Erika Johnston-MacAnanny

We come away from our video chats feeling like we fully understand the next steps and course of action. Unfortunately, subsequent communication from other staff have not seemed to agree, introducing new information we wish had been explained better and causing confusion and uncertainty.

Take notes on your conversation and review the action plan before signing off of a call, because other staff may not explain your next steps the same way she did. Better yet would be to have a way to directly follow up with her for clarification, but that doesn't seem to be an option anywhere anymore.

About $17000 to enter the Shared Risk program, but not sure about the additional tests and medications -- probably another $5000 or so, so far at this clinic. Maybe $20000 more in other treatment at previous clinics. There were also non-monetary costs: Emotional cost of repeated hormone treatments and failures. Also had to stop working with an adoption agency because they had a policy not to consider placement during or within a year of pregnancy.

In initial discussions with this doctor, single embryo was our only option despite our preference for multiple. After that attempt failed, transferring two was presented as an option we were happy to take, only to find there were no donors available with multiple embryos, and the selection process did not seem to allow that option.

Dr Johnston was our primary RE throughout our term of care. Though sometimes other doctors would do IUIs if she wasn't in clinic, she was always there for retrievals, transfers, and a fibroid removal I had to have done. We have unexplained infertility, though I also have PCOS. Since we were paying out of pocket and the initial testing looked promising, Dr Johnston offered us the chance to try IUIs before moving to the more expensive IVF. We had one interrupted by an early ovulation and another interruption later when I developed a fibroid that partially blocked a tube. When we had to move to IVF there was a slight hiccup. The clinic previously had a program for service members with a significant discount, and we'd been given a brochure for it. That program wasn't being offered anymore. When we brought it up, Dr Johnston talked with her partners and got us the discount anyway. I appreciate that Dr Johnston let me have a large say in when we could do transfers and how soon after my loss we could start again. It didn't feel like there was unnecessary waiting, and when there was a wait she explained why it had to be that way and the risks of avoiding it.

I would say not to hesitate about asking any questions or bringing up concerns. She is very busy (although I never felt like she was rushing out of the room) but she's also very willing to spend a bit of extra time explaining something, so when she asks, "Anything else on your mind?" go ahead and ask. It's not a rhetorical question.

-5x IUIs (one interrupted due to early ovulation). We did more because there was good reason to believe getting my ovulation started would work, then also I had a fibroid removed which could have been the issue. -2 retrieval cycles (one produced 21 eggs, 8 mature, 7 fertilized, 3 reached 5 day, 0 PGT normal; second was 27 eggs, 17 mature, 15 fertilized, 5 reached 5 day, 2 PGT normal) -2 frozen transfers (1 loss in first trimester, 1 ongoing pregnancy)

IUIs were around 1800/cycle. We did the shared risk program which was a bit over $20K for up to 6 cycles. I don't remember the med costs for IUIs but for retrieval cycle after insurance meds were $1k and the transfer meds were pretty cheap at $40ish per refill.

I think this would be my only issue, and it's not a big concern. I would like to have had the option to transfer both my embryos at the same time instead of one at a time. I'm older and if they didn't work, I could get back to retrievals at a younger point. The clinic only lets you transfer two if you don't do PGT testing. However, I respect the argument that doing them at the same time could have resulted in a high risk twin pregnancy.

The only thing I wish I had been told is what to expect as far a timeline, before treatment. This probably should have come from the office. We had a hiccup with our testing (I rested positive for antibodies and I have O- blood type, meaning rhogam was still in my system) and the office seemed like they wanted me to wait another month or so because of this. I contacted my OBGYN who reached out and got the ball rolling.

Ask exactly what to expect for your problems. This may be a blanket answer or very specific depending on your problems.

I have had recurrent pregnancy loss with several chemical miscarriages, longer cycles, diagnostic testing that appeared more like PCOS but without the physical characteristics. I was placed on Letrozole 2.5 for 5 days after having an ultrasound to determine I was indeed not pregnant and an HCG test when I started my period. Then, after those 5 days, I had two ultrasounds, to see when my folicules were ready. Once the appropriate size, I was instructed to take a trigger shot. Then we had times intercourse as explained to us. We then had a positive pregnancy test and two bHCGs drawn to ensure progression. Then, at 6, 7&8 weeks we had ultrasounds to ensure growth.

Between genetic testing, lab work, co-pays, drugs, and ultrasounds it was about $1500.

At first glance, Dr. Johnston is very intelligent and knows her stuff. However, when a doctor tells you any alternative treatments you're doing is not going to help, or it's as if a cancer patient is choosing herbs over chemotherapy when you take charge of your own fertility, they're belittling you as a patient and a person, as if to say it is poor judgement on my part. I think if she had chosen to be more empathetic and compassionate with her words, we might have continued our work together.

If you do not feel supported in your journey and you're given limited options, do yourself a favor and find a new doctor.

In the end, because we were disqualified from the shared risk program, our saved funds could only cover two cycles at Dr. Johnston's clinic. We decided to move forward with a different clinic for treatment.

12,000 per IVF cycle, not including meds, PGS, ICSI, cryo-preservation, OR multi-cycle discount for 18,500 (2 cycles) were what I qualified for, unless I agreed to donor egg IVF and I would have qualified for their shared risk program.

She incredibly thorough, kind and a great sense of humor which can make difficult situations less difficult. I felt very confident with all her courses of treatment and she was always spot on with what she’d expected. I never felt rushed or pushed. She always gave very thorough answers to ALL of my many many questions no matter how silly some of them were. I was always very confident in her decisions. I’m very thankful to have used her during some very difficult experiences.

She knows what she’s doing, so you can feel confident to trust her plan.

After multiple Miscarriages from having a Tubal Reversal to try and repair my tubes with a different dr, Dr.Johnston first preformed an HSG to be sure there were no blockages. The next step when I had another Miscarriage was to take 5mg Femara on CD 3-7 to try and encourage my good side/tube for the embryo to use which could then prevent possible ectopics that I was experiencing on my left side. The first two cycles I did in fact ovulate on my right side just as she predicted, the third cycle it was my left. After not getting pregnant during those cycles I chose to take a break. When I went on to have more Miscarriages she started to encourage IVF and that bypassing my tubes would give great chances of success. I was never open to trying IVF but feel more confident after speaking with her to try that path which is where I am now.

My HSG, Bloodwork, And Medicated cycles were all covered by insurance. The quote I was given for IVF was 8995 for the procedure. An estimate of anywhere from 3000-7000 for IVF meds and another 2000 roughly for embryo testing. Around 500 a year to store fertilized eggs. And then around 3000 per FET cycle not including meds

When discussing IVF she highly encouraged an eSET due me being Type 1 Diabetic and the Toll that twins would have on my body.

Dr. Johnston communicates effectively with her patients, even calling them herself at home if questions arise. She has made every effort to include us in decision making for treatment options. There have been several times where she has spent additional minutes out of her busy day talking to us like people, not just her patient and spouse. Her bedside manner is second to none.

She is worth waiting weeks for an appointment with.

She started me on femara with Ovidrel with timed intercourse following 2 failed rounds of clomid. We then moved to injections of menopur with ovidrel for three IUI cycles, in hopes of increasing my number of mature follicles

most not covered under insurance. Injectables for IUI were partially covered as were labs. The IUI and numerous US are out of pocket expenses

She was very nice and informative. She spent quite a while with my husband and I and answered any questions I had. She made us feel like everything was going to go great and we had great chances for success. However, after only 1 embryo to make it out of 10 eggs and no explanation, I was kind of put off. There was no "answers" to be had, however Dr Johnston did seem compassionate and understanding about the cost of treatments and not being able to afford further treatments

Go in knowing that although you could have a 99% chance of conceiving, things still may go wrong.

I used menopur, Lipton, /and gonal F during treatments. We used a birth control antagonist protocol before Begining. We did this because she said we should have great eggs, egg quality, and be able to produce lots of good embryos given an Unexplained dx, and young age.

I paid for all blood draws. Typically about $100 each time. I also was billed for some of the IUI, and for IVF. Still currently owe about 5,000 from last IVF

She was knowledgeable and compassionate. She listened to every question we had even if they were silly. She always made sure we understood everything that was going to happen and every side effect from whatever medication we were trying next.

Don’t be afraid to ask dumb questions.

I really don’t remember exactly- we were prescribe gonal-f and other medications the first round. Thw first round resulted in four embryos, two of which were implanted and two were frozen. The first transfer resulted in miscarriage after 8 weeks. We then did a frozen transfer that resulted in a chemical pregnancy. During our third round our medications were changed. We got 5 embryos but only two made it. We implanted those two and the result was my now 2.5 year old son.

For all three rounds of IVF we were close to $50,000

Our option was always one or two embryos transferred, never more. I preferred two because it gave me a better piece of mind.

On day one with Dr. Johnston she candidly told me at my age she would move straight to donor eggs if my objective was to have a baby. She showed me the statistics of other options. She was informative and supportive. She spent as much time with me and my Husband as we needed to answer all of our questions. After the first meeting I had her email address. I didn't hesitate to use it and her response time was amazing. Our first two transfers resulted in negative betas. After each she sat with me to plan our next steps and to answer long lists of questions I had. She allowed me to be involved in the protocol planning. When I had ideas she was open to them. After the 2nd negative result she ordered aggressive testing and found an issue which she was able to correct. The next transfer resulted in a positive beta. My betas don't double like other people's betas. Because of this, I didn't get my results from the lab or a nurse. Dr. Johnston worked directly with me through this. She explained what would likely occur and kept me informed of what to expect. When my little wonky beta turned into a heartbeat and numbers aligned to what the norms are I think she was about as happy and excited as my Husband and I were. Dr. Johnston worked with me to plan my 2nd pregnancy in a manner and time-frame that worked for my Family. Throughout my journey she was not only the doctor, she was the overall care manager. She individualized my plan of care to meet my goals. She directed her staff in a manner that made each step as painless and as efficient as could be. She accepted and worked with my need to be involved in each step. She offered the information needed to allow for true informed consent. She stayed focused on the big picture while not missing a single detail. I have a Known Donor. As she did with me, she took prodigious care of her. Donors provide no income to facilities. All of their expenses are incurred by the intended parent(s). With Dr. Johnston it isn't about generating revenue. It's about offering the care it takes to help women come our of the nightmare journey of infertility with a baby(ies) in her arms. She will treat everyone with respect and dignity and be as gentle and thorough as possible. I've taken my Children back in to show off to the staff and Dr. Johnston. It feels like coming Home. They still care about me and they care about my beautiful Children they helped bring into this world!

Listen to her and talk to her about your wishes and needs... she has the knowledge and your best interest at heart. She probably wants you to have a baby as much as you want it.

The below is from memory and my oldest Child is 3, so I could be forgetting parts. Also, I had previous to infertility had tests related to blood-clotting factors, so these were not part of my protocol, but would have been if it had not been done previously. 1st cycle for me and Known Donor... Lupron, Estradal tablets, Vivelle Dot patches, Progesterone in oil, Follistim, Menopur, hCG trigger, and antibiotics for my DH and Donor. Transferred 2 fresh embryos. I think this is all pretty run of the mill. (Negative beta.) 2nd cycle: Dr. performed a SIS. Same protocol for me minus Lupron. I did acupuncture as well. Transferred two thawed embryos. (Negative beta.) Prior to 3rd transfer: Hysteroscopy and an endo biopsy. The hysteroscopy uncovered a medical issue that was corrected during the procedure. The issue was probably what was keeping implantation from happening. We did some basic immunological testing at this time as well, but I do not remember the specifics. Dr. Johnston was open to every idea I had during our appointment following the failed transfer. We discussed all options and decided together how to move forward. 3rd cycle: Same protocol as 2nd plus low-dose aspirin, Medrol, Folgard, and Valium at transfer. Continued with acupuncture. Transferred two thawed embryos. (Positive beta resulting in a live birth!) I remained under Dr. Johnston's care until we heard a heart beat and was release to my midwives' care. 4th cycle: My period returned on its own, so we did a "natural" cycle protocol. I was still breastfeeding my Daughter during this transfer, so medications were limited to what was not contraindicated. Transferred onethawed embryo. (Positive beta resulting in 2nd live birth!) My Family is complete.

I do not remember the specifics for the fresh transfer, but know it was in line with what other clinics charged. An FET was $2700 (2012 & 2014). Because our insurance covered very little, but we still paid as we went, we were given significant discounts of overall costs. Patti, in billing was great!

I have been under the care of Erika Johnston-MacAnanny and 2 other doctors from other clinics. She is the only one that treated me as a person that she understood my goals and really wanted to see me succeed. She didn't make me feel like it was all about the money as they did. She made me feel uplifted in my journey regardless of the outcome.

Be honest with her regarding your goals

She has used clomid and IVF

about 8500

No comments

We did one round of IVF with ICSI, PGS and 2 FET (first one ending in chemical). When we first met Dr. Johnston-MacAnanny she was very straight forward about our unexplained infertility diagnosis. During our first meeting she had clearly reviewed our charts and knew everything we had been through and already had a plan In place for us based on her opinion and was very positive about the likelihood of use having a baby. She was very comforting. She was willing to start treatment as soon as we were ready. We were very excited about not having to wait months to get started, especially after all we had been through. Of our 13 embryos only 4 came back genetically normal from PGS. We transferred 2 embryos durning our first FET which resulted in a chemical. The staff were heartbroken for us and very supportive. Dr Johnston-MacAnanny got us back in to review what may have happened and proposed a new plan. She remained positive which is what we needed! We proceeded with FET of our last embryo (one did not survive the thaw during the first FET leaving us with only 3 embryos). Dr. Johnston-MacAnanny ordered blood thinners for this transfer even though my clotting factors were normal and now we have a beautiful healthy baby girl!! Dr. Johnston-MacAnanny definitely had our best interest at heart. Her and her staff were caring and supportive throughout our treatment. We would not have our daughter had it not been for Dr. Johnston-MacAnanny and her wonderful team!

She is very nice and patient. She ensure not only that I was comfortable but my husband as well. She ensured no questions were had before the meeting was over. She is open to listening and willing to take all measures before IVF was the final decision

Be honest and ask your questions

STI testing Mock Trial Blood work including A1C Semen analysis Endocrinology Appointment

22450 IVF (no insurance) 150 mock trial 600 anesthesiology (no insurance) 50 doctor appointment

Currently approved 1 5 day embryo as my other test scores were good. Multiple can be discussed if IVF cycle fails

She has a fantastic personality and bedside manner and helps put me at ease when I visit. I tend to be anxious when I’m at the office! She is patient and willing to answer tons of questions. She can also back up answers with solid clinic data which makes me feel confident in her advice.

Go see her. You won’t be disappointed. She’s worth a long drive!

I am still in the early stages of treatment. I have completed all my tests to start IVF but she discovered an issue with my thyroid. So we are currently trying to get my TSH under control with Synthroid before we can proceed.

I have not started IVF yet but I will be paying out of pocket through their Shared Risk Program which runs about $30K.

I am not sure of her approach.

I had setbacks all along but she always had a new idea. She was always willing to talk about any questions or concerns. Her bed aide manner is great. Talks to us like people and even emailed me personally after I got pregnant.

Ask anything. I always asked questions about what was on ultrasound screens. She always explained.

Started Ivf because of my age. When we went through several losses still had new ideas and encoruragee us not to give up.

It was not cheap. We paid less that 12000 for procedure and 5-7000 for medication each cycle. Visits were 70 copay. Most visits were covered up my insurance

That was not an issue for us.

She has a great personality and bedside manner that can make even the most anxious person (me) calm. She is so compassionate and empathetic; she genuinely seemed as upset and disappointed as I was after each failed cycle. I love her! I want everyone to be treated by her!

Ask as many questions as you want about whatever you are concerned about. She will take as much time as you need to explain everything, and she treats no question like a stupid question.

I did three cycles of clomid then after a brief break, I had the procedure to check the patency of my fallopian tubes. That procedure is usually done first but I am allergic to the dye used, so Dr MacAnanny wanted to try a few cycles prior to the procedure since I could possibly develop some scarring from an allergic reaction. The procedure went well without any residual effects. Afterwards there was a month break then my medication was changed to letrazole. I was using the letrazole with a trigger injection when I got pregnant.

The VA paid for it.

From our very meeting, she was always great to work with. She was very pragmatic but also positive. It was clear that she cared about me as a patient. She did a good job of explaining the science behind my diagnosis and treatment. She was great about communication as well.

She is a wonderful RE and you should work with her if given the chance.

She used a very standard treatment given my diagnosis.

We did not make it to transfer.

No complaints at all from her! She helped and guided us through out the process.

None. She is great

I started at Shady Grove Fertility as a woman choosing to be a single mother by choice. I thought I would have a few IUI at most and have a baby. I was originally with a different physician at this same clinic in the beginning. From my lab results, I had/have diminished ovarian reserve. I went ahead with 5 unmedicated IUI under the previous physician. All failed. I decided to go ahead and try medicated IUI. By this time, I had switched to Dr Johnston for a second opinion. I couldn't accept that I had very few eggs at a relatively young age. I had my first medicated IUI (sixth IUI total) under Dr Johnston. I got pregnant that cycle, but it ended up being a ruptured ectopic pregnancy. Dr Johnston was quick to diagnose it at what would have been my first OB ultrasound. I was sent to my OBGYN where I had surgery. During the surgery, it was found I had/have endometriosis. I later had another medication IUI, which failed. By this time, I decided to move on IVF. I had a consult for IVF and Dr Johnston was honest that I really wasn't a good candidate for IVF with my own eggs. I decided to go with an embryo transfer with donor embryo. I am currently pregnant from that embryo transfer.

Be realistic in your expectations.

The first medicated IUI, I used clomid 50 mg and had a decent follicle response and got pregnant that round. It resulted in the ruptured ectopic pregnancy. The second medicated IUI, I used clomid 100 mg. I must have had an allergic reaction to the clomid as I broke out in a rash every time I took it. That round I ended up with a few follicles but only 1-2 were on the side I needed them to be (I only had one tube left at this point). That cycle failed.

I did two medicated IUI cycles under Dr Johnston, which were $1200 each plus the cost of medication. I moved on to an embryo transfer, which I decided to do the shared risk option. That was $16,800.

Reproductive Endocrinologists usually only suggest to transfer one at a time and it is no different with Dr Johnston. I was okay with a single embryo transfer.

She was straight forward and honest, but spot on. Visits were timely. My only reservation was that it was an on call physician who performed my procedure each time. That surprised me at first, but every physician was excellent.

She is smart and competent.

We used the highest dose for my stimulation in the setting of my diminished ovarian reserve. My treatments were stacked and my second retrieval was much more successful.

Approximately $7000 for the treatment and $5000 for medications.

Dr. Johnston is a compassionate doctor. I felt very comfortable and at ease with her during every visit. I never left an appointment with questions and she took her time to make sure I understood and consented to every step of our fertility plan. She made me feel very involved in the planning process.

Be patient and open minded.

We decided to start with medicated cycles. I was prescribed 5mgs of letrozole and Ovidrel. As explained to me, these medications are more effective for me as a person with PCOS. After 1 cycle with these medications, I tested positive with a viable pregnancy.

My treatment was not very expensive, especially when compared to other treatments. In total, we spent about $1,500 with STI testing for both myself and my husband, various screenings, genetic testing, and prescription medications. We did use our health insurance for many of the required tests.

From the first virtual visit, to my "graduation", Dr. Johnston and her team made me feel at ease. Throughout my entire fertility journey, they were supportive, warm, welcoming and overall made me feel as if nothing was my fault and we were going to handle it all together. Dr. Johnston was realistic, but optimistic, every step of the way and it was easy for me to believe it. With fertility treatments, I believe the mental aspect is a huge part. Although a very hard process to navigate, Dr. Johnston and the Shady Grove team made me feel hopeful, which help me keep the mindset that we would find success. It is crazy how much this team turned into a second family. I knew they were just a e-mail away and would have answers for me. Forever grateful and thankful for Shady Grove, Dr. Johnston and the entire team. If you want a medical team who cares, is honest and welcoming- look to Dr. Johnston. Thank you for your expertise in making my dream a reality.

Be honest, go in open-minded. Dr. Johnston knows what she is doing and trust is crucial.

We started with lots of testing, once PCOS was confirmed, we decided to move to try IUI. We used medically induced ovulation with Letrozole then used an Ovidrel trigger shot. Next day was the IUI and 2 weeks later we had a positive pregnancy test. During those 2 weeks, leading up to 7 weeks gestation, I was prescribed progesterone suppositories to help thicken the lining of my uterus.

She was from our home state and knew of where we went to school. She shared the experience of being away from a place we called home and gave us suggestions about where to find good food. Whenever we got what felt like bad news she was able to give us an action plan as well. She also reassured use after getting poor HSG results back. She was able to provide a diagnosis after years of misdiagnosis. She completed a laparoscopic surgery that resulted in minimal scaring.

Be open to what she suggests and take it into consideration even if the suggestion goes against your original expectations.

Paid over 5000 trying to get pregnant between the HSG and the laparoscopy. Then the bloodwork when I did not have insurance it was all very exspensive.