David Ryley (retired)

Dr. Ryley certainly knows what he's doing, so I really trusted him to manage my care. However, it was so hard to get an appointment and when I was with him, I always felt the ticking clock in the background. He would talk so fast and overwhelm me with information, so I never had time to fully process and formulate questions I wanted to ask. As a result, many questions went unanswered, which was very stressful and at times upsetting, especially when things did not go as expected during some of my treatment.

Do not expect to have your hand held throughout this process. You will get very efficient, high quality care, but he is not there to guide you through it. Be your own advocate and go into each appointment prepared with questions and don't be afraid to take all the time you need with him, even if it feels like he's trying to rush you.

My husband and I have unexplained infertility, so we started with 3 medicated IUIs (with Clomid days 3-7) and then moved on to IVF (Gonal-F, Menopur, and Cetrotide). All IUIs were unsuccessful. My IVF round led to only 5 eggs retrieved, 4 fertilized, and 2 made it to day 5 blastocysts. One was transferred and one was frozen for later transfer.

My IUI and IVF cycles were fully covered by my insurance, so I only had to pay for medication and appointment co-pays out of pocket. This wound up being maybe $300 for all 3 IUI cycles plus 1 IVF cycle.

Dr. Ryley strongly advised we just transfer one embryo given my age.

Dr. Riley knows his stuff, and also knows I am a scientist who understands the background research and statistics. It took us a couple of tries to fully understand one another's styles but once we did we had a great report and he is always well-prepared having reviewed my particular history and needs, and willing to listen carefully to any of my questions. We joke around and I now never leave without feeling like we have fully discussed everything I had hoped to and that he has tailored his answers and advice to my situation.

Try to self-reflect ahead of time on your needs and what you are hoping to get out of any particular appointment, and make sure you can clearly express those. He seems very willing to adapt his general style to fit those so you can have the best, most informed experience possible.

Dr. Riley is an award-winning Medical Professor with Harvard Medical School, and up to date on all relevant research. He explains the stats and rationalization for each protocol and step suggested, but I never feel like he wouldn't consider other options if I requested them and they were within the range of approaches he feels are medically appropriate. GIven my age (41 when I started IVF) and not great numbers, we started with an aggressive cycle of estrogen priming, Gonal-F, Medipur, and Cetrotide, along with Ovidril to trigger. The first cycle could have been worse but we decided to change things by trying low dose HcG in place of the medipur. This cycle worked better. For the third we decided why mess with what had worked about as well as we could have expected so we kept it the same, but it went very poorly. Given my age it seems this is not uncommon. If I do another cycle we will try a Lupron Flare protocol, which he figured has about a 50/50 chance of working better but we can't know until we try. I had the option of sticking to the prior plan if I wanted to. We also always have a plan in place for how many embryos to transfer and on which day (as I'm doing fresh cycles) ahead of time. For example, if I have less than four embryos on Day 1 the plan would be to transfer two-three on Day 3. If I have four or more we go to day 5 and transfer 2, and freeze the others if I get more (so far I haven't). If I have extras I have elected to do PGS testing, but I can change my mind at any point if I choose not to. (Though I have given a deposit.)

Massachusetts is extremely lucky to require some infertility coverage through insurance, though policies can vary. To date then, there have been relatively few costs (PGS testing deposit was the main one) but as I may be aging out of my current insurance, I assume the numbers will be similar to those at other big clinics around the country. I have not yet done all the pricing but I am sure it is available.

He bases his suggestions on the statistics available for patient's ages and numbers. So for someone like me over 41 with not great hormone levels, an SET is not recommended. The stats of having multiples with multiple untested embryos are so small, and the risk of trying to freeze, test, and thaw the only extra one or two embryos doesn't seem worth it. That said, and I have asked, if I preferred to only do an SET he would.

I liked Dr Ryley but hated BostonIVF and because of a lot of errors. Each time Dr Ryley apologized for theses errors and told me that he couldn’t be with me each step of the way because of patient volume. He is a nice person but he is practicing in the wrong place.

PLEASE PLEASE PLEASE do research and when things feel wrong or you think things are being handled poorly speak up. I felt I gave them so many times to mend relationships because of errors and felt like I had to stay with the practice but I was wrong! No one knows you like you do and you have to put yourself first! Leave and find a different practice if things aren’t right!!!

As stated, I don't question his ability in the OR or necessarily his medical decisions. But his bedside manner (poor) makes a huge difference in patient satisfaction. I would not want him doing an egg retrieval on me again.

I'm not his patient, he just did my retrieval. I won't have to see him again.

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Again, I'm not his patient. He just did the retrieval. Costs were about $12K

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He was great to work with, very thorough and very honest. He tried to make a little too much small talk for my husband's liking, but I found him very calming and very professional. When our first round of eggs from our egg retrieval turned out to be abnormal he was very sympathetic, he asked if we wanted to move on and didn't pressure us to do another round of IVF and egg retrieval. He did explain what they would do differently to help us get a better outcome.

I would tell a prospective patient that he will give you a lot of information. Lots of statistics, probabilities, timelines etc.. If you're not someone who likes a lot of data it can be overwhelming, but its also important to know what the process looks like and what the chances are.

Because of my cancer diagnosis a lot of our treatment was covered by insurance or medication grants. Most of our routine payments were copays, or partially covered by insurance. We did opt for two items not covered by insurance: the ICSI procedure (Intracytoplasmic Sperm Injection -$2,500) and the PGTA (preimplantation genetic testing for aneuploidy - approximately $3,900 - final price dependent on the number of eggs retrieved).

Dr Rylely himself was pleasant, but he never left me with any notes to take home. I always left feeling like I had missed something because he said so many new things and just expected me to understand what was happening or what to do next.

He's a decent doctor but it hardly matters; what you need as a patient is a good billing specialist and good nursing staff. Dr. Ryley has neither.

I didn't get to this point. Right after I was prescribed Gonal-F along with other things and 2 days before I was supposed to start them, I switched clinics.

I had insurance and did not complete my cycle

I said it before--he is very caring and compassionate and explains everything well. He is smart and confident but also realistic in setting expectations. I have the feeling that he "has my back" and that he truly cares.

The clinic is really busy and it is difficult to get appointments in a timely manner. There is also the question of whether you want to deal with feeling like a number at such a big clinic... I think he's worth it but we'll see.

Gonal F, Monopur, Cetrotide, Endometrin

This first cycle is covered under insurance and Dr. Ryley fought insurance for that. Otherwise, it's about $8k-$10k.

I would definitely recommend Dr. Ryley to a friend, as he was recommended to us. I think I would just be clear that you may not see him as often as you expect and he may also not do the procedures himself. But that was understandable given timing issues. I thoroughly appreciated his care and got the treatment we so desperately needed.

Just to manage your expectations. He is a wonderful doctor but not a magician. It may take a while to see results but in our case after our first cycle was canceled he definitely made adjustments for our next treatment and called me himself to explain why the cycle was canceled. He also called me to review how our embryos were progressing which meant a lot.

My husband and I drove the process and dr. Ryley did not push us towards IVF until we felt we were ready. We tried several medicated cycles, 3 IUIs after he explained that the odds really didn’t improve after that point, took a break and finally moved forward with IVF. For IVF we did an antagonist protocol with PGS testing and a frozen transfer of a day 5 embryo. It was successful!

Dr. Ryley has an excellent bedside manner. He is compassionate and friendly and explains the process well. I did not find him open to changing protocols nor did he seem particularly well versed in treating DOR.

Be your own advocate. Ask many questions, and insist on the treatment that you want. If you have a condition such as DOR, ask specifically what would differ in your treatment compared to women without DOR.

Antagonist protocol (I responded poorly), 2 micro-flare protocols (I responded better), and two A/ACP with estrogen priming protocols (I produced many more eggs). The last protocol I insisted upon; the first two were standard for the clinic and were attempted because women often respond differently to the 2 protocols.

Massachusetts covers IVF cycles almost fully. For freezing and storing samples, as well as copays for medications, our overall costs during 5 IVF cycles over the course of 2 years was approximately $2500.

Based on my diagnosis of DOR, 2-3 embryos were thought to be best for transfer.

There was only one thing we initially did not like about Dr. Ryley; if you don’t have the first appointment of the day, he is running late. As we worked with him we understood that this is because of the time and care he takes with each person. We were never rushed through an appointment, he gave us all the information we needed in a clear and jargon-free manner. Dr. Ryley answered all of our questions completely and was always available if we had more. During our time with him he was 100% focus on us, our wellbeing, and our goal.

He’s worth the wait.

We initially used Clomid to bring on ovulation, but when that did not have the expected results we switched to Letrozole. My wife was still not ovulating normally so we used birth control pills to help “reset” her cycles. It took roughly 8 months to achieve ovulation, and the second cycle we got our first positive. We used the same protocol when we decided to have more children.

With our first our out of pocket expenses were about $14,000. Insurance covered everything with our second.

We love Dr. Ryley and we're completely satisfied with our experience with him. He was always honest with what we should expect and clear with what the course of action would be. We always felt that we were in excellent hands.

Trust him and Boston IVF - Stay the course, though it might take a while, and if it is possible for you to get pregnant, Dr. Ryley will do everything he can to make it happen.

I don't remember all the specifics. We had tried ICIs by ourselves and IUIs with a family friend who is an OB/GYN and they didn't produce a live birth. We went to Dr. Ryley after I had a miscarriage. He suggested many tests to make sure everything was working properly, which we appreciated because we wouldn't want to go through more cycles if something was wrong. We then did a few more rounds of IUIs with drugs but they didn't work. Then Dr. RYley suggested IVF- and explained the procedure very clearly. Though it was overwhelming, Dr. Ryley and all of his nurses and staff were very helpful in explaining everything every step of the way. We did the course of drugs for the egg retrieval, got 20 eggs, 4 of which fertilized. One didn't survive, we transferred one and it didn't work, the second one worked, and produced a healthy baby boy. We froze the 4th one for two years and just transferred it 9 months ago and Just gave birth to another baby boy.

The billing dept was very helpful in arranging all of the details for insurance and other than co pays and deductibles, everything was covered.

We didn't want to produce multiple births so we only transferred one at a time. It was more of our decision and Dr. Ryley supported it.

Just make sure you consider factors besides bedside manner. He was very friendly and we connected on a personal level but ultimately we were not that happy with our experience at the clinic.

I had insurance

He is very open and doesn't judge; he always answered all our questions carefully and was sympathetic to difficult / negative feelings and offered a positive outlook; he was available by phone even in the evening; he always tried to explain treatments so we would understand and used visual aids

Don't automatically assume every woman over 40 years is "defective"; check if she could do a natural (unmedicated) transfer before administering typical protocols with hormones

Several strategies with bcp and different dosages of Bravelle plus Menopur, Gonal-F and Lupron as well as Ganirelix. Treatment of thin lining with various estrogen formulations (patches, tablets). Cycle leading to pregnancy was unmedicated with progesterone support after transfer.

Drugs were typically filled by specialty pharmacies and I didn't shop around: costs ran from 50-1000$ per cycle. Fees and procedures per OE and DE ran approx. 10-30,000$, but I had insurance coverage.

OE transfer was with multiple embryos; DE transfer with 2 frozen embryos per cycle. Future DE transfers will only be single embryo transfers.

Dr Ryley is very friendly, informative and mostly, he listened to what my concerns seriously. I ended up putting 2 embryos back and was pregnant with twins at first but miscarried one of them at 9 weeks of pregnancy. When we were putting the embryos back in, he has explained to me that one of the embryos were much stronger than the other so it made sense that the weaker one just didn't make it and it wasn't meant to be. I was recommended to put 2 back in instead of just one for the likelihood of me getting pregnant doubles by doing so. And it was right, I sure am pregnant now with a singleton baby(third trimester now). One negative thing that I have experienced is the fact that I have suffered from Hyperactive Ovary Syndrome in the beginning of my pregnancy. I am a small person and have accumulated water in my lungs as well because of it. I called in to let Dr Ryley know right away and he told me to go to an ER right away. That's how I found out that I am actually pregnant (this was a very early stage)! Dr Ryley and his staff scheduled me an emergency quick surgery to drain the fluid out of my uterus (under the influence of anesthesia of course). The fluid in my lugs ended up draining on its own so I didn't need a surgery. It was a bit of a scare in the beginning but I command Dr. Ryley and his staff for their quick remedy and actions so that my symptoms won't be worse. Hyperactive Ovary syndrome is usually prevented by having the doctor watch your vital stats weekly(which was normal for me weekly) but my symptom actually occurred towards the end with a pregnancy with twins, it may have something to do with it. Either way, I'm happy that I am pregnant in the end with a good doctor who had watched over me with great care. Boston IVF in general was such a great experience with great staff overall. I definitely will recommend this doctor and it's facility.

Ask as many questions as possible, tell him about your concerns(how many embryos to put back in to maximize the chance of pregnancy versus likelihood of having twins, etc).

David Ryley was a good balance of kind and matter of fact. We wanted to know a lot of background scientific details for tests and procedures, and he always accommodated us. Really The only small downside is that he was not available for in-between visit telephone calls or emails. That just isn't how Boston IVF works - there are nurses on call for that purpose.

Be prepared to only see him before you start the cycle, for consultation and planning. You won't see him for any procedures, and if you get pregnant on the first round you'll never see him again.

Antagonist protocol: Birth control pills, FSH, Ganirelix, HCG, egg retrieval, 5 day transfer of 2 embryos. This was my first and only IVF cycle, which resulted in my identical twin girls (one embryo didn't make it, the other split!).

I was very lucky, living in MA and having a company sponsored health plan (BCBS MA) that fully covered my fertility treatment for the cycle. I paid almost nothing out of pocket.

I would not have had the results I had and the positive experience I had (despite nearly 4 years of various treatments) without the support and expertise of Dr. David Ryley.

If he says he'd recommend moving to more aggressive treatment options, listen and follow his advice right away.

I started with a long succession of medicated (injectables) IUIs and then moved to a series of IVFs with ICSI. I got pregnant several times but some were clinical pregnancies and one was a miscarriage at 12 weeks. As I turned 43, Dr. Ryley recommended I consider egg donation. I did and decided to proceed. The first donor I chose had not previously donated and despite medical tests indicating everything was fine and a total of 27 eggs retrieved, only 6 fertilized and they were all low quality. I had a strong preference for a single transfer but took his advice and transferred 2 fresh, then 2 frozen and got pregnant with one of the last 2. Unfortunately miscarried at 10 weeks. I almost gave up, but did decide to try one more time with another donor who had successfully donated previously. Got more than 30 eggs, 27 fertilized and 2 of these were discarded due to poor quality. I had one transferred fresh and got pregnant and gave birth to my daughter in 2012 nearly 4 years after I had my first fertility appointment.

I think that all told, after insurance, and counting 2 separate egg donors, my cost was a bit below $100K (insurance covered a bunch upfront, but I paid for several IVFs myself and 2 donor egg retrievals, incl. donor and personal medications and 4 transfers)

He was great at explaining everything to me and giving me realistic statistics . I felt very confident in his knowledge and the care he provided. He didn’t get more technical than I wanted , everything was at just the right level for me. I also felt like he had plenty of time with me and didn’t feel rushed

He is very trustworthy and I recommend him without hesitation

We used metformin, letrozole and IUI. I’m a single mother by choice so obviously I went straight to iui . We started with ovulation predictor kits but I asked to move to active monitoring . I got pregnant on the 5th cycle. If that hadn’t worked the next step would have been ivf but I didn’t need tha

I paid about 2000 per cycle - 800 for the sperm and 1200 for the iui and montori g. My insurance covered the visits so I only had a copay and it also covered the blood tests and HSG

Dr. Ryley was amazing! He knew I worked in the medical profession so he gave me much more detail and was very patient with my questions. He was also able to engage my husband who has no medical background and explain things in plain language. He made us feel safe and we totally trusted him.

Trust in him and the process.

We are very fortunate to live in a state where infertility treatments are covered. I work in a hospital affiliated with BOS IVF so it was considered tier 1. We paid a copay for the cycle meds but that was it. All testing was covered.

Dr. Ryley was honest and incredibly positive, even when we were starting to lose hope. He encouraged us to seek a second opinion when we told him we wanted to and also offered to raise our case at the practice's monthly meeting to see if someone else had ideas to help address our unexplained infertility. My only issue is that sometimes he talked a bit fast and details were hard to remember. I wish we had pushed more wrt egg quality, which seemed to be an issue though he assured us it wasn't.

Be prepared with questions and be honest.

Dr. Ryley was warm, compassionate, and understanding. He took the failures and setbacks as hard as we did. He provided both statistics as well as his own experience so we knew the range of things to expect with each step. We always felt like he was on our team, rooting for our success.

You are your own best advocate, but you will feel like you have another fighter on your team with Dr. Ryley.

He was very optimistic but not blindly so. He was very friendly and made a sad and uncomfortable process much easier. He talked to us like humans and made me more optimistic than my previously two failed transfers

He is very kind and has great compassion and warmth for patients

He did my transfer but my third one so my embryos were already frozen

I do not remember

None. He recommend SET for my age which is mid 20/

Every interaction with Dr. Ryley was great. He was thorough and very patient. I never felt rushed out of his office. He did not, however, do our procedures, as that was always based on whoever was in the OR on the day of a scheduled transfer. I would have liked for him to do our procedures.

I would say to make it clear to his staff when you want to speak to him directly. His team of nurses are very competent and often handle many things themselves. If you want his opinion directly (not just through the nurses), you should feel comfortable asking to speak to him directly. They will accommodate that.

Dr. Ryley was an excellent provider. He treated us respectfully and provided a full explanation of what to expect throughout the time in treatment. He did an excellent job balancing humor and compassion with providing real-time, scientific explanations of his understanding of our case and options for how to proceed. We were consistently engaged in decision-making around our care.

Ask as many questions as you need to feel like you understand and are comfortable with the plan before you.

When trying for my first child, I had unmedicated, unmonitored IUI cycles based solely on ovulation tests/symptoms. My daughter (DOB 9/2015) was conceived on the third cycle. For my second, I completed 4 unsuccessful IUI cycles with Dr. Ryley before moving out of the area. For these, we did do ovulation monitoring and trigger shots.

My care was covered by my insurance with minimal copays on my part.

Dr. Ryley is very thorough with his explanations and never rushed a conversation. He asks questions to get to know us as people, not just patients. From the first day I met him he showed confidence that he would find a plan that worked and he did!

He is very honest and you will leave his office with hope.

I feel the cost has been fair.

Dr Ryley is fantastic. He answered our questions honestly and was always optimistic even when we weren’t. My partner and I are both trying/tried to get pregnant with him and we have been very satisfied

Ask everything. If you need to talk to him, just ask his staff.

Me- ivf: ovarian stimulation, egg retrieval and 3 day transfer. My partner: 6 iuis on Femera and trigger shot (PCOS)

Insurance covered

Our insurance only covers one egg transfer, but I think if that wasn’t the case he would have let us do two.