James Nodler

Doctor Nodler is probably one of the more conservative RE’s at CCRM. He studies the practice of reproductive endocrinology diligently and will very rarely steer treatments toward any protocols that have not been “proven” or studied. In saying that; he knows how to adjust protocols when previous treatments were not successful. My first cycle with Nodler was cancelled and never went to retrieval. My subsequent cycle he completely adjusted my protocol and after 2 retrievals we ended with 2 highly graded blasts that both tested PGT normal. He listened to my husbands suggestion to add HGH (omnitrope) to our cycle and encouraged us to take certain measures with lifestyle and diet changes.

Be prepared for factual, straight forward approach to your individual situation. He is kind and very knowledgeable, but not overly emotional or compassionate which worked great for us. CCRM does not vary greatly in their prescribed protocols and so Dr Nodler will use a “pre set” protocol depending on your individual infertility diagnosis. We had a treatment plan from a different fertility clinic and he vetoed almost everything they suggested. We trusted him and are so far happy we did as we have 2 euploid embryos on ice.

For my first ever cycle we did an antagonist protocol with estrogen priming for 10 days. Max dose of Follistim and Menopur w/ dexamethasone + ganirellix. That first cycle failed and it was cancelled. I did not even get to a retrieval. Our next 3 cycles we did a protocol of clomid 100mg, dexamethasone, omnitrope, 3 vials of Menopur plus ganirellix. I retrieved 3 eggs per cycle for cycle 2 and 3. Cycle 2 ended in 0 fertilized eggs. Cycle 3 ended in all eggs fertilized, 2 blasts, 2 PGTA normal.

About $20,000 per cycle not included meds. Medication is between $3000-$6000 per cycle. Finance was simple as we self paid everything. Regroups and doctor visits were not included which we found disappointing.

We have not yet transferred. We are doing one more retrieval to bank more embryos.

Dr. Nodler is smart, kind and strikes the right balance of setting realistic expectations but also providing hope. He has good attention to detail and really seems to care about his patients' outcomes. I like that he practices evidence based medicine, but this means his protocols/approach may sometimes feel less holistic (not a lot of time spent discussing supplements and other TBD ART supports). I thankfully haven't had any major disappointments to date, so can't comment on how he might adjust/personalize protocols in the event of disappointing outcomes.

Ask questions and share any concerns you have- I've found Dr. Nodler is always happy to provide more information or explain his thought process.

IUI was really managed by the nurses. I have a high AMH and was prescribed clomid only (no injectables). Monitoring was overseen by Dr. Nodler, but the actual IUI was performed by the nurses. I had a different nurse each time, and no specific point person if I had questions during the cycle (just had to call the nurse line). I didn't feel like IUI cycles were a priority for this clinic. My experience was totally different once we moved on to IVF. IVF patients are assigned a specific nurse and this makes communication much easier. Monitoring ultrasounds were done by Dr. Nolder (or the REI covering for him if he was not available). I was prescribed gonal-f (150), menopur (150) and cetrotide. I responded well to meds and my protocol did not need to be adjusted. I did a dual trigger with lurpon to avoid OHSS. We did ICSI as that is standard for my clinic (and as we used frozen donor sperm). We retrieved 16 eggs, 13 mature, 13 fertilized, 9 day 5/6 blasts, 4/9 normal CCS/PGS results. Recovery from the egg retrieval was easy and fast. Our first FET cycle is currently in process.

IUI: $1,300 per cycle (including all monitoring) IVF (PGS with FET): $20,630 (included all monitoring, CCS/PGS and first FET), NOT including medications

I personally feel very strongly about eSET and Dr. Nolder was aware of this from the beginning so multiple embryo transfer was never a conversation we had. I do believe this clinic does more multiple embryo transfers than is ideal because they are quick to honor patient wishes and I think many patients ask for multiple embryo transfer.

I have only done the consult and initial labwork thus far. I am pretty far in my age (early to mid 40s) as far as options. He also took the time and asked me to thoughtfully consider what are my ultimate objectives, and weigh my options accordingly, with out passing judgment on and one option as better than another. Dr. Nodler and his staff have been professional, courteous and took the time to explain my options at this stage, from medical, financial, the process, drugs, donor bank options, etc. I was very impressed. I am have one additional consult scheduled, but because of the location and how I have been treated thus far, I am confident I will likely proceed with Dr. Nodler and his staff at CCRM.

Be prepared with questions and clear as to what you are hoping to accomplish in seeking the services of the clinic. Dr. Nodler reviewed the medical chart and fairly presented all options.

I have not gotten to this stage just yet, but hope to be at this stage very soon.

Too early, but they seem in line with other clinics. All of the cost options were thoroughly explained and laid out in specific packets of information based on the treatment options.

None - not applicable yet. Though I did ask and confirm that Dr. Nodler has a preference for eset, which is in line with my preference as well.

Dr. Nodler was both compassionate and effective as my physician. I had a very challenging diagnosis and he was honest with me from the beginning about the likelihood of success/me achieving pregnancy. When I wanted to speed up the timeline, he worked with his team to make that happen. When treatment outcomes didn't go as planned, he always reached out to discuss the next steps. I had never had a male OB/physician before, but I completely trust Dr. Nodler and think he has excellent bedside manner in addition to being a great physician.

Don't hesitate to make your appointment!

Utilized Gonal, Menopur, and Ganirelix for my egg retrievals which was very successful

Initially our insurance did not cover CCRM so we paid entirely out-of-pocket but were offered a decent discount by the clinic

I cannot rave about Dr. Nodler highly enough. He really gave the impression that he cared about me as a person and as a patient and was personally invested in seeing me succeed. He was willing to personalize my treatment even if it meant additional monitoring and weekend appointments. He also made sure that I was taken care of when I needed care between cycles and on occasions when I had issues with the billing department. He treated me skillfully but also with compassion. At the same time, he did not sugarcoat or just tell me things I wanted to hear, but made sure that I had full understanding even if the news wasn’t desirable.

Don’t expect to be coddled. He’s realistic and pragmatic, and that sometimes means hearing something you might not want to.

All three retrievals were a microdose lupron protocol with minimal birth control priming. I responded slowly but well and they resulted in 2, 2, and 4 viable embryos respectively. First transfer was a standard hormone replacement therapy frozen transfer. It was delayed a week due to thin lining and resulted in a failure. Second transfer using the same protocol was cancelled due to covid. Third transfer using the same protocol resulted in an allergic reaction to estrogen patches, so I switched to oral estrace. That transfer was delayed a week and then cancelled due to thin lining. For the fourth transfer attempt, Dr. Nodler suggested a natural cycle with letrozole. Although I responded well and ovulated naturally, that transfer was cancelled due to thin lining. For the fifth transfer attempt, Dr. Nodler allowed me to continue with a natural protocol plus letrozole because I found that I preferred it to the HRT. That was my second actual transfer, which we moved forward with even though lining was at 5.7mm, and it resulted in a pregnancy. That pregnancy ended in a missed miscarriage. Dr. Nodler performed a D&C at weeks. For my sixth transfer attempt, we did another natural transfer with letrozole, and that time I added in Gonal injections and an Ovidrel trigger to thicken my lining. That successfully thickened my lining to 7.6mm and resulted in a pregnancy.

Roughly $15,000 per retrieval and $3500 per transfer, not including meds.

Detailed, thorough and direct in his explanations. Presented a clear point of view on different treatment options, which really helped cut through the noise and confusion. I always felt like we had a defined direction and were moving forward.

Like with any RE, come to the consultation prepared with questions.

Antagonist protocol with combo trigger. I think this is relatively standard for a first cycle and mild PCOS. I responded well to the meds, so was able to stay at the starting gonal f and menopur doses throughout stimming. We did ICSI as we wanted genetic testing and the lab required ICSI to do CCS testing. Ended up with six normal embryos, so only had a single retrieval cycle. FET protocol included birth control, estrogen patches, Lupron, and progesterone suppositories and shots. Responded well, transferred one, and now pregnant with a singleton.

Usually there were only one or two others in the waiting room in the Fannin location for blood draws and ultrasounds. I don’t recall ever having to wait more than 5 or 10 minutes to be seen. The Memorial City location, where weekend appointments are held, is more busy on those weekends, so you might have to wait slightly longer for blood draws. Still, those appointments were always very fast and efficient.

We tested our embryos and wanted to transfer one. This was my doctor’s preference as well, so no real discussion was had.

Dr. Nodler is energetic and really easy to talk to. He's always made us feel really welcome and comfortable in his office. He explains things really well and doesn't mind taking time to elaborate if you need more information. I was referred to him first for a needed surgery to resect a septum in my uterus. My surgery experience with him was fantastic - he visited me before I got anesthesia and chatted with us to make sure we were doing okay. After my surgery he came out and spent time with my husband explaining how everything went and answering his questions. One time, I scheduled an appointment thinking I was coming in for a hysteroscopy surgery follow up appointment following the beginning of my next cycle, but apparently the lady who scheduled me didn't understand exactly the type of appointment I needed. I don't think I explained it very well on the phone. So when they brought me back, they took me to his office and he was just there waiting for me and asked me what was up and was totally open and ready to talk to me - not knowing why I scheduled the appt but ready to help me out with whatever I needed! When I explained why I was there he was like, "Oh, great! Yeah no problem! We'll get you right back!" He didn't make me feel stupid at all for miscommunicating, and I just thought it was really cool that he was so relaxed and kind and understanding despite the mix up. I didn't see it as a mistake the office made, I saw it more as good adaptation on his and his staff's part to something unexpected coming up. After I was completely recovered from surgery and we were cleared to start fertility treatment, he gave us the pros and cons of medication alone vs. IUI vs. IVF. He was informative and was okay to do whatever we felt was best. We really didn't feel pressured. We did one cycle of Clomid alone and one IUI cycle. Although they didn't work, I felt good about the overall experience and the care we received. We will likely be moving on to IVF later this year and he has already been really informative and helpful throughout our preparation process.

Come prepared with your questions ready. He will be happy to answer all of them, but you should be ready beforehand.

Monitored clomid cycle - $700 Monitored clomid cycle with IUI - $1300 IVF retrieval without CCS ~$14,000 Frozen transfer cycle ~$4,000

We haven't done IVF yet but are planning to later this year. Because we are young (26), he said he will not transfer more than one embryo to start. I believe that he is willing to with older patients or patients who need improved odds. For us, at least to start, he said it was not an option to do multiples. Which we were fine with.

We didn’t have success with Dr Nodler but we would recommend him 10/10. He is intelligent, up to date, and runs a very strict evidence based practice. He definitely does not treat you like a Guinea pig. That being said, he isn’t willing to implement interventions that aren’t well studied or proven... but I definitely prefer this science based approach to the experimental (and frankly, cavalier) approach seen at many other area clinics

I would follow his recommendations. He is well aware of the data and will guide you accordingly. If you are wanting something experimental or way outside the normal confines of ivf treatment, I would suggest going elsewhere. In Houston- he is definitely the doc I recommend

Microdose Lupron protocol - no embryos to freeze. Immediately followed by antagonist protocol with 3 Pgs tested embryos to freeze. Had 3 failed fets. 2 eras and a receptiva test

I went in the afternoon Bc if my work schedule. The clinic was very accommodating with this

Don’t remember but the clinic didn’t pester you for money

Yes. Dr nodler subscribes fo eSet which I think is the right thing to do.

Dr. Nodler is really knowledgeable and really nice. Sometimes, though, I felt like he wasn’t putting the research into our case. It was “unexplained infertility” and move to IVF instead of figuring out the cause of our infertility that could maybe be fixed by diet, supplements, or lifestyle changes. He has been great though, especially since the many failures and setbacks we have had, even calling me personally after we lost our baby at 10 weeks to unknown issues.

Ask lots of questions and request all the details.

We first did our blood work and scans and I had a minor septum so we did surgery on that. We then started with 3 IUIs using Letrozole, which didn’t worked. My insurance covered three which is why we did 3 but that is also normal protocol. We then moved to IVF using Menopur and Follistim. Our goal was a fresh cycle but I had over stimulation so we froze the eggs, 4. 3 tested normal during PGS and one was unknown. We then did a FET once my body got back to normal. FET 1 worked but at 10 weeks we had to terminate due to the growth of the organs outside the fetus body. It was never determined if that was genetic related. Have a long recovery from the D&C we did FET 2 which ended in a chemical pregnancy at 6 weeks. Currently waiting to start FET 3. All FETs have been the same protocol: 3 weeks birth control, lupron, estrogen patches, PIO, and progesterone suppositories.

IUIs, labs, egg retrieval and FET 1 were covered by insurance so I paid 20% until my $500 deductible. FET 2 was $4,500.

I wanted to transfer 2 the first time but he wanted one as it is statistically better and safer. It didn’t work. For the 2nd FET I again pushed for two but he wanted one so we did one. We now have two embryos left so we are finally transferring two during FET 3.

The first thing I liked about Dr Noddler is how smart he was and how informed he seemed about the most up to date information. I consider myself an intelligent woman, so I went into our relationship having concerns and things I wanted clarification on. Dr Noddler without hesitation answered all of my questions and had a very sophisticated approached to my treatment. He was also lighthearted when needed and serious when necessary. I really enjoy being his patient.

Dr Noddler and his nurse use a very black and white protocol. The patient needs to know that every step of their plan is being carefully put together for each patient's best result

I have a very high AMH so my antagonist protocol had to be very closely monitored. The reason I switched to Houston IVF and Dr Noddler is because my previous clinic and Dr over stimulated me so badly that I ended up with severe OHSS. To the point I had to have my belly drained. This was my biggest concern when I first met with Dr Noddler, and he took my concerns very seriously. He tailored my program to stimulate me enough to get good quality eggs, but not so much to cause me an discomfort. With a perfect cocktail of drugs, I was able to produce 26 eggs, 16 fertilized, and 9 grew to 5 day blasts. out of those 9, 3 were graded 5AA the highest quality egg possible. I am currently still in treatment. I've had my 5 day blast frozen embryo transfer 4 days ago, so I can't comment if it worked, but so far this has been the best experience I could have hoped for.

Monitoring appointments were always at 7:30am outside of working hours, so perfect

20,500$

I demanded that I have an eSET because I'm petrified of having twins. I was lucky that I fit in the perameter of those that qualify to have eSET

My egg retrieval, fertilization and blastocyst results improved with Dr Nodler. I believe that this is the result of the protocol that Dr Nodler put me on. I transferred 2 PGS embryos, and both failed to implant. In the follow up, there were no explanations of why, just many possibilities. He suggested that I do an ERA (which I am doing) or use a gestational carrier. I am hoping for a more conservation solution.

Let Dr Nodler make his recommendations and follow them. He is the expert, not us.

For simulations, Dr Nodler used the antagonist protocol. It worked well. I do not know why he chose that particular protocol. Our main issue is male factor resulting from Robertsonian Translocation 13/14. He recommended CCS to screen all 46 chromosomes for abnormalities.

Egg retrieval, PGS (7 embryos), FET (1 time) = $21,000 ERA= $2,350

Due to my history of failed SET of PGS embryos, I requested to transfer 2 and he did. But he recommended I do one. I wish I had listened to him.

Dr.Nodler has all the merits on paper. He was referred to us by my husbands urologist. But he lacks compassion. When I explained to him that we couldn’t afford this procedure of 18K with my husband being in school and only myself working. He said to come back when ready. But I pushed ourselves and found means to borrow money from family. Even after this cycle failed he didn’t seem to go thru the explanation of the failure. A year later, I came across an embryologist and showed her the pictures of the embryos my clinic transferred. In one look she said they were really poor stage and should have done laser on them to help with implantation. At the time of transfer there was no talking and I could sense they were guilty of something. I asked what stage is it. It wasn’t even a blastocyst on day 5 and they still transferred them.

Please go to other docs in the clinic

18K

My doctor transferred 2 embryos

I have done 2 eff retrievals since I have a low egg count. We are currently in the process of transferring the only embryo we have. Dr. Nodler has been kind. He has listened to and answered all my questions. He has also provided different protocols, which I appreciate. So far, I am pleased with his care.

He is very straightforward, so be prepared for that.

We used the antagonist protocol. Since I have a low egg count, he recommended that protocol since it is more aggressive. We had a failed cycle with only 1 embryo that tested abnormal. If the transfer with the only embryo we had from our first cycle is unsuccessful, he suggested using another protocol, which we will try.

All the monitoring appointments are very efficient. All the nurses are friendly, and have a great attitude.

A little over 16k per cycle.

He recommends only using one embryo at a time.

James Nodler is an excellent doctor. After many years of infertility, we had great success under his care. I have twins, conceived on the first round of IVF. My experience was positive; every visit and procedure went very smoothly.

Ask lots of questions. He will explain in detail anything you are unsure about.

Dr Nodler explained all our options and we all (Dr Nodler, my husband and myself) felt comfortable with an IVF cycle. Ultrasounds were done to assess my uterus, ovaries and eggs. Blood work was done to screen for other potential issues that would prevent conceiving. We were able to proceed with no issues.

We did chromosomal testing on the embryos. We elected to transfer 2 embryos, understanding that chromasomally normal embryos would have a higher chance of implementing with no issues to follow. We understood that our chances of twins would be higher.

He is an awesome doctor. He definitly knows his stuff in the field and he knows how to communicate and make me feel at ease. It has been a crazy rollercoaster with it all and every time I see him he makes me feel more hopeful that this next time will work.

Trust him. He knows what he is doing. He is a great doctor and I put my belief in him.

families Treatment was 17,000 and then we had to pay for the meds and that was 3 to 4,000

He wanted me to do one at fresh but now that we have gone that route he definitly what's to put 2 in this time

We are still currently in the process of treatments as we recently had a failed IUI and are now starting our IVF treatment. So far, everything has gone smoothly and we have been well-informed on the process of IUI/IVF.

Always be open, honest and ask as many questions as you can. He is very professional and personable and takes the time to answer all of your questions.

My insurance covered three rounds of IUI and one round of IVF. Currently do not know the final cost of IVF.

Dr. Noddler knew my situation and my husband and I desire to have a child after beating Breast Cancer. He was very honest and straight foward while having compassion regarding my options and what he felt would be out best option of success. He knew that time due to my age was of an concern and was ready and available to proceed with all necessary testing and medication needing to be prescribed.

To trust his judgement and his process. He has your health and best success of conceiving as his primary priority.

I have not actually started my cycles yet, due to the COVID-19 things are on hold.

$22,000.00

So far I have been very happy with Dr. Nodler. He is honest but gentle for the most part in his approach. He seems very knowledgeable and came very recommended. I did a lot of research for going to him, and many of his patients were very happy with him as a doctor. Dr. Nodler didn't seem like he is in a rush, he took all of our questions every time we met with him in his office. He has also done one procedure and was very gentle and caring.

Have a list of questions already prepared.

I was diagnosed with an under active thyroid and have to take medicine. Get fibroids removed so I can continue with IVF treatment.

Our insurance doesn't pay for IVF so we pay out of pocket.