Gabe San Roman

Partnering with Dr. SR on our journey has made me feel more comfortable throughout the process. I am a very detail-oriented person and by default I think Dr. SR tries to keep the details out unless you seek them. For some the details can be stressful but for me, the more details the better I feel. When I would ask about details I would always get informational responses but did find I would need to ask. I think it is his way of "protecting" patients as they go through this but I value the detail and thoroughness. My journey has been long and we still do not have a baby yet but Dr. SR has made us feel comfortable about not giving up and always tweaking our protocol slightly with each step in hopes to give us our family. One sticky point for him is acupuncture - it is not something he believes in...so if you are looking for him to confirm its benefits you won't find it from him - he very much focuses on the pure science of infertility treatment.

Dr. SR will make you feel wonderful and hopeful it's one of his best features and he knows his field extremely well (why I have continued to see him as my specialist) - but if you want clarity and want to understand why different courses of action may be taken or changed, don't hesitate to ask - he will provide any details you want - just ask.

IVF Retrieval 1: menopur and gonal-f for 8 nights; cetrotide for the last couple mornings of the stim cycle. (14 retrieved, 14 mature and 100% fertilized, 6 made it to day 5, 2 made it through PGS testing) Transfer 1: Estrace 19 days prior to transfer; Progesterone suppositories starting 5-days prior to transfer; Positive pregnancy with strong HCG levels resulted but ended in miscarriage at 7 weeks Transfer 2: Estrace 19 days prior to transfer; Progesterone suppositories starting 5-days prior to transfer; Nonviable pregnancy resulted with minimal HCG level IVF Retrieval 2: menopur and gonal-f for 8 nights; cetrotide for the last couple mornings of the stim cycle. (13 retrieved, 10 mature and 8 fertilized, 7 made it to day 5, 3 made it through PGS testing) Transfer 3: (2 embryos) Estrace 19 days prior to transfer; Progesterone suppositories starting 5-days prior to transfer; Medrol prior to transfer and prednizone after; Nonviable pregnancy resulted with minimal HCG level Transfer 4: went with natural cycle; Medrol prior to transfer and prednizone after; negative result

If paying out of pocket and from comparing costs to friends seeing other doctors, Dr. SR's costs were slightly higher.

As we did PGS testing on all of our day 5 embryos Dr. SR preferred to transfer only 1 embryo. After we had two transfers that did not amount to the birth of a child, he did let us transfer 2 PGS-tested embryos on our third transfer.

Dr. San Roman understands that I am the type of patient that wants to fully understand the biology and the science of what’s going on. He takes the time to teach me, even draws diagrams while we chat to help me visualize. He is patient and actively listens when I speak. When I had a negative experience during a visit to an affiliate location, Dr. San Roman and his team responded immediately to address my concerns and followed up with me after. Even months later, during a routine visit, I was asked about that experience and if I have seen improvement, which I had.

Don’t be afraid to ask for what you want. I delayed asking for a more aggressive course of action and regret that I didn’t speak up sooner because they responded so amazingly.

First Dr. San Roman prescribed Femara to boost egg production. I started with two pills a day for 5 days and over time he increased doses to 4 pills per day. 4 pills seems to have the best results, producing 4 follicles this past cycle. Out of the 11 cult leader we have gone through with Dr. San Roman I have used ovidrel 4xs and novarel 1x to trigger ovulation as ovulation prediction tests were not working. I have also undergone 3 IUIs with unfortunate negative pregnancy results.

I pay a $50 copay each visit (2-3per month) My insurance only partially covered bloodwork and sonograms so I pay an additional $75 for each visit. I pay out of pocket for for IUI, $350 per cycle. Trigger shots are approx $150 per cycle and femara medication is less then $20 per cycle.

Dr. San Roman makes you feel comfortable with him from the beginning but I believe he thought that I would be an easy case and a year later we don’t have any new information that could help in conceiving, although we’ve had several failures.

Be persistent and make sure that protocols are being looked At even when they seem to be working.

He thought that I would be very easy so he started off slow. My first cycle I was prescribed low dose letrozole and a trigger with iui which resulted in one large egg. The second iui they prescribed an increase in letrozole with the trigger and two eggs were produced. Round 3 was the same letrozole but natural ovulation with 2 eggs and the 4th on was the same letrozole, natural ovulation with 3 eggs. The 4th round resulted in a positive pregnancy test with a d & c at week 9 because the embryo did not grow. Genetic testing revealed there was an issue with chromosome 4

Much of it was covered under my insurance besides about 9,000 for the ivf cycle and the copays of 50 or 30 per visit

Again his bedside matter was amazing, he remembers you by name and interests not just by face. Always welcoming. I wish I only saw him and no one else. The only thing I would change, when you’re dealing with “unexplained infertilty” If he showed more interest in digging a little deeper to possibly find an underlying cause somewhere. Instead of repeating the same cycle of meds 3-5 times in a row and getting the same response. Nothing more nothing less. I was up for change to try anything. But when you don’t see only him and bounce around thru the clinic I feel like it’s hard to meet goals.

Try to communicate exactly what your goals and expectations are.

Treatment protocol, 3 day of cycle , sonogram. Started a round of drugs, came back for monitoring twice. Triggered and went in for IUIs. Got 0 results and repeated the same medication atleast more then three times in a row, upped the dosage once . I feel like personally after the third time and getting the same failed result something somewhere should have been changed.

Everything was covered I paid for medication and copays. Ivf I was told was covered but turned out it was not

N/a

Dr. Gabe is sincere and authentic. He is personable and open as a doctor. He has a good sense of humor and also knows when to be serious and get down to business. He adjusts his approach based on the patient’s needs. I always felt heard and respected. He walked through options and concerns with me and we decided on courses of action together.

Be honest and assertive with what you want. It’s your health and family on the line, not the doctor’s.

We started with fertility pills, 5 rounds of clomid. I produced many mature folicles, but none led to pregnancy with intercourse. The last round was IUI, to try and increase the chances of a positive pregnancy. It did not work. Then I moved to injectibles. They provided the first round for free. I produced 4 mature folicles, but no pregnancy resulted from intercourse. Dr. Gave adjusted the medication to focus on egg quality. 13 eggs were retrieved the next round, but again no fertilization happened. Again the medication was adjusted and I was out on pure LH to boost egg health. He also recommened herbal supplements. This time 6 eggs were retrieved and 5 fertilized. The first transfer at day 5 did not take. I suggest transferring 2. Dr Gabe talked to us about risks such as twins and even higher order multiples. He thought transferring 2 was a good move since we had been trying for years, and we agreed with this plan and transferred 2 eggs, which resulted in our beautiful baby girls.

They provided the first round of injections for free, and a part of my treatment it was covered under my insurance. When insurance did not cover, office visit were $250 and ultrasounds were additional.

Ok glad we tried one the first time and that dr. Gabe spoke to us about the risks of transferring multiple embryos and life with multiples.

in my experience, dr san roman is very warm and has a great bedside manner. He definitely has a bit of an ego and likes to recite his accolades almost every time my husband comes with me to our visits. he is incredibly sweet and seems to be very knowledgeable, however his office is a bit disorganized

be wary of the nurse practitioner's running the show...if things aren't going smoothly in your cycle, it is difficult to get in touch with him in the early stages...after going through a total of 2 ivf cycles and 4 failed transfers with pgs tested embryos, there is still a lack of continuity in the care that is received and the attention that is paid to the cycles

my first stim cycle, I was placed on 1 vial of menopur and 150 of follistum, but ended up doubling that dose 3 days in...stimmed for 14 days and got 8 eggs, 7 mature. My second stim cycle, I was placed on 2 menopur and 450 follistum and stimmed for 7 days and ended up with 7 eggs. I was told when I went for a second opinion that my second cycle was an incredibly high dose especially for someone with a high ovarian reserve. We also ran into a few bumps in the road with our transfers. Our second frozen transfer was rushed, ended up with a beta of 18, but my lining wasn't responding as well as it had in the past...that ended up being a chemical. The second ivf cycle with a fresh transfer, I was told to be on progesterone 2 times a day before the transfer by the nurse, then the dr said once a day...but discontinued everything due to high progesterone levels, in which my level went from over 100 to 50 then to 2...which was never going to sustain anything....

each stim cycle was around 15,000 an additional 4,000 for pgs testing and then an additional 350/embryo at the lab...also 500 for anesthesia for retrieval stim meds were not included in the 15,000

he's preference is to transfer 1 embryo if they are pgs tested

This man showed such compassion for me and my husband. It was more than you just being a patient. He truly cared about you and the obstacles you have been trying to overcome. On the day of my egg retrieval, I had a moment of self-pity and started to cry during this woe-is-me moment (while I was on the OR table). He just stood there and held my hand. He distracted me until the anesthesia kicked in. I will never forget that kindness. With my previous doctor, I had to terminate my pregnancy at 22 weeks due to severe fetal anamolies. I switched to Dr. San Ramon after some more failed attempts with my original doctor. Gabe was so sympathetic to how hard that was to us.

Trust this man. He will help you and make you grateful that you picked him to help you during this emotional journey. You will never look back or second guess having him as your doctor. I will be forever grateful to have been in his care.

Very organized with tolerable wait times.

Fresh embryo transfer was in the $10,000 range. Frozen was around $3,000. IUIs were covered by insurance but medications were not.

He preferred to do a single transfer. In his eyes, a two embryo transfer didn’t increase your overall odds of pregnancy by much. He felt that I had already experienced losing a baby at 22 weeks and didn’t want to put me in that position again, since a twins pregnancy was very risky. I more than agreed and trusted his expertise.

Dr. San Roman is very warm and took the time to explain procedures to us. He is very busy as the only doctor operating out of the office so more often than not, we met with the nurse practitioner and not the doctor. I feel that he is too willing to try the same treatment without really changing the protocol after failed procedures. I felt I had to advocate a lot for myself for him to change our protocol when we got less that optimal results from my first egg retrieval and failed frozen transfer.

Advocate for yourself—do your own research and press him to consider other protocols when the basic protocol does not work for you.

It was an efficient-well oiled machine— you got an appointment time which staggered patients, but the wait times could still get quite long

Dr. San Roman was unwilling to transfer multiple embryos because we did PGS testing.

I felt like he was really knowledgeable, deals with my specific case, is sensitive and informative, and has good bedside manor. He is trustworthy and listens to what I’m saying and remembers who I am which is really important for me in such a difficult process.

Make sure you book your consultation 3 months in advance because there is a waitlist lol!

Clomid 100mg 1 round- bad reaction to clomid. Switched to Femera with Ovidrel trigger.

Dr. San Roman is an amazing doctor and person. I and my partner felt at ease and well informed with him. He takes the time to get to know his patients. He was referred to me by a friend who had much success and had a baby girl with his help. I would would recommend him wholeheartedly to couples trying to conceive.

Do not give up and stay positive!

He was very meticulous with how and when to take the medication and well as the the rest of the process.

It wasn’t as expensive as I expected it to be, especially since we paid out of pocket.

Dr. San Roman never makes you feel like just a statistic, he is always patient, kind and listens to your concerns. He tells you exactly what the course of treatment will be and what the chances are of success.