Dr. H-C blew our expectations away. We are now 11 1/2 weeks into our first pregnancy (ever!) and could not be more delighted with the help that Dr. Hirshfeld provided to get us here...The attentiveness to us as unique patients was truly remarkable. We also appreciated the evidence-based approach to our care and the recommendation to try something different, if what we were doing before didn't work.
[Fertility Centers of Illinois] Strengths: Dr. Hirshfeld & team. Dr. Hobieka, too. All of the Ultrasound Techs (Patti is #1) and the phlebotomists at both River North and Warrenville were just the absolute best. Also, Taylor and the reception crew at FCI Warrenville were remarkable as well. Weaknesses: trying to schedule/get through to the River North desk as very trying at times. Also, communication relying almost solely on the Patient Portal (prior to Dr. Hirshfeld's team) was challenging, too.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
We've been patients of Dr. Hirshfeld's for just about a year now, after a long and difficult history of infertility. When we became patients of hers and her team, we were assured that we would be kept in the know and that direction would be personalized to our situation. Dr. H-C blew our expectations away. We are now 11 1/2 weeks into our first pregnancy (ever!) and could not be more delighted with the help that Dr. Hirshfeld provided to get us here!
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Read up about Dr. Hirshfeld-Cytron on the FCI homepage and get to know and understand her a bit better, too. Realizing how much she wanted me to reach my goals really helped ease my mind about being seen as a patient/person and not as a number (which had been my experience at other clinics in the past).
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
There were never unanswered questions, unclear instructions, nor moments that left us scratching our heads. The attentiveness to us as unique patients was truly remarkable. We also appreciated the evidence-based approach to our care and the recommendation to try something different, if what we were doing before didn't work.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
Dr. Hirshfeld's first egg retrieval with us (in August of 2022), had me taking human growth hormone for the first time. We were informed that this medication can help with egg quality, I believe, and it did. We retrieved (7) eggs (I think) and (2) made it to the PGT testing; (1) to frozen status. In October of 2022, we did another egg retrieval with Dr. Hirshfeld, to similar success. In December of 2022, we did our first frozen embryo transfer, on a medicated cycle (our choice, since we had more control over the scheduling and timeline). It was unsuccessful, so in May of 2023, we did a natural cycle to prepare for our next frozen embryo transfer, which WAS successful.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Lindsey)
This box is not big enough to sing all of Lindsey's praises. I am the biggest fan. Lindsey would call and spend time on the phone with me, answering every little question to the best of her ability or finding out on her end before getting back to me. There was not a single instance that comes to mind where Lindsey left me hanging, confused, or 'in the dark' about what was going on. When I needed meds, Lindsey also helped provide guidance about using a mail order pharmacy. I am so very grateful for her patience and care.
Describe your experience with Fertility Centers of Illinois.
Strengths: Dr. Hirshfeld & team. Dr. Hobieka, too. All of the Ultrasound Techs (Patti is #1) and the phlebotomists at both River North and Warrenville were just the absolute best. Also, Taylor and the reception crew at FCI Warrenville were remarkable as well.
Weaknesses: trying to schedule/get through to the River North desk as very trying at times. Also, communication relying almost solely on the Patient Portal (prior to Dr. Hirshfeld's team) was challenging, too.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
Our only issue is an ongoing one with our insurance. No fault of the clinic; the insurance confirmed coverage and is now reneging on that confirmation.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
I am 41 and overweight with only (3) frozen embryos so, based on the stats shared with us, the directive was to transfer one at a time to mitigate the risk of pregnancy complications and to increase the likelihood of a successful pregnancy and live birth.
What specific things went wrong at Fertility Centers of Illinois?
Failed to inform you of changes in protocol
Failed to convey critical information
Describe the specific things that went wrong at Fertility Centers of Illinois.
Prior to Dr. Hirshfeld's care, we were with another doctor at FCI, whose team sometimes missed calling in and prescribing medications that were time-sensitive. There were a NUMBER of times that we had to scramble to get the necessary meds delivered and/or had to run to pick up emergency supplies that were donated to FCI. That was NOT pleasant. On top of the stress of everything else involved with IVF, procuring meds should not be added to complicate things.
Dr. Hirshfeld has a wonderful bedside manner. She is open, curious, and takes the time to listen to your concerns and history. I have never felt rushed in my conversations or time spent with her. She is able to recite and bring in the research that supports her decisions while doing so in a simple way that one can understand. She demonstrates a great amount of empathy and patience in the work she delivers.
[the Fertility Centers of Illinois nurses] have provided endless support via telephone when sharing disappointing or heart breaking news. They reply pretty timely when questions are submitted through the portal (they have up to 24 hours but usually respond same day)...Our first retrieval (fresh transfer) cost roughly $13,000 (not including medications)...The one downside of the clinic is that all procedures (IUI, IVF transfers, retrievals, polyp removal surgery) happen in the River North Location downtown which is quite inconvenient as it is further away and they do not have public parking.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld has always made me feel comfortable before a procedure. She takes the time to explain steps involved in procedures as well as answering any and all questions I've had. She has sat with me virtually as I shared my disappointment in failed cycles and fears of future success. The way she carries herself and expresses herself shows her many years of experiences. I can honestly say I cannot pinpoint a weakness of hers.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
One piece of advice I would give is to take the time to prepare before consultations including a list of your questions as she is very patient and will take the time to explain and answer every single question. You can also be honest about not knowing what types of questions to ask and she'll go from there.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld has a wonderful bedside manner. She is open, curious, and takes the time to listen to your concerns and history. I have never felt rushed in my conversations or time spent with her. She is able to recite and bring in the research that supports her decisions while doing so in a simple way that one can understand. She demonstrates a great amount of empathy and patience in the work she delivers.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
I began by doing two IUI treatments both which included Clomid. My body responded well; however, it did not achieve the desired results. I have undergone two egg retrievals and 3 embryo transfers (one fresh transfer, two frozen transfers). My body responded well to the medications used in the first retrieval (transfer fresh), I unfortunately do not recall all of the medications (a mix of menopur, Gonal-F, Ganirelix. This cycle ended in a negative pregnancy test. In the second cycle, we removed Ganirelix and incorporated Lupron and progesterone in oil. My body did not respond as well to these medications as I had a higher than normal estrogen level which meant I needed a frozen transfer instead of a fresh transfer. This cycle ended in a biochemical pregnancy. My third transfer was frozen but instead of doing a medication transfer we decided to try a natural cycle with the reasoning being that sometimes when your body is forced to ovulate and prepare itself it can have a different outcome than when it does it naturally on it's own time. My body seemed to respond well (some medications used: endometrin, progesterone in oil). We also decided to transfer two embryos this cycle and unfortunately this cycle also ended in a biochemical pregnancy. I am currently waiting for my next consult where we will be discussing another retrieval as well as a mock transfer to help better identify best placement of the embryo as well as medication adjustments.
Describe your experience with the nursing staff at Fertility Centers of Illinois.
The nursing staff is lovely and patient. They have provided endless support via telephone when sharing disappointing or heart breaking news. They reply pretty timely when questions are submitted through the portal (they have up to 24 hours but usually respond same day).
Describe your experience with Fertility Centers of Illinois.
They have several locations which is great although some locations were closed due to flooding and staffing issues through the pandemic. The one downside of the clinic is that all procedures (IUI, IVF transfers, retrievals, polyp removal surgery) happen in the River North Location downtown which is quite inconvenient as it is further away and they do not have public parking.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
Our first retrieval (fresh transfer) cost roughly $13,000 (not including medications). Our second retrieval (FET cycle) cost about $15,000 (not including meds), and our third cycle (just a frozen cycle) cost about $3500 (not including meds).
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
My doctor strongly encouraged us to only transfer one embryo the first two cycles and was open and willing to transfer two embryos in our third cycle. She did provide risks and research that supported the effectiveness of adding a second embryo to transfer.
If you are looking for a no-nonsense, fact based experience that gets results and don't need someone who is warm and fuzzy to deliver the good and bad news, Dr. Hirshfeld is a good option...I had diminished ovarian reserve and my husband had some motility issues. Dr. Hirshfeld prescribed some vitamins including Vitamin D and CoQ10 for each of us...I believe that Dr. Hirshfeld is well informed and I trusted her care. I wouldn't characterize her as a "warm" person, but rather she is straight to the point which for me was totally fine. I appreciated her direct answers, but I could see how some other women might need a warmer experience especially during such a trying moment in their lives.
She [nurse at Fertility Center of Illinois] spent as much time on the phone as I needed explaining in fine detail all of the next steps so that I could prepare my schedule and make sure we did everything correctly...The office has some issues. They felt unorganized and honestly is the reason I'm taking the time to write this review...we had a few issues with getting appointments set via the scheduler (Frank?) and also had an issue getting our final documents transferred to our midwives office when the time came.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I believe that Dr. Hirshfeld is well informed and I trusted her care. I wouldn't characterize her as a "warm" person, but rather she is straight to the point which for me was totally fine. I appreciated her direct answers, but I could see how some other women might need a warmer experience especially during such a trying moment in their lives.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
If you are looking for a no-nonsense, fact based experience that gets results and don't need someone who is warm and fuzzy to deliver the good and bad news, Dr. Hirshfeld is a good option.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
There is a slight "cattle being ushered through the field" feeling here. When we first came to FCI, I decided I didn't want to overwhelm myself with information from the internet and came to our first meeting(s) with no questions and an open mind. After some time, we felt like we were only being given the amount of information we needed at the moment, and after consulting with some other friends who had been through this process, we decided that we needed to be more pushy and advocate for ourselves harder. That resulted in a well planned out off-scheduled meeting with the doctor that was actually very helpful.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
I had diminished ovarian reserve and my husband had some motility issues. Dr. Hirshfeld prescribed some vitamins including Vitamin D and CoQ10 for each of us. I was prescribed Letrozole for 5 days, then after an ultrasound confirming I had a viable follicle I used the Ovidrel trigger shot and then took Prometrium every evening following. We had one unsuccessful IUI, but we got pregnant on the second try. I used Prometrium every evening until I was 9 weeks. I am now 16 weeks pregnant.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Christina)
I was very happy to be under Christina's care. Our first week we were with someone named Marny who was not very organized and was not a good communicator. When Christina took over we were relieved. She spent as much time on the phone as I needed explaining in fine detail all of the next steps so that I could prepare my schedule and make sure we did everything correctly.
Describe your experience with Fertility Centers of Illinois.
This clinic seems somewhat unorganized. My nurse was really helpful in moving things along, but we had a few issues with getting appointments set via the scheduler (Frank?) and also had an issue getting our final documents transferred to our midwives office when the time came.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
My insurance is pretty good so much of my costs were covered. I think I only paid for the ultrasounds and the prescriptions. All in all, with two rounds of IUI I think we spent around $500. After the first unsuccessful IUI I did more research on IVF and that would have been considerably more, in the range of $5K-$8K, due mostly to the prescription drugs.
What specific things went wrong at Fertility Centers of Illinois?
Failed to call in prescriptions to pharmacy
Lost paperwork
Lost appointments
Failed to call with results
Failed to send your chart to another clinic
Provided conflicting information
Failed to convey critical information
Describe the specific things that went wrong at Fertility Centers of Illinois.
The office has some issues. They felt unorganized and honestly is the reason I'm taking the time to write this review.
She [Dr. Hirshfeld-Cytron] didn't sugar coat anything, and also managed to be comforting and encouraging without making false promises about success. I had a terrible scare with a bleed about 2 weeks after my positive pregnancy test (post FET); I had the doctor paged and she immediately called me, listened to my fear that I was miscarrying, and reassured me that she believed the bleeding could have another cause- again, without promising anything. She turned out to be right, I was not having a miscarriage, and everyone was so compassionate towards me in that situation. She has called me from her personal cell phone to check on me. She is a kind, consummate medical professional.
They [staff at Fertility Centers of Illinois] were also incredibly kind and offered hugs and encouragement when I came into the office scared and upset after a bleed. The ultrasound staff, especially Jan, are fantastic and helpful. Definitely feel free to ask as many questions of the financial staff as you need to ask in order to understand payment options and insurance coverage. They do a good job of outlining things for you, and even when things become frustrating (as they inevitably do when paying for fertility treatments), they took the time to explain and answer all of my questions until things were clear.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld always clearly and patiently explained procedures, risks, and even drew diagrams to illustrate her explanations. She always gave me plenty of time to consider whether I had questions. She talked over options like genetic testing - which we almost didn't do- in the way that a friend who had been through this experience would explain it. She never talked down to me, just spoke plainly and clearly. She didn't sugar coat anything, and also managed to be comforting and encouraging without making false promises about success. I had a terrible scare with a bleed about 2 weeks after my positive pregnancy test (post FET); I had the doctor paged and she immediately called me, listened to my fear that I was miscarrying, and reassured me that she believed the bleeding could have another cause- again, without promising anything. She turned out to be right, I was not having a miscarriage, and everyone was so compassionate towards me in that situation. She has called me from her personal cell phone to check on me. She is a kind, consummate medical professional.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Ask as many questions as you may have, because she is totally willing to take the time to answer them. She is extremely compassionate and knowledgeable.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Everyone was friendly, comforting, treated me as an individual that they wanted to get to know. I felt that my becoming pregnant was as important to the doctor and the staff as it was to me. The nurses always responded quickly and thoroughly to my emails, and I was always made to feel welcome to ask any questions I had no matter how small the issue.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
Dr. Hirshfeld was aware that I had been a strong responder to Gonal-F in my previous IUI cycles at another clinic. I had cycles cancelled due to this issue. So her approach to my first IVF cycle was conservative in this regard, and as we went forward, she adjusted the medication up and down as needed. She was also trying to spare me the pain of OHSS since I was higher risk for that. At the same time, she wanted to get the most eggs since, given my age, there was a high likelihood that many of them would not develop to become embryos. Right before the egg retrieval, in order to get the most eggs possible, she prescribed another, second trigger medication which would allow the few remaining eggs that were right on the cusp of being mature enough to develop in time for the retrieval- without increasing my chances of developing OHSS. This strategy worked perfectly, as they were able to retrieve 25 eggs, with 20 fertilizing, 14 becoming embryos, and 4 of them making it to the day 5 embryo stage. We opted for PGS testing. Of these 4, two were normal, 1 was undetermined (needing to be re-biopsied) and 1 was abnormal. Dr. Hirshfeld counseled us to transfer 1 embryo, explained the success rates, and also explained our options for retesting the undetermined embryo. I did have some bloating after the retrieval, but I did not develop OHSS and Dr. Hirshfeld was very helpful in advising me on how to care for myself and decrease the bloating afterwards. I was put on estrogen and birth control to prepare for the frozen transfer, and one embryo (the best available, as we chose not to know gender at that time), was transferred. Recovery was fairly easy, lots of rest and 10 days later I had a positive pregnancy test at the lab.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Jen, RN and Myung, Medical Assistant)
Jen and Myung were absolutely fantastic- I was able to email them directly with my questions, they always called me promptly with test results, asked if I had questions, and treated my kindly and professionally. I felt very comfortable expressing fears, concerns, and doubts and they handled them the way a friend would. They truly made me feel like they knew me as a person and cared for my well-being.
Describe your experience with Fertility Centers of Illinois.
The front desk staff are very helpful, friendly ladies and I was glad to interact with them on a daily basis. They know a lot and really helped me with the paperwork side of things. They were also incredibly kind and offered hugs and encouragement when I came into the office scared and upset after a bleed. The ultrasound staff, especially Jan, are fantastic and helpful.
Definitely feel free to ask as many questions of the financial staff as you need to ask in order to understand payment options and insurance coverage. They do a good job of outlining things for you, and even when things become frustrating (as they inevitably do when paying for fertility treatments), they took the time to explain and answer all of my questions until things were clear.
Describe your experience with your monitoring appointments at Fertility Centers of Illinois.
It was a specific time window, and I would choose a specific time to arrive. I was able to bring my 3 year old daughter and the staff was very accommodating. Easy to schedule and felt very efficient. I never waited past my appointment time.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
We had to meet our deductible and out of pocket max, and with the high cost of the medications, this happened very quickly. Our out of pocket max was $6000. FCI required a deposit of $1500 to begin treatment and this was applied towards this amount. Insurance covered 100% of everything after that- ultrasounds, visits, labs, additional medications.
We also opted for PGS testing of the embryos, and we paid for this entirely out of pocket as it was not covered by insurance. I believe the cost of that was approximately $4200. We also paid $500 to freeze our embryos for 1 year, also out of pocket.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
She advised one embryo since she was very much trying to reduce the possibility of a twin or higher order pregnancy. This was extremely important to my husband and I, since a twin pregnancy was NOT what we wanted. Given that we opted to do PGS, she explained that the odds of a singleton pregnancy were not helped by putting in two genetically tested embryos. If we had decided not to genetic test, she would have considered transferring two embryos but this is not what we wanted to do, so her recommendation of PGS testing and a single embryo transfer is exactly what we decided to do.
What specific things went wrong at Fertility Centers of Illinois?
Failed to send your chart to another clinic
Describe the specific things that went wrong at Fertility Centers of Illinois.
It was not a big deal; my new OB simply did not recieve the records of my prescreening genetic testing or the PGS testing of the embryo from FCI. They were requested and sent later. I was given ultrasounds of my early pregnancy in hand by the FCI staff and brought those to the new OB doctor.
There were times I felt like she [ Dr. Hirshfeld-Cytron] was more interested in my partner's fertility chances than my own because my chances of going through a successful egg retrieval were low... However, at a recent appoint in the last 6 months, I felt like she started to "click" with us a bit better and really understood that my wife and I are both going through the fertility treatments as patients who might both conceive and not just a carrier and supporter. We have been seeing Dr. H for nearly 3 years and will stick with her through the remaining pursuit to have a baby.
nursing staff [at Fertility Centers of Illinois] were attentive, responsive and knowledgeable. I felt confident in the information they were providing and knew I would always get a response if I emailed a question... is run very efficiently - this is both a strength and a weakness. The strength part of this is you can get the appointments you need to proceed with your treatments, while also working and living your life. The weakness is that this can sometimes feel like you are just a number they call to perform another procedure. There are also times when things are running behind (30 mins+) and there is no apology/explanation,
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Perhaps my opinion is schewed by the fact that both my wife and have each worked with Dr. Hirshfeld to try to get pregnant, and we have not yet gotten a healthy embryo to implant, but I often felt like I was a lower priority than my wife because my probability of producing healthy eggs was lower. This would manifest in time spent focused on my options during a consultation and how quickly she recommended moving on to only my wife attempting egg retrieval. However, at a recent appoint in the last 6 months, I felt like she started to "click" with us a bit better and really understood that my wife and I are both going through the fertility treatments as patients who might both conceive and not just a carrier and supporter. We have been seeing Dr. H for nearly 3 years and will stick with her through the remaining pursuit to have a baby. Despite some of the concerns I had about her interest in my fertility options (as opposed to my wife's), I trust her judgement and appreciate her compassionate approach to the ups and downs of the last couple of years. She also always took the time to explain the processes in great detail, in terms we could understand, was honest about the percentages of success for most procedures and took the time to answer questions.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Make sure she understands your family dynamic and that you ask questions if you feel unsure that all options have been explored or offered.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
There were times I felt like she was more interested in my partner's fertility chances than my own because my chances of going through a successful egg retrieval were low.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
I started an egg retrieval cycle following standard diagnostic tests and consultation. IUI was not an option because of a blocked tube. My bloodwork and ultrasounds revealed that my estrogen levels were very low and only 1 follicle per ovary reacted to the drugs. Per this info, Dr. H said we could not go through with the egg retrieval.
We are now working to use an egg donor, and I have completed a new round of ultrasounds and bloodwork to prep for this process. I am now on birth control pills to regulate my cycle while determine the egg donor and associated paperwork.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Marni)
Marni and Dr. H's nursing staff were attentive, responsive and knowledgeable. I felt confident in the information they were providing and knew I would always get a response if I emailed a question.
Describe your experience with Fertility Centers of Illinois.
FCI is run very efficiently - this is both a strength and a weakness. The strength part of this is you can get the appointments you need to proceed with your treatments, while also working and living your life. The weakness is that this can sometimes feel like you are just a number they call to perform another procedure.
There are also times when things are running behind (30 mins+) and there is no apology/explanation, or even acknowledgement that they are running behind.
Efficient, but not always personal. However, when you need to go for an ultrasound and blood work each morning of a week, and you can get the appointment you need before work and are in and out in 30 minutes, generally you can count on FCI to make it happen.
I also find that the nurses and office staff to do acknowledge any person accompanying a patient for treatment. In my case, my wife would be with me for many appointments (or I would go with my wife for appointments), and as the nurse or office staff would call your name to go to the procedure - they would never acknowledge or greet the non-patient. I find this odd, since in many, if not most scenarios, the non-patient is likely a partner or spouse, who feel every bit as much patient as the actual patient through this process.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
We are lucky that we have insurance that covers some of the costs associated with fertility, but only to a point and for so many attempts. I feel that the cost most glaring was tied to the storage of sperm and/or embryos. That was a significant cost for us during this process and it is not covered by insurance. This is especially difficult to get a large bill like that following an egg retrieval that results in abnormal embryos that need to be destroyed (or used in research). Long-term storage of embryos or sperm seems reasonable, but short-term storage while viability is determined seems unfair.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
No comments as it is not relevant to my treatment to date.
Dr. Hirshfeld-Cytron was 1) willing to try a different / more aggressive protocol, 2) was willing to meet with me as many times as I needed to discuss my progress and answer my insane questions, and 3) was attentive to how I was progressing, having me come in more often for bloodwork and ultrasounds as needed (sometimes multiple days in a row) and adjusted my doses as needed...She tailored my protocol as necessary.
Because this clinic [Fertility Centers of Illinois] does everything in house they are flexible with the timing of your protocol and retrieval, which means no birth control to manipulate cycle timing. They deal with a large volume of patients so you'll see different techs and nurses, that's not necessarily a bad thing because you don't have to wait for your designated nurse to receive information...Overall, I was happy with the care of the entire FCI team, they all work together.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I came to Dr. Hirshfeld-Cytron after a terrible experience with another doctor that resulted in no viable embryos and a poor bedside manner. Dr. Hirshfeld-Cytron was 1) willing to try a different / more aggressive protocol, 2) was willing to meet with me as many times as I needed to discuss my progress and answer my insane questions, and 3) was attentive to how I was progressing, having me come in more often for bloodwork and ultrasounds as needed (sometimes multiple days in a row) and adjusted my doses as needed. I think that in our video conferences she could come off distracted as she is typing at the same time, but I think she's being diligent / organized in writing notes. I would say that she was realistic in her communication with me, IVF isn't a guarantee, but was willing to be creative. Overall, I was happy with the care of the entire FCI team, they all work together.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I would say that she can come off as distracted but really she's very attentive and is writing copious notes. She's willing to monitor on a daily basis if needed and adjust as necessary, I'd say that's not typical for most IVF Doctors. She's willing to share information, just ask for an appointment, this is a very busy clinic. She'll be creative if warranted, my first round of IVF yielded no embryos so she treated me like "one of her over 40 patients" versus my actual age of mid/late 30s. She tailored my protocol as necessary.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
FCI is a private clinic and the Doctors there are all partners. Dr. Hirshfeld-Cytron handled my protocol and was the Doctor that I had all zoom meetings with. Most ultrasound and bloodwork was with various nurses and techs, my egg retrieval and transfer were with different doctors as they rotate. That said, the clinic is really set up to be efficient and everyone was very kind. I could see how some people could feel like a number, but I really didn't. If I needed to speak with my Doctor I could could set up an appointment. I knew all protocol was dictated by Dr. Hirshfeld-Cytron so I felt very comfortable.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
10 days of stims
Lupron 20 units daily for 10 days (started 2 days prior to the rest of medication)
Clomiphene 100 mg for 5 days
Gonal F 300 IU (ramped up and down based on US and Bloodwork)
Menopur 150 IU
Omnitrope 0.3ML
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Lindsey V)
Overall I thought they were wonderful and always treated me kindly. They were definitely told not to share too much information during ultrasounds but sometimes I could get a chatty US tech. There was a mix up with my desire to have all female teams for my egg retrieval and transfer, I wasn't asked my preference up front as things were scheduled, I had a full two days where I was totally devastated but had a call with Dr. Hirshfeld-Cytron and they were able to figure it out for me. But overall, I was very happy.
Describe your experience with Fertility Centers of Illinois.
Because this clinic does everything in house they are flexible with the timing of your protocol and retrieval, which means no birth control to manipulate cycle timing. They deal with a large volume of patients so you'll see different techs and nurses, that's not necessarily a bad thing because you don't have to wait for your designated nurse to receive information.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
It was communicated up front based on our insurance. When checking in online for appointments, I would advise patients not to immediately pay costs other than the copay through that portal because it's sometimes wrong. Ask for the detailed invoice before paying.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
Single fresh transfer given my poor first round results. She thought a fresh transfer the most likely to yield good results.
Dr HC is a direct communicator and even though her style is not effusive, I always felt respected and like she had my best interests in mind...Really knowledgeable, patient and clear. Very good at setting expectations and walking us through the data. Data coupled with personal preference and needs guided all treatment decisions. I never felt like any question was annoying.
[Fertility Centers of Illinois] Strengths: very efficient and organized, easy to get in at preferred time for monitoring, accessible nurses, clear Treatment plans...The imaging staff is incredible...Weaknesses: I am disabled and the Glenview clinic was not versed in accessibility laws. We had to advocate hard let than we should have to get basic access needs met.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Really knowledgeable, patient and clear. Very good at setting expectations and walking us through the data. Data coupled with personal preference and needs guided all treatment decisions. I never felt like any question was annoying.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She is not effusive but she cares deeply. She is super smart and knows statistics by heart. She is experienced and trustworthy
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr HC is a direct communicator and even though her style is not effusive, I always felt respected and like she had my best interests in mind
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
IUI w clomid, follistim and ovidrel x 3
Now prepping for IVF w frozen transfer/ natural cycle. Priming w estrogen patches and next cycle will be stimulating meds and retrieval
Describe your experience with Fertility Centers of Illinois.
Strengths: very efficient and organized, easy to get in at preferred time for monitoring, accessible nurses, clear
Treatment plans and in the midst of a busy fertility center, i feel like a person. The imaging staff is incredible and warm and my doctor and her nurses and MA are fantastic
Weaknesses: I am disabled and the Glenview clinic was not versed in accessibility laws. We had to advocate hard let than we should have to get basic access needs met. Phlebotomists could use some sensitivity training (I.e. don’t tell patients that it’s stress that’s interfering with conception. One phlebotomist at the RN location said that patients who destress by going on vacation often get pregnant spontaneously!) as a person in a same sex couple, this was tough to hear.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
Insurance covered most of our treatment minus 15% coninsurance
For my husband and me, Dr. Hirshfeld was the ideal blend of science-backed guidance and empathy for the patient. I never felt like "just a number" with her...Dr. Hirshfeld went out of her way to call me and hold space for me and any questions that I had. This meant so much...I always felt like I was in very good hands with her. She also was open to offering alternative treatments suggestions to assist / enhance the IVF process -- such as Chinese acupuncture. She is highly respected as a fertility doctor in Chicago for her knowledge and expertise -- I trust her and highly recommend her to friends who are looking for pursue fertility treatments...She gave us the facts of single versus multiple, and there was very little "steering" as to what she would recommend until I asked her point-blank
The things that went "wrong" with FCI had to do with the Financial Team. They were so disorganized and terrible with follow-up. My husband and I had to constantly email / call them to verify things -- not to mention FIX mistakes. The same empathy and organization that I experienced on the medical side did not translate to the administrative side...I always had lovely interactions with my doctor (Dr. Hirshfeld), her nursing team, the ultrasound techs, and those who administered labs
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She is the ideal balance of science-backed guidance + empathy. I always felt like I was in very good hands with her. She also was open to offering alternative treatments suggestions to assist / enhance the IVF process -- such as Chinese acupuncture. She is highly respected as a fertility doctor in Chicago for her knowledge and expertise -- I trust her and highly recommend her to friends who are looking for pursue fertility treatments.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Stay open, come with questions, know that you're in great hands with her. <3
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
For my husband and me, Dr. Hirshfeld was the ideal blend of science-backed guidance and empathy for the patient. I never felt like "just a number" with her, nor with her nursing team. Even when we had a few unanticipated hiccups with our journey, Dr. Hirshfeld went out of her way to call me and hold space for me and any questions that I had. This meant so much. The doctors and nurses at FCI are overwhelmed with caseload, so I took this very much to heart with all of my interactions while undergoing treatment. While IVF and the fertility journey was an understandably emotional time for ME, I also held empathy for those handling my care and did my best to keep a positive attitude and surround myself with support.
Describe your experience with Fertility Centers of Illinois.
I feel like almost every fertility clinic is subject to reviews that will say "I felt like a number." FCI certainly has its share of those reviews. However, I never felt this way. I always had lovely interactions with my doctor (Dr. Hirshfeld), her nursing team, the ultrasound techs, and those who administered labs. My only major grievance was with the FCI financial team -- they were so disorganized and not helpful unless pressed. There seems to be a big disconnect in quality in medical care (excellent!) vs. the administrative team (poor) at FCI, something that I communicated to my doctor.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
She gave us the facts of single versus multiple, and there was very little "steering" as to what she would recommend until I asked her point-blank. Given my age and the increased risk for miscarriage and complications, my husband and I opted to move forward with a single embryo transfer.
What specific things went wrong at Fertility Centers of Illinois?
Lost paperwork
Describe the specific things that went wrong at Fertility Centers of Illinois.
The things that went "wrong" with FCI had to do with the Financial Team. They were so disorganized and terrible with follow-up. My husband and I had to constantly email / call them to verify things -- not to mention FIX mistakes. The same empathy and organization that I experienced on the medical side did not translate to the administrative side.
Dr. Hirshfeld is not warm and fuzzy and that's completely okay with me, I don't need that. But what I don't need is someone with horrible bedside manner. She was not empathetic to my/ my husband's concerns, questions, and situation...constantly felt like we were bothering her with simple questions and tried to stay on her good side after being scolded by her
Nice people [at Fertility Centers of Illinois] but perhaps understaffed. It is up to you to know everything that is going on (even as an IVF newbie) bc nobody is holding your hand through this. Everyone who works here is just focused on their single task in front of them and cannot guide you through any answers. You have to do your own due diligence and proactively be ready to question and know everything each step of the way. This includes billing, etc.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld is not warm and fuzzy and that's completely okay with me, I don't need that. But what I don't need is someone with horrible bedside manner.
She was not empathetic to my/ my husband's concerns, questions, and situation. Maybe she favors patients who seem to be in a favorable age range (from the reviews I'm seeing) and simply feels annoyed with those patients who don't yield good results for her. My husband and I constantly felt like we were bothering her with simple questions and tried to stay on her good side after being scolded by her.
When calmly expressing a bit of frustration about admin fails, without hearing us out, she actually said, "If this is too much for you, we can stop this right now and you can come back when you're ready." We were shocked wondering where this unprofessional outburst came from considering she had encouraged us to let us know if we ever had any concerns. This is literally the only thing we ever mentioned to her bc it had gotten so frustrating. She spoke to us like we are her children, threatening to take away her IVF services. This was only the tip of the iceberg.
Even after this, we proceeded on with a few more cycles with her until I decided finally to pull the plug and switch to a different clinic altogether, knowing if you switch doctors at the same clinic, they all talk and it's just awkward.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She might be better for you if you're someone who has been through IVF a few rounds already and know what the expect and advocate for certain procedures.
She is not a doctor who thinks outside of the box or adjusts protocol based on learnings from the last cycle. So you're just sending money down the drain repeating the same cycle or sometimes having to cancel them.
During the middle of my second stim cycle for IVF, the nurse told me that we may have to cancel this cycle and I asked why. She said bc my follicles weren't getting big enough. As a last ditch effort, I did some online research to find out that other women have proactive conversations with their doctor to plan for an IUI in the off chance of these circumstances. So at the 11th hour, I asked if this could be done with us so as not to waste those 2-3 follicles that were of the right size. My request was granted though yielded negative. This was infuriating to say the least. Even if she felt there was low chance for success, I want a doctor who has that conversation with me.
Then we went into another Egg Retrieval (with the same protocol) and got no eggs. No change to meds. In our follow up consult, she then suggested we look at donor eggs. At this point, I was beyond frustrated with her lack of creativity, general passivity and bad behavior. "For some patients, it's like a 50 meter dash, they get pregnant right away. And for others, it's a long haul." she said. I think honestly she just didn't want to deal with long haulers.
With hesitation (due to my ticking DOR), I took the plunge and switched clinics and to a doctor who took me on more thoughtfully. She had me on different medications (each cycle, learning from the prior one), and developed a plan for me to bank 3 PGT-A tested embryos in trying for 1 baby before transferring again. She strongly recommended the comprehensive Mock cycle whereas Hirshfeld didn't advise me either way on this decision. This new doctor got me pregnant in less time that it took Hirshfeld to scold me and prematurely suggest donor eggs.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Getting routine bloodwork at the clinic definitely felt like you were cattle herded in and out of the phlebotomist room. This I guess is unavoidable per the size of the fertility clinic/location. Constant communication errors and phone tags made the experience that much more frustrating.
Describe your experience with the nursing staff at Fertility Centers of Illinois.
They are doing their best with the sheer amount of patients I'm sure but it was very frustrating to constantly repeat myself, send over faxes and files repeatedly, and have to do extra work on my part to be proactive so I don't continue wasting my time running around for files or medications at the last minute.
Describe your experience with Fertility Centers of Illinois.
Nice people but perhaps understaffed. It is up to you to know everything that is going on (even as an IVF newbie) bc nobody is holding your hand through this. Everyone who works here is just focused on their single task in front of them and cannot guide you through any answers. You have to do your own due diligence and proactively be ready to question and know everything each step of the way. This includes billing, etc.
What specific things went wrong at Fertility Centers of Illinois?
This doctor [Dr. Jennifer Hirshfeld-Cytron] may not be the best fit if you are a woman who has fertility issues that require close monitoring or if you need a personalized treatment plan...Miscommunications over treatment with Dr. Hirshfeld played a significant role in my negative experience...I found Dr H very polite but somewhat indirect
I don’t believe FCI is a sophisticated clinic that can address my issues. I certainly didn’t feel appropriately educated about or confident in my treatment plan...The clinic is what you would expect for a large institution. You won't get to know your ultrasound techs, nurses or even see your doctor for any of the procedures.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Miscommunications over treatment with Dr. Hirshfeld played a significant role in my negative experience with FCI.
My husband and I had two initial meetings over zoom with Dr H to discuss egg/ embryo freezing/ transfer options. I found Dr H very polite but somewhat indirect. She explained that my TSH was high (3.19) and my AMH was low (0.5) but that was pretty standard for women my age. She showed me numerous charts and graphs about the decline of fertility over time for women in their late 30’s (I’m 38). She explained that to get the optimal number of viable eggs, with my low AMH, we are looking at multiple cycles. Nothing in those conversations ever seemed prohibitive. She did tell me numerous times that low AMH would make the process harder but if the cycle fails, the plan would be to continue with additional months of stimulation and retrieval.
I did not want to pursue IUI because of the low success rate, so for my first round we opted for an IVF cycle to retrieve eggs, fertilize, conduct genetic testing, and transfer. I was given Follistim 225u, Menopur 225u, Dexamethasone 0.5mg and 250 mcg of Ganirelix beginning day 5. I triggered on day 12 with HCG. I grew 4 follicles on my right (17.4m, 26.6m, 22.1m, 16.6m) and 3 follicles on my left (18.3m, 10.7m, 9.5m). The results from the retrieval were 3 oocytes: 2 did not mature and 1 did not fertilize.
I was not surprised when the cycle did not yield any viable embryos as this was predicted and my assumption was that we would just continue additional rounds of treatment. In fact, the day after I learned of the results, Dr H called me and said, “don’t worry because there are at least 4 additional aggressive protocols we can try.” A few weeks later my husband and I had a meeting with her to discuss next steps and this is where my confusion with Dr. H begins.
During this conversation, Dr. H said I was resistant to the medication and my response was low- even though in our initial conversation she correctly predicted I would only yield 3-5 eggs based on age/ AMH. She stated that the dosage of medications I was given was the maximum for women with “poor reserve” and that if treatment goes the same way this next round, IVF is not a good option and we should consider donor eggs. When I asked why her assessment seemed in conflict with the charts, that she took care to show me in our previous meetings that outlined the necessity for numerous cycles, she said those numbers no longer apply to me because I couldn’t create a single embryo. She declared although my AMH is 0.5 I have the eggs of a 44-year-old woman. When I asked her why the medication was not adjusted at all during the cycle to account for any of these obstacles, she stated again I was on the maximum dose of all medications. (I later learned that I was not on the maximum doses, but it was a refrain Dr H would continue to tell me throughout the second IVF cycle). Needless to say, these contradictions shattered my confidence in the process. This should have been the most delicate conversation and instead I walked away totally demoralized, confused, and feeling like I was being “blamed” for the outcome. Additionally, the suggestion of donor eggs after one failed IVF cycle felt completely premature.
For my second IVF round I was put on estrogen priming then MD Lupron 20 units in the AM and PM, 225 unit of Follistim SQ, 225 units of Menopur SQ and 0.3 ml of the Omnitrope SQ for 4 days. Around day 4 Follistim was increased to 300, then 375 and eventually 425 for days 13 and 14 (see previous statement about being on max doses). I also received bi-weekly acupuncture. Ultimately, I only grew 2 follicles on the left (18.2m and 17.7m) and 2 follicles on the right (21.0m and 12.8m).
During a blood draw towards the end of the cycle, a random nurse looked at my chart and suggested I switch to IUI to save the expense of the retrieval. Days later, this recommendation was echoed by Dr H in a zoom appointment. She said we could go forward with IVF if I wanted to, but the response would likely be the same. With such a banal recommendation, I knew I could no longer continue with FCI for my treatments. I agreed to the IUI in order to quickly bring the cycle to an end. The IUI ultimately failed.
In addition to this failure of communication, I was never given a diagnosis for my fertility issues other than DOR. I later found, by requesting my full medical records, that the ultrasound techs documented on numerous occasions “Nabothian cysts” and “known myomas” which was never disclosed to me. This seems like something important a doctor might discuss with their patient, regardless of its impact or importance.
I think the moral of my story here is that if you are like me- in your late 30’s with a somewhat unsophisticated understanding of fertility, any conversations about plan, treatment, or options must be had with the utmost care and consideration. It’s not enough to say a doctor just doesn’t have a good “bedside manner” and its’ certainly never ok for patients to walk away confused, demoralized or feeling blamed for their infertility. It is also unacceptable to rely on the category of “unexplained infertility” when other possible barriers have not even been discussed.
My case appears to be one with significant complications. But based on this experience, I don’t believe FCI is a sophisticated clinic that can address my issues. I certainly didn’t feel appropriately educated about or confident in my treatment plan. The only hope I have is the possibility of obtaining a second opinion from a doctor who might be better suited to address my specific needs.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
This doctor may not be the best fit if you are a woman who has fertility issues that require close monitoring or if you need a personalized treatment plan.
Describe your experience with Fertility Centers of Illinois.
The clinic is what you would expect for a large institution. You won't get to know your ultrasound techs, nurses or even see your doctor for any of the procedures. Probably a fine place if you are younger, looking to just store some eggs away, and have no other complicated fertility issues. I've had to correct some of the nurses on what medications I'm taking, I've been unable to schedule routine blood/ultrasound appointments, the phones weren't working for a while, and there was a time when the office transitioned to another location and I didn't get the memo so had to rush between the old and new space so as to not miss my appointment. All these things can be overlooked if you feel like your doctor is on your side. When you don't feel supported, it all adds up.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
2020: Complete Workup, Bloodwork, Self-Pay Appts w DR H, Self-Pay Natera genetics testing. TOTAL: $2,430.95.
2021: Loan for meds to meet out of pocket insurance max, acupuncture, specialty pharmacy for meds not covered by insurance. TOTAL: $10,758.
Estimated total billed to insurance: around $50k
What specific things went wrong at Fertility Centers of Illinois?
Dr. Hirshfeld took the time to listen to my story and address my concerns. She provided facts and research while answering my questions. She adjusted my treatment plan after failed attempts. She was clear and precise. ... Visits with Dr. Hirshfeld were to the point but yet I never felt rushed when in a consultation. She was always willing to explain and answer questions.
Strengths [of FCI]: knowledgeable and kind Weaknesses/Concerns: I was called and told I was not pregnant before I even completed an IUI. The 2nd IUI I had a young nurse being supervised and told what to do performed the insert and messed up on clamp and then said “oh no” when pulling out the cath. Saying some may have come out. ... They [nurses]responded quickly to the email portal and always willing to call back in timely manner when questions needed answering
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld took the time to listen to my story and address my concerns. She provided facts and research while answering my questions. She adjusted my treatment plan after failed attempts. She was clear and precise.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Be prepared with questions; as she can not help you if she doesn’t know your concerns.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Visits with Dr. Hirshfeld were to the point but yet I never felt rushed when in a consultation. She was always willing to explain and answer questions.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
I began my journey a few years ago with the hopes of preserving my eggs for future use. I went through hormone shots to increase the number of follicles. And now have 6 eggs in freezer. About a year ago I went back to start my journey to motherhood. At that time my bloodwork came back that my thyroid levels were to high so was put on medicine. She then did the saline ultrasound and told me I had polyps within my uterus. I would then have surgical procedure to have them done. I was given a vaginal pill to thin my lining the morning of the procedure within 1 hr I was having every side effect I could related to that drug. They took me back flush my iv to clear the drug and then put me under. Before the surgery I was told it would be 15mins but 4hrs later i was able to go home. (partially cause of all the allergic reaction). Originally they said they would scrap the fee polyps but when I woke up I was told there were way more then they thought so they performed a full D&C. A few months later I decided to pick a sperm donor and start the iui process. The 4 trials I always took clomid the first 2 were same dosage the 3rd time she up’d the dosage and the 4th she added a hormone shot.
Describe your experience with the nursing staff at Fertility Centers of Illinois.
They responded quickly to the email portal and always willing to call back in timely manner when questions needed answering
Describe your experience with Fertility Centers of Illinois.
Strengths: knowledgeable and kind
Weaknesses/Concerns: I was called and told I was not pregnant before I even completed an IUI. The 2nd IUI I had a young nurse being supervised and told what to do performed the insert and messed up on clamp and then said “oh no” when pulling out the cath. Saying some may have come out.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
IUI treatments monthly roughly cost me $1500 out of pocket after insurance.
What specific things went wrong at Fertility Centers of Illinois?
[Dr. Hirshfeld-Cytron] may not come off as the warmest doctor at first, but she is very caring...We moved on to IVF with PGS testing...We retrieved 18 eggs, five made it to day 5, and two were normal after testing. We transferred one and did progesterone shots, but lost the pregnancy around 7-8 weeks for unknown reasons. We transferred the second embryo and had a successful pregnancy...We had ICSI done for all of our retrievals
FCI has been very organized, quick with scheduling, and easy to work with. I've been able to get appointments easily and different locations communicate with each other well. Our financial counselor could be better in explaining items or having patience when we ask questions...Everyone else from nursing staff and front desk to embryologists and surgical staff have been wonderful.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld-Cytron has been very straightforward in her communication with us. She made time for us during our first consultation to ask any questions and she honestly laid out potential plans for treatment, as well as expectations. She doesn't over promise, but is very truthful in what to expect from treatment cycles. She may not come off as the warmest doctor at first, but she is very caring. She always has clear communication every step of the way so I've never felt in the dark or unsure about next steps. Everything has been laid out for us in exact terms. She has performed the majority of my procedures and I've always felt like I was in good hands with her. I left my first consult feeling like she was the right choice and haven't changed my opinion of her in four years. She has been sympathetic to our losses, and has celebrated in our success. We have done an IUI, egg retrievals, PGS testing, hysteroscopy and embryo transfers with her. I've felt safe and empowered in her care. I would recommend her to anyone.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I would say to prepare to receive honest answers and information from her, even if it isn't always easy to hear.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I feel she has been honest about what to expect. She was willing to let me make the decision on whether or not to have a second IUI cycle or move to IVF. She has answered any questions we've had. She was sympathetic when we had miscarriages.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
I have had an IUI cycle using Clomid and a trigger shot. This cycle resulted in a miscarriage due to abnormal chromosomes.
We moved on to IVF with PGS testing. I had an egg retrieval using Follistim, Menopur, Ganorelix, and Dexamethasone. We retrieved 18 eggs, five made it to day 5, and two were normal after testing. We transferred one and did progesterone shots, but lost the pregnancy around 7-8 weeks for unknown reasons. We transferred the second embryo and had a successful pregnancy. We are trying again and did a second egg retrieval using the same protocol. We retrieved 17 eggs, six made it to day 5, and 2 were normal. We had ICSI done for all of our retrievals. Our transfer is now on hold due to COVID-19.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Shanon, Samantha)
We've had a few nurses and they have all been great. They communicate very well and are understanding. They respond the same day and everything has been very organized. When we had a loss, our nurse at the time, Shannon, was very caring and warm.
Describe your experience with Fertility Centers of Illinois.
FCI has been very organized, quick with scheduling, and easy to work with. I've been able to get appointments easily and different locations communicate with each other well. Our financial counselor could be better in explaining items or having patience when we ask questions, but she has been the only one that stands out. Everyone else from nursing staff and front desk to embryologists and surgical staff have been wonderful.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
Our most recent egg retrieval, ICSI, prescriptions was about $10,000 out of pocket even with good insurance that has a fertility benefit. Our genetic testing was about $5,000.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
Because we did PGS testing on our embryos, our clinic will only transfer one embryo since it would not increase the odds to do more than that. Dr. Hirshfeld-Cytron also went over the risks of multiples.
One thing I really appreciated Dr Hirshfeld recommending was to have a laparoscopy for endometriosis AFTER my egg retrieval. This both minimized the potential impact of the lap on my ovaries/fertility, and meant the lap would be done right before my frozen transfer - maximizing the benefit of the lap for implantation...Dr. Hirshfeld consistently has taken the time to ensure I receive all the information I need to make an educated choice, has answered all my questions, and given me direct, evidence-based guidance. I always felt she was listening to me, taking my concerns seriously, and giving me the best recommendations with the information she had available.
What I love about FCI [Fertility Centers of Illinois] is that you get both the personalized experience of going to a smaller clinic due to FCI being divided into multiple satellite clinics, and also the practical benefits of a very large clinic...I specifically sought a clinic that used eSET for younger women...Egg retrieval - $9800 FET - $3500 Cryopreservation - $1525 Embryo biopsy - $2600
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld is compassionate, personable, and an effective communicator. But most importantly to me, I felt that out of all the doctors I consulted with before beginning IVF, she was the most professional and practiced using the most up to date and evidence based practices. She was always willing to provide education when I had questions, and made recommendations that were direct and appeared to be based on current science and good sense. I always felt I could trust her guidance - a really important thing in this confusing, emotionally trying process.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Come ready with your own research and questions! She will take you seriously and the more you bring to the table, the more you will get out of the process. Dr. Hirshfeld isn’t likely to automatically recommend every additional test and intervention under the sun, but will point you in the right direction about what would be helpful for your situation, and what may not.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld consistently has taken the time to ensure I receive all the information I need to make an educated choice, has answered all my questions, and given me direct, evidence-based guidance. I always felt she was listening to me, taking my concerns seriously, and giving me the best recommendations with the information she had available.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
One thing I really appreciated Dr Hirshfeld recommending was to have a laparoscopy for endometriosis AFTER my egg retrieval. This both minimized the potential impact of the lap on my ovaries/fertility, and meant the lap would be done right before my frozen transfer - maximizing the benefit of the lap for implantation.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Michelle at Tinley Park)
I just loved working with Michelle. She was so communicative, reliable, and compassionate during a trying process.
Describe your experience with Fertility Centers of Illinois.
What I love about FCI is that you get both the personalized experience of going to a smaller clinic due to FCI being divided into multiple satellite clinics, and also the practical benefits of a very large clinic. For example, costs were lower than other clinics because the expensive overhead costs (embryology lab, surgical center, etc) are absorbed by having a large number of patients served there. There is also the advantage that with many clinics, the providers have access to other fertility professionals for consultation - empowering the doctors to remain well informed and to have assistance for challenging cases.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
I specifically sought a clinic that used eSET for younger women (as I was) - this was one of the reasons I was drawn to FCI and Dr. Hirshfeld over other clinics in the area.
She [Dr. Hirshfeld-Cytron] takes the time to explain in detail what's going on and what her recommendations are. She is unbelievably knowledgeable and kind. She definitely does not add much fluffery- she always gets right to the point...is available to meet with patients when they specifically ask or when treatment needs to be reviewed. I felt that she always was 100% focused on me when I met with her, which is a relief because every doctor obviously has so many patients. She remembered all the details of what was going on with me and my husband and proved to be extremely knowledgeable and helpful at all times.
They [the nurses at FCI] get back to you 100% of the time that you try calling, though, if you don't catch them and want to ask clarifying questions. All of them are so kind...The strengths are that they are a well oiled machine and I always got into my appointment on time or close to on time. The staff is professional, and the receptionists are super kind as well. The weakness is that on a weekend I did have to go downtown one time and it was super busy because they just had so many people... I'm not sure there's any way around that.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld is available to meet with patients when they specifically ask or when treatment needs to be reviewed. I felt that she always was 100% focused on me when I met with her, which is a relief because every doctor obviously has so many patients. She remembered all the details of what was going on with me and my husband and proved to be extremely knowledgeable and helpful at all times. We were so disappointed after a first failed IVF round, and she is extremely practical in her approach to solutions and recommendations for next steps, we always felt safe even though the road was hard. I truly cannot say enough good things about her.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld gets to the point when you meet with her. I found this refreshing during a process where everything seems uncertain (and it is!). Don't be afraid to send her an email with simple questions. The simpler it is, the easier it is for her to get back to you and it can make you feel so much better. It is always super frustrating to have to wait until your appointment to have face-to-face communications and some more complicated questions answered, but that's all part of the process. Know that when you do meet with her she is totally committed to your cause.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I can't say enough good things about Dr. Hirshfeld. The process is extremely daunting and emotional, and Dr. Hirshfeld always gave candid answers and was available when I needed her. Any time I sent her an email she would get back to me within 24 hours, and often within just one or two hours. When I met with her on our visits, she did not rush me as many doctors do. She takes the time to explain in detail what's going on and what her recommendations are. She is unbelievably knowledgeable and kind. She definitely does not add much fluffery- she always gets right to the point. But in this type of experience the best way to feel human is usually to know the truth of what's going on and get honest opinions quickly.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
We did two rounds of IVF. The first round was not very successful, I am young so it was a shock to get so few embryos of very low quality. I decided to do a second round to get more embryos before implanting any of them. Dr. Hirshfeld guided me on my choices, but really the choice was mine and she was supportive of doing another round. I also was honest about non-medical issues, like financial concerns and our current insurance plan that we knew would not last forever, so she kept all factors in mind when considering when and how to do our next treatments. This was all really important to us. The second round of IVF she did differently from the first. We had higher quality embryos, which could have been the treatment or just the luck of the draw.
Describe your experience with the nursing staff at Fertility Centers of Illinois.
The nursing staff was excellent. You work with so many nurses during IVF that you can't always count on consistency, even though they come very close. Always allow times to call and ask clarifying questions if needed, because at times they can communicate through voicemail which obviously isn't the very best method when trying to understand something new. They get back to you 100% of the time that you try calling, though, if you don't catch them and want to ask clarifying questions. All of them are so kind.
Describe your experience with Fertility Centers of Illinois.
The strengths are that they are a well oiled machine and I always got into my appointment on time or close to on time. The staff is professional, and the receptionists are super kind as well. The weakness is that on a weekend I did have to go downtown one time and it was super busy because they just had so many people... I'm not sure there's any way around that.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
It was covered by insurance, but I'm pretty sure each round of IVF is close to $20K.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
Because of my age and our circumstances, Dr. Hirsheld recommended single embryo transfer. Everybody is different.
I do feel like Dr. Hirshfeld tries her best to personalize the treatments spend time explaining the processes during our consultations...she did her best to answer all questions I had. My wife however felt as though she didn't really give us personalized attention and that perhaps she didn't have great attention to detail when dealing with us. For these reasons, we almost switched doctors, but ultimately decided to stay with Dr. Hirshfeld because of her nurses and the daunting thought of starting over with another doctor.
[The nurses at Fertility Centers of Illinois were] Very good with answering emails in a timely manner. If she didnt know the answer to a question, she would find the answer for us. She was compassionate, kind, and genuine...FCI is like a baby making factory. It is very easy to feel like just a number there. If you want or need early morning appointments you will be happy here. However if you need afternoon or evening appointments this is not the place for you.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld-Cytron is very knowledgeable and also very kind hearted. During consultations, she was very good about explaining things thoroughly and giving the reasoning behind the course of treatment she was suggesting. She always made sure to ask if I had any questions before I left her office. And she did her best to answer all questions I had. My wife however felt as though she didn't really give us personalized attention and that perhaps she didn't have great attention to detail when dealing with us. For these reasons, we almost switched doctors, but ultimately decided to stay with Dr. Hirshfeld because of her nurses and the daunting thought of starting over with another doctor.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Make sure you let her know what you feel you need from her as your doctor.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
It is difficult not to feel like a number while going through treatments at FCI. But I do feel like Dr. Hirshfeld tries her best to personalize the treatments spend time explaining the processes during our consultations.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
I went through two IUI cycles because I did not have a problem producing my own eggs. Neither resulted in pregnancy so Dr. Hirshfeld suggested moving to IVF because of my age and the increased success rate with IVF. I took clomid, follistim, and a nu.ber of other drugs I cannot recall right now. I also took some supplements and tried acupuncture treatments. After the first two cycles were unsuccessful, she tweaked the treatment a bit. I believe I did testosterone patches and estrogen patches with the third cycle. This cycle was most unsuccessful. I did not have any embryos viable for PGD testing. So she tweaked treatment again for the fourth cycle. But unfortunately no chromosomally normal embryos to implant.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Marni Z.)
Marni was amazing. Very good with answering emails in a timely manner. If she didnt know the answer to a question, she would find the answer for us. She was compassionate, kind, and genuine.
Describe your experience with Fertility Centers of Illinois.
FCI is like a baby making factory. It is very easy to feel like just a number there. If you want or need early morning appointments you will be happy here. However if you need afternoon or evening appointments this is not the place for you.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
I have blue cross blue shield pop insurance and it was still very, very costly do go through this process. Forty dollar co-pays for ever appointment which was 3-4 times per week at some points in the process.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
No comment on this as I was never able to get to the implantation phase.
She [Dr. Hirshfeld-Cytron] took the time to explain what our plan was going to be as far as treatments, what tests we had to get done first before starting anything. ... If we had any questions she didn't rush us to get out of her office. ... She also went over the pros and cons of IUI versus IVF, especially since I have PCOS. ... Our plan is to try IUI, so the doctor discussed what that looks like, the medication I would be taking, and how many cycles I would be taking the medication (along with blood work and ultrasound).
I was going to have a hysteroscopy and the doctor had me on the birth control pill for a couple of weeks, but the nurse never told me to stop taking it by a certain day and to restart the pill, which could've resulted in me getting my period and having my procedure cancelled. ... so far their front desk [Fertility Centers of Illinois] is warm and friendly, the waiting room is clean and organized. The ultrasound techs are nice and patient. When you're going to checkout, if you have any questions they're very patient to help you out.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
It's too soon to tell, but so far she's been very informative. If we had any questions she didn't rush us to get out of her office. She went over our treatment plan and explained what we had to do and made sure that this was something we wanted to do.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Have all your questions ready and write down as much information as possible because so much is thrown at you and as soon as you walk out the building you're bound to forget what was discussed.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She took the time to explain what our plan was going to be as far as treatments, what tests we had to get done first before starting anything.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
Our plan is to try IUI, so the doctor discussed what that looks like, the medication I would be taking, and how many cycles I would be taking the medication (along with blood work and ultrasound). She also went over the pros and cons of IUI versus IVF, especially since I have PCOS.
Describe your experience with the nursing staff at Fertility Centers of Illinois.
I have 2 nurses who call with tests results and any instruction for the medication I'm to start taking. There is one nurse who is very patient and thorough with the information she is giving me, and she is the only one I ask for when I call the office with questions. The other nurse seems a little bothered when I ask her to repeat something or if I have questions, plus she gave the wrong information for one medication I was on that was for a procedure I was getting done.
Describe your experience with Fertility Centers of Illinois.
I've only been at this location for maybe 3-4 months, but so far their front desk is warm and friendly, the waiting room is clean and organized. The ultrasound techs are nice and patient. When you're going to checkout, if you have any questions they're very patient to help you out.
What specific things went wrong at Fertility Centers of Illinois?
Provided conflicting information
Describe the specific things that went wrong at Fertility Centers of Illinois.
I was going to have a hysteroscopy and the doctor had me on the birth control pill for a couple of weeks, but the nurse never told me to stop taking it by a certain day and to restart the pill, which could've resulted in me getting my period and having my procedure cancelled.
She [Dr. Hirshfeld-Cytron] seems somewhat shy and uncomfortable talking to actual people and does so in a hunched over manner...There was no mention of supplements other than vitamin d and prenatal- and I specifically asked for information but was blown off. Found out later they do have a standard vitamin cocktail recommendation they include in ivf welcome folder but it was missing from mine.
Was barely ever dealing with the same nurse twice [at Fertility Centers of Illinois]. Felt rushed in her office. This place has at least 4 different waiting rooms it’s so big. My protocol seemed to be exactly like everyone else’s that I met, no matter out situation. I mentioned numerous times that my insurance covered only one cycle and this was my only shot at it. When I went for the follow up and she started talking about trial and error and the next protocol she’d try I reminded her I no longer had insurance coverage and she said “oh, I didn’t realize that.”
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She seems somewhat shy and uncomfortable talking to actual people and does so in a hunched over manner. I saw her for the initial consultation, saline sonogram, polypectomy, and then not again until after my negative beta. My original plan - based on her advice and estimates for success - was to do genetic screening and frozen transfer. When they only retrieved and two fertilized it took me stopping he process and asking whether it was better to transfer both now rather than risk losing them in screening process. Then they changed course but (after multiple pleading phone calls) still wouldn’t let me speak with a doctor. As a single person going through this it is very difficult to have no one to discuss options with- including your doctor. Ultimately did 3dau fresh transferand wasnt able to speak with a doctor about how many to transfer. Had my legs in the stirrups already and dying to urinate (they require full bladder for transfer) before I was finally able to talk to some young girl- no clue what her name or role was- about whether I should transfer 1 or 2
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Find another clinic entirely
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Was barely ever dealing with the same nurse twice. Felt rushed in her office. This place has at least 4 different waiting rooms it’s so big. My protocol seemed to be exactly like everyone else’s that I met, no matter out situation. I mentioned numerous times that my insurance covered only one cycle and this was my only shot at it. When I went for the follow up and she started talking about trial and error and the next protocol she’d try I reminded her I no longer had insurance coverage and she said “oh, I didn’t realize that.” Then she added more meds to the suggested protocol based on the fact I didn’t have endless free tries at this. FCI treats Illinois’ insurance mandate law like an atm machine. She made me feel super confident on my chances based on follicles count and hormone levels in “normal range” and “where they’d like to see them.” Only after did they say - “well, we meant normal for your age”
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
There was no mention of supplements other than vitamin d and prenatal- and I specifically asked for information but was blown off. Found out later they do have a standard vitamin cocktail recommendation they include in ivf welcome folder but it was missing from mine. Was on 150 of Menopur daily plus 300 of gonal-f. Added cetrotide on appropriate days and then triggered with pregnyll. Only the day before trigger did they up dosage, then called me at work on trigger day to say take more final-f asap so I had to leave work unexpectedly midday in order to do so. Was on 2- .1 mg estrogen patches every two days and PIO 1 ml from the day they decided switch to fresh transfer. Had to scramble to get PIO and estrogen in time because hadn’t planned to do transfer yet and insurance company (Progyny) recommended writing to order until I needed it.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: 2 part time people - Jessica and Marnie)
Super nice but they would only give you the information you needed that day. Each communicated in a different way. I have 4 differed Word versions of calendars. They have a new software system to deliver treatment plan and lab results and no one used it beyond initial baseline blood work
Describe your experience with Fertility Centers of Illinois.
Best thing about it is close proximity to where I live. Otherwise it feels like a factory and they treat your body like a science experiment. The single women support group is nice but the psychologist on staff is terrible.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
I don’t remember
What specific things went wrong at Fertility Centers of Illinois?
Lost paperwork
Provided conflicting information
Failed to convey critical information
Describe the specific things that went wrong at Fertility Centers of Illinois.
We definitely had some communication issues. It wasn't that she [Dr. Jennifer Hirshfeld-Cryton] didn't communicate with me - more that I felt I never got any real answers. Her responses to me always felt very textbook, like she was reading a script, and simply repeated the same information to me over and over again without really addressing my questions. I was also completely misdiagnosed. She diagnosed me with PCOS and told me this diagnosis was based on elevated testosterone levels and anovulation/irregular cycles.
It [FCI] seems fine, they have good success rates. Sometimes there are longer wait times before your appointment, but that doesn't really bother me as my work schedule is flexible. Most of the staff is friendly and helpful over the phone. They have an online portal where they (should) post all of your test results and ultrasound reports. There is some inconsistency in it's use, but when results are posted it's great to have that detail.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
We definitely had some communication issues. It wasn't that she didn't communicate with me - more that I felt I never got any real answers. Her responses to me always felt very textbook, like she was reading a script, and simply repeated the same information to me over and over again without really addressing my questions.
I was also completely misdiagnosed. She diagnosed me with PCOS and told me this diagnosis was based on elevated testosterone levels and anovulation/irregular cycles. I had one natural pregnancy after my PCOS diagnosis but prior to starting clomid, which resulted in a missed miscarriage - but I knew I could get pregnant. After our 5th failed medicated IUI, I asked for all of my lab work so that I could go for a second and third opinion. At this time she finally suggested a slightly different protocol, stating it was due to my DHEAS levels. I was under her care for 9 months in total before I ever heard anything about DHEAS levels. When I went for my second and third opinions, both doctors agreed traditionally PCOS was a misleading diagnosis - Adrenal PCOS was more likely.
My biggest problem was she didn't look at or address any of this until I basically yelled and was visibly frustrated during one of our consults. PCOS is an easy diagnosis to give someone who has irregular cycles - I don't feel she did her due diligence in reviewing my specific case or results.
After our 4th failed IUI I asked if it was possible there was some sort of scarring or issue as a result of my previous D&C. I had done a saline ultrasound prior to my pregnancy during our initial testing/workup. I asked if maybe we should repeat that test, or if there was anything else to check for scar tissue or issues with my uterus. We did a repeat saline ultrasound and everything looked fine. My second doctor, without me even asking, immediately suggested a hysteroscopy to check for scarring from the D&C as well as investigate whether there may be a cause for my thinner lining. I had the hysteroscopy done and no scarring was found, but I did have a polyp removed. I'll always wonder whether that could have impacted our IUI cycles, and if I could have been pregnant 6 months sooner without resorting to IVF. We are currently undergoing IVF with my second doctor.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Be aggressive. You have to be your own advocate. Do your research, and stand up for yourself.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She didn't customize treatment towards me as an individual until after the 5th failed medicated IUI cycle when I was really upset and vocal about how upset I was. I was also misdiagnosed with elevated testosterone - when in fact it was my DHEAS levels which were elevated, and therefore I could have been treated under entirely different protocol.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
We did 3 months of clomid with IUI. I responded to the lowest dose of clomid each cycle with at least one dominant follicle. The 3rd cycle I had 2 dominant follicles. My husband's numbers were always good. My lining was on the thin side during each of these cycles - around 5-6 mm at time of trigger.
We then did 3 months of Letrozole, which were a bit of a disaster. Dr. Hirshfeld said if clomid doesn't work in the first 3 tries we should try something else. My first round of letrozole I started on the lowest does and my follicle growth stalled around cycle day 15. Thankfully, rather than cancelling the cycle, she upped my dose - so I took 2 rounds of Letrozole during one cycle. I eventually had a dominant follicle and ovulated. The second round of Letrozole we started with a slightly higher dose, but the same exact thing happened again. That was my 5th failed medicated IUI. For the 6th (after I threw a fit) she added 2 mg dexamethosone with the highest dose of letrozole (I believe it was 7 mg). On CD 10 I had a big fat 20 mm follicle, but my estrogen was only at 70. I was told to trigger. That was my 6th failed medicated IUI. I switched to a new doctor, and moved to IVF. My husband and I felt exhausted, frustrated, defeated, and were sick and tired of wasting time.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Jessica)
Jessica was great, her and I got along very well. There was one cycle where she gave me the wrong date for my IUI. We only realized it because I called with a completely unrelated question and someone looked at my chart and appointment schedule.
Describe your experience with Fertility Centers of Illinois.
This is the only fertility clinic I've worked with, so I don't have anything to compare to. It seems fine, they have good success rates. Sometimes there are longer wait times before your appointment, but that doesn't really bother me as my work schedule is flexible. Most of the staff is friendly and helpful over the phone. They have an online portal where they (should) post all of your test results and ultrasound reports. There is some inconsistency in it's use, but when results are posted it's great to have that detail.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
I did have insurance coverage for all of my treatment. I believe without insurance, each ultrasound would have been something like $300.
What specific things went wrong at Fertility Centers of Illinois?
As of date she [Dr. Jennifer Hirshfeld-Cytron] has been very open about the process. She is able to explain the process in our terms to understand. We never felt rushed or left with unanswered questions. She even personally called to address questions we had sent to our nurse. She makes you feel important and not just a number...I believe our process to be somewhat basic as I responded well to the stimulation medications. I am a translocation carrier so our process was to get as much embryos as we can to day 5 so we can send out to genetic testing.
[Fertility Centers of Illinois is] such a calm place. The staff is friendly and very efficient in getting you on time for your appointment. It’s hard to navigate which waiting room you need to go in as there is like 3 different ones. A little direction on the walls would be helpful so we don’t feel so lost. The front bathroom is always busy and not so clean... She [nurse] is always available and quick to respond to the smallest question. The patience and care were so genuine that you felt like you were family. She truly is keeping this process going and always keeping me informed.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
As of date she has been very open about the process. She is able to explain the process in our terms to understand. We never felt rushed or left with unanswered questions. She even personally called to address questions we had sent to our nurse. She makes you feel important and not just a number.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She gives you time and doesn’t rush you until you have asked and received everything you need going forward.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She has the patience to listen and is not in a hurry to rush you out the door. She makes you feel she has time for you and remembers you and your situation. She is compassionate but very fair in her expectations so that we know the positives and negatives for each situation.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
I believe our process to be somewhat basic as I responded well to the stimulation medications. I am a translocation carrier so our process was to get as much embryos as we can to day 5 so we can send out to genetic testing.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Marni Zelikow )
Without her, this process would never be able to be executed so smoothly. She is always available and quick to respond to the smallest question. The patience and care were so genuine that you felt like you were family. She truly is keeping this process going and always keeping me informed.
Describe your experience with Fertility Centers of Illinois.
I went to FCI River North but my doctor wasn’t listed in initially starting this review. Everyone at river north is amazing. It’s such a calm place. The staff is friendly and very efficient in getting you on time for your appointment. It’s hard to navigate which waiting room you need to go in as there is like 3 different ones. A little direction on the walls would be helpful so we don’t feel so lost. The front bathroom is always busy and not so clean.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
It’s still ongoing but we have some insurance to help but have some responsibilities ourselves. Right now we sit at out of pocket over $10k
During my visits with Dr. Hirschfield-Cytron, she was very patient, professional and communicated very well what should be expected during the IVF procedure. My husband and I felt very comfortable talking with her and she handled us with compassion.... I'm at the beginning stages of the IVF treatment....Dr. Hirschfield-Cytron explained that the medications I will be taking will help to prevent egg loss so that as many eggs as possible may be retrieved.
One strength of the clinic [Fertility Ctr of IL] is that it is staffed with knowledgeable and professional staff. Another strength is that they offer options to help finance treatments and the location is fairly easy to find. They require psychological counseling which is very helpful as the whole process of IVF treatments can be very stressful. I really can't think of any weaknesses at the moment.... Michelle has been great with us as well. She communicates with us well and is also very pleasant to work with.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
During my visits with Dr. Hirschfield-Cytron, she was very patient, professional and communicated very well what should be expected during the IVF procedure. My husband and I felt very comfortable talking with her and she handled us with compassion.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I would advice them to not be afraid to ask questions and to be prepared to receive honest and insightful feedback.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
My doctor took the time to listen to my husband and I and handled us with empathy and care.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
At the moment, I'm at the beginning stages of the IVF treatment and am planning to start medications within the next thirty days for egg retrieval. My husband just completed the sperm freeze/preservation a few days ago. Dr. Hirschfield-Cytron explained that the medications I will be taking will help to prevent egg loss so that as many eggs as possible may be retrieved.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Michelle Moore)
Michelle has been great with us as well. She communicates with us well and is also very pleasant to work with. She has described to us what to expect in great detail and has handled us with respect and compassion.
Describe your experience with Fertility Centers of Illinois.
One strength of the clinic is that it is staffed with knowledgeable and professional staff. Another strength is that they offer options to help finance treatments and the location is fairly easy to find. They require psychological counseling which is very helpful as the whole process of IVF treatments can be very stressful. I really can't think of any weaknesses at the moment.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
As of today, my husband and I have spent approximately $800 for sperm preservation and clinical exams, however we were advised that an IVF cycle could cost a minimum of about $10,000.
She [Dr. Jennifer Hirshfeld-Cytron] always makes time to reach out and talk to you. She tailors my treatment to my specific situation...She is very thorough when explaining the possibilities of success as well as failure. She always reached out to me after a main procedure to follow up with me on next steps to take. I haven’t been successful at conceiving yet, but I trust doctor Hirschfield and plan to continue trying under her care
I was always in touch with the two nurses [at Fertility Centers of Illinois] that work directly with doctor Hirschfield and the were always super helpful and knew me as a person and not a number...The IVF nurses always communicated with me, but they were not as responsive and there isn’t one assigned to your case...Friendly staff...Could significantly improve the financial department
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She has always shown that she cares. She was always very knowledgeable and always took the time to explain in detail what my specific situation was. I didn’t feel like a number. She is very thorough when explaining the possibilities of success as well as failure. She always reached out to me after a main procedure to follow up with me on next steps to take. I haven’t been successful at conceiving yet, but I trust doctor Hirschfield and plan to continue trying under her care
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
I you like people telling you the truth and the facts about your situation then she is the right doctor for you. She doesn’t try to sugar code of hold back anything from you. To me that was incredibly important.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
The doctor Has two dedicated nurses and is always easy to reach any of them. If you need to talk to the doctor she always makes time to reach out and talk to you. She tailors my treatment to my specific situation.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
On my first round with her we tried adding micro dose Lupron and steroids to my treatment aside from Follistin and Menopur
On my second round with her we tried Follistin and Menopur in different amounts and she adjusted them along the way plus ganirelix
Aside from that she recommended I added DHEA, CQ10, and fish oil to my daily supplements to help increase egg health.
Describe your experience with the nursing staff at Fertility Centers of Illinois.
I was always in touch with the two nurses that work directly with doctor Hirschfield and the were always super helpful and knew me as a person and not a number
The IVF nurses always communicated with me, but they were not as responsive and there isn’t one assigned to your case.
Describe your experience with Fertility Centers of Illinois.
Convenient location in the city
Sometimes experienced long waits to get routinely check ups
Friendly staff
Could significantly improve the financial department, maybe add financial face to face consultations with the patients
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
Costs so far have been manageable, but our IVF rounds are covered by insurance
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
[Dr. Hirshfeld-Cytron] Easy to work with, even though I am a remote patient (live in michigan). She did phone consults instead of in person when needed. - She didn't overwhelm with data, but was able to speak to data when I asked for it...Dr. Hirshfeld also shows empathy when she is talking to you, but is also going to be real with you.
FCI [Fertility Centers of Illinois] sees A LOT of patients, so if you are a person that wants to see the same technician, or nurse at every visit, it is not for you...I like that they partner with Pulling Down the Moon for a holistic angle on treatment if you are into that...The staff is quick to respond and answers in full without leaving you guessing. They leave a voicemail and follow up by email if you aren't available. Marni helped me to get better costs on medications by writing scripts to 5 different pharmacies that I asked her to. I must have emailed her 30 times about medications and she never once acted bothered.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Some of the things that I like about Dr. Hirshfeld:
- Easy to work with, even though I am a remote patient (live in michigan). She did phone consults instead of in person when needed.
- She didn't overwhelm with data, but was able to speak to data when I asked for it. For example, what percentage chance for XYZ to happen
- She called to talk to me personally when we had to decide whether or not to cancel a cycle.
A few other notes:
- I'm sure she is a busy person, but on two occasions during phone consults my husband and I felt like she was rushing us off the call.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Even though she is the ultimate expert, you should still be your own advocate. Do your research, and ask her what she thinks if you have questions on something.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
FCI sees A LOT of patients, so if you are a person that wants to see the same technician, or nurse at every visit, it is not for you. That said, the nurse assigned to you is extremely responsive, and even more helpful. Dr. Hirshfeld also shows empathy when she is talking to you, but is also going to be real with you.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
First IVF cycle was Lupron Microdose with a priming of estrogen and lupron prior to cycle start. Although the intent was to get me to have a better response to meds, my response was very poor. 2 mature follicles, and a cancelled cycle.
2nd cycle: no priming, high dose of gonal (600 IU) from the start. Dexamethasone steroid added. Menopur on day 5. 16 Follicles, 14 mature eggs retrieved, 6 embryos, 2 frozen, 1 transferred, BFP!
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Marni and Jessica (and others))
I can't say enough good things. I am also comparing to the nursing staff at the first RE clinic that I went to before transferring to FCI. The staff is quick to respond and answers in full without leaving you guessing. They leave a voicemail and follow up by email if you aren't available.
Marni helped me to get better costs on medications by writing scripts to 5 different pharmacies that I asked her to. I must have emailed her 30 times about medications and she never once acted bothered.
The only watch out is that there wasn't a heads up when a nurse was going to be out of the office. I would most often get an out of office email response, with another person to contact. Sometimes that other person would be out too. If its really urgent, there is an after hours nurse to call though, which I did once.
At my previous clinic the nurses all shared one voicemail account, and you HAD to leave a message and wait for a call back. There was no option for email. They also said they would do something (like call in a script) and several times would not remember. They also lacked empathy and would seem bothered. I NEVER had that experience at FCI.
Describe your experience with Fertility Centers of Illinois.
Strengths are: good variety of locations, very knowledgeable doctors, huge support staff, you can do everything at one location (not go to a separate lab for blood draws), easy to schedule, lots of options for appointment times, was easy to work with even though I live far away in michigan. I like that they partner with Pulling Down the Moon for a holistic angle on treatment if you are into that.
Weakness might be that they could help patients save a bit more $$. For example, I ended up with loads of extra medications on both cycles. I could have ordered less and then reordered. Or they could tell you about alternative brand drugs to consider.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
The first cycle was very minimal because we had some insurance coverage. Roughly $500-$1000 for copays. $800 for genetic screening.
The second cycle the coverage was maxed out for medication. Meds were approx $7000. We have not finished paying bills yet, but we expect the same $1000 for co pays and misc.
Without coverage, IVF is about 12k. There would be other charges for freezing, pre-screening test needed, etc. They give you an outline of costs when you consult.
Describe Jennifer Hirshfeld-Cytron's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
The doctor recommended single embryo transfer, since the quality was very high.
She's [Dr. Jennifer E. Hirshfeld-Cytron] very candid with the direction she thinks treatment should go. A couple of times I had questions about why we were doing something a particular way, and I've asked if treatment could be adjusted. She's always been open to discussing alternatives, and has been ok with adjusting treatment if it's reasonable. She's a bit blunt (but that's what I prefer), and I get the sense that strong feelings make her uncomfortable. But she was always kind and never made me feel badly for having them.
You don't get to speak directly to the doctor often, as there are a lot of patients at this clinic [FCI]. But my experience has been that they are good at getting messages to and from the doctor through the nurse. Her nurse Marni is excellent with communication, and quickly gets my questions to the doctor and the answers back to me.... It's a giant place. I like that about it because I know that if I make my monitoring appointments by x time I'll get to work when I need to. Some may feel like a number, but I prefer getting in and out and on to my life.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She's very candid with the direction she thinks treatment should go. A couple of times I had questions about why we were doing something a particular way, and I've asked if treatment could be adjusted. She's always been open to discussing alternatives, and has been ok with adjusting treatment if it's reasonable. She's a bit blunt (but that's what I prefer), and I get the sense that strong feelings make her uncomfortable. But she was always kind and never made me feel badly for having them.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Make use of the nurses! She sees a lot of patients, but I'm still satisfied with the level of communication because it's easy to get through to the nurse and get my questions answered quickly.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
You don't get to speak directly to the doctor often, as there are a lot of patients at this clinic. But my experience has been that they are good at getting messages to and from the doctor through the nurse. Her nurse Marni is excellent with communication, and quickly gets my questions to the doctor and the answers back to me.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
So far, IUI with 50mg Clomid. These did not result in a pregnancy, but when my lining was thin she was good about adjusting. I did have good response with the Clomid, so there was no need to change that.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Marni)
Marni is awesome. She's available via email or phone, and she always calls/emails back quickly. She's enthusiastic and gets my questions to and from the doctor quickly and accurately.
Describe your experience with Fertility Centers of Illinois.
It's a giant place. I like that about it because I know that if I make my monitoring appointments by x time I'll get to work when I need to. Some may feel like a number, but I prefer getting in and out and on to my life.
She [Dr. Hirshfeld-Cytron] has explained her proposed next steps, regarding treatment, so that she knows that I understand them, and always asks if I'm comfortable with that approach before proceeding. She, not a nurse, called me with my negative beta, and had already thought of what we could do next. This NEVER happened with my previous RE, where I was always called by a nurse and then asked to schedule an appointment with the Dr...
If you have to go in [to FCI -Chi] on a Monday or a Friday be prepared to wait a little bit. It's generally a well oiled-machine (very high volume clinic, some people compare it to a cattle call), but at the beginning and end of the week it can get a little bogged down. The cattle call aspect of the clinic has thrown people off a little bit, wanting a more personalized experience, but they have top SART stats for the city...
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
If you are looking for a physician who will hold your hand and speak to you in hushed tones, she may not fit the bill. She is there to help you get pregnant. This may sound as though she has a cold bedside manner, which she doesn't. She's actually very pleasant to speak with. That being said, she won't sugarcoat things, and in my experience, I want the details, as grim as they may be. Dr. H is very intelligent and well-read, and I am very confident in her medical abilities. And I know that she cares about my treatment. She has reviews my file before she talks to me, which may seem like common sense, but the number of doctors I have seen in the past 5 years, unfortunately she is in the minority. The thing that has impressed me the most is, when she has to deliver bad news, she calls me, not a nurse, and already has a plan for going forward.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Be ready for a serious physician. You can tell that she cares, but she is more of a realist. If you're new to infertility treatment, this may seem jarring, but you want someone who will help you get pregnant, not someone who will hold your hand and just make you feel good about undergoing treatment. No one ever got pregnant by holding hands.
During treatment, were you treated like a number or a human with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
She is really well-informed and thoughtful. She has explained her proposed next steps, regarding treatment, so that she knows that I understand them, and always asks if I'm comfortable with that approach before proceeding. She, not a nurse, called me with my negative beta, and had already thought of what we could do next. This NEVER happened with my previous RE, where I was always called by a nurse and then asked to schedule an appointment with the Dr.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
After 3 complete transfer failures and one blighted ovum with my previous RE, Dr. H suggested doing a diagnostic hysteroscopy before continuing treatment. So I took off a cycle to get that done and the next cycle I prepped for another eSET. That was non-lupron hormone replacement cycle with baby aspirin, vaginal estrogen, and patches, followed by 4 days of medrol, a z-pack, 300mg Endometrin and PIO. This cycle failed and we plan to do a Endometrial Receptivity Assay next.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Marni)
Marni is easiest reached via email, but is very quick to respond if I have any questions or concerns.
Describe your experience with Fertility Centers of Illinois.
If you have to go in on a Monday or a Friday be prepared to wait a little bit. It's generally a well oiled-machine (very high volume clinic, some people compare it to a cattle call), but at the beginning and end of the week it can get a little bogged down.
The cattle call aspect of the clinic has thrown people off a little bit, wanting a more personalized experience, but they have top SART stats for the city.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
Currently minimal (HMO), I have had to pay for tests that aren't covered by my insurance. When I switch to a PPO next year the costs will be greater.
What specific things went wrong at Fertility Centers of Illinois?
Provided conflicting information
Describe the specific things that went wrong at Fertility Centers of Illinois.
There have only been a couple small things that have happened at this clinic, but they are really tied to the nursing staff of my previous RE or my previous RE. Since switching within clinic to Dr. Hirshfeld-Cytron I haven't had any problems.
Dr. Hirshfeld-Cytron was helpful during the IVF process. We didn't see her very often so I formed more of a relationship with the nurses and ultrasound tech, but she made herself available whenever needed...In order to even begin myself and my husband were required to have bloodwork done. My husband also had a sperm analysis and I had a HSG. All of which came back clear. From there we went on to try 3 medicated IUI's and finally we went through an IVF cycle. We transferred two embryo's during that cycle and were successful in becoming pregnant with our son Blake, but at 19 weeks I went into pre-term labor we lost our dear son.
[FCI Nurse] Michelle was incredible. She was compassionate but full of information. Michelle showed me such kindness through the whole process, and now that we are considering it again I know she will be just as helpful and compassionate...It was 11,500 for the total IVF procedure, plus the cost of medicine. I also had the cost of the initial consult with the doctor, the HSG cost, and all 3 IUI's, but I don't recall the cost of each of these items.
How was your experience with Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Dr. Hirshfeld-Cytron was helpful during the IVF process. We didn't see her very often so I formed more of a relationship with the nurses and ultrasound tech, but she made herself available whenever needed.
What's one piece of advice would you give a prospective patient of Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois?
Have patience.
Describe the protocols Jennifer Hirshfeld-Cytron used in your cycles at Fertility Centers of Illinois and their degree of success.
In order to even begin myself and my husband were required to have bloodwork done. My husband also had a sperm analysis and I had a HSG. All of which came back clear. From there we went on to try 3 medicated IUI's and finally we went through an IVF cycle. We transferred two embryo's during that cycle and were successful in becoming pregnant with our son Blake, but at 19 weeks I went into pre-term labor we lost our dear son.
Describe your experience with your nurse at Fertility Centers of Illinois. (Assigned nurse: Michelle)
Michelle was incredible. She was compassionate but full of information. Michelle showed me such kindness through the whole process, and now that we are considering it again I know she will be just as helpful and compassionate.
Describe your experience with Fertility Centers of Illinois.
Having access to a satellite office was rather helpful since it wasn't always easy to get into the city of Chicago for appointments. This clinic works like a well oiled machine, yet they show compassion, understanding and kindness to patients.
Describe the costs associated with your care under Jennifer Hirshfeld-Cytron at Fertility Centers of Illinois.
It was 11,500 for the total IVF procedure, plus the cost of medicine. I also had the cost of the initial consult with the doctor, the HSG cost, and all 3 IUI's, but I don't recall the cost of each of these items.