Jennifer Hirshfeld-Cytron

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!

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).

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.

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.

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.

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.

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.

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.

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).

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

Make sure she understands your family dynamic and that you ask questions if you feel unsure that all options have been explored or offered.

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.

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.

No comments as it is not relevant to my treatment to date.

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.

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.

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

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.

Single fresh transfer given my poor first round results. She thought a fresh transfer the most likely to yield good results.

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.

She is not effusive but she cares deeply. She is super smart and knows statistics by heart. She is experienced and trustworthy

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

Insurance covered most of our treatment minus 15% coninsurance

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.

Stay open, come with questions, know that you're in great hands with her. <3

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.

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.

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.

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.

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.

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

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.

Be prepared with questions; as she can not help you if she doesn’t know your concerns.

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.

IUI treatments monthly roughly cost me $1500 out of pocket after insurance.

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.

I would say to prepare to receive honest answers and information from her, even if it isn't always easy to hear.

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.

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.

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.

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.

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.

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.

Egg retrieval - $9800 FET - $3500 Cryopreservation - $1525 Embryo biopsy - $2600

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.

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.

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.

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.

It was covered by insurance, but I'm pretty sure each round of IVF is close to $20K.

Because of my age and our circumstances, Dr. Hirsheld recommended single embryo transfer. Everybody is different.

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.

Make sure you let her know what you feel you need from her as your doctor.

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.

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.

No comment on this as I was never able to get to the implantation phase.

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.

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.

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.

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

Find another clinic entirely

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.

I don’t remember

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.

Be aggressive. You have to be your own advocate. Do your research, and stand up for yourself.

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.

I did have insurance coverage for all of my treatment. I believe without insurance, each ultrasound would have been something like $300.

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.

She gives you time and doesn’t rush you until you have asked and received everything you need going forward.

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.

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 would advice them to not be afraid to ask questions and to be prepared to receive honest and insightful feedback.

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.

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 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

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.

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.

Costs so far have been manageable, but our IVF rounds are covered by insurance

No Comments

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.

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.

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!

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.

The doctor recommended single embryo transfer, since the quality was very high.

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.

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.

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.

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.

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.

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.

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.

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.

Have patience.

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.

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.