA biopsy to check my receptivity. The first one came back pre-receptive. He gave me the option of transferring right away with that information or of undergoing a second ERA to double check that 1 more day of crinone would work. I opted for the latter, and I came back POST-receptive which is crazy. Then, he told me we could do just half a dose of crinone even tho he had never seen that result before. I ended up getting pregnant “naturally” with my daughter right after the second ERA. Now I’m in a sibling cycle. His protocol changed and I did an eSET with a trigger shot and femara, no crinone. That didn’t work and so I asked for another biopsy.

He strongly prefers eSET at least for my age group

I highly recommend Dr. Hansard. She is up to date on the latest research and honest about your chances with success. She is warm and caring, but she won't just tell you what you want to hear. This builds trust in the process.

Have blood work done prior to meeting with her, and collect your medical records before you go in. This will make the process faster.

I am not far along enough in the process to leave a review on this. I am still in the discovery phase. Dr. Hansard is not going to give me a plan until we have the results of my HSG.

I am not very far along in the process, but the nurses were great at making sure my testing and preliminary surgical procedures were covered by insurance.

I don't have that information yet.

Dr. Vaughn is an amazing communicator and is truly the most experienced. He explained every avenue of treatment and the risks and benefits. He would also explain other treatment options and allow us to think on the decision. Dr. Vaughn always called my personal cell after every surgery or fertility treatment. He seemed to always want the best for us.

Don’t be afraid to ask questions and he makes your experience a collaborative appointment.

Started with iui’s with Femara then after 2 failed iui’s, we moved to an iui with gonal f and trigger shot. After that, it was confirmed I ovulated 3 eggs but none took. After taking a few months off, we went through with a laparoscopy and from there he found stage zero endometriosis. He still considered us unexplained because he didn’t feel my endometriosis caused infertility. My husband checked out fine too. After that surgery we waited 2 months and then proceeded to IVF. My body responded great to gonal f and we got 23 eggs after retreval. Ultimately we froze 4 embryos and did not PGS test. Our first FET with estradiol and PIO failed. We were devastated but tried again after 2 more months. That FET worked using the same protocol and she’s now 2. We did another FET 8/2019 using the same protocol, that failed. After a normal hysteroscopy, we’re gearing up for our Hail Mary final FET #4.

Cost for ultrasounds consultation fees as well as general office expenses .

He is a warm doctor with good bedside manner, but he is very busy! As soon as he's done seeing you, he's right out the door to the next patient. Luckily he sees patients ar 2 different locations. He definitely listens and takes into consideration what you have to say. When trying to decide on how to proceed with my next treatment (I've done 2 IUIs-only 1 with injectables), I told him that this would probably be my last IUI attempt. With that info he decided, to just go with injectables only and no femara (I started femara with my OBGYN and continued it with Dr. Propst) to hopefully maximize my chances

Just go with your questions! He will answer them all. I didn't know what to ask in the beginning and I regret not doing more research before our consultation

I "probably" have PCOS per both my OBGYN and Dr. Propst. I have irregular cycles but no cycsts on the ultrasound. I have been using femara (started with just taking this pill with my OB) for about 5 months and then went to see an RE. Our first IUI was right after our consultation since it was near the right timing of my cycle. All I used was an hcg trigger shot which resulted in a negative pregnancy test. The next round was femara, gonal f injections and an hcg trigger shot with inseminations on back to back days since he was unsure of my ovulation. This also resulted in a negative pregnancy test. I am about to start my 3rd round in which we are NOT using femara but just a gonal f injection and hcg trigger shot. So we'll see what happens!

The initial consultation is around $600 and each ultrasound is $220. You do an ultrasound at the start of your cycle and several times throughout to see how your ovaries are progressing. My medications have ranged from $400-800 and they do use a pharmacy that overnights them to you (not sure if this is built into the cost since again I didn't do any price shopping).

She is very warm and caring and takes time to answer all questions. I feel very comfortable with her. She has walked us through the different possible treatments we can pursue to become pregnant, encouraged us to start with IUI which is more cost effective, rather than jumping straight into the expensive IVF treatments. Unfortunately, the several times I have taken the medications during my cycle, have resulted in ovulation taking place in the ovarian tube which may have a blockage. We have discussed, and agreed that we would try a few more rounds to see if we can get a cycle on the "good" ovary, and proceed with the IUI, otherwise, we can attempt to unblock the other tube, or move on to IVF. I just feel that she is very compassionate and willing to try all options before jumping into the most expensive route, and we really appreciate that!

Be patient and trust in the process.

Previously answered.

For each interuterine ultrasound I have had to do (which is 2 per cycle) have been around $216 each time, so around $430 per cycle. I have been through 3 cycles so far.

Dr. Hansard has shown interest in getting me to my end goal of having a baby. My situation is a bit different in the sense that embryos look great I have no problem making day 5 blastocyst but no implantation happens. It has been difficult to choose a course of treatment because we have done ERA’s and PGS, blood thinners, steroids and laparoscopic myomectomy( a few years ago with different doctor) and most recently a hysteroscopy and no success.

I would say to trust her because she is very knowledgeable but in my situation I don’t think it’s my doctor hindering my success but rather something else we haven’t figured out.

We tried following a femara natural cycle for FET, this protocol didn’t work because ovulation always occurred too early. So I decided to do a medicated cycle because it was more controlled. We repeated the ERA with a different protocol of medication using crinone instead of progesterone in oil for FET. We tried using Heparin and dexamethasone. So far I still haven’t had success.

The costs for: IVF cycle for egg retrieval, every monitoring appointment, medications, lab tests, FET cycles had costs associated with doctors fees, surgery center fees, embryology lab fees.

Dr. Hansard recommends transfering one embryo for my age that has been PGS tested. During my previous FET we transferred two embryos due to my history of recurrent implantation failure and embryos were not PGS tested.

I was treated like a human with him he always showed compassion and took the time to answer any questions I may have . I never felt uncomfortable with him once I always felt at ease and that he knew exactly what to do. I trusted everything he said and wanted to do and he got me pregnant with my miracle baby boy and I’m forever grateful for him!

Trust him! He knows what he’s doing !

He had told us to go right to ivf but said if we wanted to try IUI we can but he wouldn’t do more than 3 because of my diagnosis . He said it was silly to waste time . We decided to do 2 IUIs before moving on to ivf . Our first IUI was with 5 mg of femara for 5 days . I produced 1 follicle . 2nd IUI was with follistim injectables my dose kept going up every visit . I also produced one follicle . Both iuis were unsuccessful . We moved onto ivf and I was on 450iu follistim and 150iu menopur daily and added in cetrotide at the end. He knew I needed high doses because of my IUI with injectable . I stimmed for 13 days today and retrieved 8 eggs , 6 were mature and we ended up with 2 five day embryos to freeze .

Under our insurance we are covered 100 percent for IVF . I paid some copays for our visits with TFC . We had to pay out of pocket for ovation which is the lab because they aren’t in network with most insurances . So we had to pay the majority out of pocket due to this.

I think putting in 1 embryo was a good choice . I didn’t think to put in 2 or more honestly as I know it can be scary with multiples and I had been pregnant before . I was totally fine with that choice

She is very knowledgeable and confident. I always felt encouraged and hopeful after meeting her. Sometimes I think she made me feel like pregnancy was going to happen easily or quickly for us, which it hasn’t. I still appreciated her encouraging approach versus a more realistic standpoint that it might be a long process. Sometimes I wanted her to slow down and talk with me a little longer about the treatment plan. I think she gladly would have if I voiced that that’s what I wanted.

Ask all the questions you want and tell her how you’re really feeling. She’s excellent at helping to ease your fears.

She diagnosed me with stage 4 endometriosis after surgery to remove it. We tried naturally for 4 cycles then began IUIs. The first IUI was with clomid only. Then I did two more IUIs with clomid (days 3-7 of my cycle) and 200mg progesterone suppository at night, 3 days after the IUI. After none of the IUIs worked she recommended IVF. While we saved for IVF, she said we could do another IUI and add injections. We decided to wait and save.

The IUI (one ultrasound, the IUI procedure and sperm prep) cost about $600.

Dr. Vaughn always is upfront about risk, what to expect and chances. He is calm but direct and changes his approach if you are not understanding terminology. I never felt rushed or like I couldn't ask more questions.

Dont wait. If you are having trouble go early and often. No question is off limits, make sure you understand and have all questions answered.

Clomid and iui was used for several years, because inwas not ready to admit i needed to go to the next step. Dr. Vaughn was patient and allowed me to go at my own speed based on comfortability. We added gonal f injections with iui and progesterone and had 1 miscarraige and 1 live birth. After that we went to ivf with gonal f, progesterone and one other drug that I cant think of. I had 1 negative, 1 tubal pregnancy and 1 live birth (one other live birth but we are not 100% sure if it was from tubal or natural)

10k per ivf cycle, 3k frozen transfer

My doctor recommended 1 or 2 embryo transfers not any more. My age and history was part of his decision.

He is quick paced and speaks very quickly but works well and is super knowledgeable. He slows down when asked and will review any information when asked. His wait time leaves something to be desired but otherwise he is amazing. He is caring and compassionate and I would recommend him!

I would advise a prospective patient to bring a book to the waiting room of the office but rest assured that it’s worth the wait.

Our first stimulation and egg retrieval resulted in a lower number of eggs retrieved than originally predicted. Dr Silverberg adjusted my next cycle appropriately with more estrogen injections to yield more eggs for fertilization. He also carefully monitored me to ensure that I didn’t become hyper stimulated. The second round of stimulation was also accompanied by a freeze all cycle rather than fresh which was easier on my emotions and body to have the break between the retrieval and the transfer. The research showed that freeze all is typically more successful which was true for our situation as well.

All in all (for two rounds of stimulation, 3 egg retrievals) we spent $35K but that included our medications, the embryology (through Ovation), the surgery center, and TFCs services. The costs associated with TFC directly were very reasonable (for the ultrasounds, office visits, retrevial and transfer).

Dr Silverberg strongly stuck to transferring only one embryo at a time. He said he was part of the initiative that wrote guidelines for age and transfer and that he had been responsible for too many NICU babies and exorbitant hospital bills. He felt it was a more responsible move to transfer one embryo at a time based on age factors. He said once I was >35 he would be willing to transfer 2 at a time.