Caroline Juneau

Our journey towards parenthood was marked by challenges until we found hope in Dr. Juneau. Prior to consulting with her, we had sought the expertise of three different doctors and facilities, enduring three IVF cycles without any success. It was a disheartening experience until we crossed paths with Dr. Juneau. From our first meeting, Dr. Juneau stood out with her kindness, calm demeanor, and unwavering compassion. Behind her gentle approach was an incredibly sharp and knowledgeable professional. She guided us through the procedure and instilled confidence in us to trust her process. Navigating through a sea of online information, some correct and some partially correct, Dr. Juneau patiently and clearly explained every aspect of our treatment plan. What truly set her apart was her commitment to walking with us every step of the way. Her follow-up was meticulous, and we felt supported throughout the entire process. I am overjoyed with the results of Dr. Juneau's treatment, and I wholeheartedly recommend her to all future mothers seeking a caring, knowledgeable, and dedicated fertility specialist. She made a significant difference in our journey, and we are immensely grateful for her expertise.

Ask a lot of questions and trust your doctor!

Dr. Juneau was very confident during the embryo transfer which was much less difficult than I imagined. She also was very patient when we did a saline sonogram which I was very nervous about. During the routine monitoring visits, Dr Juneau always performed the ultrasounds and took time to answer any questions we had.

Don’t be afraid to ask Dr. Juneau questions. She will take her time and be your advocate!

I followed a fairly standard protocol. I had produced a larger number of eggs, so Dr. Juneau modified my plan to avoid OHSS by not using one of the trigger shots. She also prescribed another medication to help with cooling everything down to avoid any hyperstimulation side effects after the retrieval. She added baby aspirin as an extra precaution to avoid any small thing that might have prevented my embryo from implanting.

The clinic runs all cycles in cohorts, so some weeks are more busy than others, especially the beginning of the month when retrieval cycles are in process. There can sometimes be delays in the actual appointment times based on the volume of patients, but the staff always make you feel cared for and not rushed even if there are more patients in the queue.

I had insurance benefits which covered a majority of many, I had about $3k in required expenses from the facility. I also paid another $3000 for embryo biopsies and genetic testing which wasn’t covered by my insurance. This is in addition to costs of approx $4000 for medications.

Dr. Juneau has been amazing every time. In 2017, we originally went for a consultation. She explained everything in detail. She took my concerns seriously when my normal OBGYN did not. When we declined treatment at that time, she said she understood and that she will always be my doctor if I needed her. That statement honestly impressed me which is one of the reasons we went back. We have done a few cycles with her but had a few canceled and only 2 IUI. She is explained every cycle and the risks of continuing (overstimulation, polyp found, etc).

Instead of going in blind, do your research prior. It’s so helpful to understand what treatments are available and medications. Also look into your insurance and check to see if infertility is covered. That way you have an idea of what to expect

cycle #1 Sept 2019was done by the NP. We used femara 5mg for 5 days. Didn’t get a large follicle so she added follistim and checked my values. Turned out I was ovulating on my own so went in for IUI #1. Cycle #2 November 2019 we used the same femara but added follistim 50 for 3 days again. It was cancelled due to my lining being extra thick but I did have a massive follicle. Juneau was concerned that there was a reason (pregnancy or polyp) bloodwork showed negative pregnancy but the saline ultrasound showed a massive polyp. I Had surgery to remove polyp in Jan 2020. Cycle #3 February 2020 was the same protocol as before. This time I had 4-6 follicles from 13-16mm and she was concerned about multiples. We would not have reduced so cycle was canceled again. Cycle #4 March 2020 we used the same femara but no follistim. Only had one good follicle (>20mm) but we went ahead with IUI. I triggered that night but she called the next day saying I needed to come in due to ovulating on my own again. Pregnancy test was negative. We took the next cycle off due to traveling then Covid-19 happened. We haven’t started again.

The HSG was about 500-600. The saline ultrasound and polyp removal was covered under insurance (praise Jesus). The IUI I think is about 1200 which includes ultrasounds, exams, and bloodwork. The femara is super cheap. Follistim was free at first but the second one was $300. Triggers are $80

No

Dr. Juneau is so positive and cares and remembers her patients. I never felt like just another woman with infertility, I felt heard. Dr. Juneau tried to make little successes and even regular appointments feel special and like we were really making progress. When we finally had a pregnancy and wanted to know the gender, she arranged some blue confetti fun so that we could have our own mini gender reveal instead of just telling us outright. After crying in her office so many times because of emotions and the process being really hard, she never waivered on her positivity and helpful attitude.

You will have a great experience.

Monitoring was in the morning and there were a lot of time slots. I went in 3 or 4 times a week when doing the monitoring and it ran very smoothly.

They used a pharmacy specifically for fertility medication and would send the prescriptions there. I would then call and make a payment directly to the pharmacy and they would ship the medications. The costs for treatment were a bundle for the general services and each surgery had its own costs.

My husband and I went to Audubon after a year of unsuccessfully trying to conceive on our own. We had a consultation to discuss future options with Dr. Juneau, and I felt so much more hopeful even after just talking to her. She has been so patient with me and my crazy questions and seems personally invested in our journey. She can somehow make me still feel positive after receiving not so great news. We’re in the middle of prepping for a third egg retrieval, and before we began each treatment, Dr. Juneau sat with me and my husband and helped us decide what was best for us. And she doesn’t stop thinking about your treatment when you leave the clinic. I’ve received multiple calls from her after leaving saying “I’ve thought about this more, and instead of doing X, I think we should do Y...”. I can’t imagine a more compassionate and caring RE.

Ask questions. Since Dr. Juneau is living and breathing infertility treatment every day, sometimes she forgets to explain (or assumes you know) next steps or reasons for why she prescribes certain things.

We started infertility treatment with an “unexplained infertility” diagnosis. IUI - Letrozole for 5 days followed by follistim (don’t recall the dosage...maybe 75 units), with an HCG trigger shot. Had 4 follicles but no pregnancy. IVF retrieval 1 - 150 units menopur, 225 units gonal-F. Cetrotide last 4 days of stims. Lupron trigger (my estrogen was over 5000 so she didn’t want to give me an HCG trigger because she was worried about OHSS risks). Retrieved 16 eggs (she had trouble getting eggs from my left ovary which was hardened), only 6 mature, 5 fertilized, 1 good quality day 5 embryo (PGS normal). IVF retrieval #2 - added omega-3, folic acid, CoQ10 vitamins to improve egg quality since it was identified as an issue. 150 units menopur, 225 units gonal-F. Cetrotide last 3 days of stims. Dual trigger of Lupron + small dose of HCG (2500). My estrogen was still very high again, but Dr. Juneau added HCG trigger to try to improve egg maturity. 26 eggs retrieved, 20 mature, 15 fertilized. I ended up with 2 fair quality day 5 embryos (one PGS normal) and 2 poor quality day 6 embryos (both PGS normal). I had very mild OHSS. IVF retrieval #3 - I’m currently on day 5 of stims under the same protocol as retrieval #2.

The following represents their IVF costs: Procedures and physician fees - $1400 (monitoring, oocyte retrieval, embryo transfer, injection teaching, etc.) Anesthesia fee - $500 Lab fee - $3,825 (oocyte ID, sperm prep, culture and fertilization, ICSI, assisted hatching, crypto preservation, prep for transfer, 1 year embryo storage) Facility fee - $3600 Medications between $2000-$5000 PGS testing - $4750 (up to 8 embryos; additional $300/embryo above 8)

Dr. Juneau has said that the typical practice is to transfer one good or fair quality embryo at a time. For poorer quality embryos, or if there has been an issue with embryos implanting, they may transfer two.

She’s a bubbly, friendly person. We felt comfortable with her instantly. If I had a question I was able to contact her through the portal or by leaving a message with the front desk. I always received a response that same day. She talked me through each ultrasound, explaining what she was doing and seeing. She calls me personally with lab results (this HUGE for me as a patient).

Be honest and don’t be afraid to ask a question.

After bloodwork she had be start Letrozole to stimulate follicles. She felt that this drug was safer for PCOS than Clomid as far as side effects. I went for follow up ultrasounds after to monitor my progress. I responded very well and a trigger shot and IUI were scheduled. Unfortunately, it was not successful, but she explained to us before hand the success rate. We were all hopeful but also not surprised when it didn’t work. I’m grateful that she was willing to try for us when our other doctor refused and would only do IVF.

There are different levels to each treatment and the clinic gives VERY detailed printouts explaining each part of the procedure, the cost associated with it, where the money goes, and financing options available. For our IUI we paid $1,200 and it included baseline and follow up ultrasounds, semen collection, washing, and count, also lab work and office visits associated with the procedure. The trigger shot was $80 (not covered by my insurance). I opted to do the pregnancy test at a local Labcorp to avoid missing more work (we travel 3 hours to get to Dr. Juneau for visits). We will soon be starting IVF and they have gone over cost with us for that as well. Again, it is broken down on a printout detailing each step and the cost associated with it. The total estimated cost was around $14,500 plus optional genetic screening for ~$4,000.

Dr. Juneau is Intelligent, trustworthy, and compassionate. She is extremely kind and makes the patient feel like family. She explains every detail of both the IUI and IVF process. She is very detailed and doesn’t miss a beat. She has been a true blessing. She was with me every step of my infertility process. She made my husband and I feel like family. She is extremely thorough. She knows her stuff! She personally performed my ectopic surgery- even though it took place at a hospital and not the clinic. This was so reassuring during such a scary time. After my ectopic, Dr. Juneau presented my husband and me with all of our possible options. We decided to move forward with IVF/ICSI/PGS and transfer using a frozen embryo rather than fresh. We only transferred one and it worked! We are excited to say we are expecting our first miracle and rainbow baby in December (2018). Dr. Juneau monitored me every week prior to the transfer and after until we reached 10 weeks. We “graduated” and I began seeing my regular OB. The week of my first visit with my OB, Dr. Juneau messaged me to check on us! She didn’t have to do that- but that is th kind of doctor that she is. Leaving Dr. Juneau was bittersweet. Although we were sad to no longer be under her care- we knew it meant things were progressing as they should for a healthy pregnancy! I would recommend, and do, Dr. Juneau to anyone experiencing infertility. She is truly a light in such a dark time!

Trust her! She welcomes questions and concerns and always listens. She gives recommended actions- trust her advice. Infertility is such a difficult time and there are so many decisions that need to be made- trust her and allow her to help take some of thher decision making off of your plate.

HSG- checked to make sure tubes were clear before beginning IUI. They were. 1st: IUI with clomid- transvaginal monitoring and bloodwork .... BFN 2nd: IUI with injectables- transvaginal monitoring and bloodwork... BFP, low HCG to start, but began to double appropriately. Resulted in ectopic, with emergency ectopic surgery and left tube removal. Dr. Juneau performed my entire procedure and checked my right tube as well. IVF- Gonal, Menapur, Cetrotide.... transvaginal monitoring and bloodwork, 15 retrieved, 11 mature and inseminated, 8 fertilized, (3) 5 day blasts (frozen after biopsy sent off for PGS testing). PGS: 2 normal and 1 abnormal. Used birth control to control cycle, started Estrace and PIO (progesterone in oil injections). Monitored often. Transfered 1 embryo when the timing was right- BFP! Dr. Juneau personally monitored the pregnancy until week 10 ( which is when I got off of PIO). Baby due 12/29/18!

About 5,000 for IUI About 24,000 for IVF All process fees stated above included my labs and monitoring, medication. My insurance doesn’t cover- so this was out of pocket fees.

Dr. Juneau recommends transferring 1 embryo. If for some reason the 1 didn’t take- she believes in having a discussion about the possibility to try (2) for the 2nd transfer. Not promised.

Dr. Juneau has always shown me compassion and empathy. I can tell she really cares for her patients and wants the best outcome for each one. She has a sweet disposition and is always so kind and gentle. Every detail was explained along the way and I always feel like I am in good hands. She is very honest, forth coming, and does not sugar-coat anything. I Would highly recommend her to anyone.

She looks very young and is very soft spoken, but she is very knowledgeable about her profession.

Antagonist protocol for DOR. 9 days of 300u Gonal F/150u Menopur. Cetrotide on day 6-9. 10,000u Hcg trigger on day 10. Expected 6 follicles. Stimmed 8. Retrieved 7.

I had some insurance coverage but have since maxed out of lifetime benefits. For prescriptions. $11,000 out of pocket.

My insurance only allows single embryo transfer. But we never made it that far.

During treatment So easy to communicate with my team. loved the Artemis app that keeps track of everything in one place. I was able to communicate directly with the doctor through my app any time I wanted. I had a barrier in Barbados of my assigned nurse coordinator who could pass along messages to doctor, would take days to weeks for an answer. This time I had the doctor at my fingertips and it was very reassuring.

I promise you’re in good hands is what I would tell them. No matter who you helps you everyone is very kind and welcoming.

I had gotten OHSS in Barbados and was very traumatized from that experience. She really monitored me closely with ultrasounds and bloodwork to make sure I medicated safely. She did this both rounds. The second round we adjusted the medication a little and got the best results out of 4 cycles!

This was my first time to have these because for my first two cycles Barbados told me what meds to take but I never had blood or ultrasounds. I had one ultrasound when I got there but that was it. I had never been so closely watched. If makes you feel good I like this is more controlled process.

So expensive compared to Barbados but worth it. $15,000 egg retrevial, $6,000 meds, did that twice. I have yet to do the transfer m

I haven’t gotten there yet

I had an overall good experience I had every test to figure out why I was miscarrying and based on the results my protocol was changed and now i'm pregnant. She's very friendly and compassionate. If i would have listened to her suggestions I probably would have been pregnant sooner.

Listen to her recommendations she's very good at what she does.

For ivf I was on gonal f menopur and centrotide. I went to the office every 2-3 days for monitoring took hcg and retrieval was 36 hours later. For frozen transfers I was on estrogen for 2 weeks and took antibiotics and pentoxifylline while taking the estrogen then i was on progesterone for 5 days for 3 cycles and progesterone for 6 days on final cycle and took antibiotics and steriods for those 6 days until transfer.

N/a

I used insurance but ivf is almost 14,000 and embryo transfer is almost 4,000

Would only transfer 1 if they were rated good, would transfer 2 if they were rated fair or poor.

The best- all around. Great clinic. Great staff. Great doctors. Can’t recommend more. There with us every step of the way. They were always very kind and endearing. Super professional. Dr. Juneau is very kind and warm and made this unfortunate experience the best it could be. I’ve recommended them time and time again. She was thorough in labs and following up on previous health records. She did not waste time trying the same treatments I had done in the past. She jumped to move onto something different so that we may find a different result. Because of Dr. Juneau we have a beautiful baby girl.

Trust her, have faith that this can work.

Sperm count for husband Then sperm collection. Letrozole for ovulation. Injection to be sure the egg released. I was seen weekly to be sure the follicle was growing properly prior to injection. IUI Then weekly ultrasounds until I was seen at OBGYN.

Juneau was amazing. From her being honest and open to what could or couldn’t happen. To getting us the treatment we needed to hopefully be able to conceive. She went above and beyond to make my husband and I feel comfortable. She had a great personality and just made us feel good at every visit even when we knew things weren’t going as expected.

Even when you’re sad be prepared to laugh and smile with Dr Juneau. She is great at opening her heart and making every situation good or bad better.

During our first round of IUI, Juneau did just oral meds. We did I believe 3 days and I came back to see follicle development before triggering for IUI. We had like 1 or 2 viable for the transfer. For the second IUI, we did injections. Just the normal maybe 5 days I went in every 2 days to check follicle development. We trigged with I believe 3 that time. On our last round we did a lot more injections as my body was not responding as quickly to the meds to mature follicles. In the end we had 4 on one ovary and 1 on the other before we triggered. Still then with as many as we had no luck in getting pregnant.

We spent at least 15,000 with the 3 IUIs plus ultrasounds and bloodwork procedures when going to fertility. Not counting the funds for when I got pregnant to do ultrasounds, bloodwork and genetic testing another 3,000 at least.

None she was amazing.

Caroline Juneau is very thorough and makes us feel very hopeful for our journey. After our first iui we were informed that my husbands count was to low for anything except for IVF. We were told that there was a small chance for us to ever conceive naturally. She made us feel very hopeful through the whole process as she explained what we needed to expect at where to go next.

Write down questions to ask because you will likely not think about them when Dr. Juneau gives you the amount of information she gives!

Dr. Juneau said that she always prefers a single embryo transfer due to less chance of multiples and therefore less chance for problems during pregnancy